The Relationship between Tendency to High-Risk Behaviors and Alexithymia with the Mediating Role of Reflective Functioning

Hossein Mohagheghi ¹ ( Department of Psychology, Faculty of Economic and Social Sciences, Bu-Ali Sina University, Hamedan, Iran )
Mehran Farhadi ² ( Department of Psychology, Faculty of Economic and Social Sciences, Bu-Ali Sina University, Hamedan, Iran )
abolghasem yaghobi ³ ( Department of Psychology, Faculty of Economic and Social Sciences, Bu-Ali Sina University, Hamedan, Iran )
Sahar Mohammadi ⁴ ( Department of Psychology, Faculty of Economic and Social Sciences, Bu-Ali Sina University, Hamedan, Iran )

Submited date : 2024-04-02 Accepted date : 2025-08-03

Keywords: Reflective Functioning, Tendency to High-Risk Behaviors, Alexithymia,

Abstract :

This study aimed to investigate the relationship between high-risk behaviors and alexithymia with the mediation role of reflective functioning. The research method was correlational. The statistical population included high school students in Hamedan a sample of 386 people was selected using the cluster random sampling method. The research instruments included the Toronto Alexithymia Scale (TAS) (1994), and Zadeh Mohammadi et al. Risk-Taking Behavior Scale (RTBS) (2011) and Fonagy et al.'s (2016) Reflective Functioning Questionnaire (RFQ). To evaluate the relationships between the variables, structural equation analysis was used by Spss27 and Lisrel8.8 software. The results showed the effect of alexithymia on uncertainty about mental states (p <0.01), certainty in mental states (p <0.01), and tendency to high-risk behaviors (p <0.01). is significant. The effect of uncertainty about mental states (p <0.01) and certainty about mental states (p <0.01) on the tendency to high-risk behaviors is also significant. Also, the indirect effects of alexithymia through uncertainty and certainty about mental states (p <0.01) on the tendency to high-risk behavior were significant. Based on the results alexithymia and reflective functioning are effective on the tendency to high-risk behaviors, and these variables can play a significant role in reducing high-risk behaviors.

References:

زاده¬محمدي، علی؛ احمدآبادي، زهره؛ و حيدري، محمود. (1390). تدوين و بررسي ويژگي هاي روان سنجي مقياس خطر پذيري نوجوانان ايراني، روانپزشكي و روانشناسي بالینی ایران، 17(3)، 225-218.
سلمانی، بهزاد؛ حسنی، جعفر؛ و آریانا کیا، المیرا. (1393). بررسی نقش صفات شخصیتی(وظیفه¬شناسی، سازگاری و هیجان-خواهی) در رفتارهای پرخطر، فصلنامه تازه¬های علوم شناختی، 16(1)، 1-10.
دروگر، الهه؛ فتحی آشتیانی، علی؛ و اشرفی، عماد. (1399). اعتباریابی و پایایی سنجی نسخه فارسی پرسشنامه ذهنی¬سازی. روان¬شناسی بالینی، 12(1)، 12-1.
هومن، حیدر علی. (1384). مدل يابي معادلات ساختاری با کاربرد نرم افزار لیزرل، تهران: انتشارات سمت

Allen, J. G. (2013). Mentalizing in the development and treatment of attachment trauma. London, UK: Karnac Books.
Allen, J. G., & Bateman, A. (2008). Mentalizing in clinical practice. Washington: American Psychiatric Press
Bressi, C., Fronza, S., Minacapelli, E., Nocito, E. P., Dipasquale, E., Magri, L., et al. (2017). Short‐Term Psychodynamic Psychotherapy with Mentalization‐Based Techniques in Major Depressive Disorder patients: Relationship among alexithymia, reflective functioning, and outcome variables – A Pilot study. Psychology and Psychotherapy: Theory, Research and Practice, 90, 299-313.
Barlow, M., Woodman, T., & Hardy, L. (2013). Great expectations: Different high-risk activities satisfy different motives. Journal of Personality & Social Psychology, 105(8), 458–475.
Besharat, M. A. (2007). Reliability and factorial validity of a Farsi version of the 20-item Toronto Alexithymia Scale with a sample of Iranian students. Psychological reports, 101(1), 209-220.
Calaresi, D., & Barberis, N. (2019). The Relationship between Reflective Functioning and Alexithymia. Journal of Clinical and Developmental Psychology, 1(2), 12‐23
da Silva, A.N., Vasco, A.B., Watson, J.C. (2017). Alexithymia and emotional processing: a mediation model. J. Clin. Psychol. 73 (9), 1196–1205.
DeRick, A., & Vanheule S. (2007). Alexithymia and DSM-IV personality disorder traits in alcoholic inpatients: a study of the relation between both constructs. Pers Individ Dif, 43(7):119-29.
Di Pierro, R., Benzi, I.M.A., Madeddu, F. (2015). Difficulties in emotion regulation among inpatients with substance use disorders: the mediating effect of mature defenses mechanisms. Clin Neuropsychiatry. 12(4):83-9.
Dunn, H.K., Gjelsvik, A., Pearlman, D.N., & Clark, M.A. (2014). Association between sexual behaviors, bullying victimization and suicidal ideation in a national sample of high school students: Implications of a sexual double standard. Women’s Health Issues; 24:567-74.
Ensink, K., Begin, M., Normandin, L., Godbout, N., & Fonagy, P. (2017). Metallization and dissociation in the context of trauma: Implications for child psychopathology. Journal of Trauma & Dissociation, 18(1), 11–30.
Ensink, K., Normandin, L., Plamondon, A., Berthelot, N., Fonagy, P. (2016). Intergenerational pathways from reflective functioning to infant attachment through parenting. Can. J. Behav. Sci. 48, 9–18.
Esposito, G., Marano, D., & Freda, M. F. (2020). Supportive and interpretative interventions in fostering metallization during counselling. British Journal of Guidance & Counselling, 48(3), 314-332.
Fonagy, P., & Bateman, A. W. (2016). Adversity, attachment, and mentalizing. Comprehensive Psychiatry, 64, 59-66.
Fonagy, P., & Luyten, P. (2009). A developmental, metallization-based approach to the understanding and treatment of borderline personality disorder. Development and Psychopathology, 21, 1355-1381.
Fonagy, P., Luyten, P., & Bateman, A. W. (2017). Treating borderline personality disorder with psychotherapy: Where do we go from here? JAMA Psychiatry, 74, 316-317.
Garofalo, C., Velotti, P., & Zavattini, D. (2017). Emotion regulation and aggression: The incremental contribution of alexithymia, impulsivity, and emotion dysregulation facets. Psychology of Violence, 8(4), 470–483.
Hahn, A. M., Simons R. M., Simons, J. S. (2016). Childhood maltreatment and sexual risk taking: the mediating role of alexithymia. Arch Sex Behav. 2016; 45(1):53-62.
Igra, V., Irwin, C.E. (1996). Theories of Adolescent Risk-Taking Behavior. In: DiClemente, R.J., Hansen, W.B., Ponton, L.E. (eds) Handbook of Adolescent Health Risk Behavior. Issues in Clinical Child Psychology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-0203-0_3
Katznelson, H. (2014). Reflective functioning: a review. Clin. Psychol. Rev. 34, 107–117.
Kim, H., Seo, J., Namkoong, K., Hwang, E. H., Sohn, S. Y., Kim, S. J., & Kang, J. I. (2016). Alexithymia and perfectionism traits are associated with suicidal risk in patients with obsessive–compulsive disorder. Journal of Affective Disorders,192, 50–55.
Luyten, P., & Fonagy, P. (2019). Mentalizing and trauma. In Handbook of mentalizing in mental
health practice, 2nd end, ed. A Bateman, P Fonagy, pp. 79-99. Washington, DC: American Psychiatric Publishing.
Maggs JL, Schulenberg JE. (2004). Trajectories of alcohol use during the transition to adulthood. Alcohol Res Health, 28(4):195-201.
Messina, A., Beadle, J. N., & Paradiso, S. (2014). Towards a classification of alexithymia: primary, secondary and organic. Journal of Psychopathology, 20, 38-49.
Messina, A., Fogliani, A. M., & Paradiso, S. (2011). Alexithymia in oncologic disease: association with cancer invasion and hemoglobin levels. Annals of clinical psychiatry: official journal of the American Academy of Clinical Psychiatrists, 23(2), 125–130.
Nicolò, G., Semerari, A., Lysaker, P.H., Dimaggio, G., Conti, C., D'Angerio, S., Procacci, M., Popolo, R., Carcione, A. (2011). Alexithymia in personality disorders Correlations with symptoms and interpersonal functioning, Psychiatry Research, 190(1), 37-42.
Parker, J. D. A., Taylor, G. J., & Bagby, R. M. (2003). The 20-item Toronto Alexithymia Scale-III. Reliability and factorial validity in a community population. Journal of Psychosomatic Research, 55, 269-275.
Schultheis, A., Mayes, L., & Rutherford, H. (2019). Associations between emotion regulation and parental reflective functioning. J. Child. Fam. Stud. 28, 1094–1104.
Sleuwaegen, E., Houben, M., Claes, L., Berens, A., & Sabbe, B. (2017). The relationship between non-suicidal self-injury and alexithymia in borderline personality disorder: “Actions instead of words”. Comprehensive Psychiatry, 77, 80–88.
Smith TME, Wessel MT. (2011). Alcohol, drugs, and links to sexual risk behaviors among a sample of Virginia college students. J Drug Educ, 41(1):1-16.
Thorberg, F. A., Young, R. M., Sullivan, K. A., & Lyvers, M. (2009). Alexithymia and alcohol use disorders: a critical review. Addictive Behaviors, 34(3): 237-245.
Velotti, P., Garofalo, C., Petrocchi, C., Cavallo, F., Popolo, R., & Dimaggio, G. (2016). Alexithymia, emotion dysregulation, impulsivity and aggression: A multiple mediation model. Psychiatry Research, 237, 296–303.
Weijers, J., Fonagy, P., Eurelings-Bontekoe, E., Termorshuizen, F., Viechtbauer, W., & Selten, J. P. (2018). Mentalizing impairment as a mediator between reported childhood abuse and outcome in non-affective psychotic disorder. Psychiatry Research, 259, 463–469.
Young, S., Greer, B., & Church, R. (2017). Juvenile delinquency, welfare, justice and therapeutic interventions: a global perspective. BJPsych Bull, 41(1):21-9.