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1- Aras International Campus, University of Tehran, Tehran, Iran
2- Department of Psychology, Faculty of Psychology and Educational Sciences, University of Tehran, Tehran, Iran
3- Department of Clinical Psychology, AJA University of Medical Sciences, Tehran, Iran
2- Department of Psychology, Faculty of Psychology and Educational Sciences, University of Tehran, Tehran, Iran
3- Department of Clinical Psychology, AJA University of Medical Sciences, Tehran, Iran
Abstract:
Purpose: Major Depressive Disorder (MDD) is associated with significant impairments in emotion regulation and executive functioning. Emerging evidence suggests that Mentalization-Based Therapy (MBT) may improve emotional functioning and depressive symptoms by enhancing reflective functioning and cognitive-emotional integration. However, limited research has simultaneously examined the effects of MBT on executive functions and adaptive/maladaptive emotion regulation strategies in individuals with MDD.
Methods: This study employed a pre-test–post-test–follow-up experimental design with control and intervention groups. Twenty individuals diagnosed with MDD were randomly assigned to either an MBT group (n = 10) or a waitlist control group (n = 10). Participants completed the Beck Depression Inventory-II (BDI-II), Difficulties in Emotion Regulation Scale (DERS), Cognitive Emotion Regulation Questionnaire (CERQ), Emotion Regulation Questionnaire (ERQ), Reflective Functioning Questionnaire (RFQ), and a computerized Stroop task at baseline, post-intervention, and two-month follow-up. The intervention consisted of a standardized 12-session individual MBT program developed by the Anna Freud Centre. Data were analyzed using repeated measures ANOVA (RANOVA).
Results: MBT significantly reduced depressive symptoms and improved several dimensions of emotion regulation and executive functioning. Significant improvements were observed in overall emotion dysregulation, emotional awareness, emotional clarity, impulsivity control, positive reappraisal, positive refocusing, rumination, self-blame, and expressive suppression. In addition, participants receiving MBT demonstrated enhanced Stroop task performance, particularly in interference control, response accuracy, and incongruent processing conditions. Although MBT led to a significant decrease in BDI scores, it failed to moderate reflective functioning and cognitive reappraisal compared to the pretest group.
Conclusion: The findings suggest that MBT effectively improves both emotional and executive functioning but does not significantly affect reflective functioning and cognitive reappraisal in individuals with MDD. By targeting maladaptive cognitive-emotional processes, MBT may facilitate adaptive emotion regulation and cognitive control. These results support the integration of mentalization-focused interventions in the treatment of depression and highlight the close interaction between executive functions and emotion regulation mechanisms.
Methods: This study employed a pre-test–post-test–follow-up experimental design with control and intervention groups. Twenty individuals diagnosed with MDD were randomly assigned to either an MBT group (n = 10) or a waitlist control group (n = 10). Participants completed the Beck Depression Inventory-II (BDI-II), Difficulties in Emotion Regulation Scale (DERS), Cognitive Emotion Regulation Questionnaire (CERQ), Emotion Regulation Questionnaire (ERQ), Reflective Functioning Questionnaire (RFQ), and a computerized Stroop task at baseline, post-intervention, and two-month follow-up. The intervention consisted of a standardized 12-session individual MBT program developed by the Anna Freud Centre. Data were analyzed using repeated measures ANOVA (RANOVA).
Results: MBT significantly reduced depressive symptoms and improved several dimensions of emotion regulation and executive functioning. Significant improvements were observed in overall emotion dysregulation, emotional awareness, emotional clarity, impulsivity control, positive reappraisal, positive refocusing, rumination, self-blame, and expressive suppression. In addition, participants receiving MBT demonstrated enhanced Stroop task performance, particularly in interference control, response accuracy, and incongruent processing conditions. Although MBT led to a significant decrease in BDI scores, it failed to moderate reflective functioning and cognitive reappraisal compared to the pretest group.
Conclusion: The findings suggest that MBT effectively improves both emotional and executive functioning but does not significantly affect reflective functioning and cognitive reappraisal in individuals with MDD. By targeting maladaptive cognitive-emotional processes, MBT may facilitate adaptive emotion regulation and cognitive control. These results support the integration of mentalization-focused interventions in the treatment of depression and highlight the close interaction between executive functions and emotion regulation mechanisms.
Keywords: Major Depressive Disorder, Mentalization-Based Therapy, Emotion Regulation, Executive Functioning
Type of Study: Original |
Subject:
Cognitive Neuroscience
Received: 2026/05/9 | Accepted: 2026/05/30
Received: 2026/05/9 | Accepted: 2026/05/30
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