Work

Mentalization and externalizing behavior from early adolescence to young adulthood: A meta-analysis

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Background Mentalization is assumed to play a role in healthy youth development, particularly in the domain of social functioning. If compromised, difficulties in social functioning are likely to occur, potentially leading to externalizing behavior. To review the existing empirical research on the association between mentalization (problems) and externalizing behavior in youth, we conducted a meta -analysis. Method A three-level meta -analysis was conducted, accounting for both within and between study heterogeneity of effect sizes, using Pearson’s r as a measure for the association between mentalization and externalizing behavior. Study (e.g., impact factor and region), sample (e.g., age and type of sample), mentalization (e.g., type of assessment), and outcome characteristics (e.g., type of externalizing behavior) were used to examine potential moderating effects. Results The meta -analysis contained 27 reports of 25 independent studies, reporting on 130 effect sizes, and a total sample of 7301 subjects. A significant and small overall correlation between mentalization and externalizing behavior was found ( r = 0.11), indicating that stronger developed mentalization capacities were associated with less externalizing behavior problems. Moderator analyses revealed a significant effect for sex and type and assessment of mentalization (problems). Conclusions Our findings show that mentalization is both a possible protective and risk factor for externalizing behavior. The enhancement of mentalization in adolescence could be a target in interventions to mitigate externalizing behavior problems. Furthermore, we argue that the assessment of mentalization needs particular attention in future research, allowing us to unravel the relation between mentalization (problems) and externalizing behavior in more detail, providing more opportunities for individualized treatment.

Source: Children and Youth Services Review

DOI: 10.1016/j.childyouth.2026.108765