Mentalization and Emotion Regulation in Adolescent Attachment: A Scoping Review

TL;DR

This review shows that secure attachments in adolescents are linked to better emotion regulation and mentalization, which help prevent mental health issues.

Contribution

The paper synthesizes recent empirical findings on how mentalization and emotion regulation interact with attachment security in adolescence.

Findings

Adolescent attachment security is consistently linked to better emotion regulation and higher mentalization.

Emotion dysregulation is strongly associated with internalizing and externalizing psychopathology.

Mentalization often mediates the relationship between attachment security and emotional outcomes.

Abstract

What are the main findings?
Across studies (2015–2025), adolescent attachment security was consistently linked to better emotion regulation and higher mentalization capacities, while emotion dysregulation was robustly associated with internalizing and externalizing psychopathology.Mentalization commonly operated as a pathway connecting attachment security to emotional outcomes (often as a mediator), and epistemic trust emerged as a related interpersonal mechanism associated with more adaptive functioning.

Across studies (2015–2025), adolescent attachment security was consistently linked to better emotion regulation and higher mentalization capacities, while emotion dysregulation was robustly associated with internalizing and externalizing psychopathology.

Mentalization commonly operated as a pathway connecting attachment security to emotional outcomes (often as a mediator), and epistemic trust emerged as a related interpersonal mechanism associated with more adaptive functioning.

What are the implications of the main findings?
Prevention and intervention efforts in adolescence may benefit from integrated targets—strengthening attachment-related security, mentalization/reflective functioning, and emotion regulation skills (and, where relevant, addressing maladaptive forms such as hypermentalizing).The field needs theoretically unified, multimethod and multi-informant assessment frameworks (beyond predominant self-report approaches) to improve comparability across studies and clarify patterns of vulnerability and resilience.

Prevention and intervention efforts in adolescence may benefit from integrated targets—strengthening attachment-related security, mentalization/reflective functioning, and emotion regulation skills (and, where relevant, addressing maladaptive forms such as hypermentalizing).

The field needs theoretically unified, multimethod and multi-informant assessment frameworks (beyond predominant self-report approaches) to improve comparability across studies and clarify patterns of vulnerability and resilience.

Background: Adolescence is a critical developmental period marked by reorganization of attachment relationships, heightened emotional reactivity, and ongoing maturation of reflective and regulatory capacities. Within this context, mentalization and emotion regulation have emerged as key concurrent associations linking attachment security to both vulnerability and resilience. This scoping review examined how mentalization and emotion regulation are conceptualized and operationalized in adolescent attachment research and synthesized empirical evidence on their interaction across clinical and non-clinical samples. Methods: Following PRISMA-ScR guidelines, four electronic databases were searched for peer-reviewed studies published between 2015 and 2025. Twelve studies met the inclusion criteria, encompassing community, high-risk, and clinical samples and employing cross-sectional, psychometric, and prospective designs. Results: Across studies, attachment security was consistently associated with more adaptive emotion regulation and higher mentalization capacities, whereas emotion regulation difficulties were linked to internalizing and externalizing psychopathology. Mentalization was frequently reported as a mediator or correlate in the association between attachment security and emotional outcomes, while epistemic trust emerged as a promising interpersonal concurrent association with adaptive functioning. Conclusions: Findings highlight differentiated patterns of vulnerability and resilience and underscore the need for theoretically integrated, multimethod assessment frameworks to guide future research and prevention efforts in adolescence.

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