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  • 2018maldacastillophd

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Asthma, caregiving and mental health: the mind keeps the score

Research output: ThesisDoctoral Thesis

  • Javier Malda Castillo
Publication date2018
Number of pages208
Awarding Institution
  • Lancaster University
Original languageEnglish


This thesis includes a systematic literature review, a research outcome paper and a critical appraisal.
The systematic literature review summarises 20 outcome papers that explore the use of Mentalisation-Based Treatment (MBT) in participants with different mental health presentations. The results suggest that MBT has strong evidence in the treatment of people with a diagnosis of Borderline Personality Disorder (BPD) and that MBT has the potential of improving clinical outcomes in people with diagnoses of eating disorders and depression, adolescents who self-harm and mothers enrolled in substance misuse treatments. As compared to other interventions, MBT yielded positive outcomes that were maintained over long follow-ups and thus should be increasingly available for people with a diagnosis of BPD. Future research addressing treatment fidelity, confounding and assessor‘s blindness bias is required.
The outcome paper explores the mental health of adult caregivers of asthmatic children living in the United Kingdom. Using an online designed questionnaire, the study collected information regarding participants´ socio-demographic characteristics, mentalising ability, family functioning, anxiety, depression and hypomanic symptoms. The aim was to further explore the association between caregivers´mentalising capacity and self-reported mental health symptoms. Sequential linear regression models showed that mentalising on its own was associated with 16%, and 14% of depressive and anxiety symptoms respectively. On the contrary, family functioning was not significantly associated with the independent variables in any of the regression models after mentalising was included. Psychological interventions targeting mentalising might be helpful in reducing anxiety and depression symptoms in this population. The critical appraisal includes the author´s personal reflections on the journey of writing a doctorate thesis along with the implications of the findings.