Peter Fonagy

Peter Fonagy
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Peter verified their affiliation via an institutional email.
Verified
Peter verified their affiliation via an institutional email.
University College London | UCL · Division of Psychology and Language Sciences

PhD

About

1,326
Publications
724,586
Reads
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79,639
Citations
Introduction
Developmental psychopathologist researcher inspired by attachment theory and psychoanalysis. Particular interest in psychosocial treatments for children and young people, mentalization-based treatments for severe and enduring disorders, person-centred evidence-based practice and improving the organization of mental health services for all these groups.
Additional affiliations
December 2011 - January 2015
Harvard University
Position
  • Professor
June 1995 - July 2005
The Menninger Clinic, Inc.
Position
  • Director of the Child and Family Programme
September 2017 - present
University College London
Position
  • Managing Director

Publications

Publications (1,326)
Preprint
Generalising information from ourselves to others, and others to ourselves allows for both a dependable source of navigation and adaptability in interpersonal exchange. Disturbances to social development in sensitive periods can cause enduring and distressing damage to lasting healthy relationships. However, identifying the mechanisms of healthy ex...
Preprint
Generalising information from ourselves to others, and others to ourselves allows for both a dependable source of navigation and adaptability in interpersonal exchange. Disturbances to social development in sensitive periods can cause enduring and distressing damage to lasting healthy relationships. However, identifying the mechanisms of healthy ex...
Article
Full-text available
This study investigated the influence of parents' Adult Attachment Interview (AAI) responses prior to the birth of a first child, on self-reported mental health symptoms of the first-born child in mid-adolescence. The sample comprised 51 first-born children aged 16 years, their mothers and fathers from a low-risk community urban sample, White, Brit...
Article
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Background The deteriorating mental health of children and young people in the United Kingdom poses a challenge that services and policy makers have found difficult to tackle. Kailo responds to this issue with a community-based participatory and systemically informed strategy, perceiving mental health and well-being as a dynamic state shaped by the...
Article
Drawing on developmental psychopathology and thinking about the we-mode of social cognition, we propose that historical myths – be they on the scale of the family, the nation, or an ethnic group – are an expression and function of our need to join with other minds. As such, historical myths are one cognitive technology used to facilitate social lea...
Article
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Suicide is a serious problem among university students. As suicidal thoughts and self-harm are predictive of completed suicide, students experiencing these problems would benefit from seeking support. This systematic review synthesised research on help-seeking in university students with suicidal thoughts and self-harm, including rates, sources, an...
Article
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Epistemic trust ‐ defined as readiness to regard knowledge, communicated by another agent, as significant, relevant to the self, and generalizable to other contexts–has recently been applied to the field of developmental psychopathology as a potential risk factor for psychopathology. The work described here sought to investigate how the vulnerabili...
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Introduction Parental Reflective Functioning describes the parents’ ability to view their child as motivated by mental states. The Parental Reflective Functioning Questionnaire (PRFQ) represents an 18-item and three-factor self-report measure. Our goal was to conduct the first German validation study. Method In a community sample of 378 mothers of...
Article
This article reviews an approach to working with families that grounds in systemic thinking the framework of mentalization-based treatment. Employing a mentalizing stance, this approach aims to interrupt coercive, nonmentalizing cycles of interaction within the family system and replace them with mentalizing conversations in which epistemic trust a...
Article
This article explores the implications of epistemic trust within the mentalizing model of psychopathology and psychotherapy, emphasizing the role of the restoration of epistemic trust in therapeutic settings. At the core of this exploration is the developmental theory of mentalizing, which posits that an individual's ability to understand mental st...
Article
Depression is a very common mental health problem in adolescence. Although over the past decades a number of psychological interventions for depression in adolescence have been developed and empirically evaluated, recent systematic reviews and meta-analyses suggest that there is considerable room for improvement of their effectiveness. This is part...
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This editorial explores how adopting a social determinants and systemic perspective can enhance preventative measures to boost the mental health of young people. It argues that to effectively elevate the mental health of young people, it is essential to tackle both the overarching influences and their specific local impacts. We maintain that a stra...
Preprint
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A decade has passed since the introduction of dimensional diagnostic systems for personality disorder. Yet, despite this pass of time, national health guidelines, like UK’s NICE, have not been updated since the previous categorical model of personality disorders. In this brief report, we show that there have only been three clinical trials on dimen...
Article
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Before the maturation of higher-order cognitive functions, infants primarily communicate via bodily expressions. Their behavior adjustments are also shaped by caregiver reactions, which differ in timing, intensity, and nature. Although mentalizing, or reflective functioning, is thought to influence caregiver interactions, the literature has largely...
Article
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Objectives Research has shown that children with epilepsy often experience mental health disorders but face barriers to effective care. One solution is to train healthcare professionals within paediatric epilepsy services to deliver psychological interventions. The aim of this paper was to examine aspects of treatment integrity of the ‘Mental Healt...
Article
Epistemic trust (ET), the personal relevance we assign to knowledge received from others, is fundamental to effective therapy, yet its exact role remains unclear. Is ET a stable characteristic of the patient, or does it catalyze change during therapy? This study examines the constituents of ET in therapy and its related effects through three distin...
Preprint
Interpersonal dynamics have long been acknowledged as instrumental to the generation and alleviation of psychopathology problems. Recent computational approaches have been argued to be uniquely suited for investigating such dynamics either with exploratory models (machine learning) or confirmatory models (generative modeling). However, the utility...
Preprint
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Existing models of personality disorder are statistical models: dispersion patterns of personality facets. Although useful in describing personality differences, such models fall short in terms of explaining those differences. Generative models can address these explanatory gaps by explicating the mechanisms that generate descriptive pathologies. I...
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Introduction Accurate prediction of short-term offending in young people exhibiting antisocial behaviour could support targeted interventions. Here we develop a set of machine learning (ML) models that predict offending status with good accuracy; furthermore, we show interpretable ML analyses can complement models to inform clinical decision-making...
Article
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Previous studies show that maternal mind-mindedness positively impacts children’s social development. In the current studies, we examine the relation between mind-mindedness during parent–child interaction, oxytocin (OT), and postnatal depression in a sample of mothers ( N = 62, ages 23–44) and their infant (ages 3–9 months). In Study 1, infant sal...
Article
Background Kailo is a community-centred research and design initiative that aims to improve adolescent mental health by addressing its wider social determinants. Unlike conventional interventions that often neglect systemic factors, Kailo employs a complex systems approach to identify and address the social causes of poor adolescent mental health i...
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Introduction Short-term psychoanalytic psychotherapy (STPP) is an evidence-based treatment for adolescents with depression, but like all treatment approaches, not all patients benefit from it. Previous investigations of the process of STPP have mostly focused on successful cases, and only a few studies have included the perspectives of young people...
Article
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Trauma-Focused mentalization-based treatment (MBT-TF) is an adaptation of mentalization-based treatment (MBT) specifically developed for patients suffering from attachment or complex trauma, with the possibility of co-occurring borderline personality pathology. The creation of MBT-TF was driven by previous research and observations that interventio...
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Mentalization-based interventions (MBIs) have been increasingly applied in school settings to support the social-emotional development and mental health of children and adolescents. This systematic review aimed to synthesize the evidence on the effectiveness of MBIs implemented in educational contexts for students aged 6–18 years. A comprehensive s...
Article
Mentalization‐based treatment (MBT) is a spectrum of interventions that share a central focus on improving the capacity for mentalizing. Although MBT was originally developed as a treatment for individuals with borderline personality disorder, its scope and focus have been broadened to become a socioecological approach that stresses the role of bro...
Article
Randomized controlled trials have reported psychoanalytic psychotherapy to improve longer-term post-treatment outcomes in patients with treatment-resistant depression. In this case study, we examine the therapy process of a female trial participant diagnosed with treatment-resistant depression. Structured clinical assessments indicated that the pat...
Preprint
Generalising information from ourselves to others, and others to ourselves allows for both a dependable source of navigation and adaptability in interpersonal exchange. Disturbances to social development in sensitive periods can cause enduring and distressing damage to lasting healthy relationships. However, identifying the mechanisms of healthy ex...
Cover Page
Full-text available
Auf Basis der Herbsttagung der Kommission Psychoanalytische Pädagogik in der Deutschen Gesellschaft für Erziehungswissenschaften (DGfE) planen wir zur Publikation im Oktober 2025 einen Sammelband im Verlag Barbara Budrich. Der Sammelband ist in vier Themenbereiche strukturiert: I) Psychoanalytische Pädagogik in Schule, Unterricht und Lehrer:innenbi...
Preprint
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Obtaining data in the medical field is challenging, making the adoption of AI technology within the space slow and high-risk. We evaluate whether we can overcome this obstacle with synthetic data generated by large language models (LLMs). In particular, we use GPT-4 and Claude 3 Opus to create agents that simulate adults with varying profiles, chil...
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Background Depression and anxiety are increasingly prevalent in adolescents. The Brief Educational Workshops in Secondary Schools Trial investigated the effectiveness of a brief self-referral stress workshop programme for sixth-form students aged 16–18 years old. Objective This study conducted a secondary analysis on the outcomes of participants w...
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Introduction In recent years, the concept of epistemic trust has emerged as a critical factor in understanding psychopathology, particularly within the context of personality disorders. A self-report instrument, the Epistemic Trust, Mistrust, and Credulity Questionnaire (ETMCQ), has demonstrated its validity among English and Italian adult populati...
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Background: Rates of poor mental health among children and young people (CYP) are increasing and wellbeing is declining, despite rising investment in treatment services. The argument for greater investments in prevention is well-established, with growing calls to address the social determinants of CYP’s mental health. However, there is a gap betwee...
Article
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The collaborative relationship between a client and therapist, known as the therapeutic alliance, plays an important part in promoting engagement and symptom improvement in adolescent psychotherapy. However, research indicates that alliance strains, called ruptures, are common among this age group, emphasizing the importance of addressing and resol...
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In this paper, we challenge prominent trait-based perspectives on personality psychopathology by arguing that when we push their implicit assumptions to their logical conclusions we realize that: either all mental disorders are personality disorders or there are no personality disorders.
Article
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Background Experiences of childhood maltreatment have been shown to be a crucial predictor of depressive symptoms. Objective This study investigated the association between a history of maltreatment and depressive symptoms in a mixed sample of adults, exploring whether feelings of shame and impairments in mentalizing mediate this association and p...
Article
Background Self-harm is common in adolescents and a major public health concern. Evidence for effective interventions is lacking. An individual patient data meta-analysis has the potential to provide more reliable estimates of the effects of therapeutic interventions for self-harm than conventional meta-analyses, to explore which treatments are bes...
Article
Background: In recent years, mentalizing – the capacity to understand one’s own and others’ intentional mental states in social contexts – has been considered to be a protective capacity that enables adaptive processing of stress-related emotional arousal, benefits general well-being and underpins adaptive emotion regulation. Objective: Several stu...
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Research on emotional factors and mental health in higher education has gained traction. Much attention has focused on first-year students as a potentially at-risk group, though some studies suggest that all students might face similar risks. This study examines differences between junior and senior undergraduates in terms of mentalizing, emotion r...
Article
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Background Adolescents exposed to adversity show higher levels of depression and anxiety, with the strongest links seen in socially/societally disadvantaged individuals (e.g., females, low socioeconomic status [SES]), as well as neurodivergent individuals. The intersection of these characteristics may be important for the differential distribution...
Preprint
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Aims: Developing integrated mental health services that focus on the needs of children and young people is a key policy goal in England. The THRIVE Framework and its associated implementation programme, i-THRIVE, are now used in areas covering over 65% of England's children. This study explores the experiences of staff involved with the i-THRIVE pr...
Article
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Background The Brief Educational Workshops in Secondary Schools Trial (BESST) is an England-wide school-based cluster randomised controlled trial assessing the clinical and cost-effectiveness of an open-access psychological workshop programme (DISCOVER) for 16–18-year-olds. This baseline paper describes the self-referral and other recruitment proce...
Article
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Background Youth adversity is associated with persistence of depression and anxiety symptoms. This association may be greater for disadvantaged societal groups (such as females) compared with advantaged groups (e.g. males). Given that persistent symptoms are observed across a range of disadvantaged, minoritized, and neurodivergent groups (e.g. low...
Article
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Background The nature of the pathway from conduct disorder (CD) in adolescence to antisocial behavior in adulthood has been debated and the role of certain mediators remains unclear. One perspective is that CD forms part of a general psychopathology dimension, playing a central role in the developmental trajectory. Impairment in reflective function...
Article
This article will outline the context of the mental health need within children and young people (CYP) in relation to rising prevalence of common mental health difficulties and the widening treatment gap. The CYP mental health political context and ambitions will then be summarised. The key CYP workforce upskilling and expansion initiatives, includ...
Article
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Background Depression ranks as the foremost mental health concern among childbearing women. Within low- and middle-income countries (LMICs), between 20 and 25% of women encounter depression during pregnancy or soon after delivery. This condition impacts not only the mothers but also their offspring. Offspring of women suffering from postnatal depre...
Article
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Introduction High dropout rates are common in youth psychotherapy, including psychoanalytic psychotherapy, yet the reasons behind this trend remain obscure. A critical focus to enhance adolescent engagement could be the therapeutic alliance, particularly in resolving alliance ruptures. This study sought to clarify the complex relationships between...
Preprint
Full-text available
Background The deteriorating mental health of children and young people in the United Kingdom poses a challenge that services and policy makers have found difficult to tackle. Kailo responds to this issue with a community-based participatory and systems-informed strategy, perceiving mental health and wellbeing as a dynamic state shaped by the inter...
Conference Paper
Full-text available
Background The escalating prevalence of mental health issues among university students is alarming, particularly as many do not receive necessary mental health interventions. While existing qualitative research has shed light on the perceived barriers students face accessing mental health care, our study explored the experiences of healthcare profe...
Article
Full-text available
Background Individuals from marginalised groups experience higher levels of mental health difficulties and lower levels of wellbeing which may be due to the exposure to stress and adversity. This study explores trajectories of mental health over time for young women and girls and young people with other marginalised identities. Methods We conducte...