Investigation of the Factor Structure of the Reflective Functioning Questionnaire (RFQ-8): One or Two Dimensions?

Construct Validity and Measurement Invariance of the Difficulties in Emotion Regulation Scale - Short Form (DERS-SF): Further Evidence From Community and Student Samples

The current study aimed to evaluate the psychometric properties of the Difficulties in Emotion Regulation Scale-Short Form (DERS-SF) in Iran, including testing its measurement invariance across sexes, as well as community and student populations. Two samples were recruited: a community sample of 583 participants (58.7% female; Mage = 33.55) and a university student sample of 409 participants (67.2% female; Mage = 24.48). Besides the DERS-SF, participants completed a battery of instruments online, measuring mentalizing capacity and borderline personality features. Confirmatory factor analyses supported the tenability of the five-factor model, excluding the awareness subscale. Except for the awareness subscale, acceptable to excellent internal consistencies were found for the DERS-SF and its subscales. The awareness-excluded DERS-SF was significantly and strongly associated with relevant constructs (|rs| = .49 to .59). This study also found evidence for configural, metric, and scalar invariance of the DERS-SF across sexes and community and student populations. Our findings extended the evidence for the validity and reliability of the DERS-SF and its awareness-excluded version by administering it in Iranian samples and supporting its cross-cultural applicability.

Reflective functioning mediates the relationship between insecure adult attachment and the severity of prolonged grief symptoms

Background

This study aimed to investigate the mediation role of reflective functioning (i.e., certainty and uncertainty about mental states) in the relationship between insecure attachment (i.e., attachment avoidance and attachment anxiety ) and the severity of prolonged grief symptoms.

Methods

A cross-sectional study was conducted with 329 bereaved participants (51.7% females, mean age= 46.94 ± 14.62 years). Participants completed the Prolonged Grief Scale (PG-13), the Attachment Style Questionnaire (ASQ), and the Reflective Functioning Questionnaire (RFQ). Demographic and bereavement-related information were also collected.

Results

Certainty about mental states fully mediated the relationship between both the attachment avoidance and attachement anxiety and severity of prolonged grief symptoms.

Conclusions

The findings of this study indicate that reflective functioning impairment, specifically certainty about mental states of self and others, mediate the paths from insecure attachment to prolonged grief symptoms. This suggests that improving reflective functioning may contribute to the treatment bereaved individuals at risk of PGD.

Mentalizing as a Predictor of Well-Being and Emotion Regulation: Longitudinal Evidence from a Community Sample of Young Adults

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 studies using cross-sectional research designs have demonstrated the potential health-promoting effect of mentalizing in non-clinical samples. However, longitudinal evidence is scarce. The present study aimed to investigate whether mentalizing predicts well-being and emotion regulation strategies in a non-clinical sample of mainly young adults using a prospective longitudinal design. Methods: In a prospective research design, 135 participants completed questionnaires assessing well-being, psychological symptom severity and mentalizing capacity at baseline (T1). Twelve months later (T2), emotion regulation strategies (suppression and cognitive reappraisal), well-being and psychological symptom severity were assessed by self-report. The data were analyzed using multivariate linear regression analysis. Results: Impairments in mentalizing were a significant negative predictor of well-being 12 months later. Furthermore, impairments in mentalizing positively predicted suppression of emotional states at T2. No association was found between deficits in mentalizing and cognitive reappraisal of emotional states over the course of 1 year. Conclusion: The findings indicate that mentalizing is longitudinally associated with mental health indicators in a non-clinical adult sample. Specifically, ineffective mentalizing was associated with impaired psychological well-being and a tendency to suppress intense emotional states over a period of 1 year. Future research should replicate these findings using multiple measurement timepoints to etablish causality.

A time to reflect: deviations from the balanced time perspective are associated with hypomentalization

Introduction

Poor mentalization, or lack of capacity to reflect on self and others in terms mental states, thoughts, and feelings, and time perspective biases were both related to mental disorders and lower wellbeing in separate studies. Expanding one prior study, we examined the relationship of mentalization and time perspective, including a measure known as deviations from the balanced time perspective (DBTP) that summarizes time perspective biases across the past, present, and future time frames.

Method

A convenience sample of 258 participants responded to a version of the Reflective Functioning Questionnaire (RFQ-8) and a six-dimensional version of the Zimbardo Time Perspective Inventory (S-ZTPI). Given recent evidence that the original two-factor structure of the RFQ may need to be reconsidered, we used confirmatory factor analyses (CFA) to compare alternative models for RFQ as a first step.

Results

In line with several recent studies, the CFA favored a unitary model of RFQ-8 reflecting hypomentalization (or uncertainty). The total score showed significant associations with Past Negative, Present Fatalistic, and Future Negative dimensions of S-ZTPI, while hypomentalization was negatively associated with Future Positive. Of major interest, DBTP and hypomentalization showed a strong positive correlation (r = 0.64 for latent constructs; r = 0.62 in an adjusted model).

Conclusion

Deviations from the balanced time perspective were substantially related to hypomentalization. Further research is required to examine the generalizability of the finding (e.g., to measures of mentalization focused on others) and to provide a better understanding of the theoretical basis of the link. Potentially shared associations in development (e.g., attachment style) and mindfulness, that may influence both time perspective and mentalization is of interest in this regard.

Total Pain and Fear of Recurrence in Post-Treatment Cancer Patients: Serial Mediation of Psychological Flexibility and Mentalization and Gender Moderation

Background: The research indicates that painful experiences can significantly affect the fear of cancer recurrence among cancer survivors, which is a distressing concern that influences both physiological and psychological recovery. This cross-sectional study aims to advance our comprehension of the associations between total pain and the fear of recurrence in post-treatment cancer patients by examining two potential mediators: psychological flexibility and mentalization. Methods: Three hundred and thirty-five participants (aged 22 to 88, 49.1% female) who had finished their cancer treatment completed self-report assessments of total pain, their fear of recurrence, psychological flexibility, and mentalization. Results: The serial mediation analysis showed that all dimensions of total pain were positively and indirectly related to the fear of recurrence through psychological flexibility and mentalization in serial. Additionally, gender was found to moderate these serial mediational effects. Conclusions: In line with the psychological flexibility model, personal capacities to face difficult internal/external problems and interpret one's behavior in motivational terms can counterbalance a patient's negative emotions and feelings related to the illness. Gender factors also determine the way in which post-treatment cancer patients manage potential future anxiety and fears.

Iranian adaptation of the Epistemic Trust, Mistrust, and Credulity Questionnaire (ETMCQ): Validity, reliability, discriminant ability, and sex invariance

INTRODUCTION

Epistemic trust, or trust in transmitted knowledge, has been proposed as a critical factor in psychopathology and psychotherapy. This study aimed at evaluating the psychometric properties of the Epistemic Trust, Mistrust, and Credulity Questionnaire (ETMCQ) in Iran.

METHOD

Data were collected from 906 participants. Along with the ETMCQ, measures of mentalizing, mindfulness, perspective-taking, attachment, emotion dysregulation, and borderline personality disorder were administered. Confirmatory factor analysis and exploratory structural equation modeling (ESEM) were used to determine factorial structure.

RESULTS

The ESEM model showed an acceptable fit and outperformed the confirmatory model. A 14-item version of the ETMCQ was retained after examining item performance. Our findings also established criterion-related validity for mistrust and credulity, an acceptable internal consistency for credulity, discriminant power for mistrust and credulity in detecting positive screens for borderline personality disorder, and measurement invariance across sexes.

CONCLUSION

This study provides evidence for the cross-cultural applicability of the ETMCQ. Nonetheless, the validity of the trust and internal consistency of the mistrust subscale require particular attention in future research.

A multifaceted approach to assessment of mentalization: the mentalization profile in patients with eating disorders

Purpose: The existing literature, however sparse, suggests an association between eating disorders (ED) and mentalization ability. The aim of this study was to investigate the mentalization profile (MP) in patients with ED. It was hypothesized that patients with ED would have a lower degree of mentalization ability compared to healthy controls (HC).Materials and methods: The study is based on a cross-sectional survey on a sample of patients diagnosed with ED compared to a HC group.Results and conclusion: A total of 88 participants, distributed between patients with ED (N = 30) and HC (N = 58) were included.Results: The study results show statistically significant differences between patients with ED and HC. Thus, patients with an ED scored significantly higher on Reflective Functioning Questionnaire (uncertainty about mental states) (RFQ-U) (mean difference: 0.31, p = 0.048) and Toronto Alexithymia Scale (TAS-20) (mean difference: 0.44, p = 0.019) compared to the HC. Furthermore, the results indicated that patients with Bulimia Nervosa (BN) may have a lower ability to mentalize about oneself as well as a generally lower ability to mentalize across different dimensions of the mentalization profile as the BN group scored significantly higher on RFQ-U (mean difference: 0.71, p = 0.023) and TAS-20 (mean difference: 0.89, p = 0.006) compared to the Anorexia Nervosa (AN) group. Further research should be conducted to gain knowledge on the mentalization ability in patients with an ED.

Effectiveness of the mentalisation-based serious game 'You & I' for adults with mild to borderline intellectual disabilities: A randomised controlled trial

BACKGROUND

Mentalising and stress regulation pose challenges for adults with mild to borderline intellectual disabilities (MBID), emphasising the importance of an intervention program. The study examined the effectiveness and social validity of the serious game 'You & I' in enhancing mentalising and stress regulation among adults with MBID.

METHOD

A randomised controlled superiority trial with experimental and waitlist-control groups was conducted with 159 adults with MBID (Mage  = 36) at baseline, post-test, and follow-up. Analyses investigated the effects on aspects of mentalising, stress regulation, and social validity.

RESULTS

The experimental group showed decreased stress from negative interpersonal relations, while the control group experienced increased stress (d = 0.26). There were no significant effects on mentalising, but positive user expectations and experiences were reported.

CONCLUSIONS

This initial study on 'You & I' provides limited evidence of its effectiveness for people with MBID, warranting further examination of the potential of serious games.

Shame-coping clusters: comparisons regarding attachment insecurities, mentalizing deficits, and personality pathology, controlling for general emotion dysregulation

BACKGROUND

General Emotion Dysregulation (GED) is increasingly implicated as an underlying factor in personality pathology; however, the regulation of specific emotions, such as shame, has been relatively overlooked in the literature. We aimed to identify distinct clusters of shame-coping/regulation and compare them regarding attachment insecurities, mentalizing deficits, and personality pathology, controlling for GED.

METHODS

A convenience sample of 600 participants (351 females and 249 males) from the general population with ages ranging from 18 to 65 (M = 33.78, SD = 12.80) completed a battery of self-report instruments, measuring shame-coping styles, GED, attachment insecurities, mentalizing deficits, criteria A and B of the alternative model for personality disorders, and borderline personality traits. A two-stage clustering method was employed, with shame-coping styles as the clustering variables. The identified clusters were then compared for their effects on dependent variables using multivariate and univariate analyses. These comparisons were also performed after controlling for GED.

RESULTS

Multiple determination methods suggested a two-cluster solution: maladaptive and adaptive shame-coping. Attack-self, withdrawal, and attack-other styles were the main discriminators. Compared with the adaptive cluster, the maladaptive cluster was characterized by higher use of maladaptive and lower use of adaptive shame-coping styles. Multivariate analyses demonstrated significant differences for all the between-cluster comparisons, with and without GED as the covariate (p < .001).

CONCLUSIONS

The current study provides evidence for the presence of homogenous clusters of shame-coping in community-based adults. Between-cluster contrasts after controlling for GED suggest that addressing shame-coping could have incremental utility over and above GED.

Mentalizing partially mediates the association between attachment insecurity and global stress in preservice teachers

Objective

Considering the fact that the teaching profession is a highly stressful occupation and that teachers' ineffective coping strategies contribute to higher levels of stress, the objective of the present study was to investigate whether insecure attachment is related to global stress experiences in preservice student teachers. Furthermore, it was examined whether this link is mediated by the preservice teachers' mentalizing-the capacity to perceive and consider one's own and others' behavior based on intentional mental states.

Methods

Data of this cross-sectional study came from 202 preservice student teachers using self-report instruments (attachment: Expectation in Close Relationships; mentalizing: Reflective Functioning Questionnaire; stress: Trier Inventory of Chronic Stress). The hypotheses were tested using structural equation modelling.

Results

Anxious attachment was positively related to stress and impairments in mentalizing. In addition, the link between attachment-related anxiety and stress was partially mediated by mentalizing. Avoidant attachment was not associated with stress or mentalizing.

Discussion

Results indicate that anxious attachment is associated with higher perceived stress in preservice student teachers. Consequently, attachment-related anxiety may be a risk factor which, in turn, may foster perceptions of higher global stress experiences.

Conclusion

Additional research needs to focus on exploring the link between attachment insecurity and global stress experiences among preservice student teachers. An examination of preservice student teachers' own attachment experiences proves to be useful, for example in the context of mentalization-based supervision or reflective practice.

Childhood Maltreatment History and Borderline Personality Symptoms: The Role of Mentalization Difficulties Among Vulnerable Women

Mentalization difficulties may be one reason why individuals who experienced childhood maltreatment (CM) are at increased risk for borderline personality (BP) symptoms. The goal of this study was to identify specific aspects of mentalization associated with CM and determine their role in the short-term course of BP symptoms. A total of 253 mothers with a previous mental health diagnosis completed online surveys at three times over 9 months. A cross-lag panel model was tested to estimate reciprocal effects between mentalization measures and BP symptoms and indirect effects from CM to mentalization to BP symptoms. At baseline, women with more CM endorsed more difficulty with general mentalization, emotional clarity, and reflecting on childhood experiences. Lack of emotional clarity and disorganized responding about childhood served as indirect paths from CM to subsequent BP symptoms and showed bidirectional associations with BP symptoms over time. Thus, these may be particularly important treatment targets in this population.