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Egmose I, Steenhoff T, Tharner A, Væver MS. Parental reflective functioning in mothers and fathers of preschoolers: Associations with adult attachment and parenting behavior. Scand J Psychol 2024; 65:747-757. [PMID: 38581691 DOI: 10.1111/sjop.13020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/08/2024]
Abstract
Parental reflective functioning (PRF) is considered a key parental competence. Since most research on PRF has focused on infancy or the first years of life, there is a gap in our understanding of PRF among parents of older children. Therefore, we investigated PRF in mothers and fathers with preschool-aged children, examining associations between PRF, parent's romantic attachment, and observed parenting behavior. The sample comprised 50 mothers, 40 fathers, and their 5-year-old children. PRF was assessed using the parental reflective functioning questionnaire (PRFQ), parental romantic attachment was assessed using the experiences in close relationships scale-revised (ECR-R), and parenting behavior was assessed during a parent-child free-play interaction with the coding interactive behavior (CIB) coding system. Results showed that mothers scored higher on the interest and curiosity scale than fathers, indicating that mothers show a more active interest and curiosity in their child's mental states. Further, higher levels of attachment anxiety in fathers were associated with higher levels of pre-mentalizing modes. In mothers, higher levels of attachment avoidance were associated with lower levels of interest and curiosity. Finally, and unexpectedly, higher levels of interest and curiosity in mothers were associated with less sensitivity during free play. In summary, the study found meaningful associations between mothers' and fathers' romantic attachment and their PRF indicating a spill-over of their attachment strategies into their relationship with their child. Further, the study results suggest that very high levels of interest and curiosity in mothers reflect hypermentalizing.
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Affiliation(s)
- Ida Egmose
- Centre for Early Intervention and Family Studies, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Tine Steenhoff
- Centre for Early Intervention and Family Studies, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Anne Tharner
- Clinical Child and Family Studies, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Mette Skovgaard Væver
- Centre for Early Intervention and Family Studies, Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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2
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Kamza A, Luyten P, Piotrowski K. Psychometric evaluation of the Parental Reflective Functioning Questionnaire in Polish mothers. PLoS One 2024; 19:e0299427. [PMID: 38630679 PMCID: PMC11023587 DOI: 10.1371/journal.pone.0299427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/11/2024] [Indexed: 04/19/2024] Open
Abstract
Parental reflective functioning (PRF) refers to a parent's capacity to reflect on and understand the inner mental states of their child, their own mental states with regard to their child, and how these mental states may influence their behavior and interactions. This capacity has been shown to foster secure attachment in children and their socio-emotional development. The present study examined the psychometric properties of the Polish translation of the Parental Reflective Functioning Questionnaire (PRFQ), a brief screening measure of PRF, in a large community sample of Polish mothers of children aged 0-5 years (N = 979). Confirmatory factor analysis supported the hypothesized three-factor structure of the PRFQ, which consists of three subscales: prementalizing modes, certainty about mental states, and interest and curiosity in mental states. However, item loadings suggested that the 15-item version fitted the data better than the original 18-item version. These three PRFQ subscales exhibited satisfactory and moderate six-month test-retest reliability. They also correlated in theoretically expected ways with several criterion measures such as maternal attachment, maternal parenting stress, parental role restriction, depression severity, and borderline symptoms. In conclusion, this study is the first to provide preliminary evidence for the reliability and validity of the PRFQ as a measure of parental reflective functioning in Polish mothers.
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Affiliation(s)
- Anna Kamza
- Center for Research on Personality Development, Institute of Psychology, SWPS University, Poznań, Poland
| | - Patrick Luyten
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Research Department of Clinical, Education and Health Psychology, UCL, London, United Kingdom
| | - Konrad Piotrowski
- Center for Research on Personality Development, Institute of Psychology, SWPS University, Poznań, Poland
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3
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Malcorps S, Vliegen N, Fonagy P, Luyten P. A four-year multi-wave prospective study on the role of parental reflective functioning and parenting stress in the development of socio-emotional problems in internationally adopted children. Dev Psychopathol 2024; 36:266-279. [PMID: 36382423 DOI: 10.1017/s0954579422001171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Parental reflective functioning (PRF) plays a protective role in the development of children with histories of early adversity, including adopted children. This is the first study to investigate the developmental trajectories of PRF and children's socio-emotional problems in the first 4 years after international adoption (N = 48 families, mean age (T1) = 20.7 months) and to examine the mediating role of parenting stress in the relation between PRF and child socio-emotional problems. Multilevel modeling indicated that age at adoption and parent gender moderated the development of PRF and child socio-emotional problems. Moreover, decreases in PRF were associated with more socio-emotional problems in the children. These relations were mediated by parenting stress, and particularly feelings of incompetence and marital dissatisfaction.
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Affiliation(s)
- Saskia Malcorps
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Nicole Vliegen
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Patrick Luyten
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Smith-Nielsen J, Stuart AC, Wendelboe KI, Egmose I, Roos CO, Væver MS. The significance of parental mentalizing for four-year-old children's solitary pretend play. PLoS One 2024; 19:e0297671. [PMID: 38295066 PMCID: PMC10830029 DOI: 10.1371/journal.pone.0297671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Pretend play is a signature behavior of early childhood and is considered to reflect the child's emerging symbolic function, enabling the interpretation of social signals, language development, and emotion understanding. While theory links parental mentalizing with children's pretend play, only a few studies have investigated this association. These studies are limited to infancy and early toddlerhood, and child pretend play is assessed during play with an adult (social play). Based on the assumption that child solitary pretend play reflects the child's 'baseline' pretend play ability, in this study, we investigated children's pretend play at its peak, i.e., during the preschool age, without the facilitation of another player. The overall objective was to investigate if parental mentalizing increases pretend play complexity in children. METHODS The sample consisted 99 Danish mothers and their 4-year-old children. Employing a cross-sectional design, we hypothesized that parental mental state language, as an indicator of 'online' mentalizing during interaction with the child, is a mechanism through which 'offline' mentalizing, measured as parental reflective functioning, is associated with child solitary pretend play. Child pretend play complexity was observed and coded with an adapted version of the 12-Step Play Scale. Maternal offline mentalizing was assessed with the Parental Reflective Functioning Questionnaire, and maternal online mentalizing was assessed by coding the mothers' mental state language during interaction with the child using a modified version of the mind-mindedness coding scheme. RESULTS While there was no direct effect of maternal offline reflective functioning on child pretend play, online mental state language mediated the link between offline maternal reflective functioning and child pretend play. CONCLUSIONS These results provide support for the theoretically assumed link between parental mentalizing and children's capacity for pretend play. Furthermore, our study contributes to the literature on parental mentalization, suggesting that parental mentalizing facilitates child development only if the parent can translate this ability into 'mentalizing in action'.
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Affiliation(s)
| | | | | | - Ida Egmose
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Wang X, Liu Q, Merrin GJ, Keller A, Yoon D, Henderson A. Harsh parenting among veterans: parents' military-related PTSD, mentalization, and pre-military trauma. Front Psychol 2023; 14:1283801. [PMID: 38169711 PMCID: PMC10758459 DOI: 10.3389/fpsyg.2023.1283801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024] Open
Abstract
Objectives Veteran parents experiencing posttraumatic stress disorder (PTSD) may resort to harsh parenting. The indirect pathway from parental military-related PTSD to harsh parenting, and the moderating role of parents' pre-military trauma histories, has been less explored. Informed by mentalization theory, as well as trauma-sensitive and posttraumatic growth perspectives, we aim to explore the associations between veteran parents' military-related PTSD, mentalization, harsh parenting, and prior trauma before military service. Methods Data were collected from an online research panel of 509 veteran parents with children under 10. We employed Structural Equation Models to test indirect and moderating effects. Results We identified an indirect effect of parental pre-mentalization from military PTSD to harsh parenting [corporal punishment: b = 0.35, p < 0.001, 95% CI (0.23, 0.46); psychological aggression: b = 0.14, p < 0.001, 95% CI (0.09, 0.19)]. Multi-group analysis on four parent groups (parents with only pre-military physical trauma, parents with only pre-military psychological trauma, parents with both pre-military physical and psychological trauma, and parents with no pre-military physical or psychological trauma) highlighted differences in these associations, particularly between parents with only pre-military physical trauma and those without any physical and psychological trauma. The military-related PTSD effects on psychological aggression, corporal punishment, and pre-mentalization were all significantly higher for parents without pre-military physical and psychological trauma. Conclusion Modifying parents' interpretation of their child's mental states can potentially counteract the effects of veterans' military PTSD on harsh parenting. Family-based programs should be created considering veteran parents' pre-military trauma histories.
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Affiliation(s)
- Xiafei Wang
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, United States
| | - Qingyang Liu
- Department of Human Development and Family Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, United States
| | - Gabriel J. Merrin
- Department of Human Development and Family Science, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, United States
| | - Amanda Keller
- Department of Social Work, McGill University, Montreal, QC, Canada
| | - Dalhee Yoon
- Department of Social Work, Binghamton University-State University of New York, Binghamton, NY, United States
| | - Ava Henderson
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, Syracuse, NY, United States
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Hammarlund M, Breitholtz M, Granqvist P, Forslund T. Parental mentalising among mothers with intellectual disability or ADHD: Links with experiences of abuse, neglect and psychosocial risk. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:1206-1217. [PMID: 37194381 DOI: 10.1111/jar.13118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/29/2023] [Accepted: 05/05/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND Parental mentalising difficulties are robustly linked to caregiving problems. Mothers with intellectual disability are at risk for caregiving problems, but knowledge on their parental mentalising abilities is lacking. The present study aimed to fill this gap. METHOD Thirty mothers with mild intellectual disability, and 61 comparison mothers with ADHD, were assessed for parental mentalising using the Parental Reflective Functioning Questionnaire. Contributions of intellectual disability, maternal exposure to childhood abuse/neglect and psychosocial risk to parental mentalising were examined through hierarchical regression analysis. RESULTS Mothers with intellectual disability had a heightened risk for parental mentalising difficulties, in the form of elevated prementalising. Intellectual disability and cumulative childhood abuse/neglect uniquely predicted prementalising among the mothers, whereas cumulative psychosocial risk added to the risk for prementalising specifically among mothers with intellectual disability. CONCLUSIONS Our findings support contextual models of caregiving, and suggest a need for mentalisation-based support for parents with mild intellectual disability.
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Affiliation(s)
| | - Mia Breitholtz
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Pehr Granqvist
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Tommie Forslund
- Department of Psychology, Stockholm University, Stockholm, Sweden
- SUF Resource Center, Region Uppsala, Uppsala, Sweden
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Arkle P, Larkin F, Wang Y, Lee Y, Fernandez A, Li LY, Meins E. Early psychosocial risk factors and postnatal parental reflective functioning. INFANCY 2023; 28:864-881. [PMID: 37243878 DOI: 10.1111/infa.12552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 04/17/2023] [Accepted: 04/28/2023] [Indexed: 05/29/2023]
Abstract
Psychosocial factors have been found to relate to parental reflective functioning (PRF), a parent's ability to mentalize about themselves and their child. Relations between maternal psychosocial risk factors and PRF were investigated in a community sample. A sample of mothers (n = 146) was assessed for risk factors when infants were 6 months, infant temperament was assessed using an observational measure, and PRF was assessed with the Parent Development Interview-Revised (PDI). PRF was measured again with the Parental Reflective Functioning Questionnaire (PRFQ) when children were 4 years (n = 105) and 5 years (n = 92), with an additional sample of mothers (n = 48) tested at these two timepoints. Results showed that in infancy, total maternal psychosocial risk related to lower PDI-PRF; regression analyses highlighted low socioeconomic status, unplanned pregnancy, and low maternal anxiety as independent predictors of lower PDI-PRF. PDI-PRF scores at 6 months did not relate to PRFQ scores, but PRFQ subscales showed stability over time from age 4-5. Results are discussed with regard to the impact of maternal psychosocial risk and infant temperament on PRF and the stability and concordance of PRF measures.
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Affiliation(s)
| | | | - Ying Wang
- University of York, York, UK
- Auckland University of Technology, Auckland, New Zealand
| | | | | | - Lydia Y Li
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Carlone C, Milan S, Decoste C, Borelli JL, McMahon TJ, Suchman NE. Self-report measure of parental reflective functioning: A study of reliability and validity across three samples of varying clinical risk. Infant Ment Health J 2023; 44:240-254. [PMID: 36857469 DOI: 10.1002/imhj.22046] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 12/29/2022] [Accepted: 01/12/2023] [Indexed: 03/03/2023]
Abstract
The Parental Reflective Functioning Questionnaire (PRFQ) provides an efficient way to measure a parent's capacity to recognize their child's mental states and to understand the relationship between underlying mental states and behavior. To date, limited work evaluates its psychometric properties beyond initial validation studies. Here we examined the reliability and validity of the PRFQ in three samples of varying clinical risk (e.g., community sample, previous mental health diagnosis, substance use disorder diagnosis). Across samples, the majority (e.g., 75%-78%) of mothers identified as White; all mothers were from the USA. We compared the PRFQ to task-based measures of mentalization, the Parent Development Interview (PDI), and measures of the parent-child relationship. The PRFQ was a reliable measure across samples, and it was associated in theoretically consistent ways with task-based measures of mentalization. Parental RF across the PDI and PRFQ were not highly correlated in a sample of mothers with substance use disorders. Existing RF measures may be tapping into a different component of the broader construct of parental reflective functioning (PRF). The PRFQ was further validated by demonstrating relationships with parent-report measures of the parent-child relationship. Taken together, these findings provide additional support for the reliability and validity of the PRFQ.
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Affiliation(s)
- Christina Carlone
- Department of Psychological Sciences, College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Stephanie Milan
- Department of Psychological Sciences, College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Cindy Decoste
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jessica L Borelli
- Department of Psychological Science, University of California, Irvine, California, USA
| | - Thomas J McMahon
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Nancy E Suchman
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
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Lindblom J, Pajulo M, Nolvi S, Tervahartiala K, Karlsson H, Karlsson L, Korja R. Early pathways of maternal mentalization: Associations with child development in the FinnBrain birth cohort study. Front Psychol 2022; 13:855190. [PMID: 36582339 PMCID: PMC9792295 DOI: 10.3389/fpsyg.2022.855190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022] Open
Abstract
Parental mentalization refers to a parents' capacity and interest to consider the individual experience and mental state underlying the behaviors of the child. Higher mentalization is considered a key aspect for parental sensitivity in interaction, fostering child's socioemotional and self-regulatory development. Yet, previous studies have not examined the dynamic pathways through which the maternal mentalization may develop, nor their effects on child development. Thus, in the current person-oriented study, first, we identify distinct profiles and longitudinal trajectories of maternal mentalization from pregnancy to child's 2 years of age. Second, we test how the profiles and trajectories associate with children's internalizing and externalizing problems, social-emotional competence and effortful control at the age of 2 years. Third, we examine how the profiles and trajectories associate with contextual demographic and child related. The substudy was part of the FinnBrain Birth Cohort and included families from general population (n = 2,687). Mothers reported their parental reflective functioning (PRF) at late pregnancy, 6 months and 2 years of child's age. Both mothers (n = 1,437) and fathers (n = 715) reported the developmental child outcomes at the child's age of 2 years. Latent Profile Analysis and Latent Transition Analysis were used to identify PRF profiles and trajectories. The results showed decreasing heterogeneity in PRF from pregnancy to child's age of 6 months and 2 years (i.e., four, three and two latent classes, respectively). Most mothers progressed towards high PRF over time. Second, the profiles and trajectories depicting high PRF associated with child high social-emotional competence at the age of 2 years, yet no clear positive effects were found on child's problems and effortful control. The group of mixed PRF trajectories showed strongest association with child's internalizing and externalizing problems. Finally, there were theoretically meaningful associations between the PRF trajectories and both the contextual (e.g., parity) and child related (e.g., infant temperament) factors. This was the first study to explore the early unfolding of maternal mentalization. The results are discussed in relation with the potential mechanisms accounting for child development and with the nature and limitations of self-reported parental mentalization.
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Affiliation(s)
- J. Lindblom
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Faculty of Social Sciences, Tampere University, Tampere, Finland,*Correspondence: J. Lindblom,
| | - M. Pajulo
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - S. Nolvi
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Turku Institute for Advanced Studies, University of Turku, Turku, Finland,Department of Psychology and Speech Language Pathology, University of Turku, Turku, Finland
| | - K. Tervahartiala
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Centre for Population Health Research, University of Turku and Turku University, Turku, Finland
| | - H. Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Centre for Population Health Research, University of Turku and Turku University, Turku, Finland,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - L. Karlsson
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Centre for Population Health Research, University of Turku and Turku University, Turku, Finland,Department of Psychiatry, Turku University Hospital and University of Turku, Turku, Finland
| | - R. Korja
- The FinnBrain Birth Cohort Study, Turku Brain and Mind Center, Department of Clinical Medicine, University of Turku, Turku, Finland,Department of Psychology and Speech Language Pathology, University of Turku, Turku, Finland
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Goudarzi Z, Seyed Mousavi PS, Vahidi E, Rafie M, Ghanbari S. Psychometric properties of the parental reflective functioning questionnaire in Iranian mothers. Clin Child Psychol Psychiatry 2022; 27:882-894. [PMID: 35238690 DOI: 10.1177/13591045211070181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aims to examine the psychometric properties of the Persian version of the Parental Reflective Functioning Questionnaire (PRFQ) in mothers, a brief self-report measure that assesses parental mentalization capacity. To examine the factor structure and construct validity of the PRFQ, 430 mothers of 3-6-year-old children completed the Persian version of the PRFQ (Persian-PRFQ) along with the Emotion Regulation Checklist (ERC) and the Strengths and Difficulties Questionnaire (SDQ). Exploratory and confirmatory factor analyses supported the three-factor structure of the PRFQ. Convergent validity was confirmed for the three subscales of the PRFQ, while divergent validity was only confirmed for the PM and IC. Furthermore, the mean score of the certainty of mental states (CMS) in this sample was higher than in other studies, and contrary to the theoretical foundations, the CMS was positively related to interest and curiosity in mental states (IC). In conclusion, our results provided initial evidence for the use of the Persian-PRFQ in the Iranian population.
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Affiliation(s)
- Zahra Goudarzi
- Department of Psychology, Faculty of Education and Psychology, 48512Shahid Beheshti University, Tehran, Iran
| | | | - Elahe Vahidi
- Department of Psychology, Faculty of Education and Psychology, 48512Shahid Beheshti University, Tehran, Iran
| | - Marjan Rafie
- Department of Clinical Psychology, Faculty of Education and Psychology, 85950Kharazmi University, Tehran, Iran
| | - Saeed Ghanbari
- Department of Psychology, Faculty of Education and Psychology, 48512Shahid Beheshti University, Tehran, Iran
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Does Parental Reflective Functioning Mediate the Associations between the Maternal Antenatal and Postnatal Bond with the Child in a Community Sample? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19126957. [PMID: 35742206 PMCID: PMC9222610 DOI: 10.3390/ijerph19126957] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 05/22/2022] [Indexed: 11/16/2022]
Abstract
Although establishing an affective tie with a child during perinatality is considered one of the most important maternal tasks, little is still known about the mediators of the association between maternal antenatal and postnatal bonding with the infant. This prospective study addresses this gap by evaluating a community sample of 110 Italian women to assess whether maternal pre- and postnatal bonds with the infant are mediated by parental reflective functioning (PRF), as assessed at the third trimester of pregnancy and three months postpartum. Controlling for confounding variables, the hierarchical regression analyses show the maternal prenatal quality of attachment to the fetus as the main predictor of maternal postnatal attachment to the child (β = 0.315; t = 0.2.86; p = 0.005). The mediation analyses show that mothers’ PRF (b = 0.245; SE = 0.119; 95% CI = 0.071, 0.531) explains 39% of the relationship between maternal pre- and postnatal bonding with the child. The findings of this study contribute to research on the association between prenatal and mother-to-infant bonding by additionally investigating the importance of taking into account maternal PRF as a mediating variable. This provides support for the clinical utility of interventions focused on maternal PRF.
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12
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Protocol for a randomized controlled trial comparing the Circle of Security-parenting (COS-P) with treatment as usual in child mental health services. PLoS One 2022; 17:e0265676. [PMID: 35472058 PMCID: PMC9041756 DOI: 10.1371/journal.pone.0265676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/03/2022] [Indexed: 11/19/2022] Open
Abstract
Background The quality of a child’s attachment to its primary caregiver plays an important role for its long-term socioemotional development. While ‘secure’ attachment is associated with better outcomes, ‘insecure’ attachment is associated with a higher risk of externalizing and internalizing symptoms. Children referred to mental health services show much higher rates of insecure attachment than the general population, yet the parent-child relationship is rarely in treatment focus. Attachment quality is closely associated with parental sensitive responsiveness that is target of attachment-based interventions like Circle of Security (COS). COS has shown to improve attachment quality and the well-being of both children and parents. No randomized controlled trials have investigated the effect of COS on parental sensitivity and child psychiatric symptoms in child mental health services. Objectives To investigate whether COS-Parenting (COS-P) can increase observed maternal sensitivity and decrease children’s psychiatric symptoms as an add on to treatment as usual (TAU). Methods In a randomized controlled parallel superiority trial COS-P is compared with TAU for parents of children referred to child mental health services (n = 186). Families are randomized 2:1 to intervention or control group, if their child is between 3 and 8 years old and scores ≥ 93d percentile on both the CBCL total score and the oppositional defiant disorder or conduct disorder subscale. Primary outcome is maternal sensitivity, secondary and exploratory outcomes include, among others, child psychiatric symptoms, parental stress and coping with children’s negative emotions. Outcomes and adverse events are assessed before (T0) and after 10 weeks of treatment (T1) and 6 months later (T2). Regression analysis and /or ANOVA will be used for all outcomes. Perspectives Targeting the parent-child relation has the potential to reduce psychiatric symptoms in children. This trial will provide valuable information if attachment-based interventions like COS-P can enhance treatment as usual in child mental health services. Trail registration ClinicalTrials.gov Identifier: NCT03578016.
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Ye P, Ju J, Zheng K, Dang J, Bian Y. Psychometric Evaluation of the Parental Reflective Functioning Questionnaire in Chinese Parents. Front Psychol 2022; 13:745184. [PMID: 35153949 PMCID: PMC8837268 DOI: 10.3389/fpsyg.2022.745184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 01/04/2022] [Indexed: 11/13/2022] Open
Abstract
Parental reflective functioning (PRF) is important for parenting and child development. To effectively assess PRF in Chinese parents, this study aimed to revise the Parental Reflective Functioning Questionnaire (PRFQ) for the Chinese context. The original Chinese version of the PRFQ (PRFQ-C) was revised by following psychometric validation procedures in a sample of Chinese parents (N = 2,021, 1,034 mothers and 987 fathers). A series of psychometric analyses, including confirmatory factor analysis (CFA), internal consistency reliability analysis, discriminant validity, and criterion-related validity analysis, and analysis for measurement invariance between mothers and fathers, were conducted. The CFA results indicated that the final 12-item, three-factor model had a good fit {χ2(49) = 472.381; CFI = 0.929; TLI = 0.904; RMSEA = 0.065, 90%CI = [0.060, 0.071]}. The Chinese version of the PRFQ with 12 items (PRFQ-12C) showed satisfactory reliability (omega = 0.68–0.82), discriminant validity [heterotrait-monotrait (HTMT) values < 0.85], and criterion-related validity. The PRFQ-12C also had measurement invariance across mothers and fathers. In conclusion, the PRFQ-12C is psychometrically sound and can be applied in China.
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Affiliation(s)
- Panqin Ye
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
| | - Jiawen Ju
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
| | - Kejun Zheng
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
| | - Junhua Dang
- Department of Surgical Sciences, Faculty of Medicine, Uppsala University, Uppsala, Sweden
| | - Yufang Bian
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
- Child and Family Education Research Center, Beijing Normal University, Beijing, China
- Institute of Mental Health and Education, Beijing Normal University, Beijing, China
- *Correspondence: Yufang Bian,
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14
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Moreira H, Fonseca A. Measuring Parental Reflective Functioning: Further Validation of the Parental Reflective Functioning Questionnaire in Portuguese Mothers of Infants and Young Children. Child Psychiatry Hum Dev 2022:10.1007/s10578-021-01288-2. [PMID: 35064394 DOI: 10.1007/s10578-021-01288-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2021] [Indexed: 11/03/2022]
Abstract
This study examines the factor structure and psychometric properties of the Portuguese Parental Reflective Functioning Questionnaire (PRFQ). The PRFQ is a brief questionnaire of parental reflective functioning that comprises three subscales: pre-mentalizing modes of mental states, certainty about mental states, and interest and curiosity in mental states. Two independent samples were included in the study: a sample composed of 710 mothers of children aged 0 to 36 months (Study 1) and a sample composed of 120 mothers of children aged 1 to 5 years (Study 2). Each sample completed a different set of self-report questionnaires. The original correlated three-factor structure was confirmed through confirmatory factor analyses. The three PRFQ subscales exhibited adequate reliability and correlated in the expected directions with several outcomes (psychopathology symptoms, emotion dysregulation, parent attachment, and parenting styles). The Portuguese PRFQ is a psychometrically robust measure of parental reflective functioning appropriate for research use in Portugal.
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Affiliation(s)
- Helena Moreira
- Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3030-115, Coimbra, Portugal.
| | - Ana Fonseca
- Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive-Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3030-115, Coimbra, Portugal
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15
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Wendelboe KI, Smith-Nielsen J, Stuart AC, Luyten P, Skovgaard Væver M. Factor structure of the parental reflective functioning questionnaire and association with maternal postpartum depression and comorbid symptoms of psychopathology. PLoS One 2021; 16:e0254792. [PMID: 34339422 PMCID: PMC8328297 DOI: 10.1371/journal.pone.0254792] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 07/04/2021] [Indexed: 02/06/2023] Open
Abstract
Parental reflective functioning (PRF) refers to the parent’s capacity to envision mental states in the infant and in themselves as a parent, and to link such underlying mental process with behavior, which is important for parenting sensitivity and child socio-emotional development. Current findings have linked maternal postpartum depression to impaired reflective skills, imposing a risk on the developing mother–infant relationship, but findings are mixed, and studies have generally used extensive methods for investigating PRF. The present study examined the factor structure and measurement invariance of the Danish version of the 18-item self-report Parental Reflective Functioning Questionnaire (PRFQ) in a sample of mothers with and without diagnosed postpartum depression. Moreover, the association between PRF and maternal postpartum depression in mothers with and without comorbid symptoms of personality disorder and/or clinical levels of psychological distress was investigated. Participants included 423 mothers of infants aged 1–11 months. Confirmatory factor analysis supported a three-factor structure of the PRFQ; however, item loadings suggested that a 15-item version was a more accurate measure of PRF in mothers of infants. Multi-group factor analysis of the 15-item PRFQ infant version indicated measurement invariance among mothers with and without diagnosed postpartum depression. Multinomial logistic regression showed that impaired PRF was associated with maternal psychopathology, although only for mothers with postpartum depression combined with other symptoms of psychopathology. These results provide new evidence for the assessment of maternal self-reported reflective skills as measured by a modified infant version of the PRFQ, as well as a more nuanced understanding of how variance in symptomatology is associated with impaired PRF in mothers in the postpartum period in differing ways.
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Affiliation(s)
- Katrine I. Wendelboe
- Department of Psychology, Center for Early Intervention and Family Studies, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
| | - Johanne Smith-Nielsen
- Department of Psychology, Center for Early Intervention and Family Studies, University of Copenhagen, Copenhagen, Denmark
| | - Anne C. Stuart
- Department of Psychology, Center for Early Intervention and Family Studies, University of Copenhagen, Copenhagen, Denmark
| | - Patrick Luyten
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Mette Skovgaard Væver
- Department of Psychology, Center for Early Intervention and Family Studies, University of Copenhagen, Copenhagen, Denmark
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16
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Anis L, Perez G, Benzies KM, Ewashen C, Hart M, Letourneau N. Convergent Validity of Three Measures of Reflective Function: Parent Development Interview, Parental Reflective Function Questionnaire, and Reflective Function Questionnaire. Front Psychol 2020; 11:574719. [PMID: 33391088 PMCID: PMC7772143 DOI: 10.3389/fpsyg.2020.574719] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 11/10/2020] [Indexed: 12/03/2022] Open
Abstract
Reflective function (RF) is defined as an individual's ability to understand human behavior in terms of underlying mental states including thoughts, feelings, desires, beliefs, and intentions. More specifically, the capacity of parents to keep their child's mental states in mind is referred to as parental RF. RF has been linked to adult mental health and parental RF to children's mental health and development. The gold standard measure of RF is the interview-based Reflective Functioning Scale (RFS) applied to the Parent Development Interview (PDI) or Adult Attachment Interview (AAI), which while well validated, is time-and labor-intensive to administer. Given the increasing need for reliable, valid, and rapid RF assessment in wide-ranging settings, two alternative measures were considered including the Reflective Function Questionnaire (RFQ) and Parental Reflective Function Questionnaire (PRFQ). We determined the convergent validity of these measures in comparison with the PDI-rated RFS. A sample of mothers and fathers (n = 150) was drawn from a sub-study of the ongoing Alberta Pregnancy Outcomes and Nutrition (APrON) longitudinal cohort when their children were 42-60 months of age. Pearson correlations and multiple linear regression was conducted, followed by splitting the sample to compute Cohen's kappas measures of agreement. Two subscales of the PRFQ correlated significantly (p < 0.05) with the gold standard PDI-rated RFS, providing evidence for convergent validity. As a brief multidimensional measure of parental RF, the PRFQ offers an alternative for measurement of RF in large-scale studies of parental development and child health.
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Affiliation(s)
- Lubna Anis
- Faculty of Nursing, Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, AB, Canada
| | - Grace Perez
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | | | - Carol Ewashen
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada
| | - Martha Hart
- Faculty of Nursing, Cumming School of Medicine (Pediatrics and Psychiatry), University of Calgary, Calgary, AB, Canada
| | - Nicole Letourneau
- Faculty of Nursing, Cumming School of Medicine (Pediatrics and Psychiatry), University of Calgary, Calgary, AB, Canada
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