Measuring mentalizing in youth: further validation of the reflective functioning questionnaire for youth (RFQY-13)

Validation of the Three-Factor Reflective Functioning Questionnaire for Youth in a Chinese Adolescent Sample

Purpose

This study focused on the validation of the Three-Factor Reflective Functioning Questionnaire for Youth(RFQY) within a sample of Chinese adolescents.

Patients and Methods

All the items of the RFQY were translated into Chinese language through the process of translation and back translation. A total of 532 adolescents aged between 12-20 years completed the Chinese version of RFQY, McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD), Basic Empathy Scale (BES), and the 20-item Toronto Alexithymia Scale (TAS-20).

Results

Twenty items meeting psychometric standards were retained in the Chinese version of the RFQY. The indices for confirmatory factor analysis, including χ2/df (2.354), SRMR (0.053), GFI (0.930), CFI (0.921), TLI (0.910), and RMSEA (0.050), all conformed to the requirements of psychometrics. The Cronbach's alpha coefficients for the three factors, "uncertainty/confusion", "interest/curiosity", and "excessive certainty", were 0.820, 0.673, and 0.839, respectively, with test-retest reliability scores of 0.751, 0.643, and 0.764. A significant positive correlation was found between uncertainty/confusion and symptoms of borderline personality disorder (BPD), particularly in adolescents with high BPD traits. Excessive certainty was positively correlated with unstable interpersonal relationships, while the interest/curiosity factor shows no significant correlation with BPD symptoms. The uncertainty/confusion factor demonstrates a complex relationship with empathy, correlating positively with affective empathy but negatively with cognitive empathy. The uncertainty/confusion factor shows a significant positive correlation with alexithymia, while the factor of excessive certainty demonstrates the opposite effect. Additionally, a significant negative correlation exists between the interest/curiosity factor and the externally oriented thinking.

Conclusion

This study validates the Chinese version of the Reflective Functioning Questionnaire for Youth (RFQY), demonstrating its reliability and validity in assessing reflective functioning among Chinese adolescents. This enhances the understanding of reflective functioning and its role in adolescent mental health.

Different epistemic stances for different traumatic experiences: implications for mentalization

Traumatic experiences may impair reflective functioning (RF), making it difficult for individuals to understand their own and others' mental states. Epistemic trust (ET), which enables evaluating social information as reliable and relevant, may vary in association with RF. In this study, we explored the implications of different ET stances (i.e., trust, mistrust, and credulity) in the relation between different childhood traumatic experiences (i.e., emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect) and different types of RF impairments (uncertainty and certainty about mental states). A non-clinical community sample of 496 cisgender emerging adults (mage = 24.91, standard deviation = 2.66, 71.85% assigned female at birth, 63.63% heterosexual) reported on their childhood traumatic experiences, ET, and RF. We used structural equation models to examine direct and indirect associations. The results showed significant indirect effects between emotional abuse and uncertainty about mental states through credibility. We also observed significant indirect effects between emotional abuse and certainty about mental states through mistrust and credibility. The findings suggest that a lack of discrimination when evaluating knowledge from others (i.e., credulity) might promote increased uncertainty in RF when emerging adults have experienced emotional abuse in their childhood. Conversely, a tendency to view all information sources as unreliable or ill-intentioned (i.e., mistrust) may foster greater certainty in RF as a protective mechanism against an unreliable and potentially harmful world when combined with childhood emotional abuse. The implications for clinical practice and intervention are discussed.