Parental Reflective Functioning on the Parent Development Interview: A narrative review of measurement, association, and future directions

A caregiver's capacity to mentalize is thought to be one of the most important features of secure parent-child relationships. Parental mentalizing can be measured using the Reflective Functioning (RF) coding system applied to the Parent Development Interview (PDI). In this narrative review, we summarize the research using this measure and synthesize what has been learnt about the predictors, correlates and sequelae of parental RF. Studies have consistently shown that PRF on the PDI is associated with both parent and child attachment and is an important factor in the intergenerational transmission of attachment. It is also related to the quality of parental representations, parent-child interactions, and child outcomes. While a number of social and clinical risk factors are associated with lower PRF, it is difficult to disentangle the unique contribution of each of these. We discuss these findings and present the direction of future work that is planned to expand and refine the PRF scale for the PDI.

Relationships between mothers and children in families formed by shared biological motherhood

STUDY QUESTION

Does shared biological motherhood, in which a woman gives birth to the genetic child of her female partner, result in more positive mother-child relationships than donor insemination, in which only one mother is biologically related to the child?

SUMMARY ANSWER

Mothers in both family types showed high levels of bonding with their children and viewed their relationship with their child positively.

WHAT IS KNOWN ALREADY

There is some evidence of feelings of inequality regarding their relationship with their child between biological and non-biological mothers in lesbian mother families formed by donor insemination, with a qualitative longitudinal study showing a tendency for children to form stronger bonds with their biological than their non-biological mother.

STUDY DESIGN, SIZE, DURATION

Thirty lesbian mother families created through shared biological motherhood were compared with 30 lesbian mother families formed by donor-IVF. All families had two mothers who both participated in the study, and the children were aged from infancy up to 8 years old. Data collection took place over 20 months beginning in December 2019.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Each mother in the family was interviewed separately using the Parent Development Interview (PDI), a reliable and valid measure of the nature of the parent's emotional bond with their child. The interviews were transcribed verbatim and coded separately by one of two trained researchers who were unaware of the child's family type. The interview produces 13 variables that relate to the parent's representations of themselves as a parent, 5 variables that relate to the parent's representations of the child, and a global variable that assesses the extent to which the parent can reflect on the child and their relationship.

MAIN RESULTS AND THE ROLE OF CHANCE

Families formed through shared biological parenthood did not differ from families created by donor-IVF in terms of the quality of mothers' relationships with their children as assessed by the PDI. Neither were differences identified between birth mothers and non-birth mothers across the entire sample, or between gestational and genetic mothers within the families formed by shared biological parenthood. Multivariate analyses were conducted to minimize the role of chance.

LIMITATIONS, REASONS FOR CAUTION

Ideally, larger samples of families and a narrower age range of children would have been studied, but this was not possible as we were reliant on the small number of families formed through shared biological motherhood in the UK when the study began. To maintain the anonymity of the families, it was not possible to request information from the clinic that may have shed light on differences between those who responded to the request to participate and those who did not.

WIDER IMPLICATIONS OF THE FINDINGS

The findings show that shared biological motherhood is a positive option for lesbian couples who wish to have a more equal biological relationship to their children. One type of biological connection does not appear to have a greater influence on the quality of parent-child relationships than the other.

STUDY FUNDING/COMPETING INTEREST(S)

This study was funded by the Economic and Social Research Council (ESRC) grant ES/S001611/1. KA is Director, and NM is Medical Director, of the London Women's Clinic. The remaining authors have no conflicts of interest to declare.

TRIAL REGISTRATION NUMBER

N/A.

The assessment of representational risk (ARR): Development and psychometric properties of a new coding system for assessing risk in the parent-infant relationship

There are few clinically valid tools that can be used to assess potential parent-infant relational risk. This study describes the development and initial validation of the assessment of representational risk (ARR) coding system to be applied to the parent development interview (Slade, A., Aber, J. L., Bresgi, I., Berger, B., & Kaplan, M. (2004). The Parent Development Interview - Revised. Unpublished protocol. New York, NY: The City University of New York.) for assessing potential risk in caregivers' representations of their infant, themselves as parents, and their relationship. The ARR was developed and validated in three samples in England. A review of the literature informed the selection of 10 items. It had a three-factor structure that was used to inform subscales: hostile, helpless, and narcissistic caregiving representations. The subscales and total risk scores showed good criterion validity for discriminating between high and low risk samples and good concurrent validity with measures of parental psychopathology and parent-infant interaction. The ARR is a potentially valuable coding system for identifying risk in early attachment relationships.

Reflective Functioning on the Parent Development Interview: validity and reliability in relation to socio-demographic factors

The Reflective Functioning coding of the Parent Development Interview (PDI-RF) is a widely used method for assessing a caregivers' capacity for mentalization. However, little is known about its psychometric properties.The aim of this study was to examine the distributions and discriminant and criterion validity of the PDI-RF scale in relation to a number of demographic and socioeconomic factors.Mothers of infants and toddlers (N = 323) from low, medium, and high-risk samples were interviewed with the PDI and transcripts were coded for RF. Demographic and socio-economic data were recorded.The PDI-RF scale showed high inter-rater reliability, internal consistency, and criterion validity. Modest associations with some sociodemographic variables and PDI-RF were found, but together these only accounted for a small amount of variance in the measure, suggesting adequate discriminant validity. Overall, the scale had good psychometric properties, although some caveats for its use were identified.