Abstract
In the last decade several studies have investigated the role of parental reflective functioning (RF), defined as the parental ability to understand his/her child’s mental states, on the child’s development. Herein, a narrative review on parental RF is presented aimed at (1) presenting an overview of the existing empirical studies, (2) pinpointing unrequited questions, and (3) identifying future research directions. Specifically, the current review focused on (a) the impact of parental RF on the quality of caregiving and the child’s attachment security, (b) the effect of parental RF on the child’s emotion regulation and the child’s RF, (c) maternal RF in women with a history of neglect and abuse, (d) the efficacy of mentalization-based clinical interventions, and (e) the recently developed Parental Reflective Questionnaire. The following terms “maternal RF,” “paternal RF,” “parental RF,” “parental mentalization,” “maternal mentalization,” and “paternal mentalization” were searched in titles, abstracts, and main texts using Medline, Web of Science, and Scopus databases. Next, a search in Mendeley was also conducted. Inclusion criteria comprised original articles if they refer to the RF Scale (Fonagy et al., 1998) and were published in an English language, peer-reviewed journal before July, 2016. According to exclusion criteria, dissertations, qualitative or theoretical papers, and chapters in books were not taken into account. The review includes 47 studies that, taken together, supported the notion that higher parental RF was associated with adequate caregiving and the child’s attachment security, whereas low maternal RF was found in mothers whose children suffered from anxiety disorders, impairment in emotion regulation, and externalizing behaviors. In addition, higher parental RF was associated with better mentalizing abilities in children. However, unexpected findings have emerged from the most recent randomized controlled trials that tested the efficacy of mentalization-based interventions in high risk samples of mothers, raising questions about the suitability of the verbal measures in capturing the mentalizing processes at the root of the parental capacity to be adequately responsive to the child’s emotional needs.
Highlights
The Development of the Construct of Parental Reflective FunctioningThe construct of reflective functioning emerged more than 20 years ago in an area of psychoanalysis close to the attachment theory that is essentially concerned with the intergenerational transmission of attachment security
We reviewed studies in which parental reflective functioning was measured through the Reflective Functioning Scale (RFS), applied to Attachment Interview (AAI), Parent Development Interview (PDI), Pregnancy Interview (PI), and Working Model of the Child Interview (WMCI)
Slade et al (2005) found that mothers who were classified as secure on AAI during pregnancy had a higher level of reflective functioning on PDI-RF when the child was 10 months old, and that the children of reflective mothers were more frequently assessed as secure by the Strange Situation procedure (Ainsworth et al, 1978) when they were 14 months old
Summary
The Development of the Construct of Parental Reflective FunctioningThe construct of reflective functioning emerged more than 20 years ago in an area of psychoanalysis close to the attachment theory that is essentially concerned with the intergenerational transmission of attachment security. It was hypothesized that the parental capacity to see the child as a psychological entity with a mental experience, as well as to attune with the child’s mental states played a central role in parenting, contributing to the development of child attachment security. To test their hypothesis, Fonagy et al (1991a) developed a scale to assess the parent’s capacity to understand mental states. It was based on the hypothesis that the capacity to make sense of one’s own personal history in terms of mental states could promote attachment security, which in turn enables the parent to transmit it to her/his child. The maternal ability to understand her child’s mental states would be crucial to allow him/her in turn to develop the same capacity
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