Parental Reflective Functioning Research Articles

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.

Parental reflective functioning in mothers and fathers of preschoolers: Associations with adult attachment and parenting behavior.

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.

Adoptive Parent-Child Interaction Quality During the COVID-19 Pandemic in Brazil

ABSTRACT This study presents findings derived from an investigation into parent-child interactions among Brazilian adoptive families conducted through online recording and analysis. Participating parents enrolled in an online Parental Training Program titled Adoption: Beginning of New Bonds, which emphasized parental reflective function. Data collection spanned from March to November 2021, coinciding with the isolation measures imposed by the COVID-19 pandemic in Brazil. The study aimed to delineate interaction patterns within the sampled group and assess whether any alterations occurred in these patterns pre- and post-program participation. The sample consisted of 23 adoptive parents who had adopted a child under the age of five from the public child welfare system. Video recordings of parent-child free play sessions were collected online both before and after program participation. Results indicated a significant difference in the proportion of parents demonstrating sensitivity toward their child, accompanied by a noticeable trend toward enhanced quality in child interaction with their caregivers. Furthermore, this study offers valuable insights for refining observational instruments within the context of adoption.

Offline and online parental mentalizing in mothers with symptoms of postpartum depression: Examining the association between self-reported parental reflective functioning and interactional mind-mindedness.

Mentalizing is, to a certain extent, considered context specific. However, research on the association between parents' abilities to reflect upon their infant's mental states outside social interaction (offline) versus during ongoing parent-infant interaction (online) is currently limited. This study investigated the association between self-reported offline and online mentalizing in a sample of primarily ethnically Danish mothers (N=142), with symptoms of postpartum depression, and their 1-11-month-old infants. Offline mentalizing was assessed with the Parental Reflective Functioning Questionnaire-Infant Version (PRFQ-I) and online mentalizing was assessed with interactional mind-mindedness. Ordinal logistic regressions showed that a higher score on the PRFQ-I prementalizing subscale was negatively related to number of overall mind-related comments and appropriate mind-related comments produced by mothers during interaction with their infant. Our results indicate partial overlaps between self-reported parental reflective functioning and mind-mindedness, that is, that particularly offline maladaptive mentalizing is associated with lower levels of mentalizing during interaction in mothers with symptoms of depression. Post-hoc examination of the interaction effect of postpartum depression showed that this association was only evident in mothers with medium to high levels of depression. Findings and implications are discussed.

Precursors and Effects of Self-reported Parental Reflective Functioning: Links to Parental Attachment Representations and Behavioral Sensitivity.

Parental reflective functioning is thought to provide a missing link between caregivers' own attachment histories and their ensuing parenting behaviors. The current study sought to extend research on this association involving 115 parents, both mothers and fathers, of 5-to-6-year-old preschoolers using the German version of the Parental Reflective Functioning Questionnaire (PRFQ). Our study was the first to combine Adult Attachment Interview classifications of parental attachment, behavioral observations of parental sensitivity and PRFQ ratings while drawing on a sizable father subsample. We found theoretically consistent significant relations between all measures, while our results particularly highlighted the role of dismissing attachment for decreases in parenting quality on both cognitive and behavioral levels as the dismissing status differentially affected specific components of self-reported parental reflective functioning and observed sensitivity. Interestingly, these patterns were largely comparable in mothers and fathers. Exploratory mediation analyses further suggested that decreased parental reflective functioning may partially mediate the relationship between parents' dismissing attachment and decreased parental sensitivity. Thus, for prevention and intervention programs targeting parental sensitivity and thus children's long term healthy mental development, the interplay between parental reflective functioning and parents' own attachment history emerges as a key mechanism. Finally, our study served as a further validation of the PRFQ given the caveat that the pre-mentalizing subscale may need further revision in the German version.

Emotional arousal and reflective functioning among parents participating in attachment-based family therapy for LGBTQ+ young adults and their nonaccepting parents

Objective Parents’ rejection of their LGBTQ + young adults can have a negative impact on their young adult’s psychological welfare, and on the young adult-parent relationship. Parents’ ability to reflect on their child’s pain and unmet needs is thought to evoke empathy and compassion, and reduce rejection. Empirical and clinical evidence suggest that parents’ level of reflective functioning (RF) is impacted by their level of emotional arousal (EA). This study examined the association between parents’ EA and RF within the context of attachment-based family therapy for nonaccepting parents and their LGBTQ+ young adults. Methods 43 therapy sessions drawn from six different cases were coded for parental RF and EA, based on 30-second segments. This generated a total of 343 observations for analyses. Results Hierarchal linear modeling revealed that parents’ level of RF was a function of their concomitant EA, with moderate levels of arousal predicting the highest RF levels. Conclusion Moderate EA may facilitate optimal parental reflective functioning. With nonaccepting parents, who typically present for treatment with high levels of maladaptive fear and shame, therapists would do well to assess their level of arousal and, when indicated, employ downregulating interventions before inviting them to reflect on their young adult’s experience and needs.

# 125 - - Maternal reflective functioning and attachment outcomes of an online s inging intervention for postnatal depression: SHAPER-PNDO, a s ingle-arm clinical trial

Parental reflective functioning (PRF), or mentalization, is critical for offspring development. Postnatal depression (PND) may negatively impact this ability, resulting into impairments in menta liza tion and reduced attachment to the child. The aim of present work is s tudying the effectiveness of 6-weeks online s inging interventions, Melodies for Mums (M4M), in improving PRF and attachment to the child in a group of mothers suffering from PND.37 mothers were recruited. Demographic characteristics were collected at base line. At base line, week 6, and week 32 PND was evaluated with the Edinburgh Postnatal Depression Scale (EPDS); mentalization was assessed using the Parental Reflective Functioning Questionnaire (PRFQ) focusing on pre-menta lizing (PM) subsca le; maternal attachment to the child eva lua ted with the Maternal Postnatal Attachment Scale (MPAS).Participants experienced s ignifica nt reductions in depression on the EPDS (16.6 ± 3.7 to 11.2 ± 5.3, p<.001, t (36) = 7.56, p <.001), showed a reduction of PM scores on the PRFQ (2.24 ± 0.66 to 1.86 ± 0.71, (t(34)=3.889, p<0.001)), and reported improvements in attachment scores on MPAS (66.89 ± 10.11 to 73.73 ± 7.57, t(33)= -3.735, p<0.001). Overall, there was a s ignificant effect of time across the s tudy, such that a total decline in EPDS (F(4,144) = 24.48, p <.001) and PM scores (F(2,148) = 13.315 (p<0.001), and increase of attachment scores (F(2,66) = 15.785 (p<0.001).Participating in M4M online may help mothers in reduction of depressive symptoms and also improve mentalization and bonding towards their infants.

The significance of parental mentalizing for four-year-old children's solitary pretend play.

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. 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. 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. 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'.

Infant carrying: Associations with parental reflective functioning, parental bonding and parental responses to infant crying.

Infant carrying may have beneficial effects on the parent-infant relationship but only limited research has been conducted in this area. Therefore, the main aim of the current study was to investigate whether infant carrying is associated with parental reflective functioning, parental bonding, and parental (emotional) and behavioral responses to infant crying, key elements within the parent-infant relationship, promoting infant development. Parents reporting high levels (N=389) of infant carrying (six times a week or daily) and parents reporting low levels (N=128) of infant carrying (less than once a week or not at all) who participated in an online survey about the developing parent-infant relationship in Germany were included in the present study. Standardized questionnaires were used to assess parental reflective functioning, parental bonding impairments, and emotional responses to infant crying. Further insensitive (non-responsive and hostile) behaviors in response to infant crying were assessed. Parents with high levels of infant carrying showed better parental reflective functioning, lower parental bonding problems, less negative emotions, and less insensitive behaviors in response to infant crying.

Listening to Infants and Parents: Observe, Reflect, and Embrace the Mess

ABSTRACT This paper offers an overview of infant observation, parental reflective functioning, and the repair theory of human development as they apply to clinical work with families with young children. Using vignettes from the author’s practice of pediatrics and early relational health, it reveals the power of playing in the uncertainty to facilitate moments of connection and healing.

What makes mothers feel competent? The relationship between parental reflective functioning, attachment style, parental competence, and stress

Adolescence is a time of changes; nevertheless, the mental health of adolescents' parents receives little attention. This study aimed to explore the relationship between parental mentalizing, attachment style, parental sense of competence, and stress among parents of adolescents. One hundred eighty-six mothers completed validated questionnaires measuring these constructs. We conducted a moderated mediation analysis with maternal attachment style as the independent variable. The dimensions of parental sense of competence, efficacy and satisfaction were chosen as the dependent variables, and stress was the moderator. The mediator was the certainty about the mental states (CMS) aspect of parental mentalizing. CMS mediated the relationships between dismissing attachment style, efficacy and satisfaction at low-stress levels. Our results suggest that in the case of the dismissing attachment style, besides the attachment style itself, mentalizing and stress levels are also important predictors of the parental sense of competence among mothers of adolescents.

Psychometric evaluation of the Parental Reflective Functioning Questionnaire in Polish mothers.

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.

Maternal psychological risk and the neural correlates of infant face processing: A latent profile analysis.

Maternal psychological factors, including anxiety, depression, and substance use, may negatively affect parenting. Previous works with mothers have often assessed each of these factors in isolation despite their frequent co-occurrence. Psychological factors have also been associated with neural processing of facial stimuli, specifically the amplitude (i.e., size) and latency (i.e., timing) of the face-specific N170 event-related potential. In the current study, 106 mothers completed measures assessing maternal psychological factors-anxiety, depression, and substance use. A latent profile analysis was used to identify profiles of psychological factors and assess profile associations with the N170 elicited by infant faces and with parental reflective functioning (PRF) as a measure related to caregiving. Two profiles (termed high and low psychological risk) were identified, with the higher risk profile associated with delayed N170 latency responses to infant faces. An exploratory analysis evidenced an indirect effect between the higher psychological risk profile and lower PRF through delayed N170 latency responses to infant faces. Taken together, maternal psychological risk across multiple indicators may together shape neural processing of infant faces, which may have downstream consequences for caregiving.

Parental guilt and children's internalizing and externalizing behavior: The moderating role of parental reflective functioning.

The immense responsibility inherent in parenthood makes feeling guilty highly prevalent among parents. Such feelings are natural, yet excessive guilt is related to depression and anxiety and could burden parents. Qualitative research suggested that guilt is predominant in parents whose children suffer from behavioral and emotional difficulties, making it necessary to quantify guilt and examine possible resilience factors that could alleviate the aversive aspects of it. In this study, we examined the association between children's externalizing and internalizing problems and different aspects of parental guilt, assessing whether parental reflective functioning (PRF) would moderate these associations. One hundred six parents of children aged 1.30-9.30 years were recruited from child daycare centers and community clinics. The Parent Development Interview was administered to measure PRF. Based on this interview, we created a new coding system, to quantify three aspects of parental guilt: intensity, reparation, and internal reaction to guilt. Children's difficulties as well as parents' depression and anxiety were assessed using validated self-report measures. We showed that children's difficulties were related to parental guilt, but only when levels of PRF were not high. Specifically, internalizing problems were related to greater intensity and negative internal reaction to guilt only when PRF was low or moderate, and externalizing problems were related to greater intensity of guilt only when PRF levels were low. These findings suggest that encouraging reflective functioning could reduce the burden of guilt. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A smartphone app effectively facilitates mothers' mind-mindedness: A randomized controlled trial.

The efficacy of a smartphone app intervention (BabyMind©) in facilitating mind-mindedness was investigated in a randomized controlled trial, assigning mothers and their 6-month-olds (N = 152; 72 girls, 146 White) to intervention or active control conditions. Mothers who had received the BabyMind© app intervention scored higher for appropriate (d = .61, 95% CI .28, .94) and lower for non-attuned (d = -.55, 95% CI -.92, -.18) mind-related comments at follow-up (age 12 months), compared with their control group counterparts. Adjusting for missing data did not alter this pattern of findings. Mothers' baseline parental reflective functioning did not moderate these relations. Results are discussed in terms of the benefits of early intervention and exploring the efficacy of the app in more diverse populations.

Adaptation and Reflection in the Transition to Parenthood for Women With Risk Factors for Early Parenting Difficulties Who Participated in the STAR Mums Program

The Supporting Transitions and Relationships (STAR Mums) program was developed in response to the clinical need for psychological intervention in pregnancy where mothers have risk factors for difficulties in the transition to parenthood. The program focuses on the developing relationship between the mother and the unborn child and aims to facilitate the normal psychological processes that are known to occur in pregnancy to prepare for the relationship with the infant and to reduce risk factors that may negatively impact this relationship. This article reports on interview data from the final follow-up of 12 high-risk participants at 12 to 14 weeks postpartum regarding their transition to parenthood and aspects of parental reflective function. These women presented with issues in developing their maternal identity and representation in the context of difficulties processing their own difficult childhood experiences. They also demonstrated some issues with limited reflective capacity in their understanding of their infant’s emotional world and experiences. Though there are ongoing issues for these women, they provided feedback that the STAR Mums program included valued discussion around the changes in both self and relationships involved in parenting that helped them to prepare for their experiences of early parenthood by supporting their wondering about the baby and the changes that this new relationship may bring for them as a parent.

What works for whom? Moderators in parental reflective functioning intervention

ABSTRACT The DUET program (a group intervention) aims to enhance parental reflective functioning (PRF). We examined whether pretreatment levels of key outcomes as well as individual parental and family-environment characteristics predicted improvement after intervention with the DUET program. One hundred forty-two parents (native Israelis; mean age = 34.84 years) of preschool children (n = 107; mean child age = 4.3 years; 53% female) were assessed before, after, and 6 months following the intervention. Results indicated significant associations between lower levels of key outcomes at the pretreatment assessment and greater improvement after treatment in PRF, child self-regulation, and child self-distraction strategies. Furthermore, two subgroups of families were uncovered based on individual parental and family-environment characteristics: low-distress and high-distress parents. Following intervention, the high-distress group showed greater improvement in parental sensitivity and child problem behavior, whereas the low-distress group reported greater improvement in locus of control. Clinical and future directions are discussed.

Encouraging Parental Reflective Functioning in Caring for the Adolescent Patient: Opportunities to Foster Connection

Parental reflective functioning is the capacity for parents to understand how their actions and those of their children are affected by both their thoughts and emotions. Strong reflective functioning skills can be especially helpful for families of adolescents, to build understanding and connection during a time of great developmental change. This article offers pediatricians ways that they can encourage and strengthen parental reflective functioning while providing anticipatory guidance and supporting families through times of conflict or stress. [ Pediatr Ann . 2023;52(11):e409–e412.]

The psychometric properties of the Hungarian Parental Reflective Functioning Questionnaire

ABSTRACT Parental reflective functioning refers to the ability of parents to understand their child as motivated by internal mental experiences such as thoughts and feelings. This study aimed to examine the factor structure of the Hungarian version of the Parental Reflective Functioning Questionnaire (PRFQ) and to assess its relationships with general reflective functioning (Certainty and Uncertainty), attachment dimensions (Confidence, Relationships as secondary, The need for approval, Discomfort with closeness, Preoccupation with relationships) and the perception of the child (Warmth and Invasiveness) among mothers of children up to five years of age. Two hundred sixty-three mothers completed the PRFQ and The Reflective Functioning Questionnaire, of which 201 mothers also completed the Mothers’ Object Relations Scale and The Attachment Style Questionnaire. Confirmatory factor analyses supported the three-factor solution. Cronbach’s alpha coefficients for Certainty about Mental States and Interest and Curiosity subscales were excellent, while it was lower for Pre-Mentalizing.

Опросник «Родительское рефлексивное функционирование»: адаптация на русскоязычной выборке

&lt;p style="text-align: justify;"&gt;Since parental reflective functioning is important for the upbringing and development of children, it attracts the attention of psychologists around the world and needs to be studied. To measure it, the Parental Reflective Functioning Questionnaire (PRFQ) is worked out, which is adapted and widely used in different countries, its psychometric properties were tested and interesting results were obtained. However, this questionnaire has not been adapted in Russia yet. That is why this research is aimed at adapting PRFQ for Russian-speaking sample, to testing its factor structure and psychometric properties. Data was collected from an online survey (2022-2023). The forms were filled out by 205 parents (38% of fathers) of children aged from 1 to 13 years. For all respondents, the survey included a socio-demographic questions and the PRFQ; 99 parents additionally completed the Questionnaire of Emotional Relations in Family (E. Zakharova), the Parental Attitude Questionnaire (A. Varga &amp;amp; V. Stolin) and the Parental Anxiety Scale (A. Prikhozhan). Factor analysis confirmed the three-factor structure of the PRFQ. Confirmatory factor analysis showed good correspondence with the data. The internal consistency of the PRFQ scales and emotional attitude towards the child, parental attitude and parental anxiety confirm the external validity of the questionnaire. The Parental Reflexive Functioning Questionnaire is a reliable, internally consistent and valid tool. Keywords. Parent Reflective Functioning, PRF, Parental Reflective Functioning Questionnaire, PRFQ, parental attitude. &lt;strong&gt; &lt;/strong&gt;&lt;/p&gt;