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.

Early psychosocial risk factors and postnatal parental reflective functioning.

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.

Translation and preliminary validation of a Korean version of the parental reflective functioning questionnaire.

This study aimed to explore the factor structure, reliability, and validity of a Korean translation of the Parental Reflective Functioning Questionnaire (PRFQ). The PRFQ consists of three subscales: prementalizing modes, certainty about mental states, and interest and curiosity in mental states. A convenience sample of 163 Korean parents completed the K-PRFQ. Exploratory factor analysis showed three factors mapped on to the original PRFQ factors, but items from the original prementalizing modes subscale clustered into two additional factors. Data from a subsample (n = 67) showed that the certainty about mental states and interest and curiosity in mental states subscales correlated positively with more optimal self-reported parenting. We discuss the validity of using the PRFQ in collectivistic cultures.

Este estudio se propuso explorar la estructura de factores, la confiabilidad y la validez de una traducción al coreano del Cuestionario de Funcionamiento de Reflexión del Progenitor (PRFO; Luyten, Mayes, Nijssens y Fonagy, 2017). El PRFQ consiste en tres escalas: Modos de Pre-mentalización, la Certeza acerca de estados mentales y el Interés y curiosidad por los estados mentales. Un conveniente grupo muestra de 163 progenitores coreanos completó el K-PRFQ. Los exploratorios análisis de factores mostraron tres factores identificados dentro de los factores del PRFQ original, sin embargo, temas de la sub-escala original de Modos de Pre-mentalización se agruparon en dos factores adicionales. Los datos provenientes de un sub-grupo muestra (n = 67) mostraron que la Certeza acerca de estados mentales y el Interés y curiosidad por los estados mentales se correlacionaron positivamente con una auto-reportada más óptima crianza. Discutimos la validez de usar el PRFQ en culturas colectivistas.

Cette étude s'est donné pour but d'explorer le facteur structure, fiabilité et validité d'une traduction coréenne du Questionnaire de Fonctionnement Réflexif Parental (PRFQ; Luyten, Mayes, Nijssens, & Fonagy, 2017). Le PRFQ consiste en trois sous-échelles: Modes pré-mentalisation, Certitude sur les états mentaux, et Intérêt et curiosité dans les états mentaux. Un échantillon de convenance de 163 parents coréens a rempli le K-PRFQ. Une analyse exploratoire de facteur a montré trois facteurs mappés sur les facteurs d'origine du PRFQl, mais des aspects de la sous-échelle des modes de pré-mentalisation se sont regroupés en deux facteurs de plus. Les données d'un sous-échantillon (n = 67) ont montré que la Certitude sur les états mentaux et les sous-échelles d'Intérêt et la curiosité dans les états mentaux étaient en corrélation positive avec un parentage auto-rapporté optimal. Nous avons discuté la validité de l'utilisation du PRFQ dans les cultures collectivistes.

Mind-mindedness versus mentalistic interpretations of behavior: Is mind-mindedness a relational construct?

Mind-mindedness is a measure of the tendency to represent significant others in internal state terms and is central to supportive parent-infant relationships. The two studies reported here explored whether mind-mindedness generalizes to representations of unknown individuals, using a novel task that assessed individual differences in adults' tendency to interpret others' behavior with reference to their internal states: the Unknown Mother-Infant Interaction Task (UMIIT). We compared UMIIT performance with measures of mind-mindedness from (a) adults' descriptions of close friends and partners (Study 1, N = 96) and (b) mothers' appropriate versus nonattuned comments on their infants' internal states (Study 2, N = 56). In line with the proposal that mind-mindedness is a relational construct, UMIIT performance was unrelated to mind-mindedness in both studies.

La consciente mentalidad es una medida que tiende a representar a quienes nos son importantes en términos de un estado interno y es esencial para las relaciones de mucho apoyo entre progenitores e infantes. Los dos estudios que se reportan aquí exploraron si la mentalidad consciente generaliza al punto de representar a individuos desconocidos, usando una novedosa tarea que evalúa las diferencias individuales en la tendencia de los adultos a interpretar la conducta de otros en función de sus estados mentales: El Trabajo de la Interacción Madre Desconocida-Infante (UMIIT). Comparamos la actuación de UMIIT con las medidas de mentalidad consciente de (a) descripciones de adultos sobre amigos cercanos y parejas (Estudio 1, N = 96), y (b) los comentarios apropiados de las madres versus sus no armonizados comentarios con respecto a los estados internos de sus infantes (Estudio 2, N = 56). Alineado con la propuesta de que la mentalidad consciente es un concepto de la relación, la actuación de UMIIT no estuvo relacionada con la mentalidad consciente en ninguno de los estudios.

L'esprit-qualité mentale (en anglais mind-mindedness) est une mesure de la tendance à représenter les personnes qui nous sont chères en des termes d'état interne. Elle est centrale aux relations parent-enfant positives. Les deux études dont on fait état ici ont exploré si l'esprit-qualité mentale généralise les représentations d'individus inconnus, en utilisant une tâche nouvelle qui a évalué les différences individuelles dans la tendance des adultes à interpréter le comportement des autres en référence à leurs états internes: la Tâche de Mère Inconnue-Interaction du Nourrisson (UMIIT en anglais, soit Unknown Mother-Infant Interaction Task). Nous avons comparé la performance UMIIT aux mesures de l'esprit-qualité mentale de (a) descriptions d'adultes de leurs amis proches et de leurs partenaires (Etude 1, N = 96) et (b) de commentaires appropriés par rapport à pas trop appropriés des mères sur les états internes de leurs nourrissons (Etude 2, N = 56). Conformément à la proposition selon laquelle l'esprit-qualité mentale est une construction relationnelle, la performance de l'UMIIT n'était pas liée à l'esprit-qualité mentale dans les deux études.

Exploring the relation between maternal mind-mindedness and children's symbolic play: A longitudinal study from 6 to 18 months.

Relations between mothers' mind-mindedness (appropriate attunement to their infants' internal states) at 6 and 12 months and infants' early symbolic play during infant-mother pretense at 12 and 18 months were investigated in a sample of 43 mothers and infants. Mothers' appropriate mind-related comments were associated with average level, length, complexity, and maturity level of symbolic play. Specific sub-categories of appropriate mind-related comments were identified as independent predictors of children's symbolic play. Appropriate comments about desires and cognitions at 6 months were associated with average level and length of episodes, as well as with maturity level of symbolic play at 12 months. Longitudinal stability in the appropriateness and content of mothers' mind-related comments was also investigated. The results are discussed in terms of the proposal that attunement to specific types of internal state should vary as a function of infant age in order to index mind-mindedness.

Mothers' Early Mind-Mindedness Predicts Educational Attainment in Socially and Economically Disadvantaged British Children.

Relations between mothers' mind-mindedness (appropriate and nonattuned mind-related comments) at 8 months (N = 206), and children's educational attainment at ages 7 (n = 158) and 11 (n = 156) were investigated in a British sample. Appropriate mind-related comments were positively correlated with reading and mathematics performance at both ages but only in the low-socioeconomic status (SES) group. Path analyses showed that in the low-SES group, appropriate mind-related comments directly predicted age-11 reading performance, with age-4 verbal ability mediating the relation between appropriate mind-related comments and age-7 reading. In contrast, maternal sensitivity and infant-mother attachment security did not predict children's educational attainment. These findings are discussed in terms of genetic and environmental contributions to reading and mathematics performance.

Origins of mother-child reminiscing style.

Maternal elaborative reminiscing supports preschool children's autobiographical memory, self-concept, and emotion understanding. What are the factors contributing to mothers' elaborative style of reminiscing? In a longitudinal community sample (n = 170 at the final data point), this study explored the role of maternal depression (8-44 months), maternal sensitivity and maternal mind-mindedness (8 months), as well as child factors of joint attention (15 months), attachment security (15 months), and language (26 months) for mother-child reminiscing about a positive (happy) and a negative (scared) event at 44 months. Mothers could be classed into two groups of low versus increasing depression from 8 to 44 months, yet maternal depression did not uniquely predict mother-child reminiscing after accounting for maternal sensitivity and other factors. Instead, maternal sensitivity, children's joint attention, and language uniquely predicted children's elaborations about the scared event at 44 months, and maternal sensitivity uniquely predicted mothers' elaborations about the scared event at 44 months. Mothers who are more sensitive in early interactions may later be better at engaging their children when reminiscing about negative emotions. These findings have implications for the design of interventions targeted at supporting mothers to engage in elaborative reminiscing with their preschool children.

Predisposing Factors for Elevated Restricted and Repetitive Behavior in Typically Developing Toddlers.

Little is known about the relation between levels of restricted and repetitive behavior (RRB) in infants and parent factors. The present study investigated maternal and psychosocial factors (depressive symptoms, socio-economic status, social support) and mother-infant engagement factors (mind-mindedness, sensitivity, and infant-mother attachment security) as predictors of children's RRB at age 26 months in a sample of 206 mothers and children. Maternal depressive symptoms predicted levels of sensory and motor repetitive behavior and rigid, routinized, and ritualistic repetitive behavior. Lower socioeconomic status also predicted independent variance in children's sensory and motor repetitive behavior. The relations between maternal depressive symptoms and both types of RRB were not mediated through observational measures of maternal sensitivity or mind-mindedness at 8 months, or attachment security at 15 months. The results are discussed in terms of whether stress regulation, self-stimulation, and genetic susceptibility can help explain the observed link between maternal depressive symptoms and RRB in the child.

Mother-Child Attachment From Infancy to the Preschool Years: Predicting Security and Stability.

Relations between maternal mind-mindedness (appropriate and nonattuned mind-related comments), children's age-2 perspective-taking abilities, and attachment security at 44 (n = 165) and 51 (n = 128) months were investigated. Nonattuned comments predicted insecure preschool attachment, via insecure 15-month attachment security (44-month attachment) and poorer age-2 perspective-taking abilities (51-month attachment). With regard to attachment stability, higher perspective-taking abilities distinguished the stable secure groups from (a) the stable insecure groups and (b) children who changed from secure to insecure (at trend level). These effects were independent of child gender, stressful life events, and socioeconomic status (SES). The contribution of these findings to our understanding of stability and change in attachment security from infancy to the preschool years is discussed.

How does restricted and repetitive behavior relate to language and cognition in typical development?

Relations between restricted and repetitive behavior at age 26 months and children's concurrent (N = 203) and later (n = 161) social cognition and language development were investigated. Restricted and repetitive behavior was assessed using two scales: sensory and motor repetitive behaviors and rigidity/routines/restricted interests. Language was assessed at ages 26 and 51 months; social cognition was assessed at ages 26 (symbolic play) and 51 and 61 months (theory of mind). Sensory and motor repetitive behavior was negatively related to children's (a) language performance at 26 and 51 months, (b) instructed symbolic play at 26 months, and (c) theory of mind performance at 51 and 61 months. Path analyses showed that children's sensory and motor repetitive behavior at age 26 months was related to lower receptive verbal ability and theory of mind at 51 months, which led to lower theory of mind at 61 months. Rigidity/routines/restricted interests at 26 months were unrelated to concurrent and later social cognition and language. These results are discussed in terms of the pathways via which sensory and motor repetitive behavior might impact negatively on development.

Proof of concept of a mind-mindedness intervention for mothers hospitalized for severe mental illness.

Studies 1 and 2 investigated how maternal severe mental illness (SMI) related to mothers' mind-mindedness (appropriate and nonattuned mind-related comments). Study 1 showed that mothers with SMI (n = 50) scored lower than psychologically well mothers for both appropriate and nonattuned comments, whereas mothers with SMI in Study 2 (n = 22) had elevated levels of nonattuned comments. Study 2 also tested the efficacy of a single-session video-feedback intervention to facilitate mind-mindedness in mothers with SMI. The intervention was associated with a decrease in nonattuned comments, such that on discharge, mothers did not differ from psychologically well controls. Study 3 assessed infant-mother attachment security in a small subset of intervention-group mothers from Study 2 (n = 9) and a separate group of standard care mothers (n = 30) at infant mean age 17.1 months (SD = 2.1). Infants whose mothers completed the intervention were more likely to be securely attached and less likely to be classified as insecure-disorganized than those of mothers who received standard care. We conclude that a single session of video-feedback to facilitate mind-mindedness in mothers with SMI may have benefits for mother-infant interaction into the second year of life.

Callous-unemotional traits and impulsivity: distinct longitudinal relations with mind-mindedness and understanding of others.

BACKGROUND: Problems in understanding other people's mental states may relate to distinct personality traits that are associated with early externalizing behavior. A distinction between theory of mind (ToM) and empathy has proven important in shedding light on the problems in understanding other minds encountered by children high on callous-unemotional (CU) traits and exhibiting impulsivity. The aim of this study was to investigate whether children's early ToM and emotion understanding abilities predicted CU traits and impulsivity at age 10. A further aim was to explore whether the quality of the parent-child relationship very early in the development indirectly or directly predicted the children's CU traits and impulsivity. METHOD: We examined whether ToM and empathy skills might differentially relate to personality traits associated with externalizing behaviors (i.e., impulsivity and CU traits). We examined these relations over time in a longitudinal cohort of 96 boys and girls using follow-back analyses, incorporating measures of maternal mind-mindedness (appropriate mind-related talk) to examine the possible role of parent-child interaction quality. RESULTS: Appropriate mind-related talk indirectly predicted CU traits (at age 10 years) via its effect on children's emotion understanding. ToM predicted impulsive/irresponsible traits, but ceased to be significant when controlling for externalizing behaviors. CONCLUSION: The present findings demonstrate that parents who remark appropriately on their infant's mental states may help the child to understand emotions and may mold an empathic understanding of others, thereby preventing CU traits.

Associations between intrusive thoughts, reality discrimination and hallucination-proneness in healthy young adults.

INTRODUCTION: People who experience intrusive thoughts are at increased risk of developing hallucinatory experiences, as are people who have weak reality discrimination skills. No study has yet examined whether these two factors interact to make a person especially prone to hallucinatory experiences. The present study examined this question in a non-clinical sample. METHODS: Participants were 160 students, who completed a reality discrimination task, as well as self-report measures of cannabis use, negative affect, intrusive thoughts and auditory hallucination-proneness. The possibility of an interaction between reality discrimination performance and level of intrusive thoughts was assessed using multiple regression. RESULTS: The number of reality discrimination errors and level of intrusive thoughts were independent predictors of hallucination-proneness. The reality discrimination errors × intrusive thoughts interaction term was significant, with participants who made many reality discrimination errors and reported high levels of intrusive thoughts being especially prone to hallucinatory experiences. CONCLUSIONS: Hallucinatory experiences are more likely to occur in people who report high levels of intrusive thoughts and have weak reality discrimination skills. If applicable to clinical samples, these findings suggest that improving patients' reality discrimination skills and reducing the number of intrusive thoughts they experience may reduce the frequency of hallucinatory experiences.

The roles of maternal mind-mindedness and infant security of attachment in predicting preschoolers' understanding of visual perspective taking and false belief.

This study is a follow-up to a previous study that examined two aspects of mother-child relationships-mothers' mind-mindedness and infant attachment security-in relation to toddlers' early manifestations of theory of mind understanding at 2 years of age. The current study aimed to assess the same two aspects of mother-child relationships in relation to children's (N=59) theory of mind performance at 4 years of age. Results of the current study confirmed and expanded on relations observed at 2 years. Mothers' use of appropriate mind-related comments specifically during toy-based free play at 12 months of age predicted preschoolers' understanding of false belief and Level 2 visual perspective taking over and above earlier perspective-taking abilities. Furthermore, more securely attached boys, but not girls, performed better on a task requiring Level 2 visual perspective taking. The similarity of results across the two time points suggests the reliability of associations among mothers' use of mind-related comments during toy-based play, boys' attachment security, and children's subsequent social understanding. The current results also suggest that maternal mind-mindedness may be most relevant to children's social cognition when assessed in toy-based play contexts.

Children with Imaginary Companions Focus on Mental Characteristics When Describing Their Real-Life Friends.

Relations between having an imaginary companion (IC) and (i) descriptions of a real-life friend, (ii) theory of mind performance, and (iii) reported prosocial behaviour and behavioural difficulties were investigated in a sample of 5-year-olds (N = 159). Children who had an IC were more likely than their peers without an IC to describe their best friends with reference to their mental characteristics, but IC status was unrelated to children's theory of mind performance and reported prosocial behaviour and behavioural difficulties. These findings are discussed in the context of the proposal that there is a competence-performance gap in children's mentalizing abilities. © 2014 The Authors. Infant and Child Development published by John Wiley & Sons Ltd.

Mind-mindedness and theory of mind: mediating roles of language and perspectival symbolic play.

Relations among indices of maternal mind-mindedness (appropriate and nonattuned mind-related comments) and children's: (a) internal state vocabulary and perspectival symbolic play at 26 months (N = 206), and (b) theory of mind (ToM) at 51 months (n = 161) were investigated. Appropriate comments were positively associated with ToM, but were unrelated to internal state language and perspectival symbolic play. Nonattuned comments were negatively correlated with internal state language and perspectival symbolic play, but were unrelated to ToM. Path analyses indicated that the best fit model assumed: (a) indirect links between nonattuned comments and ToM via children's perspectival symbolic play, (b) a direct link between appropriate comments and ToM, and (c) an indirect link between appropriate comments and ToM via children's concurrent receptive verbal ability.

Individual differences in children's private speech: the role of imaginary companions.

Relations between children's imaginary companion status and their engagement in private speech during free play were investigated in a socially diverse sample of 5-year-olds (N=148). Controlling for socioeconomic status, receptive verbal ability, total number of utterances, and duration of observation, there was a main effect of imaginary companion status on type of private speech. Children who had imaginary companions were more likely to engage in covert private speech compared with their peers who did not have imaginary companions. These results suggest that the private speech of children with imaginary companions is more internalized than that of their peers who do not have imaginary companions and that social engagement with imaginary beings may fulfill a similar role to social engagement with real-life partners in the developmental progression of private speech.

Sensitive attunement to infants' internal states: operationalizing the construct of mind-mindedness.

This paper focuses on caregiver sensitivity, its relation to mind-mindedness (caregivers' attunement to their infants' internal states), and how well both constructs predict infant attachment security. The seminal Baltimore research on sensitivity and its relation to attachment security is summarized, highlighting the conclusion that mothers in the insecure-resistant and insecure-avoidant categories could not be distinguished on the basis of sensitivity. The contrast between the complex, sophisticated construct detailed in the original studies and the broad-based nature of the sensitivity coding scale is discussed. This paper argues that we should return to Ainsworth, Bell, and Stayton's (1971, 1974) original emphasis on the caregiver's ability to perceive things from the child's point of view in defining a measure of the quality of early infant-caregiver interaction. This approach led to the development of the construct of mind-mindedness. There are two mind-mindedness indices: caregivers' tendency during infant-caregiver interaction to (a) comment appropriately on their infants' putative thoughts and feelings (appropriate mind-related comments), and (b) misread their infants' internal states (non-attuned mind-related comments). Both indices predict independent variance in infant-caregiver attachment security, and together can distinguish between the secure, avoidant, and resistant categories. The specific, multidimensional nature of mind-mindedness complements the global construct of sensitivity.

Verbal mediation of cognition in children with specific language impairment.

Private speech (PS) and inner speech (IS) are thought to be functionally important for children's and adults' cognition, but they have not been studied systematically in children with specific language impairment (SLI). Participants were 21 children with SLI (7-11 years, expressive or receptive verbal IQ ≤ 75, nonverbal IQ ≥ 84) and 21 age- and nonverbal IQ-matched controls. Participants completed three sets of Tower of London problems: one with no dual task (PS condition), one with articulatory suppression, and one while foot tapping (control condition). Participants also completed a digit span task. There was no group difference in the susceptibility of Tower of London performance to articulatory suppression, but the PS of the SLI group was less internalized than that of the controls on both tasks. The findings suggest that children with SLI experience a significant delay in the development of PS/IS, but that their PS/IS is effective for Tower of London performance in middle childhood. Findings are discussed with reference to the interpretation of the nonlinguistic deficits associated with SLI, and in terms of clinical implications.

Mind-Mindedness as a Multidimensional Construct: Appropriate and Nonattuned Mind-Related Comments Independently Predict Infant-Mother Attachment in a Socially Diverse Sample.

In a socially diverse sample of 206 infant-mother pairs, we investigated predictors of infants' attachment security at 15 months, with a particular emphasis on mothers' tendency to comment appropriately or in a non-attuned manner on their 8-month-olds' internal states (so-called mind-mindedness). Multinomial logistic regression analyses showed that higher scores for appropriate mind-related comments and lower scores for non-attuned mind-related comments distinguished secure-group mothers from their counterparts in the insecure-avoidant, insecure-resistant, and insecure-disorganized groups. Higher scores for appropriate mind-related comments and lower scores for non-attuned mind-related comments also independently predicted dichotomous organized/disorganized attachment. General maternal sensitivity predicted neither attachment security nor organization, although sensitivity was found to relate to dichotomous secure/insecure attachment specifically in the context of low socioeconomic status. The findings highlight how appropriate and non-attuned mind-related comments make independent contributions to attachment and suggest that mind-mindedness is best characterized as a multidimensional construct.