The mediating role of reflective functioning and general psychopathology in the relationship between childhood conduct disorder and adult aggression among offenders.

BACKGROUND: The nature of the pathway from conduct disorder (CD) in adolescence to antisocial behavior in adulthood has been debated and the role of certain mediators remains unclear. One perspective is that CD forms part of a general psychopathology dimension, playing a central role in the developmental trajectory. Impairment in reflective functioning (RF), i.e., the capacity to understand one's own and others' mental states, may relate to CD, psychopathology, and aggression. Here, we characterized the structure of psychopathology in adult male-offenders and its role, along with RF, in mediating the relationship between CD in their adolescence and current aggression. METHODS: A secondary analysis of pre-treatment data from 313 probation-supervised offenders was conducted, and measures of CD symptoms, general and specific psychopathology factors, RF, and aggression were evaluated through clinical interviews and questionnaires. RESULTS: Confirmatory factor analyses indicated that a bifactor model best fitted the sample's psychopathology structure, including a general psychopathology factor (p factor) and five specific factors: internalizing, disinhibition, detachment, antagonism, and psychoticism. The structure of RF was fitted to the data using a one-factor model. According to our mediation model, CD significantly predicted the p factor, which was positively linked to RF impairments, resulting in increased aggression. CONCLUSIONS: These findings highlight the critical role of a transdiagnostic approach provided by RF and general psychopathology in explaining the link between CD and aggression. Furthermore, they underscore the potential utility of treatments focusing on RF, such as mentalization-based treatment, in mitigating aggression in offenders with diverse psychopathologies.

Resolving trauma: The unique contribution of trauma-specific mentalization to maternal insightfulness.

Resolving trauma may contribute to mental health and parenting in mother with histories of childhood maltreatment. The concept of trauma-specific reflective functioning (T-RF) was developed to assess the complexity of thought processes regarding trauma. The study aimed to validate the T-RF scale applied to the Trauma Meaning-Making Interview by examining its psychometric properties, associations with measures of trauma-processing strategies, maternal reflective functioning and mental health (depression and post-traumatic stress disorder [PTSD]), as well as evaluating whether T-RF offered a unique contribution to maternal insightfulness. Good construct validity of the T-RF scale was confirmed in a sample of 112 mothers with histories of childhood maltreatment using an independent coding system of trauma-processing. Better mentalization of trauma was prospectively associated with higher parental reflective functioning and mothers with high T-RF were much more likely to be insightful regarding the child's mental states than non-reflective mothers and mothers with limited T-RF. The association between T-RF and insightfulness was observed even when controlling for maternal reflective functioning, trauma-processing strategies, maternal education and sociodemographic risk. T-RF was associated neither with depression, PTSD nor the characteristics of trauma. Findings suggest that mentalizing trauma would be an important protective factor in the intergenerational trajectories of trauma.

Characterizing the heterogeneity of disruptions in the resolution of trauma among women exposed to childhood maltreatment.

The previously observed heterogeneity in developmental and intergenerational trajectories of childhood trauma may root from interindividual differences in the way trauma-exposed individuals have resolved these experiences. The current study explored whether distinctive patterns of impaired mentalization in relation to trauma could be identified in a sample of 825 pregnant women who experienced childhood maltreatment and whether these heterogeneous patterns were marked by significant differences in internalized and externalized problems during pregnancy, intimate partner violence, personality dysfunctions, and antenatal attachment. A latent profile analysis applied to the seven subscales of the Failure to Mentalize Trauma Questionnaire unraveled interindividual variability in mentalizing impairments among pregnant women exposed to childhood maltreatment by identifying five distinctive types of psychological responses to trauma, each being associated in cross-sectional analyses with a specific set of symptoms and dysfunctions. Overall, the study highlights the need for tailored interventions based on the individuals' specific impairments in mentalizing trauma and calls for future developmental research exploring the longitudinal correlates of the five documented profiles of trauma processing.

A multifaceted approach to assessment of mentalization: the mentalization profile in patients with eating disorders.

Purpose: The existing literature, however sparse, suggests an association between eating disorders (ED) and mentalization ability. The aim of this study was to investigate the mentalization profile (MP) in patients with ED. It was hypothesized that patients with ED would have a lower degree of mentalization ability compared to healthy controls (HC).Materials and methods: The study is based on a cross-sectional survey on a sample of patients diagnosed with ED compared to a HC group.Results and conclusion: A total of 88 participants, distributed between patients with ED (N = 30) and HC (N = 58) were included.Results: The study results show statistically significant differences between patients with ED and HC. Thus, patients with an ED scored significantly higher on Reflective Functioning Questionnaire (uncertainty about mental states) (RFQ-U) (mean difference: 0.31, p = 0.048) and Toronto Alexithymia Scale (TAS-20) (mean difference: 0.44, p = 0.019) compared to the HC. Furthermore, the results indicated that patients with Bulimia Nervosa (BN) may have a lower ability to mentalize about oneself as well as a generally lower ability to mentalize across different dimensions of the mentalization profile as the BN group scored significantly higher on RFQ-U (mean difference: 0.71, p = 0.023) and TAS-20 (mean difference: 0.89, p = 0.006) compared to the Anorexia Nervosa (AN) group. Further research should be conducted to gain knowledge on the mentalization ability in patients with an ED.

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.

Adverse childhood experiences and psychological maladjustment in adolescence: The protective role of epistemic trust, mentalized affectivity, and reflective functioning.

INTRODUCTION: Adverse childhood experiences (ACEs) are psychosocial factors acknowledged as significant contributors to health consequences later in adolescence, including psychological maladjustment. The research suggests that, at a transdiagnostic and transtheoretical level, working on restoring epistemic trust (ET), mentalized affectivity (MA), and reflective functioning (RF) in adolescents with ACEs assumes a central role in the therapeutic process. However, there are still few studies that attempted to investigate the specific role of these sociocognitive factors in the detrimental positive association between levels of experienced ACEs during childhood and psychological maladjustment in nonclinical adolescents. METHODS: A community sample of 306 Italian cisgender adolescents (61.4% assigned females at birth; age range 13-19 years old; Mage = 16.1, SD = 1.64) self-reported ACEs (Childhood Trauma Questionnaire-Short Form), psychological maladjustment (Strengths and Difficulties Questionnaire), ET (Epistemic Trust, Mistrust and Credulity Questionnaire), MA (Brief-Mentalized Affectivity Scale for Adolescence), and RF (Reflective Functioning Questionnaire). A multiple mediation regression analysis has been performed to explore the association between ACEs and psychological maladjustment through the interaction with socio-cognitive factors. RESULTS: ACEs are positive predictors of psychological maladjustment later in adolescence. Regardless of gender differences, epistemic mistrust and credulity, processing and expressing emotions, and uncertainty about mental states mediated this association, while epistemic trust, identifying emotions, and certainty about mental states did not configure as significant mediators. CONCLUSION: Findings suggest that ET disruptions and deficits in RF are risk factors, while MA is a protective factor within the link between ACEs and psychological maladjustment in adolescence. These links help to specify the role of sociocognitive factors in the development of mental problems in adolescents who have been exposed to adverse experiences in childhood.

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.

Spillover effects on the relationship with the partner of a mentalization-based intervention for pregnant women.

The birth of a child has been associated with a decline in couple satisfaction, which has implications for the child's social-emotional development. This study investigated the potential spillover effect on pregnant women's perceptions of their relationships with their partners of the Supporting the Transition to and Engagement in Parenthood (STEP) program, a brief trauma-informed mentalization-based prenatal group intervention. Participants (94% White) were recruited in prenatal clinics and through online advertisements in Quebec, Canada. Both quantitative and qualitative data were collected from participants assigned to the STEP program (n = 42) and those receiving treatment-as-usual (TAU; n = 125). Women participating in STEP reported significant improvements in their relationships with their partners compared to those assigned to TAU. More precisely, they reported higher couple satisfaction, enhanced communication, and increased interest in their partners' emotional experience. The qualitative analysis further substantiated these results, with participants reporting having involved their partners in their pregnancy, shared their insights about themselves with their partners and gained fresh perspectives on their relationships. Participants in STEP also expressed sharing program materials with their partners and considered that such interventions should be extended to expecting fathers. This study underscores the potential of mentalization-based interventions to indirectly contribute to couple relationships, which may have positive implications for parenting and the infant.

Se ha asociado el nacimiento de un niño con una disminución en la satisfacción de la pareja, lo cual tiene implicaciones para el desarrollo socioemocional del niño. Este estudio investigó el potencial efecto derrame en las relaciones de mujeres embarazadas con sus parejas, del programa STEP, un grupo prenatal de intervención breve, informado sobre el trauma y con base en la mentalización. A las participantes (94% blancos) se les reclutó en clínicas prenatales y por medio de anuncios en línea en Quebec, Canadá. Se recogió información tanto cuantitativa como cualitativa de las participantes asignadas al programa STEP (n = 42) y de aquellas que recibían tratamiento como de costumbre (TAU; n = 125). Las mujeres que participaban en STEP reportaron significativas mejoras en las relaciones con sus parejas comparadas con aquellas asignadas al grupo TAU. Más precisamente, ellas reportaron una más alta satisfacción de acoplamiento, una mejorada comunicación y un aumento en el interés en la experiencia emocional de sus parejas. Los análisis cualitativos sustentaron además estos resultados, con reportes de las participantes de haber hecho a sus parejas partícipes en el embarazo, compartido su sentir acerca de sí mismas con sus parejas y haber adquirido perspectivas renovadas acerca de sus relaciones. Las participantes en STEP también expresaron que habían compartido materiales del programa con sus parejas y considerado que tales intervenciones deben extenderse a los papás que esperan un hijo. Este estudio subraya la potencialidad de las intervenciones con base en la mentalización para contribuir indirectamente a las relaciones de pareja, lo cual pudiera tener implicaciones positivas para la crianza y el infante.

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.

Se considera, hasta cierto punto, que la mentalización se corresponde con un contexto específico. Sin embargo, la investigación acerca de la asociación entre las habilidades de los padres de reflexionar sobre los estados mentales de sus infantes fuera de la interacción social (no conectada a la internet / fuera de línea) versus la continua interacción progenitor­infante (en línea) es actualmente limitada. Este estudio investigó la asociación entre la auto­reportada mentalización tanto fuera de línea como en línea en un grupo muestra primariamente de madres étnicamente danesas (N = 142), con síntomas de depresión posterior al parto, y sus infantes de 1 a 11 meses de edad. La mentalización fuera de línea se evaluó por medio del Cuestionario del Funcionamiento con Reflexión del Progenitor ­ Versión del Infante (PRFQ­I) y la mentalización en línea se evaluó con el sistema de codificación de Conciencia Mental. La regresión logística ordinal mostró que un puntaje más alto en la sub­escala de pre­mentalización del PRFQ­I se asoció negativamente con el número en general de comentarios relacionados con la mente y de apropiados comentarios relacionados con la mente producidos por las madres durante la interacción con sus infantes. Nuestros resultados indican que hay superposiciones coincidentes parciales entre el funcionamiento con reflexión auto­reportado por el progenitor y la conciencia mental, v.g. que particularmente la mentalización fuera de línea inadaptada se asocia con una conciencia mental en línea menos óptima en madres con síntomas de depresión. Las posteriores examinaciones que el efecto de la interacción de la Escala de Depresión Postnatal de Edimburgo (EPDS) tiene sobre la asociación mostraron que esta característica sólo fue evidente en madres con niveles medianos a altos de depresión. Se discuten los resultados y las implicaciones.

La mentalisation est, dans une certaine mesure, considérée comme étant spécifique au contexte. Cependant les recherches sur le lien entre les capacités des parents à réfléchir sur les états mentaux de leur bébé en dehors de l'interaction sociale (hors connexion) par rapport à l'interaction continue parent­bébé (en ligne) sont en ce moment limitées. Cette étude s'est penchée sur le lien entre la mentalisation auto­déclarée hors connexion et en ligne chez un échantillon de mères en grande partie danoises (N = 142), avec des symptômes de dépression postpartum et leurs bébés âgés de 1 à 11 mois. La mentalisation hors connexion a été évaluée au moyen du Questionnaire de la Fonction Réflexive Parentale ­ Version Nourrisson (en anglais PRFQ­I) et la mentalisation en ligne a été évaluée au moyen du système de codage esprit­sensibilité. Des régressions logistiques ordinales ont montré qu'un score plus élevé à la sous­échelle PRFQ­I était lié de manière négative au nombre de commentaires généraux liés à l'esprit et à des commentaires liés à l'esprit appropriés produits par les mères durant l'interaction avec leur bébé. Nos résultats indiquent des chevauchement spartiels entre la fonction réflexive parentale auto­rapportée et la sensibilité, c'est­à­dire que la mentalisation inadaptée en particulier hors­connexion est liée à une sensibilité moins qu'optimale chez les mères avec des symptômes de dépression. L'examen a posteriori des effets de l'interaction de l'EPDS sur ce lien a montré que cela n'était que vrai chez les mères avec des niveaux de dépression de moyens à élevés. Les résultats et implications sont discutés.

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.

Cargar al infante pudiera tener efectos beneficiosos para la relación progenitor­infante, pero sólo una limitada investigación se ha llevado a cabo en esta área. Por tanto, el objetivo principal del presente estudio fue investigar si cargar al infante se asocia con que el funcionamiento con reflexión del progenitor, los lazos de afectividad del progenitor, así como las respuestas de comportamiento (emocional) del progenitor al llanto del infante, elementos claves dentro de la relación progenitor­infante, promueven el desarrollo del infante. Se incluyó en el presente estudio a los progenitores que reportaron altos niveles (N=389) de llanto del infante (seis veces por semana o diariamente) y a los progenitores que reportaron bajos niveles (N=128) del llanto del infante (menos de una vez por semana o nunca), quienes participaron en una encuesta electrónica acerca de la relación progenitor­infante en desarrollo, en Alemania. Se usaron cuestionarios estandarizados para evaluar el funcionamiento con reflexión del progenitor, los impedimentos de lazos afectivos del progenitor, así como las respuestas emocionales al llanto del infante. Se evaluaron además comportamientos insensibles (sin respuesta afectiva y hostil) como respuesta al llanto del infante. Los progenitores con altos niveles de cargar al infante demostraron un mejor funcionamiento con reflexión del progenitor, más bajos problemas en cuanto a lazos de afectividad del progenitor, menos emociones negativas y menos comportamientos insensibles como respuesta al llanto del infante.

Porter un bébé peut avoir des effets bénéfiques sur la relation parent­bébé mais il n'existe que peu de recherches sur ce domaine. C'est pour cette raison que le but principal de cette étude était d'investiguer si le fait de porter un bébé est lié avec une fonction réflexive parentale, le lien parental et les réactions parentales (émotionnelles) et comportementales aux pleurs du bébé, des éléments clef au sein de la relation parent­bébé, promouvant le développement du bébé. Les parents faisant état de niveaux élevés (N=389) de portage du bébé (six fois par semaine ou tous les jours) et les parents faisant état de niveaux bas (N=128) de portage du bébé (moins d'une semaine ou pas du tout) qui ont participé à un questionnaire en ligne sur la relation parent­bébé se développant en Allemagne ont été inclus dans cette étude. Des questionnaires standardisés ont été utilisés afin d'évaluer la fonction réflexive parentale, les troubles du lien parental, et les réactions émotionnelles aux pleurs du bébé. D'autres comportement insensibles (non­réactifs et hostile) en réaction aux pleurs du bébé ont été évalués. Les parents avec des niveaux élevés de portage du bébé ont fait preuve d'une meilleure fonction réflexive parentale, de moins de problèmes de lien parental, de moins d'émotions négatives, et de moins de comportements insensibles en réaction aux pleurs du bébé.

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.

Se piensa que la capacidad que tiene una persona que presta el cuidado para mentalizarse es una de las más importantes características de una segura relación entre progenitor y niño. La mentalización del progenitor se puede medir usando el sistema de codificación del Funcionamiento con Reflexión (RF) aplicado a la Entrevista de Desarrollo al Progenitor (PDI; Slade et al., 2004a; 2004b). En esta revisión narrativa, resumimos la investigación usando esta medida y sintetizamos lo que se ha aprendido acerca de los factores de predicción, las correlaciones y secuelas del RF del progenitor. Los estudios han mostrado consistentemente que el RF del progenitor (PRF) en la PDI se asocia tanto con la afectividad del progenitor como con la del niño y es un factor importante en la transmisión intergeneracional de la afectividad. También está relacionado con la calidad de las representaciones del progenitor, las interacciones progenitor­niño y los resultados en el niño. Mientras que un número de factores de riesgo sociales y clínicos se asocia con un PRF más bajo, es difícil desentrañar las contribuciones únicas de cada uno de estos aspectos. Discutimos estos resultados y presentamos la dirección del trabajo futuro que se planea para expandir y refinar la escala del PRF para la PDI.

Within- and between-session changes of in-session reflective functioning of mothers in dyadic parent-infant psychotherapy.

This study investigated if in-session reflective functioning (RF) of mothers improved between and within sessions of brief dyadic focused parent-infant psychotherapy (fPIP) for the treatment of regulatory disorders in infants.In-session RF was coded for 44 therapy sessions from N = 11 mothers randomly selected from a RCT on the efficacy of fPIP as part of secondary analyses. A new rating system distinguished self-focused and child-focused in-session RF. Cumulative ordinal regression models were applied to analyze the dynamics of in-session RF within and across sessions, controlling for word count of each statement.While in-session RF improved significantly within sessions, between-session RF improved significantly only in the second session compared to the first with a significant decrease observed in the last session. Child-focused in-session RF was significantly lower than self-focused in-session RF at the beginning of the sessions but improved significantly stronger than self-focused in-session RF during sessions.In-session RF (particularly in child-focused statements) can be regarded as a dynamic change process relevant within each session of dyadic fPIP. Improvements made on a session-by-session basis may not be maintained until the next session. Implications for practitioners and in-session RF research are discussed.

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.

Reflective Functioning and Financial Exploitation Vulnerability in Older Adults: The Importance of Significant Others.

OBJECTIVES: Financial exploitation of older adults results in devastating economic, social, and psychological losses to older adults, their families, and society at large. This study examined the relationship between reflective functioning and financial exploitation vulnerability (FEV) and whether relationship status moderated the association. METHODS: A community-based sample of 156 Israeli older adults age 60 and over responded to demographic questions and questionnaires assessing reflective functioning and FEV. RESULTS: A hierarchical linear regression analysis covarying for age, sex, education, income, and sum of illnesses, revealed that higher reflective functioning was associated with lower FEV (p = .011). A main effect of relationship status was not found, but a significant interaction of reflective functioning × relationship status was discovered (p = .008), adding 4.2% to the total variance of the model. Probing the interaction revealed that the reflective functioning-FEV association was significant only for older adults not in a relationship. CONCLUSIONS: Findings suggest that low reflective functioning may be associated with increased risk of financial exploitation, specifically in certain populations of older adults. CLINICAL IMPLICATIONS: Care providers of older adults may consider assessing for, and identifying older adults with low reflective functioning, in order to prevent or intervene in the event of a potentially exploitative situation.

Longitudinal joint trajectories of gambling disorder and hypomentalization: A latent class growth analysis among young adults.

INTRODUCTION: Only a few studies have investigated the relationship between risk for gambling disorder (GD) and mentalization difficulties. However, these results on positive correlations were all from cross-sectional studies; therefore, it would be important to investigate the longitudinal relationship between the constructs. AIMS: It was aimed to identify subgroups of gamblers with different joint growth trajectories of risk for GD and hypomentalization (i.e., uncertainty of understanding own and others' mental states) and to compare the identified latent classes along impulsivity, sensation seeking and depression. METHODS: Data from waves 1-3 of the Budapest Longitudinal Study were used. The final sample included 219 young adult gamblers who completed the study questionnaire and reported past-year gambling in all three waves (Females: N = 93 [42.29%]; Mean age: 28.36 years [SD = 4.29]). Standardized questionnaires were administered to measure the main constructs. RESULTS: A four-class model was retained based on latent class growth analysis. Class 1 had consistently moderately high risk for GD and hypomentalization, and Class 4 presented consistently low risk for GD and hypomentalization. Classes 2-3 were characterized by low risk for GD and increasing hypomentalization. Class 1 had significantly higher sensation seeking and depression compared with the other subgroups in multiple cases. Class 4 showed significantly lower impulsivity and sensation seeking than the other classes. CONCLUSIONS: Elevated hypomentalization was presented among individuals with risk for GD. However, there is little empirical evidence to support that the two constructs have convergently changing trajectories. A cautious interpretation of the results is recommended due to low symptom presence.

Failure in reflective functioning as a key factor in the association between problematic social networking sites use, attachment and childhood maltreatment: A network analysis approach on gender differences.

Following a network analysis approach, the present study aims to explore the pattern of mutual relationships between failure in reflective functioning (RF) - defined as hypomentalization - problematic social networking sites use (PSNSU), attachment anxiety and avoidance, and childhood maltreatment among emerging adults, with a focus on gender differences. The study sample comprises N = 1,614 emerging adults (Mage = 23.84; SD = 3.21; 50% identified themselves as women) who completed online self-assessment measures. Results showed significantly greater PSNSU, hypomentalization, childhood emotional abuse, and both attachment avoidance and anxiety among women. Indeed, within the network analysis, performed separately for men and women, network-specific associative patterns were observed; yet also similarities have emerged. Within the women's network, differently from males, attachment avoidance connects, through attachment anxiety, to emotional abuse, mood modification related to PSNSU, and hypomentalization. Nonetheless, hypomentalization was central in both networks, functioning as a hub between attachment anxiety, the PSNSU cluster, and the childhood maltreatment cluster. These results shed light on the use of social network sites as a potential maladaptive emotion regulation strategy, particularly among women. In this regard, the role of RF should be considered as a key treatment target to reduce PSNSU and support the use of adaptive emotion regulation strategies.

In her shoes: Partner reflective functioning promotes family-level resilience to maternal depression.

Parental depression has significant implications for family functioning, yet much of the literature does not consider family-level dynamics in investigating individual, parenting and child outcomes. In the current study we apply a new index of couple-level support, partner reflective functioning (RF), or the romantic partner's ability to consider how the partner's mental states can guide behavior, to study familial resiliency in the face of prenatal parental depression among first-time parents. We investigate how partner RF buffers the association between prenatal parental depression and outcomes of postnatal parental depression, parenting style, and child effortful control. Maternal and paternal depression were measured in 91 primiparous couples during the sixth month of pregnancy and parental depression, partner RF, parental RF at 6 months postnatally. Outcomes of parental depression, permissive parenting, and children's effortful control were assessed 24 months postnatally. Results indicate that average and high levels of paternal partner (not parental) RF attenuate risk for maternal postnatal depression, maternal permissive parenting, and deficits in child effortful control. Implications are discussed from a family systems approach.

The predictors of change in reflective parenting therapy: Uncovering the influence of parental reflective functioning and child temperament in predicting the improvement in parent-child relationship and child outcome following DUET group intervention.

Parental reflective functioning (PRF) is the ability of parents to understand their child's behavior in light of underlying mental processes; it is a core element in the parent-child relationship. RF is also considered crucial for self-regulation for both parents and their children. We investigated the relationship between improvement in PRF after DUET group intervention (a RF-based intervention) and improvement in the parent-child interaction, child RF, and child adjustment, and we examined whether these improvements were distinct for children with different temperamental traits (e.g., effortful control). Eighty-four parents completed the DUET program and were assessed before and after the intervention. PRF was measured using observation (mind-mindedness) and a questionnaire. Statistical analysis included hierarchical regression and moderation of regression analysis. Results showed that improvement in the parent-child interaction, child RF, and child behavioral problems were related to improvement in PRF. Furthermore, we found that child temperament acted as a moderator in the link between PRF and child RF, supporting a vantage sensitivity model, meaning that it was the more sensitive children who benefitted the most as a result of the positive change in their parents' RF. Clinical and future directions of this study are discussed.

Past attachment experiences, the potential link of mentalization and the transmission of behavior to the child by mothers with mental health problems: cross-sectional analysis of a clinical sample.

Maternal capacity to mentalize (= reflective functioning, RF), secure attachment and emotionally available parenting has an impact on the child's development. The transmission of mothers' past attachment experiences gained with both her caregivers in her own childhood and the impact on current mother-child interaction is part of the 'transmission gap.' This study explores the transgenerational transmission mechanisms and the potential moderating effect of RF in a clinical sample of 113 mother-child dyads suffering from mental health problems. In a cross-sectional study, the associations between maternal attachment experiences, RF (coded based on Adult Attachment Interviews) and current mother-child interaction (Emotional Availability Scales) were examined with univariate correlation, moderator analyses, and structural equation models. We found relationships between attachment experiences and mother-child interaction, but RF had no moderating effect. Past loving experiences and perceived neglection, particularly with the own father in childhood, were predictors for the present mother-child interaction. There seems to be an intergenerational transmission of attachment experiences to the ongoing generation. Particularly past adverse childhood experiences with the own father seem to explain currently disruptive interactions with the child.Trial registration: DRKS00017008 and DRKS00016353.

Associations of mentalization and epistemic trust with internalizing and externalizing problems in adolescence: A gender-sensitive structural equation modeling approach.

INTRODUCTION: Mentalization, operationalized as reflective functioning (RF), allows individuals to interpret actions as caused by intentional mental states. Previous research highlighted the gender-specific associations between adolescents' internalizing and externalizing difficulties and mentalizing impairments. In addition, research suggested that mentalizing facilitates the creation of epistemic trust (ET) to evaluate social information as accurate, reliable, and relevant. However, few investigations explored the concurrent associations between RF, ET, and adolescent psychopathology. METHODS: A sample of 447 Italian cisgender adolescents (57% assigned females at birth; age range 12-19 years old; Mage = 15.54, SD = 1.98) self-reported RF (RFQY-5), ET towards mother, father, and peers (IPPA) and mental health problems (YSR-112). Gender-specific structural equation modeling explored the associations between RF, ET, and internalizing/externalizing problems. RESULTS: Results suggested an excellent fit for the theoretical model and revealed gender-related associations. In females, findings suggest that ET mediates the association between RF and psychopathology, with indirect associations from RF through ET to lower internalizing and externalizing problems. However, in males, RF and ET display independent associations with psychopathology. CONCLUSION: Overall, findings suggest that ET might be a transdiagnostic factor playing different roles associated with adolescent psychopathology. Indeed, links between RF and ET might help to explore gender differences in mental health problems in this developmental phase.