A Critical Evaluation of the Reflective Functioning Questionnaire (RFQ).

The Reflective Functioning Questionnaire (RFQ) is an 8-item self-report measure of reflective functioning that is presumed to capture individual differences in hypo- and hypermentalizing. Despite its broad acceptance by the field, we argue that the validity of the measure is not well-established. The current research elaborates on problems of the RFQ related to its item content, scoring procedure, dimensionality, and associations with psychopathology. We tested these considerations across three large clinical and non-clinical samples from Germany and the US (total N = 2289). In a first study, we found that the RFQ may assess a single latent dimension related to hypomentalizing but is rather unlikely to capture maladaptive forms of hypermentalizing. Moreover, the RFQ exhibited very strong associations with measures of personality pathology, while associations with measures of symptom distress were less strong. In a second preregistered study focused on convergent and discriminant validity, however, a commonality analysis indicated that associations with indicators of personality pathology are inflated because some of the RFQ items tap into emotional lability and impulsivity rather than mentalizing. Our findings demonstrate limitations of the RFQ. We discuss key challenges in assessing mentalizing via self-report.

Mindreading measures misread? A multimethod investigation into the validity of self-report and task-based approaches.

Mindreading ability-also referred to as cognitive empathy or mentalizing-is typically conceptualized as a relatively stable dimension of individual differences in the ability to make accurate inferences about the mental states of others. This construct is primarily assessed using self-report questionnaires and task-based performance measures. However, the validity of these measures has been questioned: According to rival interpretations, mindreading tasks may capture general cognitive ability, whereas mindreading self-reports may capture perceived rather than actual mindreading ability. In this preregistered multimethod study involving 700 participants from the U.S. general population, we tested the validity of mindreading measures by examining the nomological network of self-reports and task-based methods using structural equation modeling. Specifically, we contrasted the empirical associations with theoretical predictions that assume mindreading measures are valid versus invalid. More consistent with rival interpretations, mindreading tasks showed a negligible latent correlation with mindreading self-reports (.05) and a large one with general cognitive ability (.85), whereas mindreading self-reports were specifically associated with perceived performance in mindreading tasks (.29). Also more consistent with rival interpretations, neither mindreading self-reports nor task-based measures showed positive unique associations with psychosocial functioning when controlling for general cognitive ability and general positive self-evaluation. Instead, negative unique associations emerged for both methods, although this effect was not robust for tasks. Overall, the results cast doubt on the validity of commonly used mindreading measures and support their rival interpretations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Measuring maladaptive personality traits with the Structured Clinical Interview for DSM-IV Axis II Screening Questionnaire using a common metrics approach.

The classification of personality disorder (PD) is undergoing a paradigm shift in which categorically defined specific PDs are being replaced by dimensionally defined maladaptive trait domains. To bridge the classificatory approaches, this study attempts to use items from the categorical PD model in DSM-IV to measure the maladaptive trait domains described in DSM-5 Section III/ICD-11. A general population sample comprising 1228 participants completed the Screening Questionnaire of the Structured Clinical Interview for DSM-IV Axis II (SCID-II-SQ), the Personality Inventory for DSM-5 (PID-5), and the anankastia scale of the Personality Inventory for ICD-11 (PiCD). Using item response theory models and a psychometric linking technique, SCID-II-SQ items were evaluated for their contribution to measuring maladaptive trait domains. The best discriminating items were then selected to derive proxy scales. We found that convergent validity of these proxy scales was in a similar range to that of other self-report measures for PD, except for the proxy scale for PiCD anankastia. However, only the proxy scale for negative affectivity showed acceptable reliability that would allow its application in research settings. Future studies should seek to establish a common metric between specific PDs and maladaptive trait domains using self-report measures with higher specificity or semi-structured interviews.

Examining the role of personality functioning in a hierarchical taxonomy of psychopathology using two years of ambulatory assessed data.

The Hierarchical Taxonomy of Psychopathology (HiTOP) arranges phenotypes of mental disorders based on empirical covariation, ranging from narrowly defined symptoms to higher-order spectra of psychopathology. Since the introduction of personality functioning (PF) in DSM-5 and ICD-11, several studies have identified PF as a predictor of transdiagnostic aspects of psychopathology. However, the role of PF in the HiTOP classification system has not been systematically examined. This study investigates how PF can be integrated into HiTOP, whether PF accounts for transdiagnostic variance captured in higher-order spectra, and how its predictive value for future affective well-being (AWB) and psychosocial impairment (PSI) compares to the predictive value of specific psychopathology beyond PF. To this end, we examined two years of ambulatory assessed data on psychopathology, PF, PSI, and AWB of N = 27,173 users of a mental health app. Results of bass-ackwards analyses largely aligned with the current HiTOP working model. Using bifactor modeling, aspects of PF were identified to capture most of the internalizing, thought disorder, and externalizing higher-order factor variance. In longitudinal prediction analyses employing bifactor-(S-1) modeling, PF explained 58.6% and 30.6% of variance in PSI and AWB when assessed across one year, respectively, and 33.1% and 23.2% of variance when assessed across two years. Results indicate that personality functioning may largely account for transdiagnostic variance captured in the higher-order components in HiTOP as well as longitudinal outcomes of PSI and AWB. Clinicians and their patients may benefit from assessing PF aspects such as identity problems or internal relationship models in a broad range of mental disorders. Further, incorporating measures of PF may advance research in biological psychiatry by providing empirically sound phenotypes.

Development and Validation of the Certainty About Mental States Questionnaire (CAMSQ): A Self-Report Measure of Mentalizing Oneself and Others.

The Certainty About Mental States Questionnaire (CAMSQ) is a self-report measure of the perceived capacity to understand mental states of the self and others (i.e., mentalizing). In two studies (total N = 1828), we developed the CAMSQ in both English and German as a two-dimensional measure of Self- and Other-Certainty, investigated associations with other measures of mentalizing, and explored relationships to personality functioning and mental health. The CAMSQ performed well in terms of convergent and discriminant validity, internal consistency, test-retest reliability, and measurement invariance across the United States and Germany. The present research indicates that the CAMSQ assesses maladaptive forms of having too little or too much certainty about mental states (consistent with hypomentalizing and hypermentalizing). A psychologically adaptive profile of perceived mentalizing capacity appears to be characterized by high Self-Certainty that exceeds Other-Certainty, suggesting that imbalances between Self-Certainty and Other-Certainty (Other-Self-Discrepancy) play an important role within personality pathology.

Mapping established psychopathology scales onto the Hierarchical Taxonomy of Psychopathology (HiTOP).

The Hierarchical Taxonomy of Psychopathology (HiTOP) organizes phenotypes of mental disorder based on empirical covariation, offering a comprehensive organizational framework from narrow symptoms to broader patterns of psychopathology. We argue that established self-report measures of psychopathology from the pre-HiTOP era should be systematically integrated into HiTOP to foster cumulative research and further the understanding of psychopathology structure. Hence, in this study, we mapped 92 established psychopathology (sub)scales onto the current HiTOP working model using data from an extensive battery of self-report assessments that was completed by community participants and outpatients (N = 909). Content validity ratings of the item pool were used to select indicators for a bifactor-(S-1) model of the p factor and five HiTOP spectra (i.e., internalizing, thought disorder, detachment, disinhibited externalizing, and antagonistic externalizing). The content-based HiTOP scales were validated against personality disorder diagnoses as assessed by standardized interviews. We then located established scales within the taxonomy by estimating the extent to which scales reflected higher-level HiTOP dimensions. The analyses shed light on the location of established psychopathology scales in HiTOP, identifying pure markers and blends of HiTOP spectra, as well as pure markers of the p factor (i.e., scales assessing mentalizing impairment and suspiciousness/epistemic mistrust).

The latent structure of interpersonal problems: Validity of dimensional, categorical, and hybrid models.

Interpersonal problems are key transdiagnostic constructs in psychopathology. In the past, investigators have neglected the importance of operationalizing interpersonal problems according to their latent structure by using divergent representations of the construct: (a) computing scores for severity, agency, and communion ("dimensional approach"), (b) classifying persons into subgroups with respect to their interpersonal profile ("categorical approach"). This hinders cumulative research on interpersonal problems, because findings cannot be integrated both from a conceptual and a statistical point of view. We provide a comprehensive evaluation of interpersonal problems by enlisting several large samples (Ns = 5,400, 491, 656, and 712) to estimate a set of latent variable candidate models, covering the spectrum of purely dimensional (i.e., confirmatory factor analysis using Gaussian and nonnormal latent t-distributions), hybrid (i.e., semiparametric factor analysis), and purely categorical approaches (latent class analysis). Statistical models were compared with regard to their structural validity, as evaluated by model fit (corrected Akaike's information criterion and the Bayesian information criterion), and their concurrent validity, as defined by the models' ability to predict relevant external variables. Across samples, the fully dimensional model performed best in terms of model fit, prediction, robustness, and parsimony. We found scant evidence that categorical and hybrid models provide incremental value for understanding interpersonal problems. Our results indicate that the latent structure of interpersonal problems is best represented by continuous dimensions, especially when one allows for nonnormal latent distributions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).