Measuring Reflective Functioning in Adolescents: Relations to Personality Disorders and Psychological Difficulties

Background: Reflective Functioning (RF) is considered to play a central role in risk and resilience for psychological difficulties such as borderline personality disorder (BPD) and has become an important treatment target of transdiagnostic psychosocial interventions like Mentalization Based Therapy. However, a lack of measures to assess RF in adolescents has hampered research that can further elucidate the role of RF in different types of psychopathology.

Objective: The objective of the present study was to examine the validity of the Reflective Functioning Questionnaire for Youth (RFQ-Y), examine the factor structure of the french RFQ-Y, the relationship between RFQ-Y and social cognition, psychological difficulties, BPD and narcissistic personality disorders.

Method: A total of 533 adolescents and young adults (age 12 - 21) from the community completed the RFQ-Y, the Child Behaviour Checklist, the Borderline Personality Features Scale and the Pathological Narcissism Inventory. A subsample of 150 participants completed the Movie for the Assessment of Social Cognition (MASC).

Results: Three factors were identified. Uncertainty/confusion was strongly positively correlated with psychological difficulties, especially symptoms of borderline personality disorder. Interest/curiosity was negatively correlated with psychopathology and Excessive Certainty was positively correlated with grandiose narcissism. RFQ-Y factors correlated more strongly with psychopathology than the MASC scales.

Conclusion: This study demonstrates the validity of self-report measures like the RFQ-Y and its utility for identifying problematic styles of mentalizing associated with increased risk of psychopathology in general, as well as difficulties like narcissism in particular.