Factor structure of the parental reflective functioning questionnaire and association with maternal postpartum depression and comorbid symptoms of psychopathology

Abstract

Parental reflective functioning (PRF) refers to the parent’s capacity to envision mental states in the infant and in themselves as a parent, and to link such underlying mental process with behavior, which is important for parenting sensitivity and child socio-emotional development. Current findings have linked maternal postpartum depression to impaired reflective skills, imposing a risk on the developing mother–infant relationship, but findings are mixed, and studies have generally used extensive methods for investigating PRF. The present study examined the factor structure and measurement invariance of the Danish version of the 18-item self-report Parental Reflective Functioning Questionnaire (PRFQ) in a sample of mothers with and without diagnosed postpartum depression. Moreover, the association between PRF and maternal postpartum depression in mothers with and without comorbid symptoms of personality disorder and/or clinical levels of psychological distress was investigated. Participants included 423 mothers of infants aged 1–11 months. Confirmatory factor analysis supported a three-factor structure of the PRFQ; however, item loadings suggested that a 15-item version was a more accurate measure of PRF in mothers of infants. Multi-group factor analysis of the 15-item PRFQ infant version indicated measurement invariance among mothers with and without diagnosed postpartum depression. Multinomial logistic regression showed that impaired PRF was associated with maternal psychopathology, although only for mothers with postpartum depression combined with other symptoms of psychopathology. These results provide new evidence for the assessment of maternal self-reported reflective skills as measured by a modified infant version of the PRFQ, as well as a more nuanced understanding of how variance in symptomatology is associated with impaired PRF in mothers in the postpartum period in differing ways.

Validation of the Parental Reflective Functioning Questionnaire among maltreating and nonmaltreating mothers.

“…In contrast, internal consistencies tend to be higher in studies that administered the PRFQ to samples in which parents were primarily college educated, partnered, and not recruited based on being at-risk (e.g., Carlone & Milan, 2021; Moreira & Fonseca, 2022; Nijssens et al, 2020)—though see Pazzagli et al (2018), who found low internal consistencies of the PRFQ subscales in middle and upper socioeconomic status parents. In several studies that found low internal consistencies, removing PRFQ items with low factor loadings from subscale construction improves subscale internal consistency (e.g., Pazzagli et al, 2018; Wendelboe et al, 2021; Yule, 2021). Thus, our first aim was to examine the factor structure of the PRFQ among a low-income, racially diverse sample of maltreating and nonmaltreating mothers of preschoolers.…”

Efficacy of a randomized controlled trial of a perinatal adaptation of COS-P in promoting maternal sensitivity and mental wellbeing among women with psychosocial vulnerabilities

“…Low scores on factor 3 are considered optimal. Validation studies of the PRFQ provide evidence for its reliability and validity [ 45 , 46 ]. The version used in this study was translated by Mette Skovgaard Væver and Johanne Smith-Nielsen, Center for Early Intervention and Family Studies, University of Copenhagen.…”

Understanding Your Baby: protocol for a controlled parallel group study of a universal home-based educational program for first time parents

“…Parental reflective functioning will be measured using the Parental reflective functioning questionnaire (PRFQ; [14]), a self-report measure of the parental ability to reflect upon the mental states of oneself and the child. In this study, we use the 15-item version of the PRFQ, which has been validated in a sample of Danish mothers of infants [55]. The items are rated on a 7-point Likert type scale going from "Completely disagree" (= 1) to "Completely agree" (= 7).…”