Reflective functioning in patients with obsessive–compulsive disorder (OCD) – preliminary findings of a comparison between reflective functioning (RF) in general and OCD-specific reflective functioning

Abstract

Several scales for rating the reflective function (RF) in different psychiatric syndromes (symptom-specific reflective function [SRF]) have been developed. In this study, the validity of a rating instrument for measuring obsessive -compulsive disorder (OCD)-specific RF (OCD-SRF) was assessed. The study was conducted at two outpatient psychiatric facilities. A total of 18 women and 12 men were interviewed with adult attachment interview and the OCD-SRF interview. The patients also rated their symptoms on a self-rating scale (Yale-Brown Obsessive-Compulsive Scale [Y-BOCS]). The results indicated that there was a significant difference between the levels of RF in general and SRF. No correlations between Y-BOCS and RF or SRF were found. Illustrations of ratings are presented. The difference between RF and SRF, the relationship between SRF and symptom checklists, and a relational perspective on symptoms in OCD were discussed.

Reflective Functioning in Children and Adolescents With and Without an Anxiety Disorder

“…This also suggests that RF difficulties among clinically anxious individuals would be specific to certain tasks or contexts and intrinsically related to the nature of their anxieties. In that, our results support the relevance of the corpus of studies focusing on symptom-specific RF in clinical populations (e.g., Kullgard et al, 2013 ; Keefe et al, 2019 ; Solomonov et al, 2019 ). Symptom-specific RF refers to the capacity to reflect on the psychological roots of anxious – or any other pathological – manifestations (e.g., Why do you think you have panic attacks?…”

“…; Rudden, 2017 ). For example, symptom-specific RF of clinically anxious adult patients was found to be significantly lower than their general RF capacities ( Rudden et al, 2008 ; Kullgard et al, 2013 ). Those studies are of particular importance to understand how therapeutic processes can best help reduce symptoms.…”

Is reflective functioning associated with clinical symptoms and long-term course in patients with personality disorders?

“…Thus, it could be that future research should address the question of more domain-or context specific versions of RF. Symptom-specific RF versions already exist for panic disorder [62] and obsessive-compulsive disorder [63], and these studies indicate that a patient's symptom-specific RF is lower than a patient's RF as assessed by the AAI interview. On the other hand, moving to more symptomor context specific measures of RF may reduce it's value as a trans-diagnostic construct.…”

Mentalizing underachievement in group counseling: Analyzing the relationship between members’ reflective functioning and counselors’ interventions.

“…For example, individuals may present a decline of mentalization in specific relationships (e.g., with parents) while presenting higher ability in other relationships (e.g., with friends). Furthermore, people may experience difficulties in their reflective functioning about mental states that are connected to specific symptoms or problematic situations while having unimpaired men-talizing capacities in other realms (Kullgard, Persson, Möller, Falkenström, & Holmqvist, 2013;Rudden, Milrod, Aronson, & Target, 2008). Thus, seemingly well-functioning individuals might show reduced capacities to mentalize in conflictive attachment situations or in other contexts that evoke strong emotions, such as fear and separation anxiety.…”