The Spanish version of the reflective functioning questionnaire: Validity data in the general population and individuals with personality disorders

Abstract

Introduction Mentalization or reflective functioning (RF) is the capacity to interpret oneself or the others in terms of internal mental states. Its failures have been linked to several mental disorders and interventions improving RF have a therapeutic effect. Mentalizing capacity of the parents influences the children’s attachment. The Reflective Functioning Questionnaire (RFQ-8) is a widely used tool for the assessment of RF. No instrument is available to assess general RF in Spanish-speaking samples. The aim of this study is to develop a Spanish version of the RFQ-8 and to evaluate its reliability and validity in the general population and in individuals with personality disorders. Methods 602 non-clinical and 41 personality disordered participants completed a Spanish translation of the RFQ and a battery of self-reported questionnaires assessing several RF related constructs (alexithymia, perspective taking, identity diffusion and mindfulness), psychopathology (general and specific) and interpersonal problems. Temporal stability was tested in a non-clinical sub-sample of 113 participants. Results Exploratory and confirmatory factor analyses suggested a one-factor structure in the Spanish version of the RFQ-8. RFQ-8 understood as a single scale was tested, with low scorings reflecting genuine mentalizing, and high scorings uncertainty. The questionnaire showed good internal consistence in both samples and moderate temporal stability in non-clinical sample. RFQ correlated significantly with identity diffusion, alexithymia, and general psychopathology in both samples; and with mindfulness, perspective taking, and interpersonal problems in clinical sample. Mean values of the scale were significantly higher in the clinical group. Discussion This study provides evidence that the Spanish version of the RFQ-8, understood as a single scale, has an adequate reliability and validity assessing failures in reflective functioning (i.e., hypomentalization) in general population and personality disorders.

A time to reflect: deviations from the balanced time perspective are associated with hypomentalization

“… Outline of competing models of the latent structure of the RFQ-8 involving separate hyper- and hypomentalization factors (A) or (B) a single factor (hypomentalization). Correlated error terms for items 3 and 4 is based on prior studies (e.g., Ruiz-Parra et al, 2023 ). …”

A short version of the reflective functioning questionnaire: Validation in a greek sample

“…The RFQ-8 has been widely used in different populations and has been translated in many languages. Its psychometric properties have been evaluated in general population in English, French, Italian, Greek, German, Polish and Spanish; in clinical samples, e.g., in patients with personality disorders, and other psychiatric patients, in English, Italian, German and Spanish; and in type 1 diabetes adults in Greek [9,29,40,41,[44][45][46][47]. The two-factor structure of the original RFQ-8 was further confirmed by some of these studies, thereby substantiating the instrument's reliability and validity [29,44,45].…”

“…Therefore, a change in scoring procedure was proposed, maintaining the scoring previously used in the RFQ design process (i.e., 1, 2, 3, 4, 5, 6, 7), except for item 7, reversely scored [ 40 , 41 ]. Moreover, further evidence based on exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) suggested that a one-factor model can sufficiently explain the observed covariation of the responses to RFQ-8 items when using this new way of scoring [ 40 , 41 , 46 , 47 ]. Aditionally, given that neither RFQ-8 certainty pole (using new proposed way of scoring), nor its certainty scale (using the previously proposed way of scoring) showed positive associations with indications of psychopathology when testing for U shape [ 40 , 41 ] or linear correlations [ 9 , 15 , 46 , 49 – 53 ], it has been suggested that the RFQ-8 can not sufficiently measure hypermentalization [ 41 , 47 , 48 ].…”

“…Moreover, further evidence based on exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) suggested that a one-factor model can sufficiently explain the observed covariation of the responses to RFQ-8 items when using this new way of scoring [ 40 , 41 , 46 , 47 ]. Aditionally, given that neither RFQ-8 certainty pole (using new proposed way of scoring), nor its certainty scale (using the previously proposed way of scoring) showed positive associations with indications of psychopathology when testing for U shape [ 40 , 41 ] or linear correlations [ 9 , 15 , 46 , 49 – 53 ], it has been suggested that the RFQ-8 can not sufficiently measure hypermentalization [ 41 , 47 , 48 ]. Within this context, the unidimensionality of the RFQ-8 has been proposed as a better solution [ 40 , 41 , 46 , 47 ].…”

“…Aditionally, given that neither RFQ-8 certainty pole (using new proposed way of scoring), nor its certainty scale (using the previously proposed way of scoring) showed positive associations with indications of psychopathology when testing for U shape [ 40 , 41 ] or linear correlations [ 9 , 15 , 46 , 49 – 53 ], it has been suggested that the RFQ-8 can not sufficiently measure hypermentalization [ 41 , 47 , 48 ]. Within this context, the unidimensionality of the RFQ-8 has been proposed as a better solution [ 40 , 41 , 46 , 47 ]. In the same line of thinking, Desatnik and colleagues [ 54 ], in a study involving a sample of adolescents and young adults, used a 15-item unidimensional coding version of the RFQ, measuring strength or weakness in mentalizing, as more suitable for assessing mentalizing in non-clinical samples.…”