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Objective: Parents' rejection of their LGBTQ + young adults can have a negative impact on their young adult's psychological welfare, and on the young adult-parent relationship. Parents' ability to reflect on their child's pain and unmet needs is thought to evoke empathy and compassion, and reduce rejection. Empirical and clinical evidence suggest that parents' level of reflective functioning (RF) is impacted by their level of emotional arousal (EA). This study examined the association between parents' EA and RF within the context of attachment-based family therapy for nonaccepting parents and their LGBTQ+ young adults. Methods: 43 therapy sessions drawn from six different cases were coded for parental RF and EA, based on 30-second segments. This generated a total of 343 observations for analyses. Results: Hierarchal linear modeling revealed that parents' level of RF was a function of their concomitant EA, with moderate levels of arousal predicting the highest RF levels. Conclusion: Moderate EA may facilitate optimal parental reflective functioning. With nonaccepting parents, who typically present for treatment with high levels of maladaptive fear and shame, therapists would do well to assess their level of arousal and, when indicated, employ downregulating interventions before inviting them to reflect on their young adult's experience and needs. [ABSTRACT FROM AUTHOR]

AbstractSpace and time is an inexorable part of motherhood. The development of intrapsychic space and time is founded in the mother-infant relationship and mothers and infants experienced particular challenges during theCovid-19 lockdown periods starting in 2020. The author explores how space and time are functions of containment and Reflective Functioning, specifically in mothering. Furthermore, movement in space and time is redolent of après-coup and has implications here. The study interviewed 11 mothers about their experience of failures in containment and RF with their children aged 0-5 years. Interviews were conducted online during the initial lockdown of the Covid-19 Pandemic. The author used Cartwright’s psychoanalytic interview tool over 2 interviews. The transcripts were then analysed using Cartwrights method. 3 major themes emerge: 1) mothers’ experience of failures in containment and RF and how this relates to time and space, 2) how mothers continue to be influenced by their history in their own mothering and 3) the concept of après-coup is relevant to how successfully mothers are able to use containment and RF. These themes emerge in the context of the Covid-19 Pandemic and lockdowns. [ABSTRACT FROM AUTHOR]

Introduction: While functional neuroimaging studies have reported on the neural correlates of severe antisocial behaviors, such as delinquency, little is known about whole brain resting state functional connectivity (FC) of incarcerated adolescents (IA). The aim of the present study is to identify potential differences in resting state connectivity between a group of male IA, compared to community adolescents (CA). The second objective is to investigate the relations among FC and psychological factors associated with delinquent behaviors, namely psychopathic traits (callous unemotional traits, interpersonal problems, and impulsivity), socio-cognitive (empathy and reflective functioning RF) impairments and psychological problems (externalizing, internalizing, attention and thought problems). Methods: 31 male IA and 30 male CA participated in 8 minutes resting state functional MRI. Network Based Statistics (NBS) was used to compare FC among 142 brain regions between the two groups. Correlation and regressions analysis were performed to explore the associations between FC and the self-reported psychopathic traits, empathy, RF, and psychological problems. Results: Compared to the CA, the IA group presented significantly increased resting state FC in a distributed subnetwork including medial prefrontal, posterior and dorsal cingulate, temporal, and occipital regions. Both within the IA group and across the whole sample, increased mean connectivity of the subnetwork correlated with lower RF (RF uncertainty). Across the whole sample, the mean connectivity was associated with higher scores of externalizing problems and impulsivity dimension of psychopathy. Discussion: While extending the characterization of whole brain resting state FC in IA, our results also provide insights into the neurofunctional mechanisms linking low reflective functioning abilities to externalizing behavior during adolescence. [ABSTRACT FROM AUTHOR]

Mentalization, operationalized as reflective functioning (RF), is the ability to understand ones own and anothers mental world implicitly or explicitly. RF is a newly discovered research field in Iran and is largely under-studied in Eastern cultures in general, underscoring the high need for cross-cultural studies in this field of research. A qualitative method was used to examine the ability to understand, process, and respond to high-arousal attachment situations in typical and clinical populations of Iranian children recruited from a Tehran primary school. A well-known semi-structured interview commonly used to assess RF in children was used to collect data. Required information on internalizing and externalizing symptoms, demographic information, and all formal diagnoses of children were collected by parents. The results indicated the identification of four different profiles of RF in children, one of which was adaptive, while the other three were maladaptive. Also, the results showed that typically developing children and those having a high social and economic status (SES) were characterized as having a more adaptive profile of RF, while children from the clinical population and those with a low SES reported a more maladaptive profile (passive mentalizing, helpless mentalizing, narcissistic mentalizing) of RF. The present study is an important step in increasing our understanding of the development of mentalization in children and has significant educational and clinical implications.

Background: The mentalization model of borderline personality disorder (BPD) utilizes a developmental psychopathology lens, emphasizing an unstable or reduced capacity to mentalize—stemming from early attachment disruptions and relational trauma—as the core feature of BPD. While the empirical evidence for the proposed intersections between mentalizing, attachment, and trauma and the development and manifestations of borderline personality is still limited, this knowledge is essential for developing effective assessments and interventions. Aim: To examine mentalizing, attachment, and early relational trauma as predictors of the severity of symptoms in BPD. Materials and Methods: The sample included 60 individuals diagnosed with BPD, aged 18–45 years, recruited from inpatient and outpatient services in a tertiary care mental health center. Participants completed measures of mentalizing (Reflective Functioning Questionnaire, Interpersonal Reactivity Index, and Reading the Mind in the Eyes test), attachment (Attachment Style Questionnaire), early relational trauma (Complex Trauma Questionnaire), and symptom severity (Borderline Symptom List). Results: The majority of the participants reported experiences of polyvictimization (93.3%) with the most common traumas being psychological abuse (93.3%), neglect (91.7%), and rejection (90.0%). Regression analyses revealed that uncertain reflective functioning, anxious attachment style, and the cumulative impact of trauma together predicted 53.1% of the variance in BPD symptom severity. Conclusion: Impaired mentalizing, characterized by inflexible understanding of mental states, is a critical target for therapeutic interventions in BPD. The significant role of anxious attachment and the necessity of assessing the perceived impact of traumatic experiences highlight the importance of trauma-informed and mentalization-based interventions for this vulnerable group.

Depression is a very common mental health problem in adolescence. Although over the past decades a number of psychological interventions for depression in adolescence have been developed and empirically evaluated, recent systematic reviews and meta-analyses suggest that there is considerable room for improvement of their effectiveness. This is particularly true for the treatment of adolescents with "complex" depression, that is, those where depression is embedded within broader personality and relational problems, often related to a history of attachment trauma. Mentalization-based treatment (MBT) may be particularly effective in these cases, as it has a strong focus on temporary and long-term impairments in mentalizing (i.e., the capacity to understand the self and others in terms of intentional mental states), which are very typical of adolescents with depression. This article outlines a continuum of severity of depression as seen from a mentalizing perspective, ranging from the mild to moderate to the more severe end of the spectrum. This is followed by a summary of the mentalizing approach to understanding depression along the spectrum of severity, the empirical evidence supporting this approach, and a description of the basic principles of MBT for depression. We close with some thoughts about the future of MBT in the treatment of depression in adolescents. [ABSTRACT FROM AUTHOR]

Introduction: Adverse childhood experiences (ACEs) are psychosocial factors acknowledged as significant contributors to health consequences later in adolescence, including psychological maladjustment. The research suggests that, at a transdiagnostic and transtheoretical level, working on restoring epistemic trust (ET), mentalized affectivity (MA), and reflective functioning (RF) in adolescents with ACEs assumes a central role in the therapeutic process. However, there are still few studies that attempted to investigate the specific role of these sociocognitive factors in the detrimental positive association between levels of experienced ACEs during childhood and psychological maladjustment in nonclinical adolescents. Methods: A community sample of 306 Italian cisgender adolescents (61.4% assigned females at birth; age range 13–19 years old; Mage = 16.1, SD = 1.64) self‐reported ACEs (Childhood Trauma Questionnaire‐Short Form), psychological maladjustment (Strengths and Difficulties Questionnaire), ET (Epistemic Trust, Mistrust and Credulity Questionnaire), MA (Brief‐Mentalized Affectivity Scale for Adolescence), and RF (Reflective Functioning Questionnaire). A multiple mediation regression analysis has been performed to explore the association between ACEs and psychological maladjustment through the interaction with socio‐cognitive factors. Results: ACEs are positive predictors of psychological maladjustment later in adolescence. Regardless of gender differences, epistemic mistrust and credulity, processing and expressing emotions, and uncertainty about mental states mediated this association, while epistemic trust, identifying emotions, and certainty about mental states did not configure as significant mediators. Conclusion: Findings suggest that ET disruptions and deficits in RF are risk factors, while MA is a protective factor within the link between ACEs and psychological maladjustment in adolescence. These links help to specify the role of sociocognitive factors in the development of mental problems in adolescents who have been exposed to adverse experiences in childhood. [ABSTRACT FROM AUTHOR]

This cross‐sectional study investigated the relationship between the presence and impact of ACEs with both reactive and proactive aggression, and the possible moderating role of mentalization (operationalized as reflective functioning) in these expected relationships. Sixty‐five inpatient and outpatient adults with any kind of antisocial behaviour completed the Dutch version of the Traumatic Experiences Checklist, the Reactive‐Proactive Aggression Questionnaire, and the Adult Attachment Interview with the use of the Reflective Functioning Scale. Preliminary analysis showed a remarkably high level of ACEs, and a relatively high reported impact of these experiences. We found a positive relationship between the total presence of ACEs (including childhood maltreatment and adverse household factors), and both reactive and proactive aggression. We also found positive relationships between the experienced impact of these ACEs and both reactive and proactive aggression. Regarding childhood maltreatment in family of origin, we did not find a correlation between the presence of these experiences and respectively reactive and proactive aggression. However, we found a correlation between the impact of childhood maltreatment and reactive aggression. These results suggest that in addition to the cumulative experience of ACEs, the subjective burden of these experiences on individuals must not be underestimated in case of aggression. Additional moderation analysis showed no differences in these relationships in case of less developed versus medium‐high developed reflective functioning. The findings substantiate the importance of early prevention and treatment programs with focus on ACEs to possibly reduce aggression. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate factors associated with functioning in participants with and without borderline personality disorder (BPD). In particular, we were interested whether mentalizing and related social cognitive capacities, as factors of internal functioning, are important in predicting psychosocial functioning, in addition to other psychopathological and sociodemographic factors. Method: This is a cross‐sectional study with N = 53 right‐handed females with and without BPD, without significant differences in age, IQ, and socioeconomic status, who completed semi‐structured diagnostic and self‐report measures of social cognition. Mentalizing was assessed using the Reflective Functioning Scale based on transcribed Adult Attachment Interviews. A regularized regression with the elastic net penalty was deployed to investigate whether mentalizing and social cognition predict psychosocial functioning. Results: Borderline personality disorder symptom severity, sexual abuse trauma, and social and socio‐economic factors ranked as the most important variables in predicting psychosocial functioning, while reflective functioning (RF) was somewhat less important in the prediction, social cognitive functioning and sociodemographic variables were least important. Conclusions: Borderline personality disorder symptom severity was most important in determining functional impairment, alongside trauma related to sexual abuse as well as social and socio‐economic factors. These findings verify that BPD symptoms themselves most robustly predict functional impairment, followed by history of sexual abuse, then contextual factors (e.g. housing, financial, physical health), and then RF. These results lend marginal support to the conceptualization that mentalizing may enhance psychosocial functioning by facilitating social learning, but emphasize symptom reduction and stabilization of life context as key intervention targets. [ABSTRACT FROM AUTHOR]

Following a network analysis approach, the present study aims to explore the pattern of mutual relationships between failure in reflective functioning (RF) – defined as hypomentalization – problematic social networking sites use (PSNSU), attachment anxiety and avoidance, and childhood maltreatment among emerging adults, with a focus on gender differences. The study sample comprises N = 1,614 emerging adults (M age = 23.84; SD = 3.21; 50% identified themselves as women) who completed online self-assessment measures. Results showed significantly greater PSNSU, hypomentalization, childhood emotional abuse, and both attachment avoidance and anxiety among women. Indeed, within the network analysis, performed separately for men and women, network-specific associative patterns were observed; yet also similarities have emerged. Within the women's network, differently from males, attachment avoidance connects, through attachment anxiety, to emotional abuse, mood modification related to PSNSU, and hypomentalization. Nonetheless, hypomentalization was central in both networks, functioning as a hub between attachment anxiety, the PSNSU cluster, and the childhood maltreatment cluster. These results shed light on the use of social network sites as a potential maladaptive emotion regulation strategy, particularly among women. In this regard, the role of RF should be considered as a key treatment target to reduce PSNSU and support the use of adaptive emotion regulation strategies. [ABSTRACT FROM AUTHOR]

Loneliness is a pressing public mental health issue. So far, there has been a paucity of investigations focused on the individual differences modulating this subjective feeling in the face of difficult circumstances, e.g., the COVID-19 pandemic. As such, the present study aimed to investigate the role of mentalization ; given that the construct comprises reflection abilities that might be particularly relevant to the pandemic's interpersonal challenges. A survey representative of the German population was conducted from May to June 2020 (N = 2503). We examined mentalization, operationalized as reflective functioning (RF) and measured using the Mentalization Questionnaire (MZQ), both as a protective factor against loneliness on its own and as a moderator of the association of social isolation with loneliness. Of the overall sample, 822 (32.8 %) individuals reported social isolation. Worse RF was moderately associated with higher levels of loneliness (r = 0.433, p <.001). A linear regression model (controlling for sociodemographic characteristics and general personality pathology) confirmed this positive association, but also indicated an interaction effect of RF and social isolation in the statistical prediction of loneliness. Stratified models showed that RF was a comparatively weaker statistical predictor of loneliness among the socially isolated. This representative population study expanded our knowledge about the factors shaping loneliness in the population. RF emerged as a potentially modifiable protective influence. Further research needs to clarify the mechanisms through which it mitigates loneliness. The cross-sectional design does not give insight into the temporal association of RF and loneliness. • Joint investigation of personality and demographic risk factors for loneliness • Individuals with better reflective functioning (RF) abilities felt less lonely. • RF appears to guard against loneliness even in the case of social isolation. • Individual differences hold potential to explain the vulnerability to loneliness. [ABSTRACT FROM AUTHOR]

Ageist attitudes have been associated with various aspects of psychological functioning in older adults. According to Terror Management Theory, older adults may be seen as a reminder of human demise and death, and research has demonstrated links between ageist attitudes and compromised abilities to seek and maintain close personal relationships, which ward off awareness of one's mortality. Accordingly, the current work examined whether reflective functioning, or the ability to comprehend one's own and others' mental states, mitigates the negative psychological manifestations of ageist attitudes in older adults. Data was collected from 686 participants aged 60–94 (Mage = 72.64, SD = 6.28), who completed scales assessing ageist attitudes, reflective functioning, and psychological distress, as well as relevant socio‐demographic information. Results indicated that ageist attitudes were linked with low levels of reflective functioning and enhanced psychological distress. Moreover, reflective functioning moderated the ageist attitudes‐distress link, which was not significant in individuals reporting high levels of reflective functioning. This study provides insight into how the ability to comprehend others' mental states mitigates the adverse psychological effects of ageist attitudes and highlights the importance of examining relationship‐enhancing personal factors within the context of negative ageing perceptions and psychological distress. [ABSTRACT FROM AUTHOR]

IntroductionWhile functional neuroimaging studies have reported on the neural correlates of severe antisocial behaviors, such as delinquency, little is known about whole brain resting state functional connectivity (FC) of incarcerated adolescents (IA). The aim of the present study is to identify potential differences in resting state connectivity between a group of male IA, compared to community adolescents (CA). The second objective is to investigate the relations among FC and psychological factors associated with delinquent behaviors, namely psychopathic traits (callous unemotional traits, interpersonal problems, and impulsivity), socio-cognitive (empathy and reflective functioning RF) impairments and psychological problems (externalizing, internalizing, attention and thought problems).Methods31 male IA and 30 male CA participated in 8 minutes resting state functional MRI. Network Based Statistics (NBS) was used to compare FC among 142 brain regions between the two groups. Correlation and regressions analysis were performed to explore the associations between FC and the self-reported psychopathic traits, empathy, RF, and psychological problems.ResultsCompared to the CA, the IA group presented significantly increased resting state FC in a distributed subnetwork including medial prefrontal, posterior and dorsal cingulate, temporal, and occipital regions. Both within the IA group and across the whole sample, increased mean connectivity of the subnetwork correlated with lower RF (RF uncertainty). Across the whole sample, the mean connectivity was associated with higher scores of externalizing problems and impulsivity dimension of psychopathy.DiscussionWhile extending the characterization of whole brain resting state FC in IA, our results also provide insights into the neurofunctional mechanisms linking low reflective functioning abilities to externalizing behavior during adolescence.

Abstract Background Sexual offenses encompass a diverse array of behaviors across various contexts, affecting numerous individuals. Despite the prevalence of sexual offending among adolescents, there is still a limited understanding of this population. To contribute further to the literature in this field, the present study was conducted to compare a group of male adolescents convicted of sexual offenses with a control group in terms of reflective functioning (RF), emotion regulation (ER) strategies, and emotion dysregulation (ED). Methods 60 male adolescents aged 12 to 18 years (M = 16.90; SD = 0.97) who had been convicted of at least one serious sexual offense were recruited from male adolescents referred by juvenile courts to the Legal Medicine Organization in Mashhad, Iran, and compared with a control group of non-offending adolescents consisting of 60 male adolescents aged 12 to 18 years (M = 16.97; SD = 0.82) who were attending school. The groups were matched on age and education level. Results A comparison between these two groups revealed that adolescents with a history of sexual offending exhibited poorer RF capacity, greater use of suppression as an ER strategy, and higher scores in all ED domains (p’s

Mentalization‐based treatment (MBT) is a spectrum of interventions that share a central focus on improving the capacity for mentalizing. Although MBT was originally developed as a treatment for individuals with borderline personality disorder, its scope and focus have been broadened to become a socioecological approach that stresses the role of broader sociocultural factors in determining the closely related capacities for mentalizing and epistemic trust. This special issue brings together some of the newest developments in MBT that illustrate this shift. These contributions also highlight several current limitations in mentalization‐based approaches, providing important pointers for further research. In this editorial, we first outline the broadening scope of the mentalizing approach, and then provide a discussion of each of the contributions to this special issue in the context of the need for further research concerning some of the key assumptions of mentalization‐based approaches and their implementation in clinical practice. We close this editorial with considerations concerning future research. [ABSTRACT FROM AUTHOR]

Background: Sexual offenses encompass a diverse array of behaviors across various contexts, affecting numerous individuals. Despite the prevalence of sexual offending among adolescents, there is still a limited understanding of this population. To contribute further to the literature in this field, the present study was conducted to compare a group of male adolescents convicted of sexual offenses with a control group in terms of reflective functioning (RF), emotion regulation (ER) strategies, and emotion dysregulation (ED). Methods: 60 male adolescents aged 12 to 18 years (M = 16.90; SD = 0.97) who had been convicted of at least one serious sexual offense were recruited from male adolescents referred by juvenile courts to the Legal Medicine Organization in Mashhad, Iran, and compared with a control group of non-offending adolescents consisting of 60 male adolescents aged 12 to 18 years (M = 16.97; SD = 0.82) who were attending school. The groups were matched on age and education level. Results: A comparison between these two groups revealed that adolescents with a history of sexual offending exhibited poorer RF capacity, greater use of suppression as an ER strategy, and higher scores in all ED domains (p's < 0.001) except non-acceptance of emotional responses compared with the control group. Conclusions: Results suggest that RF, ER strategies, and ED need to be considered as important psychological factors in understanding and treating adolescents with a history of sexual offending. [ABSTRACT FROM AUTHOR]

Objectives: Mentalizing difficulties are central to borderline personality disorder (BPD), have severe consequences, and are an explicit focus in mentalizationbased treatment. The significance of mentalizing capacity as a predictor or mediator of change is however still uncertain due to a scarcity of research. The Mentalization Breakdown Interview (MBI) was developed as a time saving tool for studying psychotherapy processes and outcome in borderline pathology. This study aimed to investigate the convergent validity of reflective functioning (RF) ratings based on the MBI (MBI-RF) by a comparison with the gold standard, i.e., RF assessments based on the Adult Attachment Interview (AAI-RF). A secondary aim was to investigate how MBI-RF relates to core symptoms of BPD, levels of functional impairment and symptom distress compared with AAI-RF. Method: Forty-five patients with BPD or significant BPD traits were included. MBI-RF and AAI-RF were rated using the Reflective Functioning Scale. Levels of MBI-RF and AAI-RF and the correlation between the measures were calculated, as well as their associations with the Difficulties in Emotion Regulation Scale, Levels of Personality Functioning-Brief Form 2.0, Work and Social Adjustment Scale, Patient Health Questionnaire, Depression, Generalized Anxiety Disorder-7, self-harm, suicide attempts, and PD diagnostics. Results: The correlation between MBI-RF and AAI-RF was 0.79 (p<0.01), indicating high convergent validity. There were few significant associations between MBI-RF and AAI-RF and clinical measures. Conclusions: The study provides support for the convergent validity of the MBI as a BPD-focused RF assessment method. The MBI has the potential as a time saving, reliable and valid method to be applied in treatment research on patients with borderline pathology. The results indicate that measures of MBI-RF and AAIRF are different from clinical symptoms. [ABSTRACT FROM AUTHOR]

In this paper, we take an ecological view of children's development to argue that preventive interventions should move beyond separating the microsystems of school and home to create new intergenerational spaces for nurturing mental wellbeing. Using the 5A's theory of creativity, we draw upon our experiences of creative writing to explore how intergenerational spaces that facilitate co-creating creative writing between parents and carers and their children as actors develop reflective functioning, secure attachment and promote positive mental health. This original idea is explored further with experts from diverse landscapes of practice through a World Café and focus group discussion. Thematic analysis of these discussions conceptualises intergenerational spaces as complex, contradictory and dynamic: addressing potential barriers to actor participation caused by the microsystems of school and home; creating emotional and physical security; being underpinned by pedagogical freedom and structure; involving the writing of different artefacts for competing audiences. For those, including schools, looking beyond performativity and neoliberalism to promote positive mental health in more holistic ways, this paper offers a useful starting point for thinking about what intergenerational spaces that facilitate co-creating creative writing might look like. [ABSTRACT FROM AUTHOR]

Background The nature of the pathway from conduct disorder (CD) in adolescence to antisocial behavior in adulthood has been debated and the role of certain mediators remains unclear. One perspective is that CD forms part of a general psychopathology dimension, playing a central role in the developmental trajectory. Impairment in reflective functioning (RF), i.e. the capacity to understand one's own and others' mental states, may relate to CD, psychopathology, and aggression. Here, we characterized the structure of psychopathology in adult male-offenders and its role, along with RF, in mediating the relationship between CD in their adolescence and current aggression. Methods A secondary analysis of pre-treatment data from 313 probation-supervised offenders was conducted, and measures of CD symptoms, general and specific psychopathology factors, RF, and aggression were evaluated through clinical interviews and questionnaires. Results Confirmatory factor analyses indicated that a bifactor model best fitted the sample's psychopathology structure, including a general psychopathology factor (p factor) and five specific factors: internalizing, disinhibition, detachment, antagonism, and psychoticism. The structure of RF was fitted to the data using a one-factor model. According to our mediation model, CD significantly predicted the p factor, which was positively linked to RF impairments, resulting in increased aggression. Conclusions These findings highlight the critical role of a transdiagnostic approach provided by RF and general psychopathology in explaining the link between CD and aggression. Furthermore, they underscore the potential utility of treatments focusing on RF, such as mentalization-based treatment, in mitigating aggression in offenders with diverse psychopathologies. [ABSTRACT FROM AUTHOR]

Background and Objectives: The mother's parenting stress can lead to children's behavioral problems, and among these, variables related to the parent-child relationship can be a moderator. The present study aimed to determine the moderating role of the components of maternal reflective functioning in the relationship between the mother's parenting stress and the child's behavioral problems. Materials and Methods: The current research is descriptive. Based on the convenience sampling method, 200 mothers who visited the children's clinics in Tehran in 2023 were selected and completed questionnaires of Parental Reflective Functioning, Parental Stress, and Child Behavior Checklist. Data analysis was performed using correlation tests and hierarchical regression. Results: There was significant a positive relationship between mother's parental stress and pre-mentalizing (r=0.31, p<0.001) and certainty of mental states (r=0.32, p<0.001), and a significant negative relationship between mother's parental stress and interest and curiosity in mental states (r=-0.34, p<0.001). Moreover, there was a significant positive relationship between parental stress and child's behavioral problems (r=0.47, p<0.001), and child's behavioral problems and pre-mentalizing (r=0.26, p<0.001) and certainty of mental states (r=0.30, p<0.001), and there was a significant negative relationship between parental stress and interest and curiosity in mental states (r=-0.28, p<0.001). The moderating role of pre-mentalizing components (p=0.041) and certainty in recognizing mental states (p=0.035) in the relationship between parental stress and the child's behavioral problems was also confirmed. Conclusion: The mother's low reflective functioning and parental stress can increase the probability of behavioral problems in children. Parental stress in mothers who have lower reflective functioning has a more negative effect on children's behavioral problems. Therefore, it is recommended to pay attention to teaching reflective functioning to mothers. [ABSTRACT FROM AUTHOR]

A caregiver's capacity to mentalize is thought to be one of the most important features of secure parent–child relationships. Parental mentalizing can be measured using the Reflective Functioning (RF) coding system applied to the Parent Development Interview (PDI). In this narrative review, we summarize the research using this measure and synthesize what has been learnt about the predictors, correlates and sequelae of parental RF. Studies have consistently shown that PRF on the PDI is associated with both parent and child attachment and is an important factor in the intergenerational transmission of attachment. It is also related to the quality of parental representations, parent–child interactions, and child outcomes. While a number of social and clinical risk factors are associated with lower PRF, it is difficult to disentangle the unique contribution of each of these. We discuss these findings and present the direction of future work that is planned to expand and refine the PRF scale for the PDI. [ABSTRACT FROM AUTHOR]

The birth of a child has been associated with a decline in couple satisfaction, which has implications for the child's social‐emotional development. This study investigated the potential spillover effect on pregnant women's perceptions of their relationships with their partners of the Supporting the Transition to and Engagement in Parenthood (STEP) program, a brief trauma‐informed mentalization‐based prenatal group intervention. Participants (94% White) were recruited in prenatal clinics and through online advertisements in Quebec, Canada. Both quantitative and qualitative data were collected from participants assigned to the STEP program (n = 42) and those receiving treatment‐as‐usual (TAU; n = 125). Women participating in STEP reported significant improvements in their relationships with their partners compared to those assigned to TAU. More precisely, they reported higher couple satisfaction, enhanced communication, and increased interest in their partners' emotional experience. The qualitative analysis further substantiated these results, with participants reporting having involved their partners in their pregnancy, shared their insights about themselves with their partners and gained fresh perspectives on their relationships. Participants in STEP also expressed sharing program materials with their partners and considered that such interventions should be extended to expecting fathers. This study underscores the potential of mentalization‐based interventions to indirectly contribute to couple relationships, which may have positive implications for parenting and the infant. [ABSTRACT FROM AUTHOR]

Background: The mentalization model of borderline personality disorder (BPD) utilizes a developmental psychopathology lens, emphasizing an unstable or reduced capacity to mentalize—stemming from early attachment disruptions and relational trauma—as the core feature of BPD. While the empirical evidence for the proposed intersections between mentalizing, attachment, and trauma and the development and manifestations of borderline personality is still limited, this knowledge is essential for developing effective assessments and interventions. Aim: To examine mentalizing, attachment, and early relational trauma as predictors of the severity of symptoms in BPD. Materials and Methods: The sample included 60 individuals diagnosed with BPD, aged 18–45 years, recruited from inpatient and outpatient services in a tertiary care mental health center. Participants completed measures of mentalizing (Reflective Functioning Questionnaire, Interpersonal Reactivity Index, and Reading the Mind in the Eyes test), attachment (Attachment Style Questionnaire), early relational trauma (Complex Trauma Questionnaire), and symptom severity (Borderline Symptom List). Results: The majority of the participants reported experiences of polyvictimization (93.3%) with the most common traumas being psychological abuse (93.3%), neglect (91.7%), and rejection (90.0%). Regression analyses revealed that uncertain reflective functioning, anxious attachment style, and the cumulative impact of trauma together predicted 53.1% of the variance in BPD symptom severity. Conclusion: Impaired mentalizing, characterized by inflexible understanding of mental states, is a critical target for therapeutic interventions in BPD. The significant role of anxious attachment and the necessity of assessing the perceived impact of traumatic experiences highlight the importance of trauma-informed and mentalization-based interventions for this vulnerable group. [ABSTRACT FROM AUTHOR]

Mothering from the Inside Out (MIO) is a mentalization-based parenting intervention developed to address challenges common among mothers experiencing substance use disorders (SUDs) and previously deemed effective when delivered by research clinicians. This randomized clinical trial was designed to test the efficacy of MIO when delivered by community-based addiction counselors in Connecticut, USA. Ninety-four mothers [M(SD)age = 31.01(4.01) years; 75.53% White] caring for a child 11-60 months of age were randomly assigned to participate in 12 sessions of either MIO or psychoeducation. Caregiving, psychiatric, and substance use outcomes were assessed repeatedly from baseline through 12-week follow-up. Mothers who participated in MIO showed decreased certainty about their childs mental states, and decreased depression; their children demonstrated increased clarity of cues. Participation in MIO was not associated with the same degree of improvement that was observed in prior trials where MIO was delivered by research clinicians. However, when delivered by community-based clinicians, MIO may be protective against a deterioration in caregiving over time often seen in mothers with addictions. The drop in efficacy of MIO in this trial raises questions about intervention-intervenor fit. Research should examine factors influencing MIO effectiveness to close the science-to-service gap common in the dissemination of empirically validated interventions.

Parenting young children poses numerous emotion regulation challenges, and prevention programs that promote emotion regulation skills can help with this important task of parenthood. Relational savoring (RS), which entails savoring a positive experience of interpersonal connectedness, is a brief manualized intervention program, 4 weeks in length, grounded in positive psychology and attachment theory. In the current longitudinal, randomized, controlled trial, we examined the impacts of RS compared with an active control (personal savoring [PS], defined as savoring a positive individual experience) in a sample of N = 164 mothers of toddlers (Mage = 20.93 months) on outcomes that were assessed immediately postintervention (positive emotion, closeness to child) and at a 3-month follow-up visit (parenting sensitivity, reflective functioning [RF], savoring uptake, and parenting wellness). Compared with mothers assigned to the PS condition, mothers in the RS condition had greater immediate response to the intervention (greater increases in positive emotions [gratitude, pride], closeness to their child) as well as greater increase in sensitivity to toddlers' cues at the three-month follow-up. Neither RS nor PS increased overall parenting wellness at the three-month follow-up. Latina mothers (but not non-Latina mothers) in the RS condition had higher RF and greater savoring uptake than Latina mothers in the PS condition at follow-up. Findings provide preliminary evidence of the efficacy of RS in modifying therapeutic targets and suggest evidence of the cultural congruence of RS for Latina mothers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

This study examined parental depression and parental reflective functioning (PRF) as predictors of parental proficiency in relational savoring (RS), the association between RS proficiency and a marker of children's physiological self-regulation, respiratory sinus arrhythmia (RSA), during a stressor, and indirect effects of parental depression and PRF on children's RSA via parents' RS. At Time 1 (T1), parents of 8- to 12-year-old children (N = 139) reported on their depressive symptoms and completed a parenting interview, coded for PRF. After 1.5 years (Time 2; T2), parents savored a positive relational memory that involved their children, which was coded for savoring proficiency. Children's RSA was measured during a stressful task (a series of impossible puzzles). Depressive symptoms (inversely) and PRF (positively) were associated with RS proficiency. Higher parental RS proficiency was associated with children's higher mean levels of RSA during the stressor. Indirect effects models supported that T2 RS proficiency mediated the negative association between parental T1 depressive symptoms and children's T2 RSA, and between T1 PRF and children's T2 RSA. We discuss these findings in terms of implications for parents' emotion regulation, children's emotion regulation, children's mental health, and intervention.

Background: The current research concept of mentalization is used in the study to clearly identify affective and cognitive abilities of the caregiver-child dyad with the aim of compensating deficits on both sides with psychologicalpsychotherapeutic strategies. Methods: The objective of this explorative, longitudinal intervention study is to provide an in-depth understanding of the psycho-social background of 30 children aged 6-12 years living in institutional or family-centered foster care. Data will be collected at three time points: before, after and 12 months after participating in the newly developed group intervention, which intends to address the particular needs of children of drug abusing parents living in foster care in the latency period. The study is conducted at the Faculty of Psychology of the University of Vienna in collaboration with the Association "Dialogue" (Verein Dialog). The treatment duration spans 5 months, during which two specifically trained psychotherapists conduct 10 group sessions for children and three group sessions for foster caregivers. All statistical analyses will consider the type of data available. Therefore, the primary outcome of the study will be assessed via the Friedman test due to the ordinal dependent variable as it is the non-parametric alternative to the one-way ANOVA for repeated measures. In addition, the Mann-Whitney U test is used to compare differences between two independent groups (children living in institutional foster care vs. family foster care). To assess potential correlations regarding the child and caregivers' capacity to mentalize, Spearman correlations () are conducted. To examine the secondary outcome, apart from the methods previously outlined, we will also utilize qualitative thematic analysis. Discussion: The present study uses the current research concept of mentalization to identify affective and cognitive abilities of the caregiver-child dyad with the aim of compensating deficits on both sides with psychological-psychotherapeutic strategies. There are some limitations of the study to mention: the small sample size does not allow to generalize the results. Due to the lack of a comparison group, a randomized control study (RCT) was not conducted. The authors are aware of these limitations. However, the studies' findings, will help to deduce research questions for further studies. [ABSTRACT FROM AUTHOR]

Maternal capacity to mentalize (= reflective functioning, RF), secure attachment and emotionally available parenting has an impact on the child's development. The transmission of mothers' past attachment experiences gained with both her caregivers in her own childhood and the impact on current mother–child interaction is part of the 'transmission gap.' This study explores the transgenerational transmission mechanisms and the potential moderating effect of RF in a clinical sample of 113 mother–child dyads suffering from mental health problems. In a cross-sectional study, the associations between maternal attachment experiences, RF (coded based on Adult Attachment Interviews) and current mother–child interaction (Emotional Availability Scales) were examined with univariate correlation, moderator analyses, and structural equation models. We found relationships between attachment experiences and mother–child interaction, but RF had no moderating effect. Past loving experiences and perceived neglection, particularly with the own father in childhood, were predictors for the present mother–child interaction. There seems to be an intergenerational transmission of attachment experiences to the ongoing generation. Particularly past adverse childhood experiences with the own father seem to explain currently disruptive interactions with the child. Trial registration: DRKS00017008 and DRKS00016353. [ABSTRACT FROM AUTHOR]

Psychoeducational programs to enhance reflective parental capacity are among the main prevention and intervention strategies for parents of children with behavioural and emotional problems. The objectives of the present systematic literature review are: 1) to identify evidence-based psychoeducational programs for parents of children over three years of age that aim to increase parental capacity for reflection and self-reflection; 2) to describe the characteristics and outcomes of these programs on parameters of parental functioning, parent-child relationships, and children‘s behaviours. This systematic review follows the protocol for systematic review (PRISMA-P). In four of the studied programs, there are data on a significant increase in the ability to reflect, in two of them - on a reduction in parental stress, and in the others, tendencies are reported. Direct comparison between programs is impossible due to differences in research design. [ABSTRACT FROM AUTHOR]

This study explored the relationships between psychopathic traits and client variables that impact the psychotherapy process/outcome. Variable-centered and person-centered analyses were utilized to first examine associations between psychopathic traits and client variables, and second to identify and compare homogeneous classes of individuals with psychopathic traits in client variables. 407 university students (aged 18–57, M = 28.19, SD = 7.45) were recruited online and completed the study measures. Results of correlational analyses indicated that higher scores on all psychopathy dimensions assessed by the Youth Psychopathic Traits Inventory-Short Version (YPI-S) were significantly associated with poorer client variables scores. YPI-S behavioral dimension had the strongest correlations with client variables, while the affective dimension exhibited stronger correlations than the interpersonal dimension. Furthermore, a latent profile analysis with the three YPI-S subscales identified five distinct profiles: "non-PP" (n = 226), "High GM" (n = 23), "High II" (n = 33), "High CU" (n = 31), and "Moderate GM-High CU/II" (n = 94). These profiles demonstrated significant differences in client variables, with the "Moderate GM-High CU/II" and "High II" groups displaying poorer scores than the other groups. Findings highlight the importance of considering/interpreting each dimension of psychopathy in treatment settings, as they exhibit different degrees of associations with client variables. Additionally, the unique profiles of psychopathic features should be considered when evaluating psychopathy measures' total score since individuals with the same total score can have different patterns of elevations on each dimension. Implications of findings from this study for practice and future research are further discussed. [ABSTRACT FROM AUTHOR]

Therapists' in-session feelings in psychotherapy can be seen as indications of the development of the therapeutic relationship and the therapeutic process. To manage them appropriately, it is important to know to what extent they may be influenced by patients' pretreatment characteristics. This study aims to improve the understanding of therapists' emotional reactions in the psychotherapeutic setting by investigating if patients' pretreatment mentalization ability and attachment style predicted therapist in-session feelings. In a sample of 87 therapy dyads treated with interpersonal psychotherapy and cognitive behavioral therapy for depression, patient attachment was measured using self-reported Experiences in Close Relationships (ECR) and mentalization using Reflective Functioning (RF). ECR and RF were hypothesized to predict therapist feelings measured by the Feeling Word Checklist–24 at different treatment phases over the full course of treatment. Treatment method, patient age, gender, and pretreatment depression were evaluated as potential confounders. Multilevel modeling was used to analyze the data. Lower RF in patients predicted more negative therapist feelings in the mid- to late-treatment phases and less positive feelings in the late-treatment phase. Self-reported attachment anxiety or avoidance did not predict therapist feelings. Findings indicate that patients' ability to mentalize is important to consider when conducting psychotherapy, as it can influence therapists' feelings in the therapeutic process. Limitations of the present study's approach are discussed, and directions for future research are considered. Public Significance Statement: This study indicates that therapists treating depressed patients with less developed mentalizing capacity feel less positive and more negative feelings in sessions as treatment gets closer to its end compared to when treating patients with better mentalizing ability. However, patient self-reported attachment showed no relationship to therapist in-session feelings. [ABSTRACT FROM AUTHOR]

Aim: The aim of the current study was to determine the moderating role of reflective functioning in the relationship between perceived parental acceptance-rejection and emotion regulation in adolescents. Method: This research was a correlational study. The statistical population included Iranian students aged 14-18 years. Data were collected through convenience sampling from 400 adolescents who completed a series of online questionnaires: Fonagy et al.'s Reflective Functioning Questionnaire (2016), the short form of Rohner's Parental Acceptance-Rejection Questionnaire (2005), and Gratz and Roemer's (2004) Difficulties in Emotion Regulation Scale. Structural equation modeling was used to analyze the data. Results: There was a positive and significant relationship between perceived parental rejection and the uncertainty dimension of reflective functioning with difficulties in emotion regulation in adolescents. Conversely, the certainty dimension had a negative and significant relationship with difficulties in emotion regulation. The certainty dimension of reflective functioning moderated the relationship between perceived parental rejection and difficulties in emotion regulation, while the uncertainty dimension did not. Conclusion: Adolescents with a higher level of reflective functioning can better cope with the effects of parental rejection. Therefore, improving reflective functioning should be a focus for therapists working with children, adolescents, and in parentchild relationships. [ABSTRACT FROM AUTHOR]

Introduction: Resilience, which is negatively associated with psychological disorders, is mainly shaped during childhood and is greatly affected by parents. Previous studies have shown that maternal mentalization is linked to child emotion regulation, and emotion regulation is confirmed to be correlated with resilience in children. In addition, some studies have shown that mothers' mentalization is negatively correlated with internalizing and externalizing symptoms in children. However, no study has examined the influence of maternal mentalization on children's resilience. We hypothesized that mothers' higher mentalization increases their children's resilience, both directly and via the mediating role of emotion regulation. Method: We used convenient sampling to test our hypothesis and gathered data from 362 mothers with 2 to 12 years old children. The data were analyzed by a zero-order correlation and Structural Equation Model (SEM). Results: According to the findings of the present study, the results confirmed our hypothesis. Conclusion: We can use these findings to design mentalization-based interventions to establish resilience in children, preventing them from developing mental health conditions. [ABSTRACT FROM AUTHOR]

Ting Zhou,1 Qian Wang,2 Youyang Wang,2 Lizhi Cheng2 1Department of Medical Psychology, School of Health Humanities, Peking University, Beijing, 100191, People’s Republic of China; 2National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital of Capital Medical University, Beijing, 100088, People’s Republic of ChinaCorrespondence: Qian Wang, National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital of Capital Medical University, Room 204, He Sheng Cai Fu Building, No. 13, De Sheng Street, Hai Dian District, Beijing, 100088, People’s Republic of China, Email wangqian1313246@163.comBackground: Healthcare workers encountered novel job stressors during the late stage of the COVID-19 pandemic. These stressors possessed potential deleterious effects on mental health outcomes, yet the underlying mediating and moderating mechanisms remained relatively unexplored.Objective: The current study aimed to examine the role of cognitive emotion regulation as a mediator in the association between pandemic-related job stressors and the psychological symptoms of healthcare professionals in the late stage of the COVID-19 pandemic, and the role of reflective functioning as a resilience factor moderating both the associations of pandemic-related job stressors and cognitive emotion regulation, as well as psychological symptoms.Methods: This cross-sectional survey conducted in October 2020 included 2393 healthcare professionals working in departments with a high risk of exposure to COVID-19 from 22 hospitals in Beijing, China. Participants were asked to complete questionnaires measuring pandemic-related job stressors, anxiety, depression, reflective functioning, and cognitive emotion regulation strategies. Path analyses were performed to examine the hypothesized model.Results: Epidemic-related job stressors had significant direct effects on depression (β=0.31, p< 0.001) and anxiety symptoms (β=0.29, p< 0.001) and the indirect effects through mediation of maladaptive cognitive regulation were also significant (for depression, indirect effect=0.06, SE=0.01, CI=[0.04, 0.07]; for anxiety, indirect effect=0.06, SE=0.01, CI=[0.04, 0.08]). The dimension of certainty about mental states in the reflective functioning questionnaire (RFQc) moderated the direct effect of pandemic-related job stressors on depression (β=− 0.05, p< 0.001) and moderated the effect of job stressors on maladaptive cognitive regulation (β=0.06, p< 0.001).Conclusion: The results shed light on the roles of cognitive emotion regulation and reflective functioning in coping with pandemic-related job stressors in frontline healthcare workers in periods of dealing with major infectious diseases. The findings have implications for developing interventions for healthcare workers in need.Keywords: pandemic-related job stressors, mental health, healthcare professionals, reflective functioning, cognitive emotion regulation

BackgroundThe current research concept of mentalization is used in the study to clearly identify affective and cognitive abilities of the caregiver-child dyad with the aim of compensating deficits on both sides with psychological-psychotherapeutic strategies.MethodsThe objective of this explorative, longitudinal intervention study is to provide an in-depth understanding of the psycho-social background of 30 children aged 6–12 years living in institutional or family-centered foster care. Data will be collected at three time points: before, after and 12 months after participating in the newly developed group intervention, which intends to address the particular needs of children of drug abusing parents living in foster care in the latency period. The study is conducted at the Faculty of Psychology of the University of Vienna in collaboration with the Association “Dialogue” (Verein Dialog). The treatment duration spans 5 months, during which two specifically trained psychotherapists conduct 10 group sessions for children and three group sessions for foster caregivers. All statistical analyses will consider the type of data available. Therefore, the primary outcome of the study will be assessed via the Friedman test due to the ordinal dependent variable as it is the non-parametric alternative to the one-way ANOVA for repeated measures. In addition, the Mann–Whitney U test is used to compare differences between two independent groups (children living in institutional foster care vs. family foster care). To assess potential correlations regarding the child and caregivers’ capacity to mentalize, Spearman correlations (ρ) are conducted. To examine the secondary outcome, apart from the methods previously outlined, we will also utilize qualitative thematic analysis.DiscussionThe present study uses the current research concept of mentalization to identify affective and cognitive abilities of the caregiver-child dyad with the aim of compensating deficits on both sides with psychological-psychotherapeutic strategies. There are some limitations of the study to mention: the small sample size does not allow to generalize the results. Due to the lack of a comparison group, a randomized control study (RCT) was not conducted. The authors are aware of these limitations. However, the studies’ findings, will help to deduce research questions for further studies.

ObjectivesMentalizing difficulties are central to borderline personality disorder (BPD), have severe consequences, and are an explicit focus in mentalization-based treatment. The significance of mentalizing capacity as a predictor or mediator of change is however still uncertain due to a scarcity of research. The Mentalization Breakdown Interview (MBI) was developed as a time saving tool for studying psychotherapy processes and outcome in borderline pathology. This study aimed to investigate the convergent validity of reflective functioning (RF) ratings based on the MBI (MBI-RF) by a comparison with the gold standard, i.e., RF assessments based on the Adult Attachment Interview (AAI-RF). A secondary aim was to investigate how MBI-RF relates to core symptoms of BPD, levels of functional impairment and symptom distress compared with AAI-RF.MethodForty-five patients with BPD or significant BPD traits were included. MBI-RF and AAI-RF were rated using the Reflective Functioning Scale. Levels of MBI-RF and AAI-RF and the correlation between the measures were calculated, as well as their associations with the Difficulties in Emotion Regulation Scale, Levels of Personality Functioning-Brief Form 2.0, Work and Social Adjustment Scale, Patient Health Questionnaire, Depression, Generalized Anxiety Disorder-7, self-harm, suicide attempts, and PD diagnostics.ResultsThe correlation between MBI-RF and AAI-RF was 0.79 (p

The COVID-19 pandemic has led to a surge of conspiracy theories that are used to explain this health crisis. Belief in these theories in turn has significant implications regarding adherence to scientifically based health measures and the seeking of appropriate medical treatment. However, the precursors of conspiracy thinking have not yet been fully understood. The current study investigated the direct and indirect effect of reflective functioning on conspiracy thinking through the role of generalized perceived threat of the virus, positive and negative emotions, trust in scientists, and trust in God in a sample of 1,730 adults in Greece. The results indicate that enhanced capacity for reflective functioning is associated with less likelihood of conspiracy theory endorsement. Higher levels of reflective functioning were associated with increased negative emotionality, lower levels of generalized perceived threat, greater trust in scientists, and less trust in God. Reflective functioning in and of itself did not predict conspiracy theory endorsement directly. Rather, this relationship was fully mediated by negative emotionality, generalized perceived threat, and higher levels of trust in scientists. These findings support recently proposed positions indicating that reflective functioning has a significant role in the framework of the COVID-19 pandemic.

This study aimed to identify and inform recommendation of self-report and interview-based instruments that are feasible, reliable and valid to evaluate the quality of the maternal-fetal relationship (MFR). Several constructs predicting parent–infant interaction and later infant adjustment are used to assess mothers' thoughts and feelings towards their unborn baby, including reflective functioning, mind-mindedness, representation, and fetal attachment. As yet, there is no existing review comparing the quality and accessibility of instruments across each of these constructs. A systematic literature review was undertaken to synthesise psychometric information on measures reporting on the MFR. Searches of six databases were conducted. English articles were selected based on inclusion and exclusion criteria. The QATSDD checklist was used to assess study quality. Of 669 studies identified, 28 met inclusion criteria. Thirteen different instruments were identified for evaluation. Reported reliability and validity varied significantly across instruments, as well as availability for research and/or clinical use. Suggestions for research and clinical practice include further evaluation of the psychometric properties of tools, particularly for self-report measures of reflective functioning, use of interviews to scaffold reflexivity, and development of clinical policies and procedures to clarify care pathways for expectant mothers needing further support. [ABSTRACT FROM AUTHOR]

Childhood trauma is intimately related with suicidal behaviour. Patients who have suffered childhood trauma develop impaired Reflective Functioning (RF), which refers to the capacity to understand ourselves and others in terms of intentional mental states. An improvement in RF has been associated with a reduction in suicidal attempts, but the mediating role of RF between childhood trauma and suicidal behaviour has not been addressed so far. We aim to examine the potential mediating effect of RF among childhood trauma and suicide attempts. We included 748 patients who had attempted suicide at least once. They were asked to complete the Reflective Functioning Questionnaire (RFQ-8), the Columbia-Suicide Severity Rating scale (CSSRS), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). We conducted linear regressions by simple mediating model to examine the role of RF in the indirect association between childhood trauma and the number of suicide attempts. Our results show significant indirect effects through hypo and hypermentalizing between Emotional Abuse (EA) and Sexual Abuse (SA) in childhood and the number of suicide attempts in lifetime. These results indicate that ineffective RF significantly mediates the association between childhood trauma and suicidality. This is the first study supporting the mediational role of RF in the relationship between EA and SA , and the number of suicide attempt in lifetime. These findings have important implications for reducing suicide rates and preventing future re-attempts. Further studies analysing this mediating role and focusing efforts on increasing RF-based interventions are required. [ABSTRACT FROM AUTHOR]

ObjectivesMethodsResultsConclusionsClinical ImplicationsFinancial exploitation of older adults results in devastating economic, social, and psychological losses to older adults, their families, and society at large. This study examined the relationship between reflective functioning and financial exploitation vulnerability (FEV) and whether relationship status moderated the association.A community-based sample of 156 Israeli older adults age 60 and over responded to demographic questions and questionnaires assessing reflective functioning and FEV.A hierarchical linear regression analysis covarying for age, sex, education, income, and sum of illnesses, revealed that higher reflective functioning was associated with lower FEV (p = .011). A main effect of relationship status was not found, but a significant interaction of reflective functioning × relationship status was discovered (p = .008), adding 4.2% to the total variance of the model. Probing the interaction revealed that the reflective functioning-FEV association was significant only for older adults not in a relationship.Findings suggest that low reflective functioning may be associated with increased risk of financial exploitation, specifically in certain populations of older adults.Care providers of older adults may consider assessing for, and identifying older adults with low reflective functioning, in order to prevent or intervene in the event of a potentially exploitative situation. [ABSTRACT FROM AUTHOR]

Sensitive and responsive parenting is known to promote secure attachment. Caregiver reflective functioning (RF), one's capacity to mentalize, is a critical mechanism for caregiver behaviors supportive of secure attachment. Interventions targeting RF can improve caregiving quality, and in turn, attachment security. One such promising intervention is Circle of Security-Parenting (COS-P), a brief eight-week parenting program designed to improve caregiver behaviors known to promote attachment security. Using a randomized wait-list control design, we examined the efficacy of the COS-P program in improving caregiver RF, and in turn, positive caregiver behaviors. The present sample of forty-six primary caregivers (3 fathers, 40 mothers, 1 grandfather, 2 grandmothers) were predominately low-income and people of color. Caregivers were randomly assigned to the COS-P intervention group or wait-list control group. Pre/post data collection included demographic information, interview to assess RF (PDI-R2-S), and a caregiver-child semi-structured play interaction (Crowell). As a result of the brief intervention, intervention caregivers, compared to control group caregivers, demonstrated significant growth in RF, behavioral responsiveness, and emotional responsiveness. Caregiver RF at posttest explained a significant amount of variance in both posttest behavioral and emotional responsiveness above and beyond pretest RF, pretest parenting behavior, and intervention condition. Using a randomized waitlist control trial, and a gold-standard measure of RF, these findings extend previous literature by not only demonstrating a significant intervention effect on key outcomes known to promote attachment security, but also by highlighting the important role that caregiver RF plays in this process. Highlights: This study explored the impact of Circle of Security parenting training on caregiver reflective functioning and parenting. This trial demonstrated significant growth in parental reflective functioning and responsiveness for those in intervention. These findings highlight the impact of a targeted, brief intervention on parenting behaviors known to promote attachment. [ABSTRACT FROM AUTHOR]

This study examined parental depression and parental reflective functioning (PRF) as predictors of parental proficiency in relational savoring (RS), the association between RS proficiency and a marker of children's physiological self-regulation, respiratory sinus arrhythmia (RSA), during a stressor, and indirect effects of parental depression and PRF on children's RSA via parents' RS. At Time 1 (T1), parents of 8- to 12-year-old children (N = 139) reported on their depressive symptoms and completed a parenting interview, coded for PRF. After 1.5 years (Time 2; T2), parents savored a positive relational memory that involved their children, which was coded for savoring proficiency. Children's RSA was measured during a stressful task (a series of impossible puzzles). Depressive symptoms (inversely) and PRF (positively) were associated with RS proficiency. Higher parental RS proficiency was associated with children's higher mean levels of RSA during the stressor. Indirect effects models supported that T2 RS proficiency mediated the negative association between parental T1 depressive symptoms and children's T2 RSA, and between T1 PRF and children's T2 RSA. We discuss these findings in terms of implications for parents' emotion regulation, children's emotion regulation, children's mental health, and intervention. [ABSTRACT FROM AUTHOR]

Purpose: The existing literature, however sparse, suggests an association between eating disorders (ED) and mentalization ability. The aim of this study was to investigate the mentalization profile (MP) in patients with ED. It was hypothesized that patients with ED would have a lower degree of mentalization ability compared to healthy controls (HC). Materials and methods: The study is based on a cross-sectional survey on a sample of patients diagnosed with ED compared to a HC group. Results and conclusion: A total of 88 participants, distributed between patients with ED (N = 30) and HC (N = 58) were included. Results: The study results show statistically significant differences between patients with ED and HC. Thus, patients with an ED scored significantly higher on Reflective Functioning Questionnaire (uncertainty about mental states) (RFQ-U) (mean difference: 0.31, p = 0.048) and Toronto Alexithymia Scale (TAS-20) (mean difference: 0.44, p = 0.019) compared to the HC. Furthermore, the results indicated that patients with Bulimia Nervosa (BN) may have a lower ability to mentalize about oneself as well as a generally lower ability to mentalize across different dimensions of the mentalization profile as the BN group scored significantly higher on RFQ-U (mean difference: 0.71, p = 0.023) and TAS-20 (mean difference: 0.89, p = 0.006) compared to the Anorexia Nervosa (AN) group. Further research should be conducted to gain knowledge on the mentalization ability in patients with an ED. [ABSTRACT FROM AUTHOR]

Objective: Mentalization is discussed as a mechanism of change in psychotherapy due to its positive effects on psychological functioning. In order to specifically apply mentalization-based interventions, a better understanding of the relationship between interventions and in-session mentalization is needed. The study aimed to explore the association between interventions and effective mentalizing. Method: Fifteen therapy sessions of three therapies with male adolescents with conduct disorder were transcribed and rated with the Reflective Functioning (RF) Scale and a newly developed Mentalization-based Treatment (MBT) intervention coding manual. The coded interventions were categorized into intervention levels according to the MBT manual. Fisher's exact tests were performed to test differences in frequencies of interventions in high-RF sequences (RF score ≥ 4) compared with remaining therapy sequences (RF score ≤ 3). Results: Specific MBT interventions such as demand questions, affectelaboration, empathic validation, change of subject, challenge, patienttherapist relation and mentalizing for the patient were related to effective mentalizing. Moreover, intervention levels such as supportive & empathic, basic-mentalizing & affect mode and relational mentalizing were positively associated with effective mentalizing. Conclusion: MBT interventions seem to promote effective mentalizing at various intervention levels. Interventions that enhance effective mentalizing seem to be patient specific. In line with MBT theory, their effect on effective mentalizing might depend on various variables, such as the patients' arousal and pre-mentalizing mode. [ABSTRACT FROM AUTHOR]

Based on the accumulation of interactions with their caregivers, children develop expectations regarding interactions between themselves and their attachment figures. Tied to these expectations are emotions that regulate behavior and eventually come to organize behavior in all significant relationships. Reflective Functioning (RF) is defined as the capacity to understand and interpret one's own and other's behavior as an expression of mental states (Fonagy et al., 2002). There have been numerous papers linking RF to attachment and parent- child interaction. Here, we seek to extend our knowledge of RF and its link to attachment by investigating its role in maternal behaviors such as acknowledgment and overall supportive parental presence. The current pilot study examined 20 mothers' Adult Attachment Interviews (AAIs) using the RF scale and parent-child dyadic interactive behavior utilizing the Coding Interactive Behavior (CIB) manual. The current work underscores the value of measuring RF in AAI responses or other narrative material to gain an early picture of strengths and difficulties in parents of infants before they enter a treatment program. [ABSTRACT FROM AUTHOR]