XClose

Psychoanalysis Unit

Home
Menu

The Parental Reflective Functioning Questionnaire (PRFQ)

General information

Mentalizing, or reflective functioning, refers to the capacity to understand ourselves and others as motivated by intentional mental states, such as feelings, desires, wishes, goals and attitudes [1] . Mentalizing is an essential capacity to successfully navigate the social world. Impairments in mentalizing have been shown to be implicated in a wide variety of disorders and behavioural problems, ranging from psychosis to personality disorders, mood and anxiety disorders, eating disorders, and conduct disorder [1].

Parental reflective functioning (PRF) refers to the caregiver’s capacity to reflect upon his/her own internal mental experiences as well as those of the child [2] [3]. PRF is assumed to play a key role in fostering the developing infant’s own capacity for mentalizing, which in turn is important for the development of emotion regulation, a sense of personal agency, and secure attachment relationships [2] [4] [5]. The development of mentalizing is thought to depend largely on the extent to which the infant’s subjective experiences have been adequately mirrored by a trusted other, and thus PRF is likely to be an important factor influencing the development of mentalizing in children and young people.

There is increasing evidence for the effectiveness in both adults and young people of intervention programmes that are rooted in the mentalizing approach [1], and a focus on improving mentalizing may be a common factor in all effective psychosocial interventions [6]. A number of interventions have also been shown to increase parental reflective functioning specifically [7] [8] [9].

Development of the PRFQ

The Parental Reflective Functioning Questionnaire (PRFQ) has been developed to provide a brief, multidimensional assessment of parental reflective functioning that is easy to administer to parents with a wide range of socioeconomic and educational backgrounds [10] [11]. Because of the current interest in the role of PRF in the intergenerational transmission of attachment in early childhood, the PRFQ was primarily designed for parents of children 0–5 years of age. Currently, we advise against the use of the PRFQ in parents of children older than 5 years. We are piloting a version for older children and adolescents, and this measure will be made available in the future as we obtain more information on its reliability and validity.

The PRFQ does not aim to replace other measures of parental reflective functioning, which often yield more detailed and idiosyncratic information. The PRFQ was developed as a brief screening tool that can be used in studies with large sample sizes. We therefore recommend that studies use a combination of the PRFQ as an initial screening tool, and more detailed interview- and/or observer-based measures to characterize a sample in greater detail.

For more information on the development of the PRFQ, see Luyten, Mayes, Nijssens & Fonagy (2017) and [12].

Statistical analysis

For the purposes of statistical analysis, we recommend (multi-group) Confirmatory Factor Analysis with maximum likelihood estimation either on Pearson r correlation coefficients or on polychoric correlations, allowing error correlations only between items that are similar in formulation or meaning (for more details, see [10]).

Availability

On this website, we make available the 18 items and scoring syntax in English, and translations of the 18 items in the various languages that are currently available. Validation studies of each of the translations will be made available in the future.

The PRFQ is freely available to download for research purposes only. The measure is not yet suited for clinical purposes.

PRFQ–Adolescent version

We have also developed the PRFQ for adolescents (PRFQ-A) based on the rewording of some of the PRFQ items so that they are suitable for parents with children between 12 and 18 years of age. There is good evidence for the factor structure, reliability and validity of the PRFQ-A. The subscales, order of items and scoring procedure is the same as for the PRFQ. Results of these studies will be made available soon on this website.

Please refer to as:

Luyten, P., Mayes, L. C., Nijssens, L., & Fonagy, P. (2017). The Parental Reflective Functioning Questionnaire – Adolescent version. University of Leuven, Belgium.

Other language versions will be available soon. If you are interested in translating the PRFQ, or if you have any other questions, please contact:

Patrick Luyten: p.luyten@ucl.ac.uk

References

1. Allen JG, Fonagy P, Bateman AW. Mentalizing in clinical practice. Washington, DC: American Psychiatric Press; 2008.

2. Slade A. Parental reflective functioning: An introduction. Attachment & Human Development. 2005;7(3):269-281. doi: 10.1080/14616730500245906

3. Slade A, Grienenberger J, Bernbach E, Levy D, Locker A. Maternal reflective functioning, attachment, and the transmission gap: A preliminary study. Attachment & Human Development. 2005;7(3):283-298. doi: 10.1080/14616730500245880

4. Grienenberger J, Kelly K, Slade A. Maternal reflective functioning, mother–infant affective communication, and infant attachment: Exploring the link between mental states and observed caregiving behavior in the intergenerational transmission of attachment. Attachment & Human Development. 2005;7(3):299-311. doi: 10.1080/14616730500245963

5. Sharp C, Fonagy P. The parent's capacity to treat the child as a psychological agent: Constructs, measures and implications for developmental psychopathology. Social Development. 2008;17(3):737-754. doi: 10.1111/j.1467-9507.2007.00457.x

6. Fonagy P, Luyten P, Allison E. Epistemic petrification and the restoration of epistemic trust: A new conceptualization of borderline personality disorder and its psychosocial treatment. Journal of Personality Disorders. 2015;29(5):575-609. doi: 10.1521/pedi.2015.29.5.575

7. Suchman NE, DeCoste C, Castiglioni N, McMahon TJ, Rounsaville B, Mayes L. The Mothers and Toddlers Program, an attachment-based parenting intervention for substance using women: Post-treatment results from a randomized clinical pilot. Attachment & Human Development. 2010;12(5):483-504. doi: 10.1080/14616734.2010.501983

8. Suchman NE, Decoste C, Rosenberger P, McMahon TJ. Attachment-based intervention for substance-using mothers: A preliminary test of the proposed mechanisms of change. Infant Mental Health Journal. 2012;33(4):360-371. doi: 10.1002/imhj.21311

9. Sadler LS, Slade A, Close N, Webb DL, Simpson T, Fennie K, Mayes LC. Minding the Baby: Enhancing reflectiveness to improve early health and relationship outcomes in an interdisciplinary home visiting program. Infant Mental Health Journal. 2013;34(5):391-405. doi: 10.1002/imhj.21406

10. Luyten P, Mayes LC, Nijssens L, Fonagy P. The parental reflective functioning questionnaire: Development and preliminary validation. PLOS ONE. 2017;12(5):e0176218. doi: 10.1371/journal.pone.0176218

11. Luyten P, Nijssens L, Fonagy P, Mayes LC. Parental reflective functioning: Theory, research, and clinical applications. Psychoanalytic Study of the Child. 2017;70(1):174-199. doi: 10.1080/00797308.2016.1277901

12. Camoirano A. Mentalizing makes parenting work: A review about parental reflective functioning and clinical interventions to improve it. Frontiers in Psychology. 2017;8:14. doi: 10.3389/fpsyg.2017.00014