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The Reflective Functioning Questionnaire (RFQ)

General information

Mentalizing, or reflective functioning, refers to our capacity to understand ourselves and others in terms of intentional mental states, such as feelings, desires, wishes, goals and attitudes. Mentalizing is a quintessential human capacity that is needed to be able to successfully navigate the social world. Impairments in this capacity 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].

There is increasing evidence to support the effectiveness of intervention programmes that have been explicitly inspired by the mentalizing approach, and a focus on improving mentalizing may be a common factor in all effective psychosocial interventions [2].

The Reflective Functioning Questionnaire (RFQ) was developed as a brief, easy-to-administer screening measure of reflective functioning [3]. It is not aimed at capturing the different dimensions of mentalizing (for a detailed description of these dimensions, see [4]), nor is it aimed at capturing the process of mentalizing as it unfolds in social interactions. A wide range of measures are currently available that tap into these specific capacities, or that allow the assessment of 'online' (real-time) mentalizing. For a more extensive discussion of the assessment of mentalizing for clinical and research purposes, see [5].

We are currently in the process of developing a longer, multidimensional self-report and clinician-report measure of reflective functioning, as well as measures that assess different dimensions of mentalizing. These will be made available in the future.

Important note: The RFQ has been developed to assess severe impairments or imbalances in mentalizing as typically observed in patients with borderline personality disorder features. Hence, we advise researchers to use and validate the measure in samples of individuals that are likely to have severe problems with mentalizing, or in samples where at least enough variance in mentalizing capacities can be expected. Therefore, the measure might not be particularly suitable for use in normal community samples or student samples. There are a number of other measures that assess aspects or features of mentalizing, many of which are discussed in [5].

Development of the RFQ

A detailed description of the development of the RFQ can be found in Fonagy et al. (2016) [3].

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 (e.g., item 17, "I don't always know why I do what I do" and item 36, "Sometimes I do things without really knowing why"). For more details, see Fonagy et al. 2016 [3].

Availability

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

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

Publications

We would like to be able to provide a comprehensive list of publications of studies using the RFQ. We will provide details of papers on this webpage and links to the full-text of each paper online where possible. We will provide details of these papers regardless of the nature of the sample, design or findings. Being included on this webpage does not imply our agreement or approval; it reflects our commitment to open science.

Park MK, Song JH. Validity of primary screening reflective function questionnaire for youth in Korean adolescents. Journal of Emotional & Behavioral Disorders (Korea) 2018;34(2):115-131. [In Korean with English abstract].

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

Peter Fonagy: p.fonagy@ucl.ac.uk

References

  1. Allen JG, Fonagy P, Bateman AW. Mentalizing in clinical practice. Washington, DC: American Psychiatric Press; 2008.
  2. 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
  3. Fonagy P, Luyten P, Moulton-Perkins A, Lee YW, Warren F, Howard S, et al. Development and validation of a self-report measure of mentalizing: The Reflective Functioning Questionnaire. PLOS ONE. 2016;11(7):e0158678. doi: 10.1371/journal.pone.0158678
  4. Luyten P, Fonagy P. The neurobiology of mentalizing. Personality Disorders: Theory, Research, and Treatment. 2015;6(4):366-79. doi: 10.1037/per0000117.
  5. Luyten P, Malcorps S, Fonagy P, Ensink K. (2019) Assessment of mentalizing. In: Bateman AW, Fonagy P, editors. Handbook of mentalizing in mental health practice, 2nd edn. Washington, DC: American Psychiatric Publishing; 2019.
  6. Badoud D, Luyten P, Fonseca-Pedrero E, Eliez S, Fonagy P, Debbane M. The French version of the Reflective Functioning Questionnaire: Validity data for adolescents and adults and its association with non-suicidal self-injury. PLOS ONE. 2015;10(12):e0145892. doi:10.1371/journal.pone.0145892