Further studies are needed to replicate the present results in a larger sample and investigate potential age differences in the relationship between cognitive empathy and reflective functioning.
Nevertheless, given the configural invariance, satisfactory homogeneity indices and the finding that most of relationships with other constructs are similar in the adult and adolescent sample, overall results provide some confidence in the reliability and validity of the French version of the reflective functioning questionnaire.
Finally, the present results suggest that hypomentalizing as expressed in low certainty and high uncertainty about mental states may be associated with a recent history of episodes in adolescents and adults. In the adult sample, we found a significant association between a lower degree of certainty as well as a higher degree of uncertainty about mental states and a history of recent non-suicidal self-injury.
Although no studies have directly addressed the relationship between non-suicidal self-injury and reflective functioning, dysfunctions in reflective functioning have been consistently highlighted in borderline personality disorder and allied conditions see [ 30 — 31 ] for reviews.
In particular, the present study supports, on the one hand, that a certain degree of certainty about the mental origin of behaviors may sustain an adaptive functioning as emphasized in the correlational pattern observed between the reflective functioning questionnaire certainty score and several measures of clinical and psychological variables. On the other hand, the associations found between reflective functioning and non-suicidal self-injury further suggest that an absence of this adaptive certainty about mental states concerning oneself and others i.
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One possible interpretation of this finding relates to the major function of non-suicidal self-injury, namely, to regulate strong and overwhelming emotions to produce fast, but short-term, relief. This kind of body-centred self-regulation strategy may be indicative of disrupted RF abilities hypomentalization that prevent individuals from envisioning less action-based coping strategies. Conversely, higher reflective functioning may promote more mentalized, cognitive-based coping strategies, enabling the individual to regulate the arousal induced by events they encounter in daily life.
This is consistent with the conceptualization of reflective functioning as being involved in resilience [ 50 ].
The situation might be slightly different for adolescents, in that similar trends but no significant associations were observed between features of reflective functioning and non-suicidal self-injury history. At least two hypotheses may account for these differences. As mentioned earlier, the adolescent sample may have been too small for statistically significant differences to be detected. As well as methodological issues, the present results may indicate underlying but partially distinct processes of non-suicidal self-injury according to the developmental period in which they occur.
Non-suicidal self-injury consists of a wide range of heterogeneous behaviors that may vary in terms of type, function, and psychological or clinical correlates see [ 51 ] for a review. In particular, differences have been observed between episodic and repetitive non-suicidal self-injury, including differences at the level of associated risk factors [ 52 — 54 ].
Episodic non-suicidal self-injury is by definition a transient phenomenon that typically has onset early in adolescence 12—14 years , while some epidemiological studies suggest that there is another peak at around 18—19 years [ 55 ].
While the prospective data on this issue remain scarce, on the basis of prevalence data, episodic non-suicidal self-injury is thought to be less frequent in adulthood [ 56 ]. In contrast to adolescents, recent episodes of non-suicidal self-injury reported by the adult group in the present study are therefore more likely to reflect chronic rather than acute manifestations of self-harming behavior.
As previously illustrated with clinical correlates e. Thus, if the non significant relationship between reflective functioning and non-suicidal self-injury found in the adolescent sample is not due to methodological issues, the mechanism that underlies the distinct associations might not reflect a developmental shift resulting from age per se , but differences in the nature occasional vs.
The nature of self-harming behaviors reported in this sample of adolescents may be more transient than those reported by adults, which would weaken the relationship with uncertainty about mental states. Nevertheless, these conclusions remain speculative and need to be confirmed by a more comprehensive assessment of NSSI that includes a direct measure of chronicity. Some limitations of the present study must be acknowledged. First, the results need to be replicated within clinical samples. The second limitation concerns the relatively small number of adolescents and adults reporting a recent history of non-suicidal self-injury.
Further, the prevalence of NSSI in the present sample is very similar to lifetime prevalence in several recent studies e. Hence, it is possible that participants, rather than considering the one-year occurrence of NSSI mentioned in the instructions of the BPI, reported on the lifetime incidence. Indeed, NSSIs comprise heterogeneous phenomena, sometimes associated with various psychopathological symptoms, and their measurement can also vary following the methods that are employed. Their experiential and functional characteristics may also play a role in their variability from one sample to another.
These clinical and qualitative features are likely to affect the potential relationships with RF processes such as those evaluated in the present study. Future investigation of this topic would definitely benefit from a more comprehensive evaluation of NSSI. The extent to which RF will be identified as a factor that underlies different types of self-harm remains an empirical question, for which the current results foster further inquiry. In conclusion, the present study provides preliminary evidence for the reliability and validity of a self-report questionnaire to assess reflective functioning in French-speaking individuals and furthers our knowledge about individual differences in reflective functioning.
The current data also constitute the first step towards the examination of reflective functioning in clinical settings of French-speaking population. We are grateful to all the participants who participated in this study. We thank Sarah Menghetti and Alexandra Zaharia for their help with data collection. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. National Center for Biotechnology Information , U.
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PLoS One. Published online Dec Ulrich S Tran, Editor. Author information Article notes Copyright and License information Disclaimer. Competing Interests: The authors have declared that no competing interests exist. Received Dec 13; Accepted Dec 9. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. This article has been cited by other articles in PMC. Results The current results showed configural invariance of the original two-factor structure of the RFQ across French-speaking adolescents and adults and satisfactory reliability and construct validity of the two subscales.
Discussion The present research has methodological and clinical implications in that it provides the first evidence that the RFQ can be used to reliably assess reflective functioning in French-speaking population. Introduction Reflective functioning RF refers to the empirically grounded operationalization of psychological processes that sustain the capacity to mentalize, that is, to understand and interpret behaviors of the self and others as expressions of intentional mental states such as beliefs, desires, or needs [ 1 ]. Material and Methods Participants Participants were community adolescents and young adults from Geneva, Switzerland, who were recruited via written advertisements and word of mouth.
Measures The following battery of self-report questionnaires was individually administered under the supervision of trained clinical psychologists M. Data analyses The validation process of the French RFQ started with the translation of the original English RFQ by independent French and English native speakers, following a forward-backward-forward procedure [ 42 ].
Results Measurement invariance of the RFQ scores across age The hypothesized two-factor model showed an adequate to good fit to the data in each sample separately see Table 1. Open in a separate window. Table 2 Factor loading, factor covariance and error term covariance for measurement invariance across age.
Table 3 Reliability indices internal consistency and temporal stability for adolescent and adult groups. Table 4 Construct validity indices for adolescent and adult groups. Adolescent group The results for construct validity Table 4 in the adolescent group largely mirror those for the adult sample. Table 5 Descriptive statistics of the groups with and without Non-Suicidal Self-Injury NSSI and its association with reflective functioning in adolescence and adulthood.
NSSI occurrence was missing for 1 adolescent and 8 adults. Discussion The present study was designed to examine the psychometric properties of a French translation of the reflective functioning questionnaire in non-referred adolescent and adult samples.
Acknowledgments We are grateful to all the participants who participated in this study. References 1. Gergely G, Watson JS The social biofeedback theory of parental affect mirroring: the development of emotional self-awareness and self-control in infancy. Int J Psychoanal 77 : — Fonagy P, Target M Playing with reality: Theory of mind and the normal development of psychic reality. Int J Psycho-Anal 77 : — Attachment Human Development 7 : — 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.
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