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

Eduardo Ruiz-Parra, Guadalupe Manzano-García, Roberto Mediavilla, Beatriz Rodríguez-Vega, Guillermo Lahera, Ana I Moreno-Pérez, Alberto M Torres-Cantero, Juan Rodado-Martínez, Amaia Bilbao, Miguel Ángel González-Torres, Eduardo Ruiz-Parra, Guadalupe Manzano-García, Roberto Mediavilla, Beatriz Rodríguez-Vega, Guillermo Lahera, Ana I Moreno-Pérez, Alberto M Torres-Cantero, Juan Rodado-Martínez, Amaia Bilbao, Miguel Ángel González-Torres

Abstract

Introduction: Mentalization or reflective functioning (RF) is the capacity to interpret oneself or the others in terms of internal mental states. Its failures have been linked to several mental disorders and interventions improving RF have a therapeutic effect. Mentalizing capacity of the parents influences the children's attachment. The Reflective Functioning Questionnaire (RFQ-8) is a widely used tool for the assessment of RF. No instrument is available to assess general RF in Spanish-speaking samples. The aim of this study is to develop a Spanish version of the RFQ-8 and to evaluate its reliability and validity in the general population and in individuals with personality disorders.

Methods: 602 non-clinical and 41 personality disordered participants completed a Spanish translation of the RFQ and a battery of self-reported questionnaires assessing several RF related constructs (alexithymia, perspective taking, identity diffusion and mindfulness), psychopathology (general and specific) and interpersonal problems. Temporal stability was tested in a non-clinical sub-sample of 113 participants.

Results: Exploratory and confirmatory factor analyses suggested a one-factor structure in the Spanish version of the RFQ-8. RFQ-8 understood as a single scale was tested, with low scorings reflecting genuine mentalizing, and high scorings uncertainty. The questionnaire showed good internal consistence in both samples and moderate temporal stability in non-clinical sample. RFQ correlated significantly with identity diffusion, alexithymia, and general psychopathology in both samples; and with mindfulness, perspective taking, and interpersonal problems in clinical sample. Mean values of the scale were significantly higher in the clinical group.

Discussion: This study provides evidence that the Spanish version of the RFQ-8, understood as a single scale, has an adequate reliability and validity assessing failures in reflective functioning (i.e., hypomentalization) in general population and personality disorders.

Conflict of interest statement

The authors have declared that no competing interest exist.

Copyright: © 2023 Ruiz-Parra et al. 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 credited.

Figures

Fig 1. Confirmatory factor analysis for the…
Fig 1. Confirmatory factor analysis for the one-factor structure in the non-clinical sample.
Note: The standardized factor loadings and error variances are shown. As in Spitzer et al. [28], Müller et al. [29], and Wozniak-Prus et al. [38] studies, the error of items 3 and 4 were allowed to covariate.
Fig 2. Confirmatory factor analysis for the…
Fig 2. Confirmatory factor analysis for the two-factor structure in the non-clinical sample.
Note: The standardized factor loadings, error variances and covariance among exogenous variables are shown. As in Spitzer et al. [28], and Müller et al [29] studies, the error of items 3 and 4 were allowed to covariate.
Fig 3. Exploratory factor analysis for the…
Fig 3. Exploratory factor analysis for the two-factor structure in the non-clinical sample using Promax rotation.
Note: The factor loadings are shown, and those smaller than 0.30 are grayed out. The percentage of variance explained by the two factors was 53.01%.

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