Mentalizing in adolescence: Psychometric properties of the reflective functioning questionnaire (RFQ) and links with mental health, psychological well-being, and suicidal behaviours

J Affect Disord. 2025 May 5:S0165-0327(25)00757-8. doi: 10.1016/j.jad.2025.05.001. Online ahead of print.

ABSTRACT

BACKGROUND: Reflective functioning [RF] or mentalizing refers to the ability to understand others and the self in terms of internal mental states. RF is thought to play a key role in the development of mental health problems, and to attenuate risk and morbidity associated to psychopathology. The main goal of this study was to validate the Reflective Functioning Questionnaire (RFQ) into Spanish in a community-derived sample of adolescents. In addition, the association between RFQ scores and suicidal behaviour, mental health strengths and difficulties, and personal well-being was analyzed.

METHOD: A total of 1588 students (M = 16.13 years, SD = 1.36; 46.5 % boys), participated in the study. Several measuring instruments of mental health, subjective well-being, and suicidal behaviours were administrated.

RESULTS: Results revealed that a model with 7 items, excluding item 4, had adequate goodness-of-fit indices. Partial measurement invariance of the RFQ-7 scores across gender was supported. The total score displayed a McDonald’s Omega coefficient of 0.98 for the RFQ-7. The RFQ-7 was positively correlated with psychological well-being and negatively associated with suicidal behaviours, emotional and behavioural problems.

CONCLUSIONS: The RFQ is a brief, easy, and reliable tool for assessing reflective functioning in adolescents from the general population.

PMID:40334860 | DOI:10.1016/j.jad.2025.05.001