Parental reflective functioning in adult outpatients with personality disorders: associations with symptoms of psychopathology and interpersonal problems

Impaired parental reflective functioning (PRF), i.e. difficulties in understanding one's child in terms of mental states, may constitute a risk for children's development and wellbeing. Impaired PRF has been linked to parental psychopathology, however no study has investigated PRF in adult patients with personality disorders (PDs). We examined PRF in a sample of adult outpatients with diagnosed PDs compared with healthy controls (HCs), and explored associations between PRF and symptoms of psychopathology and interpersonal problems in parents with PD. A convenience sample of treatment-seeking outpatients with PDs (n = 34) were assessed with questionnaires measuring PRF (The Parental Reflective Functioning Questionnaire (PRFQ)), symptoms of psychopathology (Symptom Checklist Revised (SCL-90-R)) and interpersonal problems (Inventory of Interpersonal Problems (IIP)). PRF scores were compared with reported means of HCs (n = 156) pooled from a previous study. Parents with PD reported higher levels of pre-mentalizing and lower levels of certainty about mental states compared with HCs. Both groups reported high levels of interest and curiosity and did not differ significantly in this regard. Exploratory analyses showed that low levels of certainty about mental states was associated with high levels of depressive and psychotic symptoms and submissive types of interpersonal problems (social-avoidance and non-assertiveness). Our findings provide preliminary evidence that patients with PD have impairments in PRF compared with HCs. The findings stress the importance of assessing the multidimensional nature of PRF in parents with PD.