First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens.
Second Department of Psychiatry, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens.
Psychiatriki. 2020 Jul-Sep;31(3):216-224. doi: 10.22365/jpsych.2020.313.216.
The ability to mentalize, namely to understand, interpret and effectively communicate the mental state of self and others is considered important in self-organisation and affect regulation. The aim of the present study was to provide data on the validation process of Reflective Functioning Questionnaire (RFQ), a recently developed measure of mentalizing, in order to evaluate its use in research and in clinical practice for Greek populations. A total of 219 participants (102 people with type 1 diabetes and 117 healthy individuals) completed the RFQ. A principal component analysis supported the 2-factor model (RF certainty for mental states and RF uncertainty for mental states) in both samples. Internal consistencies of both subscales were satisfactory (α=0.80 for RF certainty and α=0.79 for RF uncertainty). Relationships with validity measures of psychological distress, empathy and emotional intelligence provided further support for the psychometric properties of the scale. As expected, there were positive associations between the degree of certainty concerning mental states and emotional intelligence (r=0.390, p<0.01), as well as empathy (r=0.292, p<0.01) in general population. Conversely, negative associations were found between the degree of certainty about mental states and psychological distress in the diabetes group (r=-0.470, p<0.01) and in general population (r=0.320, p<0.01). A reverse pattern of associations was observed between the degree of uncertainty about mental states and emotional intelligence (r=-0.265, p<0.01) in general population, as well as psychological distress in both the diabetes group (r=0.590, p<0.01) and in general population (r=0.330, p<0.01). Also, as expected, there were differences across age groups, with older participants reporting a more balanced reflective functioning - with higher certainty levels in the diabetes group (t=-2.133, p>0.05) and the healthy participants (t=-2.738, p>0.05) and lower uncertainty levels in the diabetes group (t=-2.480, p>0.05) and the healthy participants (t=-2.779, p>0.05). The data collected so far support the reliability and validity of the measure that can be used in research to address mentalizing impairments. However, further research is needed to evaluate its consistency thought time with a test-retest analysis, and to evidence its factorial structure with a confirmatory factor analysis. In addition, it is of primary importance to extend the validity testing of RFQ in clinical populations to further support its use in clinical practice.
心理化能力，即理解、解释和有效地沟通自我和他人的心理状态的能力，被认为在自我组织和情绪调节中很重要。本研究的目的是提供关于最近开发的心理化测量工具——反思功能问卷（RFQ）的验证过程的数据，以评估其在希腊人群的研究和临床实践中的使用。共有 219 名参与者（102 名 1 型糖尿病患者和 117 名健康个体）完成了 RFQ。一项主成分分析支持了两个样本中的 2 因素模型（用于心理状态的 RF 确定性和用于心理状态的 RF 不确定性）。两个分量表的内部一致性均令人满意（用于心理状态的 RF 确定性的α=0.80，用于心理状态的 RF 不确定性的α=0.79）。与心理困扰、同理心和情绪智力的有效性衡量标准的关系进一步支持了该量表的心理测量特性。正如预期的那样，在一般人群中，对心理状态的确定性程度与情绪智力（r=0.390，p<0.01）以及同理心（r=0.292，p<0.01）之间存在正相关。相反，在糖尿病组（r=-0.470，p<0.01）和一般人群中（r=0.320，p<0.01），对心理状态的确定性程度与心理困扰之间存在负相关。在一般人群中，对心理状态的不确定性程度与情绪智力（r=-0.265，p<0.01）以及糖尿病组（r=0.590，p<0.01）和一般人群（r=0.330，p<0.01）的心理困扰之间也观察到了相反的关联模式。同样，如预期的那样，不同年龄组之间存在差异，年龄较大的参与者报告了更平衡的反思功能——糖尿病组（t=-2.133，p>0.05）和健康参与者（t=-2.738，p>0.05）的 RF 确定性水平更高，而糖尿病组（t=-2.480，p>0.05）和健康参与者（t=-2.779，p>0.05）的 RF 不确定性水平更低。迄今为止收集的数据支持该测量的可靠性和有效性，该测量可用于研究以解决心理化损伤。然而，需要进一步的研究来评估其随着时间推移的一致性，通过重测分析来评估其因子结构，并通过验证性因子分析来证明其因子结构。此外，扩展 RFQ 在临床人群中的有效性测试，以进一步支持其在临床实践中的应用，这一点至关重要。
