The Reflective Functioning Questionnaire (RFQ) is an 8-item self-report measure of reflective functioning that is presumed to capture individual differences in hypo-and hypermentalizing. Despite its broad acceptance by the field, we argue that the validity of the measure is not well-established. The current research elaborates on problems of the RFQ related to its item content, scoring procedure, dimensionality, and associations with psychopathology. We tested these considerations across three large clinical and non-clinical samples from Germany and the US (total N = 2289). In a first study, we found that the RFQ may assess a single latent dimension related to hypomentalizing but is rather unlikely to capture maladaptive forms of hypermentalizing. Moreover, the RFQ exhibited very strong associations with measures of personality pathology, while associations with measures of symptom distress were less strong. In a second preregistered study focused on convergent and discriminant validity, however, a commonality analysis indicated that associations with indicators of personality pathology are inflated because some of the RFQ items tap into emotional lability and impulsivity rather than mentalizing. Our findings demonstrate limitations of the RFQ. We discuss key challenges in assessing mentalizing via self-report.
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Borderline personality disorder (BPD) is characterized by a wide variety of interpersonal problems. We examined whether there are different characteristic interpersonal patterns in BPD and how these patterns are related to symptom distress and therapeutic alliance. In 228 inpatients with diagnoses of BPD, interpersonal subtypes based on the Inventory of Interpersonal Problems (Horowitz et al., Inventar zur Erfassung Interpersonaler Probleme, 2000) were examined through cluster analyses. The global symptom severity and therapeutic alliance were also assessed. We identified five characteristic interpersonal patterns, which we labeled as follows: Cluster 1, "Vindictive"; Cluster 2, "Moderate Submissive"; Cluster 3, "Nonassertive"; Cluster 4, "Exploitable"; and Cluster 5, "Socially Avoidant." The clusters differed significantly in terms of interpersonal distress, interpersonal differentiation, and severity of global symptoms. The ratings of the therapeutic alliance by therapists during treatment significantly differed between the interpersonal subtypes, and the lowest ratings for patients were in the "Socially Avoidant" cluster. Our results stress the impact of interpersonal style on the appearance and treatment of BPD.
Both theories and cutting-edge research highlight the dynamic nature of personality and personality pathology, thereby posing significant challenges for an exclusively between-person, trait-based approach to personality assessment. In a series of three studies, we explored the viability of integrating within-person, dynamic aspects into clinical personality assessment by means of daily dairy methods. In Study 1, 314 students filled out a 73-item questionnaire capturing daily behaviors and situation experiences across seven to ten consecutive days. We used multilevel exploratory factor analyses to construct a shortened version, the Personality Dynamics Diary (PDD). In Study 2, the PDD was applied in a sample of 77 psychotherapy inpatients across 40 days, on average. In Study 3, 35 psychotherapy outpatients as well as their therapists judged the clinical utility of a smartphone version of the PDD. Taken together, we were able to construct a relatively brief self-report measure that assesses major dimensions of within- and between-person differences of situations and behaviors in daily life with acceptable reliability. Application in clinical samples provided further evidence for the reliability, validity, and clinical utility of the PDD, but also highlighted possible obstacles in clinical practice as well as the need for further replication and refinement. We conclude that daily diary methods have the potential to integrate between- and within-person approaches to personality assessment. By applying measures like the PDD, clinicians may gain insight into the psychological mechanisms that give rise to, and maintain, a person’s maladaptive dispositions, and ultimately find individualized leverage points for targeted therapeutic interventions.
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