Pregnant women’s history of childhood maltreatment and current opioid use: The mediating role of reflective functioning

Macfie, Jenny; Zvara, Bharathi J.; Stuart, Gregory L.; Kurdziel-Adams, Gretchen; Kors, Stephanie; Fortner, Kimberly B.; Towers, Craig V.; Gorrondona, Andrea M.; Noose, Samantha K.

doi:10.1016/j.addbeh.2019.106134

Cited by 12 publications

(9 citation statements)

References 38 publications

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“…The aim of the present research is to replicate and extend previous findings from Spitzer and colleagues, while also comprehensively presenting our concerns regarding the measure. A critical reexamination and discussion of the RFQ-8 appears to be of particular importance given that researchers are increasingly adopting the measure for primary investigations of the mentalizing construct (e.g., Agostini et al, 2019;Badoud et al, 2018;Berthelot et al, 2019;Brugnera et al, 2020;Carlone & Milan, 2020;Cosenza et al, 2019;de Meulemeester et al, 2017de Meulemeester et al, , 2018Euler et al, 2019;Gambin et al, 2020;Huang et al, 2020;Li et al, 2020;Macfie et al, 2020;Morosan et al, 2019Morosan et al, , 2020Perroud et al, 2017;Sacchetti et al, 2019;Salaminios et al, 2020;Scandurra et al, 2020) or as an outcome measure for evaluating psychotherapy effectiveness (e.g., Arnfred et al, 2017;Derks et al, 2019).…”

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confidence: 99%

A Critical Evaluation of the Reflective Functioning Questionnaire

Müller¹,

Wendt²,

Spitzer³

et al. 2020

Preprint

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The Reflective Functioning Questionnaire-8 (RFQ-8) is a short self-report measure of reflective functioning (i.e., the ability to understand mental states of both the self and others) that is presumed to capture individual differences in hypo- and hypermentalizing. Despite its broad acceptance by the field and its regular use in primary investigations of the construct, we argue that the validity of the measure is still not well established. The current research elaborates on why the proposed scoring procedure may be methodologically problematic, the item content might not sufficiently cover the full breadth of the mentalizing construct, and it is unclear whether the measure captures mentalizing processes in particular or rather general psychological impairment. In a clinical sample (N = 861) and a sample of young adults (N = 566), we explore these critical considerations and demonstrate that the RFQ-8 may assess a single latent dimension related to hypomentalizing, but provides little unique variance above and beyond broad dimensions of personality pathology and is unlikely to capture maladaptive forms of hypermentalizing. The findings cast doubt on the validity of the RFQ-8 as a measure of reflective functioning. Future research should increase validation efforts concerning the RFQ-8 or develop new measures of reflective functioning.

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confidence: 99%

A Critical Evaluation of the Reflective Functioning Questionnaire

Müller¹,

Wendt²,

Spitzer³

et al. 2020

Preprint

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“…Low levels of PRF are commonly observed in high-risk samples such as mothers with substance abuse ( Hakansson et al, 2018 ; Adams, 2020 ), leading to difficulties detecting statistical effects. Nonetheless, maternal adult RF has shown mediating effect on the link between maternal experience of childhood maltreatment and substance use severity ( Macfie et al, 2020 ). Thus, the improvement of PRF might also help high-risk mothers in their self-regulation to process adverse early experiences.…”

Section: Discussionmentioning

confidence: 99%

Parental Reflective Functioning and Its Association With Parenting Behaviors in Infancy and Early Childhood: A Systematic Review

et al. 2022

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BackgroundParental reflective functioning (PRF) refers to parents’ mental capacity to understand their own and their children’s behaviors in terms of envisioned mental states. As part of a broader concept of parental mentalization, PRF has been identified as one of the central predictors for sensitive parenting. However, the unique contribution of PRF to the quality of various parenting behaviors has not yet been addressed systematically. Thus, the present article provides a systematic overview of current research on the associations between PRF or its sub-dimensions and observed parenting behaviors in infancy and early childhood, while considering the influence of contextual factors.MethodsThe review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Systematic searches were carried out in five electronic databases. The eligibility and methodological quality of the identified studies were assessed using pre-defined criteria and a standardized checklist.ResultsSixteen studies with moderate to high quality on a total of 15 parenting behaviors were included, the majority of which examined positive parenting behaviors, while negative parenting behaviors were rarely investigated. Most of the associations indicated a positive effect of PRF on parenting behavior, with mostly small-sized effects. The strength and direction of the associations varied depending on the dimensionality of PRF, observation settings, sample types, socioeconomic factors, and cultural background. Moreover, five assessment instruments for PRF and 10 observation instruments for parenting behaviors were identified.ConclusionIn summary, PRF has shown a positive association with parenting quality. However, its complex interaction with further contextual factors emphasizes the need for differentiation of PRF dimensions and the consideration of the observation settings, assessment time points, psychosocial risks, and sample types in observational as well as intervention studies. Further high-quality studies with multivariate analyses and diverse study settings are required.

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“…Interventions need to continue postpartum to prevent relapse. For example, interventions that improve the ability to understand mental states of self and other (reflective functioning) may address the link between childhood maltreatment and opioid use in pregnancy ( Macfie et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Medication-assisted treatment vs. detoxification for women who misuse opioids in pregnancy: Associations with dropout, relapse, neonatal opioid withdrawal syndrome (NOWS), and childhood sexual abuse

Macfie

Towers

Fortner

et al. 2020

Addictive Behaviors Reports

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Highlights A professional organization does not recommend opioid detoxification in pregnancy. Medically-assisted treatment (MAT) is recommended to reduce relapse and dropout. We sampled 55 pregnant women who misused opioids who chose detoxification or MAT. There was no dropout in either group and more relapse with MAT than detoxification. Replication and follow-up are needed to assess relative rates of relapse postpartum.

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Pregnant women’s history of childhood maltreatment and current opioid use: The mediating role of reflective functioning

Cited by 12 publications

References 38 publications

A Critical Evaluation of the Reflective Functioning Questionnaire

A Critical Evaluation of the Reflective Functioning Questionnaire

Parental Reflective Functioning and Its Association With Parenting Behaviors in Infancy and Early Childhood: A Systematic Review

Medication-assisted treatment vs. detoxification for women who misuse opioids in pregnancy: Associations with dropout, relapse, neonatal opioid withdrawal syndrome (NOWS), and childhood sexual abuse

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