Reflective Functioning on the Parent Development Interview: validity and reliability in relation to socio-demographic factors

Abstract

Background: The Reflective Functioning coding of the Parent Development Interview (PDI-RF) is a widely used method for assessing a caregivers' capacity for mentalization. However, little is known about its psychometric properties. Aim: This study examined the distributions and discriminant and criterion validity of the PDI-RF scale in relation to a number of demographic and socioeconomic factors. Method: Mothers of infants and toddlers (N = 323) from low, medium and high-risk samples were interviewed with the PDI and transcripts were coded for RF. Demographic and socioeconomic data were recorded. Results: The PDI RF scale showed high inter-rater reliability, internal consistency, and criterion validity. Modest associations with some sociodemographic variables and PDI RF were found, but together these only accounted for a small amount of variance in the measure, suggesting adequate discriminant validity. Overall, the scale had good psychometric properties, although some caveats for its use were identified.

Evaluation of early relational disturbance in high‐risk populations: Borderline personality disorder features, maternal mental state, and observed interaction

“…Scores on the PDI range from –1 to 9, with exceptionally low scores (–1) indicating bizarre and distorted RF, and exceptionally high scores (9) indicating superior RF capacity. The PDI has adequate interrater (ICC > .75) reliability and high internal consistency with a single factor solution (Cronbach's alpha = .91) confirming that all scores contribute relatively equally to the overall RF score (Sleed, Slade, & Fonagy, 2020). In terms of infant factors, maternal RF can be potentially confounded by infant age for infants younger than 2 months (Sleed et al., 2020).…”

Enhancing parental reflective functioning through early dyadic interventions: A systematic review and meta‐analysis

“…The included studies targeted a range of parents, including high‐risk primiparous women with demographic risk factors (Sadler et al., 2013; Sleed, Slade, & Fonagy, 2020); mothers experiencing mental health problems and high levels of social adversity (Fonagy, Sleed, & Baradon, 2016); mother–infant dyads in prison (Fonagy et al., 2016) or those taking part in substance treatment programs (Suchman et al., 2010). Only one of the six studies included toddlers (Suchman et al., 2010), the remainder targeted babies <18 months.…”

“…Five of the included studies measured parental depression. Four used the Centre for Epidemiological Studies Depression Scale (CES‐D) (Radloff, 1977) (Fonagy et al., 2016; Sadler et al., 2013; Slade et al., 2018; Sleed et al., 2020); and one used the Beck Depression Inventory (BDI) (Beck, Steer, & Brown, 1996) (Suchman et al., 2010). A total of 450 participants were included, and the results show a large but non‐significant difference favouring the control group (SMD: –1.55, 95% CI [–3.74, 0.64], p = .16) with an acceptable level of heterogeneity ( χ 2 = 5.86, df = 4, p = .21, I 2 = 32%) (see Figure 7).…”

“…A number of interventions were delivered, all of which were dyadic, relational and manualised attachment-based interventions. Four interventions were explicitly informed by concepts relating to mentalisation in terms of the underlying theory of change (Sadler et al, 2013;Sleed et al, 2020;Suchman et al, , 2017, the remaining two being informed by psychoanalytic theory with a primary focus on changing maternal representations of the infant (Fonagy et al, 2016; Sleed, Baradon, & Fonagy, 2013). MTB (Sadler et al, 2013) comprises a mentalisationbased home visiting program, which is delivered by a team that includes a nurse practitioner and a clinical social worker.…”

“…The fact that intervention effects were found on the PDI-RF measure is encouraging because the variability on the F I G U R E 7 Forest plot of meta-analysis for maternal depression F I G U R E 8 Forest plot of meta-analysis for maternal global distress RF scale is limited, with the majority of parents in clinical populations showing RF levels only at the moderate to low end of the scale, thereby reducing the potential range and sensitivity to treatment change (Sleed et al, 2020). However, the fact that this systematic review found treatment effects on PRF in the large pooled sample suggests that this instrument may be sensitive to treatment change in sufficiently powered studies.…”