Development and Validation of a Self-Report Measure of Mentalizing: The Reflective Functioning Questionnaire
Open accessAbstract
Reflective functioning or mentalizing is the capacity to interpret both the self and others in terms of internal mental states such as feelings, wishes, goals, desires, and attitudes. This paper is part of a series of papers outlining the development and psychometric features of a new self-report measure, the Reflective Functioning Questionnaire (RFQ), designed to provide an easy to administer self-report measure of mentalizing. We describe the development and initial validation of the RFQ in three studies. Study 1 focuses on the development of the RFQ, its factor structure and construct validity in a sample of patients with Borderline Personality Disorder (BPD) and Eating Disorder (ED) (n = 108) and normal controls (n = 295). Study 2 aims to replicate these findings in a fresh sample of 129 patients with personality disorder and 281 normal controls. Study 3 addresses the relationship between the RFQ, parental reflective functioning and infant attachment status as assessed with the Strange Situation Procedure (SSP) in a sample of 136 community mothers and their infants. In both Study 1 and 2, confirmatory factor analyses yielded two factors assessing Certainty (RFQ_C) and Uncertainty (RFQ_U) about the mental states of self and others. These two factors were relatively distinct, invariant across clinical and non-clinical samples, had satisfactory internal consistency and test-retest stability, and were largely unrelated to demographic features. The scales discriminated between patients and controls, and were significantly and in theoretically predicted ways correlated with measures of empathy, mindfulness and perspective-taking, and with both self-reported and clinician-reported measures of borderline personality features and other indices of maladaptive personality functioning. Furthermore, the RFQ scales were associated with levels of parental reflective functioning, which in turn predicted infant attachment status in the SSP. Overall, this study lends preliminary support for the RFQ as a screening measure of reflective functioning. Further research is needed, however, to investigate in more detail the psychometric qualities of the RFQ.
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Internal consistency of RFQc and RFQu are α = 0.65 and α = 0.77 in a clinical sample and α = 0.67 and α = 0.63 in a non-clinical sample, respectively.
“Internal consistency of RFQc and RFQu respectively are α = 0.65 and α = 0.77 in a clinical sample and α = 0.67 and α = 0.63 in a non-clinical sample, respectively [55].”
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“Despite these limitations, together with two recent similar studies with the French version of the RFQ [42, 61], this study lends preliminary evidence for the reliability and validity of the RFQ as a brief measure of RF.”
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BackgroundResultInfluentialSelf-citationSkårderud, F. (2007) · European eating disorders review · doi:10.1002/erv.817 · Cited by 130 · cited 5× · see citing works
“Study 1 focused on the development of the RFQ and its factor structure in a sample of patients with BPD and EDs (n = 108) and a sample of normal controls (n = 295).”
BackgroundInfluentialZimmerman, M. A., Sheeran, T. F., & Young, D. (2003) · Journal of Clinical Psychology · doi:10.1002/jclp.10207 · Cited by 127 · cited 3× · see citing works
“The RFQ_U was associated with increased levels of self-harm, indices of maladaptive personality functioning as assessed with the IPO, higher levels of depression, greater social impairment, and lower quality of life as assessed with the DID.”
BackgroundMethodWesten, D., Moses, M. J., Silk, K. R., Lohr, N. E., Cohen, R., & Segal, H. G. (1992) · Journal of Personality Disorders · doi:10.1521/pedi.1992.6.4.382 · Cited by 119 · cited 1× · see citing works
“Additionally, the RFQ_U was highly significantly associated with clinical features that have been proposed as core features of personality pathology by many authors from various theoretical orientations, including selfharm [76], indices of structural personality pathology, including identity diffusion, the use of prim…”
BackgroundComorbid antisocial and borderline personality disorders: mentalization-based treatment.
Bateman, A., & Fonagy, P. (2008) · Journal of Clinical Psychology · doi:10.1002/jclp.20451 · Cited by 119 · see citing works
Self-citationMinding the Baby: A Mentalization‐Based Parenting Program
Sadler, L. S., Slade, A., & Mayes, L. C. (2006) · Wiley eBooks · doi:10.1002/9780470712986.ch14 · Cited by 115 · see citing works
Psychodynamic Psychotherapy for Personality Disorders: A Clinical Handbook
Fonagy, P., & Gabbard, G. O. (2010) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615376643 · Cited by 114 · see citing works
Self-citationEating one's words, Part II: the embodied mind and reflective function in anorexia nervosa—theory
Skårderud, F. (2007) · European Eating Disorders Review · doi:10.1002/erv.778 · Cited by 113 · cited 1× · see citing works
“Such impairments have been shown to play a key role in a variety of disorders and problem behaviors such as BPD [8], eating disorders (EDs) [9, 10], depression [11], and antisocial personality disorder [12].”
BackgroundLemma, A., Target, M., & Fonagy, P. (2011) · Psychiatry · doi:10.1521/psyc.2011.74.1.41 · Cited by 96 · see citing works
Self-citationThe Development of Mentalisation in Children From a Theory of Mind Perspective
Ensink, K., & Mayes, L. C. (2010) · Psychoanalytic Inquiry · doi:10.1080/07351690903206504 · Cited by 93 · see citing works
Developmental science and psychoanalysis. Integration and innovation
(2008) · Psychoanalytic Psychotherapy · doi:10.1080/02668730802102708 · Cited by 93 · see citing works
Kuipers, G. S., & Bekker, M. H. J. (2012) · Current Psychiatry Reviews · doi:10.2174/157340012803520478 · Cited by 68 · cited 1× · see citing works
“RFQ_C, in turn, was generally negatively related to caseness, but may be more specifically related to types of psychopathology characterized by hypermentalizing, as is, for instance, observed in patients with eating disorders [13, 60, 103] or adolescents with BPD features, [104, 105].”
BackgroundAttachment and Reflective Functioning in Women With Borderline Personality Disorder
Badoud, D., Prada, P., Nicastro, R., Germond, C., Luyten, P., Perroud, N. A., & Debbané, M. (2017) · Journal of Personality Disorders · doi:10.1521/pedi_2017_31_283 · Cited by 64 · cited 2× · see citing works
“Despite these limitations, together with two recent similar studies with the French version of the RFQ [42, 61], this study lends preliminary evidence for the reliability and validity of the RFQ as a brief measure of RF.”
BackgroundResultSelf-citationFearon, P., Target, M., Sargent, J., Williams, L. L., McGregor, J., Bleiberg, E., & Fonagy, P. (2006) · Handbook of Mentalization‐Based Treatment · doi:10.1002/9780470712986.ch10 · Cited by 58 · see citing works
Self-citationThe role of child and parental mentalizing for the development of conduct problems over time
Ha, C., Sharp, C., & Goodyer, I. M. (2011) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-011-0174-4 · Cited by 57 · cited 1× · see citing works
“Also, trajectories of change as a result of maturation or psychosocial interventions might differ for both types of impairments, and they might have different developmental and neurobiological underpinnings [25, 40, 41].”
BackgroundAttachment and its Vicissitudes in Borderline Personality Disorder
Levy, K. N., Beeney, J. E., & Temes, C. M. (2010) · Current Psychiatry Reports · doi:10.1007/s11920-010-0169-8 · Cited by 55 · cited 1× · see citing works
“Additionally, the RFQ_U was highly significantly associated with clinical features that have been proposed as core features of personality pathology by many authors from various theoretical orientations, including selfharm [76], indices of structural personality pathology, including identity diffusion, the use of prim…”
BackgroundOn tolerating mental states: Theory of mind in borderline patients
Fonagy, P. (1989) · UCL Discovery (University College London) · Cited by 52 · see citing works
Self-citationReflective Functioning in 70 Patients Suffering from Bulimia Nervosa
Pedersen, S. H., Lunn, S., Katznelson, H., & Poulsen, S. (2012) · European Eating Disorders Review · doi:10.1002/erv.2158 · Cited by 50 · cited 2× · see citing works
“RFQ_C, in turn, was generally negatively related to caseness, but may be more specifically related to types of psychopathology characterized by hypermentalizing, as is, for instance, observed in patients with eating disorders [13, 60, 103] or adolescents with BPD features, [104, 105].”
BackgroundResultAttachment and personality pathology
Fonagy, P., Luyten, P., BATEMAN, A. W., Gergely, G., Strathearn, L., Target, M., & Allison, E. (2010) · UCL Discovery (University College London) · Cited by 50 · see citing works
Self-citationBrief Dynamic Interpersonal Therapy: A Clinician's Guide
Lemma, A., Target, M., & Fonagy, P. (2011) · Cited by 48 · see citing works
Self-citationKalpakci, A. H., Vanwoerden, S., Elhai, J. D., & Sharp, C. (2015) · Journal of Personality Disorders · doi:10.1521/pedi_2015_29_192 · Cited by 35 · cited 1× · see citing works
“RFQ_C, in turn, was generally negatively related to caseness, but may be more specifically related to types of psychopathology characterized by hypermentalizing, as is, for instance, observed in patients with eating disorders [13, 60, 103] or adolescents with BPD features, [104, 105].”
BackgroundRobinson, P., Barrett, B., Bateman, A., Hakeem, A., Hellier, J., Lemonsky, F., Rutterford, C., Schmidt, U., & Fonagy, P. (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-51 · Cited by 32 · see citing works
Self-citationBers, S. A., Avi Besser, A., Harpaz‐Rotem, I., & Blatt, S. J. (2013) · Psychoanalytic Psychology · doi:10.1037/a0032512 · Cited by 30 · cited 2× · see citing works
“The RFQ_C scale was associated with comorbidity between BPD and ED diagnosis, which is congruent with other studies suggesting substantial hyper-reflectivity in patients with these features [26, 39, 60].”
BackgroundResultLuyten, P., & Fonagy, P. (2014) · Springer eBooks · doi:10.1007/978-1-4939-1314-5_13 · Cited by 16 · cited 2× · see citing works
“Hypomentalizing has been related to vulnerability for a wide range of disorders, including BPD [25], EDs [9], and depression [32, 33].”
BackgroundSelf-citationPrimary parental preoccupation: revisited
Leckman, J. F., Feldman, R., Swain, J. E., & Mayes, L. C. (2018) · Routledge eBooks · doi:10.4324/9780429473654-6 · Cited by 12 · see citing works
Claes, L., Vandereycken, W., & Vertommen, H. (2005) · Cited by 7 · see citing works
Leptin—a parameter for body fat measurement in patients with eating disorders
Zipfel, S., Specht, T., Blum, W. F., Hebebrand, J., Englaro, P., Hartmann, M., Wüster, C., Ziegler, R., & Herzog, W. (1998) · European Eating Disorders Review · doi:10.1002/(sici)1099-0968(199803)6:1 · Cited by 5 · see citing works
Fonagy (1991) · doi:10.1002/1097-0355(199123)12:3
Self-citationSansone (1998) · doi:10.1002/(sici)1097-4679(199811)54:7
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The mentalizing approach to psychopathology: State of the art and future directions
Luyten, P., Campbell, C., Allison, E., & Fonagy, P. (2020) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-071919-015355 · Cited by 748 · see citing works
“…such impairments and substance abuse, violence, eating disorders, and self-harm, which can all be seen as attempts to regulate, through specific goal-directed behavior, unbearable and unmentalized self-states (Fonagy et al. 2016, Jewell et al. 2016, Suchman et al. 2018, Taubner et al. 2016).”
BackgroundSelf-citationZeegers, M. A. J., Colonnesi, C., Stams, G. J. J. M., & Meins, E. (2017) · Psychological Bulletin · doi:10.1037/bul0000114 · Cited by 431 · see citing works
“The effect size was calculated from the average association of the three PRFQ subscales (i.e., prementalizing modes, certainty of mental states, and interest and curiosity of in mental states) with infant attachment security.”
BackgroundMethodInfluentialDevelopment and validation of a self-report measure of epistemic trust
Campbell, C., Tanzer, M., Saunders, R., Booker, T. L., Allison, E., Li, E. T., O’Dowda, C., Luyten, P., & Fonagy, P. (2021) · PLoS ONE · doi:10.1371/journal.pone.0250264 · Cited by 210 · see citing works
“The Reflective Function Questionnaire (RFQ) [29].”
InfluentialSelf-citationThe bodymind model: a platform for studying the mechanisms of change induced by art therapy
Czamanski-Cohen, J., & Weihs, K. L. (2016) · The Arts in Psychotherapy · doi:10.1016/j.aip.2016.08.006 · Cited by 209 · see citing works
The Mentalization Scale (MentS): A Self-Report Measure for the Assessment of Mentalizing Capacity
Dimitrijević, A., Hanak, N., Dimitrijević, A. A., & Marjanović, Z. J. (2017) · Journal of Personality Assessment · doi:10.1080/00223891.2017.1310730 · Cited by 176 · see citing works
“It is only very recently that this gap has been filled by the Reflective Functioning Questionnaire (RFQ; Badoud et al., 2015; Fonagy et al., 2016).”
BackgroundElevated empathy in adults following childhood trauma
Greenberg, D. M., Baron‐Cohen, S., Rosenberg, N., Fonagy, P., & Rentfrow, P. J. (2018) · PLoS ONE · doi:10.1371/journal.pone.0203886 · Cited by 148 · see citing works
Self-citationBadoud, D., Luyten, P., Fonseca‐Pedrero, E., D, S. E. M., Fonagy, P., & Debbané, M. (2015) · PLoS ONE · doi:10.1371/journal.pone.0145892 · Cited by 142 · see citing works
“Further research with this instrument led to the identification of two subscales in the RFQ assessing Certainty (RFQc) and Uncertainty (RFQu) about the mental states of self and others [26].”
BackgroundMethodInfluentialSelf-citationA Critical Evaluation of the Reflective Functioning Questionnaire (RFQ)
Müller, S., Wendt, L. P., Spitzer, C., Masuhr, O., Back, S. N., & Zimmermann, J. (2022) · Journal of Personality Assessment · doi:10.1080/00223891.2021.1981346 · Cited by 138 · see citing works
“…article, we have elaborated our concerns with respect to the instrument’s validity and the methodology used in prior studies (e.g., Badoud et al., 2015; Fonagy et al., 2016), particularly in reference to its item content, scoring procedure, dimensionality, and associations with psychopathology.”
BackgroundMethodResultInfluentialEuler, S., Nolte, T., Constantinou, M., Griem, J., Montague, P. R., & Fonagy, P. (2019) · Journal of Personality Disorders · doi:10.1521/pedi_2019_33_427 · Cited by 128 · see citing works
“reflective functioning, the operationalized form of mentalizing (Fonagy et al., 2016).”
BackgroundSelf-citationHuang, Y. L., Fonagy, P., Feigenbaum, J., Montague, P. R., & Nolte, T. (2020) · Psychopathology · doi:10.1159/000506406 · Cited by 112 · see citing works
Self-citationBerthelot, N., Lemieux, R., Garon‐Bissonnette, J., Lacharité, C., & Muzik, M. (2019) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2019.104065 · Cited by 112 · see citing works
Morandotti, N., Brondino, N., Merelli, A. A., Boldrini, A., Vidovich, G. Z. D., Ricciardo, S., Abbiati, V., Ambrosi, P., Caverzasi, E., Fonagy, P., et al. (2018) · PLoS ONE · doi:10.1371/journal.pone.0206433 · Cited by 107 · see citing works
Self-citationMentalized affectivity: A new model and assessment of emotion regulation
Greenberg, D. M., Kolasi, J., Hegsted, C. P., Berkowitz, Y., & Jurist, E. L. (2017) · PLoS ONE · doi:10.1371/journal.pone.0185264 · Cited by 102 · see citing works
“The 70-item RFQ captures two factors: Certainty and Uncertainty.”
MethodInfluentialLysaker, P. H., Cheli, S., Dimaggio, G., Buck, B., Bonfils, K. A., Huling, K. S., Wiesepape, C. N., & Lysaker, J. T. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03338-4 · Cited by 97 · see citing works
“The Reflective Functioning Questionnaire [99] and Parent Reflective Functioning Questionnaire [100] are self-report measures designed to assess mentalizing capacity across two subscales, which, respectively, represent salient aspects of mentalizing and evaluate a parent’s ability to understand their child’s behavior i…”
Mentalization‐based treatment and its evidence‐base status: A systematic literature review
Malda‐Castillo, J., Browne, C., & Perez‐Algorta, G. (2019) · Psychology and Psychotherapy: Theory, Research and Practice · doi:10.1111/papt.12195 · Cited by 89 · see citing works
Stuhrmann, L. Y., Göbel, A., Bindt, C., & Mudra, S. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.765312 · Cited by 93 · see citing works
Meulemeester, C. D., Vansteelandt, K., Luyten, P., & Lowyck, B. (2017) · Personality Disorders Theory Research and Treatment · doi:10.1037/per0000256 · Cited by 84 · see citing works
Self-citationAnis, L., Perez, G., Benzies, K., Ewashen, C., Hart, M. J., & Letourneau, N. L. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.574719 · Cited by 87 · see citing works
Liotti, M., Milesi, A., Spitoni, G. F., Tanzilli, A., Speranza, A. M., Parolin, L. A. L., Campbell, C., Fonagy, P., Lingiardi, V., & Giovanardi, G. (2023) · PLoS ONE · doi:10.1371/journal.pone.0280328 · Cited by 75 · see citing works
“The Reflective Functioning Questionnaire (RFQ; [28]), an eight-item self-report instrument to evaluate mentalization.”
MethodSelf-citationHypermentalizing and Borderline Personality Disorder: A Meta-Analytic Review
McLaren, V., Gallagher, M., Hopwood, C. J., & Sharp, C. (2022) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.20210018 · Cited by 75 · see citing works
Stagaki, M., Nolte, T., Feigenbaum, J., King‐Casas, B., Lohrenz, T. M., Fonagy, P., & Montague, P. R. (2022) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2022.105576 · Cited by 79 · see citing works
“…to the romantic partner or mentalising and adult self-harm or suicidality, yielding mixed results which require further research (Du ˜ n ´ o et al., 2009; Fonagy et al., 2016; Grunebaum et al., 2010; Hatkevich et al., 2019; Levesque et al., 2010; Levi-Belz et al., 2013; Smith et al., 2012).”
BackgroundMethodResultInfluentialSelf-citationMüller, S., Wendt, L. P., & Zimmermann, J. (2021) · Assessment · doi:10.1177/10731911211061280 · Cited by 84 · see citing works
“Genuine mentalizing is characterized by acknowledging the opaqueness of mental states (Fonagy et al., 2016), that is, being apprehensive of the circumstance that individuals are not always aware of their own inner workings and those of others.”
BackgroundMethodInfluentialLuyten, P., Campbell, C., Moser, M., & Fonagy, P. (2024) · Clinical Psychology Review · doi:10.1016/j.cpr.2024.102380 · Cited by 77 · see citing works
Self-citationLinking childhood emotional abuse and adult depressive symptoms: The role of mentalizing incapacity
Li, E. T., Carracher, E., & Bird, T. (2019) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2019.104253 · Cited by 75 · see citing works
“As depressed individuals tend to externalize alien self-experiences that they cannot mentalize (Luyten & Fonagy, 2016), individuals in a state of hypermentalizing often show reasoning about mental states with repetitive, lengthy, and overly analytical and detailed patterns for self-serving…”
Penner, F., Gambin, M., & Sharp, C. (2019) · Journal of Adolescence · doi:10.1016/j.adolescence.2019.08.002 · Cited by 74 · see citing works
Dysfunction of Empathy and Related Processes in Borderline Personality Disorder: A Systematic Review
Salgado, R. M., Pedrosa, R., & Bastos-Leite, A. J. (2020) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000260 · Cited by 67 · see citing works
Fischer‐Kern, M., & Tmej, A. (2019) · Zeitschrift für psychosomatische Medizin und Psychotherapie · doi:10.13109/zptm.2019.65.2.162 · Cited by 64 · see citing works
Gordo, L., Martínez‐Pampliega, A., Elejalde, L. I., & Luyten, P. (2020) · Journal of Child and Family Studies · doi:10.1007/s10826-020-01840-z · Cited by 66 · see citing works
“…Belgium 3 Research Department of Clinical, Educational and Health Psychology, University College London, London, UK 12 34 56 78 90 () ;,: 12 34 56 78 90 (); ,: completely certain about their children’s mental states (Fonagy et al. 2016; Luyten et al. 2017b; Meins et al. 2001, 2012; Slade 2005).”
BackgroundSelf-citationAttachment and Reflective Functioning in Women With Borderline Personality Disorder
Badoud, D., Prada, P., Nicastro, R., Germond, C., Luyten, P., Perroud, N. A., & Debbané, M. (2017) · Journal of Personality Disorders · doi:10.1521/pedi_2017_31_283 · Cited by 64 · see citing works
“The RFQ (Badoud et al., 2015; Fonagy et al., 2016) provides a valid self-reported measure of RF, which strives to make RF assessment more readily accessible (i.”
BackgroundMethodResultInfluentialSelf-citationThe steamy mirror of adolescent gamblers: Mentalization, impulsivity, and time horizon
Cosenza, M., Ciccarelli, M., & Nigro, G. (2018) · Addictive Behaviors · doi:10.1016/j.addbeh.2018.10.002 · Cited by 62 · see citing works
Bora, E. (2021) · Psychological Medicine · doi:10.1017/s0033291721003718 · Cited by 60 · see citing works
“personality disorders might present with similar levels of deficits in RF (Fonagy et al., 2016; Sacchetti et al., 2019).”
BackgroundMethodInfluentialDoba, K., Saloppé, X., Choukri, F., & Nandrino, J. (2022) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2022.105815 · Cited by 67 · see citing works
Musetti, A., Starčević, V., Boursier, V., Corsano, P., Billieux, J., & Schimmenti, A. (2021) · Journal of Clinical Psychology · doi:10.1002/jclp.23138 · Cited by 60 · see citing works
“Prior research has shown that there is a link between problems related to self–other boundaries (i.e., identity diffusion) and uncertain reflective functioning (De Meulemeester et al., 2017; Fonagy et al., 2016).”
BackgroundMethodInfluentialMeulemeester, C. D., Lowyck, B., Vermote, R., Verhaest, Y., & Luyten, P. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.09.061 · Cited by 58 · see citing works
Self-citationWoźniak‐Prus, M., Gambin, M., Cudo, A., & Sharp, C. (2022) · Journal of Personality Assessment · doi:10.1080/00223891.2021.2014505 · Cited by 55 · see citing works
“Finally, it is surprising that the assumed two-factor structure of the original version of RFQ-8 was not verified using exploratory factor analysis, but only verified using confirmatory factor analysis without checking whether the solution had a different number of factors (see Fonagy et al., 2016).”
BackgroundMethodResultInfluentialSystematic Review on Mentalization as Key Factor in Psychotherapy
Lüdemann, J., Rabung, S., & Andreas, S. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18179161 · Cited by 52 · see citing works
“[28] The instrument uses 12 items on 2 subscales, measuring security and insecurity in reflective functioning.”
MethodCiccarelli, M., Nigro, G., D’Olimpio, F., Griffiths, M. D., & Cosenza, M. (2020) · Journal of Gambling Studies · doi:10.1007/s10899-020-09967-w · Cited by 55 · see citing works
Perroud, N. A., Badoud, D., Weibel, S., Nicastro, R., Hasler, R., Küng, A., Luyten, P., Fonagy, P., Dayer, A. G., Aubry, J., et al. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.06.087 · Cited by 53 · see citing works
“impairments of RF/mentalizing, as measured by the Reflective Functioning Questionnaire (RFQ) (Badoud et al., 2015; Fonagy et al., 2016), in a sample of adults suffering from ADHD.”
MethodInfluentialSelf-citationTalia, A., Miller‐Bottome, M., Katznelson, H., Pedersen, S. H., Steele, H., Schröder, P., Origlieri, A., Scharff, F. B., Giovanardi, G., Andersson, M., et al. (2018) · Psychotherapy Research · doi:10.1080/10503307.2017.1417651 · Cited by 51 · see citing works
“Although these methods are more time efficient, they still rely on administering an interview—the limitations of which we discussed earlier.1 More recently, Fonagy et al. (2016) have begun to assess RF with selfreport questionnaires (RFQ).”
MethodAival‐Naveh, E., Rothschild‐Yakar, L., & Kurman, J. (2019) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12300 · Cited by 100 · see citing works
Midgley, N., Cirasola, A., Austerberry, C., Ranzato, E., West, G., Martin, P., Redfern, S., Cotmore, R., & Park, T. (2019) · Developmental Child Welfare · doi:10.1177/2516103218817550 · Cited by 68 · see citing works
Theory of mind performance in depression: A meta-analysis
Nestor, B. A., Sutherland, S. L., & Garber, J. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.02.028 · Cited by 51 · see citing works
PATERNAL AND MATERNAL REFLECTIVE FUNCTIONING IN THE WESTERN AUSTRALIAN PEEL CHILD HEALTH STUDY
Cooke, D., Priddis, L. E., Luyten, P., Kendall, G. E., & Cavanagh, R. F. (2017) · Infant Mental Health Journal · doi:10.1002/imhj.21664 · Cited by 51 · see citing works
Self-citationSafiye, T., Vukčević, B., Gutić, M., Milidrag, A., Dubljanin, D., Dubljanin, J., & Radmanović, B. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19116577 · Cited by 51 · see citing works
“Public Health 2022, 19, 6577 5 of 13 As in the previously mentioned study [21], the capacity for mentalizing was examined using the hypomentalizing and hypermentalizing scales of the Reflective Functioning Questionnaire of 8 items (RFQ-8) [18].”
BackgroundMethodInfluentialGaron‐Bissonnette, J., Duguay, G., Lemieux, R., Dubois‐Comtois, K., & Berthelot, N. (2021) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2021.105030 · Cited by 49 · see citing works
“…risk and resilience trajectories in people exposed to CA & N, both in theoretical work (Fonagy & Bateman, 2016; Luyten & Fonagy, 2019) and empirical research (Ensink, Berthelot, Begin, Maheux, & Normandin, 2017; Ensink, Normandin, Plamondon, Berthelot, & Fonagy, 2016; Quek et al., 2017).”
Executive Functioning Predicts Reflective Functioning in Mothers
Rutherford, H. J. V., Byrne, S., Crowley, M. J., Bornstein, J., Bridgett, D. J., & Mayes, L. C. (2017) · Journal of Child and Family Studies · doi:10.1007/s10826-017-0928-9 · Cited by 46 · see citing works
“In a similar vein, self-reported questionnaire measures of reflective functioning (Fonagy et al. 2016) and PRF (Luyten et al.”
BackgroundSafiye, T., Gutić, M., Dubljanin, J., Stojanović, T. M., Dubljanin, D., Kovačević, A., Zlatanović, M., Demirović, D., Nenezić, N., & Milidrag, A. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20085594 · Cited by 48 · see citing works
“In contrast, hypomentalizing refers to the lack of assumptions about the mental states that determine behavior in interpersonal interaction, which manifests itself as uncertainty regarding the accurate assessment of the mental states underlying some behavior [17].”
InfluentialGori, A., Arcioni, A., Topino, E., Craparo, G., & Grotto, R. L. (2021) · Journal of Personalized Medicine · doi:10.3390/jpm11040305 · Cited by 48 · see citing works
“, the Reading the Mind in the Eyes Test [13], narrativebased measures, such as the Reflective Functioning Scale [14], or questionnaires, among which the Mentalization Scale [15], the Mentalization Questionnaire [16], and the Reflective Functioning Questionnaire [17] can be mentioned.”
MethodJørgensen, C. R., & Bøye, R. (2021) · Journal of Personality Disorders · doi:10.1521/pedi_2021_35_526 · Cited by 45 · see citing works
Tanzilli, A., Cibelli, A., Liotti, M., Fiorentino, F., Williams, R., & Lingiardi, V. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192114290 · Cited by 43 · see citing works
“Reflective Functioning Questionnaire: The RFQ [90] is an 8-item self-report questionnaire developed to assess mentalizing abilities, i.”
BackgroundInfluentialCucchi, A., Hampton, J. A., & Moulton‐Perkins, A. (2018) · PeerJ · doi:10.7717/peerj.5756 · Cited by 44 · see citing works
“Desiring a more practical and less labour-intensive tool, Fonagy and colleagues developed the self-report Reflective Function Questionnaire, RFQ (Fonagy et al., 2016).”
InfluentialSelf-citationAttachment and Mentalizing Abilities in Patients with Inflammatory Bowel Disease
Agostini, A., Scaioli, E., Belluzzi, A., & Campieri, M. (2019) · Gastroenterology Research and Practice · doi:10.1155/2019/7847123 · Cited by 43 · see citing works
“The reflective functioning questionnaire (RFQ) brief version [32, 33] is a self-report, eight-item questionnaire designed to assess mentalization abilities.”
BackgroundSchwarzer, N.-H., Nolte, T., Fonagy, P., & Gingelmaier, S. (2021) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2021.105018 · Cited by 43 · see citing works
“To this end, we employed the Reflective Functioning Questionnaire, a self-report measure that operationalizes certainty and uncertainty about mental states (Fonagy et al., 2016).”
InfluentialSelf-citationFonagy, P., Simes, E., Yirmiya, K., Wason, J. M. S., Barrett, B. M., Frater, A. P., Cameron, A., Butler, S., Hoare, Z., McMurran, M., et al. (2025) · The Lancet Psychiatry · doi:10.1016/s2215-0366(24)00445-0 · Cited by 42 · see citing works
Self-citationScandurra, C., Dolce, P., Vitelli, R., Esposito, G., Testa, R. J., Balsam, K. F., & Bochicchio, V. (2020) · Journal of Clinical Psychology · doi:10.1002/jclp.22951 · Cited by 43 · see citing works
Quek, J., Newman, L. K., Bennett, C., Gordon, M. S., Saeedi, N., & Melvin, G. A. (2017) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2017.08.008 · Cited by 39 · see citing works
“An instrument that operationalizes both self-reflective and interpersonal components of ascribing mental states, the RFQY was adapted from an earlier 46-item version of the RFQ, which was originally developed for adults (Fonagy et al., 2016).”
BackgroundMethodPattern of social cognition deficits in individuals with borderline personality disorder
Anupama, V. V., Bhola, P., Thirthalli, J., & Mehta, U. M. (2018) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2018.03.010 · Cited by 39 · see citing works
Metacognition in gambling disorder: A systematic review and meta-analysis
Rogier, G., Zobel, S. B., Morganti, W., Ponzoni, S., & Velotti, P. (2020) · Addictive Behaviors · doi:10.1016/j.addbeh.2020.106600 · Cited by 42 · see citing works
Jewell, T., Herle, M., Serpell, L., Eivors, A., Simic, M., Fonagy, P., & Eisler, I. (2021) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-021-01930-3 · Cited by 40 · see citing works
“• Reflective Function Questionnaire (RFQ8) [35]: This 8-item measure yields two subscales: Certainty about Mental States (henceforth referred to as Certainty) and Uncertainty about Mental States (henceforth: Uncertainty).”
BackgroundInfluentialSelf-citationSacchetti, S., Robinson, P. H., Bogaardt, A., Clare, A., Ouellet‐Courtois, C., Luyten, P., BATEMAN, A. W., & Fonagy, P. (2019) · BMC Psychiatry · doi:10.1186/s12888-019-2112-9 · Cited by 39 · see citing works
“Furthermore, not only do individuals with EDs have difficulty recognizing their own emotional states, but they also show impairments in acknowledging other people’s emotions [17, 39].”
BackgroundMethodInfluentialSelf-citationSpitzer, C., Zimmermann, J., Brähler, E., Euler, S., Wendt, L. P., & Müller, S. (2020) · PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie · doi:10.1055/a-1234-6317 · Cited by 39 · see citing works
“Abgebildet sind von links nach rechts zunächst a ein eindimensionales CFAMessmodell mit korrelierten Residuen zwischen Items 3 und 4, b ein 2-dimensionales Messmodell mit Kreuzladungen in Anlehnung an Fonagy und Kollegen [21, 23, 24] und c ein 2-dimensionales EFA-Messmodell.”
BackgroundInfluentialGambin, M., Woźniak‐Prus, M., Konecka, A., & Sharp, C. (2020) · European Journal of Developmental Psychology · doi:10.1080/17405629.2020.1736030 · Cited by 43 · see citing works
Brugnera, A., Zarbo, C., Compare, A., Talia, A., Tasca, G. A., de Jong, K., Greco, A., Greco, F., Pievani, L., Auteri, A., et al. (2020) · Psychotherapy Research · doi:10.1080/10503307.2020.1762946 · Cited by 37 · see citing works
Metacognitive self-assessment scale: psychometric properties and clinical implications
Faustino, B., Vasco, A. B., Oliveira, J., Lopes, P., & da Fonseca, I. B. (2019) · Applied Neuropsychology Adult · doi:10.1080/23279095.2019.1671843 · Cited by 39 · see citing works
“To our knowledge, there is no evidence of convergent validity between the MSAS with other assessment measures of metacognition as the Reflective Function (RF) interview and questionnaire (Fonagy, Steele, Steele, & Target, 1997; Fonagy et al., 2016) and the MCQ (Cartwright-Hatton & Wells, 1997).”
BackgroundNarrative Coherence in Adolescence: Relations With Attachment, Mentalization, and Psychopathology
Lind, M., Vanwoerden, S., Penner, F., & Sharp, C. (2020) · Journal of Personality Assessment · doi:10.1080/00223891.2019.1574805 · Cited by 30 · see citing works
“The RFQY was adapted from the adult RFQ items (Fonagy et al., 2016).”
MethodCarlone, C., Milan, S., Decoste, C., Borelli, J. L., McMahon, T. J., & Suchman, N. E. (2023) · Infant Mental Health Journal · doi:10.1002/imhj.22046 · Cited by 35 · see citing works
Morosan, L., Ghisletta, P., Badoud, D., Sprüngli‐Toffel, E., D, S. E. M., & Debbané, M. (2019) · Child Psychiatry & Human Development · doi:10.1007/s10578-019-00910-8 · Cited by 36 · see citing works
Chevalier, V., Simard, V., & Achim, J. (2023) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2023.102694 · Cited by 36 · see citing works
Euler, S., Stalujanis, E., Lindenmeyer, H. J., Nicastro, R., Kramer, U., Perroud, N. A., & Weibel, S. (2019) · Journal of Personality Disorders · doi:10.1521/pedi_2019_33_461 · Cited by 34 · see citing works
Löf, J., Clinton, D., Kaldo, V., & Rydén, G. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1699-6 · Cited by 29 · see citing works
“Since self-reported reflective functioning using the Reflecting Functionning Questionnaire (RFQ) [38, 40], a more specific instrument for assessing a key aspect of mentalisation, has been shown to have moderate to high correlations with self-rated alexithymia, it will be important for future”
MethodDesatnik, A., Bird, A., Shmueli, A., Venger, I., & Fonagy, P. (2023) · PLoS ONE · doi:10.1371/journal.pone.0286500 · Cited by 33 · see citing works
“The original RFQ [58] was developed to measure deficits in PLOS ONE The mindful trajectory: Developmental changes in mentalizing throughout adolescence and young adulthood”
BackgroundMethodSelf-citationArnfred, S. M., Aharoni, R., Hvenegaard, M., Poulsen, S., Bach, B., Arendt, M., Rosenberg, N. K., & Reinholt, N. (2017) · BMC Psychiatry · doi:10.1186/s12888-016-1175-0 · Cited by 31 · see citing works
A Temperament-Attachment-Mentalization-Based (TAM) Theory of Personality and Its Disorders
Karterud, S., & Kongerslev, M. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.00518 · Cited by 32 · see citing works
“The level of mentalizing ability is a major component of self-consciousness and thus a most important factor to consider when planning treatment (Bateman and Fonagy, 2016).”
BackgroundMethodInfluentialMentalizing Subtypes in Eating Disorders: A Latent Profile Analysis
Gagliardini, G., Gullo, S., Tinozzi, V., Baiano, M., Balestrieri, M., Todisco, P., Schirone, T., & Colli, A. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.564291 · Cited by 32 · see citing works
“Method: A sample of patients with eating disorders (N = 157) completed a battery of measures assessing mentalization and related variables, including the Reflective Functioning Questionnaire (RFQ), the Difficulties in Emotion Regulation Strategies (DERS), the Interpersonal Reactivity Index (IRI).”
BackgroundInfluentialApplying AMBIT to teacher training
Dlugosch, A., & Henter, M. (2023) · doi:10.1093/med-psych/9780198855910.003.0011 · Cited by 31 · see citing works
Theory of Mind and Suicidality: A Meta-Analysis
Nestor, B. A., & Sutherland, S. L. (2021) · Archives of Suicide Research · doi:10.1080/13811118.2021.1939209 · Cited by 31 · see citing works
“…1993), relevant items from the Social Cognition and Object Relations Scale (SCORS; Westen, 1991), the Reflective Functioning Questionnaire (RFQ; Fonagy et al., 2016), and relevant items from an empathic accuracy task (Brook & Kosson, 2013; see Harenski et al., 2017), and perspective-taking…”
Greenberg, D. M., Rudenstine, S., Alaluf, R., & Jurist, E. L. (2021) · Journal of Clinical Psychology · doi:10.1002/jclp.23203 · Cited by 32 · see citing works
Krink, S., & Ramsauer, B. S. (2021) · Infant Mental Health Journal · doi:10.1002/imhj.21914 · Cited by 30 · see citing works
Santoro, G., Midolo, L. R., Costanzo, A., & Schimmenti, A. (2021) · Bulletin of the Menninger Clinic · doi:10.1521/bumc.2021.85.4.358 · Cited by 30 · see citing works
Wibbelink, C. J. M., Arntz, A. R., Grasman, R. P. P. P., Sinnaeve, R., Boog, M., Bremer, O. M. C., Dek, E. C. P., Alkan, S. G., James, C., Koppeschaar, A. M., et al. (2022) · BMC Psychiatry · doi:10.1186/s12888-021-03670-9 · Cited by 33 · see citing works
Georg, A. K., Schröder, P., Cierpka, M., & Taubner, S. (2018) · Praxis der Kinderpsychologie und Kinderpsychiatrie · doi:10.13109/prkk.2018.67.5.421 · Cited by 30 · see citing works
Sharp, C., Steinberg, L., McLaren, V., Weir, S., Ha, C., & Fonagy, P. (2021) · Assessment · doi:10.1177/10731911211003971 · Cited by 28 · see citing works
“Fonagy et al. (2016) did not make use of IRT to reduce the item set, but rather took a more content-driven approach to refining the questionnaire.”
InfluentialSelf-citationMartin-Gagnon, G., Normandin, L., Fonagy, P., & Ensink, K. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1237735 · Cited by 31 · see citing works
“Although mentalizing deficits are known as transdiagnostic risk factors for psychopathology (Fonagy et al., 2016; Luyten et al., 2020), further research is required to clarify how Uncertainty/Confusion about mental states relates to CEA and adolescent psychological difficulties such as depression and anxiety.”
BackgroundResultSelf-citationWendt, L. P., Zimmermann, J., Spitzer, C., & Müller, S. (2024) · Psychological Assessment · doi:10.1037/pas0001310 · Cited by 31 · see citing works
Paetzold, R. L., & Rholes, W. S. (2021) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2020.1869654 · Cited by 28 · see citing works
“Individuals have the capability of hypomentalizing or hypermentalizing (Fonagy et al., 2016), both of which have been linked to psychopathology.”
BackgroundInfluentialJohnstone, O. K., Marshall, J. J., & McIntosh, L. G. (2021) · Adolescent Research Review · doi:10.1007/s40894-020-00147-w · Cited by 28 · see citing works
Levante, A., Martis, C., Bianco, F., Castelli, I., Petrocchi, S., & Lecciso, F. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1182309 · Cited by 31 · see citing works
“(3) Depression Anxiety Stress Scale-−21 (Fonagy et al., 2016): mother’ distress; Coping Scale (Hamby et al.”
BackgroundInfluentialEfficacy of mentalization‐based therapy in treating self‐harm: A systematic review and meta‐analysis
Hajek Gross, C., Oehlke, S., Prillinger, K., Goreis, A., Plener, P. L., & Kothgassner, O. D. (2024) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.13044 · Cited by 31 · see citing works
Borelli, J. L., Palmer, A. C., Vanwoerden, S., & Sharp, C. (2017) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2017.1399400 · Cited by 26 · see citing works
“Construct, convergent, and divergent validity of the RFQ have been demonstrated (Fonagy et al., 2016).”
BackgroundSelf-Rated Mentalizing Mediates the Relationship Between Stress and Coping in a Non-Clinical Sample
Schwarzer, N.-H., Nolte, T., Fonagy, P., & Gingelmaier, S. (2021) · Psychological Reports · doi:10.1177/0033294121994846 · Cited by 26 · see citing works
“…of mentalizing using self-rating assessment in particular has been criticized by various authors (Taubner & Sevecke, 2015), although efforts have been made to use economically manageable test instruments based on questionnaires for some time now (Badoud et al., 2015; Fonagy et al., 2016).”
BackgroundMethodSelf-citationAgency via Awareness: A Unifying Meta-Process in Psychotherapy
Gorlin, E. I., & Békés, V. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.698655 · Cited by 27 · see citing works
BATEMAN, A. W., Rüfenacht, E., Perroud, N. A., Debbané, M., Nolte, T., Shaverin, L., & Fonagy, P. (2023) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12514 · Cited by 30 · see citing works
“The short (8-item) version of the RFQ (Fonagy et al., 2016) is a self-report tool gauging reflective functioning, a measure of mentalizing capacity focusing on variations in hypomentalizing and hypermen-talizing.”
InfluentialSelf-citationTatnell, R., Hasking, P. A., & Newman, L. K. (2017) · Australian Journal of Psychology · doi:10.1111/ajpy.12166 · Cited by 29 · see citing works
Pajulo, M., Tolvanen, M., Pyykkönen, N., Karlsson, L., Mayes, L. C., & Karlsson, H. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.09.020 · Cited by 28 · see citing works
Taubner, S., Hauschild, S., Kasper, L. A., Kaess, M., Sobanski, E., Gablonski, T., Schröder‐Pfeifer, P., & Volkert, J. (2021) · Pilot and Feasibility Studies · doi:10.1186/s40814-021-00876-2 · Cited by 26 · see citing works
“ASPD: Antisocial personality disorder; BRFI: Brief Reflective Functioning Interview; CECA-Q: Childhood Experience of Care and Abuse Questionnaire; CFT-2: Cultural-Fair-Test 2; CGI-SI: Clinical Global Impression – Severity Index; DAPP-BQ: Dimensional Assessment of Personality Pathology – Basic Questionnaire; DSM: Diagn…”
MethodInfluentialBizzi, F., Riva, A., Borelli, J. L., Mora, S. C., Bomba, M., Cavanna, D., & Nacinovich, R. (2021) · Journal of Clinical Psychology · doi:10.1002/jclp.23218 · Cited by 24 · see citing works
“(2015) have adapted the RFQ (Fonagy et al., 2016) for French adolescents, showing configural invariance of the original two‐factor structure of the RFQ across French‐speaking adolescents and adults, satisfactory reliability and construct validity of the two subscales.”
BackgroundMethodResultInfluentialWu, H., Fung, B. J., & Mobbs, D. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.791835 · Cited by 26 · see citing works
Horváth, Z., Demetrovics, O., Paksi, B., Unoka, Z., & Demetrovics, Z. (2023) · PLoS ONE · doi:10.1371/journal.pone.0282000 · Cited by 28 · see citing works
“Genuine mentalizing is thus characterized by both some extent of certainty and uncertainty while individuals consider having a decent knowledge about their mental states [1].”
BackgroundMethodInfluentialAttachment Security and Suicide Ideation and Behaviour: The Mediating Role of Reflective Functioning
Green, J., Berry, K., Danquah, A., & Pratt, D. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18063090 · Cited by 25 · see citing works
“78, respectively) in a clinical sample and have been found to significantly relate in theoretically predicted ways with related constructs of empathy, mindfulness and perspective-taking [57].”
BackgroundMethodInfluentialAssessing mentalization in psychotherapy: first validation of the Mentalization Imbalances Scale
Gagliardini, G., Gullo, S., Caverzasi, E., Boldrini, A., Blasi, S., & Colli, A. (2018) · Research in Psychotherapy Psychopathology Process and Outcome · doi:10.4081/ripppo.2018.339 · Cited by 27 · see citing works
“A further limitation, somewhat related to the previous one, is that we did not evaluate convergent validity comparing MIS evaluations with other concurrent measures such as, for example, the RFQ (Fonagy et al., 2016), the RFS, or the MAS (Semerari et al.”
MethodResultInfluential
- Authors
- Fonagy, P., Luyten, P., Moulton-Perkins, A., Lee, Y.-W., Warren, F., Howard, S., Ghinai, R., Fearon, P., & Lowyck, B.
- Affiliations
- University College London (GB)
- University of Surrey (GB)
- KU Leuven (BE)
- Corresponding author
- Fonagy, Peter
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2016-07-08
- Volume
- 11
- Issue
- 7
- Pages
- e0158678
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4938585
- OpenAlex
- W2468117220
- Cited by
- 754
- References
- 113
- Citations by year
- 2026: 102 · 2025: 106 · 2024: 112 · 2023: 108 · 2022: 84 · 2021: 95 · 2020: 54 · 2019: 34 · 2018: 32 · 2017: 21 · 2016: 3 · 2015: 1
- FWCI
- 39.84
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Lirias (KU Leuven) (submittedVersion, other-oa)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institute for Health Research (NF-SI-0514-10157)
- Economic and Social Research Council (RES-060-25-0044)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- mentalization, reflective functioning, self-report measure development, borderline personality disorder, eating disorders, parental reflective functioning, infant attachment, Strange Situation Procedure, empathy, mindfulness, perspective taking, psychometric validation, factor structure
- MeSH terms
- Female, Humans, Male, Psychometrics, Surveys and Questionnaires, Theory of Mind, Self Report
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