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Development and Validation of a Self-Report Measure of Mentalizing: The Reflective Functioning Questionnaire
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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 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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“…that goes beyond observable information (Abu-Akel & Bailey, 2000; Sarig-Shmueli et al., 2023), while hypomentalizing refers to an inability or unwill-ingness to reflect on simple or complex mental states of oneself or others (Baron-Cohen, 1995; Fonagy et al., 2016; Sarig-Shmueli et al., 2023).”
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“In order to evaluate students’ mentalizing ability , the Reflective Functioning Questionnaire was administered (RFQ; Fonagy et al., 2016; Morandotti et al., 2018), an 8-item self-report that measures mentalizing operationalization, the indicators, which could facilitate results interpretation.”
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“…System Disorder, SSD-12 [13]), short symptom checklist (Symptom-Checkliste Kurzversion, SCLK-11 [14]), work ability (Work Ability Index [15]), reflective functioning (Reflective Functioning Questionnaire, RFQ [16]), and 8-item Eating Disorder Examination-Questionnaire (EDE-Q8) [17] were applied.”
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“An Italian research group used an 8-item version to generate RFQ certainty and uncertainty scores for two studies (Brugnera et al., 2021, 2023).”
InfluentialMaluenda-Gatica, R., Araya, C., Morán, J., Ríos, U., Möritz, S., & MacBeth, A. M. (2026) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70260 · Cited by 1
“Therapist MASC-SP scores were introduced as a Level-2 fixed effect (Model 4), followed by RFQ-8 scores (Model 5).”
InfluentialQuayle, E., Schwannauer, M., Varese, F., & Bucci, S. (2026) · Victims & Offenders · doi:10.1080/15564886.2025.2540969 · Cited by 1
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“Reflective Functioning Questionnaire RFQ-8 (Fonagy et al., 2016; Spanish adaptation by Ruiz-Parra et al., 2023) is a brief questionnaire designed to assess the capacity for reflective functioning or mentalization.”
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“…affectivity and CAMSQ dimensions (Müller et al., 2023), our results align with evidence suggesting that emotional instability is linked to hy-pomentalizing (Fossati et al., 2017), characterized by a reduced capacity to reason about complex mental states of the self and others (Fonagy et al., 2016).”
When Stigma Enters Healthcare: Positive Identity and Mentalization in LGBTQ+ People’s Well-Being
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“Ineffective mentalizing was assessed using the short German version of the Reflective Functioning Questionnaire (RFQ) [43], which measures individual tendencies to consider mental states as relevant for understanding one’s own and others’ behavior.”
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“Reflective Functioning Questionnaire (RFQ-8; [63]) The RFQ-8 is an eight-item self-report measure of mentalizing.”
Self-citationLegendre, M., Garon‐Bissonnette, J., Lemieux, A., Lemieux, R., Gamache, D., & Berthelot, N. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.122267 · Cited by 1
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Wenn Schülerinnen und Schüler glauben, unmusikalisch zu sein:
Zeeb, H., Fischer, A. K., Geißler, C., Eitel, A., Brunner, G., & Renkl, A. (2018) · Beiträge empirischer Musikpädagogik · doi:10.62563/bem.v2018154 · Cited by 1
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Quevedo, Y., Hernández, C., Gómez, D. M., Díaz, C. G., & Valdés, N. (2019) · Revista de psicología · doi:10.5354/0719-0581.2019.53941 · Cited by 1
“En un estudio que incluyó 405 sujetos con trastorno de personalidad y sujetos sanos, una baja mentalización, medida con el cuestionario de autorreporte Reflective Functioning Questionnaire, se asoció a difusión de identidad medida con el Inventario de la Personalidad Organización (Fonagy et al., 2016).”
BackgroundDDAA and Maternal Reflective Functions
Frolli, A., Cavallaro, A., Oduro, S., Bosco, A., Lombardi, A., Carmine, F. D., & Ricci, M. C. (2021) · Current Psychology · doi:10.1007/s12144-021-01818-0 · Cited by 1
“…and Developmental Disorders of Infancy and childhood – DC 0–5) (ZERO TO THREE, 2016), (PRFQ (Parental Reflective Function Questionnaire created by (Fonagy et al., 2016; Luyten, Mayes, et al., 2017), PSI/SF (Parenting Stress Index-Short Form authored by Abidin, 1990), and CBCL (Child Behaviour…”
BackgroundFountoglou, E., Juen, B. H., Bliem, H. R., Karl, R., & Sulz, S. K. D. (2022) · Psychotherapie · doi:10.30820/2364-1517-2022-2-113 · Cited by 1
Esposito, G., Cutolo, A. S., Passeggia, R., Formentin, S., & Gonçalves, M. M. (2022) · Research in Psychotherapy Psychopathology Process and Outcome · doi:10.4081/ripppo.2022.648 · Cited by 1
“, the tendency to develop very complex and rigid models of the mind that have poor correspondence to appropriate evidence (Fonagy et al., 2016).”
BackgroundInfluentialEvési szokások magyar serdülők körében
Siska, D., Cserép, M., & Szabó, B. (2023) · Orvosi Hetilap · doi:10.1556/650.2023.32657 · Cited by 1
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“…studies that have utilised the coding of RF on the PDI include Suchman et al. (2017) study on their Mothering From the Inside Out programme, Fonagy et al. (2016) study on the Parent-Infant Psychotherapy intervention, Sleed et al. (2013) study on their New Beginnings programme, and Sadler…”
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Mentalization Based Therapy for Eating Disorders
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“Reflective functioning was assessed with the Reflective Functioning Questionnaire (RFQ; Fonagy et al., 2016).”
MethodGiunta, S., Mannino, G., Sideli, L., Quattropani, M. C. A., & Lenzo, V. (2024) · Health Psychology Research · doi:10.52965/001c.122543 · Cited by 1
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“The questionnaire comprises 8-items on a 7-point scale (from Strongly Disagree to Strongly Agree ) has reli - able psychometric properties (Fonagy et al., 2016 ).”
Lee, J.-Y., Shin, H. K., Choi, S., Lee, M.-W., Jeong, S., Park, S., Kim, J., Seok, J., & Jang, S. (2025) · 신경정신의학 · doi:10.4306/jknpa.2025.64.2.58 · Cited by 1
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“Reflective Functioning Questionnaire RFQ-8 Versión en español (Fonagy et al., 2016).”
BackgroundInfluentialPsychodynamik und Operationalisierung
Benecke, C., & Schauenburg, H. (2020) · PDP – Psychodynamische Psychotherapie · doi:10.21706/pdp-19-1-36 · Cited by 1
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“…en relaciones revisadas (ecr) Es una prueba tipo Likert realizada originalmente por Brennan et al. (1998) (Experiences in Close Relationships, ecr) y revisada en el 2000 por Fraley et al. (2000), que contiene 36 ítems agrupados en dos escalas: una de ansiedad (18 ítems) y una de evitación.”
BackgroundPsychological treatment of an adolescent who was prone to non suicidal self injury A case report
Vukčević, B., Safiye, T., & Gutić, M. (2023) · Journal of Clinical and Medical Images Case Reports · doi:10.55920/2771-019x/1337
Binge-Eating Disorder and Obesity in Women: The Role of Attachment States of Mind
Maxwell, H. (2017) · uO Research (University of Ottawa) · doi:10.20381/ruor-20343 · Cited by 1
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Beyond Descriptive Models of Personality Problems
Zavlis, O., & Fonagy, P. (2024) · Journal of Personality Assessment · doi:10.1080/00223891.2024.2430322 · Cited by 1
“Historically, mentalizing was examined via self-report, inter-views, or naturalistic observation (Fonagy et al., 2016).”
Self-citationWas Blind But Now I See: Understanding Ethical Blindness in Terms of Function Rather than ContentPreprint
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Quando è importante la verità?
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YOĞUN DUYGUSAL ZEKA EĞİTİMİNİN ETKİLİLİĞİ ÜZERİNE BİR ÇALIŞMA
Bilican, F. I. (2020) · Current Research in Social Sciences · doi:10.30613/curesosc.753207
Socialkognitive vanskeligheder hos patienter med depression
Ladegaard, N. (2019) · Psyke & Logos · doi:10.7146/pl.v40i2.117813
“…af mentalisering har bl.a. Fonagy udviklet et interviewbaseret assessment-instrument Reflective Functioning Scale (Fonagy, Target, Steele, & Steele, 1998) og senest et selvrapporteringsskema, The Reflective Functioning Questionnaire, med vurdering af samme kompetence for øje (Fonagy et al., 2016).”
BackgroundKim, H.-J., Park, M.-J., Cha, H.-M., & Kim, E. Y. (2020) · 한국심리학회지: 일반 · doi:10.22257/kjp.2020.12.39.4.633
Kho, K. L. (2020) · Murdoch University Research Portal
Effectiveness of an Intensive Three-Day Emotional Intelligence Training
Bilican, F. I., CAMCI, Y., CİHAN, A., Yaman, H., Murat, U. G. U. R., JURİČKO, A., Arzenšek, A., WİNKELS, K., REİCHRATH, G., Kovachev, L., et al. (2021) · Current Research in Social Sciences · doi:10.30613/curesosc.945196
“…the intervention group SSEIT, DERS, SCL-90-R, and RFQ total scores in order to determine the covariates which had substantial correlation with the dependent variable and to adjust the results for differences existing among the participants before the start of the study (George & Mallery, 2006).”
MethodAini, A. N. (2021) · Psychiatry Nursing Journal (Jurnal Keperawatan Jiwa) · doi:10.20473/pnj.v3i1.26813
Sakata, H. (2021) · The Japanese Journal of Personality · doi:10.2132/personality.30.2.9
“…Testの 提供と使用許可をいただいた吉川左紀子先生，丁寧 に論文を読み適切な助言をくださった匿名査読者の 先生方に感謝申し上げます。 2） 前版であるDSM-IV-TRでは身体表現性障害に分類 されていた。診断基準は概ね変わりないが，DSM-5 では，本文に記載した（b）の基準が加わり，強迫 行為が強調された。 パーソナリティ研究 2021 第 30巻 第 2号 101–110 DOI: http://doi.org/10.2132/personality.30.2.9 J-STAGE First published…”
InfluentialChopra, N., Yang, T., Hlaing, T., Ettensohn, K., Holinstat, I., Zhang, W., Pfeifer, K. E., Roden, D. M., & Knollmann, B. C. (2006) · Circulation
Seguridad en los multímetros: Criterios de aplicación
López, N. B. D. M. (1998) · Mundo electrónico
Willén, R. M., & Kronkvist, O. (2022) · doi:10.31222/osf.io/qvmsn
Willén, R. M., & Kronkvist, O. (2022) · doi:10.31234/osf.io/6rbau
The Use of Synchronous Videoconference in Bipolar Patients
Maluenda-Gatica, R., Schwannauer, M., & MacBeth, A. M. (2022) · Social Science Protocols · doi:10.7565/ssp.v5.6714
“The Reflective Functioning Questionnaire (RFQ-54) (Fonagy et al., 2016) Reflective Function x”
BackgroundInfluentialRolontwikkeling en persoonlijke ontwikkeling
van Dijk, M., & Holleman, G. (2020) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-368-2447-7_2
Rolontwikkeling en persoonlijke ontwikkeling
van Dijk, M., & Holleman, G. (2018) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-368-2085-1_2
عرفة, ن. م. (2022) · مجلة کلیة التربیة فى العلوم النفسیة · doi:10.21608/jfeps.2022.236872
Georg, A. K., Hauschild, M. S. S., Schröder‐Pfeifer, P., Kasper, L. A., & Taubner, S. (2022) · Research Square · doi:10.21203/rs.3.rs-1611099/v2
Semkiv, I., Kechur, R., Tymkiv, T., & Ткачук, Т. (2022) · TECHNOLOGIES OF INTELLECT DEVELOPMENT · doi:10.31108/3.2022.6.2.4
Sulz, S. K. D., Esterbauer, D., Fountoglou, E., Hoenes, A., Hoy, V.-U., & Schober, S. (2022) · Psychotherapie · doi:10.30820/2364-1517-2022-2-99
da Silva, R. P., Bittencourt, A. A., Feijó, L. P., & Serralta, F. B. (2022) · Aletheia · doi:10.29327/226091.55.2-5
Exploring reflective function in support workers at a homeless centre
Tozer, L. (2017) · Clinical Psychology Forum · doi:10.53841/bpscpf.2017.1.298.13
Cimino, S., & Cerniglia, L. (2023) · BJPsych Open · doi:10.1192/bjo.2022.634
Metadata
- 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
- 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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