Qualitative Markers of Reflective Functioning: Exploratory Psychometric Examination in Community Participants Meeting or Not Meeting Borderline Personality Disorder Criteria.

Abstract

Reflective Functioning (RF) is the capacity to understand oneself and others in terms of mental states. It is central to intra- and interpersonal functioning, as impairments in RF are associated with psychopathology, and especially borderline personality disorder (BPD). The Reflective Functioning Scale (RFS), the gold-standard measure of RF, requires the identification of qualitative markers, but their specific contribution to the global score and whether the prevalence of these markers differs among proxies of clinical samples has rarely been examined. Participants who met the criteria for BPD (n = 51), other psychiatric disorders (n = 49), or healthy controls (n = 51) were interviewed for RF using the Brief Reflective Functioning Interview, which was coded with the RFS. Positive markers were stronger predictors of RF scores than negative ones, though both uniquely contributed to the prediction of RF. Qualitative categories did not predict the global RF scores beyond the prediction by marker valence. Groups differed in marker prevalence, with BPD displaying higher rates of distorted, self-serving markers of RF. Findings suggest that qualitative markers of RF add unique insight into mentalizing, informing theoretical and clinical endeavors, but that the current set of markers may be redundant and requires reconsideration.