Testing Children’s Mentalizing in Middle Childhood: Adopting the Child and Adolescent Reflective Functioning Scale with Clinical and Community Children

Abstract

Beginning with Ensink’s seminal study (2015), the field entered a new era in which we were able to measure mentalizing in school-aged children. The goal of this work is to continue developing the state of the research within this tradition by exploring the psychometric properties of the Child Reflective Functioning Scale (CRFS) - a measure applied to the Child Attachment Interview and designed to assess RF during middle childhood - within both clinical and normative groups, and to examine if it differentiates between both groups. Participants were 159 Italian children (age range 8–12 years, M_age = 10.66, SD =1.83; 57% males) divided into two groups: 71 children with emotional-behavioral problems (‘clinical group’) and 88 children without emotional-behavioral problems (‘community group’). Demographic data and Verbal Comprehension Index were collected. A two-factor model of CRFS (self- and other-focused RF) was confirmed in both groups, revealing that these intrapersonal and interpersonal indicators of children’s RF are important domains of mentalizing abilities in middle childhood. The results revealed adequate inter-rater reliability of the CRFS. Controlling for the effect of potentially confounding demographic variables, significant differences on CRFS scales between clinical and community groups were found. The clinical group showed lower levels of CRFS scores than normative group, but importantly, the self-focused RF score uniquely predicted clinical/community status. Taken together, the findings showed that the CRFS is a reliable and validity measure for assessing RF in middle childhood with clinical and normative groups, contributing important information to the scientific literature on mentalizing in middle childhood.

Highlights

The CRFS is a reliable and valid measure used to assess RF in middle childhood, discriminating between clinical and community children (children with and without emotional behavioral problems).

Testing the psychometric proprieties of CRFS through the use of clinical and community groups, we found that the measure achieved adequate internal consistency, high inter-rater reliability, with a two-factor solution of CRFS (self- and other-focused RF).

In both the clinical and the normative samples, CRFS scores were associated with age, gender and verbal competence, while they were not associated with SES and family composition. Clinical group showed lower levels of CRFS scores of all three dimensions (general, self- and other-focused RF) than the normative group, and only self-focused RF predicted clinical/community status in middle childhood.

New evidence regarding the similar factorial invariance of CRFS for clinical and community children suggest that the two intrapersonal and interpersonal components of children’s RF are reliable dimensions of mentalizing within clinical and community children during middle childhood.