Validation of the Three-Factor Reflective Functioning Questionnaire for Youth in a Chinese Adolescent Sample

Abstract

Wen Chen,1,2 Yun Li,2 Haitham Jahrami,3,4 Weiyan Wang,5 Wei Zheng,2 Yuxia Huang,1 Nicola Luigi Bragazzi,6,7 Weijia Gao1 1Department of Child Psychology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, People’s Republic of China; 2Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, People’s Republic of China; 3College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain; 4Ministry of Health, Manama, Bahrain; 5Affiliated Mental Health Center & Hangzhou Seventh People’s Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 6Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, Canada; 7Human Nutrition Unit (HNU), Department of Food and Drugs, Medical School, University of Parma, Parma, ItalyCorrespondence: Weijia Gao, Department of Child Psychology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, Zhejiang Province, People’s Republic of China, Email [email protected] Nicola Luigi Bragazzi Human Nutrition Unit (HNU), Department of Food and Drugs, Medical School, University of Parma, Parma, Italy, Email [email protected]: This study focused on the validation of the Three-Factor Reflective Functioning Questionnaire for Youth(RFQY) within a sample of Chinese adolescents.Patients and Methods: All the items of the RFQY were translated into Chinese language through the process of translation and back translation. A total of 532 adolescents aged between 12– 20 years completed the Chinese version of RFQY, McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD), Basic Empathy Scale (BES), and the 20-item Toronto Alexithymia Scale (TAS-20).Results: Twenty items meeting psychometric standards were retained in the Chinese version of the RFQY. The indices for confirmatory factor analysis, including χ 2/df (2.354), SRMR (0.053), GFI (0.930), CFI (0.921), TLI (0.910), and RMSEA (0.050), all conformed to the requirements of psychometrics. The Cronbach’s alpha coefficients for the three factors, “uncertainty/confusion”, “interest/curiosity”, and “excessive certainty”, were 0.820, 0.673, and 0.839, respectively, with test-retest reliability scores of 0.751, 0.643, and 0.764. A significant positive correlation was found between uncertainty/confusion and symptoms of borderline personality disorder (BPD), particularly in adolescents with high BPD traits. Excessive certainty was positively correlated with unstable interpersonal relationships, while the interest/curiosity factor shows no significant correlation with BPD symptoms. The uncertainty/confusion factor demonstrates a complex relationship with empathy, correlating positively with affective empathy but negatively with cognitive empathy. The uncertainty/confusion factor shows a significant positive correlation with alexithymia, while the factor of excessive certainty demonstrates the opposite effect. Additionally, a significant negative correlation exists between the interest/curiosity factor and the externally oriented thinking.Conclusion: This study validates the Chinese version of the Reflective Functioning Questionnaire for Youth (RFQY), demonstrating its reliability and validity in assessing reflective functioning among Chinese adolescents. This enhances the understanding of reflective functioning and its role in adolescent mental health.Keywords: mentalizing, adolescence, psychometric validation, borderline personality disorder

Keywords

• mentalizing
• adolescence
• psychometric validation
• borderline personality disorder