Middle childhood represents for the child and his family a period of important changes that occur on several levels. At the individual level, we witness the maturational evolution of a child’s cognitive and emotional processes parallel to pubertal growth. These processes also include significant development of the child’s mentalization and social cognition skills. Concurrently, at a social level, there is an expansion of the relevance that the extra-familiar context assumes for child development. Relationships with peers, primarily grounded within the school context, become a significant source of exploration and enhancement of social–emotional competencies. Although such important changes make this stage of child’s life of great interest, studies related to attachment theory that have addressed middle childhood are relatively lacking. Furthermore, although there has been an increase in research in recent years, several gaps related to the study of parental mentalizing, the father’s role, and the link between parenting variables and a child’s psychological and psychopathological outcomes still remain.
1. Parental Mentalizing: Theory and Assessment
Mentalizing construct, originally operationalized as Reflective Functioning (RF) by Peter Fonagy and colleagues
[1], has gained wide space over the last thirty years. Early studies thus focused on the predictive value of the quality of parents’ mentalizing with respect to their child’s psychological outcomes
[1][2], which are closely related to the quality of family relationships
[3].
It is in this line of research that David Oppenheim and Nina Koren-Karie
[4] and Arietta Slade
[5] proposed respectively the two concepts of Parental Insightfulness (PI) and Parental Reflective Functioning (PRF). The construct of PRF—i.e., a parent’s ability to reflect upon their child’s inner mental world
[5]—expands the goal of measuring RF by exploring it directly within the parent–child relationship and investigating parents’ ability to understand their own and their child’s internal experience in terms of intentional mental states. In this regard, a modified version of the Reflective Functioning Scale
[6] was implemented and applied to the Parental Development Interview (PDI
[7]) an interview specifically designed to explore the parental ability to reflect on the ongoing parent–child relationship. Unlike the original Reflective Functioning Scale (RFS
[8]), which uses transcripts related to past relational experiences from the Adult Attachment Interview
[9], Slade’s Reflective Functioning Scale uses current material—that is obtained from PDI transcripts—related to dyadic interactions occurring in the present moment. Over the past few years, a less time-consuming measure for assessing mentalizing has been developed: the Parental Reflective Functioning Questionnaire (PRFQ
[10]). PRFQ is a self-report questionnaire that measures key dimensions of parental mentalizing including interest and curiosity about their child’s mental states, the parent’s pre-mentalizing modes of thinking and certainty about the child’s mental states.
The construct of PI, similarly to that of PRF, indicates a parent’s ability to think about the processes underlying their child’s behavior in an accepting, complex and open manner, taking into account the child’s perspective
[11]. Differently from the PDI, Nina Koren-Karie and David Oppenheim have developed a video-replay assessment procedure—the Insightfulness Assessment procedure (IA
[12][13])—that explores parental mentalizing employing several videotaped segments of the parent–child dyadic interaction that are viewed and then commented on by the parent along with the interviewer. Thus, PI could be understood as a concept contiguous with that of PRF although it should be distinguished from it at least procedurally, in that to be measured it requires the parent to observe a videotaped interaction with their child. PI thus refers to the parent’s ability to be able to convey an image of the child that is emotionally complex and open to change, understanding the child’s mental states in the here and now of the relationship with the child
[13]. In doing so, the main aim of its evaluation focuses on the parent’s ability to think about the motives that underlie the child’s behavior while linking these thoughts to the child’s behavior
[14]. It is based on Ainsworth’s description of the sensitive mother as “seeing things from the child’s point of view”
[15] and is assessed using a video-replay method in which parents are interviewed about “what went on in your child’s head” after watching several video clips of the child interacting with them. Thus, parents are required to engage in a “dialogue” between what they know about their child based on their shared history and the specific behaviors and reactions of the child as captured on video. A task requiring the parent to understand, and especially to accept the child as a separate person with their own thoughts, emotions, needs and desires different from those of the parent and sometimes contradictory to their own goals
[11]. Moreover, by virtue of its procedure for mentalizing evaluation, the Insightfulness Assessment procedure could constitute a potential intervention model able to increase a parental mentalizing stance similar to video-feedback interventions and could also be used prior to mentalization-based parenting programs to target therapeutic goals according to the specific mentalistic deficits (e.g.,
[16]).
2. Parental Mentalizing and Child’s Psychological Outcomes
The construct of parental mentalizing, which has been identified and measured in this study throughout the two constructs of Parental Reflective Functioning (PRF
[5]) and Parental Insightfulness (PI
[4]), allows us to place attachment theory within a broader and more complex context defined by parental ability to understand a child’s behaviors on the basis of intentional mental states. Within this framework, many studies have shown the association between parental mentalizing and a child’s psychological and psychopathological outcomes, suggesting an important role played by familial relationships (for a review
[3][17]).
As regards PRF construct, the studies listed below mostly used an interview-based assessment of mentalizing (e.g., RFS
[6][8]) while a few studies
[10][18][19][20][21] used the newly developed Parental Reflective Functioning Questionnaire
[10] which is easier and more convenient to operate but prone to the tradeoffs of self-report questionnaires. These studies have highlighted the role of PRF in regard to a child’s psychopathological symptoms by showing a negative association between good parental mentalizing and child’s internalizing and externalizing problems
[18][20][21][22][23][24][25][26][27], and better socio-emotional competencies and fewer socio-emotional problems for the child
[21][28]. Other studies have shown a negative association between parental mentalizing and a child’s anxiety levels
[29] and a positive relationship with a child’s mentalizing
[30][31][32][33]. Finally, additional studies have shown significant associations between parental mentalizing and child attachment security
[10][34][35][36][37][38][39][40] and higher child emotional regulation competencies
[41]. Finally, other studies suggested a protective role of parental mentalizing, some of which have shown a moderating role of maternal PRF within the relationship between difficult temperament and a child’s behavioral difficulties
[42] and between emotional distress and a child’s coping strategies during a stress-task
[19].
Moreover, concerning PI, several studies have shown its relationship to a child’s attachment security
[43][44][45][46][47], lower child externalizing symptoms
[48], lower child externalizing and internalizing symptoms
[16], higher child cognitive abilities
[49], and higher child responsiveness and involvement during a mother–child dyadic interaction
[50]. Finally, some studies showed a protective role of PI within the relationship between a child’s exposure to violent behaviors and the presence of internalizing and externalizing symptoms and negative affectivity
[51].
Overall, these studies have outlined the relationship between parental mentalizing and a child’s psychological outcomes, stressing the key role played by mentalistic representations that parents have of their children and the influence that these representations may have on a child’s psychological trajectories. However, most of the research has mainly focused on early childhood and on the mother’s role, leaving aside later developmental stages such as middle childhood and adolescence except for a few studies
[23][24][29][30][31][32][33][34][52][53][54]—together with the father’s mentalizing role. Following this direction, some studies addressed the relationship between paternal PRF and a child’s psychological outcomes, showing associations with Attention-Deficit/Hyperactivity Disorder
[55], child social–emotional competencies
[21][56], child internalizing and externalizing symptoms
[52], and child anger propensity
[57], while other studies did not find significant associations
[29][54][58][59][60][61].
Furthermore, most of the studies focused on children’s psychopathological outcomes—e.g., internalizing and externalizing symptomatology—while a gap in studies of other children’s psychological dimensions such as social–emotional competencies (e.g.,
[21][28]) and prosocial behaviors still remains. The inclusion of parental mentalizing as an explanatory variable is still limited to a few studies. For example, Nijssens et al.
[56] highlighted the role of both parents’ PRF as a mediator within the relationship between parental attachment dimensions and a child’s social–emotional competencies in families with children aged 8 to 13 months. Gordo et al.
[62] showed the indirect effect of both parents’ PRF on child’s social–emotional adjustment by mediating the role of perceived parental competence in families with children aged 2 to 36 months. Finally, León and Olhaberry
[60] showed, in families with children aged 12 to 38 months, the absence of a direct relation between both parents’ PRF and the child’s social–emotional behavior while the indirect effect of maternal PRF alone on the child’s social–emotional behavior was shown throughout the mediational role of the quality of triadic family interaction.