Regula A icle
Pa en al men aliza ion and child en’s ex e nalizing p oblems:
A sys ema ic e iew and me a-analysis
Mai ane Nie o-Re ue o , Ba ba a To es-Gomez and I zia Alonso-A biol
Depa men o Clinical and Heal h Psychology & Resea ch Me hods, Uni e si y o he Basque Coun y UPV/EHU, Donos ia-San Sebas ian, Spain
Abs ac
Pa en al men aliza ion, as he abili y o unde s and men al s a es (e.g., desi es) behind hei child en’s ac ions, may play a ele an ole in he
p e en ion o u u e ex e nalizing p oblems. We conduc ed a me a-analysis o examine he ela ionship be ween pa en al men aliza ion and
child en’s ex e nalizing p oblems. Six elec onic da abases we e sea ched o s udies, published in English o Spanish, linking empi ically hose
wo a iables. Pa icipan s included ca egi e s and child en be ween 0 and 18 yea s. The il e ing p ocess yielded 42 s udies wi h 52 e ec sizes.
Random-e ec analysis e ealed highe pa en al men aliza ion associa ed wi h ewe ex e nalizing p oblems, wi h an e ec size o =−.19
(95% CI [−.25, −.13]). Due o high he e ogenei y (I2=83.750), u he analyses we e conduc ed o explo e ac o s a ec ing such associa ion.
Pa en ing expe ience and child en’s de elopmen al s age mode a ed he ela ionship, bu app oaches o ope a ionalize men aliza ion (MM o
PRF), sample ype (clinical/a - isk s. communi y), and epo ing igu e (p ima y ca egi e s. o he in o man s) did no . The s udy highligh s
he signi icance o pa en al men aliza ion as a po en ial con ibu o o he p e en ion o ex e nalizing beha io s among in an s, child en, and
adolescen s. Ou indings may unde sco e p ac ical implica ions o equipping ca egi e s wi h men aliza ion skills, helping hem o answe
app op ia ely o hei child en needs.
Keywo ds: Child en’s ex e nalizing p oblems; de elopmen al s age; me a-analysis; pa en ing expe ience; pa en al men aliza ion
(Recei ed 16 Janua y 2024; e ised 26 July 2024; accep ed 29 July 2024)
Ea ly mani es a ions o ex e nalizing beha io s, such as an ums,
disobedience, and agg ession (Pe e son e al., 2018), a e obse ed
as ea ly as in ancy (Pe a e al., 2021). Recen me a-analysis esul s
in child en aged 1–7 yea s (Vasile a e al., 2021) e eal a 10%
p e alence o ex e nalizing psychopa hology, including a en ion-
de ici hype ac i i y diso de , conduc diso de , and opposi ional
de ian diso de . Failu e o add ess hese maladap i e beha io s in
hei ea ly s ages inc eases he isk o u u e issues, including
subs ance abuse and iolence (Mo i , 2017), an isocial pe sonali y
diso de (Diaman opoulou e al., 2010), and c iminal eco ds
(Be ilacqua e al., 2018). In ac , ea ly ex e nalizing p oblems ha e
shown o p edic c iminal con ic ions wo decades la e (Kassing
e al., 2019). Hence, i is essen ial o p e en he eme gence o
ex e nalizing beha io s and/o o a oid hei pe sis ence a
ea ly ages.
Ex e nalizing beha io s esul om a complex in e play o
gene ics, neu ological changes, and en i onmen al ac o s (Ro i a
e al., 2020), including biological disposi ion (Dodge & Pe i ,
2003), pa en –child ela ionship cha ac e is ics (Hewi -Ramí ez
& Mo eno-Méndez, 2018), and he in e ac ion be ween gene ics
(e.g., empe amen ) and en i onmen al (e.g., amily) elemen s
(Goodnigh e al., 2016). Since in e en ions and p e en i e
measu es a e no applicable o gene ic ac o s, a ele an a ea o
a en ion and in e en ion is he ealm o he pa en –child
ela ionship. Pa en ing is conside ed a signi ican con ibu ing
ac o o he child en’s ex e nalizing beha io (Ro hbaum & Weisz,
1994). Thus, pa en al abili ies become a p ima y a ge o
in e en ions. Encou aging he de elopmen o speci ic pa en ing
skills can enhance he bond be ween pa en s and child en and
educe a ious ad e se e ec s, pa icula ly ex e nalizing p oblems
(e.g., see Cooke e al.’s2022, me a-analysis on pa en al sensi i i y
and child beha io al p oblems). The e o e, he pa en –child
ela ionship eme ges as an explica i e ac o wo h s udying in
p e en ing ju enile c ime (Webs e -S a on & Reid, 2018). While
he in luence o pa en ing is well es ablished in he case o bo h
ex e nalizing (Pinqua , 2017a) and in e nalizing p oblems (Lin
e al., 2024; Pinqua , 2017b), he p esen e iew ocuses on
child en’s and adolescen s’ex e nalizing beha io s since including
bo h in e nalizing and ex e nalizing p oblems is beyond he scope
o he p esen e iew.
F om a de elopmen al pe spec i e, in an s’su i al hinges on
hei ca egi e s’capaci y o in e p e hei hough s, eelings, and
beha io s o mee hei needs (La ende e al., 2023). Pa en al
men aliza ion is closely linked o child en’s inne g ow h, assis ing
hem in managing emo ional con lic s and p omo ing posi i e
psychological de elopmen (Calda e a e al., 2022). In ac , he e is
e idence showing he links be ween pa en al men aliza ion and
posi i e pa en ing beha io s ( o a sys ema ic e iew, see
S uh mann e al., 2022). Speci ically, pa en al men aliza ion has
been obus ly ela ed o secu e child–pa en a achmen (Zeege s
Co esponding au ho s: Mai ane Nie o-Re ue o; Email: mai ane.nie [email protected],
Ba ba a To es-Gomez; Email: ba ba a[email p o ec ed]
Ci e his a icle: Nie o-Re ue o, M., To es-Gomez, B., & Alonso-A biol, I. (2024).
Pa en al men aliza ion and child en’s ex e nalizing p oblems: A sys ema ic e iew and
me a-analysis. De elopmen and Psychopa hology,1–17, h ps://doi.o g/10.1017/
S0954579424001391
© The Au ho (s), 2024. Published by Camb idge Uni e si y P ess. This is an Open Access a icle, dis ibu ed unde he e ms o he C ea i e Commons A ibu ion licence (h p://
c ea i ecommons.o g/licenses/by/4.0/), which pe mi s un es ic ed e-use, dis ibu ion and ep oduc ion, p o ided he o iginal a icle is p ope ly ci ed.
De elopmen and Psychopa hology (2024), 1–17
doi:10.1017/S0954579424001391
h ps://doi.o g/10.1017/S0954579424001391 Published online by Camb idge Uni e si y P ess
e al., 2017), which, in u n, has been s ongly associa ed wi h a
lowe incidence o ex e nalizing p oblems (based on me a-analyses
o esul s wi h mo he s by Fea on e al., 2010, and wi h a he s by
Deneaul e al., 2021).
Despi e he exis en g owing numbe o s udies in he ield,
he e a e disc epancies ega ding he consis ency o he ela ion-
ship be ween pa en al men aliza ion and child en’s ex e nalizing
beha io s. Speci ically, esea ch indings show a ying deg ees o
such associa ion. Fo example, esea ch shows ha pa en al
men aliza ion and ex e nalizing p oblems a e posi i ely associa ed
(Meins e al., 2013, Wade e al., 2021), weakly nega i ely ela ed
(e.g., Dollbe g e al., 2023), o s ongly in e sely co ela ed (e.g.,
Khosh oo & Seyed Mousa i, 2022). Such dispa i ies ac oss s udies
e eal he need o explo ing po en ial easons behind hem.
The e o e, he me a-analy ic echnique, including he use o me a-
eg ession, is ins umen al in o e coming inconsis encies in
esul s. The cu en s udy ep esen s he i s me a-analysis ha
syn hesizes esea ch examining he issue.
Pa en al men aliza ion linked o child en’s ex e nalizing
p oblems
O e all, men aliza ion is a dynamic and de elopmen al capaci y
mainly con ex - and ela ionship-speci ic. Pa en al men aliza ion
p ima ily eme ges wi hin he con ex o secu e a achmen
ela ionships, se ing as a key cons uc in child en’s de elopmen
and bene icial pa en –child ela ionships (Sha p & Fonagy, 2008).
Wi hin ha amewo k, pa en al men aliza ion is a psychological
mechanism ha acili a es pa en al sel - egula ion and he co-
egula ion o he child’s emo ional s a es (S uh mann e al., 2022).
I encompasses pa en s’capaci y o pe cei e hei child as a
psychological en i y, di e en ia ing be ween hei child en’s
men al expe iences and hei own. Pa en al abili y o comp ehend
no only hei child’s ex e nal beha io s bu also he in e nal
men al ac i i y (e.g., mo i es and emo ions) ha d i e hose
beha io s (Med ea & Benga, 2021), is closely associa ed o
esponding o he child app op ia ely h ough a ec i ely a uned
pa en ing beha io (Kelly e al., 2005).
In con as , pa en s wi h lowe men alizing capaci ies may
s uggle o pe cei e hei child en’s men al s a es, ailing o
comp ehend he mo i a ions behind hei child en’s ac ions and
o mee hei needs, especially in challenging si ua ions.
Consequen ly, his lowe men alizing capaci y may esul in
puni i e esponses exace ba ing he child’s dis ess and dys egu-
la ion (Dollbe g e al., 2021; Ensink, Bégin e al., 2017). E idence
sugges s ha poo pa en al men aliza ion is co ela ed wi h
heigh ened nega i e emo ionali y (Smaling e al., 2016), inc eased
endencies owa ds con olling beha io s (Sua di e al., 2020), and
wi h issues in socioemo ional de elopmen (Nijssens e al., 2020).
In ac , when i comes o he ela ionship wi h child en’s
ex e nalizing beha io s, i has been ound ha high pa en al
men aliza ion can con ibu e o he p e en ion o he onse o hese
p oblems (Sua di e al., 2020), and poo pa en al men aliza ion is
associa ed wi h highe ex e nalizing beha io s (Khosh oo & Seyed
Mousa i, 2022). Ne e heless, he e a e some s udies ha ha e
epo ed a null (Zeege s e al., 2020) o e en a posi i e ela ionship
(Kochanska & An, 2023; Wade e al., 2021) be ween pa en al
men aliza ion and ex e nalizing p oblems. The e o e, i is e iden
he need o cla i y he associa ion be ween hese a iables. In iew
o he abo e, we expec a nega i e ela ionship. Ye , se e al
ci cums ances need o be conside ed in he analysis. A b ie
accoun o possible mode a o s ollows.
Pa en al men aliza ion: ope a ionaliza ion app oaches
Men aliza ion consis s o ou p ima y dimensions: Aspec
(au oma ic s. con olled), Focus (in e nal s. ex e nal), Pe son
(sel s. o he ), and Mode (cogni i e s. a ec i e), being essen ial
ha hese dimensions main ain a balanced in e ac ion o e ec i e
men aliza ion (Ba eman & Fonagy, 2019). Pa en al men aliza ion
is in es iga ed h ough h ee app oaches –mind-mindedness
(MM; Meins, 2013), pa en al e lec i e unc ioning (PRF;
Slade e al., 2005), and insigh ulness (Oppenheim & Ko en-
Ka ie, 2002)–all ocusing on pa en s’comp ehension o hei
child en’s in e nal s a es (Zeege s e al., 2017). Each one
ope a ionalizes ca egi e s’capaci ies di e en ly and o e s a
unique pe spec i e on comp ehending pa en –child dialogue
and in e ac ion (Med ea & Benga, 2021). A simple way o
unde s and how o ope a ionalize pa en al men aliza ion is
concep ualizing i , ollowing he e minology o Meins and
Fe nyhough (2015), as ‘o line’( ep esen a ional) and ‘online’
(in e ac ional) men alizing abili ies.
MM is he only measu e ha can be e alua ed om bo h online
and o line pe spec i es, while PRF and insigh ulness a e
ope a ionalized in a ep esen a ional way (o line). App op ia e
MM can be measu ed in: (a) pa en –child in e ac ions, whe e
pa en s p o ide accu a e and spon aneous commen s on he
child’s men al s a e, ma ching he in an ’s expe ience o beha io
(online) and (b) ia he ca egi e ’s desc ip ion o he child in e ms
o men al a ibu es (o line; Dollbe g, 2022). PRF can be e alua ed
by coding an in e iew (e.g., he Pa en De elopmen In e iew:
PDI; Slade e al., 2005; Sleed e al., 2020), o ia sel - epo using a
ques ionnai e (e.g., The Pa en al Re lec i e Func ioning
Ques ionnai e: PRFQ; Ca lone e al., 2023; Luy en e al., 2017).
Wi hin he PRFQ, he dimensions include p e-men alizing (PM),
ce ain y abou men al s a es (CMS), and in e es and cu iosi y
(IC), wi h adequa e men aliza ion cha ac e ized by low PM and
a e age CMS and IC sco es. The PM subscale, which assesses
dis o ions in men alizing, e eals pa icula ly de imen al e ec s
o se ious men aliza ion impai men s, and is he mos closely
ela ed dimension o emo ional una ailabili y and insecu e
a achmen (Luy en e al., 2017). Insigh ulness is assessed h ough
ca egi e s’ e lec ions on hei ela ionship wi h he child in
esponse o ques ions abou he child’s hough s and eelings
(Oppenheim & Ko en-Ka ie, 2002).
Ne e heless, he s eng h and di ec ion among hese h ee
app oaches (MM, PRF, insigh ulness) and child en’s ex e nalizing
p oblems seems o a y ac oss s udies. Fo ins ance, he co ela ion
be ween MM and ex e nalizing p oblems has been epo ed as
s ong (Camisasca e al., 2018), weak (Dollbe g e al., 2023), o
nonexis en (Zeege s e al., 2020). Simila ly, PRF’s associa ion wi h
ex e nalizing has been obse ed as s ongly nega i e (Khosh oo &
Seyed Mousa i, 2022) o posi i e (Bo elli e al., 2021). Las ly,
analyses o he ela ionship be ween insigh ulness and ex e nal-
izing p oblems ha e showed posi i e (G ay e al., 2015) and
nega i e associa ions (Fenige -Schaal & Ko en-Ka ie, 2021).
The e o e, in iew o he a o emen ioned disc epancies be ween
s udies, u he esea ch is equi ed. Thus, he p esen me a-
analysis will explo e whe he MM, PRF o insigh ulness has
s onge powe o p edic he expec ed nega i e ela ionship
be ween pa en al men aliza ion and child en’s ex e nalizing
p oblems. We an icipa e he ela ionship be ween pa en al
men aliza ion and ex e nalizing p oblems o a y depending on
whe he i is assessed ep esen a ionally o h ough ac ual
in e ac ions. Some pa en s may possess adequa e men aliza ion
2 Mai ane Nie o-Re ue o e al.
h ps://doi.o g/10.1017/S0954579424001391 Published online by Camb idge Uni e si y P ess
skills a he ep esen a ional le el (assessed ia PRF), bu s uggle o
demons a e hem in eal- ime in e ac ions, when measu ed online
h ough hei e baliza ions abou he child’s men al s a es du ing
di ec play (Shai e al., 2017). Hence, we expec ha , when pa en al
men aliza ion is analyzed in eal- ime (online) in e ac ions, he
ela ionship be ween men aliza ion and ex e nalizing p oblems
will be s onge han when he measu e is a ‘ ep esen a ional’
app oach (o line).
Child en’s de elopmen al s age
Following no ma i e de elopmen al ajec o ies, ex e nalizing
p oblems dec ease om ea ly childhood o p eadolescence,
inc ease du ing adolescence, and hen dec ease again om la e
adolescence in o adul hood (Pe e sen e al., 2015). Ye he impac
o pa en al men aliza ion on educing hese beha io s may a y
depending on he child’s de elopmen al s age. Fo example, some
s udies ha e ound ha he ela ionship be ween pa en al
men aliza ion and ex e nalizing p oblems in adolescen s is close
o ze o (e.g., Benbassa & P iel, 2012; Bo elli e al., 2019). Howe e ,
i has been ound o be nega i e du ing in ancy (e.g., Salo e al.,
2022; Smaling e al., 2016), in young child en (e.g., Colonnesi e al.,
2019; Dollbe g e al., 2021) and du ing middle childhood (e.g.,
Condon e al., 2019; Ensink e al., 2016). Mo eo e , a s udy
compa ing bo h ea ly and middle childhood ound a s onge
nega i e e ec be ween pa en al men aliza ion and ex e nalizing
p oblems in he olde g oup (Khosh oo & Seyed Mousa i, 2022).
Thus, younge child en may equi e highe pa en al men aliza ion
skills o e ec i ely egula e hei emo ions and beha io s.
Conside ing he abo e indings, we may posi a s onge nega i e
ela ionship be ween men aliza ion and ex e nalizing p oblems
du ing middle childhood and a smalle e ec du ing ea ly
childhood and adolescence.
Pa en ing expe ience
Gi en he inconsis ency o esea ch e idence, we sugges ha
pa en ing expe ience may be ano he mode a o . While ce ain
s udies in ol ing i s - ime pa en s e ealed a modes associa ion
(Salo e al., 2021), esea ch in ol ing expe ienced ca egi e s
unco e ed a highe co ela ion (Lunn e al., 2019). Hence, we
hypo hesize ha he nega i e ela ionship be ween pa en al
men aliza ion and child en’s ex e nalizing p oblems will be
s onge in expe ienced pa en s as compa ed o i s - ime pa en s.
Popula ion ype
Gi en he p ocesses unde lying men aliza ion, psychopa hology
will in a iably en ail challenges ela ed o men alizing skills
(Ba eman, 2022). As a ma e o ac , in a ecen sys ema ic e iew
and me a-analysis (Geo g e al., 2023), pa en al dep ession has
been associa ed o lowe pa en al men aliza ion. Ye , he ela ion-
ship be ween pa en al men aliza ion and child en’s ex e nalizing
p oblems migh di e be ween clinical and nonclinical popula-
ions. In ac , he e is esea ch e idence showing a likely s onge
e ec o pa en al men aliza ion in clinical/a isk samples (e.g.,
Hughes e al., 2017). Speci ically, ma e nal men aliza ion has been
ound o ha e a s onge p o ec i e ole in mi iga ing ex e nalizing
symp oms in challenging si ua ions o wi h a - isk amilies, as
opposed o gene al communi y samples (Meins e al., 2013).
The e o e, we expec he s eng h o he nega i e associa ion
be ween pa en al men aliza ion and ex e nalizing beha io s o be
mo e p onounced in clinical o a - isk samples compa ed o
s udies in ol ing he gene al communi y.
Pa en al educa ion
Resea ch explo ing a ious educa ion le els has shown di e en ial
associa ions o pa en al men aliza ion wi h child ex e nalizing
p oblems. MM was a p edic o o child ex e nalizing p oblems a
childhood, bu only wi h pa en s wi h no seconda y educa ion
(Meins e al., 2013). Howe e , some s udies epo ed no associa ion
be ween pa en al men aliza ion and ex e nalizing beha io when
con olling o pa en al educa ion (e.g., Colonnesi e al., 2019;
Dollbe g e al., 2021). Gi en he mixed na u e o he e idence, we
e ain om p oposing a speci ic hypo hesis ega ding his ma e .
Repo ing igu e
F om a me hodological pe spec i e, he epo ing igu e may also
a ec he ela ionship be ween pa en al men aliza ion and
beha io . The e may be di e ences be ween pa en s’and eache s’
epo s o child en’s ex e nalizing p oblems, as hese in o man s
ely on dis inc expe iences (Deneaul e al., 2023). In ac , a me a-
analysis epo ed ha pa en s o en pe cei e mo e ex e nalizing
beha io s han eache s (Ca nei o e al., 2021). In addi ion, when
he same obse e e alua es wo di e en a iables, he co ela ion
be ween hem may inc ease due o co a iance bias (Hoy , 2000).
Thus, i is easonable o hink ha he ela ionship be ween
pa en al men aliza ion and child en’s ex e nalizing p oblems
would be s onge when he p ima y ca egi e s a e he epo ing
igu e o he la e a iable (as opposed o eache s o o he
epo ing igu es).
Aims o he me a-analysis
In summa y, he e idence ha pa en al men aliza ion is associa ed
wi h a dec ease in child en’s ex e nalizing p oblems is inconclusi e.
The e o e, one o he objec i es o his me a-analysis is o con i m
he ype o ela ionship be ween hese a iables. We also seek o
de e mine he magni ude o his associa ion, as well as o in es iga e
ac o s ha may mode a e his ela ionship. The p esen me a-
analysis aims a examining he ela ionship among in an s, child en,
and adolescen s. I will conside he ollowing mode a o s: (a)
di e en app oaches o he ope a ionaliza ion o pa en al men al-
iza ion (MM, PRF o insigh ulness), (b) child en’sde elopmen al
s age (ea ly childhood, middle childhood o adolescence), (c)
pa en ing expe ience ( i s - ime s. expe ienced pa en ing), (d)
sample ype (clinical/a - isk s. communi y), (e) pa en al educa ion,
and ( ) epo ing igu e (p ima y ca egi e s. o he s).
The main hypo hesis is ha highe pa en al men aliza ion will be
associa ed wi h ewe ex e nalizing p oblems in child en and
adolescen s. Fu he mo e, we expec a s onge nega i e associa ion
be ween highe le els o pa en al men aliza ion and ex e nalizing
p oblems in eal ime in e ac ions ( s. ep esen a ional app oaches),
in middle childhood ( s. younge child en and adolescen s), in
expe ienced ( s. i s - ime) pa en ing amily si ua ions, in clinical/
a - isk ( s. communi y), and in p ima y ca egi e ( s. o he s’
epo s). Las ly, based on con lic ing e idence when examining he
possible mode a ing e ec s o pa en al educa ion, we will ake an
explo a o y app oach ega ding his ques ion.
Me hods
Inclusion and exclusion c i e ia
This sys ema ic e iew and me a-analysis ollowed he P e e ed
Repo ing I ems o Sys ema ic Re iews and Me a-Analyses
(PRISMA) guidelines (Page e al., 2021). Fo hei inclusion,
s udies had o mee he ollowing c i e ia: (a) w i en in English o
Spanish; (b) empi ical in na u e; (c) epo ed in pee - e iewed
De elopmen and Psychopa hology 3
h ps://doi.o g/10.1017/S0954579424001391 Published online by Camb idge Uni e si y P ess
jou nal a icles; and (d) included child en aged be ween 0 and
18 yea s in he sample. S udies we e excluded i : (a) hey p o ided
insu icien da a o e ec size analysis, and addi ional da a could
no be ob ained om he espec i e au ho s; (b) hey did no
e alua e pa en al men aliza ion;1(c) hey did no assess child en’s
ex e nalizing beha io in he age ange unde analysis (0-18 yea s);
(d) hey did no in es iga e he ela ionship be ween pa en al
men aliza ion and child ex e nalizing symp oms; o (e) we e
disse a ions o book chap e s.
Sea ch s a egy c i e ia and selec ion o s udies
The ini ial sea ch was pe o med in June 2021; i was upda ed in
Janua y 2024 o e ie e documen s included in da abases un il
Decembe 2023. Fi s , six elec onic da abases we e sea ched o
iden i y eco ds ela ed o pa en al men aliza ion and ex e nalizing
p oblems. These da abases included APA PsycA icles, APA
PsycIn o, PsycBooks, PSICODOC, Scopus, and Web o Science.
The ollowing combina ion o e ms was used in he abs ac ,
keywo ds, and subjec s: Men ali*OR e lec i e unc ion*OR
mind-mind*OR mind- ela ed OR insigh ul AND ex e nal*OR
in e nal*OR beha *diso de *OR beha *di icul *OR beha *
p oblem*OR conduc diso de *OR conduc *di icul *OR
conduc p oblem*OR dis up i e beha *OR child*p oblem OR
an isocial beha *OR ADHD OR CBCL. Ini ially, we e ie ed
5,442 eco ds; e en ually, we included 42 s udies (N=7,761
pa icipan s) wi h 52 e ec sizes in he me a-analysis (see Figu e 1).
To ensu e consis ence and eplicabili y o he me a-analysis, a
andom sample o e e y i h sc eened pape was independen ly
coded by he second au ho ; disag eemen s we e esol ed by
ha ing he i s au ho and he second au ho e iew he a icle in
ques ion and join ly come o a consensus ega ding he app op ia e
coding. Subsequen ly, he i s and he second au ho independ-
en ly e iewed all ull- ex le el eco ds. A high ag eemen was
ob ained (Kappa =0.98). The hi d au ho esol ed disc epancies.
The i s and he hi d au ho s independen ly assessed he isk
o bias o each o he included s udies and discussed hei
assessmen s o achie e consensus. An adap ed e sion o he
Newcas le–O awa Scale o c oss-sec ional s udies (NOS; He zog
e al., 2013; Wells e al., 2000) was used o e alua e he quali y o he
me hodology used in he included s udies. The NOS is a checklis
ha assesses he app op ia eness o esea ch design, he ec ui -
men s a egy, he ep esen a i eness o sample, he objec i i y/
eliabili y o ou come de e mina ion, he powe calcula ion
p o ided, and app op ia e s a is ical analyses. Sco e disag eemen s
we e esol ed by consensus and a inal ag eed-upon a ing was
assigned o each s udy (see S1 o Supplemen a y Online Ma e ials).
Finally, he da a ex ac ion p ocess in ol ed wo s ages. The
i s au ho e ie ed he necessa y da a o analysis (see Table 1),
and he hi d au ho independen ly checked he alues. Any
disag eemen s we e esol ed by all au ho s.
Analysis plan
Ou p ima y analysis included 52 e ec sizes assessing pa en al
men aliza ion and ex e nalizing p oblems (see Table 1 o
Figu e 1. Flow diag am.
1The s udy was excluded i he o al o a non alida ed e sion o he PRFQ scale was
epo ed, and no u he da a could be ob ained.
4 Mai ane Nie o-Re ue o e al.
h ps://doi.o g/10.1017/S0954579424001391 Published online by Camb idge Uni e si y P ess
o e all e ec sizes and s udy cha ac e is ics). The ollowing
mode a o s we e examined: app oaches o he ope a ionaliza-
ion o pa en al men aliza ion (MM, PRF, o insigh ulness),
child en’s de elopmen al s age (ea ly childhood, middle child-
hood, o adolescence), pa en ing expe ience ( i s - ime s.
expe ienced), he sample ype (clinical/a - isk s. communi y),
and epo ing igu e (p ima y ca egi e s. o he s). Only
ca ego ical mode a o a iables ha had a leas i e con as s
in he ca ego ies we e used (Bake mans-K anenbu g e al.,
2003); hus,wewe eunable oanalyzepa en alinsigh ulness
(k=3). The da a om pa en al educa ion was noncompa able
among he s udies o pe o m mode a ion analyses (i.e., s udies
epo ing he pe cen ages o pa icipan s’educa ional a ain-
men ). When s udies epo ed bo h ma e nal and pa e nal
co ela ions, we chose he ma e nal co ela ion o consis ency,
as mo e s udies ocused on ma e nal men aliza ion. In
longi udinal s udies and in e en ions, we selec ed he e ec
size epo ed a baseline. In o de o main ain a compa able
numbe o s udies, he ope a ionaliza ion o PRF was p io i ized
when bo h PRF and MM we e epo ed, aiming o balance
mode a ion analyses.
Taking in o accoun he h ee dimensions o PRFQ, we ha e
no conside ed he CMS o he IC subscales. The eason is ha he
op imal le els o bo h subscales a e a he midpoin ; con-
sequen ly, a cu ilinea analysis migh be mo e app op ia e, bu i
complica es he linea eg ession equi ed o me a-analy ic
echniques. The e o e, we ha e chosen he PM co ela ion in
o de o pe o m he analyses. Acco dingly, co ela ion sco es
we e e e ed because i assesses a non-men alizing s ance,
indica ing ha highe sco es co espond o lowe men alizing
abili ies. Mo eo e , o es whe he he ela ionship be ween
men aliza ion and ex e nalizing p oblems di e ed ac oss he
a ious app oaches o he ope a ionaliza ion o men aliza ion,
we compa ed e ec sizes be ween o line s. online measu es. To
de ine age g oups, we ha e ca ego ized indi iduals in o ea ly
childhood (0-5 yea s), middle childhood (6-12 yea s), and
adolescence (13-18 yea s) (see S2 o Supplemen a y Online
Ma e ials).
The analysis was conduc ed using R 4.2.2 (R Co e Team, 2022)
and he me a o package 4.0.0. Random e ec s model was chosen
due o i s abili y o accoun o he excess a iance (Viech baue ,
2010). E ec sizes (Pea son’s ) we e compu ed o ha e he same
s a is ic depic ing he ela ionship be ween pa en al men aliza ion
(MM o PRF) and ex e nalizing p oblems. S anda d o mulas
allowed o he ans o ma ion o di e se e ec sizes, such as g oup
di e ences (Wilson, 2023) and eg ession coe icien s (Pe e son &
B own, 2005). In o de o educe a iabili y, pooled e ec sizes
we e compu ed wi h co esponding 95% con idence in e als
(Bo ens ein & Hedges, 2019).
Resul s
Cha ac e is ics o he s udies
The ollowing lines p o ide a summa y o some no ewo hy
aspec s o he included esea ch in he me a-analyses. A o al o 42
s udies wi h 52 e ec sizes we e inco po a ed in he me a-analysis.
The in es iga ions we e conduc ed in a ious coun ies, including
Aus alia, Belgium, Canada, Finland, Is ael, I aly, he Ne he lands,
Swi ze land, Tü kiye, he UK, and he USA. The me a-analysis
included 7,761 ca egi e s and hei child en. Mos s udies (k=38)
included bi h pa en s, while a ew in ol ed o he ca egi e s
(k=4), such as adop i e and os e pa en s. Twen y-six s udies
included pa icipan s om he communi y, nine s udies used
clinical o isk samples (i.e., child en who expe ienced abuse o low
socioeconomic amilies), and se en s udies compa ed bo h sample
ypes. In e en ion p og ams we e included in se en esea ch
pape s. S udies analyzing pa en al men aliza ion as a media o
be ween pa en /child men al heal h (i.e., pa en al dep ession o
psychopa hological impac o sexual abuse in child en) on
ex e nalizing p oblems ound highe le els o his abili y ela ed
o ewe ex e nalizing p oblems. This sugges s bo h di ec and
indi ec e ec s o pa en al men aliza ion on ex e nalizing
beha io s (see S3 o Supplemen a y Online Ma e ials o de ails
o a iables analyzed in he s udies).
Me a-analy ic e ec s
E ec sizes (Pea son’s ) we e compu ed o examine he ela ion-
ship be ween pa en al men aliza ion and ex e nalizing p oblems.
The coe icien based on he andom-e ec s model o was −.19
(95% [CI: −.24, −.13]), anging om −.56 o .23, wi h mos
es ima es being nega i e (83%). As expec ed, he e was a nega i e
ela ionship be ween pa en al men aliza ion and ex e nalizing
p oblems. This indica es a small o mode a e nega i e ela ionship
be ween he a iables, implying ha highe pa en al men aliza ion
is associa ed wi h ewe ex e nalizing p oblems obse ed in
child en. Figu e 2displays a o es plo illus a ing obse ed
ou comes and es ima es.
The Q- es sugges s he e ogenei y among he ue ou comes
(Q(51) =383.760, p=.001, τ2=.029, I2=83.750), deno ing ha a
signi ican p opo ion o he a iabili y in e ec sizes is due o
di e ences be ween s udies a he han sampling e o . The high I2
alue sugges s ha app oxima ely 84% o he o al a ia ion ac oss
s udies is a ibu able o he e ogenei y. Consequen ly, despi e he
a e age ou come being es ima ed as nega i e, some s udies may
indica e a posi i e ue ou come (e.g., highe men aliza ion,
ele a ed ex e nalizing p oblems). Figu e 3p esen s a unnel plo o
he es ima es. Nei he he ank co ela ion (p=.894) no he
eg ession (p=.849) es indica ed any unnel plo asymme y,
sugges ing no publica ion bias.
We conduc ed u he explo a ion o he possible sou ces o
he e ogenei y h ough mode a ion analyses. The mixed-e ec s
model indica ed ha he associa ion be ween pa en al men aliza-
ion and ex e nalizing beha io s a ied signi ican ly ac oss
di e en de elopmen al s ages. As hypo hesized, i was s onge
o he middle childhood ca ego y ( =−.328, p<.001) han o
younge child en ( =−.112, p=.002), bu was nonsigni ican in
he adolescence g oup ( =−.129, p=.065). Also, in line wi h ou
expec a ions, pa en ing expe ience also u ned ou o be a
signi ican mode a o , such ha he in e se ela ionship be ween
pa en al men aliza ion and child en’s ex e nalizing p oblems was
g ea e in he case o expe ienced pa en s ( =−.208, p<.001). In
he es o he mode a ion analyses –(a) di e en app oaches o
he ope a ionaliza ion o pa en al men aliza ion (MM o PRF),
(b) sample ype (clinical/a - isk o communi y), and (c) epo ing
igu e (p ima y ca egi e s. o he s) –, he e we e no di e ences
be ween he le els o he mode a o s (see Table 2). The e o e, ou
hypo heses in ela ion o hese a iables we e no con i med.
Discussion
The pu pose o his s udy was o e iew he li e a u e on he
ela ionship be ween pa en al men aliza ion and child en’s
ex e nalizing p oblems, analyzing esul s om a quan i a i e
pe spec i e. To he bes o ou knowledge, his is he i s a emp a
De elopmen and Psychopa hology 5
h ps://doi.o g/10.1017/S0954579424001391 Published online by Camb idge Uni e si y P ess
Table 1. In o ma ion o he s udies included in he me a-analysis
Au ho s NCoun y
%
gi ls
% Fi s
− ime
pa en s
Child en’s
mean age
(mon hs)
Men aliza ion
measu e
Ex e nalizing
beha io
measu e Main esul s
Pea son
Benbassa &
P iel (2012)
105 Is ael nd nd 189.6 PDI YSR High le els o pa e nal con ol we e associa ed
wi h highe le els o adolescen ex e nalizing
p oblems, only in he p esence o low le els o
pa e nal RF. In he p esence o highe le els o
pa en al RF, hese pa en ing beha io s we e
associa ed wi h g ea e posi i e adolescen
ou comes.
.06
Bo elli e al.
(2019)
265 US 49.4 nd 184.56 RFQ CBCL Highe pa en al e lec i e unc ion was
associa ed wi h less ex e nalizing p oblems, only
when epo ed by he adolescen s. Pa en
e lec i e unc ion was no associa ed wi h
con e gence o pa en –adolescen epo s wi h
espec o ex e nalizing symp oms.
−.07
Bo elli e al.
(2019)
265 US 49.4 nd 184.56 RFQ CBCL When adolescen s epo ed on ex e nalizing
p oblems, highe pa en al e lec i e unc ion did
no ha e a nega i e co ela ion wi h ex e nalizing
symp oms.
.01
Bo elli e al.
(2021)
112 US 46 nd 150 PRFQ CBCL Eigh -week in e en ion e ealed signi ican
p e−pos inc eases in pu po ed mechanisms o
change ( e lec i e unc ioning) and ea ly
in e en ion ou comes (ex e nalizing p oblems).
−.17
B own e al.
(2023)
44 US 50 nd 13.34 MM CBCL Mind-mindedness a 28 mon hs did no p edic
beha io al di icul ies in child en om
nonmal ea ing amilies.
−.12
B own e al.
(2023)
54 US 50 nd 13.34 MM CBCL Mind−mindedness a 28 mon hs p edic ed ewe
beha io al di icul ies a 39 mon hs in child en
om mal ea ing amilies.
−.13
Camisasca
e al. (2018)
46 I aly 58.7 nd 16.93 MM CBCL Soma ic symp oms, conjoin ly wi h impai ed
mind-mindedness, p edic ed ex e nalizing
beha io s
−.46
Ca lone &
Milan (2021)
212 US nd nd 108.12 PRFQ BESS Low ma e nal e lec i e unc ion was associa ed
wi h ele a ed child ex e nalizing symp oms, and
a g ea e pe cei ed need o ea men .
−.34
Cen i an i
e al. (2016)
203 UK 52.42 42.36 61 MM SDQ App op ia e mind- ela ed alk indi ec ly p edic ed
callous unemo ional ai s ia i s e ec on
child en’s emo ion unde s anding.
−.15
Cha pen ie
−Mo a e al.,
(2022)
87 I aly 40 nd 121.2 PRFQ CBCL Pa en al men alizing was signi ican ly associa ed
wi h child’s ex e nalizing symp oms.
−.35
Colonnesi
e al. (2019)
104 The
Ne he lands
52.88 nd 53.41 MM SCBE −30 In equen use o app op ia e mind- ela ed
commen s o bo h pa en s p edic ed child en’s
ex e nalizing p oblems.
−.08
Colonnesi
e al. (2022)
138 The
Ne he lands
49.27 nd 161.04 MM SDQ Gene al, neu al, and posi i e mind-mindedness
ela ed nega i ely o ex e nalizing p oblems.
−.15
Condon
e al. (2019)
54 US nd nd 80.16 PRFQ CBCL High pa en al e lec i e unc ion was associa ed
wi h ewe child eme gency depa men isi s,
whe eas impai ed pa en al e lec i e unc ion
was associa ed wi h mo e ex e nalizing
p oblems.
−.49
Dieleman
e al. (2020)
268 Belgium 50.7 nd 181.68 PRFQ CBCL Ex e nalizing p oblems ela ed o bo h a he s’
and mo he s p emen aliza ion.
−.47
Dollbe g
e al. (2021)
144 Is ael 55.2 50 50.04 MM CBCL Ma e nal mind-mindedness, bu no pa e nal
mind-mindedness, mode a ed he di ec link
be ween pa en s’gene al anxie y and he child’s
ex e nalizing beha io .
−.01
Dollbe g
e al. (2023)
87 Is ael 50 91.64 47.52 MM CBCL Mo he s who demons a ed lowe men aliza ion
skills and highe anxie y symp oms epo ed
mo e child ex e nalizing beha io s.
−.11
(Con inued)
6 Mai ane Nie o-Re ue o e al.
h ps://doi.o g/10.1017/S0954579424001391 Published online by Camb idge Uni e si y P ess
Table 1. (Con inued )
Au ho s NCoun y
%
gi ls
% Fi s
− ime
pa en s
Child en’s
mean age
(mon hs)
Men aliza ion
measu e
Ex e nalizing
beha io
measu e Main esul s
Pea son
Dollbe g
e al.
(2023)
53 Is ael 50 91.64 54.36 MM CBCL When mo he s showed highe men aliza ion
skills, he indi ec e ec o anxie y on he link
be ween COVID - 19 and child en’s ex e nalizing
beha io s was weake , compa ed o when
mo he s showed lowe men aliza ion skills in he
isk sample.
−.05
Ensink e al.
(2016)
168 Canada 57.14 nd 112.06 PDI CBCL Ma e nal men aliza ion was an independen
p edic o o child ex e nalizing di icul ies, wi h
highe ma e nal e lec i e unc ion associa ed
wi h less ex e nalizing di icul ies.
−.3
Ensink,
Bégin,
No mandin,
and Fonagy
(2017)
154 Canada 61.92 nd 74 PDI CBCL Signi ican in e se ela ionships be ween
ma e nal men alizing and child ex e nalizing
di icul ies we e obse ed.
−.31
Ensink,
Bégin,
No mandin,
Godbou
e al. (2017)
168 Canada 47.07 nd 91 PDI CBCL Ma e nal e lec i e unc ion dec eased he
ela ionship be ween sexual abuse on
ex e nalizing di icul ies.
−.3
Ensink,
Le oux e al.
(2017)
85 Canada 49.27 nd 112.5 PDI CBCL A signi ican nega i e co ela ion was ound
be ween e lec i e pa en ing s ance assessed by
he eache and ex e nalizing di icul ies epo ed
by he pa en .
−.38
Ensink,
Le oux e al.
(2017)
158 Canada 49.27 nd 112.5 PDI CBCL The associa ions be ween e lec i e pa en ing
s ance and pa en epo s o child ex e nalizing
di icul ies we e small and no signi ican , in
con as o he signi ican and mode a e s eng h
associa ions be ween he e lec i e pa en ing
s ance and eache epo s o child di icul ies.
−.25
Fenige -
Schaal &
Ko en-Ka ie
(2021)
28 Is ael 50 nd 102 Insigh ul CBCL A e he in e en ion p og am o inc ease
pa en al e lec i e unc ion, a signi ican decline
in he child en’s ex e nalized and gene al
beha io al p oblems was ound.
−.12
Ghanba i
e al. (2023)
357 I an 48.7 nd 87.12 PRFQ CBCL P emen alizing mode a ed he ela ionship
be ween e o ul con ol and ex e nalizing
p oblems, and be ween nega i e a ec i i y and
ex e nalizing beha io s.
−.37
G ay e al.
(2015)
39 US 53 nd 45.96 Insigh ul CBCL Among child en no exposed o iolence,
insigh ulness was no ela ed o child en’s
ex e nalizing beha io s, sugges ing iolence-
speci ic p ocesses.
.23
G ay e al.
(2015)
20 US 53 nd 45.96 Insigh ul CBCL Violence-exposed child en wi h noninsigh ul
ca egi e s demons a ed highe ex e nalizing
beha io s.
−.37
Ha e al.
(2011)
659 UK 48.40 nd 114.72 Social s o ies SDQ Poo ma e nal accu acy did no signi ican ly
p edic he de elopmen o ex e nalizing
p oblems a 1-yea ollow-up when con olling
o baseline ex e nalizing p oblems and age.
−.22
Hobby e al.
(2023)
91 Aus alia 39.6 67 7 MM SDQ Highe ea ly app op ia e mind-mindedness in
mo he s wi h highe pa en ing dis ess a 36
mon hs was associa ed wi h lowe ex e nalizing
p oblems a 51 mon hs.
−.19
Hughes e al.
(2017)
116 UK 45 nd 72.36 FMSS SDQ Mo he s’mind-mindedness p edic ed unique
a iance in dis up i e beha io .
−.08
Khosh oo &
Seyed
Mousa i
(2022)
224 I an 51.7 47.7 48 PRFQ CBCL Mo he s o school-aged child en showed
signi ican ly highe le els o p emen alizing han
mo he s o p eschoole s. Ce ain y abou men al
s a es mode a ed he ela ionship be ween
ma e nal dep ession and child ex e nalizing
beha io s in school-aged child en.
−.49
(Con inued)
De elopmen and Psychopa hology 7
h ps://doi.o g/10.1017/S0954579424001391 Published online by Camb idge Uni e si y P ess
Table 1. (Con inued )
Au ho s NCoun y
%
gi ls
% Fi s
− ime
pa en s
Child en’s
mean age
(mon hs)
Men aliza ion
measu e
Ex e nalizing
beha io
measu e Main esul s
Pea son
Khosh oo &
Seyed
Mousa i
(2022)
461 I an 51.7 47.7 48 PRFQ CBCL Pa en al men aliza ion was nega i ely co ela ed
wi h ex e nalizing p oblems. No mode a ing
e ec was ound o p emen alizing o in e es
and cu iosi y in men al s a es in he p eschoole s
g oup.
−.43
Kochanska &
An (2023)
175 US 49.14 nd 36 PRFQ ITSEA Mo he s, bu no a he s, who had mo e nega i e
highe p emen alizing sco es a ed hei child en
as less dis up i e.
.15
Konijn e al.
(2020)
48 The
Ne he lands
49.7 nd 116.4 MM SDQ Fos e pa en s’mind-mindedness was no
signi ican ly ela ed o child en ex e nalizing
p oblems.
−.21
Ko en Swisa
e al. (2024)
89 Is ael 49 44 47.52 MM CBCL The posi i e associa ions be ween con lic
exposu e and child en’s ex e nalizing beha io s
we e mi iga ed when he pa en s’men aliza ion
skills we e ma ched o when he mo he ’s
men aliza ion skills we e high.
−.1
Lunn e al.
(2019)
67 UK 44 nd 123.6 Social S o ies CBCL In he no ma i e sample, lowe ma e nal mind
−mindedness p edic ed child ex e nalizing
p oblems.
−.44
Lunn e al.
(2019)
34 UK 44 nd 144 Social S o ies CBCL Highe nega i e ma e nal mind-mindedness in
child en wi h epilepsy, p edic ed g ea e
ex e nalizing p oblems.
−.51
Meins e al.
(2013)
91 UK 49 47.7 52.71 MM SDQ Ma e nal mind-mindedness was no associa ed
wi h ex e nalizing beha io s in he high
socioeconomic g oup.
.14
Meins e al.
(2013)
60 UK 49 47.7 52.71 MM SDQ In he low socioeconomic g oup, ha ing a mind-
minded mo he mi iga ed hei nega i e e ec s
on child en’s ex e nalizing beha io s a 44
mon hs and in he i s yea o school.
−.03
Menashe-
G inbe g &
A zaba-Po ia
(2023)
84 Is ael 53 62 51.6 MM CBCL Imp o emen in he pa en –child in e ac ion,
child e lec i e unc ion, and child ex e nalizing
p oblems we e ela ed o imp o emen in PRF.
−.08
Salo e al.
(2021)
429 Finland nd 100 12 PRFQ BITSEA Fo mo he s, ea lie ela ionship sa is ac ion
p edic ed la e in an ex e nalizing p oblems,
also h ough he cu en le el o pa en al
e lec i e unc ion. Fo a he s, bo h ela ionship
sa is ac ion and pa en al e lec i e unc ion had
di ec , bu no media ed, e ec s, and on in an
ex e nalizing p oblems.
−.04
Salo e al.
(2022)
1016 Finland nd 100 24 PRFQ CBCL Fo bo h mo he s and a he s, a low le el o
ela ionship sa is ac ion, bu no PRF, p edic ed
consis en ly highe le els o child ex e nalizing
p oblems a age 2.
−.01
Shai &
Belsky (2017)
200 US nd nd 54 TRF PEM Highe pa en al embodied men alizing nega i ely
p edic ed ex e nalizing p oblems. Highe
ma e nal sensi i i y, a e con olling o pa en al
embodied men alizing, was ela ed wi h mo e
ex e nalizing p oblems.
−.19
Shale e al.
(2023)
106 Is ael 50.49 nd 48.84 PDI CBCL Ex e nalizing p oblems we e ela ed o g ea e
in ensi y o pa en al guil only when PRF le els
we e low.
−.24
Smaling
e al. (2016)
123 The
Ne he lands
44 100 19.97 PDI CBCL Pos na al sel - ocused e lec i e unc ion was
posi i ely linked o ex e nalizing beha io and
nega i e emo ionali y in o sp ing, while ela ion-
ocused e lec i e unc ion sco es we e nega i ely
associa ed wi h child physical agg ession.
.08
Sua di e al.
(2020)
23 Swi ze land 52 48 26.7 Wo king
Model o he
Child
In e iew
ITSEA Ma e nal e lec i e unc ion was nega i ely
co ela ed wi h ex e nalizing beha io s in he
gene al sample.
−.31
(Con inued)
8 Mai ane Nie o-Re ue o e al.
h ps://doi.o g/10.1017/S0954579424001391 Published online by Camb idge Uni e si y P ess
summa izing he empi ical esul s on he opic. The included
s udies we e conduc ed in di e en coun ies, p edominan ly
in ol ed biological pa en s wi h hei child en, and we e d awn
om a combina ion o communi y and clinical/a - isk samples.
We obse ed ha he expec ed nega i e associa ion be ween
pa en al men aliza ion and child ex e nalizing p oblems was
p edominan ly consis en ac oss s udies. The magni ude o he
e ec size may be conside ed small o mode a e (Funde & Oze ,
2019), being sligh ly s onge han simila me a-analyses in he
ield, such as hose e iewing he p edic i e powe o pa en al
sensi i i y on child en’s beha io p oblems –e.g., =−.14 in
Cooke e al.’s(2022) and =−.08 in Rod igues e al.’s(2021).
Thus, i seems ha pa en al abili y o unde s and a child’s
men al s a es allows ca egi e s o be e espond o he child’s
needs, likely p omp ing a dec ease in ex e nalizing p oblems and
con i ming he ele ance o paying special a en ion o pa en ing
men aliza ion. This inding e eals subs an i e e ec s ha unde -
line he impo ance o in e ening wi h pa en s on men aliza ion
as a use ul s a egy ha can con ibu e o p e en la e child en’s
ex e nalizing p oblems.
Beyond he o e all nega i e associa ion be ween pa en al
men aliza ion and ex e nalizing p oblems in o sp ing, he
signi ican he e ogenei y in his ela ionship sugges s he need o
conside po en ial mode a o s. Wi h espec o he possible
mode a o s examined, he di e en app oaches and measu es o
pa en al men aliza ion did no e eal signi ican e ec s. Child en’s
de elopmen al s age (ea ly and middle childhood) and pa en ing
expe ience (expe ienced pa en ing s. i s - ime pa en s) we e
ound o s eng hen he nega i e ela ionship be ween pa en al
men aliza ion and ex e nalizing p oblems. Popula ion ype
(clinical/a isk s. communi y), and epo ing igu e (p ima y
ca egi e s s. o he s) ailed o each s a is ical signi icance.
Insigh ulness and pa en al educa ion could no be analyzed due
o lack o da a. Below we ou line some e lec ions on he possible
meaning o ou esul s.
Con a y o wha expec ed, di e en ope a ionaliza ion o
pa en al men aliza ion (o line- ep esen a ional s. online-in e ac-
ional) did no mode a e he ela ionship be ween pa en al
men aliza ion and ex e nalizing p oblems. Al hough di e en
app oaches o pa en al men aliza ion a e epo ed in he li e a u e
(e.g., Med ea & Benga, 2021), ou esul s sugges ha hese may be
close o each o he . This may indica e ha pa en al men aliza ion
migh be a singula cons uc ha can be ope a ionalized in a ious
ways. In line wi h ou esul s, Ya zi e al. (2020) ound PRF
(o line- ep esen a ional) and MM (online-in e ac ional) o be
posi i ely co ela ed, ha is, mo he s who ended o spon aneously
desc ibe hei child in a men alis ic manne du ing in e ac ions
(MM) we e mo e likely o ha e mo e elabo a ed ep esen a ions o
hei child’s mind (PRF). Hence, bo h ope a ionaliza ions appea
o explo e he common domain o he pa en –child ela ionship
h ough he lenses o pa en ’s men alizing abili ies.
In line wi h ou expec a ions, child en’s de elopmen al s age
mode a ed he nega i e ela ionship be ween pa en al men aliza-
ion and ex e nalizing beha io s. These esul s show ha pa en al
Table 1. (Con inued )
Au ho s NCoun y
%
gi ls
% Fi s
− ime
pa en s
Child en’s
mean age
(mon hs)
Men aliza ion
measu e
Ex e nalizing
beha io
measu e Main esul s
Pea son
Sua di e al.
(2020)
33 Swi ze land 52 48 27.5 Wo king
Model o he
Child
In e iew
ITSEA Ma e nal e lec i e unc ion was nega i ely
co ela ed wi h ex e nalizing beha io s in he
pos auma ic sample.
−.4
Wade e al.
(2021)
501 Canada 49.3 nd 18 FMSS BITSEA Lowe ma e nal e lec i e capaci y was
associa ed ma ginally wi h lowe ex e nalizing
psychopa hology.
.2
Walke e al.
(2012)
21 UK 56 44 47.21 MM SDQ In he communi y g oup he e was a s ong
nega i e co ela ion be ween mind-mindedness
and child en’s ex e nalizing p oblems.
−.56
Walke e al.
(2012)
25 UK 56 44 44.68 MM SDQ In he clinical g oup he e was no signi ican
co ela ion be ween mind-mindedness and
child en’s ex e nalizing p oblems.
−.23
Ya zi e al.
(2020)
98 Is ael nd 32 66.03 PDI SDQ The links be ween execu i e unc ions and
pa en al e lec i e unc ioning we e s onge
when child en we e pe cei ed as mo e di icul ,
ha is, as ha ing nega i e a ec i i y,
ex e nalizing p oblems, and di icul ies in
adjus men .
.09
Zeege s
e al. (2020)
53 Ams e dam 54.7 nd 97.44 MM CBCL Pa en s epo ed less child ex e nalizing
p oblems a pos es and ollow-up. Pa en s’
mind-mindedness inc eased om p e- o pos -
es bu no om p e es o ollow-up.
.00
Zimme -
Gembeck
e al. (2019)
139 Aus alia 30 nd 53.3 PRFQ BASC −2 Imp o emen in p emen alizing modes we e
associa ed wi h imp o emen in child en’s
ex e nalizing symp oms.
.14
No es. BASC −2=Beha io Assessmen Scale o Child en−Second Edi ion; BITSEA =B ie In an −Toddle Social and Emo ional Assessmen ; CBCL =Child Beha io Checklis ; ECBI =The
Eybe g Child Beha io In en o y; FMSS =Fi e-Minu e Speech Sample; ICQ =In an ’s Cha ac e is ics Ques ionnai e; ITSEA =In an −Toddle Social and Emo ional Assessmen ; nd =No da a;
Ohio =Ohio You h P oblem Func ioning, and Sa is ac ion Scales; PDI =Pa en De elopmen In e iew; SCBE −30 =Social Compe ence and Beha io E alua ion −30; SDQ =S eng hs and
Di icul ies Ques ionnai e; TRF =Teache Repo Fo m; YSR =You h Sel −Repo .
De elopmen and Psychopa hology 9
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