A systematic review of parental psychological flexibility and child outcomes, and an empirical study of the relationship between psychological flexibility and parental reflective functioning, and their association with parental stress

Freeman, Katherine 2025. A systematic review of parental psychological flexibility and child outcomes, and an empirical study of the relationship between psychological flexibility and parental reflective functioning, and their association with parental stress. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

This thesis is made up of two papers, a systematic review and empirical study, both considering the concept of ‘Psychological Flexibility’ (PF) in parents, but with distinct research questions. PF is described as the process of noticing and accepting thoughts and feelings and continuing to act in line with one’s values (Hayes et al., 2012). The systematic review considered the relationship between parental PF and child outcomes, whereas the empirical paper considered the relationship between PF and parental reflective functioning (PRF), and their independent relationships with parental stress. Systematic review: The systematic review aimed to evaluate and summarise the available research regarding the impact of parental PF on child outcomes. Parental PF has been found to be associated with reductions in parental stress, depression and anxiety (Byrne et al., 2021) and improved relationships in the family (Daks & Rogge, 2020). However, as yet, there has not been a review of the studies that have investigated the association between parental PF and child outcomes. This review collected data from multiple sources and found 24 papers relevant to this topic. Of these 24 papers, 17 were correlational, five were longitudinal, one was an intervention study, and one used a time-lag design. The quality of these studies was assessed and found to be generally of moderate to high quality. The findings suggested that parental PF is positively associated with better general, mental health and physical health functioning. However, there were both significant relationships and non-significant relationships found between parental PF and child outcomes. Most of the studies used a correlational design, so the review is limited in terms of establishing the direction of the relationships found. Despite this, the review summarises important findings that demonstrate the potential impact of parental PF on children and so provides support for the potential benefit of parenting interventions focused on increasing PF on child outcomes. Empirical paper: The empirical paper aimed to explore the relationships between psychological flexibility (PF) and parental reflective functioning (PRF), and their associations with parenting stress. It is relevant to consider the factors that influence parenting stress because these factors could inform parenting interventions, which can be used to promote the mental health and wellbeing of parents, which would likely have positive impacts also on their children. PRF is described as a parent’s capacity to reflect on their own internal mental states, alongside the ability to envision their child as motivated by their own feelings and desires (Luyten et al., 2017). On a commonly used questionnaire, PRF is made up of three distinct factors: pre-mentalising (PM) (i.e., tendency to make maladaptive attributions about the child's intentions), certainty about mental states (CMS) (i.e., a parent’s ability to recognise that mental states are not readily apparent) and interest and curiosity in mental states (IC) (i.e., the parent’s active curiosity about and willingness to understand the mental states of the child) (Luyten et al., 2016). Previous research has provided some support for PRF being associated with increased tolerance of infant distress, improved emotional regulation and decreased parenting stress. Similarly to PRF, PF (described above) has been associated with greater use of positive parenting strategies and reduced depressive symptoms and stress. Although PF and PRF have developed through different theoretical pathways, the two constructs are similar in that they focus on self-awareness of internal processes, and the individual’s relationship with their thoughts and emotions. However, they are also distinct from each other (e.g., PF has an additional focus on values, whilst PRF has an additional focus on perspective-taking of the child). Despite their overlapping concepts and relationships with parenting stress, these constructs have not been studied together in relation to parental stress. A total of 362 parent/carers of children aged 0-10 years old completed an online questionnaire regarding their PF, PRF and parenting stress. Results showed significant correlations with aspects of PRF (specifically higher PM, lower IC, and lower CMS) and higher parental stress. Although the correlational findings regarding PM and IC were as expected, past research has shown greater PRF to be adaptive, and that higher CMS is not representative of greater PRF, therefore the finding that CMS had a negative relationship with parental stress (i.e., parents with higher CMS experienced less parental stress) was unexpected. As predicted, lower PF was also significantly associated with higher levels of parental stress. When considering both the PRF subscales and PF together, PF and aspects of PRF (PM and CMS subscales) still independently predicted parental stress. Lastly, PF significantly correlated with each of the parent reflective functioning (PRF) subscales (lower PM, higher CMS and IC). The results suggest that although PRF and PF involve similar processes, they also have somewhat independent relationships with parental stress. Hence, combining two theoretical models within parenting interventions may provide a potential additive benefit for reducing parenting stress.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Schools > Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	29 July 2025
Last Modified:	01 Aug 2025 11:01
URI:	https://orca.cardiff.ac.uk/id/eprint/180092

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