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Updated: May 1, 2026

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Parental mentalization and children's externalizing problems: A systematic review and meta-analysis.

Maitane Nieto-Retuerto1, Barbara Torres-Gomez1, Itziar Alonso-Arbiol1

  • 1Department of Clinical and Health Psychology & Research Methods, University of the Basque Country UPV/EHU, Donostia-San Sebastian, Spain.

Development and Psychopathology
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Summary

Higher parental mentalization, the ability to understand mental states, is linked to fewer child externalizing problems. This finding supports interventions aimed at enhancing parental mentalization skills for better child behavior outcomes.

Keywords:
Children’s externalizing problemsdevelopmental stagemeta-analysisparental mentalizationparenting experience

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Area of Science:

  • Developmental Psychology
  • Child Psychiatry
  • Clinical Psychology

Background:

  • Parental mentalization, understanding children's mental states, is crucial for child development.
  • Externalizing problems in children are a significant concern with long-term implications.
  • The link between parental mentalization and child externalizing behaviors requires further empirical investigation.

Purpose of the Study:

  • To conduct a meta-analysis examining the relationship between parental mentalization and children's externalizing problems.
  • To quantify the association between parental mentalization and reduced externalizing behaviors.
  • To explore potential moderators influencing this relationship.

Main Methods:

  • A systematic meta-analysis of 42 studies involving caregivers and children aged 0-18 years.
  • Searched six electronic databases for relevant empirical studies.
  • Employed random-effects modeling to analyze 52 effect sizes.

Main Results:

  • A significant inverse association was found: higher parental mentalization correlated with fewer externalizing problems (r = -.19).
  • High heterogeneity was observed (I² = 83.750), prompting further analysis.
  • Parenting experience and child's developmental stage significantly moderated the association.

Conclusions:

  • Parental mentalization is a significant protective factor against the development of externalizing behaviors in children.
  • Findings suggest practical implications for parent-focused interventions to improve mentalization skills.
  • Enhancing parental mentalization may be a viable strategy for preventing externalizing problems across childhood and adolescence.