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Parental Psychiatric Symptoms and Child Emotional and Behavioural Difficulties: Exploring the Mediating Role of

Amanda Kaas¹, Olivia Pepin¹, Sebastian Simonsen²

¹Department of Psychology, University of Copenhagen, Copenhagen, Denmark.

Early Intervention in Psychiatry

|June 26, 2026

Abstract

Introduction:

Children of parents with a mental disorder are at increased risk of developing mental health problems. A potentially important construct in the intergenerational transmission of mental health problems is parental mentalizing, referred to as parental reflective functioning (PRF). The aim of this study was to examine the links between parental psychiatric symptom severity, PRF, and child emotional and behavioural difficulties among parents with a mental disorder. Furthermore, we sought to explore the potential mediating role of PRF.

Methods:

The study involved parents with various diagnosed mental disorders (N = 70) with a child aged 0-17. Psychiatric symptom severity was assessed using the Brief Symptom Inventory, PRF was assessed with the Parental Reflective Functioning Questionnaire, and child emotional and behavioural difficulties were assessed with the Strengths and Difficulties Questionnaire. Linear regressions and Hayes PROCESS macro were utilised to examine the links between the variables and test for the mediating role of PRF.

Results:

Parental psychiatric symptom severity was significantly related to higher levels of child emotional and behavioural difficulties. Parental psychiatric symptom severity was closely associated with maladaptive PRF, as indicated by higher levels of pre-mentalizing, which in turn was related to child emotional and behavioural difficulties. PRF did not mediate the relationship between parental psychiatric symptom severity and child emotional and behavioural difficulties.

Conclusion:

Parental psychiatric symptom severity and PRF are important for child emotional and behavioural difficulties. However, the relationship between parental psychiatric symptom severity and child emotional and behavioural difficulties was not mediated by PRF.

Keywords:

behavioural problems child development emotional problems mentalization parental reflective functioning parenting psychopathology

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