Reciprocal associations between parental reflective functioning and behavioral problems in Chinese children with autism spectrum disorder: a cross-lagged panel analysis

Higher levels of parental reflective functioning are associated with normatively developing children's secure attachment and better socioemotional functioning. Children with autism spectrum disorder (ASD) exhibit more severe behavioral problems than normatively developing children, which hinder social adaptation and impose significant parenting challenges. However, the relationship between parental reflective functioning and behavioral problems in children with ASD remains underexplored, with most studies being cross-sectional. The present study examined reciprocal associations between parental reflective functioning and behavioral problems over a 6-month period across three timepoints in a sample of 180 Chinese parents of children with ASD using cross-lagged panel analyses. The result revealed a bidirectional relationship between parental reflective functioning and children's internalizing behavioral problems. Higher level of pre-mentalizing predicted increased internalizing behavioral problems at the subsequent time point, and vice versa. A child-driven effect was found in the association between externalizing behavioral problems and parental reflective functioning. A higher level of children's externalizing behaviors was correlated with increased parental pre-mentalizing and decreased certainty about mental states, as well as reduced parental interest and curiosity, at subsequent time points. The results underscore the importance of developing parenting interventions aimed at enhancing parental reflective functioning to mitigate behavioral problems in children with ASD.