The Benefits of Being Present Mindfulness and Its Role in Psychological Wellbeing - Estudiado
The Benefits of Being Present Mindfulness and Its Role in Psychological Wellbeing - Estudiado
Many philosophical, spiritual, and psychological traditions emphasize the importance of the quality of consciousness for the
maintenance and enhancement of well-being (Wilber, 2000). Despite this, it is easy to overlook the importance of consciousness in
human well-being because almost everyone exercises its primary
capacities, that is, attention and awareness. Indeed, the relation
between qualities of consciousness and well-being has received
little empirical attention. One attribute of consciousness that has
been much-discussed in relation to well-being is mindfulness. The
concept of mindfulness has roots in Buddhist and other contemplative traditions where conscious attention and awareness are
actively cultivated. It is most commonly defined as the state of
being attentive to and aware of what is taking place in the present.
For example, Nyanaponika Thera (1972) called mindfulness the
clear and single-minded awareness of what actually happens to us
and in us at the successive moments of perception (p. 5). Hanh
(1976) similarly defined mindfulness as keeping ones consciousness alive to the present reality (p. 11).
Recent research has shown that the enhancement of mindfulness
through training facilitates a variety of well-being outcomes (e.g.,
regular or sustained consciousness of ongoing events and experiences. For example, in speaking with a friend, one can be highly
attentive to the communication and sensitively aware of the perhaps subtle emotional tone underlying it. Similarly, when eating a
meal, one can be attuned to the moment-to-moment taste experience while also peripherally aware of the increasing feeling of
fullness in ones stomach. This is to be contrasted with consciousness that is blunted or restricted in various ways. For example,
rumination, absorption in the past, or fantasies and anxieties about
the future can pull one away from what is taking place in the
present. Awareness or attention can also be divided, such as when
people are occupied with multiple tasks or preoccupied with concerns that detract from the quality of engagement with what is
focally present. Mindfulness is also compromised when individuals behave compulsively or automatically, without awareness of or
attention to ones behavior (Deci & Ryan, 1980). Finally, mindlessness, which we denote as the relative absence of mindfulness,
can be defensively motivated, as when an individual refuses to
acknowledge or attend to a thought, emotion, motive, or object of
perception. These forms of consciousness thus serve as concrete
counterpoints to mindful presence and the attention to current
experience within and without oneself that such presence entails.
As presently defined, mindfulness bears some relation to other
constructs that have received empirical attention. For example,
emotional intelligence, as described by Salovey, Mayer, Goldman,
Turvey, and Palfai (1995), includes perceptual clarity about ones
emotional states. Insofar as mindfulness involves receptive attention to psychological states, we expect it to be associated with such
clarity. In less mindful states, emotions may occur outside of
awareness or drive behavior before one clearly acknowledges
them. Mindfulness also appears to relate to aspects of the Openness to Experience dimension of personality (Costa & McCrae,
1992), which involves receptivity to and interest in new experiences. Receptive attention would appear to support the contact
with and assimilation of feelings and new ideas, for example. On
the other hand, the imagination, fantasy, and aesthetic interest
facets of Openness measured in Big Five research do not theoretically relate to mindfulnessmindlessness as presently defined,
given the role of cognition in Openness.
Finally, the concept of mindfulness as we describe it bears some
relation to earlier groundbreaking work by Langer (1989) and
colleagues (e.g., Bodner & Langer, 2001; Langer & Moldoveanu,
2000). Langers formulation includes an open, assimilative wakefulness to cognitive tasks and in this has some overlap with the
current formulation. However, Langers formulation emphasizes
active cognitive operations on perceptual inputs from the external
environment, such as the creation of new categories and the
seeking of multiple perspectives. The present definition emphasizes an open, undivided observation of what is occurring both
internally and externally rather than a particular cognitive approach to external stimuli.
Mindfulness can also be distinguished from various forms of
self-awareness that have received considerable attention over the
past 30 years. Most prominently, Duval and Wicklunds (1972)
theory of objective self-awareness, Busss (1980) self-consciousness theory, and Carver and Scheiers (1981) control theory all
define self-awareness in terms of knowledge about the self. For
example, private self-consciousness represents a disposition to be
highly aware of internal states (e.g., Fenigstein, Scheier, & Buss,
823
824
(1973) saw the healthy organism as forming clear and vital gestalts
or perceptions that emerge in states of relaxed attention. Bringing
awareness to bear on facets of experience that have been alienated,
ignored, or distorted has been theorized to convert hidden subjects into conscious objects that can be differentiated from,
transcended, and integrated into the self (Wilber, 2000). Finally,
theorists in the cognitive tradition have discussed the importance
of attention to gathering factual information on behavior or subjective experience as a first step in making health-enhancing
behavior changes (Safran & Segal, 1990).
Several theories of self-regulation discuss the place of awareness and attention in the maintenance and enhancement of psychological and behavioral functioning. One of these is selfdetermination theory (SDT; Deci & Ryan, 1985; Ryan & Deci,
2000), which posits that an open awareness may be especially
valuable in facilitating the choice of behaviors that are consistent
with ones needs, values, and interests (Deci & Ryan, 1980). In
contrast, automatic or controlled processing often precludes considerations of options that would be more congruent with needs
and values (Ryan, Kuhl, & Deci, 1997). In this sense, then,
mindfulness may facilitate well-being through self-regulated activity and fulfillment of the basic psychological needs for autonomy (self-endorsed or freely chosen activity), competence, and
relatedness (Hodgins & Knee, 2002). That is, awareness facilitates
attention to prompts arising from basic needs, making one more
likely to regulate behavior in a way that fulfills such needs.
Not all self-regulatory processes require conscious awareness
and attention to operate smoothly, and a substantial portion of
day-to-day behavior has been thought to occur automatically or
mindlessly (Bargh, 1997; Deci & Ryan, 1980; Tart, 1994). Thinkers have long argued over the merits and demerits of such behavior
(Maddux, 1997), which is defined by the lack of intentional or
conscious effort. Although a pragmatic view argues that automaticity saves time and frees the mind for more important tasks,
others argue that such automatic thought and behavior patterns
may have problematic consequences. For example, Baumeister,
Heatherton, and Tice (1994) reviewed evidence showing that the
deployment of conscious attention can override unwanted responses, and such deployment is linked to well-being in cognitive,
emotional, and behavioral domains.
There are also many instances where attentional sensitivity to
psychological, somatic, and environmental cues, a key component
of mindfulness, is crucial to the operation of healthy regulatory
processes (Brown, 1998; cf. Waldrup, 1992). Indeed, cybernetic
theories, such as Carver and Scheiers (1981) control theory,
propose that attention is key to the communication and control
processes that are thought to underlie the regulation of behavior.
Biofeedback research has long shown that attention can be a key
component in reducing unhealthy somatic conditions or symptoms
of illness (e.g., Basmajian, 1989). The process of disregulation can
occur when signals are ignored or suppressed, as happens, for
example, when painkillers, alcohol, or drugs are taken to selfmedicate. When disregulation of this kind occurs, attention is
required to reestablish communication between elements of a
system (e.g., mind and body, or thought and behavior) before
wellness can return (G. E. Schwartz, 1984). Disregulation may
also occur when somatic and other signals brought to awareness
are then cognitively exaggerated, as may happen in panic states,
for example (Clark, 1986). In contrast, mindfulness involves per-
825
826
Table 1
Sample Characteristics (Scale Construction and Study 1)
Sample
Characteristic
Location
Cronbachs alpha
N
Age range (years)
Age mean (years)
Female (%)
Caucasian (%)
Asian (%)
African American (%)
Hispanic (%)
Native American (%)
Other ethnicity (%)
URa
.84
313
1823
19.5
66
73
15
3
4
0
5
URb
.82
327
1728
19.6
64
77
10
5
3
1
5
HWSc
.80
207
1723
19.0
62
85
3
5
3
1
5
URd
.82
187
1723
19.7
62
77
9
4
4
0
6
URe
.87
145
1832
19.8
64
63
19
9
4
0
5
Communityf
.86
74
1862
37.6
55
88
3
3
0
4
3
Nationalg
.87
239
1877
43.3
66
93
1
1
2
0
3
Table 2
Means, Standard Deviations, Factor Loadings, and Item-Total Correlations for the Mindful
Attention Awareness Scale
Scale item
SD
I-T
4.02
1.12
.46
.45
4.13
1.47
.45
.42
3.80
3.41
1.23
1.27
.51
.45
.49
.39
3.83
1.22
.27
.25
3.40
1.54
.33
.31
3.72
1.24
.78
.72
3.81
3.74
1.11
1.15
.74
.38
.67
.38
3.70
3.52
1.20
1.16
.69
.55
.61
.49
4.36
2.66
3.66
4.11
1.42
1.03
1.14
1.42
.62
.28
.77
.47
.57
.26
.69
.41
Note. All scores are based on Sample A data (N 313). Items were introduced by the following: Below is
a collection of statements about your everyday experience. Using the 1 6 scale below, please indicate how
frequently or infrequently you currently have each experience. Please answer according to what really reflects
your experience rather than what you think your experience should be. The accompanying 6-point scale was
1 almost always, 2 very frequently, 3 somewhat frequently, 4 somewhat infrequently, 5 very
infrequently, and 6 almost never. F factor loadings; I-T item-total correlations.
827
828
Method
Participants
Samples AF are described in Table 1. Participants in Samples AE
were students taking psychology courses who received extra course credit
for participation. Sample F comprised adults drawn from a northeastern
U.S. community (see Study 4 for recruitment details). Participants in all
samples completed measures in a single session. Group sizes in Samples
AE ranged from 5 to 25 persons, and in Sample F, groups ranged from 1
to 15 persons.
Materials
Convergent and Discriminant Scales
NEO Personality Inventory (NEO-PI) and NEO Five-Factor Inventory
(NEO-FFI) Openness to Experience (Costa & McCrae, 1992). This Big
Five personality scale measures openness to ideas, values, aesthetics,
emotions, fantasy, and actions. High scorers report a receptivity to novel
experiences and actions and a high frequency of, and interest in, imaginative and reflective thought.
Trait Meta-Mood Scale (TMMS; Salovey et al., 1995). This measure of
emotional intelligence taps individual differences in attention to feelings
(attention), the clarity of experience of these emotions (clarity), and beliefs
about prolonging pleasant mood states and ending unpleasant states
(repair).
Mindfulness/Mindlessness Scale (MMS; Bodner & Langer, 2001). The
MMS assesses individual differences in the propensity to achieve mindful
states, defined as the awareness of behavioral routines, a questioning of
their efficacy, and active consideration of alternative behaviors. Its 21
items assess four components: Flexibility, Novelty Seeking, Novelty Producing, and Engagement.
Self-Consciousness Scale (SCS; Fenigstein et al., 1975). This well-known
23-item measure has three subscales. Private Self-Consciousness assesses
the tendency to reflect upon oneself, fantasize, and attend to ones moods,
motives, and cognitive processes. Recent work indicates that two factors
may underlie this subscale: self-reflectiveness and internal state awareness
(e.g., Cramer, 2000). The subscale Public Self-Consciousness measures the
tendency to view oneself from the perspective of the social world and
reflects a concern for ones appearance, social behavior, and the impression
one makes upon others. Relatedly, the subscale Social Anxiety taps shyness, embarrassment, and anxiety in social situations.
RuminationReflection Questionnaire (RRQ; Trapnell & Campbell,
1999). The 12-item Reflection subscale of the RRQ assesses intellectual
self-attentiveness through items tapping the tendency to explore, analyze,
and contemplate the self. The 12-item Rumination subscale measures
ruminative self-attention, the tendency to dwell on, rehash, or reevaluate
events or experiences.
Self-Monitoring ScaleRevised (Snyder & Gangestad, 1986). This
widely researched 18-item scale assesses the tendency to observe and
control expressive behavior and self-presentation in accordance with situational cues to social appropriateness.
Need for Cognition (Cacioppo, Petty, & Kao, 1984). This 18-item
scale measures individual differences in engagement and enjoyment of
effortful cognitive endeavors. High scorers endorse items reflecting
interest in thinking, complex problem solving, and intellectual tasks.
Well-Being Scales
We also used a number of measures reflecting various aspects of
well-being.
Traits and attributes. The Neuroticism scales from the NEO-PI and
NEO-FFI (Costa & McCrae, 1992) assessed dispositional anxiety, hostility,
depression, impulsiveness, and vulnerability. Self-esteem was measured
with both the 10-item Multidimensional Self-Esteem Inventory (OBrien &
Epstein, 1988) Self-Worth subscale and the Rosenberg Self-Esteem Scale
(Rosenberg, 1965). Optimism was assessed using the Life Orientation Test
(Scheier & Carver, 1985).
Emotional disturbance. Depressive symptoms were specifically assessed using both the 20-item Center for Epidemiological Studies
Depression (CES-D) scale (Radloff, 1977) and the 20-item Beck Depression Inventory (BDI; Beckham & Leber, 1985). Anxiety was measured
using the 20-item StateTrait Anxiety Inventory (STAI; Spielberger, 1983)
and the 9-item Profile of Mood States (POMS) Anxiety subscale (McNair,
Lorr, & Droppleman, 1971). Reports on both depression and anxiety were
made over the past week or past month, depending on the sample.
Emotionalsubjective well-being. Both the valence (hedonic tone) and
arousal dimensions of affective experience were assessed. Pleasant and
unpleasant affective tone were measured using the 9-item scale derived by
Diener and Emmons (1984). The 20-item Positive and Negative Affect
Schedule (PANAS; Watson, Clark, & Tellegen, 1988) assessed affective
arousal. Reports were made on affective experience over the past week or
month. Life satisfaction was assessed using the 15-item Temporal Life
Satisfaction Scale (Pavot, Diener, & Suh, 1998).
Eudaimonic well-being. Self-actualization was measured using the
Measure of Actualization of Potential (Lefranc ois, Leclerc, Dube , He bert,
& Gaulin, 1997). To test the hypothesis that MAAS would predict greater
autonomy, competence, and relatedness we used the relevant subscales
from Ryffs (1989) Personal Well-Being Scales. The seven-item Subjective
Vitality Scale (Ryan & Frederick, 1997) assessed the extent to which
individuals felt energized and vital over the past week or month.
Physical well-being. We assessed physical well-being using a measure
of common physical symptoms adapted from Larsen and Kasimatis (1991),
the Hopkins Symptom Checklist Somatization scale (Derogatis, Lipman,
Rickels, Uhlenhuth, & Covi, 1974), and a self-report of medical health visit
frequency over the past 21 days.
Results
Convergent and Discriminant Correlations
Correlations of the MAAS with other measures assessed are
shown in Table 3. As predicted, the MAAS was correlated at a
moderate level with emotional intelligence. It was most strongly
related to clarity of emotional states but also with mood repair and,
to a lesser degree, attention to emotions. The MAAS showed
modest positive correlations with NEO-PI Openness to Experience
and NEO-FFI Openness to Experience, and was specifically related to the Feelings, Actions, Ideas, and Values subscales on the
NEO-PI, which more strongly reflect attentiveness and receptivity
829
Table 3
Correlations of the Mindful Attention Awareness Scale With Other Scales: Convergent and
Discriminant Validity (Study 1)
Scale
NEO-PI Openness to Experience
Fantasy
Aesthetics
Feelings
Actions
Ideas
Values
NEO-FFI Openness to Experience
Trait Meta-Mood Scale
Clarity
Attention
Repair
Mindfulness/Mindlessness Scale
Flexibility
Novelty Seeking
Novelty Producing
Engagement
Self-Consciousness Scale
Private Self-Consciousness
Self-Reflectiveness
Internal State Awareness
Public Self-Consciousness
Social Anxiety
RRQ
Reflection
Rumination
Self-Monitoring
Need for Cognition
Absorption
Sample(s)
A
A
A
A
A
A
A
D,
A,
A,
A,
A,
D,
D,
D,
D,
D,
E
D,
D,
D,
D,
E
E
E
E
E
A,
A,
A,
A,
A,
D,
D,
D,
D,
D,
Correlation(s)
.18**
.07
.10
.17**
.20***
.17**
.15**
.12, .19*
.46****, .42****, .37****
.49****, .45****, .50****
.19***, .17*, .13
.37****, .33****, .25**
.31****, .33****
.002, .24**
.30***, .29***
.23**, .26***
.39****, .33****
E
E
E
E
E,
E,
E,
E,
E,
A, D, E
B, D, E
B
C
C
F
F
F
F
F
Note. Ns for Samples A, B, C, D, E, and F are 313, 327, 207, 187, 145, and 74, respectively. NEO-PI NEO
Personality Inventory; NEO-FFI NEO Five-Factor Inventory; RRQ Reflection Rumination Questionnaire.
* p .05. ** p .01. *** p .001. **** p .0001.
to experience and behavior than the Fantasy and Aesthetics subscales. The MMS (Bodner & Langer, 2001) was, as expected,
correlated with the MAAS. Befitting our theory, the MAAS was
most strongly related to mindful engagement. It was correlated to
a lesser degree with both novelty seeking and producing, and was
unrelated to cognitive flexibility.
As already noted, several scales measure the use of cognitive
processes in service of self-examination and reflection on the self.
The MAAS was expected to show little or no relation to these
measures. As Table 3 shows, there was no correlation with Private
Self-Consciousness. However, in line with theoretical expectation,
the MAAS was correlated with the internal state awareness aspect
of this measure. Although significant, this correlation was modest,
perhaps in part because of the poor internal consistency of this
subscale (Creed & Funder, 1998). There were also expectable
negative relations to both Public Self-Consciousness and Social
Anxiety. Also as predicted, the MAAS was unrelated to SelfMonitoring. Regarding the RRQ, the MAAS was unrelated to
Reflection and inversely related to Rumination. A small though
significant correlation with the Need for Cognition was found,
indicating that mindfulness does not preclude the enjoyment of
intellectual activity. Absorption was weakly and inversely related
to the MAAS, as expected. Turning finally to social desirability,
the MAAS showed positive correlations with the Marlowe
Well-Being Correlations
Table 4 presents correlations between the MAAS and wellbeing scales. Among the Big Five personality traits, neuroticism
has been consistently related to poorer psychological well being.
The MAAS was moderately related to lower levels of this trait.
Across the six facets of this measure, the MAAS was most strongly
and inversely related to Depression, Self-Consciousness, and Angry Hostility and less strongly, though still significantly, to
Impulsiveness.
The MAAS was related to other indicators of well being, both
positive and negative, in consistently expected directions. The
MAAS was inversely related to CES-D and BDI measures of
depression and STAI and POMS measures of anxiety. Regarding
affect, the MAAS was positively related to pleasant hedonic tone
and PANAS-measured positive affectivity in two samples of undergraduates and a sample of adults; it was negatively related to
unpleasant tone and PANAS negative affectivity. Along with
affect, a primary component of subjective well-being is life satisfaction (Diener, Suh, Lucas, & Smith, 1999). In both college
830
Table 4
Correlations of the Mindful Attention Awareness Scale With Dispositional and State Scales
Measuring Psychological Well-Being (Study 1)
Scale
Sample(s)
Correlation(s)
.56****
.34****
.41****
.53****
.45****
.29****
.47****
.33****, .56****
.36****
.39****, .50****
.27****, .34****
A
A
A
A
A
A
A
D, E
B
D, E
D, E
Emotional disturbance
CES-D Depression
BDI Depression
STAI Anxiety
POMS Anxiety
.37****
.41****, .42****
.40****
.26***, .42****
B
D, E
B
D, E
Emotionalsubjective well-being
Pleasant Affect
Unpleasant Affect
PANAS Positive Affect
PANAS Negative Affect
Life Satisfaction
A, B,
A, B,
B, D,
B, D,
B, F
D, E, F
D, E, F
E
E
Eudaimonic well-being
Vitality
MAP Self-Actualization
Autonomy
Competence
Relatedness
A, B, F
B
B, F
B, F
B, F
Reported physical
symptoms
HSCL Somatization
Medical visit frequency,
past 21 days
B, F
A, F
.25****, .51****
.40****, .42***
.32**
Note. Ns for Samples A, B, C, D, E, and F are 313, 327, 207, 187, 145, and 74, respectively. NEO-PI NEO
Personality Inventory; NEO-FFI NEO Five-Factor Inventory; MSEI Multidimensional Self-Esteem
Inventory; LOT Life Orientation Test; CES-D Center for Epidemiologic Studies Depression Scale; BDI
Beck Depression Inventory; STAI StateTrait Anxiety Inventory; POMS Profile of Mood States;
PANAS Positive and Negative Affect Schedule; MAP Measure of Actualization of Potential; HSCL
Hopkins Symptom Checklist.
* p .05. ** p .01. *** p .001. **** p .0001.
students and adults, the MAAS was positively associated with this
variable. Self-esteem scores on both the Multidimensional SelfEsteem Inventory and the Rosenberg measures were higher among
those scoring higher on the MAAS. In three samples, the MAAS
was associated with higher levels of subjective vitality. Greater
self-actualization was also associated with higher mindfulness
scores. Finally, in line with our SDT-based hypotheses, the MAAS
was related to autonomy, competence, and relatedness fulfillment.
Although our primary interest in this article is relations between
the MAAS and psychological well-being, because physical health
Incremental Validity
We examined whether the correlations found between the
MAAS and a number of well-being variables would remain significant after controlling for the effects of a number of constructs
that were shown to be related to the MAAS and that themselves
have been associated with various well-being indicators in past
research. The MAAS was shown to bear only small to moderate
relations to existing measures of dispositional self-awareness.
However, these latter measures have themselves been shown to
relate to well-being. Private self-consciousness appears to intensify
existing positive and, especially, negative affect (Fejfar & Hoyle,
2000). It has also been associated with lower self-esteem (Fejfar &
Hoyle, 2000), negative mood states (Flory, Raikkonen, Matthews,
& Owens, 2000), anxiety (Davis & Franzoi, 1999), and depression
(Davis & Franzoi, 1999). Rumination has been associated with
depression (e.g., Nolen-Hoeksema, Morrow, & Fredrickson,
1993), anxiety, and negative affect (Trapnell & Campbell, 1999).
The disposition to regulate ones emotional states (emotional intelligence) has been associated with more positive affect, lower
levels of depression (Salovey et al., 1995), and lower anxiety
(Goldman, Kraemer, & Salovey, 1996). The traits neuroticism and
extraversion have been strongly associated with negative and
positive psychological well-being (Diener et al., 1999). Although
not directly relevant to this research, extraversion was related to
the MAAS in this study (Samples D and E: rs .19 and .22,
respectively; ps .01). Also, given that the MMS is the only other
instrument known to assess mindfulness (though defined differently) and showed some relation to the MAAS, we controlled for
its effects in testing MAASwell-being relations. Finally, it is
important to control for the effects of social desirability, given both
its relation to the MAAS and its positive relation to subjective
well-being (Diener, Sandvik, Pavot, & Gallagher, 1991).
Incremental validity was assessed using combined data from
Samples D and E. We used the Rosenthal (1991) meta-analytic
approach to apply Fishers (1928) r-to-z transformation to the
831
Table 5
Correlations of the Mindful Attention Awareness Scale With Well-Being Variables Before and After Controlling for Other Constructs
(Study 1)
MAAS controlling for
Scale
Zero-order
correlation
Rum
PrSC
TMMS
MMS
BDI Depression
POMS Anxiety
Pleasant Affect
Unpleasant Affect
PANAS Positive Affect
PANAS Negative Affect
Rosenberg Self-Esteem
.40****
.34****
.38****
.38****
.36****
.41****
.44****
.29****
.22****
.30****
.28****
.30****
.33****
.38****
.44****
.35****
.37****
.39****
.37****
.44****
.44****
.32****
.27****
.24****
.30****
.25****
.35****
.32****
.36****
.31****
.30****
.35****
.25****
.40****
.34****
N
.16**
.12*
.20***
.14**
.23****
.22****
.25****
E
.38****
.32****
.32****
.36****
.31****
.39****
.42****
Social
desirability
.34****
.28****
.35****
.33****
.33****
.38****
.41****
Note. N 332 (Samples D and E; see Table 1). MAAS Mindful Attention Awareness Scale; Rum Rumination; PrSC Private self-consciousness;
TMMS Trait Meta-Mood Scale; MMS Mindfulness/Mindlessness Scale; N NEO Five-Factor Inventory (NEO-FFI) Neuroticism; E NEO-FFI
Extraversion; Social desirability MarloweCrowne Social Desirability Scale; BDI Beck Depression Inventory; POMS Profile of Mood States;
PANAS Positive and Negative Affect Schedule.
* p .05. ** p .01. *** p .001. **** p .0001.
832
Discussion
The pattern of correlations described in this section supports,
first, the convergent and discriminant validity of the MAAS in a
way consistent with our theory and hypotheses. Although the scale
converges with several measures of psychological awareness, the
relations are moderate at best, indicating that the scale is tapping
a distinct construct. The scale was weakly related or unrelated to
a number of popular measures of reflexive consciousness. Overall,
the pattern of associations indicates that higher scorers on the
MAAS tend to be more aware of and receptive to inner experiences and are more mindful of their overt behavior. They are more
in tune with their emotional states and able to alter them, and
they are more likely to fulfill basic psychological needs. Conversely, such individuals are less likely to be self-conscious, socially anxious, and ruminative than low scorers and are also
slightly less likely to enter absorptive states of consciousness.
They are generally not more likely to be reflective or to engage in
self-scrutiny but appear to value intellectual pursuits slightly more
than lower scorers. The MAAS was modestly correlated with one
measure of social desirability, the MarloweCrowne, and unrelated to a second, namely the MMPI Lie scale. The first result
suggests that self-presentation concerns may affect MAAS scores,
but it may also reflect the greater attention to personal conduct that
the MarloweCrowne taps. The incremental validity results indicated that the MAASwell-being relations cannot be explained by
social desirability. Also noteworthy in this regard is the absence of
a positive association between the MAAS and both public selfconsciousness, reflecting a concern over how others view one, and
self-monitoring, which measures the tendency to self-present to
meet social demands.
The correlations of the MAAS with various well-being measures supported a primary hypothesis of this research program,
namely that mindfulness is associated with greater well-being. The
MAAS was related to lower neuroticism, anxiety, depression,
results are made more interesting by the fact that the MAAS does
not contain well-being-related content. Indeed, the concept of
mindfulness itself is devoid of motivational and attitudinal components that could be construed as predispositions toward wellbeing enhancement. The diversity of well-being constructs with
which the MAAS is associated suggests a number of avenues that
social, personality, and health research can take to explore the
impact that this form of consciousness has on psychological
well-being.
Method
Participants and Procedure
Scores from two samples were compared. Individuals from the community membership rolls of a Zen center located in Rochester, New York were
selected on the basis of a matching strategy. An investigator naive to other
data randomly selected, on a 1:1 basis, persons from that list who were
matched in gender and age (2 years) with 74 Rochester generalcommunity adults (Sample F; see Table 1 and recruitment details in Study
4). A packet, which included a cover letter, the MAAS, and a brief survey
concerning relevant practices, was mailed to the 74 Zen center matches.
The cover letter promised a $2 donation to the centers retreat center
building fund for every packet returned. The practice-related survey asked
whether the individual currently had a meditation practice, the duration of
practice history, and the amount of time currently meditating (per day,
week, month, etc.). It also asked to what extent the individual perceived
that he or she carried the meditative practice into daily life (rated on a
7-point scale from 1 not at all to 7 very much). A total of 50 packets
(68% response rate) were returned. Analyses are based on the two matched
samples of 50 persons, each composed of 21 men and 29 women (mean
age 41.08; range 22 62 years).
833
STUDY 3. SELF-CONCORDANCE
THROUGH MINDFULNESS
A key facet of the construct of mindfulness is the capacity for
self-awareness; that is, highly mindful individuals are theorized to
be more attentive to and aware of internal (psychological and
physical) constructions, events, and processes than are less mindful individuals. Indeed, we and others have argued that effective
self-regulation depends on this capacity for self-insight (e.g., G. E.
Schwartz, 1984). The present study was designed to test, within a
laboratory setting, whether MAAS-measured mindfulness is associated with greater self-awareness in relation to well-being using
awareness of implicit emotional states as a model.
An explosion of research over the past decade has highlighted a
distinction between implicit and explicit psychological processes.
Implicit processes, also called indirect, automatic, intuitive, and
unconscious, are those that become active without conscious
choice, effort, or intention (Bargh, 1997). Explicit processes, in
contrast, are consciously activated and guided. Priming and implicit classification tasks have revealed the implicit or automatically activated aspect of a number of social and personality phenomena, including attitudes, self-esteem, and motives (see Bargh
& Ferguson, 2000; Greenwald & Banaji, 1995; and Wilson, Lindsey, & Schooler, 2000).
An important point of discussion in this area of research is
whether and how individuals can be aware of implicit constructs
and processes (e.g., Wilson et al., 2000). One way in which such
awareness could be demonstrated would be through concordance,
such that responses on an explicit measure of a psychological
construct match those of the implicit counterpart. Research to date
has shown evidence of little or no concordance between explicit
and implicit measures in some domains (e.g., self-esteem) and
moderately strong relations between the two kinds of measures in
others (e.g., gender self-concept; Greenwald & Farnham, 2000).
834
Method
Participants
Ninety (31 male and 59 female) undergraduates, ranging in age from 18
to 26 (M 19.8 years) participated in exchange for extra credit in
psychology courses. Data from 7 additional participants were dropped from
analysis because of high incorrect response rates (greater than 20% of
trials) on the combined task blocks of the IAT (see below). Data from a
further 5 participants were not used because of incorrect completion of, or
outlying values on, one or more of the measures.
Procedures
General Procedure
Participants completed both self-report measures and the computerized
IAT in a single session. Participants completed the study individually and,
3
The present study was interested in implicit explicit concordance in
state rather than trait affect, given that self-regulation through mindfulness
could result in overriding of an implicit process (cf. Levesque & Brown,
2002; Wilson et al., 2000) and therefore an absence of implicit explicit
concordance. Research using the IAT has shown that it can tap both
dispositional and state phenomena (e.g., Gemar, Segal, Sagrati, &
Kennedy, 2001).
835
Table 6
Multiple Regression Testing Moderation of Implicit
AffectExplicit Affect Relation by Mindfulness (Study 3)
Predictor
SE
.13
.17
.53
.21
.19
.24
.07
.09
.24*
relation between implicit and explicit affect than those less dispositionally mindful. To verify this, analyses tested whether the slope
of each regression line was significantly different from zero (see
Aiken & West, 1991). The slope for low mindfulness (.23, 1
standard deviation below the mean) was nonsignificant, t(86)
0.74, ns, whereas the slope for high mindfulness (.49, 1 standard
deviation above the mean) was significant, t(86) 2.33, p .05.
In sum, using both implicit and explicit measures, participants in
this study associated themselves with predominantly pleasant
rather than unpleasant affect. However, the relation between implicit and explicit measures was small and nonsignificant (cf.
Greenwald & Farnham, 2000). The MAAS was shown to moderate
the relation between implicit and explicit affect valence, such that
individuals higher in mindfulness demonstrated a stronger relation
between the two measures. The MAAS did not predict current
affective state, but this is unsurprising, given that mindfulness is
not theorized to predict emotional experience at a single point in
time.
This study provides lab-based evidence for the construct validity
of the MAAS and the self-regulatory capacity of mindfulness. The
results showed that individuals scoring higher on the scale were
more concordant with respect to their implicit and explicit affective experience, suggesting that more mindful individuals may be
more attuned to their implicit emotions and reflect that awareness
in their explicit self-descriptions. Although research is needed to
more fully test this idea, these results accord with various theories
of mindfulness that posit that the enhancement of this disposition,
through practice or psychotherapy, for example, facilitates the
uncovering of previously inaccessible emotional and other psychological realities (Wilber, 2000). Further, theories of self-regulation
converge on the idea that attention to and awareness of ones
current states facilitates psychological well-being. We turn our
attention now to the role of MAAS-measured mindfulness in
predicting both self-regulated behavior and well-being.
836
each persons average level on that variable. In line with hypotheses regarding the trait form of the MAAS, we hypothesized that
state or momentary mindfulness would be related to autonomous
action and emotional well-being measured at the same point in
time. We further predicted that state mindfulness would be more
strongly related to momentary outcomes than the trait measure
given its temporal proximity to ongoing events and experiences.
However, because trait is defined as a propensity to act in a
particular way, we can expect a person to have a tendency to
behave that way in his or her typical environment. As such, some
correspondence between the trait MAAS measure and average
state ratings of mindfulness was expected.
In sum, we hypothesized that trait mindfulness would predict
both state mindfulness and day-to-day autonomous action and
emotional well-being. It was predicted that state mindfulness
would be related to autonomy and emotional state measured at the
same point in time. In general, finding significant effects at both
trait and state levels would support the position that mindfulness
plays a broad and important role in self-regulation and emotional
experience.
Method
Figure 1. Moderation effect of Mindful Attention Awareness Scale mindfulness on the relation between implicit and explicit affect valence. High
and low values are 1 standard deviation above and below the mean,
respectively.
whether a self-report measure taps what is occurring in individuals regular day-to-day lives. In this study, measures of selfregulated behavior (autonomy) and emotional state were collected multiple times a day over a period of weeks through
experience sampling. This approach allowed for the measurement of affect and behavior on a quasi-random basis to obtain a reasonably representative picture of these outcomes in daily
life. We hypothesized that the MAAS would predict more autonomous activity and higher levels of emotional well-being
over time.
Traits are often assumed to be temporally consistent characteristics, as classically defined. But we theorize that mindfulness is
inherently a state, and thus is also variable within persons, apart
from the general tendency to be mindful. Recent research has
shown substantial variability across time in several phenomena
that clearly qualify as traits, including Big Five dispositions (Sheldon, Ryan, Rawsthorne, & Ilardi, 1997), interpersonal behavior
(Brown & Moskowitz, 1998), and attachment styles (LaGuardia,
Ryan, Couchman, & Deci, 2000), among others. Further, both
emotional states and autonomous behavior are known to vary over
time both within and between persons (Reis, Sheldon, Gable,
Roscoe, & Ryan, 2000; Sheldon, Ryan, & Reis, 1996). Thus, a
second major purpose of this study was to assess the degree of
within-person variability in mindfulness and relate it to withinperson variability in autonomy and emotional well-being.
As Reis et al. (2000) discussed, trait (between-person) and state
(within-person) effects are both conceptually and statistically independent. A trait effect relates stable individual differences to
average levels of an outcome across days. State effects identify
systematic fluctuations above and below (that is, controlling for)
Participants
Sample 1
Participants (Sample F, Table 1) were employed adults drawn from the
Rochester, New York area. From approximately 200 phone calls received
in response to local newspaper and poster advertisements, 83 participants
were enrolled after screening for four criteria: (a) They were at least 18
years old; (b) to help ensure homogeneity across participants in diurnal
activity patterns, participants were currently working at least 30 hr per
week in the daytime; (c) they were the primary spender of their households money; and (d) they spent money at least three times per week. The
latter two criteria were set for purposes of another study (Brown, Kasser,
Ryan, & Konow, 2002). Of the 83 individuals enrolled, data from 9 were
excluded7 because of failure to complete the experience-sampling phase
of the study, 1 because of extraordinarily long pager signal response times,
and 1 because of a large number of sampling forms completed incorrectly.
Thus, 74 participants (55% female) successfully completed the study,
ranging in age from 18 to 62 years (M 37.6). Each received both a
personalized research report and $50 for completing the study.
Sample 2
Students from an introductory psychology course at a small Northeastern
U.S. university participated for extra credit. Of 100 who began the study, 1
did not comply with questionnaire instructions, and 7 did not complete the
experience sampling portion, leaving 92 completers (74% female) who
ranged in age from 18 to 21 years (M 19.5).
Procedure
Participants in both samples completed demographic and all psychological measures during an experience-sampling training session. Trainings
were conducted on Mondays and Tuesdays, and all participants began
experience-sampled recordings on the immediately following Wednesday.
Keeping the starting day constant facilitates the analysis of day-of-week
effects. Participants were given a pager users guide and sampling form
instructions, along with contact information if questions arose.
Participants recorded their experiences for 21 (Sample 1) and 14 (Sample 2) consecutive days using identical forms bound into a small pad. Each
Measures
Trait Mindfulness
The MAAS was completed before the experience-sampling phase of the
study. The alphas were .86 and .87 for Samples 1 and 2, respectively.
Baseline Affect
To control for baseline emotional state, the 9-item Diener and Emmons
(1984) scale of affect valence (pleasantness unpleasantness) was completed before experience sampling. The emotion adjectives were happy,
worried/anxious, frustrated, pleased, angry/hostile, enjoyment/fun, unhappy, depressed/blue, and joyful. Using a 7-point scale from 1 (not at all)
to 7 (extremely), participants indicated their emotional state over the past
week. The alphas for pleasant and unpleasant affect were .86 and .78,
respectively, for Sample 1 and .90 and .85, respectively, for Sample 2.
837
autonomy index (RAI) was formed by weighting each statement and then
averaging the weighted statement values on each form (see Sheldon et al.,
1997). Scores on the RAI could range from 18 to 18, with higher scores
reflecting greater autonomy.
Emotional State
The same list of nine emotion adjectives on the baseline affect scale
(Diener & Emmons, 1984) was used to assess momentary affect valence.
Participants responded to the question, How did you feel emotionally
during this activity? using a 7-point scale anchored at 0 (not at all), 3
(somewhat), and 6 (extremely). Mean scores for both pleasant and unpleasant affect were computed for each momentary assessment. When collapsed
across time, the reliability of the scales was .94 and .94, respectively, for
Sample 1, and .93 and .92 for Sample 2.
Results
In both samples, compliance with procedures and timely completion of forms was good. In Sample 1, 4,260 (91.4%) of 4,662
possible forms (74 participants 63 signals) were returned. The
number of minutes from signal to form completion was M 11.04
(SD 26.57). Most (83.8%) were completed within 15 min of the
pager signal. A small percentage (3.3%) were completed after 60
min; data from these forms were excluded from analyses to avoid
retrospective biases. This left 4,118 data points for analysis (M per
participant 56, range 30 63). In Sample 2, 3,662 (94.8%)
of 3,864 possible forms (92 participants 42 signals) were completed and returned. The number of minutes from signal to form
completion was M 8.12 (SD 24.00). Again, most forms
(89.3%) were completed within 15 min. The 3% of forms completed after 60 min were excluded, leaving 3,559 data points in this
sample (M number per participant 39, range 24 42 forms).
Using aggregated sampling data, the MAAS was correlated with
day-to-day autonomy (Sample 1: r .27, p .05; Sample 2: r
.28, p .01). MAAS scores were unrelated to day-to-day pleasant
affect (Sample 1: r .08, ns; Sample 2: r .13, ns), but were
strongly and inversely related to unpleasant affect experiences
(Sample 1: r .49, p .0001; Sample 2: r .33, p .01).
As in other diary research (e.g., Brown & Moskowitz, 1997),
day-to-day pleasant and unpleasant affect scores were unrelated
(Sample 1: r .02, ns; Sample 2: r .12, ns).
Multilevel Models
A multilevel random coefficient modeling (MRCM) approach
was used (e.g., Bryk & Raudenbush, 1992; Kreft & deLeeuw,
1998). The MRCM approach is well suited to hierarchically nested
data structures in which a lower level unit of analysis (Level 1;
e.g., momentary reports) is nested within a higher level of analysis
(Level 2; e.g., persons). Among other advantages (see Reis et al.,
2000; J. E. Schwartz & Stone, 1998), such models are able to
incorporate tests of the three primary characteristics that commonly appear in time-serial data: linear trend over time, regular
cyclicity over intervals of time, and serial autocorrelation (West &
Hepworth, 1991). The MIXED procedure in SAS was used to
estimate all models (SAS Institute, 1992, 1997).
We first examined the relations between person-level trait mindfulness and momentary-level autonomy and pleasant and unpleasant affect. Next, we examined the relation between person-level
838
Table 7
Predictions of Day-to-Day Autonomy and Affect From Mindful
Attention Awareness ScaleMeasured Mindfulness,
Demographics, and Time Serial Variables in Both Adult
Community Members (Sample 1) and College Students
(Sample 2) (Study 4)
Estimate
Predictor
Autonomy
Pleasant affect
Unpleasant affect
Sample 1 (N 74)
Gender
Age
Time of day
Day of study
Weekly cyclicity
Autocorrelation
Trait mindfulness
0.23
0.09**
1.21****
0.06***
0.59***
0.99****
1.63**
0.25
0.02
0.19****
0.00
0.24****
0.59
0.14
0.33**
0.00
0.07****
0.00
0.06***
0.95****
0.47****
Sample 2 (N 92)
Gender
Age
Time of day
Day of study
Weekly cyclicity
Autocorrelation
Trait mindfulness
0.97
0.67****
0.03
0.69****
0.04
1.12**
0.09
0.26****
0.02**
0.22****
0.62
0.16
0.01
0.01
0.01*
0.14****
0.14
0.26**
4
The fit of a sine function was also examined, but across analyses, a
cosine function consistently provided a better fit. We tested for septurnal,
or 7-day weekly, cyclicity because this is the most common interval over
which cyclical effects have been reported in both pleasant and unpleasant
affect (e.g., Brown, 1998; Larsen & Kasimatis, 1991) and autonomy (Reis
et al., 2000). Cyclicity is most commonly tested with either a dummy
variable approach or the trigonometric approach used here (Bowerman &
OConnell, 1993). Because we were not interested in specific day-of-week
effects, we chose the latter approach, which allows for fewer terms in
model equations.
5
A continuous time variable was created, in which the day and time that
each record form was completed was used to create a continuous time
variable that started at Day 1, Record 1, and ran linearly upward to day n,
record n. For each sampling record, the number of minutes after the pager
signal that the form was completed was subtracted from the actual time of
record completion to derive the actual time referred to by each records
data. Incorporation of time into SAS PROC MIXED to test for autocorrelation was discussed by J. E. Schwartz and Stone (1998).
between trait and state scores was also measured as the amount of
between-person variance in mean state scores accounted for by
trait score. The covariance between these two measures was .19;
this translates into a correlation of .44. These results suggest that
the subset of items from the MAAS used to measure state mindfulness adequately capture the construct.
Table 8 shows results of analyses using both trait and state
mindfulness to predict autonomy and emotions while controlling
for gender and the time series variables. To test these relations, a
term representing the effect of state mindfulness was added to the
preexisting model. The state measure predicted autonomy, pleasant affect, and unpleasant affect: When individuals were more
attentive to the activities they were engaged in, they were also
more likely to experience those activities as autonomous
(t 10.71, p .0001) and to evidence higher levels of pleasant
emotion and lower levels of unpleasant emotion (t 7.93 and t
8.72, respectively, both ps .0001). A comparison of the
covariance parameter estimates between these models and models
including only the demographic, time series, and trait MAAS
predictors (presented earlier) showed that state mindfulness
uniquely accounted for 16% of the explainable between-subjects
variation in autonomy, 14% of the variation in pleasant affect, and
16% of the between-subjects variation in unpleasant affect. Notably, the effect of trait MAAS in predicting more autonomous
activity and less unpleasant affect remained significant in these
models (t 2.56, p .01, and t 3.39, p .001, respectively).
Similar results were found using affect frequency scores. The
interaction between trait and state mindfulness was also tested in
these models. This term was marginally significant in the prediction of pleasant affect ( p .10) and nonsignificant in the prediction of autonomy and unpleasant affect. Thus, the covariation
between state mindfulness and both autonomous activity and affective experience was not limited to those with higher trait mindfulness. Finally, analyses were conducted in which baseline affect
scores were controlled for in the prediction of the three experiencesampled variables. In eight of the nine models presented here (see
Tables 7 and 8), the mindfulness predictors (trait and state) remained significant (all ps .05). In the prediction of autonomy in
Sample 1, trait mindfulness became marginally significant ( p
.06).
Table 8
Predictions of Day-to-Day Autonomy and Affect From Trait and
State Mindfulness, Gender, and Time Serial Variables
(Sample 2, Study 4, N 92)
Estimate
Predictor
Autonomy
Pleasant affect
Unpleasant affect
Gender
Time of day
Day of study
Weekly cyclicity
Autocorrelation
Trait mindfulness
State mindfulness
0.98
0.53****
0.03
0.51***
0.02
1.08**
1.59****
0.06
0.23****
0.02**
0.19****
0.71**
0.10
0.25****
0.03
0.02
0.01*
0.11****
0.13
0.26**
0.22****
839
Discussion
840
Method
Participants
Patients were eligible if they met the following inclusion criteria: (a)
age 18 or older; (b) a diagnosis of Stage 0, I, or II breast or early-stage
(localized) prostate cancer at any time in the past; and (c) a minimum of 3
months since cancer surgery (e.g., mastectomy, prostatectomy). Breast and
prostate cancers have similarly positive prognoses in the early stages, and
offer similar, though often differently expressed, degrees of physical and
psychological challenge (DeFlorio & Masie, 1995; Keller & Henrich,
1999). Breast and prostate cancers are also the most currently prevalent
Table 9
Selected Patient Characteristics (Study 5)
Variable
Gender (% female)
Age (years)
Married
Education (years)
Work hours/week
Cancer stage
I
II
Time since diagnosis
(years)
Quality of lifephysical
(EORTC QLQ)
Functioning
Symptoms
Fatigue
Pain
Mindfulness (MAAS)
Mood disturbance (POMS)
Stress symptoms (SOSI)
SD
55.31
10.02
Range
78.0
36.92, 75.89
85.4
14.63
27.08
2.89
11.55
10.00, 24.00
3.00, 51.00
35.0
65.0
2.05
2.24
0.39, 10.00
184.88
19.89
120.00, 200.00
34.42
23.33
4.27
13.88
82.17
21.20
24.38
0.64
27.92
48.22
0, 100.00
0, 100.00
2.60, 5.36
30.00, 85.00
17.00, 182.00
Note. EORTC QLQ European Organization for Research and Treatment of Cancer Quality of Life Questionnaire; MAAS Mindful Attention Awareness Scale; POMS Profile of Mood States; SOSI Symptoms of Stress Inventory.
Intervention
A detailed description of the mindfulness training program used in this
study has been provided by Speca et al. (2000). The program was modeled
on the work of Kabat-Zinn and colleagues (e.g., Kabat-Zinn, 1990) and
was adapted and standardized to a cancer treatment context. The intervention consisted of 8 weekly 90-min group sessions held at the hospital and
one 3-hr retreat that took place between Weeks 6 and 7. Didactic, inductive, and experiential modes of learning were used. Training consisted of
three primary components: (a) theoretical material related to relaxation,
mindfulness, and bodymind connections; (b) experiential practice of
mindfulness both during group meetings and at home on a daily basis; and
(c) group process focused on problem solving related to impediments to
effective practice, day-to-day applications of mindfulness, and supportive
interaction. In addition, a booklet was provided containing information
pertinent to each weeks instruction, as well as bibliographic resources and
audiotapes with relaxation and guided mindfulness exercises.
841
Results
As Table 9 shows, EORTC QLQ scores at the study outset
indicated that, on average, participants had a high level of daily
functioning and low to moderate levels of fatigue and pain. Scores
on the MAAS were somewhat higher than those observed in the
other adult samples reported in this article. Average scores on the
SOSI and POMS were comparable to that seen in other cancer
patient samples, including those with early stage breast and prostate cancers (e.g., Carlson, Ottenbreit, St. Pierre, & Bultz, 2001;
Speca et al., 2000). Most participants were well past the early
postdiagnostic phase, when emotional disturbance is generally
more pronounced (e.g., Sellick & Crooks, 1999).
Paired t tests were conducted on Time 1 to Time 2 changes in
MAAS, POMS, and SOSI scores. SOSI scores showed a significant drop over the intervention period, t(40) 3.27, p .01.
Neither samplewide MAAS nor POMS scores showed a significant change. Notable for both the mood and stress variables was
the high standard deviation and range of the scores (see Table 9).
Similar degrees of variability were observed in the Time 2 scores
and the scores representing change over time. Examination of
change in outcomes showed that POMS scores increased up to
50% and dropped as much as 30% across participants. SOSI scores
increased up to 15% and decreased as much as 30%. Thus, in both
variables there was substantial variability to explain.
In testing the relations between mindfulness and the outcomes,
we controlled for the effects of demographic, medical, and physical health variables. Past research has shown that variables such as
time since diagnosis (Velikova et al., 2001) and symptoms related
to cancer (Nordin, Berglund, Glimelius, & Sjoden, 2001) can
impact psychological state. Accordingly, multiple regression analyses were performed using data from Time 1, Time 2, and the
change across time, in which the two outcome variablestotal
mood disturbance and total stresswere regressed on MAAS
scores while controlling for any demographic, medical, or health
variables that showed significant relations to these outcomes in
preliminary analyses.
None of the demographic variables except gender were significantly related to the psychological outcomes. Specifically, women
showed higher stress scores than men at Time 1, t(39) 2.16, p
.05. However, in a preliminary regression analysis with other
predictors in the equation, gender did not significantly predict
Time 1 stress. Thus, to simplify the presentation of the results, this
variable was not further considered.
Table 10 shows the intercorrelations of the medical, physical
health, MAAS, and outcome variables at Time 1 and Time 2. Stage
6
In this study, Cronbachs alpha values for all scales are given for the
preintervention administration.
842
Table 10
Intercorrelation of Medical, Physical, and Psychological Characteristics (Study 5; N 41)
Characteristic
1.
2.
3.
4.
5.
6.
7.
8.
Stage
Time since diagnosis
Physical functioning
Fatigue
Pain
Mindfulness
Mood disturbance
Stress symptoms
.18
.10
.18
.05
.06
.05
.06
.18
.48***
.35*
.20
.03
.08
.01
.06
.25
.41**
.51***
.25
.12
.15
4
.02
.09
.24
.54***
.18
.54***
.60****
5
.10
.20
.26
.25
.16
.46**
.51***
.15
.03
.23
.44**
.10
.43**
.46**
.08
.04
.11
.51****
.43***
.61****
.76****
.22
.07
.07
.58****
.53***
.51***
.75****
Note. Values below the diagonal are for Time 1; values above the diagonal are for Time 2. Correlations with cancer stage were based on n 40;
determination of stage could not be made for one patient.
* p .05. ** p .01. *** p .001. **** p .0001.
Table 11
Multiple Regression of Time 1, Time 2, and Pre- to
Postintervention Residual Change in Mood Disturbance and
Stress on Fatigue, Pain, and MAAS Scores (Study 5)
Predictor
Time 1
Time 2
Change
Mood disturbance
Fatigue
B
SE
Pain
B
SE
MAAS
B
SE
.48
.19
.37*
.35
.29
.16
.23
.14
.23
.24
.17
.21
.39
.15
.31
.18
.14
.18
27.45
6.77
.51***
.38
.14
.38**
14.43
5.52
.33**
Stress
Fatigue
B
SE
Pain
B
SE
MAAS
B
SE
.93
.31
.41**
.76
.36
.28*
.18
.14
.18
.45
.27
.23
.60
.19
.38**
.24
.14
.24
26.66
8.76
.35**
23.62
8.53
.35**
.39
.14
.39**
Discussion
The results of this clinical intervention study showed that higher
levels of mindfulness were related to lower levels of both mood
disturbance and stress before and after the MBSR intervention.
Increases in mindfulness over the course of the intervention predicted decreases in these two indicators of psychological disturbance. These relations between the MAAS and the outcomes were
found after controlling for the influences of fatigue and pain. Such
results suggest that the scale can be applied to the study of
well-being issues in cancer populations.
It is worth noting that average baseline MAAS scores in this
patient sample were higher than in other populations tested. Why
these scores were elevated at study entry is an open question, but
it would be of interest for future research to determine whether the
experience of cancer acts to heighten attention to present-moment
experiences and concerns. Evidence has indicated that cancer
patients, faced with a life-threatening illness, often reconsider the
ways in which they have been living their lives, and many choose
to refocus their priorities on existential issues such as personal
growth and mindful living (Brennan, 2001).
This study did not include a randomized control group, so the
question of the differential effect of training on mindfulness scores
between those receiving treatment and those not receiving treatment cannot be answered. However, the present study was not
designed to test the efficacy of intervention per se but rather to
examine whether mindfulness and changes in it were related to
well-being outcomes and changes in them. That said, future research could use the MAAS in a randomized-trials context to test
its sensitivity to treatment versus control condition effects. Scores
on the MAAS did not change significantly over the 8 weeks of the
study, and longer time spans may be necessary to detect changes
in this disposition. In this regard, Study 2, presented above,
showed that mindfulness practice history (measured in years) was
positively associated with MAAS scores.
Finally, the present study focused on a relatively small sample
with early-stage prostate and breast cancer. Future research addressing the utility of the MAAS would do well to study larger
samples with advanced cancers, among which psychological distress could be higher. The fact that distress is common in patients
with a wide variety of acute and chronic medical conditions
suggests that the MAAS may also have value in research with
other clinical populations.
GENERAL DISCUSSION
The studies presented in this article were designed to examine
the nature of mindfulness and its relation to psychological wellbeing. Initial studies provided evidence for the psychometric adequacy and validity of the Mindful Attention Awareness Scale
(MAAS) through exploratory factor analysis and CFA. The MAAS
was shown to be a reliable and valid instrument for use in both
college student and general adult populations. The MAAS was
shown to discriminate between groups expected to differ in degree
of mindfulness, and laboratory research provided evidence that
843
844
contents directly connoting well-being or outcomes closely connected to it (e.g., patience, acceptance). Although the scale was
shown to predict a variety of indicators of psychological wellbeing, it does not tap well-being itself and therefore is not confounded with it. In fact, mindfulness, as perceptual presence, is not
about achieving well-being; it is purposeless in this sense. As
Epstein (2001) argued, an assigned or mandated purpose (to feel
good, to be patient, to move past anger, etc.) would only limit an
individuals awareness. Such purposive states do not represent
being present to what is. Mindfulness, as we conceive it, is present
awareness and attention per sethe ground in which the minds
contents manifest themselves (Deikman, 1996, p. 351), whatever
those contents might be at the moment.
Conclusion
The intent of this program of studies was to demonstrate the role
of mindfulness, measured in both inter- and intraindividual terms,
in psychological well-being. Interest in the underpinnings and
enhancement of well-being has been burgeoning in recent years
(e.g., Ryan & Deci, 2001; Seligman & Csikszentmihalyi, 2000).
Our hope is that the present research nourishes this trend, because
it indicates that mindfulness is a reliably and validly measured
characteristic that has a significant role to play in a variety of
aspects of mental health. Further research into this attribute may
open up significant new avenues for well-being enhancement.
References
Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A.,
Duez, N. J., et al. (1993). The European Organization for Research and
Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in
international clinical trials in oncology. Journal of the National Cancer
Institute, 85, 365376.
Aiken, L. A. (1985). Three coefficients for analyzing the reliability and
validity of ratings. Educational and Psychological Measurement, 45,
131142.
Aiken, L. A. (1996). Rating scales and checklists: Evaluating behavior,
personality, and attitudes. New York: Wiley.
Aiken, L. S., & West, S. G. (1991). Multiple regression: Testing and
interpreting interactions. Newbury Park, CA: Sage.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Arbuckle, J. L., & Wothke, W. (1999). Amos 4.0 users guide. Chicago:
SmallWaters Corporation.
Astin, J. A. (1997). Stress reduction through mindfulness meditation.
Psychotherapy and Psychosomatics, 66, 97106.
Averill, J. R. (1992). The structural bases of emotional behavior: A
metatheoretical analysis. Review of Personality and Social Psychology,
13, 124.
Bargh, J. A. (1997). Automaticity in social psychology. In E. T. Higgins &
A. W. Kruglanski (Eds.), Social psychology: Handbook of basic principles (pp. 109 183). New York: Guilford Press.
Bargh, J. A., & Ferguson, M. J. (2000). Beyond behaviorism: On the
automaticity of higher mental processes. Psychological Review, 126,
925945.
Basilevsky, A. (1994) Statistical factor analysis and related methods:
Theory and applications. New York: Wiley.
Basmajian, J. V. (1989). Biofeedback: Principles and practice for clinicians (3rd ed.). Baltimore: William & Wilkins.
Baumeister, R. F. (1991). Escaping the self: Alcoholism, spirituality,
masochism, and other flights from the burden of selfhood. New York:
Basic Books.
Baumeister, R. F. (1999). The nature and structure of the self: An overview. In R. F. Baumeister (Ed.), The self in social psychology (pp. 120).
Philadelphia: Psychology Press.
Baumeister, R. F., Heatherton, T. F., & Tice, D. M. (1994). Losing control:
How and why people fail at self-regulation. San Diego, CA: Academic
Press.
Beckham, E. E., & Leber, W. (Eds.). (1985). Handbook of depression:
Treatment, assessment, and research. Homewood, IL: Dorsey.
845
consciousness: Self-report, peer-report, and behavioral correlates. European Journal of Personality, 12, 411 431.
Crowne, D. P., & Marlowe, D. (1960). A new scale of social desirability
independent of psychopathology. Journal of Consulting Psychology, 24,
349 354.
Csikszentmihalyi, M. (1990). Flow: The psychology of optimal experience.
New York: HarperCollins.
Cudeck, R. (2000). Exploratory factor analysis. In H. E. A. Tinsley & S. D.
Brown (Eds.), Handbook of applied multivariate statistics and mathematical modeling (pp. 266 296). San Diego, CA: Academic Press.
Cunningham, W. A., Preacher, K. J., & Banaji, M. R. (2001). Implicit
attitude measures: Consistency, stability and convergent validity. Psychological Science, 12, 163170.
Davis, M. H., & Franzoi, S. L. (1999). Self-awareness and selfconsciousness. In V. J. Derlega, B. A. Winstead, & W. H. Jones (Eds.),
Personality: Contemporary theory and research (2nd ed., pp. 307338).
Chicago: Nelson-Hall.
Dawis, R. V. (2000). Scale construction and psychometric considerations.
In H. E. A. Tinsley & S. D. Brown (Eds.), Handbook of applied
multivariate statistics and mathematical modeling (pp. 6594). San
Diego, CA: Academic Press.
Deci, E. L., & Ryan, R. M. (1980). Self-determination theory: When mind
mediates behavior. The Journal of Mind and Behavior, 1, 33 43.
Deci, E. L., & Ryan, R. M. (1985). Intrinsic motivation and selfdetermination in human behavior. New York: Plenum Press.
DeFlorio, M., & Masie, M. J. (1995). Review of depression in cancer:
Gender differences. Depression, 3, 66 80.
DeHart, T., & Pelham, B. W. (2002, February). Are explicit and implicit
self-esteem always uncorrelated? Paper presented at the 3rd annual
meeting of the Society for Personality and Social Psychology, Savannah,
GA.
Deikman, A. J. (1982). The observing self. Boston: Beacon Press.
Deikman, A. J. (1996). I awareness. Journal of Consciousness Studies,
3, 350 356.
Derogatis, L. R., Lipman, R. S., Rickels, K., Uhlenhuth, E. H., & Covi, L.
(1974). The Hopkins Symptom Checklist (HSCL): A self-report symptom inventory. Behavioral Science, 19, 115.
Diener, E., & Emmons, R. A. (1984). The independence of positive and
negative affect. Journal of Personality and Social Psychology, 47,
11051117.
Diener, E., Sandvik, E., Pavot, W., & Gallagher, D. (1991). Response
artifacts in the measurement of subjective well-being. Social Indicators
Research, 24, 3556.
Diener, E., Suh, E. M., Lucas, R. E., & Smith, H. L. (1999). Subjective
well-being: Three decades of progress. Psychological Bulletin, 2, 276
302.
Duval, S., & Wicklund, R. A. (1972). A theory of objective selfconsciousness. New York: Academic Press.
Epstein, R. M. (2001). Just being. Western Journal of Medicine, 174,
63 65.
Farnham, S. D., Greenwald, A. G., & Banaji, M. R. (1998). Implicit
self-esteem. In D. Abrams & M. A. Hogg (Eds.), Social cognition and
social identity (pp. 230 248). London: Blackwell.
Fejfar, M. C., & Hoyle, R. H. (2000). Effect of private self-awareness on
negative affect and self-referent attribution: A quantitative review. Personality and Social Psychology Review, 4, 132142.
Fenigstein, A., Scheier, M. F., & Buss, A. H. (1975). Public and private
self-consciousness: Assessment and theory. Journal of Consulting and
Clinical Psychology, 43, 522527.
Fisher, R. A. (1928). Statistical methods for research workers (2nd ed.).
London: Oliver & Boyd.
Flory, J. D., Raikkonen, K., Matthews, K. A., & Owens, J. F. (2000).
Self-focused attention and mood during everyday social interactions.
Personality and Social Psychology Bulletin, 26, 875 883.
846
Individual differences in the occurrence, duration, and emotional concomitants of minor daily illnesses. Journal of Personality, 59, 387 423.
LeBel, J. L., & Dube , L. (2001, June). The impact of sensory knowledge
and attentional focus on pleasure and on behavioral responses to
hedonic stimuli. Paper presented at the 13th annual American Psychological Society Convention, Toronto, Ontario, Canada.
Leckie, M. S., & Thompson, E. (1979). Symptoms of Stress Inventory.
Seattle: University of Washington.
Lefranc ois, R., Leclerc, G., Dube , M., He bert, R., & Gaulin, P. (1997). The
development and validation of a self-report measure of selfactualization. Social Behavior and Personality, 25, 353365.
Levesque, C. S., & Brown, K. W. (2002). Mindful awareness as a moderator of the relationship between implicit and explicit motives. Manuscript in preparation.
Linehan, M. M, Cochran, B. N., & Kehrer, C. A. (2001). Dialectical
behavior therapy for borderline personality disorder. In D. H. Barlow
(Ed.), Clinical handbook of psychological disorders: A step-by-step
treatment manual (3rd ed., pp. 470 522). New York: Guilford Press.
Litt, M. D., Cooney, N. L., & Morse, P. (1998). Ecological momentary
assessment (EMA) with treated alcoholics: Methodological problems
and potential solutions. Health Psychology, 17, 48 52.
Maddux, J. E. (1997). Habit, health and happiness. Journal of Sport and
Exercise Psychology, 19, 331346.
Martin, J. R. (1997). Mindfulness: A proposed common factor. Journal of
Psychotherapy Integration, 7, 291312.
Mayer, J. D. (2000). Spiritual intelligence or spiritual consciousness. The
International Journal for the Psychology of Religion, 10, 4756.
Mayer, J. D., Chabot, H. F., & Carlsmith, K. (1997). Conation, affect, and
cognition in personality. In G. Matthews (Ed.), Cognitive science perspectives on personality and emotion (pp. 31 63). Amsterdam: Elsevier.
McIntosh, W. D. (1997). East meets West: Parallels between Zen Buddhism and social psychology. International Journal for the Psychology
of Religion, 7, 3752.
McNair, D. M., Lorr, M., & Droppleman, L. F. (1971). Profile of mood
states. San Diego, CA: Educational and Industrial Testing Service.
National Cancer Institute of Canada. (2001). Canadian cancer statistics
2001. Retrieved April 20, 2002, from http://66.59.133.166/stats/tables/
table.htm
Nolen-Hoeksema, S., Morrow, J., & Fredrickson, B. L. (1993). Response
styles and the duration of episodes of depressed mood. Journal of
Abnormal Psychology, 102, 20 28.
Nordin, K., Berglund, G., Glimelius, B., & Sjoden, P. O. (2001). Predicting
anxiety and depression among cancer patients: A clinical model. European Journal of Cancer, 37, 376 384.
Nyanaponika Thera. (1972). The power of mindfulness. San Francisco, CA:
Unity Press.
OBrien, E. J., & Epstein, S. (1988). MSEI: The Multidimensional SelfEsteem Inventory: Professional manual. Odessa, FL: Psychological Assessment Resources.
Packer, T. (2002). The wonder of presence. Boston: Shambhala.
Pavot, W., Diener, E., & Suh, E. (1998). The Temporal Satisfaction With
Life Scale. Journal of Personality Assessment, 70, 340 354.
Perls, F. (1973). The gestalt approach and eye witness to therapy. New
York: Bantam Books.
Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for
research in the general population. Applied Psychological Measurement,
1, 385 401.
Reibel, D. K., Greeson, J. M., Brainard, G. C., & Rosenzweig, S. (2001).
Mindfulness-based stress reduction and health-related quality of life in a
heterogeneous patient population. General Hospital Psychiatry, 23,
183192.
Reis, H. T., Sheldon, K. M., Gable, S. L., Roscoe, J., & Ryan, R. M. (2000)
Daily well-being: The role of autonomy, competence, and relatedness.
Personality and Social Psychology Bulletin, 26, 419 435.
847
848
Wild, K. P. (1999). Time sampling procedures with Random 2.1: Introduction and users guide. Neubiberg, Germany: University of the Armed
Forces, Munich.
Williams, K. A., Kolar, M. M., Reger, B. E., & Pearson, J. C. (2001).
Evaluation of a wellness-based mindfulness stress reduction intervention: A controlled trial. American Journal of Health Promotion, 15,
422 432.
Wilson, T. D., Lindsey, S., & Schooler, T. Y. (2000). A model of dual
attitudes. Psychological Review, 107, 101126.