Emily L. B. Lykins

Construct Validity of the Five Facet Mindfulness Questionnaire in Meditating and Nonmeditating Samples

Previous research on assessment of mindfulness by self-report suggests that it may include five component skills: observing, describing, acting with awareness, nonjudging of inner experience, and nonreactivity to inner experience. These elements of mindfulness can be measured with the Five Facet Mindfulness Questionnaire (FFMQ). The authors investigated several aspects of the construct validity of the FFMQ in experienced meditators and nonmeditating comparison groups. Consistent with predictions, most mindfulness facets were significantly related to meditation experience and to psychological symptoms and well-being. As expected, relationships between the observing facet and psychological adjustment varied with meditation experience. Regression and mediation analyses showed that several of the facets contributed independently to the prediction of well-being and significantly mediated the relationship between meditation experience and well-being. Findings support the construct validity of the FFMQ in a combination of samples not previously investigated.

An empirical study of the mechanisms of mindfulness in a mindfulness-based stress reduction program.

S. L. Shapiro and colleagues (2006) have described a testable theory of the mechanisms of mindfulness and how it affects positive change. They describe a model in which mindfulness training leads to a fundamental change in relationship to experience (reperceiving), which leads to changes in self-regulation, values clarification, cognitive and behavioral flexibility, and exposure. These four variables, in turn, result in salutogenic outcomes. Analyses of responses from participants in a mindfulness-based stress-reduction program did not support the mediating effect of changes in reperceiving on the relationship of mindfulness with those four variables. However, when mindfulness and reperceiving scores were combined, partial support was found for the mediating effect of the four variables on measures of psychological distress. Issues arising in attempts to test the proposed theory are discussed, including the description of the model variables and the challenges to their assessment.

Psychological Functioning in a Sample of Long-Term Practitioners of Mindfulness Meditation

Although mindfulness meditation traditionally is viewed as a lifelong practice, much current knowledge about its effects is based on short-term practitioners who have participated in mindfulness-based treatment. In the current study, long-term meditators and demographically similar nonmeditators completed self-report measures of constructs expected to be related to the practice of mindfulness meditation. Extent of meditation experience was correlated in the expected directions with levels of mindfulness and with many other variables. Mean differences between meditators and nonmeditators were significant in most cases. Mediation analyses were consistent with the hypothesis that practicing meditation is associated with increased mindfulness in daily life, which is related to decreased rumination, decreased fear of emotion, and increased behavioral self-regulation. These mechanisms appear partially responsible for the relationships between mindfulness skills and psychological adjustment. Overall, the current study suggests that the long-term practice of mindfulness meditation may cultivate mindfulness skills and promote adaptive functioning.

Psychological Health in Cancer Survivors

OBJECTIVES The prevalence of both negative (distress) and positive responses (growth, well-being) to the cancer experience is examined and difficulties in establishing the prevalence of these responses discussed. A conceptual framework for understanding factors associated with psychological health in cancer survivors is presented. Finally, strategies for promoting psychological health in cancer survivors are examined. DATA SOURCES Review of the literature. CONCLUSION Psychological health in cancer survivors is defined by the presence or absence of distress as well as the presence or absence of positive well-being and psychological growth. Furthermore, psychological health in cancer survivors is determined by the balance between two classes of factors: the stress and burden posed by the cancer experience and the resources available for coping with this stress and burden. IMPLICATIONS FOR NURSING PRACTICE In general, promotion of psychological health is based on the prevention or treatment of distress as well as the encouragement of growth and well-being. Periodic screening for psychological distress across the cancer trajectory is critical to appropriate management of distress.

Assessment of Mindfulness

Mindfulness-based interventions have been developed for a wide range of problems, disorders, and populations and are increasingly available in a variety of settings. Empirically supported interventions that are based on or incorporate mindfulness training include acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 1999), dialectical behavior therapy (DBT; Linehan, 1993), mindfulness-based cognitive therapy (MBCT; Segal, Williams, & Teasdale, 2002), and mindfulness-based stress reduction (MBSR; Kabat-Zinn, 1982, 1990). Variations on these approaches, including integration of mindfulness training into individual psychotherapy from diverse perspectives, also have been described (Germer, Siegel, & Fulton, 2005). As the empirical evidence for the efficacy of these interventions continues to grow, the importance of investigating the mechanisms or processes by which they lead to beneficial outcomes is increasingly recognized (Bishop et al., 2004; Shapiro, Carlson, Astin, & Freedman, 2006). Addressing this question requires psychometrically sound measures of mindfulness (Baer, Smith, & Allen, 2004; Brown & Ryan, 2004; Dimidjian & Linehan, 2003). Without such measures it is impossible to determine whether the practice of mindfulness leads to increased levels of mindfulness and whether these changes are responsible for the improvements in psychological functioning that are often observed. The development of tools for assessing mindfulness requires clarity about its definition. According to Clark and Watson (1995), a sound measure must be based on “a precise and detailed conception of the target construct” (p. 310). Although the current literature includes many descriptions of mindfulness, several authors have noted that mindfulness is a subtle and somewhat elusive construct and that defining it in concrete terms is difficult (Block-Lerner, Salters-Pednault, & Tull, 2005; Brown & Ryan, 2004). Compounding the difficulty is the necessity of understanding closely related constructs such as acceptance and decentering. These are sometimes described as components or elements of mindfulness (Block-Lerner et al., 2005; Dimidjian & Linehan, 2003), whereas others argue that they are better understood as outcomes of practicing mindfulness (Bishop et al., 2004) or as skills that aid in fostering mindfulness (Brown, Ryan, & Creswell, in press). This chapter will provide an overview of current definitions and descriptions

Goal Shifts Following Reminders of Mortality: Reconciling Posttraumatic Growth and Terror Management Theory

Research findings within posttraumatic growth (PTG) and terror management theory (TMT) currently appear contradictory. Following confrontations with mortality, PTG research demonstrates intrinsic goal shifts, whereas TMT suggests extrinsic shifts. The current studies examine factors contributing to these inconsistent results. Study 1 demonstrates that perceived death threat is associated with PTG effects. Study 2 illuminates the importance of duration of death processing. Study 3 demonstrates that existing goal values and duration and type of processing all interact in determining ultimate goal structure, with a match between level of goals and processing producing the most psychologically advantageous outcomes. Although previous research suggests that short-term confrontations with death may lead to defensiveness, the current studies suggest that encountering death over a longer period or in a manner consistent with goal structure may lead individuals to transcend defensiveness and maintain intrinsic goals or become more intrinsically oriented.

Differential Item Functioning on the Five Facet Mindfulness Questionnaire Is Minimal in Demographically Matched Meditators and Nonmeditators

A recent study of the Five Facet Mindfulness Questionnaire reported high levels of differential item functioning (DIF) for 18 of its 39 items in meditating and nonmeditating samples that were not demographically matched. In particular, meditators were more likely to endorse positively worded items whereas nonmeditators were more likely to deny negatively worded (reverse-scored) items. The present study replicated these analyses in demographically matched samples of meditators and nonmeditators (n = 115 each) and found that evidence for DIF was minimal. There was little or no evidence for differential relationships between positively and negatively worded items for meditators and nonmeditators. Findings suggest that DIF based on items’ scoring direction is not problematic when the Five Facet Mindfulness Questionnaire is used to compare demographically similar meditators and nonmeditators.

Beliefs about cancer causation and prevention as a function of personal and family history of cancer: a national, population-based study.

Objective: Research suggests individuals possess multifaceted cognitive representations of various diseases. These illness representations consist of various beliefs, including causal attributions for the disease, and are believed to motivate, guide, and shape health‐related behavior. As little research has examined factors associated with beliefs about cancer causation, this study examined the relationship between personal and family history of cancer and beliefs about the causes and prevention of malignant disease.

Differences in cancer information-seeking behavior, preferences, and awareness between cancer survivors and healthy controls: a national, population-based survey.

Background. No research has examined how cancer diagnosis and treatment might alter information source preferences or opinions. Methods. We examined data from 719 cancer survivors (CS group) and 2012 matched healthy controls (NCC group) regarding cancer-related information-seeking behavior, preferences, and awareness from the population-based 2003 Health Information National Trends Survey. Results. The CS group reported greater consumption of cancer-related information, but the CS and NCC groups did not differ in information source use or preferences. The CS group was more confident of their ability to get cancer information, reported more trust in health care professionals and television as cancer information sources, but evaluated their recent cancer information-seeking experiences more negatively than the NCC group. Awareness of cancer information resources was surprisingly low in both the CS and NCC groups. Conclusions. Cancer diagnosis and treatment subtly alters cancer information-seeking preferences and experience. However, awareness and use of cancer information resources was relatively low regardless of personal history of cancer.

Validity of Self-Reports of Return for Routine Repeat Screening in an Ovarian Cancer Screening Program

Cancer screening research relies on reliable and valid measurement of cancer screening behavior. Self-reports of screening constitute a cost-effective approach to measuring screening behavior; however, demonstration of suitable validity of these self-reports is critical. We evaluated the validity of self-report of return for repeat, routine, annual transvaginal sonography (TVS) screening for ovarian cancer. Participants (n = 535) in a university-based ovarian cancer screening program for asymptomatic, average risk women completed a telephone interview 18 months following an initial, baseline TVS screening test. Self-reports of return for a repeat, routine ovarian cancer screening test since baseline were obtained and compared with objective records of repeat screening from the screening program database. Overall agreement of self-reports and objective records of ovarian cancer screening was 97.57% (κ = 0.94). Sensitivity was 0.98, specificity was 0.96, positive predictive value was 0.98, and negative predictive value was 0.96. The month of last screening was accurately identified by 80% of participants. It was concluded the validity of self-reports of TVS screening for ovarian cancer is very high and may even exceed the validity of self-reports of participation in breast, cervical, and colorectal cancer screening over similar recall periods. Consequently, self-reports of TVS screening may serve as a cost-effective substitute for more objective methods of assessing TVS screening behavior. (Cancer Epidemiol Biomarkers Prev 2007;16(3):490–3)