Portuguese validation of the Cognitive and Affective Mindfulness Scale-Revised and the Philadelphia Mindfulness Scale

Abstract

Objectives

The purpose of this study was the validation of two instruments: Cognitive and Affective Mindfulness Scale-Revised (CAMS-R) and the Philadelphia Mindfulness Scale (PHLMS) in a non-clinical Portuguese sample.

Methods

Participants were 168 undergraduates (123 women), aged 18–50 years old (M = 22; SD = 5.94). Participants answered the following instruments: Cognitive and Affective Mindfulness Scale-Revised (CAMS-R); Philadelphia Mindfulness Scale (PHLMS); Portuguese version of the Toronto Alexithymia Scale; and Separation/Individuation Process Inventory.

Results

The factorial analysis for the CAMS-R yielded a 9-items one factor with adequate internal consistency (.76). For PHLMS, the results showed a clear two-factor structure with exactly the same structure as the original version, and with adequate internal consistencies: awareness (.77) and acceptance (.85). The quality of mindfulness (CAMS-R) was positively correlated with awareness and acceptance (PHLMS), and negatively with self-differentiation (more problematic) and alexithymia.

Conclusion

Both instruments seem to present adequate psychometric properties to be used in the Portuguese population.

Resumen

Objetivos

El presente estudio evalúa la validación de dos instrumentos: la Cognitive and Affective Mindfulness Scale-Revised (CAMS-R) y la Philadelphia Mindfulness Scale (PHLMS) en una muestra portuguesa no clínica.

Métodos

Participaron 168 estudiantes (123 mujeres), con una edad de entre 18 y 50 años (M = 22; DE = 5,94). Los participantes respondieron a los siguientes instrumentos: CAMS-R; PHLMS; versión en portugués de la Escala de Alexitimia de Toronto, e Inventario del Proceso de Separación/Individuación.

Resultados

El análisis factorial de la CAMS-R produjo un factor de 9 artículos con una coherencia interna adecuada (0,76). Los resultados de la PHLMS mostraron una clara estructura de dos factores exactamente con la misma estructura que la versión original y con coherencias internas adecuadas: conciencia (0,77) y aceptación (0,85). La calidad de la conciencia plena o mindfulness (CAMS-R) se correlacionó positivamente con la conciencia y la aceptación (PHLMS), y negativamente con la autodiferenciación (más problemática) y la alexitimia.

Conclusión

Parece que ambos instrumentos presentan propiedades psicométricas adecuadas para ser utilizados en la población portuguesa.

Introduction

In the last decade, there has been a growing interest in the study of mindfulness, moving from a Buddhist approach to a psychotherapy technique (Davis & Hayes, 2011). Mindfulness can be defined as the ability to be focused and aware of the present moment, without any judgment or avoidance (Brown and Ryan, 2003, Brown et al., 2007, Kabat-Zinn, 2005, Lykins and Baer, 2009). The practice of mindfulness has affective, interpersonal and intrapersonal benefits to the individual (Davis & Hayes, 2011). Actually, mindfulness promotes the development of emotional regulation, allowing the individual to manage the problems and worries in a healthy way, helping to cope with life contingencies with emotional balance and without distorting the experience (Davis and Hayes, 2011, Hayes and Feldman, 2004). Lykins and Baer (2009) compared mindfulness meditators with non-meditators and found that the meditators reported higher scores on mindfulness globally, and in the dimensions of observing, describing, non-judging and non-reactivity, than non-meditators. Meditators also showed lower psychological symptoms and higher psychological well-being. The practice of meditation was also associated with mindfulness in daily life, which, in turn, was associated with lower rumination and fear of emotions, and higher behavioral self-regulation. Therefore, meditators were more likely to show an adaptive functioning (Lykins & Baer, 2009).

In the same sense, several studies showed an association between mindfulness and lower levels of depression and anxiety, more clarity of feelings, cognitive flexibility and more well-being (Davis and Hayes, 2011, Hayes and Feldman, 2004). Mindfulness facets, namely “describe”, “act aware”, “nonjudge and nonreact”, were negatively associated with psychological symptoms and alexithymia (Baer, Smith, Hopkins, Krietemeyer, & Toney, 2006).

Alexithymia is characterized by the difficulty in identifying and describing feelings, limited skills of imagination, as well as an external style of thinking (Taylor et al., 1991, Taylor et al., 1997). Individuals with higher levels of alexithymia have been shown intolerance to stress, lack of skills to use emotions in order to guide their behavior, as well as lack of adaptive resources (Parker, Taylor, & Bagby, 2001). Mindfulness and alexithymia may be interpreted as opposite concepts, since mindfulness is focused on the awareness of the present thoughts and feelings without reaction or judgment while alexithymia is characterized by the inability to identify and describe feelings (Gilbert et al., 2012). In fact, lower alexithymia has been associated with the quality of mindfulness, greater acceptance and awareness (Teixeira & Pereira, 2015). Also, Dekeyser, Raes, Leijssen, Leysen, and Dewulf (2008) found that difficulties in identifying or describing feelings were associated with lower mindful dimensions, namely description, acting with awareness and non-judgmental acceptance.

Literature has also shown that alexithymia is positively associated with depression (Gilbert et al., 2012) and negatively with emotional intelligence (Parker et al., 2001) and self-differentiation (Teixeira & Pereira, 2015). In fact, like mindfulness and alexithymia, self-differentiation is an important concept related to one's psychological functioning (Kerr and Bowen, 1988, Murdock and Gore, 2004). This concept has been proposed by Bowen describes the capacity to function autonomously as an individual, being emotionally independent from the family of origin (Bowen, 1978, Kerr and Bowen, 1988). Murdock and Gore (2004) provided evidences that corroborate the Bowen's theory, since they found that self-differentiation moderated the relationship between psychological distress and psychological functioning. The finding revealed that poor differentiated individuals who experienced higher distress showed greater psychological dysfunction, than well-differentiated individuals experiencing the same stress levels (Murdock & Gore, 2004). Poor differentiated individuals are also more likely to report anxiety regarding leaving the family of origin, lack of confidence in taking care of their own lives, as well as lower adaptation to stress (cf. Miller, Anderson, & Keala, 2004). Several studies have suggested that lower differentiation of self was associated with higher psychological distress (cf. Miller et al., 2004). The literature is scarce regarding the association between mindfulness and self-differentiation (Appel & Kim-Appel, 2010). Notwithstanding, the quality of mindfulness and acceptance has been associated with higher self-differentiation (Teixeira & Pereira, 2015).

In general, the literature has shown the benefits of mindfulness to an individuals’ psychological functioning. As a result, it is important to have operational definitions of mindfulness in order to develop valid instruments to study the psychological processes associated with it (Bishop et al., 2004, Brown and Ryan, 2004). However, there is some divergences about how to measure mindfulness, since some authors suggested that it comprises only one factor – the attention and awareness to the present moment (Brown & Ryan, 2004); while others proposed that it comprises several factors, such as observation of the present moment, acceptance, non-judgment and non-reactivity (Segal, Williams, & Teasdale, 2002). Taking in consideration the different facets of the construct mindfullness, this study was focused in the validation of the instruments “Cognitive and Affective Mindfulness Scale-Revised” (CAMS-R) and the “Philadelphia Mindfulness Scale” (PHLMS), in a non-clinical Portuguese sample.