Better Measurement of Mindfulness, Anxiety, and Depression

 

By John M. de Castro, Ph.D.

 

“Thus, differing assessments may support implicitly distinct theoretical positions with respect to operationalizing mind- fulness. . . . researchers must be well informed and intentional in their selection of assessment tools because the breadth of currently available assessments provides researchers with a variety of measures, each with specific strengths and weaknesses. Not surprisingly, the various measures resulting from the diverse operational definitions of mindfulness have, at times, been found to be uncorrelated or only modestly associated, providing further evidence of confusion within the mindfulness literature.” – Adam Hanley

 

A prerequisite in science is that in order to study something you have to be able to measure it. With many concepts such as mindfulness, depression, and anxiety that reflect subjective states, there are currently no objective means to measure them. Measurement then falls to some kind of after the fact test or to a self-report. Traditionally, these variables have been measured with paper and pencil psychometric tests, such as the Cognitive Affective Mindfulness Scale-Revised, the Beck Depression Inventory, or the Profile of Mood States. They ask the participant to answer the question in regard to how they generally feel. These forms are filled out before and again after an intervention to assess the effect of the intervention on these subjective states.

 

With the advent of smart phones, a different kind of assessment method has emerged and is gaining greater popularity. It is sometimes called ecological momentary assessment (EMA). Individuals receive messages on their smart phones periodically asking them to answer questions about their state at the present moment. This can be done on multiple, somewhat randomly selected, occasions over the day or longer. It provides a measure that doesn’t require the participant to estimate how they feel in general, but rather uses an average of measures provided by the participant at various times.

 

In today’s Research News article “Ecological momentary assessment versus standard assessment instruments for measuring mindfulness, depressed mood, and anxiety among older adults”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1184314174925840/?type=3&theater

Moore and colleagues recruited elderly (over 65 years of age) participants with clinically significant anxiety distress. They compared the results for participants’ levels of mindfulness, depression, and anxiety measured either by traditional paper and pencil measures of how they were in general to those measured with an ecological momentary assessment (EMA) using smart phones. To obtain the EMA measures participants were sampled 3 times per day for ten days. The participants were randomly assigned to receive Mindfulness Based Stress Reduction (MBSR) program or a health education program. They were compared both before and after the interventions with both the traditional and EMA measurements.

 

Mindfulness Based Stress Reduction (MBSR) involves training in meditation, body scan, and yoga. It has been shown previously to increase mindfulness, and to decrease depression and anxiety levels in normal individuals and those with anxiety disorders, including the elderly. Moore and colleagues found in their study that on average both measures showed an increase in mindfulness and decreases in depression and anxiety, but, the effects were only statistically significant for ecological momentary assessment (EMA) and not for the traditional paper and pencil measures. These results suggested that EMA measurement in more sensitive and less unstable than traditional measures. To further document this, they calculated the number of participants that would be needed to show a statistically significant effects for the two measurement types and found that EMA measures required nearly half as many participants as the traditional measures. Hence, they found that EMA measure are substantially more sensitive and is capable of detecting differences with fewer participants.

 

These results indicate that ecological momentary assessment (EMA) is a better way to assess the states of research participants. Obtaining measures at a variety of points in time appears to produce more accurate results than asking the participant to estimate their overall states. This makes sense that actual measures are superior to participant estimates. The EMA technique is more expensive, takes more time and effort, and is more intrusive into the daily lives of the participants, but may be worth it for the improved accuracy and sensitivity.

 

“If you’ve ever struggled with depression, take heart. Mindfulness, a simple yet powerful way of paying attention to your most difficult emotions and life experiences, can help you break the cycle of chronic unhappiness once and for all.” – Mark Williams

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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