Deciding who’s more mindful than whom: Creating a mindfulness scale

In the dark ages of 2004 – before Siri! before Twitter! before mindfulness became the phenomenon it is today! – if you wanted a quick survey to find out how mindful tended to be, you were on your own. Then came the Cognitive and Affective Mindfulness Scale (CAMS), and now we have more mindfulness scales than you can shake a stick at. We have mindfulness scales for all occasions: long, short, for how mindful you are in everyday life, for how you feel immediately after you meditate, and incorporating many different perspectives on what mindfulness truly is.

This proliferation of mindfulness scales is all the more impressive when you know what goes into creating a useful, valid measure. It’s not a matter of just writing a list of questions and hitting the streets; you can do this, but then neither you nor anyone else can be sure your scale measures what you want it to measure. A great deal of work has to happen behind the scenes, more than I think I would ever care to take on.

It does start with just thinking about what you want to measure and writing questions you think will do the job. The CAMS-Revised, for example, started with the idea that there are four pieces to mindfulness: focusing your attention when you want to, being oriented to the present (not the future or the past), being aware of what’s going on around you, and an “attitude of acceptance” (a tendency to accept what’s going on or what you feel without getting bent up of shape about it). Other people have different ideas about what mindfulness should include; the Mindful Attention Awareness Scale (MAAS), for example, is more concerned with attention and awareness and skips over that accepting attitude.

questionnaire1Once you’ve got your concepts down, you can start dashing off questions, suited to your own ideas of what makes a question clear and likely to get truthful answers. The CAMS-R, for example, asks you to agree rather baldly with “I am easily distracted”; the MAAS goes for more detail and more concrete examples with “I break or spill things because of carelessness, not paying attention, or thinking of something else.” It can be easy to get bogged down in the precise wording of a sentence, particularly if you’re creating your scale with someone else, but at some point you just have to decide to run with a question and see if it works.

“If it works” is determined by giving your proposed scale to a very large number of people; this is the only time that my students’ intuition that you must have hundreds of subjects for a scientific study to be valid is correct, and you want as diverse a group as you can get. These hundreds of people answer all the questions you wrote and thought were worth trying out for your new scale, and then you get to go over those answers with the fine-tooth comb of a statistical analysis package. You’re looking for questions that are sensitive, which means people offered all possible answers (Yes, that is so me! to Never, I am nothing like that! and all points in between), and that correlate, meaning that your answers tend to line up instead of being all over the place.

Consider the idea that mindful means being aware of your experience. If you think that  the questions

  •  “I can usually describe how I feel at the moment in considerable detail.”
  • “It’s easy for me to keep track of my thoughts and feelings.”, and
  • “I try to notice my thoughts without judging them.”

all get at that concept of being aware, then some people (the more aware ones) should answer very high on all of them, and some people (the least aware) should answer very low. There might be some middling aware people who just say “sure, sometimes” to all the questions…but you shouldn’t be running into a lot of people who say they really identify with one of the three but not the other two.

Once you’ve narrowed down the list of questions, now it’s time to find out if your scale is valid, which means it measures what you think it measures (mindfulness), and reliable, which means that the same person taking the scales on different days is likely to get the same score. This means another group of several hundred subjects, who get to take your scale and as many other surveys as you can get them through before their hands cramp. That way you can check your scale’s validity against other mindfulness scales, and other things you think mindfulness should relate to: less stress, a better sense of well-being, that sort of thing.

This is also when you get to find out if your questions are mixed up with more ideas than just mindfulness. When the authors of the CAMS were busy revising it, for example, they wondered if “I can usually describe how I feel at the moment in considerable detail” might be more about emotion processing than mindfulness, so they made sure it didn’t correlate unduly with surveys known to get at emotions. They did find that questions intended to get at living in the now, like “I am preoccupied with the future”, tapped worry more than mindfulness, but it didn’t seem to change anyone’s overall mindfulness rating to leave them out.

Finally, with all that work behind you, the scale can be published and used in research to investigate the potential benefits (and costs) of being mindful, and to determine whether those mindful trainings really do help us maintain mindfulness months or years down the road. Scale creators are like the crew of a hit television show; they don’t get the name recognition, they’re probably underappreciated for doing a very tough job, and the show couldn’t go on without them. But thanks to all their work, we can sit down and start putting some kind of measurable number to how mindful any given person is.

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