What can we learn from randomized clinical trials about the construct validity of self-report measures of mindfulness? A meta-analysis

Self-report measures of mindfulness show larger gains in mindfulness-based interventions compared to waitlist controls at post-treatment (effect size = 0.52) and follow-up (effect size = 0.52), though the follow-up effect became non-significant after adjusting for publication bias. Compared to other bona fide treatments, mindfulness measures showed larger gains only at post-treatment (effect size = 0.25), not at follow-up. All three conditions (mindfulness, bona fide, waitlist) showed larger improvements on clinical outcomes than on mindfulness measures, except waitlist at follow-up. These findings partially support that mindfulness self-report measures are uniquely responsive to interventions promoting mindfulness meditation practice.

Study at a glance

Abstract

Because they provide data on responsiveness to experimental manipulation, clinical trials involving mindfulness-based inter- ventions are a source of evidence for the construct validity of self-report measures of mindfulness. Within-group and between- group changes in mindfulness were examined from randomized clinical trials comparing mindfulness interventions to other bona fide treatment comparison conditions or waitlist control conditions. We also examined changes in clinical outcomes and the magnitude of these changes relative to changes in mindfulness. We included 69 published studies representing 55 unique samples (n = 4743). Self-report mindfulness measures showed relatively larger gains in mindfulness intervention conditions vis-à-vis waitlist comparison conditions at both post-treatment (effect size [ES] = 0.52, 95% CI [0.40, 0.64]) and follow-up (ES = 0.52 [0.20, 0.84]), although the effect at follow-up diminished to non-significance in a trim-and-fill analysis intended to account for publication bias (ES = 0.35 [− 0.03, 0.72]). Measures of mindfulness also showed relatively larger gains in mindfulness inter- vention conditions vis-à-vis bona fide comparison conditions, but only at post-treatment (ES = 0.25 [0.11, 0.38], 0.10 [− 0.08, 0.28], at post-treatment and follow-up, respectively). All three conditions (mindfulness, bona fide, waitlist) showed relatively larger improvements on measures of clinical outcomes than measures of mindfulness, with the exception of waitlist conditions for which this effect was no longer significant at follow-up. Taken together, findings provide partial support for the unique respon- siveness of mindfulness self-report measures to interventions that include promotion of mindfulness meditation practice.