(PS14-75) Mindfulness Matters: Examining Mindfulness and Severe Mental Illness in DBT Intensive Outpatient Programs

Mindfulness, a Dialectical Behavioral Therapy (DBT) core skill, has been shown to improve resiliency and long-term recovery. While mindfulness interventions have empirical support in experimental settings, more understanding is needed of the clinical utility of mindfulness with people who meet the criteria for a serious mental illness (SMI). Though individuals with SMI are at an increased risk of health disparities, SMI has been -- and continues to be – overlooked and marginalized. Mitigating these disparities and developing a greater understanding of these vulnerable populations encourages the ethical and empirical nature of third-wave behavioral therapies.  

This study investigated whether individuals who met criteria for SMI had a significant difference in mindfulness when compared to individuals who did not meet criteria in two archival samples from an intensive outpatient DBT community mental health program. This study also aimed to evaluate and compare the psychometric fitness of the FFMQ and FFMQ-SF, the long and short forms of the five-facet mindfulness questionnaire, respectively. Both forms of this questionnaire are comprised of five subscales, including observing, describing, acting with awareness, nonjudging, and nonreactivity. 

The psychometrics of Sample 1 and 2 (N1 = 39; N2 = 125) indicated that both the FFMQ (α1 = .945; α2 = .914)) and FFMQ-SF (α1 = .865; α2 = .796) met DeVellis’ criteria and were appropriate for inclusion in statistical analyses. Though results from independent-samples t-tests with Sample 1 indicated no significant differences in mindfulness by SMI designation (FFMQ Total: t(34.153) = -.461, p = .648, g = -.146; FFMQ-SF Total: t(36.169) = -1.140, p = .262, g = -.355), results in Sample 2 indicated that individuals meeting SMI criteria had significantly greater mindfulness than those without this designation (FFMQ Total: t(120.003) = -2.848, p = .005, g = -.509; FFMQ-SF Total: t(118.975) = -3.245, p = .002, g = -.580). Though results from a MANOVA with Sample 1 indicated significant differences in observing (F(1,1) = 4.448, p = .042, ηp2 = .107) based on SMI designation, results from Sample 2 indicated significant differences in observing (F(1,67) = 2.309, p < .001, ηp2 = .734), describing (F(1,67) = 2.836, p < .001, ηp2 = .772), acting with awareness (F(1,67) = 2.225, p = .001, ηp2 = .727), nonjudging (F(1,67) = 1.657, p = .027, ηp2 = .665), and nonreactivity (F(1,67) = 2.098, p = .002, η_{p^{2 = .}}715) based on SMI designation.  

As mindfulness is a DBT cornerstone, these results indicate that mindfulness interventions may be promising for improved health outcomes and stigma reduction for individuals with SMI. Clinicians are encouraged to utilize the long-form of the FFMQ, given its demonstrated psychometric strength when compared to its short-form counterpart. These findings advance the mission of ABCT in transforming the delivery of psychological services to be more ethically and empirically informed.