Facets of Dispositional Mindfulness and Health Among College Students

Abstract

Objective:

The purpose of the current study was to examine the relationship between the facets of trait mindfulness with psychological and physical health while controlling for health behaviors in college students.

Participants:

310 students from a small, private college in the Northeastern United States.

Outcome measures:

Students completed self-report measures, including the Perceived Stress Scale (PSS-14), the Five Facet Mindfulness Questionnaire (FFMQ), Medical Outcomes Short-Form Health Survey (SF-36), and the Rutgers Alcohol Problems Index (RAPI).

Results:

After controlling for other health behaviors, the observation facet of mindfulness was negatively associated with physical health. Both acting with awareness and nonjudging facets were positively associated with emotional well-being. For social functioning, nonjudging was a significant positive facet for this domain of health.

Conclusions:

Tailoring mindfulness-based interventions to enhance these facets may be beneficial to young adults.

Introduction

Over the last few decades, mindfulness has become a popular clinical tool to enhance health and decrease negative mood states. Mindfulness has been defined as “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.”¹ Mindfulness can be fostered through meditation, yoga, or directing awareness to senses during everyday tasks. Mindfulness-based stress reduction (MBSR) programs,² as well as some third-wave cognitive behavior therapies,³ use mindfulness as a central component to help regulate emotions.

Mindfulness-based interventions have positive effects on a variety of outcomes in both medical patients and healthy individuals.^4

–7 For instance, mindfulness-based interventions are helpful in dealing with obesity-related eating behaviors^8,9 as well as increasing positive outcomes in patients with HIV infection and those with cancer.^10

–13 However, not all studies examining the benefits of mindfulness have shown strong effects for all outcomes. Mindfulness-based interventions for patients with fibromyalgia have indicated that the effects on quality of life and pain are weak.¹⁴ In addition, a recent large-scale meta-analysis conducted among 41 controlled clinical trials that included 2993 participants suggests that mindfulness-based programs show only small improvements in mental health problems, such as depression, stress, and negative affect.¹⁵ Therefore, more work is needed to understand the specific aspects of mindfulness that are helpful in improving health.

Mindfulness can be examined as a state or disposition. Dispositional mindfulness refers to the amount of mindfulness a person has in daily activities and is thought to be stable over time.¹⁶ Higher levels of dispositional mindfulness are associated with health benefits, such as lower negative mood states,^17
–19 more satisfying relationships,²⁰ lower levels of the interleukin-6 antibody,²¹ better heart rate variability,²² and better self-reported health.¹⁹ In a study with college students, Murphy and colleagues found that dispositional mindfulness was associated with better sleep, healthier eating habits, and better physical health over a 10-week period.²³ Higher baseline levels of dispositional mindfulness may also enhance the effects of mindfulness-based programs. Shapiro and colleagues found that higher dispositional mindfulness among college students receiving MBSR was associated with greater increases in mindfulness and well-being and larger declines in stress after 1 year of treatment.²⁴ Further exploration into how dispositional mindfulness relates to health, health behaviors, and wellness may therefore be a beneficial first step to tailoring mindfulness interventions for different populations.

Because dispositional mindfulness is a complex phenomenon, exploring its individual facets is beneficial. Previous work has suggested that mindfulness has five facets: observing (noticing or attending to experiences, such as sensations, thoughts, and emotions), describing (labeling internal experience with words), acting with awareness (attending to one's activities of the moment), nonjudging of experience (taking a nonevaluative stance toward thoughts and feelings), and nonreactivity to inner experience (the tendency to allow thoughts and feelings to come and go).²⁵ A few recent studies have begun to explore how these individual facets of dispositional mindfulness relate to health.^26

–29 Consedine and Butler found no effect of overall dispositional mindfulness on health outcomes or utilization in a group of adults but did find that the individual facets of observation and nonreactivity to inner experiences were important predictors of outcomes.²⁸ Lower levels of acting with awareness, being nonjudgmental, and being nonreactive are also associated with current substance use disorder compared with people with no history of one.²⁹ Exploring the specific facets of mindfulness may help us better understand how to improve interventions and maximize their effects by focusing on enhancement of specific qualities that are related to improved health.

The current study builds from the existing literature by examining how facets of dispositional mindfulness relate to physical and psychological domains of health in college students. After controlling for health behaviors, the study assessed which facets of mindfulness are related to different domains of health. This appears to be the first study to examine these relationships in college students. This study aims to help delineate which aspects of mindfulness are important to physical and psychological health among college students.

Materials and Methods

Participants were 310 undergraduate college students (68% female and 32% male) recruited from a small liberal arts college in the Northeastern United States. Participants were age 18–24 years (mean ± standard deviation [SD], 19.7 ± 1.3) and included 40% freshmen, 24% sophomores, 20% juniors, and 16% seniors. Most the sample was white (85%). This sample was not significantly different than the student population at this college, which is 83% white and 42% male (p = ns).

After approval by the university's institutional review board, participants were recruited by using several different recruitment strategies. Flyers providing information about the study were placed around campus and information about the study was sent via campus-wide e-mail. Additionally, the two research assistants on this project went to classes in several academic departments and made announcements in class to students about the study. Students in the psychology department were offered extra credit for their participation or could alternatively opt to be entered into a raffle for a $50 gift card instead. Psychology students were also given the option to complete a paper for extra credit instead of participating in a research study. All students outside of the psychology department were eligible to be entered into the gift card drawing. All participants signed an informed consent, and all participation was voluntary. Participants filled out a series of self-report surveys (counter-balanced) that took approximately 20–30 minutes to complete. A research assistant was present at all times to answer any questions that participants may have had about the measures.

Measures

Demographic characteristics

Background data and lifestyle information were collected, including age, sex, ethnicity, eating and exercise behaviors, and sleeping and drinking habits. Eating habits were assessed by how many times a week participants ate fast food and the daily number of servings of fruits and vegetables. Participants reported how often and for how many minutes they engaged in moderate levels of exercise per week. A total number of minutes of exercise per week was calculated on the basis of this information. Duration of sleep was measured by asking how long participants slept on weekdays versus weekend days. Drinking behaviors were assessed by one item asking how many standard-size alcohol beverages (12 ounces of beer, 5 ounces of wine, and 1.5 ounces of liquor) were consumed per week.

Medical Outcomes Study Short Form Survey

The Medical Outcomes Study Short Form Survey (SF-36) assesses different aspects of physical and mental health in adults. The survey was designed for self-report use in individuals older than 14 years of age.^30,31 The SF-36 has been used in previous studies with undergraduate college populations and has been established as an effective tool.^32,33 There are eight different dimensions in the SF-36, and subscale scores (0–100) are calculated for each. A higher score indicates better overall health, and all scales have good reliability with coefficient α values of 0.80 or higher.³¹ For the current study, the following subscales were used in analyses: physical functioning, emotional well-being, social functioning, pain, general health, and energy.

Perceived Stress Scale

The participants' level of subjective stress was evaluated by the Cohen 14-item Perceived Stress Scale (PSS-14).³⁴ The PSS-14 uses a Likert method (1–5) to measure the frequency and severity of stress, with 5 indicating the highest levels of stress. Previous studies have found the PSS-14 to be a valid and reliable measure of stress in young adult populations (α = 0.87).^35,36

Five Facet Mindfulness Questionnaire

The Five Facet Mindfulness Questionnaire (FFMQ) is a 39-item questionnaire used to analyze individual's dispositional mindfulness.³⁷ The FFMQ uses a Likert method (1–5) to determine the frequency with which elements of mindfulness occur. Possible scores on the FFMQ range from 39 to 195, with overall higher scores reflecting higher levels of mindfulness. The FFMQ was derived from a factor analysis of five psychometrically sound mindfulness subscales: observing, describing experience, acting with awareness, non-judging of experience, and non-reactivity to inner experience.³⁸ The FFMQ has reliability α coefficients ranging from 0.75 to 0.91 for the subscales.³⁹

Rutgers Alcohol Problem Index

The Rutgers Alcohol Problem Index (RAPI) has been commonly used to assess and screen for alcohol problems in adolescent and college-aged populations.^40
–42 The RAPI is a 23-item scale⁴³ that asks participants to assess how often they encounter various harmful consequences of alcohol. A total score on the RAPI can range from 0 to 69, with a higher score indicating a greater instance of problematic drinking behaviors. The RAPI correlates well with other measures of alcohol misuse in clinical populations.⁴⁴ The RAPI has been found to be a reliable and valid measure of identifying alcohol abuse or dependence symptoms (α = 0.75)⁴² as well as identifying alcohol consumption patterns that cause personal and social consequences (α = 0.73 and 0.68, respectively).⁴⁵

Statistical analyses

Data were analyzed by using PASW Statistics 18 (IBM, Armonk, NY). Means and standard deviations of all variables were calculated (Table 1). Sex differences on health behaviors, facets of mindfulness, and health outcomes were examined. Bivariate correlations were used to examine the relationship between five facets of mindfulness, health behaviors, and domains of health functioning in the sample (Table 2). Multiple hierarchical regression analyses were used to examine the relationship of health behaviors and facets of mindfulness to different domains of health among college students. Health behavior variables, such as weekly fast food consumption, fruit and vegetable intake, minutes of physical activity per week, average nightly sleep (on weekdays and weekends), weekly number of alcoholic drinks, stress level (PSS-14), problematic alcohol use (RAPI), and the five facets of mindfulness were entered as predictors in each analysis. Separate regression analyses were run to assess the different domains of health. Statistically significant results refer to those with an α value <0.05 and trends refer to those with an α level <0.10.

Table 1.

Variable Descriptives

Variable	Mean ± SD	Range
Occasions of fast food consumption per week	0.45 ± .91	0–7
Servings fruits/vegetables daily	2.73 ± 1.72	0–12
Alcoholic beverages per week	8.43 ± 9.26	0–60
Exercise per week (min)	267.02 ± 234.59	0–1260
Average amount of sleep per weekday (h)	7.17 ± 1.10	3–11
Average amount of sleep per weekend day (h)	8.47 ± 1.78	3–14
Quality of sleep on weekday	6.90 ± 1.53	1–10
Quality of sleep on weekend	7.59 ± 1.82	1–10
SF-36 subscales
Physical functioning	94.85 ± 12.45	0–100
Emotional well-being	70.05 ± 17.77	12–100
Social functioning	81.63 ± 22.17	0–100
Pain	82.85 ± 17.23	0–100
General health	73.09 ± 17.51	10–100
Energy	57.83 ± 18.20	10–90
RAPI total score	7.41 ± 8.20	0–47
PSS-14 total score	37.58 ± 7.51	20–59
FFMQ total score	130.60 ± 16.43	79–175
Subscales
Observing inner experience	25.81 ± 5.47	10–40
Describing experience	28.35 ± 5.87	12–40
Acting with awareness	26.67 ± 5.54	11–40
Nonjudging of experience	28.28 ± 6.28	11–40
Nonreactivity to inner experience	21.54 ± 3.64	9–33

Higher scores on quality of sleep indicate better sleep. On the SF-36, higher scores indicate better health. On the RAPI, a higher score indicates problematic alcohol behaviors. For the PSS-14, higher scores indicate greater levels of stress and on the FFMQ, higher scores indicate greater levels of mindfulness or related facets.

SD, standard deviation; SF-36, Medical Outcomes Study Short Form Survey; RAPI, Rutgers Alcohol Problems Index; PSS-14, Perceived Stress Scale-14; FFMQ, Five Facet Mindfulness Questionnaire.

Table 2.

Bivariate Correlations Among Scales and Subscales

Variable	1	2	3	4	5	6	7	8	9	10	11	12	13
1. RAPI total	–
2. PSS-14 total	0.227^**	–
3. FFMQ total	−0.204^**	−0.598^**	–
4. Observing inner experience	−00.045	−0.164^**	0.461^**	–
5. Describing experience	−0.117^*	−0.339^**	0.748^**	0.252^**	–
6. Acting with awareness	−0.268^**	−0.475^**	0.663^**	00.017	0.354^**	–
7. Nonjudging of experience	−00.105	−0.427^**	00.603^**	−0.122^*	0.308^**	0.376^**	–
8. Nonreactivity to inner experience	−00.062	−0.443^**	0.562^**	00.349	0.296^**	0.221^**	00.115	–
9. SF-36 physical functioning	−0.007	−0.120^*	0.069	−0.033	0.033	0.080	0.082	0.037	–
10. SF-36 emotional well-being	−0.206^**	−0.765^**	0.595^**	0.129^*	0.326^**	0.457^**	0.513^**	0.380^**	0.098	–
11. SF-36 social functioning	−0.171^**	−0.608^**	0.406^**	0.002	0.235^**	0.333^**	0.413^**	0.230^**	0.274^**	0.655^**	–
12. SF-36 general health	−0.143^*	−0.428^**	0.236^**	−0.018	0.138^*	0.202^**	0.282^**	0.078	0.254^**	0.410^**	0.450^**	–
13. SF-36 energy	−0.147^*	−0.695^**	0.474^**	0.104	0.374^**	0.289^**	0.391^**	0.265^**	0.158^**	0.740^**	0.565^**	0.531^**	–

^*p < 0.05.

^**p < 0.01.

Results

Sex differences

Male participants consumed more alcoholic beverages in a typical week than female participants (mean ± SD, 13.07 ± 12.06 versus 6.23 ± 6.55) (t [306] = 6.44; p = 0.00). Men (mean ± SD, 9.34 ± 9.07) also had higher scores on the RAPI than did women (6.49 ± 7.61) (t [303] = 2.87; p = 0.00). Fast food consumption was greater among men than women (mean ± SD, 0.76 ± 1.30 versus 0.30 ± 0.61) (t [308] = −1.71; p = 0.00). The scores on the PSS-14 were higher among women than men (mean ± SD, 38.25 ± 7.02 versus 36.14 ± 8.29) (t [307] = −2.32; p = 0.02). Number of minutes of exercise per week was greater among men (mean ± SD, 317.96 ± 265.07) than women (243.01 ± 215.29) (t [307] = 2.65; p = 0.01). Overall mindfulness did not differ by sex. The only facet of mindfulness that differed among male and female participants was nonreactivity to inner experience, men scoring higher on this facet than women (mean ± SD, 22.14 ± 3.64 versus 21.24 ± 3.61) (t [304] = 2.03; p = 0.04). No significant differences on the health domains on the SF-36 or other health variables were found for male and female participants.

Variables associated with health outcomes

Bivariate correlation analyses revealed negative associations of PSS-14 with all facets of mindfulness and health domains (Table 2). The overall FFMQ score was positively associated with all of the SF-36 health domains except for physical functioning. All facets of the FFMQ were positively associated with emotional well-being. None of the facets of the FFMQ were associated with physical functioning. The describing experience, acting with awareness, and nonjudging experience facets of mindfulness were positively associated with all health domain variables except for physical functioning. Nonreactivity to inner experience was positively associated with all health domain variables except for physical functioning and general health.

Regression analysis

Hierarchical multiple regression analyses were used to examine the relationship of health behaviors and facets of mindfulness with five health outcomes from the SF-36 among college students (Table 3). For physical functioning, servings of fruits and vegetable (β = 0.12; t = 1.93; p = 0.05), total amount of exercise (β = 0.13; t = 2.30; p = 0.02), and the observation factor of mindfulness (β = −0.13; t = −2.02; p = 0.04) were significant factors in the model. Higher levels of exercise and consumption of fruits and vegetables as well as lower levels of observation of inner experience were related to more positive physical functioning. There was a trend for the describing factor of mindfulness (β = 0.11; t = 1.71; p = 0.09).

Table 3.

Multiple Regression Analyses of Health Behaviors and Facets of Mindfulness as Predictors of Health Outcomes

	Physical functioning ^a				Emotional well-being ^a				Social functioning ^a				General health ^a				Energy ^a
Variable	B	SE B	β	p-value	B	SE B	β	p- value	B	SE B	β	p-value	B	SE B	β	p-value	B	SE B	β	p-Value
Constant	115.99	12.56		0.00	85.81	10.97		0.00	136.24	17.9		0.00	128.74	15.52		0.00
Weekday sleep (in hours)	−1.12	0.70	−0.09	0.11	0.74	0.61	0.05	0.23	0.52	0.99	0.03	0.60	0.05	0.87	0.00	0.96	10.19	0.75	0.07	0.11
Weekend sleep (in hours)	−0.66	0.41	−0.09	0.11	0.03	0.36	0.00	0.94	−0.03	0.58	−0.00	0.96	−10.07	0.50	−0.11	0.03	−0.76	0.43	−0.04	0.08
Alcoholic drinks per week	0.12	0.09	0.09	0.16	0.14	0.08	0.07	0.07	−0.03	0.13	−0.01	0.80	0.02	0.11	0.01	0.85	0.21	0.09	0.11	0.03
Fast food consumption per week	−0.75	0.82	−0.06	0.36	−0.82	0.71	−0.04	0.25	−20.82	10.16	−0.12	0.01	−20.52	10.01	−0.13	0.01	0.43	0.86	0.02	0.62
Fruit/vegetable intake per week	0.84	0.43	0.12	0.05	−0.71	0.38	−0.07	0.06	−0.83	0.61	−0.07	0.17	−0.00	0.53	0.00	0.99	0.00	0.46	0.00	0.99
Exercise per week (minutes)	0.01	0.00	0.13	0.02	0.00	0.00	0.00	0.83	0.00	0.00	0.03	0.58	0.01	0.00	0.19	0.00	0.00	0.00	0.02	0.64
PSS-14	−0.17	0.13	−0.10	0.19	−10.42	0.11	−0.60	0.00	−10.67	0.18	−0.57	0.00	−10.00	0.16	−0.43	0.00	−10.49	0.14	−0.61	0.00
RAPI	−0.05	0.10	−0.03	0.62	−0.08	0.09	−0.04	0.35	−0.00	0.15	−0.00	0.99	−0.09	0.13	−0.04	0.48	−0.03	0.11	−0.01	0.76
FFMQ: Nonreactivity	−0.07	−0.23	−0.02	0.77	0.30	0.20	0.06	0.14	−0.06	0.33	−0.01	0.87	−0.44	0.29	−0.09	0.12	−0.20	0.25	−0.04	0.42
FFMQ: Awareness	−0.07	0.15	−0.03	0.66	0.26	0.14	0.08	0.05	0.03	0.22	0.01	0.88	−0.12	0.19	−0.04	0.52	0.14	0.16	0.04	0.39
FFMQ: Describe	0.24	0.14	0.11	0.09	0.04	0.12	0.01	0.75	0.07	0.20	0.02	0.72	0.09	0.18	0.03	0.60	0.16	0.15	0.05	0.28
FFMQ: Nonjudging	−0.05	0.14	−0.02	0.74	0.59	0.12	0.21	0.00	0.51	0.19	0.14	0.01	0.24	0.17	0.09	0.15	0.22	0.14	0.08	0.12
FFMQ: Observe	−0.30	0.15	−0.13	0.04	0.10	0.13	0.03	0.44	−0.31	0.22	−0.08	0.14	−0.31	0.19	−0.10	0.09	−0.03	0.16	−0.08	0.87

Physical functioning: R² = 0.05; emotional well-being: R² = 0.65; social functioning: R² = 0.40; general health: R² = 0.26; energy: R² = 0.51.

Model is significant at p < 0.01.

SE, standard error.

Significant factors for emotional well-being included the following: PSS-14 (β = −0.58; t = −12.67; p = 0.00), acting with awareness factor (β = 0.08; t = 1.93; p = 0.05), and nonjudging of experience factor (β = 0.21; t = 4.96; p = 0.00). Positive emotional well-being was associated with lower levels of stress and being more aware in one's daily activities, as well as taking a nonjudgmental approach to these experiences. Servings of fruits and vegetables (β = −0.07; t = −1.87; p = 0.06) and alcohol beverages (β = 0.07; t = 1.79; p = 0.07) per week trended toward significance as factors for emotional well-being.

For social functioning, significant factors in this model were fast food consumption (β = −0.17; t = −2.44; p = 0.02), PSS-14 (β = −0.57; t = −9.17; p = 0.00) and nonjudging factor of mindfulness (β = 0.14; t = 2.63; p = 0.01). Lower levels of fast food consumption and stress and higher levels of a nonjudgmental attitude toward experiences were associated with better social functioning.

The significant factors in the model for general health were fast food consumption (β = −0.13; t = −2.50; p = 0.01), PSS-14 (β = −0.44; t = −6.36; p = 0.00), total amount of exercise (β = 0.19; t = 3.58; p = 0.00), and hours of sleep on the weekend (β = −0.11; t = −2.14; p = 0.03). General health was associated with less fast food consumption, less stress, fewer hours of sleep on the weekend, and more exercise. There was a trend for the observing factor of mindfulness in this model (β = −0.10; t = −1.67; p = 0.09).

Finally, for the energy domain of health, alcoholic beverages consumed in a week (β = 0.11; t = 2.25; p = 0.03) and PSS-14 (β = −0.61; t = −10.93; p = 0.00) were significant factors in this model. More alcohol and less stress were associated with more energy among the participants. There was a trend for hours of sleep (β = −0.07; t = −1.76; p = 0.08) on the weekend as a predictor for energy.

Discussion

The present study examined the associations between facets of dispositional mindfulness and health behaviors with different health outcomes in a college population. After controlling for other health behaviors, the observation facet of mindfulness was negatively associated with physical health. Both acting with awareness and nonjudging facets were positively associated with emotional well-being. For social functioning, nonjudging was a significant positive facet for this domain of health.

People who reported better physical functioning stated that they had lower levels of noticing or attending to internal and external experiences (observing facet). This finding is consistent with a recent study exploring the relationship of facets of mindfulness with panic symptoms in patients with asthma. Researchers found that higher levels of observation were associated with more body vigilance and anxiety sensitivity.⁴⁶ This finding may be a function of those who have higher interoceptive awareness (one's awareness of the internal and physiologic state of his or her body) or are more “in-tune” with their body being more likely to find physical problems. This finding may also explain why pain is not reported to be relieved in patients with fibromyalgia undergoing mindfulness interventions.¹⁴

The mindfulness facets of acting with awareness and nonjudging were positively associated with emotional well-being in this college sample. These results are consistent with those of Cash and Whittingham, who also found that acting with awareness and nonjudgmental facets of mindfulness were associated with better emotional functioning in a sample of meditators and college students.²⁶ In another study with treatment-seeking adults, the nonjudging facet, but not the acting with awareness facet, was negatively related to depressive symptoms.⁴⁷ Attending to one's activities in the moment probably leads to fewer mistakes, a richer experience, and more connection with those around oneself, which is related to emotional well-being. In addition, nonjudging of thoughts, feelings, and experiences fosters a self-compassion that is less likely to lead to rumination and negative emotional states.⁴⁸

Previous studies support the connection between mindfulness and social well-being. For instance, long-term meditation practice is associated with overall better social adjustment.⁴⁹ In addition, higher levels of mindfulness have been associated with better social adjustment in adolescents.⁵⁰ Trait mindfulness also modulates cortisol response to acute social stressors.⁵¹ The current results add to this body of literature by examining the facets of mindfulness related to social health. The nonjudging facet of mindfulness was a predictor of social well-being in this sample of college students. Less judgment of one's thoughts, feelings, and experiences may affect levels of rumination, which in turn may increase presence in social situations.⁵² In addition, lower levels of self-judgment may generalize to how one judges other people: that is, if a person has lower levels of judgment toward his or her own experiences, the person may “judge” others less and may be more accepting of other people.

This study also found that the mindfulness facets of describing, acting with awareness, and nonjudging of experience were positively associated with general health and energy. The nonreactivity facet was associated only with energy. After adjustment for other health behaviors, however, these facets of mindfulness did not predict the outcomes of general health and energy. The observing factor of mindfulness was trending toward significance for general health. When dispositional mindfulness is viewed without examination of individual facets, there are associations with general health. For instance, Whitaker and colleagues found that among adults with different levels of adversive childhood events, dispositional mindfulness was associated with better quality of life, increased engagement in health behaviors, and fewer health conditions.⁵³ In addition, mindfulness has been associated with lower blood pressure and lower interleukin-6 levels in young adults.²¹

The current findings seem inconsistent with this literature. It may be a function of how this study measured general health and energy, especially in a population of young adults. Or perhaps it may be more important to look at interactions of the facets of mindfulness for these variables, as Tomfohr and colleagues did in their work.²¹

Mindfulness interventions have been helpful in reducing stress, depression, and cortisol levels in college students.⁵⁴ More recent work points to their potential benefits with substance use problems among students.⁵⁵ Although mindfulness has much potential to benefit both emotional and physical health among college students,⁵⁶ it is important to tailor these interventions for the individuals involved. Given the findings from this study, it may be important for college counselors to emphasize acting with awareness and a nonjudgmental stance when working with college students because this has been associated with better emotional and social health in this sample. Individuals may practice acting with awareness by doing walking meditations and bringing their attention back to their breath to be present in the moment. Although it can be difficult to be nonjudgmental of oneself and one's thoughts, it is possible to practice by minimizing the tendency to label thoughts as good or bad. Rather than labeling thoughts as good, bad, or something else, one can just say “thinking” when noticing one. College students should be aware that increasing dispositional mindfulness might require ongoing practice before experiencing increases in health.

Future research is needed to understand how to best tailor mindfulness interventions, how dispositional mindfulness moderates outcomes in these interventions, and the relationship between mindfulness and objective measures of health outcomes (such as inflammatory markers, blood pressure, weight change, or cortisol levels). It is also important for intervention research to test for mediators of change. For instance, Josefsson and colleagues found that when looking at the relationship between meditation practice and well-being, nonreactivity facet is the primary mediator.⁵⁷ Because the results of this study indicate that the awareness and nonjudging facets of mindfulness are related to positive functioning, it is suggested that mindfulness-based interventions with college students be examined to ensure that they are specifically targeting these facets for cultivation. It is necessary to further understand the mechanisms of change in different subgroups in order to enhance the quality of interventions.

This study has limitations. First, the sample consisted predominantly of white college students from the Northeast, so generalizability is limited. Given the limited variability in age and that the sample consisted of young healthy adults, physical functioning and health did not vary much. A more demographically diverse group may have allowed for a fuller range of health scores. Future research with participants who have a specific health issue, such as chronic pain, would be beneficial. Self-report measures are also a weakness of this study. The use of unvalidated measures for diet and physical activity is a weakness. Future research should use validated and reliable scales to assess these variables, especially those that examine levels of physical activity (e.g., moderate physical activity). Finally, demand characteristics could have affected the way that participants answered questions on these scales.

Overall, this research adds to the existing literature by examining which facets of mindfulness are related to domains of health in college students. The findings suggest that acting with awareness and nonjudging facets play the biggest role in emotional and social health among young adults. It is important for school counselors to consider these findings when developing mindfulness interventions for this group.

Footnotes

Author Disclosure Statement

No competing financial interests exist.

References

Kabat-Zinn

. Wherever You Go There You Are: Mindfulness Meditation in Everyday Life. New York: Hyperion, 1994.

Kabat-Zinn

. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York: Delta Trade Paperbacks, 1991.

Spiegler

. Contemporary Behavior Therapy. 5th ed. Belmont, CA: Wadsworth, Cengage Learning, 2010.

Fjorback

, Arendt

, Ornbol

, Fink

, Walach

. Mindfulness-based stress reduction and mindfulness-based cognitive therapy: a systematic review of randomized controlled trials. Acta Psychiatr Scand, 2011; 124:102–119.

Chiesa

, Serretti

. Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. J Altern Complement Med, 2009; 15:593–600.

Zernicke

, Campbell

, Blustein

, et al. Mindfulness-based stress reduction for the treatment of irritable bowel syndrome symptoms: a randomized wait-list controlled trial. Int J Behav Med., 2013; 20:385–396.

Lakhan

, Schofield

. Mindfulness-based therapies in the treatment of somatization disorders: a systematic review and meta-analysis. PloS One., 2013; 8:e71834.

O'Reilly

, Cook

, Spruijt-Metz

, Black

. Mindfulness-based interventions for obesity-related eating behaviours: a literature review. Obes Rev, 2014; 15:453–461.

Katterman

, Kleinman

, Hood

, Nackers

, Corsica

. Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: a systematic review. Eat Behav, 2014; 15:197–204.

10.

Gayner

, Esplen

, DeRoche

, et al. A randomized controlled trial of mindfulness-based stress reduction to manage affective symptoms and improve quality of life in gay men living with HIV. J Behav Med, 2012; 35:272–285.

11.

Lengacher

, Reich

, Kip

, et al. Influence of mindfulness-based stress reduction (MBSR) on telomerase activity in women with breast cancer (BC). Biol Res Nurs, 2014; 16:438–447.

12.

Lengacher

, Reich

, Paterson

, et al. The effects of mindfulness-based stress reduction on objective and subjective sleep parameters in women with breast cancer: a randomized controlled trial. Psychooncology, 2015; 24:424–432.

13.

Branstrom

, Kvillemo

, Akerstedt

. Effects of mindfulness training on levels of cortisol in cancer patients. Psychosomatics., 2013; 54:158–164.

14.

Lauche

, Cramer

, Dobos

, Langhorst

, Schmidt

. A systematic review and meta-analysis of mindfulness-based stress reduction for the fibromyalgia syndrome. J Psychosom Res, 2013; 75:500–510.

15.

Goyal

, Singh

, Sibinga

, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med, 2014; 174:357–368.

16.

Brown

, Ryan

. The benefits of being present: mindfulness and its role in psychological well-being. J Pers Soc Psychol, 2003; 84:822–848.

17.

Tamagawa

, Giese-Davis

, Speca

, Doll

, Stephen

, Carlson

. Trait mindfulness, repression, suppression, and self-reported mood and stress symptoms among women with breast cancer. J Clin Psychol, 2013; 69:264–277.

18.

Roberts

, Danoff-Burg

. Mindfulness and health behaviors: is paying attention good for you?. J Am Coll Health, 2010; 59:165–173.

19.

Branstrom

, Duncan

, Moskowitz

. The association between dispositional mindfulness, psychological well-being, and perceived health in a Swedish population-based sample. Br J Health Psychol, 2011; 16(Pt 2):300–316.

20.

Barnes

, Brown

, Krusemark

, Campbell

, Rogge

. The role of mindfulness in romantic relationship satisfaction and responses to relationship stress. J Marital Fam Ther, 2007; 33:482–500.

21.

Tomfohr

, Pung

, Mills

, Edwards

. Trait mindfulness is associated with blood pressure and interleukin-6: exploring interactions among subscales of the Five Facet Mindfulness Questionnaire to better understand relationships between mindfulness and health. J Behav Med, 2015; 38:28–38.

22.

Burg

, Wolf

, Michalak

. Mindfulness as self-regulated attention: associations with heart rate variability. Swiss J Psychol, 2012; 71:135–139.

23.

Murphy

, Mermelstein

, Edwards

, Gidycz

. The benefits of dispositional mindfulness in physical health: a longitudinal study of female college students. J Am Coll Health, 2012; 60:341–348.

24.

Shapiro

, Brown

, Thoresen

, Plante

. The moderation of mindfulness-based stress reduction effects by trait mindfulness: results from a randomized controlled trial. J Clin Psychol, 2011; 67:267–277.

25.

Baer

, Smith

, Lykins

, et al. Construct validity of the Five Facet Mindfulness Questionnaire in meditating and nonmeditating samples. Assessment, 2008; 15:329–342.

26.

Cash

, Whittingham

. What facets of mindfulness contribute to psychological well-being and depressive, anxious, and stress-related symptomatology?. Mindfulness, 2010; 1:177–182.

27.

Fernandez

, Wood

, Stein

LAR

, Rossie

. Measuring mindfulness and examining its relationship with alcohol use and negative consequences. Psychol Addict Behav, 2010; 24:608–616.

28.

Consedine

, Butler

. Mindfulness, health symptoms and healthcare utilization: active facets and possible affective mediators. Psychol Health Med, 2014; 19:392–401.

29.

Levin

, Dalrymple

, Zimmerman

. Which facets of mindfulness predict the presence of substance use disorders in an outpatient psychiatric sample?. Psychol Addict Behav, 2014; 28:498–506.

30.

Ware

Jr , Sherbourne

. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care, 1992; 30:473–483.

31.

Ware

Jr.

SF-36 Health Survey. In: Maruish

, ed. The Use of Psychological Testing for Treatment Planning and Outcomes Assessment. 2nd ed. Mahwah, NJ: Lawrence Erlbaum Associates, 1999:1227–1246.

32.

DeBerard

, Masters

. Psychosocial correlates of the short-form-36 multidimensional health survey in university students. Psychology, 2014; 5:941–949.

33.

Davis

, Nida

, Zlomke

, Nebel-Schwalm

. Health related quality of life in college undergraduates with learning disabilities: the mediational roles of anxiety and sadness. J Psychopathol Behav Assess, 2009; 31:228–234.

34.

Cohen

, Kamarck

, Mermelstein

. A global measure of perceived stress. J Health Soc Behav, 1983; 24:385–396.

35.

Moeini

, Shafil

, Hidarnia

, Babaii

, Birasch

. Perceived stress, self-efficacy and its relations to the psychological well-being status in Iranian male high school students. Soc Behav Pers, 2008; 36:257–266.

36.

Ries

, Hino

, Rodriguez-Anez

. Perceived Stress Scale: reliability and validity study in Brazil. J Health Psychol, 2010; 15:107–114.

37.

Baer

, Smith

, Hopkins

, Krietemeyer

, Toney

. Using self-report assessment methods to explore facets of mindfulness. Assessment, 2006; 13:27–45.

38.

Gill

, Hodgkinson

. Development and validation of the Five-Factor Model Questionnaire (FFMQ): an adjectival-based personality inventory for use in occupational settings. Personnel Psychol, 2007; 60:731–766.

39.

Schutze

, Rees

, Preece

, Schutze

. Low mindfulness predicts pain catastrophizing in a fear-avoidance model of chronic pain. Pain, 2010; 148:120–127.

40.

White

, Labouvie

, Papadaratsakis

. Changes in substance us during the transition to adulthood: a comparison of college students and their noncollege age peers. J Drug Issues, 2005; 35:281–305.

41.

Devos-Comby

, Lange

. Standardized mesures of alcohol-related problems: a review of their use among college students. Psychol Addict Behav, 2008; 22:349–361.

42.

Martens

, Neighbors

, Dams-O'Connor

, Lee

, Larimer

. The factor structure of a dichotomously scored Rutgers Alcohol Problems Index. J Stud Alcohol Drugs, 2007; 68:597–606.

43.

White

, Labouvie

. Towards the assessment of adolescent problem drinking. J Stud Alcohol Drugs, 1989; 50:30–37.

44.

Miller

, Miller

, Verhegge

, Linville

, Pumariega

. Alcohol misuse among college athletes: self-medication for psychiatric symptoms?. J Drug Educ, 2002; 32:41–52.

45.

White

, Labouvie

. Longitudinal trends in problem drinking as measured by the Rutgers Alcohol Problem Index. Alcohol Clin Exp Res., 2000; 24:76A.

46.

Kraemer

, McLeish

, Johnson

. Associations between mindfulness and panic symptoms among young adults with asthma. Psychol Health Med, 2015; 20:322–331.

47.

Desrosiers

, Klemanski

D. H.

, Nolen-oeksema

. Mapping mindfulness facets onto dimensions of anxiety and depression. Behav Ther, 2013; 44:373–384.

48.

Neff

. Self-compassion: an altnerative conceptualization of a health attitude toward oneself. Self Identity, 2003; 2:85–101.

49.

Lykins

ELB

, Baer

. Psychological functioning in a sample of long-term practitioners of mindfulness meditation. J Cog Psychol, 2009; 23:226–241.

50.

Beauchemin

, Hutchins

, Patterson

. Mindfulness meditaton may lessen anxiety, promote social skills, and improve academic performance among adolescents with learning disabilities. J Evid Based Complementary Altern Med, 2008; 13:34–45.

51.

Brown

, Weinstein

, Creswell

. Trait mindfulness modulates neuroendocrine and affective responses to social evaluative threat. Psychoneuroendocrinology, 2012; 37:2037–2041.

52.

Chiesa

, Anselmi

, Serretti

. Psychological mechanisms of mindfulness-based interventions: what do we know?. Holist Nurs Pract, 2014; 28:124–148.

53.

Whitaker

, Dearth-Wesley

, Gooze

, Becker

, Gallagher

, McEwen

. Adverse childhood experiences, dispositional mindfulness, and adult health. Prev Med, 2014; 67:147–153.

54.

Regehr

, Glancy

, Pitts

. Interventions to reduce stress in university students: a review and meta-analysis. J Affect Dis, 2013; 148:1–11.

55.

Bodenlos

, Noonan

, Wells

. Mindfulness and alcohol problems in college students: the mediating effects of stress. J Am Coll Health, 2013; 61:371–378.

56.

Conley

, Durlak

, Dickson

. An evaluative review of outcome research on universal mental health promotion and prevention programs for higher education students. J Am Coll Health, 2013; 61:286–301.

57.

Josefsson

, Larsman

, Broberg

, Lundh

. Self-reported mindfulness mediates the relation between meditation experience and psychological well-being. Mindfulness, 2011; 2:49–58.