Abstract
A growing body of research suggests that mindfulness-based therapies may be effective in treating a
variety of disorders including stress, chronic pain, depression and anxiety. However, there are few
valid and reliable measures of mindfulness. Furthermore, mindfulness is often thought to be related to
spirituality, given its roots in Buddhist tradition, but empirical studies on this relationship are difficult
to find. The present study: (1) tested the reliability and validity of a new mindfulness measure, the
Freiburg Mindfulness Inventory (FMI), (2) explored the relationship between mindfulness and
spirituality, and (3) investigated the relationship between mindfulness and/or spirituality and alcohol
and tobacco use in an undergraduate college population (N=196). Results support the reliability of the
FMI and suggest that spirituality and mindfulness may be separate constructs. In addition, smoking
and frequent binge-drinking were negatively correlated with spirituality scores; as spirituality scores
increased the use of alcohol and tobacco decreased. Thus, spirituality may be related to decreased
substance use. In contrast, a positive relationship between mindfulness and smoking/frequent bingedrinking behavior was uncovered, and warrants further investigation.
D 2005 Elsevier Ltd. All rights reserved.
Keywords: Spirituality; Mindfulness; Substance abuse; Smoking; Binge-drinking; Freiburg Mindfulness Inventory
1. Introduction
Mindfulness is receiving increased attention in the scientific community, and has been
described as an awareness of moment by moment experience arising from purposeful
T Corresponding author. Present address: Department of Psychiatry and Behavioral Sciences, 1959 NE Pacific
Street, Box 356560, Seattle WA 98195-6560, United States.
E-mail address: janis2@u.washington.edu (J. Leigh).
0306-4603/$ - see front matter D 2005 Elsevier Ltd. All rights reserved.
doi:10.1016/j.addbeh.2005.01.010
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(NIAAA), 2002). Furthermore, full-time college students are more likely to drink than their
non-fulltime peers. Over 63% of college students reported drinking in 2001, as compared to
53.3% of non-college students (US DHHS, 2001).
Results of The Harvard University School of Public Health 1999 College Alcohol Study
(as reported by Wechsler, Lee, Kuo, & Lee, 2000) found that the overall rate of bbingeQ
drinking (5 drinks in a row for men, or 4 drinks in a row for women) did not change
significantly between 1993 and 1999. However, the number of frequent binge-drinkers (those
engaging in binge-drinking an average of 2 or more times per week) did change significantly,
increasing by 14.5% between 1993 and 1999.
Although the health hazards of smoking have been widely reported, cigarette use is
increasing on campuses nationwide. A recent review of the Harvard School of Public Health
College Alcohol Study (Wechsler, Rigotti, Gledhill-Hoyt, & Lee, 1998), found that the
prevalence of current smoking rose by 27.8% from 1993 to 1997 to 28.5% of college
students.
2. Methods
Undergraduate students (N=196) 18 and older completed questionnaires administered
during mass/pre-testing in their Introductory Psychology class. The sample consisted of 123
females (63%), 70 males (36%), and 3 (1%) unidentified.
Mindfulness was measured using the newly developed FMI. The FMI includes 30 items
(e.g., bI am open to the experience of the present moment.Q) rated on a 4-point scale ranging
from Rarely to Almost Always. Spirituality was assessed with two measures: the Spirituality
Assessment Scale (SAS) (Howden, 1992), and the Spiritual Transcendence Index (STI). The
SAS has been reported to be a reliable and valid measure of spirituality, while having no
significant relationship to ones attendance at weekly religious meetings (Howden, 1992).
The 28-item SAS is rated on a 6-point scale ranging from Strongly Disagree to Strongly
Agree (e.g., bMy inner strength is related to a belief in a Higher Power or Supreme Being.Q).
The STI has been reported to be a reliable and valid measure assessing a more inclusive
concept of spirituality, as distinct from religiousness or religious affiliation (Seidlitz et al.,
2002). The 8-item STI is rated on a 6-point scale ranging from Strongly Disagree to Strongly
Agree (e.g., bMy spirituality gives me a feeling of fulfillment.Q).
Alcohol use was assessed with two measures: the Daily Drinking Inventory (DDQ;
Dimeff, Baer, Kivlahan, & Marlatt, 1999), and the Alcohol Use Disorders Identification
Test (AUDIT; NIAAA, 2000). Subjects also identified themselves as either a smoker or a
non-smoker.
3. Results
A reliability analysis of the FMI scale yielded a reliability coefficient of 0.80. A principal
components factor analysis (with Varimax rotation) extracted three factors: (1) Acceptance
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Table 1
Smoking, hazardous drinking, peak weekend drinking, mindfulness and spirituality
Audita,TTT
Drinks Pk. WE nightTTT
FMI score (1 to 4)T
STI score (1 to 6)TT
SAS score(1 to 6)
Non-smokers (n=146151)
M (S.D.)
Smokers (n=3842)
M (S.D.)
3.81
1.40
2.66
3.84
4.62
10.42 (5.08)
6.37 (5.00)
2.79 (.31)
3.04 (1.41)
4.43 (.48)
(5.14)
(2.50)
(.33)
(1.56)
(.57)
Smokers had significantly higher AUDIT scores than non-smokers (t(191)= 7.38, pb0.001), and drank
significantly more drinks per night on a peak week-end (t(187)= 8.71, pb0.001). The significant positive
relationship between smoking and FMI scores (t(190)= 2.20, pb0.05), is contrasted with a significant negative
relationship between smoking and STI scores t(185)=2.89, pb0.01). The negative relationship between smoking
and SAS scores approached significance (t(182)=1.95, p=0.052).
a
A score of 8 or higher is considered hazardous drinking.
T Significant at 0.05 value.
TT Significant at 0.01 value.
TTT Significant at 0.001 value.
and Openness to Self and Experiences (e.g., bI accept myself as I am.Q) alpha=0.76, (2) Mind/
Body Awareness (e.g., bI notice how my emotions express themselves through my body.Q)
alpha=0.73, and (3) Non-Attachment to Thoughts (e.g., bI watch my thoughts without
identifying with themQ) alpha=0.62.
To assess the relationship between the constructs of mindfulness and spirituality, a
correlational analysis was performed on the FMI, SAS, and STI mean scores. SAS scores
were positively correlated with FMI scores (r=0.45, pb0.01), and with STI scores (r=0.52,
pb0.01). No significant correlation was found between FMI and STI scores. This might
suggest that the SAS contains features of both mindfulness and spirituality, while the FMI and
STI may be measuring these constructs separately.
A t-test comparing smokers and non-smokers with FMI, SAS and STI mean scores
revealed that non-smokers scored significantly higher than smokers on the STI, while the
reverse was true on the FMI (Table 1). A t-test of drinking behavior was limited to
Table 2
Drinking, mindfulness and spirituality
Non-drinker (n=7981)
M (S.D.)
2.65 (.34)
4.06 (1.61)
4.63 (.62)
2.83 (.31)
3.30 (1.32)
4.54 (.50)
The significant positive relationship between frequent binge-drinking and FMI scores t(120)= 2.78, pb0.01) is
contrasted with a significant negative relationship between frequent binge-drinking and STI scores (t(116)=2.54,
pb0.05). SAS score differences were not significant.
T Significant at 0.05 value.
TT Significant at 0.01 value.
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In contrast to the positive relationship between mindfulness and substance use, we found a
negative relationship between spirituality and substance use. This finding suggests that those
with high spirituality engage in fewer harmful behaviors and is consistent with the 12-step
philosophy. Perhaps those with high spirituality scores have a higher internal locus of control,
a relationship that will be explored in our follow-up study.
Given the rise in both frequent binge-drinking and smoking on college campuses, there is a
growing need for new interventions. Further research may clarify the role of mindfulness and
spirituality in substance use, and assist in prevention efforts by identifying important
mediators of these addictive, and potentially harmful, behaviors.
To our knowledge this is the first study to test the reliability and validity of the FMI in the
United States. This study may also be the first to examine empirically the relationship
between mindfulness and spirituality. While the results are preliminary, they suggest that
these constructs can be measured reliably through self-report and may assist in identifying an
important relationship between substance use and mindfulness. Can heightened sensitivity be
a risk-factor in the use of substances? Our next study may help to answer that question.
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