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Psychometric properties of the Dutch Five Facet Mindfulness Questionnaire (FFMQ) in patients with fibromyalgia
Open accessAbstract
Mindfulness-based interventions are increasingly being used in clinical populations to reduce psychological distress and improve functioning. The Five Facet Mindfulness Questionnaire (FFMQ) is a questionnaire that measures five facets of mindfulness: observe, describe, actaware, nonjudge and nonreact. The goal of this study was to examine the psychometric properties of the FFMQ in a clinical population of fibromyalgia patients. A total of 141 patients completed an online questionnaire on mindfulness (FFMQ) and theoretically related (e.g. acceptance, openness, alexithymia) and unrelated (physical health) constructs. Thirty-eight patients filled in the FFMQ twice. A confirmatory factor analysis (CFA) was conducted to test the five-factor structure of the FFMQ. Internal consistency and test-retest reliability were respectively assessed with Cronbach's α and intraclass correlation coefficients. Construct validity was examined by correlating FFMQ facets with theoretically related and unrelated constructs. Incremental validity in predicting mental health and psychological symptoms was examined with regression analyses. CFA confirmed the correlated five-factor structure of the FFMQ. Internal consistency of the five facets was satisfactory and test-retest reliability was good to excellent. Construct validity was excellent, as shown by the moderate to large correlations with related constructs (except observe facet) and weak correlation with a theoretically unrelated construct. Two of the five facets (actaware and nonjudge) had incremental validity over the others in predicting mental health and psychological symptoms. After controlling for related constructs, the actaware facet remained a significant predictor. This study showed satisfactory psychometric properties of the Dutch FFMQ in fibromyalgia patients. The observe facet, however, should be used with caution given its deviant relationship with theoretically related constructs.
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“Even though conceptualized to represent a hierarchical factor structure, with mindfulness on top of the five facets, empirical research among non-meditators repeatedly showed that Observe fits only insufficiently into this structure, or is even unrelated to overall mindfulness [14], [19], [20], [22]–[24].”
From The serenity of the meditating mind: A cross-cultural psychometric study on a two-factor higher order structure of mindfulness, its effects, and mechanisms related to mental health among experienced meditators (2014) · cites this paper as [19]
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“Validation studies of the FFMQ, for instance, have shown that its mindfulness facets correlate to a medium-to-large magnitude with specific measures of decentering (e.g., EQ) and acceptance (e.g., the Accpetance and Action Questionnaire, AAQ; Soler et al., 2014; Veehof et al., 2011), suggesting that these aspects may be operationally challenging to disentangle from each other.”
From Mediators of acceptance and mindfulness-based therapies for anxiety and depression: A systematic review and meta-analysis (2022) · cites this paper as Veehof et al., 2011
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“As validation studies of the FFMQ have shown that the various mindfulness facets measured by the FFMQ correlate to a medium-to-large magnitude with specific measures of decentering (e.g., EQ) and acceptance (e.g., the Accpetance and Action Questionnaire, AAQ) (Soler et al., 2014; Veehof et al., 2011)”
From Mediators of acceptance and mindfulness-based therapies for anxiety and depression: A systematic review and meta-analysis (2022) · cites this paper as Veehof et al., 2011
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“These findings correspond to earlier research (e.g., Baer et al., 2006; Veehof et al., 2011).”
From Further evaluation of the psychometric properties of the acceptance and action questionnaire-II (2012) · cites this paper as Veehof et al., 2011
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“However, FFMQ facets and decentering appear to be stable over time (Veehof et al. 2011; Soler et al. 2014b).”
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“…based on previous studies on ACT in the area of chronic pain (e.g., McCracken & Eccleston, 2005; Trompetter, Bohlmeijer, Baalen, et al., 2013; Vowles & McCracken, 2008; Wicksell, Lekander, Sorjonen, & Olsson, 2010), nonsignificant to small negative correlations were anticipated with pain…”
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“…5 Valkamo (2001)122 Chest pain M Finland 200 58.1 (9.4) 34% TAS-20 4 van Middendorp (2008)123 Fibromyalgia C, G, M Netherlands 403 46.5 (12.3) 100% TAS-20 6 Veehof (2011)124 Fibromyalgia M Netherlands 141 43.1 (10.9) 92% TAS-20 5 Vieira (2013)125,* Headache C, M Brazil 39 43.6 (10.7) 100% TAS-26 6…”
InfluentialThe Italian five facet mindfulness questionnaire: A contribution to its validity and reliability
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“…clinical and non-clinical samples across different languages and cultural backgrounds (Baer et al. 2008; Bohlmeijer et al. 2011; Bränström et al. 2010; Carmody and Baer 2008; Deng et al. 2011; Fernandez et al. 2010; Heeren et al. 2011; Lilja et al. 2011; Sugiura et al. 2011; Veehof et al. 2011).”
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“Besides in English, the FFMQ has been validated in a number of other languages (Chinese [18], Dutch [19], German [20], Spanish [21], and Swedish [22]), using patient, meditating, and nonmeditating samples.”
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“Moreover, the values of the items factor loadings were satisfactory with an average of 0.58, in comparison with the other validations, wherein the factor loadings ranged from 0.31 to 0.92 (Christopher, Neuser, Michael, & Baitmangalkar, 2012; Tran et al., 2013; Veehof et al., 2011).”
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“Furthermore, the Nonreact facet that captured the acceptance has been criticized for its low internal consistency and poor association with the global mindfulness score (Deng et al. 2011; Veehof et al. 2011).”
BackgroundDimensions of Mindfulness and Their Relations with Psychological Well-Being and Neuroticism
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“The Five Facet Mindfulness Questionnaire (FFMQ) is a validated, 39-item questionnaire that measures five facets of mindfulness: observe, describe, act aware, nonjudge, and nonreact [52].”
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“…hand, studies have also found support for a five-factor correlated and a five-factor hierarchical model as providing the best fit in individuals with no meditation experience (Bohlmeijer, ten Klooster, Fledderus, Veehof, & Baer, 2011; Veehof, ten Klooster, Taal, Westerhof, & Bohlmeijer, 2011).”
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“The results from this study showed that the data taken from the patient sample had a similar factorial structure to data taken from a healthy sample [28].”
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“Of note, this measure has been used previously with patients with fibromyalgia and was found to be a reliable and valid measure with which to assess mindfulness in that population [34].”
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“The test-retest reliability has also been demonstrated to be good to excellent in a Dutch sample (Veehof et al., 2011).”
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“Mindfulness skills are examined with the 39-item Five Facet Mindfulness Questionnaire (FFMQ) [61,62].”
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“It is interesting that also in other target groups like for example men with advanced prostate cancer [57], fibromyalgia patients [58], and a community sample comprising of non-meditators and experienced meditators [59] of all FFMQ subscales ‘acting with awareness’ and ‘non-judging’ are strongest associated with lower…”
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Scrutinizing the Components of Mindfulness: Insights from Current, Past, and Non-meditators
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“The FFMQ has been shown to have good internal consistency and test–retest reliability (Lilja et al., 2011; Veehof et al., 2011) and has been used in a range of mindfulness studies comprising large numbers of participants (Thompson & Waltz, 2010; Veehof et al., 2011; Cowdrey & Park, 2012).”
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“Dispositional mindfulness was assessed via the 39-item Five Facet Mindfulness Questionnaire [39] which has five subscales related to observing, describing, being non-judgmental and non-reactive to feelings, thoughts, and emotions, and acting with awareness in the moment.”
Mindfulness and Emotional Distress: the Mediating Role of Psychological well-Being
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“The FFMQ is one of the most commonly used measures to assess mindfulness and has been validated with both clinical and nonclinical populations (Aguado et al. 2015; Veehof et al. 2011).”
MethodItem Response Theory Analysis of the Five Facet Mindfulness Questionnaire and Its Short Forms
Pelham III, W. E., Gonzalez, O., Metcalf, S. A., Whicker, C. L., Scherer, E. A., Witkiewitz, K., Marsch, L. A., & Mackinnon, D. P. (2019) · Mindfulness · doi:10.1007/s12671-019-01105-x · Cited by 25
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“, psychological well-being) [43], and retest reliability [44].”
Wang, C., McAlindon, T. E., Fielding, R. A., Harvey, W. F., Driban, J. B., Price, L. L., Kalish, R. A., Schmid, A., Scott, T. M., & Schmid, C. H. (2015) · Trials · doi:10.1186/s13063-015-0548-x · Cited by 28
“The Five Facet Mindfulness Questionnaire is a validated, 39-item questionnaire that measures five facets of mindfulness: observe, describe, act aware, nonjudge, and nonreact [59].”
BackgroundKlaassen, K., Nyklíček, I., Traa, S., & de Nijs, R. N. J. (2011) · Clinical Rheumatology · doi:10.1007/s10067-011-1905-0 · Cited by 25
Cladder-Micus, M. B., Vrijsen, J. N., Becker, E. S., Donders, R. A. R. T., Spijker, J., & Speckens, A. E. M. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0647-y · Cited by 25
“The Dutch version of the FFMQ has good psychometric properties [35, 36] and has previously been used in research on mindfulness skills in bipolar disorder [37].”
MethodCheng, S. K., Banks, K., Bartlett, B. A., Miguel, G. S., & Vujanovic, A. A. (2017) · Mindfulness · doi:10.1007/s12671-017-0814-y · Cited by 24
Trait mindfulness during pregnancy and perception of childbirth
Hulsbosch, L. P., Boekhorst, M. G. B. M., Potharst, E. S., Pop, V. J. M., & Nyklíček, I. (2021) · Archives of Women s Mental Health · doi:10.1007/s00737-020-01062-8 · Cited by 23
The Validity and Reliability of the Short Form of the Five Facet Mindfulness Questionnaire in Japan
Takahashi, T., Saito, J., Fujino, M., Sato, M., & Kumano, H. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.833381 · Cited by 26
Feliu-Soler, A., Pérez-Aranda, A., Luciano, J. V., Demarzo, M., Mariño, M., Soler, J., Van Gordon, W., García-Campayo, J., & Montero-Marín, J. (2021) · Mindfulness · doi:10.1007/s12671-020-01549-6 · Cited by 22
Reynolds, L., Consedine, N. S., & McCambridge, S. A. (2013) · Mindfulness · doi:10.1007/s12671-013-0200-3 · Cited by 25
Mind fulness and Music: A Promising Subject of an Unmapped Field
Lecuona, O. Z., & Rodríguez‐Carvajal, R. (2014) · International Journal of Behavioral Research & Psychology · doi:10.19070/2332-3000-140006 · Cited by 27
Racine, M., Jensen, M. P., Harth, M., Morley-Forster, P., & Nielson, W. R. (2018) · Journal of Pain · doi:10.1016/j.jpain.2018.09.013 · Cited by 22
Schuman‐Olivier, Z., Hoeppner, B. B., Evins, A. E., & Brewer, J. A. (2014) · Substance Use & Misuse · doi:10.3109/10826084.2014.850254 · Cited by 23
“The FFMQ nonjudgment subscale ranges from 0 to 40 with means in community samples and clinical populations ranging from 23.85 (7.33) to 29.13 (5.79) compared with meditators, 32.4 (5.63) (Baer et al., 2008; Veehof et al., 2011).”
BackgroundInfluentialSpinhoven, P., Hoogerwerf, E., van Giezen, A. E., & Greeven, A. (2022) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2022.102599 · Cited by 28
Validation of the five facet mindfulness questionnaire among community-dwelling older adults.
Brady, B., Kneebone, I. I., & Bailey, P. E. (2019) · Mindfulness · doi:10.1007/s12671-018-0994-0 · Cited by 20
Consedine, N. S., & Butler, H. F. (2014) · Psychology, Health & Medicine · doi:10.1080/13548506.2013.824596 · Cited by 19
Psychometric properties of Persian version of five facets of mindfulness questionnaire
Khanjani, S., Foroughi, A., Bazani, M., Rafiee, S., Tamannaeifar, S., & Habibi, M. (2022) · Journal of Research in Medical Sciences · doi:10.4103/jrms.jrms_10_20 · Cited by 20
“[7] However, no consensus has been reached on the conceptualization of mindfulness, and there were differences such as generalizability, content, and structure problems.[8] On the other hand, most of these self‐report scales do not measure different dimensions of mindfulness.”
BackgroundSchneider, M. N., Zavos, H. M. S., McAdams, T. A., Kovas, Y., Sadeghi, S., & Gregory, A. M. (2019) · Behaviour Research and Therapy · doi:10.1016/j.brat.2018.11.002 · Cited by 17
McClintock, A. S., Anderson, T., & Cranston, S. (2015) · Behavior Therapy · doi:10.1016/j.beth.2015.08.002 · Cited by 17
“The FFMQ has demonstrated convergent validity with other mindfulness measures, divergent validity with measures of thought suppression and absentmindedness, and test-retest reliability (ICCs N 0.60) over a 2-week interval (Baer et al., 2006; Baer et al., 2008; Veehof et al., 2010).”
BackgroundInfluentialLilja, J. L., Falkenström, F., Zelleroth, C., Jacobson, E., Risberg, S., Nissling, L., & Weineland, S. (2020) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12602 · Cited by 14
Caluyong, M. B., Zambrana, A. F., Romanow, H. C., Nathan, H. J., Nahas, R., & Poulin, P. A. (2015) · Mindfulness · doi:10.1007/s12671-015-0401-z · Cited by 14
“acting with awareness was a positive predictor of mental HRQOL and a negative predictor of depression (Veehof et al. 2011).”
BackgroundTrait mindfulness scores are related to trajectories of depressive symptoms during pregnancy
Hulsbosch, L. P., Boekhorst, M. G. B. M., Endendijk, J. J., Nyklı́ček, I., Potharst, E. S., & Pop, V. J. M. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.04.023 · Cited by 15
Hulsbosch, L. P., van de Poel, E., Nyklı́ček, I., & Boekhorst, M. G. B. M. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.12.007 · Cited by 14
Five Facet Mindfulness Questionnaire (FFMQ)
Danielson, C. M., & Jones, S. M. (2017) · Wiley eBooks · doi:10.1002/9781119102991.ch26 · Cited by 15
Mindfulness-Based Stress Reduction in Pre-symptomatic Genetic Frontotemporal Dementia: A Pilot Study
Poos, J. M., van den Berg, E., Papma, J. M., van der Tholen, F. C., Seelaar, H., Kaat, L. D., Kievit, J., Tibben, A., Swieten, J. C. V., & Jiskoot, L. C. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.864391 · Cited by 13
Svendsen, J. L., Schanche, E., Osnes, B., Vøllestad, J., Visted, E., Dundas, I., Nordby, H., Binder, P., & Sørensen, L. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00614 · Cited by 13
“The test-retest reliability was demonstrated to be good to excellent in a Dutch sample (Veehof et al., 2011).”
BackgroundZainal, N. H., Tan, H. H., Hong, R. Y. S., & Newman, M. G. (2024) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2024.102858 · Cited by 15
Mindfulness, Sustained Attention and Post-traumatic Stress in Tsunami Survivors
Hagen, C., Lien, L., Hauff, E., & Heir, T. (2016) · Psychology and Cognitive Sciences - Open Journal · doi:10.17140/pcsoj-2-115 · Cited by 13
Validation of the Polish version of the Short Form of the Five Facet Mindfulness Questionnaire
Radoń, S., & Rydzewska, M. (2018) · Roczniki Psychologiczne · doi:10.18290/rpsych.2018.21.3-5 · Cited by 12
“They also support the thesis that mindfulness has a multifaceted structure (5-facet orthogonalmodel), as suggested in various studies conducted in other countries (Baer et al., 2006; Bohlmeijer et al., 2011; Dundas et al., 2013; Heeren et al., 2011; Hou et al., 2013; Sugiura et al., 2012; Veehof et al., 2011).”
MethodResultInfluentialIs mindfulness protective against PTSD? A neurocognitive study of 25 Tsunami disaster survivors
Hagen, C., Lien, L., Hauff, E., & Heir, T. (2016) · Journal of Negative Results in BioMedicine · doi:10.1186/s12952-016-0056-x · Cited by 11
“The FFMQ has been validated in several countries [7, 15–19], including Norway [20].”
MethodNonreactivity and metacognition in mindfulness
Whitmarsh, S. (2013) · Radboud Repository (Radboud University) · Cited by 11
Baminiwatta, A., Alahakoon, H., Herath, N. C., Kodithuwakku, K. M., & Nanayakkara, T. (2022) · Mindfulness · doi:10.1007/s12671-022-01863-1 · Cited by 11
“Nonjudge being negatively correlated with Observe has been previously reported in studies validating several translations of the FFMQ, including Chinese, Japanese, Italian and Dutch versions (Arthur et al., 2017; Giovannini et al., 2014; Hou et al., 2013; Sugiura et al., 2012; Veehof et al., 2011).”
ResultCiere, Y., Snippe, E., Padberg, M., Jacobs, B., Visser, A., Sanderman, R., & Fleer, J. (2018) · Health Psychology · doi:10.1037/hea0000692 · Cited by 11
The Relationship between Mindfulness and Burnout among Master of Social Work Students
Piatkowska, J. (2000) · doi:10.15760/etd.1961 · Cited by 10
“Although in some previous studies (Baer et al., 2008, Bohlmeijer et al., 2011, Eisenlohr-Moul et al., 2012, Veehof et al., 2011) one of the facets of mindfulness, observing, was strongly correlated with well-being for the experienced meditators, but not for the non-meditators, this study has not…”
BackgroundResultSturgess, M. A. (2012) · doi:10.26686/wgtn.17003407 · Cited by 13
Barros, V. V., Opaleye, E. S., Demarzo, M., Bowen, S., Curado, D. F., Hachul, H., & Noto, A. R. (2018) · PLoS ONE · doi:10.1371/journal.pone.0194035 · Cited by 9
Mindfulness and asthma symptoms: A study among college students
Shi, L., Liang, D., Gao, Y., Huang, J., Nolan, C., Mulvaney, A., Poole, T., & Zhang, H. (2018) · Journal of Asthma · doi:10.1080/02770903.2017.1306545 · Cited by 10
Mindfulness-Based Cognitive Therapy for Individuals Who Are Suicidal: A Randomized Controlled Trial
Jaegere, E. D., Dumon, E., van Heeringen, K., van Landschoot, R., Stas, P., & Portzky, G. (2023) · Archives of Suicide Research · doi:10.1080/13811118.2023.2282663 · Cited by 9
“The FFMQ-SF has good psychometric properties (Bohlmeijer et al., 2011; Veehof et al., 2011).”
Refinement and Validation of the Balanced Inventory of Mindfulness-Related Skills (BIMS)
Padmanabham, S. S., Bilgrami, Z. R., Eisenlohr-Moul, T. A., & Dam, N. T. V. (2021) · Mindfulness · doi:10.1007/s12671-020-01590-5 · Cited by 10
Kraemer, K. M., & McLeish, A. (2019) · Psychology, Health & Medicine · doi:10.1080/13548506.2018.1529326 · Cited by 7
Metadata
- Authors
- Veehof, M. M., ten Klooster, P. M., Taal, E., Westerhof, G. J., & Bohlmeijer, E. T.
- Affiliations
- University of Twente (NL)
- Corresponding author
- Veehof, Martine M.
- Venue
- Clinical Rheumatology
- Published
- 2011-02-25
- Volume
- 30
- Issue
- 8
- Pages
- 1045-1054
- ISSN
- 0770-3198 (ISSN-L)
- 1434-9949
- PMC
- PMC3145081
- OpenAlex
- W2102457727
- Cited by
- 158
- References
- 46
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 8 · 2023: 7 · 2022: 19 · 2021: 7 · 2020: 9 · 2019: 16 · 2018: 14 · 2017: 10 · 2016: 16 · 2015: 9 · 2014: 15 · 2013: 10 · 2012: 3
- FWCI
- 10.68
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Clinical Rheumatology (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- University of Twente Research Information (publishedVersion)
- University of Twente Research Information (submittedVersion, other-oa)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- Five Facet Mindfulness Questionnaire, fibromyalgia, mindfulness, psychometric properties, incremental validity, construct validity, test-retest reliability, acceptance, alexithymia, mental health, psychological symptoms
- MeSH terms
- Adult, Mental Disorders, Female, Fibromyalgia, Humans, Male, Psychometrics, Surveys and Questionnaires, Self-Assessment, Stress, Psychological, Reproducibility of Results, Mind-Body Relations, Metaphysical, Mind-Body Therapies
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