Psychometric Comparison of the Mindful Attention Awareness Scale and the Five Facet Mindfulness Questionnaire in Veterans Treated for Posttraumatic Stress Disorder

Objectives Mindfulness is increasingly relevant to posttraumatic stress disorder (PTSD) in veterans as a treatment component. The Mindful Attention Awareness Scale (MAAS) and Five Facet Mindfulness Questionnaire (FFMQ) are measures commonly used to assess mindfulness, but it is unclear if these scales measure distinct constructs, and their applicability to veterans has not been studied. We compare the psychometric properties of the MAAS and FFMQ in data collected from clinical trials. Methods Across three trials involving veterans with PTSD ( n = 487), analyses of factor structure, reliability, and validity were conducted for the MAAS and FFMQ. Validity analyses examined correlations between scales, demographic associations, treatment effects, and correlations with the PTSD Checklist 4 (PCL-4) and the World Health Organization Quality of Life scale (WHOQOL). Results The MAAS was consistent with a single-factor measurement model, and the FFMQ was consistent with a five-factor model. The FFMQ did not have a clear higher-order factor. Scores for both the MAAS and FFMQ demonstrated good reliability. Treatment had positive association with both MAAS and FFMQ Nonreactivity scores, and follow-up PCL-4 scores were strongly negatively associated with baseline MAAS scores and FFMQ Acting with Awareness and Nonreactivity scores. Also, WHOQOL scores were associated with MAAS and FFMQ baseline and change scores indicating good validity in this population. Conclusion The MAAS and FFMQ are reliable and valid measures of mindfulness in veterans with PTSD, though they measure different aspects of mindfulness, suggesting clinical trials should not use the MAAS or FFMQ as outcomes by themselves.