The influence of anxiety sensitivity on observing in mindfulness among clinical populations with anxiety and/or depressive disorders

Abstract Background: Many individuals who engage in mindfulness techniques experience decreased anxiety. Yet some who engage in mindfulness, particularly those with panic disorder (PD) or elevated anxiety sensitivity (AS) note heightened anxiety when focusing on particular sensations. The Five Facet Mindfulness Questionnaire (FFMQ) is the most widely utilized mindfulness questionnaire- however, the Observe facet has shown variability in the literature. This study therefore aimed to determine whether specific aspects of the Observe facet of the FFMQ differ in individuals with PD or elevated anxiety sensitivity (AS). Methods: We examined a clinical sample of 1521 Japanese individuals who completed online self-report questionnaires, including the Five Facet Mindfulness Questionnaire (FFMQ). Results: Several multiple indicator multiple cause (MIMIC) models investigated differential item functioning among the items in the Observe facet of the FFMQ, based on PD and/or AS. This process was repeated to examine the relationship between the Anxiety Sensitivity Index-3 (ASI-3) subscales and particular items of the Observe facet. Increased AS correlated with more observing generally, and increased AS was associated with greater scores on observing internal items and lower scores on observing external items. When PD and AS were analyzed simultaneously, only AS remained significant. The cognitive subscale showed the same pattern of results as the total ASI-3 subscale. Conclusions: The findings of this study reveal that AS may modulate the mindfulness experience. The study sheds light on the importance of understanding where an individual observes in order to tailor mindfulness treatments for individuals.