Preliminary validation of the Cognitive Affective Mindfulness Scale-Revised in cancer populations.

A 10-item version of the Cognitive Affective Mindfulness Scale-Revised (CAMS-R) shows promise for measuring mindfulness in people with cancer. In a sample of 404 patients with breast, gastrointestinal, lung, or prostate cancer (half with stage IV cancer, 51% women), the scale's original four-factor structure (attention, present focus, awareness, acceptance) with an overall mindfulness factor fit the data reasonably well. Internal consistency was excellent. Higher mindfulness scores correlated with greater self-compassion and lower anxiety, depressive symptoms, rumination, psychological inflexibility, and avoidant coping. The scale performed consistently across genders, cancer types, and cancer stages. Further research should test whether the CAMS-R can detect changes from mindfulness interventions.

Study at a glance

Abstract

A brief, valid, and comprehensive measure of mindfulness is needed for cancer populations. This study examined the factor structure, internal consistency, construct validity, and measurement invariance of the 10-item Cognitive Affective Mindfulness Scale-Revised (CAMS-R) in patients with cancer. Patients with breast, gastrointestinal, lung, or prostate cancer (N = 404, 50% stage IV cancer, 51% women) were recruited from academic and public clinics in Indianapolis, IN. Patients completed the CAMS-R and other psychological measures at one time point. Confirmatory factor analysis (CFA) was used to examine the dimensionality of the CAMS-R. Internal consistency and construct validity were also assessed. Measurement invariance was examined for gender, cancer type, and cancer stage. CFA showed that the original CAMS-R structure with four first-order factors (attention, present focus, awareness, and acceptance) and one second-order factor (mindfulness) had a reasonable fit (RMSEA = 0.09, CFI = 0.95, SRMR = 0.04). Internal consistency was excellent (α = 0.90). The CAMS-R total score showed significant positive associations with several subscales of a widely used mindfulness questionnaire and self-compassion (rs = 0.61-0.66) and significant negative associations with anxiety, depressive symptoms, rumination, psychological inflexibility, and avoidant coping (rs = -0.35-0.58). Measurement invariance testing indicated that the CAMS-R was invariant across populations of varying genders, cancer types, and stages. Findings provide preliminary support for using the CAMS-R in cancer populations. Future research should assess the responsiveness of the CAMS-R to intervention.