STATE MINDFULNESS SCALE (SMS) 1

Running Head: STATE MINDFULNESS SCALE (SMS)

State Mindfulness Scale (SMS)

Liad Ruimi, M.A.

Yuval Hadash, M.A.

Galia Tanay, Ph.D.

Amit Bernstein, Ph.D.

University of Haifa

Preprint submitted and accepted for publication as a chapter in Handbook of Assessment

in Mindfulness, O. N. Medvedev, C. U. Krägeloh, R. J. Siegert, & N. N. Singh (Eds.).

Corresponding Author: Amit Bernstein, Ph.D.; Director, The International Research

Collaborative on Anxiety. Dr. Bernstein can be contacted at the University of Haifa, Department

of Psychology, Mount Carmel, Haifa, 31905, Israel, 972-4-824-8863 (phone), 972-4-824-0966

(facsimile). Electronic mail: abernstein@psy.haifa.ac.il

Author Note. A. Bernstein recognizes the support of the Israel Science Foundation. Y. Hadash

recognizes the support of the Mind and Life Institute Varela Award. Authors have no conflict of

interest to report.
 STATE MINDFULNESS SCALE (SMS) 2

Abstract

The Satipatṭhāna Sutta describes mindfulness as a mental state characterized by the

objects of mindful awareness (i.e., what experience a person attends to) and mental qualities of

that mindful awareness (i.e., how a person attends to experience). In contemporary psychology,

mindfulness is often similarly conceptualized as a trait or a state characterized by two

components: attention of physical/bodily and mental present moment experience (i.e., what

experience a person attends to) and a mental attitude characterized by curiosity and acceptance of

present moment experience (i.e., how a person attends to experience) (Bishop et al., 2004;

Lindsay & Creswell, 2017). Integrating these canonical and contemporary theoretical

perspectives, Tanay and Bernstein (2013) developed the State Mindfulness Scale (SMS). The

SMS is a 21-item self-report measure designed to assess state mindfulness. More specifically, the

SMS is designed to quantify subjective levels of present moment attention to and awareness of

two domains of experiential events or objects of which one may be mindful, bodily sensations

and mental events, during a specific period of time (e.g., past 15 minutes) and context (e.g.,

mindfulness meditation or other activity). In this chapter, we review the theoretical foundations,

development, initial validation and subsequent psychometric study of the SMS. We also describe

the SMS administration and scoring, and briefly, the limitations and possible next steps for the

psychometric study of the SMS and the measurement of state mindfulness more broadly.

Key Words: mindfulness, state mindfulness, trait mindfulness, mindfulness measurement

 STATE MINDFULNESS SCALE (SMS) 3

State Mindfulness Scale (SMS)

Theoretical Foundations

The canonical Satipatṭhāna Sutta delineates four foundations for mindfulness, each

referring to objects of experience of which one may be mindful: body, hedonic tone, mind, and

mental states conducive to wisdom (Anālayo, 2003; Shulman, 2010; Thera, 1972). Mindful

awareness of each of these objects of experience is characterized by the following mental

qualities: a balanced and sustained application of effort (ātāpī), clear knowing (sampajāna), and

a balanced state of mind free from desire (abhijjhā) and discontent (Anālayo, 2003). The

Satipatṭhāna Sutta thus describes mindfulness as a mental state characterized by the objects of

mindful awareness (i.e., what experience a person attends to) and mental qualities of that

mindful awareness (i.e., how a person attends to experience).

Although a debate in defining mindfulness is ongoing (Chiesa, 2013; Dreyfus, 2011; Van

Dam et al., 2018), in contemporary psychology mindfulness is often similarly conceptualized as

a trait or a state characterized by two components: attention of physical and mental present

moment experience (i.e., what experience a person attends to) and a mental attitude characterized

by curiosity and acceptance of present moment experience (i.e., how a person attends to

experience) (Bishop et al., 2004; Lindsay & Creswell, 2017). Studies focusing on mindfulness as

a trait have contrasted participants with different levels of experience in mindfulness (e.g., long-

term practitioners vs. novices) or examined individual differences in self-report measures of

dispositional or trait mindfulness. These include studies focusing on self-reports (e.g., Hollis-

Walker & Colosimo, 2011), behavioral measures (e.g., Hodgins & Adair, 2010), indices of brain

morphology (e.g., Fox et al., 2014), and indices of functional brain activity not during

mindfulness meditation (e.g., Creswell, Way, Eisenberger, & Lieberman, 2007). Studies focusing
 STATE MINDFULNESS SCALE (SMS) 4

on mindfulness as a state have investigated differences in psychophysiological activity or

functional brain activity between states of mindful practice and resting states (state X trait

interactions; Davidson & Kaszniak, 2015; e.g., Gard et al., 2012); as well as individual

differences in self-report measures of state mindfulness (e.g., Lau et al., 2006; Tanay &

Bernstein, 2013), or experience samples of mindful states (e.g., Shoham, Goldstein, Oren,

Spivak, & Bernstein, 2017; Shoham, Hadash, & Bernstein, in press).

As highlighted in this volume on mindfulness assessment, the large majority of measures of

mindfulness are retrospective self-report scales of dispositional or trait mindfulness (see Sauer et

al., 2013, for a review). To date, there are three published state mindfulness scales: the state-

Mindful Attention Awareness Scale (state-MAAS; Brown & Ryan, 2003), the Toronto

Mindfulness Scale (TMS; Lau et al., 2006), and the State Mindfulness Scale (SMS; Tanay &

Bernstein, 2013). State mindfulness measures are necessary to study mindfulness as a dynamic

mental state with high temporal- and contextual- resolution. Such measurements, we argue, can

advance the science of mindfulness by enabling study of, for example: the developmental

trajectory of mindfulness over the course of mindfulness training (Shoham et al., 2017; Shoham

et al., in press), the effects of mindfulness practice types and “dose” (e.g., duration and

frequency; Dahl, Lutz, & Davidson, 2015; Lutz, Jha, Dunne, & Saron, 2015), and the correlates

or effects of state mindfulness in different contexts (e.g., mindfulness meditation, daily living)

and levels of expertise (e.g., novices, experts).

Despite their important contribution to early study of mindfulness as a state, the state-

MAAS and TMS have notable limitations. State-MAAS items do not capture attention and

awareness of physical and mental experience but are designed to measure mind-wandering and

lack of attention and awareness during one’s engagement in daily activities, and not during
 STATE MINDFULNESS SCALE (SMS) 5

mindfulness meditation (e.g., “I rushed through activities without being really attentive to them”;

see (Van Dam, Earleywine, & Borders, 2010). Likewise, the TMS is limited as it incorporates

decentering, that has been conceptualized and studied as a proximal mechanism or outcome of

mindfulness (Bernstein et al., 2015; Hadash, Lichtash, & Bernstein, 2017; Holzel et al., 2011;

Naragon-Gainey & DeMarree, 2017); and its items do not reflect the breadth of objects and

qualities of mindful awareness due to their focus on curiosity, decentering, and limited reference

to mindfulness of physical sensations. To overcome these limitations of extant measures of state

mindfulness, Tanay and Bernstein (2013) developed the SMS in an effort to better assess the

breadth of objects (e.g., body & mind) and qualities (e.g., curiosity, intimacy, sensitivity to

experience) of mindful awareness in different contexts (e.g., mindfulness meditation, daily

living).

The SMS is grounded in an integrative conceptual and operational model of state

mindfulness based on traditional Buddhist and contemporary psychological definitions of

mindfulness. Tanay and Bernstein (2013) related to this as the two-level model of state

mindfulness (see Figure 1). The first level reflects the objects of mindful awareness (i.e., what

experience a person attends to). This level includes the two main domains of objects of attention

of which one may be mindful –physical sensations and mental events. Importantly, according to

the model, objects in these domains of mindful awareness can have different types of hedonic

tone: pleasant, unpleasant, or neutral. In line with the Buddhist canonical Satipatṭhāna Sutta,

hedonic tone and the two domains and of mindful awareness (i.e., physical sensations, mental

events) reflect three of the four foundations of mindfulness (Anālayo, 2003). The second level in

the model reflects the qualities of mindful awareness (i.e., how a person attends to experience).

In line with mindful attitudes emphasized by contemporary and Buddhist scholars, these qualities
 STATE MINDFULNESS SCALE (SMS) 6

of mindful awareness include perceptual sensitivity to stimuli, deliberate attention, willingness to

feel one’s subjective experience (originally described as intimacy or closeness to experience),

and curiosity (e.g., Anālayo, 2003; Bishop et al., 2004; Lau et al., 2006). Importantly, these

qualities are not distinct facets or dimensions but integral properties of mindfulness as a unified

mental state.

How a person attends to experience

(a) Perceptual sensitivity to stimuli

Level 2: Qualities of
(b) Deliberate attention
mindful awareness
(c) Willingness to feel one’s subjective experience
(d) Curiosity

What experience a person attends to

(a) Physical (b) Mental

sensations events
Level 1: Objects of
mindful awareness Pleasant, Pleasant,
unpleasant, unpleasant,
or neutral or neutral

Figure 1. The two-level model of state mindfulness (Tanay & Bernstein, 2013).

Initial Development and Validation

The State Mindfulness Scale (SMS) is a self-report measure designed to assess state

mindfulness (Tanay & Bernstein, 2013). It is designed to quantify participants' perceived level of

attention to and awareness of their present experience during a specific period of time (e.g., past
 STATE MINDFULNESS SCALE (SMS) 7

15 minutes) and context (e.g., following mindfulness meditation or other activity). Items were

selected per the proposed conceptual model of state mindfulness grounded in Buddhist

scholarship and contemporary psychology as reflected by the two-level model of state

mindfulness (above). Item content was generated to reflect mindful attention and awareness of

mind, body, the pleasant/unpleasant/neutral hedonic tones of these objects of awareness, and the

qualities thought to characterize mindful awareness. A particular emphasis was placed on using

simple language so that participants with variable levels of mindfulness experience could

meaningfully and accurately report on their subjective experience. Moreover, whereas item

content was explicitly designed to not admix reference to the objects of mindful awareness (i.e.,

mind and body), authors explicitly sought to generate individual items that concurrently reflect

multiple qualities of that awareness. The initial pool of items and their wording was developed

and revised, iteratively, based on experts’ feedback over the course of the measure development

and pilot testing. Items were discarded due to lack of linguistic clarity, item content overlapping

with other items, or item content not clearly reflective of the conceptual model through which

items were generated. A semi-final list of 25-items was generated, and then tested in a series of

studies. This pool of 25-items included two reverse-scored items which proved psychometrically

problematic, and were consequently omitted. Following factor analytic study and item reduction,

the final SMS included 21 items. Below we summarize findings from 3 initial development and

validation studies. Data reported in this section were reported by Tanay and Bernstein (2013).

First, to empirically explore and evaluate the SMS latent structural and measurement

model, Study 1 included: (1) Exploratory factor analysis (EFA) and parallel analyses of SMS

items (N = 178); (2) Confirmatory factor analysis (CFA) of the EFA-extracted solution among an

independent sample (N = 175); and (3) Evaluation of the internal consistency and distributional
 STATE MINDFULNESS SCALE (SMS) 8

normality of the derived SMS (sub)scale(s). EFA and CFA supported a higher-order two-factor

solution entailing one higher-order state mindfulness factor, and two first-order factors, one

reflecting state mindfulness of bodily sensations and the other state mindfulness of mind. These

findings are consistent with the two-level model of state mindfulness guiding the development of

the SMS (see Figure 1). Specifically, observed factors distinguish between the objects of mindful

awareness (level I – physical sensations and mental events), but not between the qualities of

mindful awareness (level II) which are theorized to be integral properties of mindfulness as a

unified mental state (not distinct facets or dimensions of mindfulness). SMS scores in this

sample demonstrated strong internal consistency (SMS Total α = .94; Mind sub-scale α = .95;

Body sub-scale α = .89).

Second, to evaluate the convergent, discriminant, and incremental convergent validity of

SMS scores with respect to published measures of state- and trait-mindfulness, Study 2 tested

the cross-sectional associations between SMS Total as well as SMS Body and Mind sub-scale

scores with respect to Toronto Mindfulness Scale (TMS state scale; Lau et al., 2006) total and

sub-scale scores, Mindful Attention and Awareness Scale (MAAS trait scale; Brown & Ryan,

2003) total scores, and Five Facet Mindfulness Questionnaire (FFMQ trait scale; Baer et al.,

2008) total and sub-scale scores. Relations between SMS and TMS sub-scales were moderate in

magnitude – highlighting the intended empirical difference in the construct(s) that each was

designed to measure. In addition, they observed evidence of discriminant validity with respect to

trait mindfulness, as measured by the MAAS and most FFMQ sub-scales, with the key exception

of the FFMQ Observing sub-scale, as predicted a priori. Moreover, they reported preliminary

evidence of incremental convergent validity, above and beyond the TMS with respect to trait

mindful attention and awareness, and specifically dispositional “noticing or attending to internal
 STATE MINDFULNESS SCALE (SMS) 9

and external experiences, such as sensations, cognitions, emotions, sights, sounds, and smells”

(FFMQ-observing sub-scale; Baer et al., 2008, p. 330). SMS scores in this sample again

demonstrated strong internal consistency (SMS Total α = .92; Mind sub-scale α = .91; Body sub-

scale α = .85). Study 2 thus provided an initial set of modest cross-sectional data relevant to the

associations between state mindfulness as measured by the SMS and other state- and trait-

mindfulness scales.

Finally, Study 3 tested the following: (1) the stability of SMS scores as a function of time

and context; (2) the construct validity of the SMS as a putative index of state mindfulness within

the context of a mindfulness training intervention; (3) the incremental sensitivity to change in

state mindfulness as measured by the SMS (Haynes & Lench, 2003), relative to the State-

MAAS, over the course of a mindfulness training intervention; and (4) the predictive incremental

validity of change in SMS scores, above and beyond change in State-MAAS scores, over the

course of the training with respect to the development of trait mindfulness. Results provided

initial controlled experimental evidence of the context-specific prospective stability, construct

validity, incremental sensitivity to change, and incremental predictive validity of the SMS.

First, among the no-intervention (assessment-only) control group, SMS scores

demonstrated strong levels of 1-week (mean r = .65, p < .01) and 6-week (mean r = .68 p < .01)

test-retest reliability. Likewise, among the mindfulness intervention group, SMS scores

demonstrates strong 1-week (mean r = .64, p < .01) and 2-week (mean r = .63, p < .01) test-rest

reliability between observations taken during mindfulness meditation; similar levels of stability

were observed for 6-week (r = .59, p < .01) test-retest reliability between observations in daily

living (cf. mindfulness meditation). Moreover, and an important indicator of hypothesized

context-sensitivity of state mindfulness, test-retest reliability of SMS scores between daily living
 STATE MINDFULNESS SCALE (SMS) 10

and mindfulness meditation contexts were small to moderate in magnitude in 1-week (r = .47 p <

.01), 2-week (r = .22, n.s) and 6-week (r = .45 p < .01). This context-related dissociation of SMS

score stability provides preliminary evidence for the construct validity of SMS scores as a

temporally- and context-sensitive index of state mindfulness. Finally, degree of elevation in SMS

scores from pre- to post-intervention, prospectively predicted elevation of trait mindfulness as

measured by the MAAS at 6-weeks post-intervention. Moreover, the SMS displayed incremental

predictive validity with respect to the development of trait mindfulness above and beyond the

State-MAAS. They proposed that in light of the incremental sensitivity to change findings, and

these incremental predictive validity data, there is reason to argue that the SMS may make a

unique contribution to the mindfulness measurement literature.

Subsequent Evidence of Reliability and Validity

Validation in Different Populations. The SMS has to-date been studied and

demonstrated reliability amongst a number of population groups: (a) college and university

students (e.g., Hussein, Egan, & Mantzios, 2017, α = .92 pre- and .94 post- mindfulness

intervention); (b) adults and young adults from the general community (e.g., Koval & Todaman,

2015, α = .95; Roche, Barrachina, & Fernández, 2016, α = .95); (c) meditation-naïve participants

and/or experienced meditators (e.g., Bravo, Pearson, Wilson, & Witkiewitz, 2018, SMS-Body α

= .88, SMS-Mind α = .94); (d) participants engaged in mindfulness training or mindfulness-

based intervention (e.g., Calma-Birling & Gurung, 2017, SMS Total α = .94; Jislin-Goldberg,

Tanay, & Bernstein, 2012, α = .92, one-month test-retest reliability r = .52, one-week test-retest

reliability measured immediately following weekly mindfulness meditation sessions r = .72;

Kohlenberg et al., 2015, α = .86); and (e) multiple specific population groups and sub-groups

such as adults exposed to recent traumatic (e.g., Nitzan-Assayag et al., 2017), and deprived and
 STATE MINDFULNESS SCALE (SMS) 11

non-deprived daily cigarette smokers (e.g., Luberto & McLeish, 2018, α = .91 and .95, before

and after a 10-minute sitting meditation exercise, respectively; Paz, Zvielli, Goldstein, &

Bernstein, 2017). Importantly, as a state measure of mindfulness, it has been studied among

meditation-naïve adults in the context of mindfulness meditation specifically (see above), in

controlled lab settings, in response to mindfulness interventions or experimental manipulations

of present moment attention and awareness (e.g., Allirot et al., 2017; e.g., Hadash, Segev, Tanay,

Goldstein, & Bernstein, 2016), as well as in daily living (e.g., Pryss et al., 2018; Shoham et al.,

2017). Notably, to the best of our knowledge, there are no published data to-date examining the

performance or psychometrics of the SMS amongst children or adolescents nor amongst clinical

population groups to whom mindfulness-based interventions are often delivered.

Experimental Validation: Sensitivity to Change. The majority of studies that

contribute to the validation of the SMS have examined the effect of mindfulness training,

meditation practice or laboratory experimental present moment attention and awareness

manipulations on state mindfulness. This form of validation has characterized early psychometric

study of SMS because of the nature of the construct (state mindfulness) and the intended utility

of the SMS to study mindfulness training and meditation. To-date, findings generally suggest

that relative to various (passive and active) control conditions, mindfulness practice and/or

training leads to significant elevations in SMS scores (Luberto & McLeish, 2018; Paz et al.,

2017; Roche et al., 2016; Shoham et al., 2017).

As part of a study of responding to a biological stressor among daily smokers deprived of

cigarettes for 18-hours (N = 104), Paz et al (2017) found that, relative to a coping-as-usual

control condition, a 7-minute mindfulness intervention laboratory analogue (i.e., present moment

attention and awareness training) led to elevated SMS scores (F(1,79) = 95.69, p = .000).
 STATE MINDFULNESS SCALE (SMS) 12

Luberto and McLeish (2018) found that adult daily smokers (N = 44) who received a brief

mindfulness exercise demonstrated elevated SMS scores (i.e., change in SMS scores from pre- to

post-intervention) (t43 = -4.75, p < .001) relative to controls (N = 42) (t41 = 0.42, p = .67) (F(1) =

14.24, p < .001, η2partial = .15). Hussein et al (2017) tested the effects of mindful construal diaries

to assist in weight control among 54 participants. The mindfulness diaries intervention led to

significant elevation in SMS scores from pre- to post-intervention (t39 = 3.82, p < .001, d = .58).

Kohlenberg et al (2015) found that elevations in SMS scores from pre- to post-intervention were

greater among an intrapersonal (i.e., traditional group intra-personal mindfulness meditation, N

= 37, M(SD) = .71(.8)) and interpersonal (i.e., inter-personal mindfulness meditation practice

involving group interaction and intimacy-related self-disclosure, N = 43, M(SD) = .58(.81))

mindfulness interventions relative to a (nature video) control condition (N = 34, M(SD) =

.26(.7)) (F(2,111) = 2.90, p = .059, η2 = .015). Planned comparisons revealed that, although SMS

scores increased from pre- to post-intervention across conditions (interpersonal condition: t36 =

5.81, p < .001, d = .88; intrapersonal condition: t42 = 4, p < .001, d = .72; control condition: t33 =

2.37, p = .024, d = .37), significant differences were only found between the intrapersonal and

interpersonal conditions relative to the control condition. Koval and Todaman (2015) found that

participants exposed to a boredom-inducing task (Vowel Cancellation task condition) reported

lower SMS scores than control participants (Reading Task condition) (t86.119 = -2.024, p = .044, d

= .418). This is unique evidence not only of the sensitivity of SMS to reflect elevations in state

mindfulness following various forms and “doses” of mindfulness training, but to reductions in

state mindfulness that may follow from mental states characterized by mindlessness or

mindwandering. Roche et al (2016) found that, relative to a non-intervention control group, a

one-month Exercise Without Movement (EWM) yoga intervention (i.e., yoga method focused on
 STATE MINDFULNESS SCALE (SMS) 13

the development of attention, consciousness and control through attention, relaxation, breathing

and meditation practices; Rama, 1984) led to significant elevations in SMS scores (i.e., change

from pre- to post-intervention) (F = 2.094, p = .043, η2partial = .125). Moreover, they reported that

change in SMS scores was significantly correlated with reductions in anxiety (Beck & Steer,

1990; r = -.569, p < .001); and depression (Beck, Steer, & Brown, 1996; r = -.355, p < .05)

symptoms. Finally, Bravo et al (2018) found that a brief mindfulness exercise (i.e., focused on

bodily sensations and the breath) elicited higher SMS Body sub-scale scores (F(1,297) = 18.39, p

< .001, partial η2 = .06), but not SMS Mind sub-scale scores (F(1,297) = 1.14, p = .29, partial η2

= .00).

Criterion Validity: Known-Group. Koval and Todaman (2015) found that self-report

meditation experience was correlated with SMS scores (r = .271, p = .008). Likewise,

participants who reported that they practiced meditation "weekly" or "almost every day"

displayed higher SMS scores compared those who practiced "sometimes", had only "tried"

meditation, or had never practiced (t93 = 2.64, p = .01, d = .543). Bravo et al (2018) found that:

(1) individuals with previous meditation experience and higher scores on trait mindfulness had

the highest levels of state mindfulness of body and mind; and (2) among individuals with

meditation experience, the strengths of the associations between trait and state mindfulness

increased with frequency of meditation practice.

Structural Validity. There have been no reported tests of the factor structure of the SMS

beyond CFA and EFA reported by Tanay and Bernstein (2013). Anecdotally, in our lab, we have

conducted such analyses in multiple populations and contexts and have consistently observed

similar factor structure as originally reported.

 STATE MINDFULNESS SCALE (SMS) 14

Convergent and Incremental Validity. Here we consider studies and findings

examining associations between SMS scores and other measures of mindfulness (i.e., state- but

not trait-mindfulness) and related variables (e.g., mindfulness-related processes, mental health).

First, with respect to other measures of state mindfulness, we only found reports by Tanay and

Bernstein (2013) with respect to the TMS (r = .43) and state-MAAS (r = .05, n.s.). This may be

largely a byproduct of the limited number of measures of state mindfulness available and the

relatively limited use of these measures to study state mindfulness to-date. Nevertheless, we

mention here that, with respect to trait mindfulness, associations between SMS scores and

measures of dispositional or trait mindfulness (e.g., FFMQ sub-scales, MAAS) have been

explored both as evidence of convergent, discriminant, and incremental validity (Bravo et al.,

2018; Tanay & Bernstein, 2013).

Additional forms of convergent validity have been explored by examining the

associations between SMS scores and processes thought to be closely related to mindfulness

broadly and state mindfulness more specifically. In a prospective randomized controlled

mindfulness intervention study (N = 51), Jisling-Goldberg, Tanay, and Bernstein (2012) found

that during mindfulness meditation, greater levels of SMS scores were significantly correlated

with greater levels of state positive affect (rsession1 = .43, r session2 = .45, r session3 = .53; p's < .05).

Moreover, this association between SMS scores and state positive affect was largely unchanged

even after controlling for baseline levels of trait-mindfulness and trait PA (i.e., partial r's: r1 =

.52, r2 = .41, r3 = .4; p's < .05). Hadash et al (2016) found that, relative to non-intervention

control condition (N = 53), a mindfulness intervention (N = 138) (i.e., 4-session mindfulness

training) led to changes in a manifestation of equanimity (reactivity to unpleasant hedonic tone)

over time as a function of degree of elevations in SMS scores over the course of the intervention
 STATE MINDFULNESS SCALE (SMS) 15

(F(3,219) = 2.92, p = .03). They found that mindfulness training led to reductions in reactivity to

unpleasant hedonic tone over time, as a function of elevation in SMS scores (i.e., responding to

the training): from session 1 to session 2 (t118.9 = 3.83, p = .0002), from session 1 to session 3

(t122.7 = 2.52, p = .0129), and from session 1 to session 4 (t120.8 = 3.39, p = .0009). In an

experience sampling study wherein state mindfulness was based on SMS items, Shoham et al

(2017) found that state mindfulness scores were correlated with levels of decentering as well as

emotional valance and emotional arousal, over the course of a 6-session mindfulness training

intervention. Specifically, the associations between state mindfulness and decentering were

significant in daily living (β = .25, SE = .04, t = 7, p < .0001) but the magnitude of this

association was stronger meditative states (β = .47, SE = .05) (t = 3.67, p < .0002). Moreover,

they found that state mindfulness levels were related to positive emotional valence (happy – sad

difference scores) in daily living (β = .17, SE = .06, t = 3.00, p = .003) and meditative states (β =

.45, SE = .09, t = 5.24, p < .001). Finally, they reported that state mindfulness levels were related

to reduced emotional arousal (calm – nervous difference scores) in meditative states (β = .61, SE

= .12, t = 5.16, p < .001) but not in daily living (β = .09, SE = .08, t = 1.16, p = .25). Finally,

Allirot et al (2017) found that relative to a 7-min video control condition, a 7-minute mindfulness

video intervention led to reduced number of finger food consumed (e.g., degree of self-control

and behavioral reactivity to reward), and this effect was moderated by SMS scores (F(1,66) =

5.00, p = .029). Moreover, they found that the effect of the mindfulness intervention on total

energy intake was also moderated by SMS scores (F(1,66) = 4.55, p = .037).

Discriminant or Divergent Validity. To-date, limited research has examined

discriminant validity of SMS scores. Bravo et al (2018) found that SMS scores and sub-scales of

the FFMQ were small in magnitude consistent indicating that individual differences in SMS
 STATE MINDFULNESS SCALE (SMS) 16

scores were largely not accounted for by levels of trait or dispositional mindfulness (i.e., SMS-

Mind and FFMQ-Observing (r = .23, p < .05), FFMQ-Describing (r = .27, p < .05), FFMQ-Non-

reactivity (r = .26, p < .05); SMS-Body and FFMQ-Observing (r = .21, p < .05), FFMQ-

Describing (r = .27, p < .05), FFMQ-Non-reactivity (r = .25, p < .05).

Translations of the SMS

To the best of our knowledge, the SMS has been translated and back-translated to a

number of language where work is either ongoing or published. These languages include:

English, Hebrew, Spanish, German, Dutch, Portuguese, French, Polish, and Chinese. Interested

researchers can contact A.B. to access these translations.

Citation, Administration, and Scoring

The SMS is a self-report measure that may be administered in paper/pencil, online, and

mobile experience sampling formats. The SMS has been administered individually as well as in a

group setting. The SMS quantifies participants' perceived level of attention to and awareness of

their present experience during a specific period of time (e.g., past 15 minutes) and context (e.g.,

following mindfulness meditation or other activity). The scale measures attention to and

awareness of two domains of experiential events or objects of which one may be mindful: bodily

sensations (i.e., SMS-Body sub-scale), mental events (i.e., SMS-Mind sub-scale, e.g., emotions,

patterns of thoughts, etc.), or a combined total score. Numeric responses (i.e., 1 = not at all to 5

= very well) to the 21 items are summed or averaged (see Table 1). Higher scores reflect higher

levels of state mindfulness. Participants are instructed as follows: "Below is a list of statements.

Please use the rating scale to indicate how well each statement describes your experiences in the

past 15 minutes", and asked to describe what they were doing during this 15-minute period of

time. Depending on the study design and context of interest, researchers can change the
 STATE MINDFULNESS SCALE (SMS) 17

instructions to probe a different period of time (e.g., 5-, 10-, 20-minutes). To cite the measure,

refer to: Tanay, G., & Bernstein, A. (2013). State Mindfulness Scale (SMS): development and

initial validation. Psychological assessment, 25(4), 1286.

Table 1. The SMS subscales and related Items.

SMS Items Subscale I Subscale II

State State
Mindfulness Mindfulness
of Mind of Body
1. I was aware of different emotions that arose in me ✓
2. I tried to pay attention to pleasant and unpleasant ✓
sensations.
3. I found some of my experiences interesting ✓
4. I noticed many small details of my experience ✓
5. I felt aware of what was happening inside of me ✓
6. I noticed pleasant and unpleasant emotions ✓
7. I actively explored my experience in the moment ✓
8. I clearly physically felt what was going on in my body ✓
9. I changed my body posture and paid attention to the ✓
physical process of moving
10. I felt that I was experiencing the present moment ✓
fully
11. I noticed pleasant and unpleasant thoughts ✓
12. I noticed emotions come and go ✓
13. I noticed various sensations caused by my ✓
surroundings (e.g., heat, coolness, the wind on my face)
14. I noticed physical sensations come and go ✓
15. I had moments when I felt alert and aware ✓
16. I felt closely connected to the present moment ✓
17. I noticed thoughts come and go ✓
18. I felt in contact with my body ✓
19. I was aware of what was going on in my mind ✓
20. It was interesting to see the patterns of my thinking ✓
21. I noticed some pleasant and unpleasant physical ✓
sensations
 STATE MINDFULNESS SCALE (SMS) 18

Limitations

There are a number of limitations that may inform use as well as ongoing study of the

SMS. First, the SMS is a relatively new measure. The overall body of empirical research of SMS

psychometrics and utility is modest in scale and scope. As reviewed, a number of psychometric

properties need further study (e.g., discriminant/divergent validity, structural validity, study in

younger populations as well as clinical populations, known-group criterion validity). Moreover,

future research could evaluate SMS scores with respect to putative markers or proxies of state

mindfulness across levels of analysis (e.g., electrophysiology, fMRI) (Tang, Hölzel, & Posner,

2015). Second, and critically, the SMS is a self-report measure characterized by well-

documented limitations inherent to such methods. These include retrospective recall biases (e.g.,

Shadish, Cook, & Campbell, 2002) and introspective abilities or meta-awareness that may not

only depend on, but may also influence, the validity of participant self-report on state

mindfulness (e.g., Grossman, 2008; Hadash et al., 2016; Sauer et al., 2013). Accordingly, the

SMS guides participants to report on a specific brief time-period (e.g., past 15 minutes) and

context (e.g., during mindfulness meditation, daily living, etc). Finally, beyond the SMS and

self-report methods of mindfulness, the development of behavioral measurement methods that

quantify state mindfulness by integrating first- and third-person perspectives may represent an

important way forward for mindfulness research (Ruimi et al., 2018; Thompson, 2017; Varela,

1996).

Summary

In this chapter we reviewed Buddhist and contemporary psychological contemplative

perspectives conceptualizing mindfulness as a state and their implications for its measurement.

We described the SMS, a 21-item self-report measure of state mindfulness grounded in the two-
 STATE MINDFULNESS SCALE (SMS) 19

level model of state mindfulness and initial years of empirical study of its psychometric

properties and utility. Use of the SMS, in multiple languages and contexts, in research and

applied settings, is now fast growing. We hope that the SMS will prove useful to advance the

field’s study and application of mindfulness training and mindfulness-based interventions.

 STATE MINDFULNESS SCALE (SMS) 20

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