Influence of anxiety sensitivity on the observe facet of the five facet mindfulness questionnaire: differential item functioning in a clinical population

Many individuals who engage in mindfulness experience decreased anxiety. Yet some individuals, particularly those with panic disorder (PD) or elevated anxiety sensitivity (AS), note heightened anxiety when observing particular sensations. The Five Facet Mindfulness Questionnaire (FFMQ) is one of the most widely utilized mindfulness questionnaires. However, its Observe facet has shown variability in the literature. This study explored a transdiagnostic approach to determine whether specific aspects of the Observe facet of the FFMQ differ in individuals with elevated anxiety sensitivity (AS).

We examined a clinical sample of 1521 Japanese individuals who completed the FFMQ and Anxiety Sensitivity Index 3 (ASI-3). A multiple indicator multiple cause (MIMIC) model approach was adopted utilizing latent variables to examine differential item functioning (DIF) of the Observe facet of the FFMQ, based on PD and/or AS diagnosis. This process was repeated to examine the relationship between the Anxiety Sensitivity Index-3 (ASI-3) subscales and particular items of the Observe facet.

The measurement model revealed good acceptability of a one-factor solution of the Observe facet (χ² (20) = 208.73, p < 0.001). PD significantly predicted Observe (B = 0.09, R² = 0.06, p = 0.008) and AS significantly predicted Observe (B = 0.02, R² = 0.18, p < 0.001). 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.

The findings of this study reveal that AS, particularly cognitive AS, may modulate the mindfulness experience. The study reveals the importance of understanding where an individual observes and its results may be beneficial for tailoring mindfulness interventions for individuals.