The research, conducted by Ben C. L. Yu of The Hong Kong Polytechnic University and colleagues at The Chinese University of Hong Kong and The University of Hong Kong, set out to compare two competing qualities of mindfulness that appear, on the surface, to be nearly contradictory. The first is nonjudgment, the familiar operationalization embedded in the widely used Five Facet Mindfulness Questionnaire, which asks whether people approach their thoughts and feelings in a non-evaluative way. The second is discernment, a construct rooted in classical Buddhist teachings that emphasizes actively assessing whether one’s mental states are wholesome or unwholesome, that is, whether they lead toward well-being or toward suffering. From a Buddhist psychological perspective, this evaluative function is not a corruption of mindfulness but one of its defining features. In the ancient text The Questions of King Milinda, the monk Nāgasena describes mindfulness precisely as the examination of the wholesomeness and unwholesomeness of mental states, and early discourses such as the Kālāma Sutta frame unwholesome states as those marked by greed, aversion, and delusion that lead to harm, while wholesome states are those conducive to welfare and happiness.

To translate these concepts into testable psychological terms, the research team drew on the Mindfulness-Discernment Scale, a recently validated instrument grounded in Buddhist teachings that reconceptualizes mindfulness as having two functions. The first function is maintaining steady, non-forgetting awareness of internal and external objects, including sensations, thoughts, feelings, and mental states. The second is discernment, a clear knowing of those objects, such as recognizing whether one’s breath is long or short, or whether one’s current mental state is characterized by greed. The scale’s developers found that discernment correlated moderately with well-being, lower stress, and lower psychological distress, and showed moderate-to-strong associations with secularized Buddhist constructs including nonattachment, acceptance of impermanence, wisdom, tranquility, and concentration. Nonjudgment, meanwhile, has accumulated its own impressive empirical record. Studies have linked the nonjudging facet of the Five Facet Mindfulness Questionnaire to higher well-being, lower psychological disturbance, and, in a meta-analysis, strongly reduced post-traumatic stress symptoms.

The Hong Kong study followed 275 adults with no meditation experience over eight months, with assessments at baseline, four months, and eight months. Participants had a mean age of 24.5 years, just over half were women, and nearly all held at least an undergraduate degree, with the majority reporting no religious affiliation. The researchers used path analysis with full maximum likelihood estimation in Mplus, structuring their models with baseline discernment and nonjudgment as independent variables, nonattachment at the four-month follow-up as the mediator, and either life satisfaction or psychological distress at eight months as the outcome. Crucially, the longitudinal portion of the model controlled for baseline levels of the mediator and outcomes, allowing the team to test whether the mindfulness qualities genuinely predicted change over time rather than merely correlating with it. Indirect effects were estimated using bias-corrected bootstrapping with 5,000 resamples, and the models showed excellent fit to the data.

The answer to which quality matters more depended entirely on the timescale. When all variables were measured at the same time point, both discernment and nonjudgment performed respectably. Both were significantly associated with higher nonattachment, which in turn was associated with lower psychological distress and greater life satisfaction. But the concurrent results already hinted at an asymmetry: after controlling for each other, discernment showed a much stronger association with nonattachment than nonjudgment did, with standardized coefficients of 0.51 versus 0.18. The indirect effect of discernment on distress through nonattachment was roughly two and a half times larger than that of nonjudgment. In other words, even in the cross-sectional picture, the evaluative quality of mindfulness appeared to be doing considerably more work.

The longitudinal results were more decisive. When the researchers inserted a four-month time lag between the predictor and the mediator, nonjudgment simply stopped predicting anything. Baseline nonjudgment showed no significant association with nonattachment at four months, and no indirect pathway to either distress or life satisfaction at eight months. Discernment, by contrast, held its ground. Baseline discernment significantly predicted higher nonattachment at four months, and nonattachment at four months in turn significantly predicted greater life satisfaction at eight months, producing a significant indirect effect of discernment on life satisfaction through nonattachment. The parallel indirect pathway to reduced psychological distress, while directionally consistent, did not reach significance, likely because of the modest effect sizes involved and the attrition of participants reporting higher distress. Still, the pattern was unambiguous: only discernment carried psychological benefits forward across time.

Why might this be? The researchers draw on Buddhist psychological models in which suffering arises from habitual clinging to pleasant feeling tones and aversion to unpleasant ones, followed by mental proliferation of the initial events. Mindfulness, in this framework, is not an end in itself but a vehicle for recognizing these patterns of clinging and repulsion and fostering nonattachment, defined psychologically as a flexible, balanced way of relating to one’s experiences without clinging to or suppressing them. Discernment, the authors argue, is what makes this possible. According to the theory of embodied mindfulness, bodily states and cognitive-emotional processes interact bidirectionally: unwholesome states characterized by greed, aversion, or delusion may manifest as visceral tightness, constriction, or physiological agitation, while wholesome states present as bodily ease, spaciousness, and relaxation. A person with discerning awareness can use these somatic signals as a compass, deliberately letting go of unwholesome states and cultivating wholesome ones. Nonjudgment, by contrast, may offer only a temporary buffer, shielding people from the sting of negative experiences in the short term without fostering the deeper understanding needed to release them.

There is also a darker possibility that has concerned scholars for a decade. Some researchers have warned that an emphasis on nonjudging may foster passive acceptance, in which individuals tolerate adverse or even abusive situations rather than changing or leaving them, potentially exacerbating their difficulties and allowing harmful sensations to accumulate unexamined. Intriguingly, the new study found a hint of this: after controlling for nonattachment and discernment, nonjudgment showed a significant negative direct effect on life satisfaction at the eight-month follow-up. The authors are appropriately cautious, noting the small effect size and the absence of a zero-order correlation between nonjudgment and life satisfaction, and they stop short of declaring nonjudgment harmful. But they urge researchers to remain alert to its potential long-term costs.

The findings also connect to a growing body of temporal evidence suggesting that the benefits of mindfulness may be less durable than cross-sectional studies imply. Previous work by the same research group using ecological momentary assessment found that mindfulness predicted nonattachment and positive affect only when variables were measured concurrently, with the association vanishing when a lag of a few hours was introduced. A subsequent two-month study produced the same pattern. The authors of the new study suspected that part of the problem lay in measurement: those earlier studies used instruments capturing bare awareness or the mere absence of inattention, which may not capture the multidimensional richness of mindfulness. By pitting two distinct, well-measured qualities against each other, the present study suggests that the choice of which quality to cultivate, not merely whether to be mindful, may determine whether benefits persist.

The practical implications could be significant for the design of mindfulness-based interventions. If discernment is the active ingredient for enduring well-being, programs might benefit from teaching participants not just to observe thoughts, bodily states, and emotions without immediate reactivity, but to evaluate whether those states are wholesome, unwholesome, skillful, or unskillful, and to respond without clinging or avoidance. Such training would represent a meaningful departure from the strictly non-evaluative stance that has dominated secular mindfulness pedagogy. The study’s authors also caution that future research should not treat mindfulness qualities as interchangeable, recommending finer-grained measurement rather than reliance on broad global scales.

Limitations remain. The sample consisted of young, highly educated, predominantly non-religious university affiliates in Hong Kong with no meditation experience, and the authors note that meditators interpret mindfulness qualities differently. The longitudinal design, while stronger than cross-sectional work, cannot establish causation, all measures were self-reported within the same surveys, raising the possibility of common method bias, and attrition reached roughly 21 percent by the final follow-up, though full information maximum likelihood estimation was used to mitigate missing data. Even so, the study represents one of the most rigorous comparisons to date between two rival conceptions of what mindfulness actually is. Taken together with earlier null findings for bare awareness and inattentiveness, the evidence points toward a provocative conclusion: simply watching the mind without judgment may calm it for a moment, but learning to discern the nature of what arises, and to release what harms, may be what sustains well-being over the long run.

The findings, published in Mindfulness, are important because the Self-Compassion Scale is used extensively in psychological research, clinical studies, and intervention trials. Self-compassion is generally defined as responding to personal suffering with understanding rather than harsh self-criticism, recognizing that hardship is part of the shared human condition, and maintaining balanced awareness of painful thoughts and emotions. The concept has been associated with lower depression, anxiety, perceived stress, and self-harm, as well as stronger emotional regulation and psychological well-being. Yet the measurement debate surrounding the scale has persisted for years. Researchers have disagreed over whether its positive and negative items should be combined, whether the six components are truly distinct, and whether the resulting total score can be interpreted as a single latent psychological trait.

The short-form scale was developed by Raes and colleagues in 2011 as a less burdensome alternative to Neff’s original 26-item instrument. It contains 12 questions, with two items assigned to each of six components. The positive dimensions are self-kindness, common humanity, and mindfulness. The negative dimensions are self-judgment, isolation, and over-identification; these items are reverse-scored when calculating an overall self-compassion score. For example, the positive items reflect treating oneself with care, remembering that personal difficulties are not unique, and maintaining perspective during distress. The negative items assess harsh self-evaluation, feeling cut off from others, and becoming overwhelmed or absorbed by painful thoughts and emotions. Because each component is represented by only two items, the scale is efficient but statistically challenging to evaluate.

To examine its structure, the researchers conducted confirmatory factor analysis, a theory-driven statistical method that tests whether observed responses conform to predefined models. The study compared four possibilities. The first treated the six components as correlated but separate factors. The second placed those six factors beneath one general self-compassion factor in a higher-order structure. The third grouped the items into two correlated factors—positive and negative self-compassion. The fourth assumed that all 12 items measured one general factor. Analyses used robust maximum likelihood estimation to address non-normality in the responses, with weighted least squares estimation used as a sensitivity check because the items were measured on a five-point ordinal scale. Both analytical approaches produced a similar ranking of the models.

The six-factor correlated model showed excellent descriptive fit under the primary analysis, with a robust comparative fit index of 0.99, a root mean square error of approximation of 0.04, and a standardized root mean square residual of 0.03. The chi-square test was statistically significant, but the researchers noted that chi-square is highly sensitive to large samples and can indicate misfit even when other indices suggest that a model describes the data well. The standardized item loadings were generally strong, ranging from 0.62 to 0.86 across the six components. However, the apparent success of the six-factor model came with an important warning: some latent factors were so highly correlated that their practical distinctiveness became uncertain. Isolation and over-identification correlated at 0.99, while self-kindness correlated at 0.94 with mindfulness and at 0.91 with common humanity.

These high correlations suggest that the six-factor solution may fit the data mathematically without proving that the six dimensions represent fully independent psychological processes. In psychometric terms, factors that correlate above approximately 0.80 may have limited discriminant validity, meaning they may not be sufficiently distinct from one another. The researchers therefore describe the six components as closely related facets rather than isolated traits. The two-factor model offered a more compact alternative. It produced a robust comparative fit index of 0.95, a root mean square error of approximation of 0.07, and a standardized root mean square residual of 0.05. The positive and negative factors correlated at 0.40, indicating that they were related but not excessively overlapping. Its relative simplicity may make it attractive for studies focused on broad self-compassionate versus self-critical tendencies, although some fit indices were weaker than those of the six-factor model.

The higher-order model performed poorly, despite its previous use in research on both the short and long versions of the scale. Its comparative fit index was 0.82, its root mean square error of approximation was 0.14, and its standardized root mean square residual was 0.14. The one-factor model performed even worse, with a comparative fit index of 0.68, a root mean square error of approximation of 0.18, and a standardized root mean square residual of 0.16. These results indicate that the 12 responses could not be adequately explained by one common underlying factor in this sample. The distinction is crucial: a scale can have high internal consistency while still failing to be unidimensional. In this study, the total score had strong reliability, with a McDonald’s omega of 0.93, but hierarchical omega was only 0.51, suggesting that much of the reliable variance came from the component factors rather than a dominant general self-compassion factor.

The researchers also examined how the scale’s scores related to perceived stress, depression and anxiety symptoms, and compassion for other people. The total self-compassion score correlated negatively with perceived stress at approximately −0.61 and with symptoms measured by the Patient Health Questionnaire-4 at approximately −0.49. These associations are consistent with the idea that people who report more self-compassion tend to experience less stress and fewer symptoms of depression and anxiety. However, the individual dimensions told a more differentiated story. Over-identification, isolation, and self-judgment showed stronger relationships with perceived stress and mental-health symptoms than self-kindness, common humanity, or mindfulness. Over-identification correlated −0.61 with perceived stress and −0.59 with PHQ-4 scores, while common humanity correlated only −0.15 with stress and −0.04 with the PHQ-4.

This pattern suggests that the absence of self-critical and distress-amplifying tendencies may be more closely connected to mental-health outcomes than the presence of positive self-compassionate qualities alone. That interpretation does not establish causation: the study was primarily cross-sectional for these analyses, and the PHQ-4 was collected at follow-up approximately one month after the baseline self-compassion assessment. Changes in symptoms, recall effects, and other measurement differences could therefore influence the correlations. Compassion for others showed a different pattern. The total self-compassion score had only a small positive correlation with outward compassion, approximately 0.13. Positive self-compassion components such as self-kindness and common humanity correlated around 0.29 with compassion for others, whereas the negative components showed very small or near-zero relationships. The findings imply that being compassionate toward others may overlap with some positive ways of relating to oneself, but it is not simply the same psychological capacity.

The study drew on baseline data from the seventh cohort of a larger longitudinal project conducted during the early months of the SARS-CoV-2 pandemic. Participants were recruited online through Amazon Mechanical Turk and Qualtrics panels in June 2020, a period marked by public-health uncertainty, economic disruption, and heightened national attention to racial injustice after the killing of George Floyd. The sample was intentionally more racially diverse than many earlier validation samples, including 280 Black or African American participants and 315 Hispanic or Latino participants, although it remained majority White and relied on convenience sampling. Exploratory comparisons found small differences in total self-compassion scores across racial groups, with Black participants reporting higher scores than White participants in some comparisons. No significant difference emerged by Hispanic or Latino ethnicity. Because the researchers did not conduct formal measurement-invariance testing, these group comparisons cannot determine whether the scale functioned equivalently across populations.

The authors caution that the results should not be interpreted as evidence that researchers must abandon the total SCS-SF score. Rather, they argue that total scores should be supplemented with subscale or positive-versus-negative composite scores, especially when studying stress, depression, anxiety, or intervention effects. The study also has important limitations, including the exclusion of roughly one-third of consenting participants because of incomplete item responses. Those excluded differed from the analytic sample in age, gender, race, marital status, income, and education, potentially affecting generalizability. The two-item subscales also place an unavoidable ceiling on reliability and precision. Future research using longer item sets, representative samples, formal invariance testing, longitudinal designs, and alternative models such as exploratory structural equation modeling could clarify whether the six dimensions are culturally stable and conceptually separable. For now, the central message is clear: self-compassion may be better understood as a network of related capacities—including both supportive and self-critical tendencies—than as a single number.

Subject of Research: The factor structure, reliability, and construct validity of the 12-item Self-Compassion Scale–Short Form in a racially diverse English-speaking U.S. adult sample.

Article Title: Confirmatory Factor Analysis of the Short Form Self-Compassion Scale in an English-Speaking U.S. Sample

Article References: Manjanatha, D., Karnaze, M. M., Roesch, S., et al. “Confirmatory Factor Analysis of the Short Form Self-Compassion Scale in an English-Speaking U.S. Sample.” Mindfulness (2026). References include Neff (2003), Raes et al. (2011), Muris and Petrocchi (2017), and Muris and Otgaar (2020).

Image Credits: AI Generated

DOI: 10.1007/s12671-026-02962-z

Keywords: Self-compassion; Self-Compassion Scale–Short Form; confirmatory factor analysis; psychometrics; perceived stress; depression; anxiety; mental health; positive psychology; measurement validity

The CAMS-R is a pivotal tool designed to assess mindfulness by encapsulating both cognitive and affective dimensions. This multifaceted nature allows researchers and practitioners to measure the nuances of mindfulness in individuals, making it particularly suitable for high-stress professional environments like nursing. The necessity to evaluate the tool for diverse nursing groups is paramount, as it ensures that the scale is versatile and reliable in measuring a crucial psychological attribute across various demographics within the profession.

Mindfulness, defined as the psychological process of bringing one’s attention to the present moment, has gained traction in psychological and healthcare research. The relationship between mindfulness and positive health outcomes, including reduced stress, improved emotional regulation, and enhanced patient care, is well-documented. The potential benefits of integrating mindfulness practices into nursing training and professional development have prompted this study, as administrators seek evidence-based strategies to improve overall nurse well-being and patient outcomes.

In this study, the authors utilized rigorous statistical methods to assess validity and measurement invariance. Validity refers to the degree to which the CAMS-R measures what it is intended to measure – in this case, mindfulness. Measurement invariance examines whether the tool functions equivalently across different groups. This rigor ensures that the conclusions drawn about the effectiveness of mindfulness interventions can be generalized across the diverse populations of nursing professionals surveyed.

The research found that the CAMS-R demonstrated strong construct validity, indicating that it effectively captures the mindfulness construct in nursing contexts. By comparing nursing postgraduates, interns, and registered nurses, the study highlights that mindfulness levels may vary within different stages of a nursing career. This variance can have significant implications for targeted mindfulness interventions, indicating that educational programs may benefit from tailored approaches to foster mindfulness based on a nurse’s career stage.

Moreover, the findings underline the importance of integrating mindfulness practices into nursing curricula. As stress and burnout continue to plague the nursing profession, equipping new nurses with mindfulness skills prior to entering the workforce could lead to improved resilience and coping mechanisms. The research suggests that educational institutions should prioritize mental health and mindfulness training, thereby cultivating a more supportive and effective healthcare workforce.

An intriguing aspect of the study was its emphasis on the relationship between mindfulness and improved patient care. The authors assert that nurses who practice mindfulness may demonstrate greater empathy, awareness, and emotional regulation, factors that are critical for high-quality patient interactions. By enhancing mindfulness among nurses, institutions stand to improve overall patient outcomes, a goal that resonates profoundly within the healthcare sector.

In addition to highlighting the tool’s validity, the study meticulously addressed measurement invariance, showcasing that the CAMS-R operates consistently across the diverse subgroups of nursing professionals. This indicates that the findings concerning mindfulness can be applied broadly within the nursing community, bridging the gap between different levels of experience and educational backgrounds.

The significance of this research extends beyond the confines of academia; it highlights a critical area that healthcare administrators must address. With the increasing recognition of psychological well-being as integral to effective nursing practice, implementing structured mindfulness programs in training can be a strategic directive. Healthcare settings must evolve to recognize that nurturing the mental health of their workforce translates to better care for patients, creating a cycle of improved outcomes on both ends.

Furthermore, the study advocates for continued research in mindfulness within the nursing profession. As the landscape of healthcare evolves, so too must the approaches used to support those on the front lines. The call for deeper exploration into mindfulness not only reflects a commitment to practitioners’ well-being but also recognizes the broader implications of mental health in delivering safe and compassionate patient care.

In conclusion, the findings from Fan, Z., Luo, Y., and Cai, J.’s study offer pivotal insights into the role of mindfulness in nursing. The validation of CAMS-R among varying nursing groups sets a precedent for future research in the field, laying the groundwork for integrated mindfulness strategies to enhance nurse education and practice. The implications are profound, suggesting that by fostering mindfulness among nurses, we can not only elevate their professional experience but also significantly improve patient care.

This comprehensive exploration of the CAMS-R’s validity paves the way for the future of nursing education and practice. As the evidence mounts, it is incumbent upon nursing leaders and educators to harness these insights to cultivate a workforce that is not only skilled but also mentally resilient. The time has come for the healthcare system to embrace mindfulness as an essential ingredient for both professional satisfaction and patient safety.

Subject of Research: Validity and measurement invariance of the cognitive and affective mindfulness scale-revised (CAMS-R) among nursing postgraduates, nursing interns, and registered nurses.

Article Title: Validity and measurement invariance of the cognitive and affective mindfulness scale-revised (CAMS-R) among nursing postgraduates, nursing interns, and registered nurses.

Article References:

Fan, Z., Luo, Y., Cai, J. et al. Validity and measurement invariance of the cognitive and affective mindfulness scale-revised (CAMS-R) among nursing postgraduates, nursing interns, and registered nurses. BMC Nurs (2025). https://doi.org/10.1186/s12912-025-04220-4

Image Credits: AI Generated

DOI: 10.1186/s12912-025-04220-4

Keywords: mindfulness, nursing education, CAMS-R, measurement invariance, psychological well-being.