Citation for the Mindful Self-Care Scale- SHORT:
Cook-Cottone, C. P. & Guyker, W. (2016, manuscript in preparation). The Mindful Self-Care Scale:
Mindful self-care as a tool to promote physical, emotional, and cognitive well-being]
Mindful Self-Care: Psychometric evaluation of the measure
Self-care is the daily process of being aware of and attending to one’s basic
physiological and psychosocial needs including the shaping of one’s daily routine,
relationships, and environment as needed to promote optimal daily functioning (CookCottone, 2015; McCusker et al., 2015; Norcross & Guy, 2007). Active practice of
mindful self-care is believed to help an individual remain embodied, in a positive
manner. In mindful self-care, an individual meets personal needs while staying
effectively connected with his or her outer experience. The initial version of the scale was
a scale that measured the self-reported frequency of self-care behaviors. The actionable
items were accompanied by a range of possible answers: “This past week, how many
days did I do the following? You can give yourself the following scores: 0 = never (0
days), 1 = rarely (1 day), 2 = sometimes (2 to 3 days), 3 = often (3 to 5) days, and 4 =
regularly (6 to 7 days). For the items that state “reverse score” score as: 4 = never (0
days), 3 = rarely (1 day), 2 = sometimes (2 to 3 days), 1 = often (3 to 5) days, and 0 =
regularly (6 to 7 days).”
Participants and Procedure. After receiving IRB approval from our university,
participants were recruited from graduate and undergraduate classes, Facebook and
Instagram pages of researchers and graduate students within the graduate program, email
requests to departmental listservs and emails lists of graduate students.
Data were screened for duplicate, erroneous or missing information. From the
initial data set of 523, 448 participants remained (86%), and their data were analyzed.
They ranged in age from 18 to 71 (Mage = 33.52, SD = 11.74) and identified as White
(90.0%), Native American (3.3%), African American (2.6%), Asian American (1.2%),
Alaskan Native (.70%), multiracial (1.9%) or other (.4%). With regard to their education,
they attained: a doctorate degree (7.2%), a professional degree (4.2%), a Master’s degree
(28.6%), some graduate school (11.6%), a Bachelor’s degree (24%), an Associate degree
(7.4%), some college (13.3%), high school graduation (3.3%), and some high school
(.5%).
Measures. Four measures were used during this analysis: the 84-item version of
the Mindful Self-Care Scale (MSCS-84), Eating Attitudes Test- 26 (EAT-26), Body
Esteem Scale (BES), and a set of questions on demographic information.
Preliminary Analyses. MSCS items were examined for normality of distribution.
Skewness values greater than an absolute value of 3 and/or kurtosis values exceeding the
absolute value of 10 are considered problematic for statistical analyses (Kline 2005).
MSCS item values were lower than these limits; all skewness values did not exceed an
absolute value of 2.585, and all kurtosis values did not exceed an absolute value of 5.855.
Of the 84 total MSCS items, the three general MSCS items were not expected to load on
a single factor as they were created with the intention to assess an individual’s general or
more global practices of self care: planning self-care, engaging in a variety of self-care
strategies, and exploring new ways of bringing self-care into one’s life. These three items
were excluded from statistical analyses. Three items were also commonly (n≥21) skipped
by participants (“I accessed the medical/dental care I needed”) and two other items that
both contained the word “spiritual” in them (Item 78: “I spent time in a spiritual place…”
and Item 80: “I spent time with others who share my spiritual worldview”) and thus,
these three items were also removed from the scale.
Exploratory Analyses. The size of the Kaiser-Meyer-Oklin measure of sampling
adequacy (KMO=.860) suggested that the MSCS items in the sample had adequate
common variance for factor analysis, and the significance of Bartlett’s test of sphericity,
χ (3486)=14,545.05, p<.0001, suggested that the correlation matrix was factorable
(Tabachnick & Fidell, 2007). An exploratory factor analysis using principal axis
factoring (PAF) was conducted on the sample’s item-level data. A parallel analysis
(Horn, 1965) is commonly regarded as one of the most accurate methods for selecting the
number of factors to retain in a factor analysis. Parallel analysis was utilized to produce
95 percentile eigenvalues extracted from 100 randomly generated correlation matrices.
We compared the 95 percentile of the randomly generated eigenvalues with the real data
eigenvalues and for the seventh factor, the random eigenvalue exceeded the real data
eigenvalue, thus supporting the presence of six factors. We therefore extracted a sixfactor solution by PAF, and since we did not assume the factors would be independent,
an oblique (Promax) rotation was applied.
Items were retained if they had an item-factor loading of at least .40 on a primary
factor and cross-loadings less than .30 on other factors (Tabachnick & Fidell, 2007). Of
the 77 MSCS items analyzed, 51 items had factor loadings of greater than .40 and less
than .30 on the other five factors. The anti-image correlation matrix was also used to
determine if the item was highly correlated with other items, which resulted in the
deletion of 18 items. Twenty-six items were deleted for low primary item-factor loadings.
One item crossloaded on both the exercise construct as well as the relaxation construct
and was therefore deleted. In summary, of the 77 original items analyzed, 33 items were
retained. From the 77 initial items, 26 items had inadequate loadings, 18 items were
deleted due to redundant content, and 1 item was deleted because it crossloaded on two
factors.
A second factor analysis using PAF with promax rotation on this set of 33 items
revealed a six-factor solution, which accounted for 50.26% of the total variance in the
items. Item-factor loadings exceeded .40 on their primary factor and were less than or
equal to .30 on the other factors.
Next, the substantive makeup of the six empirical scales was explored. Factor 1
was labeled Physical Care and accounted for 22.54% of the variance after rotation. Eight
items loaded on this factor, and its item-factor loadings ranged from .44 to 89. Factor 2
was labeled Supportive Relationships, included five items (item-factor loadings ranged
from .60 to .84), and accounted for 8.33% of the variance after rotation. Factor 3 was
labeled Mindful Awareness and accounted for 7.79% of the variance after rotation. Four
items loaded on this factor, and its item-factor loadings ranged from .53 to .99. Next,
Factor 4 was labeled Self Compassion and Purpose. This factor contained six items
(loadings ranged from .56 to .72), and accounted for 4.53% of the variance after rotation.
Mindful Relaxation was named for Factor 5, which contained six items (item-factor
loadings ranged from .46 to .71) and accounted for 4.07% of the variance after rotation.
Lastly, Factor 6 was labeled Supportive Structure. This factor included four items with
item-factor loadings that ranged from .64 to .67, and accounted for 3.01% of the variation
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after rotation. The new factor-based subscales correlated positively with each other (r’s
from .06 to .49).
Internal consistency reliability. Cronbach’s coefficient alphas were .89 for the
total 33-item MSCS, .84 for Physical Care, .86 for Supportive Relationships, .92 for
Mindful Awareness, .83 for Self Compassion and Purpose, .77 for Mindful Relaxation,
and .77 for Supportive Structure. In summary, these values support the internal
consistency of MSCS total and subscale scores.
Construct Validity. The MSCS total scale and subscales were expected to
correlate in a negative direction with eating disorder symptomology and in a positive
direction with body esteem. Cohen’s (1992) criteria were used to indicate strength of
effect. As hypothesized, MSCS scores by and large correlated negatively with EAT-26
total scores, ranging from slightly/negligibly to moderately. It was hypothesized that
higher self-care scores would be associated with higher body esteem. Among males, the
positive relation between perceived physical attractiveness and MSCS scores ranged from
small to moderate in size (r’s ranged from .02 to .30). Among females, even stronger,
positive effects were found. Overall, these findings provide initial support for construct
validity, particularly in the relations of MSCS scores and body esteem.
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155-159.
Cook-Cottone, C. P. (2015). Incorporating positive body image into the treatment of
eating disorders: A model for attunement and mindful self-care. Body Image, 14,
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Horn, J.A. (1965). A rationale and test for the number of factors in factor analysis.
Psychometrika, 30, 179-185.
McCusker, J., Cole, M. G., Yaffe, M., Strumpf, E., Sewitch, M., Sussman, T., Ciampi,
A., Lavoie, K., Platt, R. & Belzile, E. (2015). A randomized trial of a depression
self-care toolkit with or without lay telephone coaching for primary care patients
with chronic physical conditions. General Hospital Psychiatry, 37(3), 257-265.
doi:10.1016/j.genhosppsych.2015.03.007
Norcross, J. C., & Guy, J. D. (2007). Leaving it at the office: A guide to psychotherapist
self-care. New York, NY: The Guildford Press.
Tabachnick, B.G., & Fidell, L.S. (2007). Using Multivariate Statistics (5 ed.). Boston,
MA: Allyn & Bacon.
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