Assessing Mindfulness in Children and Adolescents: Development and Validation of the Child and Adolescent Mindfulness Measure (CAMM) Laurie A. Greco Department of Veterans Affairs, Chalmers P. Wylie Ambulatory Care Center, Columbus, Ohio Ruth A. Baer and Gregory T. Smith University of Kentucky This article presents 4 studies (N = 1,413) describing the development and validation of the Child and Adolescent Mindfulness Measure (CAMM). In Study 1 (n = 428), the authors determined procedures for item development and examined comprehensibility of the initial 25 items. In Study 2 (n = 334), they reduced the initial item pool from 25 to 10 items through exploratory factor analysis. Study 3 (n = 332) evaluated the final 10-item measure in a cross-validation sample, and Study 4 (n = 319) determined validity coefficients for the CAMM using bivariate and partial correlations with relevant variables. Results suggest that the CAMM is a developmentally appropriate measure with adequate internal consistency. As expected, CAMM scores were positively correlated with quality of life, academic competence, and social skills and negatively correlated with somatic complaints, internalizing symptoms, and externalizing behavior problems. Correlations were reduced but generally still significant after controlling for the effects of 2 overlapping processes (thought suppression and psychological inflexibil- ity). Overall, results suggest that the CAMM may be a useful measure of mindfulness skills for school-aged children and adolescents. Keywords: mindfulness, acceptance, children and adolescents Supplemental materials: http://dx.doi.org/10.1037/a0022819.supp Mindfulness-based interventions are becoming increasingly popular, and the literature supporting their efficacy is growing quickly. The approaches with the strongest empirical support in- clude acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 1999), dialectical behavior therapy (DBT; Linehan, 1993), mindfulness-based cognitive therapy (MBCT; Segal, Wil- liams, & Teasdale, 2002), and mindfulness-based stress reduction (MBSR; Kabat-Zinn, 1982, 1990). Randomized trials of these interventions have shown beneficial outcomes across a vast array of clinical problems, including depression, anxiety, substance abuse, chronic pain, disordered eating, psychosis, and borderline personality disorder, among others (for reviews see Baer, 2003; Coelho, Canter, & Ernst, 2007; Grossman, Neimann, Schmidt, & Walach, 2004; Hayes, Luoma, Bond, Masuda, & Lillis, 2006; Hofmann, Sawyer, Witt, & Oh, 2010; Lynch, Trost, Salsman, & Linehan, 2007). Mindfulness research over the past two decades has focused primarily on adult clinical populations; however, in recent years these approaches have been adapted for use with children and adolescents (see Greco & Hayes, 2008). For example, Semple and colleagues developed an MBCT protocol that shows promising preliminary support in anxious children (Semple, Reid, & Miller, 2005). DBT has been successfully adapted for adolescents with bipolar disorder (Goldstein, Axelson, Birmaher, & Brent, 2007), self-injurious behavior (Miller, Rathus, & Linehan, 2007), and binge-eating disorder (Salbach-Andrae, Bohnekamp, Pfeiffer, Lehmkuhl, & Miller, 2008). Similarly, ACT has been adapted for childhood anxiety (Greco, Blackledge, Coyne, & Ehrenreich, 2005), eating disorders (Greco, Barnett, Blomquist, & Gevers, 2008; Heffner, Sperry, Eifert, & Detweiler, 2002) and pediatric chronic pain (Wicksell & Greco, 2008; Wicksell, Melin, & Olsson, 2007). Furthermore, mindfulness-based interventions are being applied across broader social contexts to effect change at home, school, and pediatric medical settings (e.g., Greco, Barnett, et al., 2008; Robinson, 2008; Rogers, Murrell, Adams, & Wilson, 2008; Wahler, Rowinski, & Williams, 2008). As the empirical evidence for these approaches continues to grow, the importance of examining the processes or mechanisms by which mindfulness-based interventions lead to beneficial out- comes is increasingly acknowledged (Bishop et al., 2004; Dimi- djian & Linehan, 2003). Psychometrically sound measures of mindfulness skills are essential for determining whether participa- tion in these treatments leads to increases in the ability to respond mindfully to the experiences of daily life and whether such in- creases mediate the improvements in psychological functioning that often are observed. Several tools for assessing mindfulness in adults are now avail- able. These include the Freiburg Mindfulness Inventory (Buch- held, Grossman, & Walach, 2001), the Mindful Attention Aware- ness Scale (MAAS; Brown & Ryan, 2003), the Kentucky Inventory of Mindfulness Skills (KIMS; Baer, Smith, & Allen, This article was published Online First April 11, 2011. Laurie A. Greco, Department of Veterans Affairs, Chalmers P. Wylie Ambulatory Care Center; Ruth A. Baer and Gregory T. Smith, Department of Psychology, University of Kentucky. Correspondence concerning this article should be addressed to Laurie A. Greco, Chalmers P. Wylie VA Ambulatory Care Center, Specialty and Acute Care—Pain Service, 420 North James Road, Columbus, OH 43219- 1834. E-mail: Laurie.Greco@va.gov or LaurieAGreco@gmail.com Psychological Assessment © 2011 American Psychological Association 2011, Vol. 23, No. 3, 606 – 614 1040-3590/11/$12.00 DOI: 10.1037/a0022819 606