Mindfulness in a College Physiology Course

Students will complete the Applied Mindfulness Process Scale (AMPS) at baseline and post-intervention completion. The scale consists of 15 questions that quantify the application of mindfulness skills to navigate difficult situations and stressors in life. The AMPS encompasses three subscales: decentering, negative emotion regulation, and positive emotion regulation. The total scores are the sum of the item scores. The total possible scores range from 0 to 60. Higher scores reflect a more active use of mindfulness practice in everyday life. The scale demonstrated high internal consistency (Cronbach's α = 0.91) among 134 adults in the original study.

Trait mindfulness will be assessed with the Five Facet Mindfulness Questionnaire (FFMQ), a 39-item questionnaire evaluating five distinct components of mindfulness: observation (8 items), description (8 items), aware actions (8 items), non-judging of inner experience (8 items), and non-reactivity to inner experience (7 items). The total score is the average across the five subscales. Possible scores range from 1 to 5, with higher scores indicating higher dispositional mindfulness.

At the time of intervention completion, physiological stress reactivity will be evaluated using the online version of the Trier Social Stress Test (TSST) in our laboratory (Heyers et al., 2025). During the TSST, heart rate will be measured using a chest-worn Polar H10 (Polar Electro Oy, Kempele, Finland) (Schaffarczyk et al., 2022) and video-based photoplethysmography (PPG) (Pirzada et al., 2023). Wrist collected PPG heart rate data will also be measured during the TSST-OL (ActiGraph LEAP; Ametris, Pensacola, Florida). Raw inter-beat intervals will be recorded via Bluetooth pairing with an accelerometer (ActiGraph wGT3X-BT; Ametris, Pensacola, Florida). The mean heart rate (MHR) will be computed during the baseline resting phase, the TSST (speech preparation and speaking), and the recovery phase (Nyklíček et al., 2013). Reactivity to the acute stressor will be operationalized as differences in heart rate parameters during the TSST (preparation + speaking) compared to the baseline.

Well-being will be assessed with the 5-item World Health Organization Well-Being Index (WHO-5). Participants will rate five positively phrased items on subjective well-being, i.e., "I have felt cheerful and in good spirits." Responses are anchored from 0 (none of the time) to 5 (all the time). The total score is the sum of item responses ranging from 0 to 25, with 25 indicating the maximum possible mental well-being. The index has shown high internal consistency with α = 0.86 and test-retest reliability of r = 0.77 in 903 college students.

Harmful alcohol intake will be assessed via the Consumption subscale from the Alcohol Use Disorders Identification Test (AUDIT-C). The AUDIT-C has three items on the frequency and quantity of alcohol use. The total score is the sum across items, which range from 0 to 12, with higher scores indicating a higher risk of alcohol abuse or dependence. A score of 3 and above is indicative of possible risky drinking that warns of clinical concerns.

Addictive use of social media will be examined with the Bergen Social Media Addiction Scale (BSMAS). Participants will rate six items reflecting elements of addiction to social media, e.g., "I spent a lot of time thinking about social media or planned use of social media (salience)" and "I felt an urge to use social media more and more (craving/tolerance)." Responses are anchored from 1 (very rarely) to 5 (very often). A total score will be computed by summing all item responses (range: 1 to 30). Higher scores indicate more addictive use of social media. The scale has shown adequate internal validity (α = 0.88, N = 23533 adults).

Social belongingness will be measured via the revised Social Connectedness Scale (SCS-r). Participants will rate 20 items on a six-point Likert scale from 1 (strongly disagree) to 6 (strongly agree), e.g., "I am able to relate to my peers." A total score will be computed by taking the sum across items. Possible scores range from 20 to 120, with 120 indicating the strongest sense of belongingness.

Anxiety around learning will be assessed with the learning-related anxiety subscale from the Achievement Emotions Questionnaire-Short Form (AEQ-S). Participants will rate four five-point Likert scales on feelings of anxiousness when studying, e.g., "I get tense and nervous while studying." The subscale showed adequate internal validity in the original study with an α of 0.72 in 180 adults (71% female, 58% White).

Subjective stress in the last month will be measured with the ten-item Perceived Stress Scale (PSS-10). The scale evaluates individuals' perception of how uncontrollable and overloaded their lives have been in the past month, e.g., "In the past month, how often have you felt you were unable to control the important things in your life?" Participants will rate items on a five-point Likert scale from 0 (never) to 5 (very often). The possible scores range from 0 to 50; higher scores reflect more perceived stress. The scale has shown strong internal validity (α > 0.70) and test-retest reliability (r > 0.70) in a systematic review.

Participants will evaluate their confidence in managing stress with the Stress Management Self-Efficacy Scale (α = 0.86, N = 2292) (Sawatzky et al., 2012). The scale has four items, e.g., "I believe I have the ability to cope with the demands of my life." All items will be rated on a four-point Likert scale from 1 (strongly disagree) to 4 (strongly agree). A global score will be computed with the mean across the four items (range: 1 to 4), with higher scores indicating greater self-efficacy in identifying and managing stress.

The severity of generalized anxiety disorder will be evaluated with the seven-item anxiety scale (GAD-7). The scale had high internal validity (α = 0.92) and test-retest reliability (interclass correlation = 0.83) in the original study. Item responses are anchored on a four-point Likert scale from 0 (not at all) to 3 (nearly every day). A total score will be computed by taking the sum of item responses. Possible scores range from 0 to 21, with higher scores reflecting more severe anxiety. A score of 8 and above indicates possible cases of GAD with a sensitivity of 83% and specificity of 84%.

Heart rate variability response to the TSST will be assessed by the change in Root Mean Square of Successive Differences (RMSSD) during the TSST (speech preparation + speaking) compared to the baseline.

Emotional Eating will be assessed with the 13-item Emotional Eating Subscale from the Dutch Eating Behavior Questionnaire (DEBQ) (Van Strien et al., 1986). The Emotional Eating scale has demonstrated strong internal consistency (α > 0.98) in English-speaking populations (Mason et al., 2019). Items are scored on a five-point Likert scale from 1 (never) to 5 (very often). A total score will be computed by averaging all items. Possible scores range from 1 to 5, with higher scores indicating higher rates of emotional eating (Mason et al., 2019; Van Strien et al., 1986).