Psychometric Properties of an Arabic Translation of the Child and Adolescents Mindfulness Measure (CAMM) in adolescents

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Methods In this cross-sectional study, 793 adolescents were recruited to participate by completing the translated Arabic version of the CAMM through an online Google Forms survey. The validation of the scale was carried out using the Confirmatory Factor Analysis approach. Results The Confirmatory Factor Analysis revealed a one-factor structure. Both the alpha coefficient (α = .89) and the omega coefficient (ω = .89) demonstrated excellent reliability. Sex invariance was shown at the configural, scalar and metric levels, with no statistically significant difference in CAMM scores was observed between males and females. Moreover, the CAMM total score exhibited a significant association with lower irritability, higher wellbeing, and depression-happiness (r = .43; p < .001). Conclusion Our results confirm the reliability and validity of the Arabic version of the CAMM, suggesting its suitability for use among Arabic-speaking adolescents in various settings. This concise and user-friendly tool has the potential to promote cross-cultural research on mindfulness and wellbeing. Child and Adolescents Mindfulness Measure Arabic Validation Factor Analysis Figures Figure 1 BACKGROUND Mindfulness is a practice that involves increased awareness of one's self and the surrounding environment, focusing on the present moment and observing inner experiences [ 1 ]. It allows individuals to disengage from automatic thought patterns and experience the present without judgment or commentary [ 2 ]. Research indicates that mindfulness can have various benefits, such as promoting well-being, reducing stress, enhancing emotional regulation, improving attention and self-awareness [ 3 , 4 ]. Mindfulness-based interventions, like Mindfulness-Based Cognitive Therapy (MBCT), have been effective in preventing depression recurrence [ 5 ]. This concept has had a central role in the world of clinical psychology and psychiatry, but also have a central place within the world of research, specially within vulnerable populations and younger people. Indeed, mindfulness demonstrated various benefits for children and adolescents in different areas. Research supports that mindfulness-based interventions can enhance cognitive function [ 6 ], reduce anxiety symptoms, attention issues, and behavioral problems in children and adolescents [ 7 ]. Indeed, there is also some evidence that mindfulness can significantly improve irritability symptoms [ 8 ]. Additionally, mindfulness techniques have been associated with better coping responses to peer stress and may contribute to building resilience in children and youth [ 9 , 10 ]. Moreover, mindfulness practices have been linked to improvements in health-related quality of life [ 11 ], and could even mediate very specific somatic complaints like a reduction in headache attacks in adolescents with migraines [ 12 ]. Multiple scales and widely used measures attempt to operationalize the concept of mindfulness. Some of these we can count the Mindful Attention Awareness Scale (MAAS), a measure that gauges a unique quality of consciousness related to attention and self-awareness [ 13 ]. Another prominent scale is the Five Facet Mindfulness Questionnaire, which assesses various facets of mindfulness such as observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience [ 14 ]. These scales, along with the Freiburg Mindfulness Inventory, contribute to the comprehensive assessment of mindfulness in psychological research [ 15 ], and mainly within the adult population. On another note, when assessing mindfulness in a specific population such as individuals under the age of 18, it is essential to consider validated measures tailored for children and adolescents. Among the various instruments available, notable options include the Mindful Attention Awareness Scale for Adolescents (MAAS-A) [ 16 ], its counterpart for children (MAAS-C) [ 17 ], and the Child and Adolescent Mindfulness Measure (CAMM) [ 18 ]. These tools have shown promising psychometric properties across diverse samples [ 19 – 24 ]. However, the CAMM stands out as particularly promising due to its robust psychometric properties across contexts [ 25 ], and its coverage of a broad age range from 10 to 17 years, unlike the MAAS-A, which targets individuals aged 14 to 18 years, therefore making it unsuitable for all age groups. Moreover, the CAMM is a concise 10-item version that can be swiftly completed, a crucial factor when dealing with a young population. Additionally, criticisms have been raised regarding the validity of the MAAS-A, with concerns that it primarily emphasizes attention and awareness while overlooking other vital aspects of mindfulness [ 15 ]. While the CAMM also features a one-factor structure, which some may view as overly simplistic, its development considered the need for age-appropriate measures, especially for a younger population, where multifaceted mindfulness skills may be less distinct compared to adults [ 18 ]. Indeed, this measure was created in 2011 by Greco, Baer, and Smith [ 18 ] as a pioneering tool to assess mindfulness in children and adolescents, and it was thoroughly developed across four studies. The CAMM has undergone psychometric evaluation and validation in a variety of languages, including German [ 26 ], Persian [ 27 ], Dutch [ 21 ], a 7-item Spanish version [ 24 ], Portuguese [ 28 ], French [ 29 ], Greek [ 30 ], an eight-item Italian version, and Chinese [ 31 ]. Research has shown that the CAMM is a reliable scale that correlates positively with various aspects of well-being like measures of happiness, healthy self-regulation, and quality of life and negatively associated with relevant psychopathological constructs [ 21 , 26 , 27 , 32 ]. In the context of gender differences, studies have shown that there are no significant gender differences within Dutch [ 22 ], Italian [ 33 ], Portuguese [ 28 ], and Catalan-speaking Spanish adolescents [ 34 ]. Transitioning from childhood to adulthood, particularly during adolescence, poses significant psychological challenges for individuals. Adolescents experience a myriad of changes, including physical, emotional, and social adjustments [ 35 ]. And more recently, the COVID-19 pandemic has exacerbated these challenges, introducing fears, uncertainties, disruptions to routines, and increased stress levels for adolescents and their families [ 36 ]. Specifically, adolescents and younger individuals in Lebanon and the broader Arab vicinity are raised amidst persistent instability, violence, and political unrest [ 37 ]. Having a validated mindfulness measure in Arabic specifically for adolescents and children in the Middle Eastern context is crucial. As already mentioned above, mindfulness has been recognized for its positive effects on psychological well-being, and the increasing awareness of mental health issues among youth in the region emphasizes the need for such a tool. By having a concise and validated mindfulness measure in Arabic, it becomes easier to assess and implement mindfulness-based interventions that are tailored to the cultural nuances of the Middle East. Validating the CAMM in Arabic would fill a significant gap in the field, enabling researchers and practitioners to accurately measure mindfulness levels among Arab youth, customize interventions to suit their specific needs, and potentially enhance their mental health and overall well-being. Given this, our objective was to assess the psychometric properties of the first Arabic adaptation of the Child and Adolescent Mindfulness Scale among Arabic-speaking adolescents. We aimed to explore its concurrent validity with well-being, happiness, and irritability, as well as investigate its factor structure and sex invariance. Our initial hypothesis was that the psychometrically sound translated scale would yield a reliable single-factor assessment with no sex differences. We also anticipated positive associations with well-being and happiness measures and negative correlations with irritability, a marker of pathological conditions. METHODS Study design and participants This cross-sectional study took place during November 2023. An anonymous online questionnaire was distributed to Lebanese adolescents nationwide. Eligible participants for the study were required to be citizens of Lebanon, between the ages of 14 and 18, and willing to participate. Data collection employed snowball sampling and respondent-driven methods. The survey was designed with Google Forms and distributed to potential participants via social media platforms and messaging applications. Study objectives and general instructions were clearly explained before participation. Minimal sample size calculation A minimum sample of 200 participants was deemed necessary to conduct the CFA based on 3 to 20 times the number of the scale’s variables [ 38 ]. Translation Procedure To ensure an accurate translation of the CAMM, a standard forward and backward translation procedure was employed. An independent Lebanese translator converted the English version of the CAMM into Arabic. Subsequently, a Lebanese psychologist with working proficiency in English translated the Arabic version back into English. The original and back-translated English versions were then compared to assess translation accuracy [ 39 , 40 ]. Any discrepancies were identified and rectified by a committee consisting of the research team and two translators. To confirm the clarity and comprehension of the questions, a pilot study was conducted with 20 participants, and no further changes were necessary. Questionnaire The survey was constructed in Arabic, Lebanon’s official language, and divided into three distinct sections. The first part served as an online consent checkpoint to confirm voluntarily submission and to address ethical considerations such as confidentiality and response anonymity. This section also included an introduction to the project and instructions for the questionnaire. Part two focused on gathering socio-demographic information from participants such as sex and age. The third section covered various measures detailed below. Measures Child and Adolescents Mindfulness Measure (CAMM) This 10-item self-report measure [ 18 ] assesses present-moment awareness and nonjudgmental, nonavoidant responses to thoughts and feelings in children and adolescents aged 10 to 17. It uses a 5-point Likert scale (0 = never true; 4 = always true), with higher scores indicating greater mindfulness. The scale was translated and adapted to the Arabic language and context through forward and backward translation, ensuring conceptual equivalence with the original version. Brief Irritability Test This five-item self-report scale [ 41 ] measures irritability over the past two weeks. Each item is rated on a 6-point Likert scale from 1 (never) to 6 (always). The total score is obtained by summing the scores of each item, with higher scores indicating greater irritability. The scale was validated in Lebanon among adolescents and translated into Arabic [ 42 ]. Current Cronbach’s Alpha = .87 The World Health Organization 5-item Well-Being Index The WHO-5 [ 43 , 44 ] consists of 5 items that assess subjective psychological well-being, each rated on a 5-point Likert scale from 5 (all of the time) to 0 (none of the time). The total raw scores are multiplied by 4 to obtain a percentage score from 0 (absence of wellbeing) to 100 (maximum wellbeing). The Arabic adaptation of this instrument has undergone a thorough validation among young individuals from many Arabic-speaking countries [ 45 ]. Current Cronbach’s Alpha = .92 Short Depression and Happiness Scale (SDHS) The SDHS [ 46 ] is a 6-item questionnaire designed to measure both depression and happiness levels. It comprises three positive and three negative statements, with responses given on a four-point scale from 0 (never) to 3 (often). For instance, a positive statement like "I felt happy" contrasts with negative ones like "I felt dissatisfied with my life." Higher scores indicate a higher level of happiness and lower levels of depression. This measure was also previously validated in Arabic [ 47 ]. Current Cronbach’s Alpha = .66 Data analysis There were no missing responses in the dataset. To examine the factor structure of the CAMM, we conducted a Confirmatory Factor Analysis (CFA) using the data from the total sample via SPSS AMOS v.29 software. Parameter estimates were obtained using the maximum likelihood method. Calculated fit indices were the normed model chi-square (χ²/df), the Steiger-Lind root mean square error of approximation (RMSEA), the standardized root mean square residual (SRMR), the Tucker-Lewis Index (TLI) and the comparative fit index (CFI). Values ≤ 5 for χ²/df, ≤ .08 for RMSEA, ≤ .05 for SRMR and ≥ .90 for CFI and TLI indicate good fit of the model to the data [ 48 ]. Multivariate normality was not verified at first (Critical ratio > 5; Bollen-Stine p = .002); therefore, we performed non-parametric bootstrapping procedure. Sex invariance. To examine sex invariance of CAMM scores, we conducted multi-group CFA [ 49 ]. Measurement invariance was assessed at the configural, metric, and scalar levels [ 50 ]. We accepted ΔCFI ≤ .010 and ΔRMSEA ≤ .015 or ΔSRMR ≤ .010 as evidence of invariance [ 49 ]. Comparison between males and females was done using the Student t -test only if scalar or partial scalar invariance. Composite reliability in both subsamples was assessed using McDonald’s ω and Cronbach’s alpha, with values greater than .70 reflecting adequate composite reliability. Normality of the CAMM score was verified since the skewness and kurtosis values for each item of the scale varied between − 1 and + 1 [ 51 ]. To assess concurrent validity, Pearson test was used to correlate two scores. RESULTS Seven hundred ninety-three adolescents filled the survey, with a mean age of 16.08 ± 1.74 years and 62.4% females. The mean and SD of the scores were as follows: CAMM (25.08 ± 7.37), wellbeing (20.54 ± 5.38), irritability (13.39 ± 4.78) and SDHS (10.71 ± 3.24). CFA indicated that fit of the one-factor model of CAMM scores was modest: χ 2 /df = 239.94/35 = 6.86, RMSEA = .086 (90% CI .076, .096), SRMR = .051, CFI = .937, TLI = .919. We added a correlation between residuals of items 5 and 10 since the modification index was high; the numbers improved as follows: χ 2 /df = 151.54/34 = 4.46, RMSEA = .066 (90% CI .056, .077), SRMR = .038, CFI = .964, TLI = .952. The standardized estimates of factor loadings were all adequate (Fig. 1 ). Internal reliability was excellent (ω = .89; α = .89). Sex Invariance Indices suggested that configural, metric, and scalar invariance was supported across sex (Table 1). No significant difference was found between males and females in terms of CAMM scores (25.56 ± 7.28 vs 24.80 ± 7.41, t (791) = 1.40, p = .161. Table 1. Measurement Invariance across Gender in the total sample. Model CFI RMSEA SRMR Model Comparison ΔCFI ΔRMSEA ΔSRMR Configural .955 .052 .043 Metric .953 .050 .049 Configural vs metric .002 .002 .006 Scalar .952 .048 .049 Metric vs scalar .001 .002 <.001 Note. CFI = Comparative fit index; RMSEA = Steiger-Lind root mean square error of approximation; SRMR = Standardised root mean square residual. Concurrent validity The CAMM total score was significantly associated with lower irritability ( r = − .66; p < .001), higher wellbeing ( r = .51; p < .001) and depression-happiness ( r = .43; p < .001). DISCUSSION The validation of the CAMM in Arabic is a significant step forward in the assessment of mindfulness within Arabic-speaking children and adolescents, highlighting its potential for both research and clinical applications given its validity and reliability. In fact, this measure showed excellent internal reliability, with both Cronbach’s Alpha and McDonald's Omega coefficients at 0.89. Given that this is a brief scale, achieving a Cronbach's alpha between 0.8 and 0.9 is considered ideal [ 52 ]. Some example for comparison, the original CAMM construction paper reported an alpha of 0.81 [ 18 ]. The Dutch version demonstrated an acceptable reliability of 0.70 in children and 0.80 in adolescents [ 21 ]. The Chinese version [ 31 ] showed an alpha and omega both of 0.826, whereas a Portuguese translation [ 53 ] found both reliability measures at 0.75. These findings underscore the high reliability of the current Arabic version and highlight the need for further research to explore cross-cultural variations in this measure's internal consistency. The instrument also showed a one-factor structure. This is in line with the original construction article and several other where 10 items converged into one unique mindfulness dimension [ 18 , 29 , 32 , 33 ]. This aligns with the theory proposed by these studies, which suggests that mindfulness skills may be more simplistic and unidimensional in young individuals compared to adults. However, variations in the number of items have been noted in some versions, such as the German version with 7 items [ 26 ], and Spanish version that is the briefest yet with only 5 items [ 54 ]. Interestingly, the Persian version [ 27 ] of the survey and another distinct UK investigation [ 55 ] have found that the 10 items converge to a 2-factor solution comprising of the subfactors “present moment awareness” and “avoidance of thoughts and feelings”. Our analysis indicates that configural, metric, and scalar invariance are upheld across sexes, showing no difference in CAMM scores between males and females. This finding is also supported by most previous research [ 21 , 28 , 32 , 33 ] indicating its effectiveness in measuring mindfulness in children and adolescents regardless of sex differences. However, other research on the CAMM where sex differences were found indicated that females tend to exhibit slightly lower levels of mindfulness [ 29 , 30 , 56 ], as it was stipulated that girls tend to adopt a more internalized coping approach, primarily characterized by negative rumination and resignation [ 57 , 58 ]. Future studies should further confirm the gender variance taking into consideration contextual and cultural factors into consideration. We also observed that higher mindfulness levels could potentially lower irritability and depression while enhancing well-being and happiness. In fact, a randomized controlled trial assessing a mindfulness app's effectiveness showed a significant reduction in irritability levels after a 10-day introductory program [ 8 ]. A paper from 2022, which thoroughly reviewed methods to boost resilience and address irritability and outbursts in adolescents, highlighted mindfulness as a key approach to forestalling relapses in such behaviors among youth [ 59 ]. Likewise, this holds true for individuals with ADHD, as a previous study also suggested that interventions rooted in mindfulness helped reduce episodic irritability [ 60 ]. More pertinent to our circumstances, a study carried out in Lebanon in 2024 with adolescents further confirms the positive connection between mindfulness and decreased levels of irritability [ 61 ]. Apart from diminishing irritability, our sample also experienced decreased levels of depression. Indeed, extensive meta-analyses have demonstrated the beneficial impact of mindfulness on psychopathology, particularly depression [ 62 – 64 ]. Mindfulness-based interventions have long been employed to help manage young individuals with depressive symptoms. More relevant to our setting, third culture students attending a multicultural school in the UAE, who exhibited relatively high levels of depressive symptoms, would likely benefit from mindfulness as a protective factor [ 65 ]. In addition to reducing negative elements, the second function is also to enhance positive constructs. Indeed, the correlation between mindfulness and increased well-being can be traced back to its neurobiological foundations [ 66 , 67 ]. Mindfulness-based intervention studies have validated this association, exemplified by a British study involving 14–15 year old boys, where overall well-being increased following mindfulness-based interventions [ 68 ]. Bluth and Blanton [ 69 ] reached the same conclusion in their study of urban high school adolescents aged 14 to 18 year old. Nevertheless, extensive research and reviews [ 70 , 71 ] confirm that well-being is highly correlated with mindfulness, reinforcing the construct validity of our translated scale. A recent exploratory mixed-method study conducted in a Lebanese private school demonstrated that a mindfulness-based social and emotional learning program significantly enhanced students' subjective well-being, as evidenced by both qualitative and quantitative analyses [ 72 ]. A 2018 investigation [ 73 ] found a connection between mindfulness and subjective happiness in a sample of adolescent boys. Singh stipulated that mindfulness not only reduces adolescents' stress levels but also enhances their happiness by altering their perceptions and relationships with their experiences [ 74 ]. Indeed, someone who has extensive experience in meditation would likely experience heightened levels of happiness, tranquility, and peace [ 75 ]. Remaining mindful and present allows us to become more aware of our emotions, leading to a deeper understanding and improved regulation of them. Skillfully managing our internal emotional experiences in the present moment can ultimately contribute to long-term happiness. Clinical Implications This study has significant implications, as it offers a valid and reliable measure for clinicians and researchers to assess mindfulness in Lebanese adolescents, and therefore enhance the potential for further research opportunities in Arabic-speaking populations. Additionally, evaluating the implementation of mindfulness-based interventions and promoting a holistic approach to patient care could be more effective, as the Arabic CAMM showed a correlation with the reduction in irritability and depression, alongside an increase in happiness and well-being. The tool is applicable to both males and females, enabling its use across the population without requiring sex-specific adaptations. Furthermore, the availability of an Arabic version of the CAMM facilitates comparisons across different cultural contexts. Limitations It is imperative to be cautious when interpreting the results, given that the current research may contain a few limitations. Response bias could be introduced because people invited through snowball sampling might have chosen not to participate in the survey. Furthermore, even though our sample size was adequate, there was a slight overrepresentation towards females. The cross-sectional design of this investigation prohibits us to ascertain causality or the temporal order of connections between variables. Furthermore, the participants in our validation work were exclusively from Lebanon, underscoring the necessity of including individuals from other Arab nations in future studies to evaluate the scale's psychometric qualities, including test-retest reliability, and test its cross-cultural validity. CONCLUSION Our findings validated the robust psychometric properties of the Arabic version of the Child and Adolescent Mindfulness Measure (CAMM), confirming its suitability for assessing mindfulness in Arabic-speaking adolescents, particularly in Lebanon. This makes the Arabic CAMM a reliable and valuable tool for researchers and practitioners, aiding the integration of mindfulness practices into educational and clinical settings. However, further research is recommended to extend the validation of this translated measure to encompass a more diverse Arabic-speaking population. This expansion would enhance the generalizability and applicability of the CAMM across various cultural contexts within the Arabic-speaking community. Ultimately, this advancement supports the broader goal of enhancing adolescent mental health and well-being through culturally sensitive measures. Declarations Ethics Approval and Consent to Participate. The Lebanese International University's School of Pharmacy ethics committee granted this study ethics permission (2023RC-033-LIUSOP). When filling out the online form, each participant provided written informed consent, as did their parents or legal guardian(s) if they were study participants under the age of sixteen. All methods were performed in accordance with the relevant guidelines and regulations (in accordance with the Declaration of Helsinki). Consent for publication: Not applicable. Availability of data and materials : Because of ethical committee constraints, none of the data collected or analyzed during this study are publicly available. However, the corresponding author (SH) may make the data available upon reasonable request. Competing interests: The authors have nothing to disclose. Funding: None. Author contributions: SO, FFR and SH designed the study; CJEZ drafted the manuscript; SH carried out the analysis and interpreted the results; FS and MD collected the data. DM reviewed the paper for intellectual content; all authors reviewed the final manuscript and gave their consent. 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Advanced issues in partial least squares structural equation modeling. Los Angeles: SAGE; 2018. 254 p. Morgado FFR, Meireles JFF, Neves CM, Amaral ACS, Ferreira MEC. Scale development: ten main limitations and recommendations to improve future research practices. Psicol Refl Crít. 2018 Jan;30(1):3. Limpo T, Rasteiro I, Aguiar S, Magalhães S. Examining the Factorial Structure, Reliability, and Predictive Validity of the Portuguese Version of the Child and Adolescent Mindfulness Measure (CAMM). Mindfulness. 2022 Nov;13(11):2879–90. Guerra, García-Gómez, Turanzas, Cordón, Suárez-Jurado, Mestre. A Brief Spanish Version of the Child and Adolescent Mindfulness Measure (CAMM). A Dispositional Mindfulness Measure. IJERPH. 2019 Apr 15;16(8):1355. Sanders A, Gains H, Baer R, Ball S, Jones B, Banks H, et al. Investigation of the Factor Structure and Differential Item Functioning of the Child and Adolescent Mindfulness Measure (CAMM): Analysis of Data from a School-Based Cluster Randomised Controlled Trial. Mindfulness. 2023 Jul;14(7):1718–34. Dion J, Paquette L, Daigneault I, Godbout N, Hébert M. Validation of the French Version of the Child and Adolescent Mindfulness Measure (CAMM) Among Samples of French and Indigenous Youth. Mindfulness. 2018 Apr;9(2):645–53. Hampel P, Petermann F. Age and Gender Effects on Coping in Children and Adolescents. J Youth Adolescence. 2005 Apr;34(2):73–83. Broderick PC. Early Adolescent Gender Differences in the Use of Ruminative and Distracting Coping Strategies. The Journal of Early Adolescence. 1998 May;18(2):173–91. Singh MK, Hu R, Miklowitz DJ. Preventing Irritability and Temper Outbursts in Youth by Building Resilience. Child and Adolescent Psychiatric Clinics of North America. 2021 Jul;30(3):595–610. Mitchell JT, McIntyre EM, English JS, Dennis MF, Beckham JC, Kollins SH. A Pilot Trial of Mindfulness Meditation Training for ADHD in Adulthood: Impact on Core Symptoms, Executive Functioning, and Emotion Dysregulation. J Atten Disord. 2017 Nov;21(13):1105–20. Fekih-Romdhane F, Malaeb D, Azzi V, Hallit R, Dabbous M, Sakr F, et al. Psychometric properties of the Arabic versions of the long (27 items) and short (13 items) forms of the interpersonal mindfulness scale (IMS). BMC Psychiatry. 2024 Apr 3;24(1):253. McCarney RW, Schulz J, Grey AR. Effectiveness of mindfulness-based therapies in reducing symptoms of depression: A meta-analysis. European Journal of Psychotherapy & Counselling. 2012 Sep;14(3):279–99. Chi X, Bo A, Liu T, Zhang P, Chi I. Effects of Mindfulness-Based Stress Reduction on Depression in Adolescents and Young Adults: A Systematic Review and Meta-Analysis. Front Psychol. 2018 Jun 21;9:1034. Reangsing C, Punsuwun S, Schneider JK. Effects of mindfulness interventions on depressive symptoms in adolescents: A meta-analysis. International Journal of Nursing Studies. 2021 Mar;115:103848. Thomas J, Humeidan M, Barrack C, Huffman KL. Mindfulness, Stress Reactivity, and Depressive Symptoms Among “Third Culture Kids” in the United Arab Emirates. Journal of Cross-Cultural Psychology. 2021 Feb;52(2):192–208. Kong F, Wang X, Song Y, Liu J. Brain regions involved in dispositional mindfulness during resting state and their relation with well-being. Social Neuroscience. 2016 Jul 3;11(4):331–43. Wheeler MS, Arnkoff DB, Glass CR. The Neuroscience of Mindfulness: How Mindfulness Alters the Brain and Facilitates Emotion Regulation. Mindfulness. 2017 Dec;8(6):1471–87. Huppert FA, Johnson DM. A controlled trial of mindfulness training in schools: The importance of practice for an impact on well-being. The Journal of Positive Psychology. 2010 Jul;5(4):264–74. Bluth K, Blanton PW. Mindfulness and Self-Compassion: Exploring Pathways to Adolescent Emotional Well-Being. J Child Fam Stud. 2014 Oct 1;23(7):1298–309. Fullman N, Yearwood J, Abay SM, Abbafati C, Abd-Allah F, Abdela J, et al. Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016. The Lancet. 2018 Jun;391(10136):2236–71. McKeering P, Hwang YS. A Systematic Review of Mindfulness-Based School Interventions with Early Adolescents. Mindfulness. 2019 Apr;10(4):593–610. Halwani F, Geha M. Studying the Effect of a Mindfulness-Based Social and Emotional Learning Program on Students’ Wellbeing: The Case of a Lebanese Private School. International Journal of Science and Research (IJSR). 2022 Nov 7;11. Teal C, Downey LA, Lomas JE, Ford TC, Bunnett ER, Stough C. The Role of Dispositional Mindfulness and Emotional Intelligence in Adolescent Males. Mindfulness. 2019 Jan;10(1):159–67. Singh A. Mindfulness and Happiness among Students: Mediating Role of Perceived Stress. Journal of the Indian Academy of Applied Psychology. 2018 Jul 1;44:198–207. Englund-Helmeke S. Mindfulness and Well-Being. Master of Social Work Clinical Research Papers [Internet]. 2014 May 1; Available from: https://sophia.stkate.edu/msw_papers/313 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4522801","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":312809850,"identity":"06bbec9b-bb26-4ca6-963e-a53a20ef9834","order_by":0,"name":"Christian-Joseph El Zouki","email":"","orcid":"","institution":"Université de Picardie Jules Verne","correspondingAuthor":false,"prefix":"","firstName":"Christian-Joseph","middleName":"El","lastName":"Zouki","suffix":""},{"id":312809851,"identity":"8ee1cba4-6aad-4b27-8369-a4c7ed87b5bb","order_by":1,"name":"Diana Malaeb","email":"","orcid":"","institution":"Gulf Medical University","correspondingAuthor":false,"prefix":"","firstName":"Diana","middleName":"","lastName":"Malaeb","suffix":""},{"id":312809852,"identity":"165d889f-6afd-448c-bf04-6c7a22b86c29","order_by":2,"name":"Fouad Sakr","email":"","orcid":"","institution":"Lebanese International University","correspondingAuthor":false,"prefix":"","firstName":"Fouad","middleName":"","lastName":"Sakr","suffix":""},{"id":312809853,"identity":"c83ce2c7-a793-44cd-93e5-608d4c22c13c","order_by":3,"name":"Mariam Dabbous","email":"","orcid":"","institution":"Lebanese International University","correspondingAuthor":false,"prefix":"","firstName":"Mariam","middleName":"","lastName":"Dabbous","suffix":""},{"id":312809854,"identity":"c5366e49-825f-4dd8-a847-9ccbfc37fd42","order_by":4,"name":"Souheil Hallit","email":"","orcid":"","institution":"Holy Spirit University of Kaslik","correspondingAuthor":false,"prefix":"","firstName":"Souheil","middleName":"","lastName":"Hallit","suffix":""},{"id":312809855,"identity":"1f55263b-01b9-49f9-a13f-b8749ba0a7d8","order_by":5,"name":"Feten Fekih-Romdhane","email":"","orcid":"","institution":"Razi hospital","correspondingAuthor":false,"prefix":"","firstName":"Feten","middleName":"","lastName":"Fekih-Romdhane","suffix":""},{"id":312809856,"identity":"64836242-812f-4bff-9c9d-03f4ff22ef37","order_by":6,"name":"Sahar Obeid","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/0lEQVRIiWNgGAWjYFACHhBxgIGNIfnwg48NIA5j4wEitaSlGc5sYJAAamkgTgsDQ46BNC9YC4SLE8i3nz34uaLijhwfe4KBse0Omzrd9sNAW2psonFpMTiTlyx55swzYzaeBwmPc8+kSZidSQRqOZaW24BLC9A9ko1thxPbJBIOGOe2HZYwOwDUwthwGKcW+f43xj+BWurbJBIbpC1BWs4/xK+F4UaOGciWBDaJZAZpRpCWGwRsMbjxxsyy4cwzwzaeZ2yGvW1pkttuAG1JwOMX+f4c45sNFXfk5dvzPz/42WbDb3Y+/eGDDzU2uB2GHSSQpnwUjIJRMApGARoAAA1IZj5/UTisAAAAAElFTkSuQmCC","orcid":"","institution":"Lebanese American University","correspondingAuthor":true,"prefix":"","firstName":"Sahar","middleName":"","lastName":"Obeid","suffix":""}],"badges":[],"createdAt":"2024-06-03 15:25:50","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4522801/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4522801/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":58754105,"identity":"e63f906b-23b6-4292-a4b4-f4d14e75b623","added_by":"auto","created_at":"2024-06-20 16:22:36","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":88894,"visible":true,"origin":"","legend":"\u003cp\u003eS\u003cem\u003etandardized Estimates of Factor Loadings from the Confirmatory Factor Analysis.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-4522801/v1/c8f565bec6e99a3a55d28a13.png"},{"id":74208763,"identity":"293be194-7af7-4faf-8e73-efe088a5bfb0","added_by":"auto","created_at":"2025-01-20 04:23:48","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":745991,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4522801/v1/3d881631-c23e-4f1f-9651-5f1e80b097d3.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Psychometric Properties of an Arabic Translation of the Child and Adolescents Mindfulness Measure (CAMM) in adolescents","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eMindfulness is a practice that involves increased awareness of one's self and the surrounding environment, focusing on the present moment and observing inner experiences [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. It allows individuals to disengage from automatic thought patterns and experience the present without judgment or commentary [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Research indicates that mindfulness can have various benefits, such as promoting well-being, reducing stress, enhancing emotional regulation, improving attention and self-awareness [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Mindfulness-based interventions, like Mindfulness-Based Cognitive Therapy (MBCT), have been effective in preventing depression recurrence [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. This concept has had a central role in the world of clinical psychology and psychiatry, but also have a central place within the world of research, specially within vulnerable populations and younger people. Indeed, mindfulness demonstrated various benefits for children and adolescents in different areas. Research supports that mindfulness-based interventions can enhance cognitive function [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], reduce anxiety symptoms, attention issues, and behavioral problems in children and adolescents [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Indeed, there is also some evidence that mindfulness can significantly improve irritability symptoms [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAdditionally, mindfulness techniques have been associated with better coping responses to peer stress and may contribute to building resilience in children and youth [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Moreover, mindfulness practices have been linked to improvements in health-related quality of life [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], and could even mediate very specific somatic complaints like a reduction in headache attacks in adolescents with migraines [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMultiple scales and widely used measures attempt to operationalize the concept of mindfulness. Some of these we can count the Mindful Attention Awareness Scale (MAAS), a measure that gauges a unique quality of consciousness related to attention and self-awareness [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Another prominent scale is the Five Facet Mindfulness Questionnaire, which assesses various facets of mindfulness such as observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. These scales, along with the Freiburg Mindfulness Inventory, contribute to the comprehensive assessment of mindfulness in psychological research [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e], and mainly within the adult population. On another note, when assessing mindfulness in a specific population such as individuals under the age of 18, it is essential to consider validated measures tailored for children and adolescents. Among the various instruments available, notable options include the Mindful Attention Awareness Scale for Adolescents (MAAS-A) [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], its counterpart for children (MAAS-C) [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], and the Child and Adolescent Mindfulness Measure (CAMM) [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. These tools have shown promising psychometric properties across diverse samples [\u003cspan additionalcitationids=\"CR20 CR21 CR22 CR23\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. However, the CAMM stands out as particularly promising due to its robust psychometric properties across contexts [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e], and its coverage of a broad age range from 10 to 17 years, unlike the MAAS-A, which targets individuals aged 14 to 18 years, therefore making it unsuitable for all age groups. Moreover, the CAMM is a concise 10-item version that can be swiftly completed, a crucial factor when dealing with a young population. Additionally, criticisms have been raised regarding the validity of the MAAS-A, with concerns that it primarily emphasizes attention and awareness while overlooking other vital aspects of mindfulness [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. While the CAMM also features a one-factor structure, which some may view as overly simplistic, its development considered the need for age-appropriate measures, especially for a younger population, where multifaceted mindfulness skills may be less distinct compared to adults [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Indeed, this measure was created in 2011 by Greco, Baer, and Smith [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] as a pioneering tool to assess mindfulness in children and adolescents, and it was thoroughly developed across four studies. The CAMM has undergone psychometric evaluation and validation in a variety of languages, including German [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], Persian [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], Dutch [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], a 7-item Spanish version [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], Portuguese [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], French [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e], Greek [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e], an eight-item Italian version, and Chinese [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Research has shown that the CAMM is a reliable scale that correlates positively with various aspects of well-being like measures of happiness, healthy self-regulation, and quality of life and negatively associated with relevant psychopathological constructs [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. In the context of gender differences, studies have shown that there are no significant gender differences within Dutch [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], Italian [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e], Portuguese [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], and Catalan-speaking Spanish adolescents [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTransitioning from childhood to adulthood, particularly during adolescence, poses significant psychological challenges for individuals. Adolescents experience a myriad of changes, including physical, emotional, and social adjustments [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. And more recently, the COVID-19 pandemic has exacerbated these challenges, introducing fears, uncertainties, disruptions to routines, and increased stress levels for adolescents and their families [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. Specifically, adolescents and younger individuals in Lebanon and the broader Arab vicinity are raised amidst persistent instability, violence, and political unrest [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. Having a validated mindfulness measure in Arabic specifically for adolescents and children in the Middle Eastern context is crucial. As already mentioned above, mindfulness has been recognized for its positive effects on psychological well-being, and the increasing awareness of mental health issues among youth in the region emphasizes the need for such a tool. By having a concise and validated mindfulness measure in Arabic, it becomes easier to assess and implement mindfulness-based interventions that are tailored to the cultural nuances of the Middle East. Validating the CAMM in Arabic would fill a significant gap in the field, enabling researchers and practitioners to accurately measure mindfulness levels among Arab youth, customize interventions to suit their specific needs, and potentially enhance their mental health and overall well-being.\u003c/p\u003e \u003cp\u003eGiven this, our objective was to assess the psychometric properties of the first Arabic adaptation of the Child and Adolescent Mindfulness Scale among Arabic-speaking adolescents. We aimed to explore its concurrent validity with well-being, happiness, and irritability, as well as investigate its factor structure and sex invariance. Our initial hypothesis was that the psychometrically sound translated scale would yield a reliable single-factor assessment with no sex differences. We also anticipated positive associations with well-being and happiness measures and negative correlations with irritability, a marker of pathological conditions.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and participants\u003c/h2\u003e \u003cp\u003eThis cross-sectional study took place during November 2023. An anonymous online questionnaire was distributed to Lebanese adolescents nationwide. Eligible participants for the study were required to be citizens of Lebanon, between the ages of 14 and 18, and willing to participate. Data collection employed snowball sampling and respondent-driven methods. The survey was designed with Google Forms and distributed to potential participants via social media platforms and messaging applications. Study objectives and general instructions were clearly explained before participation.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eMinimal sample size calculation\u003c/h2\u003e \u003cp\u003eA minimum sample of 200 participants was deemed necessary to conduct the CFA based on 3 to 20 times the number of the scale\u0026rsquo;s variables [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eTranslation Procedure\u003c/h2\u003e \u003cp\u003eTo ensure an accurate translation of the CAMM, a standard forward and backward translation procedure was employed. An independent Lebanese translator converted the English version of the CAMM into Arabic. Subsequently, a Lebanese psychologist with working proficiency in English translated the Arabic version back into English. The original and back-translated English versions were then compared to assess translation accuracy [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. Any discrepancies were identified and rectified by a committee consisting of the research team and two translators. To confirm the clarity and comprehension of the questions, a pilot study was conducted with 20 participants, and no further changes were necessary.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eQuestionnaire\u003c/h2\u003e \u003cp\u003eThe survey was constructed in Arabic, Lebanon\u0026rsquo;s official language, and divided into three distinct sections. The first part served as an online consent checkpoint to confirm voluntarily submission and to address ethical considerations such as confidentiality and response anonymity. This section also included an introduction to the project and instructions for the questionnaire. Part two focused on gathering socio-demographic information from participants such as sex and age. The third section covered various measures detailed below.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eMeasures\u003c/h2\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003eChild and Adolescents Mindfulness Measure (CAMM)\u003c/h2\u003e \u003cp\u003eThis 10-item self-report measure [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] assesses present-moment awareness and nonjudgmental, nonavoidant responses to thoughts and feelings in children and adolescents aged 10 to 17. It uses a 5-point Likert scale (0\u0026thinsp;=\u0026thinsp;never true; 4\u0026thinsp;=\u0026thinsp;always true), with higher scores indicating greater mindfulness. The scale was translated and adapted to the Arabic language and context through forward and backward translation, ensuring conceptual equivalence with the original version.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eBrief Irritability Test\u003c/h2\u003e \u003cp\u003eThis five-item self-report scale [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e] measures irritability over the past two weeks. Each item is rated on a 6-point Likert scale from 1 (never) to 6 (always). The total score is obtained by summing the scores of each item, with higher scores indicating greater irritability. The scale was validated in Lebanon among adolescents and translated into Arabic [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. Current Cronbach\u0026rsquo;s Alpha\u0026thinsp;=\u0026thinsp;.87\u003c/p\u003e \u003cdiv id=\"Sec10\" class=\"Section3\"\u003e \u003ch2\u003eThe World Health Organization 5-item Well-Being Index\u003c/h2\u003e \u003cp\u003eThe WHO-5 [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e] consists of 5 items that assess subjective psychological well-being, each rated on a 5-point Likert scale from 5 (all of the time) to 0 (none of the time). The total raw scores are multiplied by 4 to obtain a percentage score from 0 (absence of wellbeing) to 100 (maximum wellbeing). The Arabic adaptation of this instrument has undergone a thorough validation among young individuals from many Arabic-speaking countries [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. Current Cronbach\u0026rsquo;s Alpha\u0026thinsp;=\u0026thinsp;.92\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eShort Depression and Happiness Scale (SDHS)\u003c/h2\u003e \u003cp\u003eThe SDHS [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e] is a 6-item questionnaire designed to measure both depression and happiness levels. It comprises three positive and three negative statements, with responses given on a four-point scale from 0 (never) to 3 (often). For instance, a positive statement like \"I felt happy\" contrasts with negative ones like \"I felt dissatisfied with my life.\" Higher scores indicate a higher level of happiness and lower levels of depression. This measure was also previously validated in Arabic [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. Current Cronbach\u0026rsquo;s Alpha\u0026thinsp;=\u0026thinsp;.66\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eThere were no missing responses in the dataset. To examine the factor structure of the CAMM, we conducted a Confirmatory Factor Analysis (CFA) using the data from the total sample via SPSS AMOS v.29 software. Parameter estimates were obtained using the maximum likelihood method. Calculated fit indices were the normed model chi-square (χ\u0026sup2;/df), the Steiger-Lind root mean square error of approximation (RMSEA), the standardized root mean square residual (SRMR), the Tucker-Lewis Index (TLI) and the comparative fit index (CFI). Values\u0026thinsp;\u0026le;\u0026thinsp;5 for χ\u0026sup2;/df, \u0026le; .08 for RMSEA, \u0026le; .05 for SRMR and \u0026ge;\u0026thinsp;.90 for CFI and TLI indicate good fit of the model to the data [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. Multivariate normality was not verified at first (Critical ratio\u0026thinsp;\u0026gt;\u0026thinsp;5; Bollen-Stine \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.002); therefore, we performed non-parametric bootstrapping procedure.\u003c/p\u003e \u003cp\u003e \u003cb\u003eSex invariance.\u003c/b\u003e To examine sex invariance of CAMM scores, we conducted multi-group CFA [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]. Measurement invariance was assessed at the configural, metric, and scalar levels [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. We accepted ΔCFI\u0026thinsp;\u0026le;\u0026thinsp;.010 and ΔRMSEA\u0026thinsp;\u0026le;\u0026thinsp;.015 or ΔSRMR\u0026thinsp;\u0026le;\u0026thinsp;.010 as evidence of invariance [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]. Comparison between males and females was done using the Student \u003cem\u003et\u003c/em\u003e-test only if scalar or partial scalar invariance.\u003c/p\u003e \u003cp\u003eComposite reliability in both subsamples was assessed using McDonald\u0026rsquo;s ω and Cronbach\u0026rsquo;s alpha, with values greater than .70 reflecting adequate composite reliability. Normality of the CAMM score was verified since the skewness and kurtosis values for each item of the scale varied between \u0026minus;\u0026thinsp;1 and +\u0026thinsp;1 [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. To assess concurrent validity, Pearson test was used to correlate two scores.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003eSeven hundred ninety-three adolescents filled the survey, with a mean age of 16.08\u0026thinsp;\u0026plusmn;\u0026thinsp;1.74 years and 62.4% females. The mean and SD of the scores were as follows: CAMM (25.08\u0026thinsp;\u0026plusmn;\u0026thinsp;7.37), wellbeing (20.54\u0026thinsp;\u0026plusmn;\u0026thinsp;5.38), irritability (13.39\u0026thinsp;\u0026plusmn;\u0026thinsp;4.78) and SDHS (10.71\u0026thinsp;\u0026plusmn;\u0026thinsp;3.24).\u003c/p\u003e \u003cp\u003eCFA indicated that fit of the one-factor model of CAMM scores was modest: χ\u003csup\u003e2\u003c/sup\u003e/df\u0026thinsp;=\u0026thinsp;239.94/35\u0026thinsp;=\u0026thinsp;6.86, RMSEA\u0026thinsp;=\u0026thinsp;.086 (90% CI .076, .096), SRMR\u0026thinsp;=\u0026thinsp;.051, CFI\u0026thinsp;=\u0026thinsp;.937, TLI\u0026thinsp;=\u0026thinsp;.919. We added a correlation between residuals of items 5 and 10 since the modification index was high; the numbers improved as follows: χ\u003csup\u003e2\u003c/sup\u003e/df\u0026thinsp;=\u0026thinsp;151.54/34\u0026thinsp;=\u0026thinsp;4.46, RMSEA\u0026thinsp;=\u0026thinsp;.066 (90% CI .056, .077), SRMR\u0026thinsp;=\u0026thinsp;.038, CFI\u0026thinsp;=\u0026thinsp;.964, TLI\u0026thinsp;=\u0026thinsp;.952. The standardized estimates of factor loadings were all adequate (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Internal reliability was excellent (ω\u0026thinsp;=\u0026thinsp;.89; α\u0026thinsp;=\u0026thinsp;.89).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eSex Invariance\u003c/h2\u003e \u003cp\u003eIndices suggested that configural, metric, and scalar invariance was supported across sex (Table\u0026nbsp;1). No significant difference was found between males and females in terms of CAMM scores (25.56\u0026thinsp;\u0026plusmn;\u0026thinsp;7.28 vs 24.80\u0026thinsp;\u0026plusmn;\u0026thinsp;7.41, \u003cem\u003et\u003c/em\u003e(791)\u0026thinsp;=\u0026thinsp;1.40, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.161.\u003c/p\u003e \n\u003cp\u003eTable 1. \u003cem\u003eMeasurement Invariance across Gender in the total sample.\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"73%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eModel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" valign=\"top\"\u003e\n \u003cp\u003eCFI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003eRMSEA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" valign=\"top\"\u003e\n \u003cp\u003eSRMR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.958333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eModel Comparison\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026Delta;CFI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026Delta;RMSEA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026Delta;SRMR\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eConfigural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" valign=\"top\"\u003e\n \u003cp\u003e.955\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" valign=\"top\"\u003e\n \u003cp\u003e.043\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.958333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eMetric\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" valign=\"top\"\u003e\n \u003cp\u003e.953\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e.050\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" valign=\"top\"\u003e\n \u003cp\u003e.049\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.958333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eConfigural vs metric\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"14.583333333333334%\" valign=\"top\"\u003e\n \u003cp\u003eScalar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" valign=\"top\"\u003e\n \u003cp\u003e.952\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e.048\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\" valign=\"top\"\u003e\n \u003cp\u003e.049\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.958333333333332%\" valign=\"top\"\u003e\n \u003cp\u003eMetric vs scalar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\" valign=\"top\"\u003e\n \u003cp\u003e.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.416666666666666%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003eNote.\u003c/em\u003e CFI = Comparative fit index; RMSEA = Steiger-Lind root mean square error of approximation; SRMR = Standardised root mean square residual.\u003c/p\u003e\u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eConcurrent validity\u003c/h2\u003e \u003cp\u003eThe CAMM total score was significantly associated with lower irritability (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;.66; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001), higher wellbeing (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.51; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001) and depression-happiness (\u003cem\u003er\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.43; \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001).\u003c/p\u003e \u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe validation of the CAMM in Arabic is a significant step forward in the assessment of mindfulness within Arabic-speaking children and adolescents, highlighting its potential for both research and clinical applications given its validity and reliability.\u003c/p\u003e \u003cp\u003eIn fact, this measure showed excellent internal reliability, with both Cronbach\u0026rsquo;s Alpha and McDonald's Omega coefficients at 0.89. Given that this is a brief scale, achieving a Cronbach's alpha between 0.8 and 0.9 is considered ideal [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. Some example for comparison, the original CAMM construction paper reported an alpha of 0.81 [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. The Dutch version demonstrated an acceptable reliability of 0.70 in children and 0.80 in adolescents [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. The Chinese version [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] showed an alpha and omega both of 0.826, whereas a Portuguese translation [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e] found both reliability measures at 0.75. These findings underscore the high reliability of the current Arabic version and highlight the need for further research to explore cross-cultural variations in this measure's internal consistency.\u003c/p\u003e \u003cp\u003eThe instrument also showed a one-factor structure. This is in line with the original construction article and several other where 10 items converged into one unique mindfulness dimension [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. This aligns with the theory proposed by these studies, which suggests that mindfulness skills may be more simplistic and unidimensional in young individuals compared to adults. However, variations in the number of items have been noted in some versions, such as the German version with 7 items [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], and Spanish version that is the briefest yet with only 5 items [\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e]. Interestingly, the Persian version [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] of the survey and another distinct UK investigation [\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e] have found that the 10 items converge to a 2-factor solution comprising of the subfactors \u0026ldquo;present moment awareness\u0026rdquo; and \u0026ldquo;avoidance of thoughts and feelings\u0026rdquo;.\u003c/p\u003e \u003cp\u003eOur analysis indicates that configural, metric, and scalar invariance are upheld across sexes, showing no difference in CAMM scores between males and females. This finding is also supported by most previous research [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e] indicating its effectiveness in measuring mindfulness in children and adolescents regardless of sex differences. However, other research on the CAMM where sex differences were found indicated that females tend to exhibit slightly lower levels of mindfulness [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e], as it was stipulated that girls tend to adopt a more internalized coping approach, primarily characterized by negative rumination and resignation [\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e, \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e]. Future studies should further confirm the gender variance taking into consideration contextual and cultural factors into consideration.\u003c/p\u003e \u003cp\u003eWe also observed that higher mindfulness levels could potentially lower irritability and depression while enhancing well-being and happiness. In fact, a randomized controlled trial assessing a mindfulness app's effectiveness showed a significant reduction in irritability levels after a 10-day introductory program [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. A paper from 2022, which thoroughly reviewed methods to boost resilience and address irritability and outbursts in adolescents, highlighted mindfulness as a key approach to forestalling relapses in such behaviors among youth [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e]. Likewise, this holds true for individuals with ADHD, as a previous study also suggested that interventions rooted in mindfulness helped reduce episodic irritability [\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e]. More pertinent to our circumstances, a study carried out in Lebanon in 2024 with adolescents further confirms the positive connection between mindfulness and decreased levels of irritability [\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e]. Apart from diminishing irritability, our sample also experienced decreased levels of depression. Indeed, extensive meta-analyses have demonstrated the beneficial impact of mindfulness on psychopathology, particularly depression [\u003cspan additionalcitationids=\"CR63\" citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e]. Mindfulness-based interventions have long been employed to help manage young individuals with depressive symptoms. More relevant to our setting, third culture students attending a multicultural school in the UAE, who exhibited relatively high levels of depressive symptoms, would likely benefit from mindfulness as a protective factor [\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn addition to reducing negative elements, the second function is also to enhance positive constructs. Indeed, the correlation between mindfulness and increased well-being can be traced back to its neurobiological foundations [\u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e66\u003c/span\u003e, \u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e67\u003c/span\u003e]. Mindfulness-based intervention studies have validated this association, exemplified by a British study involving 14\u0026ndash;15 year old boys, where overall well-being increased following mindfulness-based interventions [\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e]. Bluth and Blanton [\u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e] reached the same conclusion in their study of urban high school adolescents aged 14 to 18 year old. Nevertheless, extensive research and reviews [\u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e70\u003c/span\u003e, \u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e] confirm that well-being is highly correlated with mindfulness, reinforcing the construct validity of our translated scale. A recent exploratory mixed-method study conducted in a Lebanese private school demonstrated that a mindfulness-based social and emotional learning program significantly enhanced students' subjective well-being, as evidenced by both qualitative and quantitative analyses [\u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e72\u003c/span\u003e]. A 2018 investigation [\u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e73\u003c/span\u003e] found a connection between mindfulness and subjective happiness in a sample of adolescent boys. Singh stipulated that mindfulness not only reduces adolescents' stress levels but also enhances their happiness by altering their perceptions and relationships with their experiences [\u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e74\u003c/span\u003e]. Indeed, someone who has extensive experience in meditation would likely experience heightened levels of happiness, tranquility, and peace [\u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e75\u003c/span\u003e]. Remaining mindful and present allows us to become more aware of our emotions, leading to a deeper understanding and improved regulation of them. Skillfully managing our internal emotional experiences in the present moment can ultimately contribute to long-term happiness.\u003c/p\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eClinical Implications\u003c/h2\u003e \u003cp\u003eThis study has significant implications, as it offers a valid and reliable measure for clinicians and researchers to assess mindfulness in Lebanese adolescents, and therefore enhance the potential for further research opportunities in Arabic-speaking populations. Additionally, evaluating the implementation of mindfulness-based interventions and promoting a holistic approach to patient care could be more effective, as the Arabic CAMM showed a correlation with the reduction in irritability and depression, alongside an increase in happiness and well-being. The tool is applicable to both males and females, enabling its use across the population without requiring sex-specific adaptations. Furthermore, the availability of an Arabic version of the CAMM facilitates comparisons across different cultural contexts.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eIt is imperative to be cautious when interpreting the results, given that the current research may contain a few limitations. Response bias could be introduced because people invited through snowball sampling might have chosen not to participate in the survey. Furthermore, even though our sample size was adequate, there was a slight overrepresentation towards females. The cross-sectional design of this investigation prohibits us to ascertain causality or the temporal order of connections between variables. Furthermore, the participants in our validation work were exclusively from Lebanon, underscoring the necessity of including individuals from other Arab nations in future studies to evaluate the scale's psychometric qualities, including test-retest reliability, and test its cross-cultural validity.\u003c/p\u003e \u003c/div\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eOur findings validated the robust psychometric properties of the Arabic version of the Child and Adolescent Mindfulness Measure (CAMM), confirming its suitability for assessing mindfulness in Arabic-speaking adolescents, particularly in Lebanon. This makes the Arabic CAMM a reliable and valuable tool for researchers and practitioners, aiding the integration of mindfulness practices into educational and clinical settings. However, further research is recommended to extend the validation of this translated measure to encompass a more diverse Arabic-speaking population. This expansion would enhance the generalizability and applicability of the CAMM across various cultural contexts within the Arabic-speaking community. Ultimately, this advancement supports the broader goal of enhancing adolescent mental health and well-being through culturally sensitive measures.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate.\u0026nbsp;\u003c/strong\u003eThe Lebanese International University\u0026apos;s School of Pharmacy ethics committee granted this study ethics permission (2023RC-033-LIUSOP). When filling out the online form, each participant provided written informed consent, as did their parents or legal guardian(s) if they were study participants under the age of sixteen. All methods were performed in accordance with the relevant guidelines and regulations (in accordance with the Declaration of Helsinki).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003cstrong\u003e:\u0026nbsp;\u003c/strong\u003eBecause of ethical committee constraints, none of the data collected or analyzed during this study are publicly available. However, the corresponding author (SH) may make the data available upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u003c/strong\u003e The authors have nothing to disclose.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eNone.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions:\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eSO, FFR and SH designed the study; CJEZ drafted the manuscript; SH carried out the analysis and interpreted the results; FS and MD collected the data. DM reviewed the paper for intellectual content; all authors reviewed the final manuscript and gave their consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThe authors would like to thank all participants.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003e1. Shapiro SL, Carlson LE, Astin JA, Freedman B. Mechanisms of mindfulness. J Clin Psychol. 2006 Mar;62(3):373\u0026ndash;86. \u003c/li\u003e\n\u003cli\u003eHyland PK, Lee RA, Mills MJ. Mindfulness at Work: A New Approach to Improving Individual and Organizational Performance. Ind Organ Psychol. 2015 Dec;8(4):576\u0026ndash;602. \u003c/li\u003e\n\u003cli\u003eBrown KW, Ryan RM. The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology. 2003;84(4):822\u0026ndash;48. \u003c/li\u003e\n\u003cli\u003eNeumann MM, Tillott S. 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Available from: https://iris.who.int/handle/10665/349766\u003c/li\u003e\n\u003cli\u003eTopp CW, \u0026Oslash;stergaard SD, S\u0026oslash;ndergaard S, Bech P. The WHO-5 Well-Being Index: A Systematic Review of the Literature. Psychother Psychosom. 2015;84(3):167\u0026ndash;76. \u003c/li\u003e\n\u003cli\u003eFekih-Romdhane F, Cherif W, Alhuwailah A, Fawaz M, Shuwiekh HAM, Helmy M, et al. Cross-Country Validation of the Arabic version of the WHO-5 Well-Being Index in non- clinical young adults from six Arab countries [Internet]. 2023 [cited 2024 May 27]. Available from: https://www.researchsquare.com/article/rs-2988215/v1\u003c/li\u003e\n\u003cli\u003eJoseph S, Linley PA, Harwood J, Lewis CA, McCollam P. Rapid assessment of well‐being: The Short Depression‐Happiness Scale (SDHS). Psychol Psychother. 2004 Dec;77(4):463\u0026ndash;78. \u003c/li\u003e\n\u003cli\u003eYildirim M, Balahmar NB. Adaptation and validation of the Arabic version of the short depression-happiness scale. 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Mindfulness and Happiness among Students: Mediating Role of Perceived Stress. Journal of the Indian Academy of Applied Psychology. 2018 Jul 1;44:198\u0026ndash;207. \u003c/li\u003e\n\u003cli\u003eEnglund-Helmeke S. Mindfulness and Well-Being. Master of Social Work Clinical Research Papers [Internet]. 2014 May 1; Available from: https://sophia.stkate.edu/msw_papers/313\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Child and Adolescents Mindfulness Measure, Arabic, Validation, Factor Analysis","lastPublishedDoi":"10.21203/rs.3.rs-4522801/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4522801/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe objective of this study is to examine the factor structure, reliability, and validity of the Arabic adaptation of the Child and Adolescents Mindfulness Measure (CAMM) within a sample of Lebanese adolescents.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eIn this cross-sectional study, 793 adolescents were recruited to participate by completing the translated Arabic version of the CAMM through an online Google Forms survey. The validation of the scale was carried out using the Confirmatory Factor Analysis approach.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe Confirmatory Factor Analysis revealed a one-factor structure. Both the alpha coefficient (α\u0026thinsp;=\u0026thinsp;.89) and the omega coefficient (ω\u0026thinsp;=\u0026thinsp;.89) demonstrated excellent reliability. Sex invariance was shown at the configural, scalar and metric levels, with no statistically significant difference in CAMM scores was observed between males and females. Moreover, the CAMM total score exhibited a significant association with lower irritability, higher wellbeing, and depression-happiness (r\u0026thinsp;=\u0026thinsp;.43; p\u0026thinsp;\u0026lt;\u0026thinsp;.001).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eOur results confirm the reliability and validity of the Arabic version of the CAMM, suggesting its suitability for use among Arabic-speaking adolescents in various settings. This concise and user-friendly tool has the potential to promote cross-cultural research on mindfulness and wellbeing.\u003c/p\u003e","manuscriptTitle":"Psychometric Properties of an Arabic Translation of the Child and Adolescents Mindfulness Measure (CAMM) in adolescents","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-20 16:22:31","doi":"10.21203/rs.3.rs-4522801/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a8beca5a-b9d4-406e-836c-792e0f7890a3","owner":[],"postedDate":"June 20th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-01-20T09:08:15+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-20 16:22:31","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4522801","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4522801","identity":"rs-4522801","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}