A Functional Connectivity Study to Investigate the Role of the Right Anterior Insula in Modulating Emotional Dysfunction in Borderline Personality Disorder.

OBJECTIVE: Previous imaging studies in patients with borderline personality disorder (BPD) have detected functional brain dysfunctions. Mindfulness training may improve the symptoms of BPD, although the neural mechanisms involved remain poorly understood. This study had several key aims: a) to investigate the role of right anterior insula (rAI) functional connectivity in modulating baseline emotional status in BPD, b) to compare differences in connectivity changes after mindfulness training versus interpersonal effectiveness intervention, and c) to explore the correlation between longitudinal changes in imaging data and clinical indicators. METHODS: Thirty-eight patients with BPD underwent resting-state functional magnetic resonance imaging. Participants completed self-report clinical scales and participated in a dialectical-behavioral therapy (mindfulness versus interpersonal effectiveness modules). Changes in clinical and imaging variables were evaluated longitudinally after completion of the first 10-week sessions of psychotherapeutic intervention. RESULTS: At baseline, the rAI was strongly connected with the other salience network nodes and anticorrelated with most core nodes of the default mode network (p < .05, corrected). The functional connectivity of the rAI correlated with emotional dysregulation and deficits in mindfulness capacities (p < .05, corrected). After completion of psychotherapeutic intervention, both groups (mindfulness and interpersonal effectiveness) showed divergent posttherapy functional connectivity changes, which were in turn associated with the clinical response. CONCLUSIONS: The functional connectivity of the rAI seems to play an important role in emotion dysregulation and deficits in mindfulness capacities in individuals with BPD. Psychotherapy seems to modulate this functional connectivity, leading to beneficial changes in clinical variables.

"Skills for pills": The dialectical-behavioural therapy skills training reduces polypharmacy in borderline personality disorder.

OBJECTIVE: Polypharmacy and overprescription of off-label medications are common in patients with borderline personality disorder (BPD). The aim of the present naturalistic study was to explore whether the skills training module of dialectical-behavioural therapy (DBT) can reduce polypharmacy in these patients in routine clinical practice. METHODS: Retrospective, observational study of 377 patients with a primary diagnosis of BPD consecutively admitted to the BPD outpatient unit from 2010 through 2020. All patients were invited to participate in the DBT skills training module (DBT-ST). DBT-ST participants (n = 182) were compared with a control group who did not participate in DBT-ST (n = 195). Pre-post intervention changes in medication load and use of antidepressants, benzodiazepines, mood stabilizers, and antipsychotics were evaluated. RESULTS: At baseline, most patients (84.4%) were taking at least one medication and 46.9% were on polypharmacy. Compared to controls, patients in the DBT-ST group presented a significant reduction in the number of medications (2.67-1.95 vs. 2.16-2.19; p < 0.001), medication load (4.25-3.05 vs. 3.45-3.48; p < 0.001), use of benzodiazepines (54.4%-27.5% vs. 40%-40.5%; p < 0.001), mood stabilizers (43.4%-33% vs. 36.4%-39.5%; p < 0.001), and antipsychotics (36.3%-29.1% vs. 34.4%-36.9%; p < 0.001). CONCLUSIONS: These findings suggest that patients with BPD can benefit from the DBT-ST module, which may reduce the medication load, particularly of sedatives. The results suggest that DBT-ST may be useful to treat overmedication in patients with BPD and could help to promote "deprescription" in clinical practice.

Ayahuasca may help to improve self-compassion and self-criticism capacities.

OBJECTIVE: Ayahuasca is a psychedelic brew that originated in the Amazon basin. The psychological effects of this drug are becoming better understood due to the growing research interest in identifying new potential therapeutic agents for the treatment of emotion dysregulation and other disorders. Previous studies suggest that ayahuasca enhances mindfulness-related capacities (decentering, non-judging, non-reacting and acceptance) and emotion regulation. The aim of the present exploratory study was to determine the effects of ayahuasca on self-compassion in a community sample. METHODS: We administered validated questionnaires (the Self-Compassion Scale-Short Form and Forms of Self-Criticism and Self-Reassurance) to evaluate pre-post changes in self-compassion and self-criticism/self-reassurance in 45 volunteers (27 women; 60%) before and after (≤24 h) an ayahuasca ceremony. Most participants (n = 29; 67.4%) had previously used ayahuasca. RESULTS: Ayahuasca resulted in significant improvements, with medium to large effect sizes (η2  = 0.184-0.276), in measures of self-compassion (p < 0.05), self-criticism (p < 0.01) and self-reassurance (p < 0.01). CONCLUSIONS: The findings of this study suggest that ayahuasca promotes well-being and self-compassion, which could have a therapeutic effect on individuals with negative affect and other psychopathological conditions. Large, controlled studies are needed to confirm these findings.

Evidence for default mode network dysfunction in borderline personality disorder.

BACKGROUND: Although executive and other cognitive deficits have been found in patients with borderline personality disorder (BPD), whether these have brain functional correlates has been little studied. This study aimed to examine patterns of task-related activation and de-activation during the performance of a working memory task in patients with the disorder. METHODS: Sixty-seven DSM-IV BPD patients and 67 healthy controls underwent fMRI during the performance of the n-back task. Linear models were used to obtain maps of within-group activations and areas of differential activation between the groups. RESULTS: On corrected whole-brain analysis, there were no activation differences between the BPD patients and the healthy controls during the main 2-back v. baseline contrast, but reduced activation was seen in the precentral cortex bilaterally and the left inferior parietal cortex in the 2-back v. 1-back contrast. The patients showed failure of de-activation affecting the medial frontal cortex and the precuneus, plus in other areas. The changes did not appear to be attributable to previous history of depression, which was present in nearly half the sample. CONCLUSIONS: In this study, there was some, though limited, evidence for lateral frontal hypoactivation in BPD during the performance of an executive task. BPD also appears to be associated with failure of de-activation in key regions of the default mode network.

Effects of mindfulness training on the default mode network in borderline personality disorder.

Patients with borderline personality disorder (BPD) present dysfunctions of the default mode network (DMN). Mindfulness training has proven effective to improve the symptoms of BPD. The present study examines the effect of mindfulness training on BPD symptomatology and DMN activity during the performance of a working memory task in patients with BPD. Sixty-five individuals with BPD were randomized to receive psychotherapy with either the mindfulness module of dialectical behavioural therapy (DBT-M) or with interpersonal effectiveness module (DBT-IE). The impact of treatments was evaluated with clinical and mindfulness variables as well as with functional magnetic resonance imaging during performance of the task. Both groups showed improvement in BPD symptoms and other clinical variables after treatment. Unexpectedly, there were no between-group differences in DMN activation or deactivation. However, activation of the left anterior insula increased in both groups after the intervention. Compared with the control group, participants in the DBT-M group presented higher deactivation in a cluster extending bilaterally from the calcarine to the cuneus and superior occipital gyri.

Correction to: Exploring the relation between childhood trauma, temperamental traits and mindfulness in borderline personality disorder.

In the original publication of this article [1] the funding acknowledgement for grant "PI13/00134, ERDF Funds" was missing.

Factors predicting early dropout from dialectical behaviour therapy in individuals with borderline personality disorder.

BACKGROUND: Dialectical behaviour therapy skills training (DBT-ST) has proven effective to treat individuals with borderline personality disorder (BPD). However, therapy still faces the problem of early dropout. The aim of the present study is to examine which factors are associated with early dropout from DBT-ST in a sample of subjects with BPD. METHOD: 118 subjects with BPD diagnosis were included in the study. Apart from socio-demographic and clinical variables, childhood trauma history, personality dimensions, and comorbidities with other psychiatric disorders were collected. Differences in regards to the aforementioned variables were compared between individuals who dropped out prematurely from therapy and those who finalized it. RESULTS: Significant differences between groups regarding socio-demographic and clinical variables, including childhood trauma history and comorbid personality disorders, were not found. Both groups differed significantly in regards to trait impulsiveness and in comorbidity with Eating Disorders (ED) and Cocaine Use Disorder (CUD). The regression analyses showed that ED and CUD significantly predicted drop-out (p=0.011 and p=0.031 respectively), while scores in trait impulsivity showed a tendency towards signification (p=0.063). CONCLUSIONS: Comorbidities between BPD and axis I disorders (i.e., ED and CUD) should be taken into account when referring patients to DBT-ST.

Assessing the Psychedelic "After-Glow" in Ayahuasca Users: Post-Acute Neurometabolic and Functional Connectivity Changes Are Associated with Enhanced Mindfulness Capacities.

Background: Ayahuasca is a plant tea containing the psychedelic 5-HT2A agonist N,N-dimethyltryptamine and harmala monoamine-oxidase inhibitors. Acute administration leads to neurophysiological modifications in brain regions of the default mode network, purportedly through a glutamatergic mechanism. Post-acutely, ayahuasca potentiates mindfulness capacities in volunteers and induces rapid and sustained antidepressant effects in treatment-resistant patients. However, the mechanisms underlying these fast and maintained effects are poorly understood. Here, we investigated in an open-label uncontrolled study in 16 healthy volunteers ayahuasca-induced post-acute neurometabolic and connectivity modifications and their association with mindfulness measures. Methods: Using 1H-magnetic resonance spectroscopy and functional connectivity, we compared baseline and post-acute neurometabolites and seed-to-voxel connectivity in the posterior and anterior cingulate cortex after a single ayahuasca dose. Results: Magnetic resonance spectroscopy showed post-acute reductions in glutamate+glutamine, creatine, and N-acetylaspartate+N-acetylaspartylglutamate in the posterior cingulate cortex. Connectivity was increased between the posterior cingulate cortex and the anterior cingulate cortex, and between the anterior cingulate cortex and limbic structures in the right medial temporal lobe. Glutamate+glutamine reductions correlated with increases in the "nonjudging" subscale of the Five Facets Mindfulness Questionnaire. Increased anterior cingulate cortex-medial temporal lobe connectivity correlated with increased scores on the self-compassion questionnaire. Post-acute neural changes predicted sustained elevations in nonjudging 2 months later. Conclusions: These results support the involvement of glutamate neurotransmission in the effects of psychedelics in humans. They further suggest that neurometabolic changes in the posterior cingulate cortex, a key region within the default mode network, and increased connectivity between the anterior cingulate cortex and medial temporal lobe structures involved in emotion and memory potentially underlie the post-acute psychological effects of ayahuasca.

The role of hypothalamus-pituitary-adrenal genes and childhood trauma in borderline personality disorder.

Current knowledge suggests that borderline personality disorder (BPD) results from the interaction between genetic and environmental factors. Research has mainly focused on monoaminergic genetic variants and their modulation by traumatic events, especially those occurring during childhood. However, to the best of our knowledge, there are no studies on the genetics of hypothalamus-pituitary-adrenal (HPA) axis, despite its vulnerability to early stress and its involvement in BPD pathogenesis. The aim of this study was to investigate the contribution of genetic variants in the HPA axis and to explore the modulating effect of childhood trauma in a large sample of BPD patients and controls. DNA was obtained from a sample of 481 subjects with BPD and 442 controls. Case-control differences in allelic frequencies of 47 polymorphisms in 10 HPA axis genes were analysed. Modulation of genetic associations by the presence of childhood trauma was also investigated by dividing the sample into three groups: BPD with trauma, BPD without trauma and controls. Two FKBP5 polymorphisms (rs4713902-C and rs9470079-A) showed significant associations with BPD. There were also associations between BPD and haplotype combinations of the genes FKBP5 and CRHR1. Two FKBP5 alleles (rs3798347-T and rs10947563-A) were more frequent in BPD subjects with history of physical abuse and emotional neglect and two CRHR2 variants (rs4722999-C and rs12701020-C) in BPD subjects with sexual and physical abuse. Our findings suggest a contribution of HPA axis genetic variants to BPD pathogenesis and reinforce the hypothesis of the modulating effect of childhood trauma in the development of this disorder.

Exploring the relation between childhood trauma, temperamental traits and mindfulness in borderline personality disorder.

BACKGROUND: Deficits in mindfulness-related capacities have been described in borderline personality disorder (BPD). However, little research has been conducted to explore which factors could explain these deficits. This study assesses the relationship between temperamental traits and childhood maltreatment with mindfulness in BPD. METHODS: A total of 100 individuals diagnosed with BPD participated in the study. Childhood maltreatment was assessed using the Childhood Trauma Questionnaire (CTQ-SF), temperamental traits were assessed using the Zuckerman-Khulman Personality Questionnaire (ZKPQ), and mindfulness capabilities were evaluated with the Five Facet Mindfulness Questionnaire (FFMQ). RESULTS: Hierarchical regression analyses were performed including only those CTQ-SF and ZKPQ subscales that showed simultaneous significant correlations with mindfulness facets. Results indicated that neuroticism and sexual abuse were predictors of acting with awareness; and neuroticism, impulsiveness and sexual abuse were significant predictors of non-judging. Temperamental traits did not have a moderator effect on the relationship between childhood sexual abuse and mindfulness facets. CONCLUSIONS: These results provide preliminary evidence for the effects of temperamental traits and childhood trauma on mindfulness capabilities in BPD individuals. Further studies are needed to better clarify the impact of childhood traumatic experiences on mindfulness capabilities and to determine the causal relations between these variables.

Efficacy of cognitive rehabilitation on psychosocial functioning in Borderline Personality Disorder: a randomized controlled trial.

BACKGROUND: Follow-up studies revealed that subjects with borderline personality disorder (BPD) present high rates of clinical remission, although psychosocial functioning often remains impaired. The aim of this study is to evaluate the efficacy of a cognitive rehabilitation intervention versus a psychoeducational program on psychosocial functioning in subjects with BPD. METHODS: A multicenter, randomized, and positive-controlled clinical trial was conducted. Seventy outpatients with BPD were randomized to cognitive rehabilitation or psychoeducational group interventions. Participants were evaluated after completion of the intervention period (16 weeks) and after the follow-up period (6 months). Psychosocial functioning, clinical and neuropsychological outcomes were evaluated. RESULTS: No main effects of group or group x time were observed on functionality but a significant effect of time was found. Post-hoc analyses showed that only cognitive rehabilitation increased psychosocial functioning significantly at endpoint. Psychoeducation showed a significant enhancement of depressive symptoms. CONCLUSIONS: Cognitive rehabilitation and psychoeducational interventions appeared to show good efficacy in improving disabilities in daily life in subjects with BPD. These interventions are easily implemented in mental health settings and have the advantage of improving general functioning and clinical symptoms. TRIAL REGISTRATION: Clinicaltrials.gov: NCT02033044. Registered 9 January 2014.

Parental bonding in subjects with pathological gambling disorder compared with healthy controls.

The new Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V) includes pathological gambling disorder (PGD) in the subgroup of "Addiction and Related Disorders" due to the similarities between PGD and substance-based addictions in neurobiological, psychological, and social risk factors. Family factors as parental rearing attitudes play a crucial role in the development of substance use disorders and PGD. The aim of the present study was to assess the parental bonding during childhood perceived for adults with PGD compared with healthy controls. Twenty males with PGD and 20 control subjects answered the parental bonding instrument, which measures subjects' recollections of parenting on dimensions of care and protection. Subjects with PGD showed significantly lower maternal and paternal care (p = 0.016 and p = 0.031, respectively) than controls, and higher paternal protection (p = 0.003). The most common parental pattern for PGD subjects was the affectionless control (50% for the father and 60% for the mother). Preliminary results suggest that, as previously reported for substance use disorders, an affectionless control parenting style is associated with PGD.

Effects of dialectical behaviour therapy-mindfulness training on emotional reactivity in borderline personality disorder: preliminary results.

UNLABELLED: Emotional dysregulation has been proposed as a hallmark of borderline personality disorder (BPD). Mindfulness techniques taught in dialectical behaviour therapy (DBT) appear to be effective in reducing affective symptoms and may enhance emotion regulation in BPD patients. In the present study, we assessed whether 10 weeks of DBT-mindfulness (DBT-M) training added to general psychiatric management (GPM) could improve emotion regulation in BPD patients. A total of 35 patients with BPD were included and sequentially assigned to GPM (n = 17) or GPM plus DBT-M (n = 18). Participants underwent a negative emotion induction procedure (presentation of standardized unpleasant images) both pre-intervention and post-intervention. Clinical evaluation was also performed before and after treatment. No differences were observed in emotional response at the post-treatment session. However, patients in the DBT-M group showed greater improvement in clinical symptoms. Formal mindfulness practice was positively correlated with clinical improvements and lower self-reported emotional reactivity. Our preliminary results suggest that mindfulness training reduces some psychiatric symptoms but may not have a clear effect on how patients respond to emotional stimuli in an experimental setting. KEY PRACTITIONER MESSAGE: No clear effect of mindfulness training was observed on emotional response to a negative emotion induction procedure. Application of the DBT-M module jointly to GPM induced better clinical outcomes than GPM alone. Formal mindfulness practice showed a positive impact on emotion regulation and clinical improvement.

Could intranasal oxytocin enhance the effects of psychotherapy in individuals with mental disorders? A systematic review and meta-analysis.

Interest in the therapeutic potential of oxytocin for the treatment of mental health disorders, especially those involving social dysfunction, has increased considerably in recent years. To date, most studies have only evaluated oxytocin as monotherapy, with highly inconsistent results. A new line of research is exploring the effects of combining oxytocin with psychotherapy. The aim of the present review was to evaluate the therapeutic effects of intranasal oxytocin combined with psychotherapy in individuals with psychiatric disorders. Only randomized clinical trial design was eligible for inclusion. A search of relevant databases yielded 2480 articles published through April 30, 2024. Of these, 13 trials (518 participants) were included in this review and 4 of them in a meta-analysis. The trials evaluated a range of different psychotherapeutic interventions, oxytocin doses, and mental disorders. Overall, the trials suggested that combined treatment reduced negative mental representations, decreased stress, and increased therapeutic alliance. Meta-analysis showed that combined treatment significantly reduced depressive symptoms (d= -1.58, 95 % CI: -3.15 to -0.01). However, the treatment with oxytocin had no significant effects on psychiatric symptoms (d= 0.00, 95 % CI: -0.56-0.57) or social functioning (d = 0.21, 95 % CI: -0.07-0.49). Limitations included the heterogeneity and limited sample sizes of the trials. The findings suggest that the combination of intranasal oxytocin and psychotherapy may be an effective therapeutic approach to reduce depressive symptoms in individuals with mental disorders and may improve retention and therapeutic alliance.

Long-lasting symptoms in borderline personality disorder: Defining an emergent population with differential clinical and therapeutic features.

Although the clinical symptoms of borderline personality disorder (BPD) tend to remit over time, a substantial proportion continues to present "long-lasting symptoms" (LLS). This term refers to individuals who present some degree of clinical improvement, but low mood, feelings of emptiness, and poor psychosocial adjustment typically persist. The aim of this study was to compare the sociodemographic, clinical, and therapeutic variables in individuals with BPD with and without LLS. A total of 620 participants with BPD were included and subdivided into two groups: non-LLS group (n = 549, mean age = 28.02 [6.1] and range, 18-40 years) and LLS group (n = 71, mean age = 44.69 [3.6] and range, 41-56 years). The groups were compared in sociodemographic, clinical, and drug treatment characteristics. We also evaluated the impact of dialectical behavioral therapy-skills training (DBT-ST) on polypharmacy. The prevalence of individuals with long-lasting BPD symptoms increased significantly over a 20-year period (from <1% to 16%). The LLS group was characterized by less clinical severity, higher comorbidity with affective disorders but lower comorbidity with eating disorders, more disability, and more medication taking. Patients with LLS who received DBT-ST experienced a significant decrease in the use of benzodiazepines and the number of medications prescribed compared with those who did not receive DBT-ST. Clinicians should be aware of the specific features of older patients with BPD in order to better identify and address their specific therapeutic needs.

Physical health, primary care utilization and long-term quality of life in borderline personality disorder: A 10-year follow-up study in a Spanish sample.

OBJECTIVE: We aimed to study physical health and primary care utilization in the long-term course of borderline personality disorder (BPD) and their impact on quality of life (QOL) in a Spanish clinical sample. METHODS: This study is part of a longitudinal study following a clinical cohort with BPD. A total of 41 participants were re-evaluated at 10-year follow-up, when current medical conditions, primary care utilization, and quality of life were assessed. Comparative population data were extracted from the Catalan Health Survey ESCA. RESULTS: 68% of BPD patients reported physical health problems, and 32% informed of multiple medical illnesses at follow-up. Higher rates of musculoskeletal disorders and frequent use of general practitioner (GP) consultations were reported by BPD patients compared to the general population. Differences in physical health and use of primary care services between remitted and non-remitted BPD patients were not significant. BPD remission was independently associated with better long-term QOL. Comorbid somatic diseases worsened the long-term QOL of non-remitted BPD patients. CONCLUSION: Chronic somatic conditions are prevalent in people with BPD and interact negatively with persistent BPD pathology, worsening their QOL in the long-term. Health care strategies in the assistance of long-lasting BPD patients are recommended.

How does mindfulness skills training work to improve emotion dysregulation in borderline personality disorder?

BACKGROUND: Mindfulness skills training is a core component of Dialectical Behavior Therapy and aims to improve emotion dysregulation (ED) in people with Borderline Personality Disorder (BPD). However, the underlying mechanisms of change are not fully understood. METHODS: A total of 75 BPD outpatients participated in a 10-week mindfulness skills training. Multilevel models with a time-lagged approach were conducted to examine the temporal dynamics between the proposed mechanisms and ED. Decentering, nonjudgment, body awareness and attention awareness as putative mechanisms and ED as outcome were assessed on a session-by-session basis. RESULTS: Greater nonjudgment and body awareness showed within-person effects; participants who reported higher nonjudgement of inner experience and body awareness than their own personal average at a given week showed improvement in ED at the following week. Notably, decentering moderated these associations, such that increased nonjudgment and body awareness predicted improvements in ED more strongly in those participants with high decentering ability. Lastly, a bidirectional relationship between the mechanisms and ED was found; when participants were more emotionally dysregulated than their usual state, they showed less gain in the mechanisms at the following week. CONCLUSIONS: Knowing how mindfulness training works is relevant to optimize treatments. Clinicians may use strategies to increase these mechanisms when the goal is to improve emotion regulation difficulties in BPD.

Pharmacological Management of Borderline Personality Disorder and Common Comorbidities.

Comorbidity between borderline personality disorder (BPD) and other mental disorders is common. Although no specific pharmacological treatments have been approved for the treatment of BPD, many drugs, including antidepressants such as selective serotonin reuptake inhibitors (SSRIs), mood stabilizers, second-generation antipsychotics, and even benzodiazepines, are routinely prescribed off label. Nonetheless, recommendations for off-label drugs in these patients are highly varied, with a notable lack of agreement among clinical guidelines. The most common reason for pharmacological treatment and polypharmacy in these patients is comorbidity with other psychiatric disorders. In this context, we reviewed major clinical guidelines and the available data on pharmacotherapy in patients with BPD to develop practical recommendations to facilitate decision-making in routine clinical practice, thus helping clinicians to select the optimal therapeutic approach in patients with BPD who have comorbid disorders. This review confirmed that no clear recommendations for the pharmacological treatment are available in clinical guidelines. Therefore, based on the available evidence, we have developed a series of recommendations for pharmacotherapy in patients with BPD who present the four most common comorbidities (affective, anxiety, eating, and drug use disorders). Here, we discuss the recommended treatment approach for each of these comorbid disorders. The prescription of medications should be considered only as an adjunct to BPD-specific psychotherapy. Polypharmacy and the use of unsafe drugs (i.e., with a risk of overdose) should be avoided. Our review highlights the need for more research to provide more definitive guidance and to develop treatment algorithms.

Physiological responses induced by emotion-eliciting films.

Emotion-eliciting films are commonly used to evoke subjective emotional responses in experimental settings. The main aim of the present study was to investigate whether a set of film clips with discrete emotions were capable to elicit measurable objective physiological responses. The convergence between subjective and objective measures was evaluated. Finally, the effect of gender on emotional responses was investigated. A sample of 123 subjects participated in the study. Individuals were asked to view a set of emotional film clips capable to induce seven emotions: anger, fear, sadness, disgust, amusement, tenderness and neutral state. Skin conductance level (SCL), heart rate (HR) and subjective emotional responses were measured for each film clip. In comparison with neutral films, SCL was significantly increased after viewing fear films, and HR was also significantly incremented for anger and fear films. Physiological variations were associated with arousal measures indicating a convergence between subjective and objective reactions. Women appeared to display significantly greater SCL and HR responses for films inducing sadness. The findings suggest that physiological activation would be more easily induced by emotion-eliciting films that tap into emotions with higher subjective arousal such as anger and fear.

Psychometric proprieties of Spanish version of Mindful Attention Awareness Scale (MAAS).

The Mindful Attention Awareness Scale (MAAS) is a brief and easy to administer scale that mainly assesses the individual's dispositional capacity to be aware and conscious in day-to-day life experiences. This is a 15-item self-reported single-factor scale that is exclusively focused on attention/awareness component of mindfulness construct. The instrument can be independently used to assess individuals either with or without meditation experience and has been widely used in mindfulness research. In order to establish the psychometric proprieties of the MAAS a total of 385 individuals were assessed. 201 individuals came from a clinical sample and 184 control individuals were university students. The MAAS showed good psychometric proprieties in terms of validity and reliability. The scale obtained an adequate convergent validity with the Five Facets Mindfulness Questionnaire (FFMQ) and good discriminating validity with relation to depressive symptoms. Additionally, the MAAS obtained good reliability indexes (Cronbach's α = 0.89), good temporal stability and adequately replicates the original single-factor structure accounting for 42.8% of the total variance. These results were comparable to those obtained by the original English version of the scale. MAAS can be briefly administered and enables us to measure the individual's frequency of mindfulness states in daily life and can be used both on clinical research and healthy subjects.