Date of Submission


Degree Type


Degree Name

Doctor of Psychology (PsyD)



Department Chair

Robert A DiTomasso, PhD, ABPP, Chair, Department of Psychology

First Advisor

Elizabeth Gosch, PhD, Chairperson

Second Advisor

Robert A DiTomasso, PhD, ABPP

Third Advisor

LeeAnn Cardaciotto, PhD


The overarching goal of this study was to better understand relationships between health habits, stress, and mindfulness. In doing so, this research examined the interaction of mindfulness with responses to stress as it affects negative health habits. There was also a psychometric development study conducted, using confirmatory factor analyses (CFA) to test the applicability of the two-factor model of the PHLMS to a primary care population. Data were collected from 198 adult patients in a primary care medical practice. Participants ranged in age from 18 to 89 years old, were 51% female, and 92% Caucasian. For CFA analyses, three fit indexes were examined, and fit indexes marginally supported a two-factor model ( 2/df = 2.26, CFI = .871, TLI = .851, RMSEA = .08). Despite differences in goodness of fit between this researcher’s data and the original model, it was found that the two-factor structure of the PHLMS demonstrated acceptable reliability and consistency when administered to a primary care population. Multiple linear regression analyses were then conducted to test the moderator hypothesis of Mindfulness; these regressions approached significance but did not achieve statistical significance. Although mindfulness was not found to moderate the relationship between stress and health behaviors, a further suggestion is to investigate the relationships between mindfulness, particularly mindful or nonjudgmental acceptance, and stress, as well as relationships between stress and health habits. This research demonstrated a clear relationship between acceptance as a factor of mindfulness, and stress. Based on these results, it is suggested that further investigation be carried out into the usefulness of acceptance-based interventions with chronically stressed primary care populations.