Mixed methods instrument development studies have not experienced the complexity of discussion and elaboration that other mixed methods studies have received (Onwuegbuzie, Bustamante & Nelson, 2010). This study reviews 102 articles describing the development of 76 instruments using a mixed methods approach. The results provide insight into the presence of quality indicators in mixed methods instrument designs (O'Cathain, 2010), detail the use of the PROMIS® approach (U. S. Federal Drug Administration, 2009) to developing instruments, expand the concept of timing (Creswell & Plano Clark, 2011) to include a third recursive option for timing decisions, and provide evidence for a typology of mixed methods instrument development studies.