The Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2)

Wolf E Mehling, Michael Acree, Anita Stewart, Jonathan Silas, Alexander Jones, Wolf E Mehling, Michael Acree, Anita Stewart, Jonathan Silas, Alexander Jones

Abstract

Interoception, the process by which the nervous system senses, interprets, and integrates signals originating from within the body, has become major research topic for mental health and in particular for mind-body interventions. Interoceptive awareness here is defined as the conscious level of interoception with its multiple dimensions potentially accessible to self-report. The Multidimensional Assessment of Interoceptive Awareness (MAIA) is an 8-scale state-trait questionnaire with 32 items to measure multiple dimensions of interoception by self-report and was published in November 2012. Its numerous applications in English and other languages revealed low internal consistency reliability for two of its scales. This study's objective was to improve these scales and the psychometrics of the MAIA by adding three new items to each of the two scales and evaluate these in a new sample. Data were collected within a larger project that took place as part of the Live Science residency programme at the Science Museum London, UK, where visitors to the museum (N = 1,090) completed the MAIA and the six additional items. Based on exploratory factor analysis in one-half of the adult participants and Cronbach alphas, we discarded one and included five of the six additional items into a Version 2 of the MAIA and conducted confirmatory factor analysis in the other half of the participants. The 8-factor model of the resulting 37-item MAIA-2 was confirmed with appropriate fit indices (RMSEA = 0.055 [95% CI 0.052-0.058]; SRMR = 0.064) and improved internal consistency reliability. The MAIA-2 is public domain and available (www.osher.ucsf.edu/maia) for interoception research and the evaluation of clinical mind-body interventions.

Conflict of interest statement

The authors have declared that no competing interests exist.

References

    1. Mehling W E, Price C, Daubenmier J J, Acree M, Bartmess E and Stewart A, The Multidimensional Assessment of Interoceptive Awareness (MAIA). PLoS One, 2012. 7(11): p. e48230
    1. Feinstein J S, Khalsa S S, Yeh H, Al Zoubi O, Arevian A C, Wohlrab C, et al., The Elicitation of Relaxation and Interoceptive Awareness Using Floatation Therapy in Individuals With High Anxiety Sensitivity. Biol Psychiatry Cogn Neurosci Neuroimaging, 2018. 3(6): p. 555–562.
    1. Tsakiris M and Critchley H, Interoception beyond homeostasis: affect, cognition and mental health. Philos Trans R Soc Lond B Biol Sci, 2016. 371(1708).
    1. Hassanpour M S, Simmons W K, Feinstein J S, Luo Q, Lapidus R C, Bodurka J, et al., The Insular Cortex Dynamically Maps Changes in Cardiorespiratory Interoception. Neuropsychopharmacology, 2018. 43(2): p. 426–434.
    1. Forkmann T, Scherer A, Meessen J, Michal M, Schachinger H, Vogele C, et al., Making sense of what you sense: Disentangling interoceptive awareness, sensibility and accuracy. Int J Psychophysiol, 2016. 109: p. 71–80.
    1. Garfinkel S N, Seth A K, Barrett A B, Suzuki K and Critchley H D, Knowing your own heart: Distinguishing interoceptive accuracy from interoceptive awareness. Biol Psychol, 2015. 104: p. 65–74.
    1. Ceunen E, Van Diest I and Vlaeyen J W, Accuracy and awareness of perception: related, yet distinct (commentary on Herbert et al., 2012). Biol Psychol, 2013. 92(2): p. 426–7.
    1. Cali G, Ambrosini E, Picconi L, Mehling W E and Committeri G, Investigating the relationship between interoceptive accuracy, interoceptive awareness, and emotional susceptibility. Front Psychol, 2015. 6: p. 1202
    1. Ring C and Brener J, Influence of beliefs about heart rate and actual heart rate on heartbeat counting. Psychophysiology, 1996. 33(5): p. 541–6.
    1. Ferentzi E, Drew R, Tihanyi B T and Koteles F, Interoceptive accuracy and body awareness—Temporal and longitudinal associations in a non-clinical sample. Physiol Behav, 2018. 184: p. 100–107.
    1. Garfinkel S N and Critchley H D, Interoception, emotion and brain: new insights link internal physiology to social behaviour. Commentary on:: "Anterior insular cortex mediates bodily sensibility and social anxiety" by Terasawa et al. (2012) Soc Cogn Affect Neurosci, 2013. 8(3): p. 231–4.
    1. Chesney M A, Reeves A N, Goldberger W A, Mehling W E, Avins A L, Pressman A, et al., Mindful Breathing: Effects on Respiration and Blood Pressure in Pre-hypertensive Women, “Project Inspire” Abstract: presented at International Congress for Integrative Medicine and Health; Las Vegas, NV, 2016.
    1. Paulus M P and Stein M B, An insular view of anxiety. Biol Psychiatry, 2006. 60(4): p. 383–7.
    1. Farb N, Daubenmier J, Price C J, Gard T, Kerr C, Dunn B D, et al., Interoception, contemplative practice, and health. Front Psychol, 2015. 6: p. 763
    1. Holzel B K, Lazar S W, Gard T, Schuman-Oliver Z, Yago D R and Ott U, How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science, 2011. 6(6): p. 537–59.
    1. Farb N and Mehling W E, Editorial: Interoception, Contemplative Practice, and Health. Front Psychol, 2016. 7: p. 1898
    1. Ring C and Brener J, Heartbeat counting is unrelated to heartbeat detection: A comparison of methods to quantify interoception. Psychophysiology, 2018: p. e13084
    1. Parkin L, Morgan R, Rosselli A, Howard M, Sheppard A, Evans D, et al., Exploring the Relationship Between Mindfulness and Cardiac Perception. Mindfulness, 2013. 5(3): p. 298–313.
    1. Daubenmier J, Sze J, Kerr C E, Kemeny M E and Mehling W, Follow your breath: respiratory interoceptive accuracy in experienced meditators. Psychophysiology, 2013. 50(8): p. 777–89.
    1. Khalsa S S, Rudrauf D, Sandesara C, Olshansky B and Tranel D, Bolus isoproterenol infusions provide a reliable method for assessing interoceptive awareness. Int J Psychophysiol, 2008.
    1. Bornemann B, Herbert B M, Mehling W E and Singer T, Differential changes in self-reported aspects of interoceptive awareness through 3 months of contemplative training. Front Psychol, 2014. 5: p. 1504
    1. Porges S W, Body Perception Questionnaire. , 1993: p. Accessed May, 2007.
    1. Shields S A, Mallory M E and Simon A, The Body Awareness Questionnaire: Reliability and validity. Journal of personality assessment, 1989. 53(4): p. 802–815.
    1. Miller L C, Murphy R and Buss A H, Consciousness of body: Private and public. Journal of Personality and Social Psychology, 1981. 41(2): p. 397–406.
    1. Mehling W E, Gopisetty V, Daubenmier J, Price C J, Hecht F M and Stewart A, Body awareness: construct and self-report measures. PLoS ONE, 2009. 4(5): p. e5614
    1. Daubenmier J, The relationship of Yoga, body awareness, and body responsiveness to self-objectification and disordered eating. Psychology of Women Quarterly, 2005. 29(2005): p. 207–219.
    1. Price C J and Thompson E A, Measuring dimensions of body connection: body awareness and bodily dissociation. J Altern Complement Med, 2007. 13(9): p. 945–53.
    1. Mehling W, Differentiating attention styles and regulatory aspects of self-reported interoceptive sensibility. Phil. Trans. R. Soc. B 2016. 371: 20160013
    1. Tang W, Cui Y and Babenko O, Internal Consistency: Do We Really Know What t Is and How to Assess It? Journal of Psychology and Behavioral Science, 2014. 2(2): p. 205–220.
    1. Mehling W, Bartmess-Levasseur E, Acree M, Price C, Daubenmier J, Gopisetty V, et al., Pain and interoceptive body-awareness: understanding of pain-related questionnaire items differs between primary care patients and mind-body therapy practitioners. European J Pain, 2011. 5, Supplements(1): p. 157.
    1. Mehling W E, Daubenmier J, Price C J, Acree M, Bartmess E and Stewart A L, Self-reported interoceptive awareness in primary care patients with past or current low back pain. J Pain Res, 2013. 6: p. 403–18.
    1. de Jong M, Lazar S W, Hug K, Mehling W E, Holzel B K, Sack A T, et al., Effects of Mindfulness-Based Cognitive Therapy on Body Awareness in Patients with Chronic Pain and Comorbid Depression. Front Psychol, 2016. 7: p. 967
    1. Mehling W E, Wrubel J, Daubenmier J J, Price C J, Kerr C E, Silow T, et al., Body Awareness: a phenomenological inquiry into the common ground of mind-body therapies. Philos Ethics Humanit Med, 2011. 6: p. 6
    1. Ackerman S, Lown E A, Dvorak C C, Dunn E A, Abrams D I, Horn B N, et al., Massage for Children Undergoing Hematopoietic Cell Transplantation, a qualitative report eCAM, 2012. in press.
    1. SASv9, SAS Institute Inc. Cary, NC, 2001.
    1. Muthén B and Muthén L, Mplus. , 2009. Version 5.21.
    1. Hooper D, Coughlan J and Mullen M, Structural Equation Modelling: Guidelines for Determining Model Fit. Electronic Journal of Business Research Methods, 2008. 6(1): p. 53–60.
    1. Hu L-T and Bentler P M, Cutoff criteria for fit Indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 1999. 6: p. 1–55.
    1. Feldt L S, A test of the hypothesis that cronbach's alpha or kuder-richardson coefficent twenty is the same for two tests. Psychometrika, 1969. 34(3): p. 363–373.
    1. Mehling W E, Daubenmier J, Price C, Acree M, Bartmess E and Stewart A, Validation of the Multidimensional Assessment of Interoceptive Awareness (MAIA) in a primary care cohort of patients with back pain. in peer review, 2012.
    1. Hanley A, Garland E L, Stern E, Mehling W E and Price C J, Listen to Your Body: A Multidimensional Assessment of Interoceptive Awareness for Mind–Body Research. Global Advances in Health and Medicine, 2018. 7: p. 15–16.
    1. Mehling W, The Multidimensional Assessment of Interoceptive Awareness Questionnaire: Benefits, Shortcomings, Controversies. Global Advances in Health and Medicine, 2018. 7: p. 122.

Source: PubMed

3
購読する