Multidimensional Assessment of Interoceptive Awareness (MAIA)

Developed by Mehling, Price, Daubenmier, Acree, Bartmess & Stewart (2012, PLoS ONE) explicitly to move past the assumption that interoception is one thing you have more or less of. Its design goal was to parse beneficial from maladaptive functions of interoception: to allow “I am very aware of my body” to mean either mindful attunement or anxious body-scanning, and to tell them apart.

Three of its authors (Mehling, Price, Daubenmier) later co-wrote Farb et al. (2015) with Farb, which is why the MAIA sits so neatly inside that paper’s interoceptive-taxonomy — the instrument and the taxonomy come from an overlapping group with a shared motivation.

The eight subscales

SubscaleWhat it capturesItems
NoticingAwareness of body sensations4
Not-distractingTendency not to ignore or distract from pain/discomfort3
Not-worryingTendency not to experience distress or worry with pain/discomfort3
Attention regulationAbility to sustain and control attention to body sensation7
Emotional awarenessAwareness of the connection between body sensation and emotion5
Self-regulationAbility to regulate distress by attending to body sensation4
Body listeningTendency to actively listen to the body for insight3
TrustingExperience of one’s body as safe and trustworthy3

Where it sits in the taxonomy

Under Farb et al.’s Box 1, the MAIA measures sensibility — “an individual’s personal account of their internal-sensation experience, including confidence in their own interoceptive ability and feelings of engagement,” gauged by questionnaire. It is explicitly not a measure of accuracy, which requires an objective criterion and is normally obtained via the heartbeat-detection-task.

This distinction is doing real work, not bookkeeping. The two dissociate: meditators show strong interoceptive attention tendencies without superior heartbeat-detection accuracy (Khalsa et al. 2008; Parkin et al. 2013) — see does-mindfulness-enhance-interoceptive-accuracy. And the accuracy/sensibility mismatch is itself a construct of interest — see interoceptive-trait-prediction-error. Any finding stated as “X is associated with better/worse interoception” on MAIA evidence alone is a claim about sensibility only.

The Not-worrying subscale as a hypervigilance detector

The subscale that carries the most weight in Oldroyd et al. (2019) is Not-worrying, which produced by far their largest effect (attachment anxiety r = -0.43, vs. |r| = 0.18-0.26 for everything else). This is the MAIA’s design paying off: attachment anxiety was associated with higher Noticing and much lower Not-worrying — the profile of someone who attends to their body a great deal and is frightened by what they find. A single-score body-awareness instrument would have scored that person as simply “high,” which is exactly the conflation the MAIA was built to prevent.

Read the reverse-keyed names carefully — high Not-worrying is good (little worry), and the interpretive burden falls on remembering that Noticing means nothing without it.

Caution

Given that the strongest MAIA correlate reported in the wiki’s sources is with attachment anxiety, the concern Farb et al. raise about the Porges Body Perception Questionnaire — that its interoceptive validity is questionable because it may largely index anxiety — is worth keeping live for the MAIA’s affect-laden subscales too. It is a better instrument than that critique’s target, but it is still a questionnaire measuring how people feel about how they feel.