Primary Topic: Mind-body (including meditation and yoga)
Listen to Your Body: a Multidimensional Assessment of Interoceptive Awareness (MAIA) for Mind-Body Research
Wolf E Mehling, M.D., , San Francisco, CA, United States; Eric Garland, PhD; Adam Hanley, PhD, Center on Mindfulness and Integrative Health Intervention Development, Salt Lake City, UT, United States; Emily Stern, PhD, , New York, NY, United States; Cynthia J. Price, PhD, University of Washington, Seattle, WA, United States
Late Breaker: No
Interoception has been defined as the sensing of the physiological condition of the body. Interoceptive bodily awareness is emerging as a critical element for the understanding of mechanisms in mind-body research and psychological health. Mindfulness approaches include training in attention regulation towards breathing and other subtle body sensations. Alterations of interoception play a key role in psychological health, and integrative medicine approaches appear to be able to improve medical conditions through interoceptive training. Interoceptive awareness is ambiguous and can be clinically beneficial or maladaptive depending on the mode of attention, being either anxiety-driven or mindful. Scientific research in the field of interoception is still hindered by unresolved differences in the terminology of its multiple dimensions and the lack of strong measurements for research that are also meaningful to clinicians.
Following a brief overview of the current terminology, the controversies around it, and available objective/behavioral and self-report measures, the presenters will focus on the MAIA and their research with this self-report measure, its usefulness and limitations.
Researchers in this field are just beginning to cooperate across the world. This symposium addresses the need for stronger collaboration among interoception and mind-body researchers to advance integrative health using mind-body approaches. The MAIA’s 20 translations may assist in international cooperation.
As a result of this session, participants will have learned about the concept of interoception, the complexity of its multiple dimensions, the current state of measurement development for rigorous research in the field of interoceptive body awareness, and will be able to make informed measurement decisions for research and clinic.
Following a 5 minute introduction, each of the 4 speakers will have 10 minutes to present their data. The remaining 15 minutes will be used for interactive discussion.
Introduction: Wolf Mehling will introduce the speakers. He will clarify terms: Bodily Awareness, Interoceptive Awareness, Interoceptive Accuracy, Interoceptive Sensibility, Mindfulness, and their place in mind-body therapies and contemplative practices. He will give a brief overview of measurements: objective and self-report.
Emily Stern investigated neural mechanisms of interoception when 19 healthy individuals attended to their heartbeat and skin temperature, and examined the relationship between neural activity during interoception and individual differences in self-reported interoceptive sensibility (IS) using the MAIA together with fMRI brain imaging. IS represents the construct underlying the MAIA, here synonymous with interoceptive awareness, a multidimensional construct including not only the tendency to be aware of sensation but also how sensations are interpreted, regulated, and used to inform behavior, with different dimensions relating to different aspects of health and disease. Her data suggest that self-rated IS is related to altered activation in regions involved in monitoring body state, which has implications for disorders associated with abnormality of interoception.
Cynthia Price will present data from a NIDA-funded clinical trial of Mindful Awareness in Body-oriented Therapy (MABT) for women in substance use disorder treatment. MABT is designed to teach interoceptive awareness and related skills for emotion regulation. The presentation will focus on the associations between baseline measures and the MAIA (N =217), as well as the performance of the MAIA (i.e. sensitivity to change) in response to the intervention. These results support prior neurobiological models and imaging research indicating the importance of interoceptive awareness for emotion regulation and the potential relevance to improved substance use disorder treatment outcomes.
Eric Garland and Adam Hanley will present results from clinical studies using the MAIA with Mindfulness-Oriented Recovery Enhancement (MORE) from two separate RCTs: MORE in obese cancer survivors (N=51) and MORE for opioid misusing chronic pain patients (N=62). In both studies, MORE was associated with significant increases in multiple MAIA subscales, and increases in Self-Regulation mediated the effect of MORE on reducing psychological distress. They will also present cross-sectional network associations between MAIA scales, dispositional mindfulness (FFMQ) and Scales of Psychological Well-Being in healthy adults (N =478).
Wolf Mehling will present data from (1) a study of Mindfulness-Based Cognitive Therapy (MBCT) for comorbid depression and chronic pain (N= 31). Increases in the MBCT group were significantly greater than in the TAU group on the Self-Regulation and Not Distracting scales of the MAIA. Furthermore, the positive effect of MBCT on depression severity was mediated by “Not Distracting.” (2) In another study of Integrative Exercise (IE) using aerobic and resistance exercise with mindfulness-based principles and yoga provided improvements in PTSD intensity, quality of life improvements in mindfulness, interoceptive bodily awareness (MAIA) and positive states of mind in 47 war veterans with PTSD randomized to 12-week IE versus waitlist. Large effect sizes for the intervention were observed on FFMQ Non-Reactivity (d=.85), MAIA Body Listening (d=.80) and Self-Regulation (d=1.05). Finally he will provide an overview over shortcomings of the original MAIA, efforts to improve it and the use of the MAIA in its 20 translations in other countries.
Methods/Session Format (60 min): Following a 5 minute introduction, each of the 4 speakers will have 10 minutes to present their data. The remaining 15 minutes will be used for interactive discussion.