Validation of the Multidimensional Assessment of Interoceptive Awareness (MAIA-2) questionnaire in hospitalized patients with major depressive disorder

Abstract

Objectives Interoception refers to the sensation, interpretation, and integration of internal somatic signals. Abnormalities in self-reported interoception are prevalent features of major depressive disorder (MDD) and may affect treatment outcomes. In the present study, we investigated the psychometric properties of the revised eight-dimensional and 37-item Multidimensional Assessment of Interoceptive Awareness questionnaire (the MAIA-2) in a severely depressed sample, after translating two updated scales (Not-Distracting, Not-Worrying) into German. Specifically, we examined the measure’s internal consistency reliability, sensitivity to change, and minimal important differences (MID) with a focus on patient’s antidepressive responses to treatment. Methods The study enrolled 110 participants (age: M = 46.85, SD = 11.23; female: 55.45%) undergoing hospital treatment, of whom 87 were included in the pre-post analysis. Participants completed a German translation of MAIA-2 and the Beck Depression Inventory-II (pre-/post-treatment). Internal consistency reliability was determined by Cronbach’s α/McDonalds’s ω, sensitivity to change was determined by effect sizes, and MIDs were determined by distribution- (0.5*SD) and anchor-based approaches (mean change method; ROC curve cut-points). Results Depression severity reduced over the course of treatment (Median = -65.22%), and 34.48% of patients achieved remission. Reliability was appropriate for post-treatment (range of ω: .70-.90), but questionable for two pre-treatment scales (Noticing: ω = .64; Not-Distracting: ω = .66). The eight dimensions of MAIA-2 were sensitive to change (standardized response mean: .32-.81; Cohen’s effect size: .30-.92). Distribution-based MIDs (.38-.61) and anchor-based mean change MIDs (remission vs. partial response: .00-.85; partial response vs. nonresponse: .08-.88) were established on the group level. For six scales, ROC cut-points (remission: .00–1.33; response: -.20–1.00) demonstrated accurate classification to treatment response groups on the individual level. Conclusions This study demonstrated the applicability of the MAIA-2 questionnaire in MDD. The updated version may have led to reliability improvements regarding the revised scales, but subthreshold reliability was evident prior to treatment. The measure’s dimensions were sensitive to change. MIDs were established that corresponded with antidepressive treatment outcomes. Our findings are consistent with a growing area of research which considers somatic feelings as key contributors to mental health.

A Pilot Feasibility Study of Reconnecting to Internal Sensations and Experiences (RISE), a Mindfulness-Informed Intervention to Reduce Interoceptive Dysfunction and Suicidal Ideation, among University Students in India

“…The internal reliabilities of the subscales were as follows: Noticing (0.76), Not-Distracting (0.87), Not-Worrying (0.56), Attention Regulation (0.86), Emotional Awareness (0.85), Self-Regulation (0.85), Body Listening (0.85), and Body Trust (0.87). Notably, the low internal consistency of the Not-Worrying subscale is in keeping with other studies that have found similarly low reliabilities for this subscale [29,30].…”

Preliminary Rasch analysis of the Multidimensional Assessment of Interoceptive Awareness in adults with stroke

“…The internal consistency, as measured by Cronbach's alpha, was below 0.70 for the subscales "Noticing", "Not-Distracting", and "Not-Worrying" and was confirmed in some subsequent studies. The other subscales ranged from 0.79 to 0.87 [6,37,[42][43][44][45][46][47][48][49][50][51][52][53][54]. The confirmatory factor analysis confirmed the multidimensionality of the scale [6].…”

Altered Interoceptive Sensibility in Adults With Chronic Tic Disorder

“…Importantly, neither of these studies incorporated sex or severity of co-occurring psychiatric symptoms into their analyses ( 53 , 56 ). These clinical factors are critical considerations in studies of interoceptive sensibility given evidence of divergent interoceptive sensibility between the sexes ( 65 , 91 ) and atypical interoceptive sensibility in depressive ( 92 , 93 ), anxiety ( 94 , 95 ), and obsessive-compulsive disorders ( 64 ). Among individuals with CTD, lifetime prevalence of depression, anxiety, and OCD is 30, 36, and 66%, respectively ( 57 ), highlighting the relevance of these conditions when researching interoception in CTD populations.…”