What it is
The Multidimensional Assessment of Interoceptive Awareness (MAIA; Mehling et al., 2012) is a self-report questionnaire designed to measure multiple dimensions of interoceptive body awareness. Unlike the sensory processing instruments described elsewhere in this wiki (which focus on the external senses, vestibular, and proprioceptive systems), the MAIA is specifically designed for interoception — the perception of the body’s internal states.
The MAIA was developed at the University of California San Francisco by Wolf Mehling and colleagues, originally in the context of mind-body therapy research. A revised version, the MAIA-2 (Mehling et al., 2018), refined the original scales and improved psychometric properties.
What it measures
The MAIA-2 assesses eight dimensions of interoceptive body awareness:
- Noticing: awareness of comfortable, uncomfortable, and neutral body sensations.
- Not-Distracting: tendency not to ignore or distract oneself from sensations of pain or discomfort.
- Not-Worrying: tendency not to experience emotional distress or worry about sensations of pain or discomfort.
- Attention Regulation: ability to sustain and control attention to body sensations.
- Emotional Awareness: awareness of the connection between body sensations and emotional states.
- Self-Regulation: ability to regulate distress by attending to body sensations.
- Body Listening: actively attending to the body for insight.
- Trusting: experiencing one’s body as safe and trustworthy.
This multidimensional approach is an advance over single-construct measures. Interoceptive awareness is not a monolithic ability; a person may be good at noticing sensations (high on Noticing) but poor at regulating their attention to those sensations (low on Attention Regulation), or may notice them readily but find the experience distressing (low on Not-Worrying, low on Trusting).
Who it’s for
Adults. The MAIA is a self-report instrument that requires the capacity to reflect on and report one’s own body awareness. It was developed and validated with general adult populations and has been used in research with autistic adults, though it was not designed specifically for autism populations. There is no child or adolescent version, and it is not suitable for individuals who cannot complete self-report questionnaires.
How it works
The MAIA-2 consists of 37 items rated on a 6-point scale (0 = never to 5 = always). It can be completed in approximately 10 minutes. Subscale scores are calculated as the mean of the items within each scale. Higher scores indicate greater interoceptive awareness on that dimension (with the caveat that “Not-Distracting” and “Not-Worrying” are reverse-framed, so higher scores mean less tendency to distract or worry).
Strengths
- The only widely-used, multidimensional self-report measure of interoceptive awareness. Most other interoception measures are either objective tasks (heartbeat counting) or single-scale questionnaires.
- Good psychometric properties in general populations. The MAIA-2 showed improved internal consistency over the original (Cronbach’s α ranging from 0.64 to 0.87 across scales).
- Available in many languages — the MAIA has been translated into over 20 languages, including German, French, Spanish, Portuguese, Chinese, Japanese, and Korean.
- Captures aspects of interoception (Trusting, Self-Regulation, Body Listening) that are particularly relevant to wellbeing and therapeutic intervention, not just accuracy.
- Freely available for research and clinical use.
Limitations
- Not validated specifically for autistic populations. The MAIA was developed with general populations, and its psychometric properties in autism have not been formally established. Some autistic people may interpret items differently than intended (e.g., literal interpretation of metaphorical language).
- Self-report limitations. People who have difficulty with introspection — including some autistic people, especially those with alexithymia — may struggle to provide accurate self-assessments of body awareness. The MAIA measures interoceptive sensibility (subjective self-report), not interoceptive accuracy (objective performance).
- Mul et al. (2018) found that autistic adults scored lower on the MAIA than non-autistic controls, but Garfinkel et al. (2016), using a different self-report measure (BPQ), found the opposite. This suggests the MAIA and other interoceptive self-report measures may be capturing subtly different constructs. Williams et al. (2023) have called for greater specificity in interoceptive measurement.
- No child or adolescent version limits its use in developmental contexts.
- Dutch validation status: a Dutch translation exists but formal psychometric validation in Dutch-speaking populations — and certainly in Dutch-speaking autistic populations — requires further investigation. This area requires further citation.
Availability and language versions
Freely available from the developer’s website (osher.ucsf.edu/maia). Translations exist in over 20 languages. The availability and validation status of a Dutch version should be confirmed directly with the developer.
Relationship to other instruments
The MAIA fills a gap that the Sensory Profile, SPM, and SEQ do not address: interoceptive awareness. It is the most commonly used self-report interoception measure in autism research. However, it measures only one dimension of interoception (sensibility/self-report); objective interoceptive accuracy requires behavioural tasks such as heartbeat counting or heartbeat discrimination. A comprehensive interoceptive assessment would ideally combine the MAIA (or similar self-report) with an objective accuracy task and a confidence measure to capture all three of Garfinkel et al.’s (2015) interoceptive dimensions.
Key sources
- Mehling, W.E., Price, C., Daubenmier, J.J., Acree, M., Bartmess, E. & Stewart, A. (2012). The Multidimensional Assessment of Interoceptive Awareness (MAIA). PLoS ONE, 7(11), e48230. doi: 10.1371/journal.pone.0048230
- Mehling, W.E., Acree, M., Stewart, A., Silas, J. & Jones, A. (2018). The Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2). PLoS ONE, 13(12), e0208034. doi: 10.1371/journal.pone.0208034
- Mul, C.-L., Stagg, S.D., Herbelin, B. & Aspell, J.E. (2018). The feeling of me feeling for you: interoception, alexithymia and empathy in autism. Journal of Autism and Developmental Disorders, 48, 2953–2967. doi: 10.1007/s10803-018-3564-3
- Garfinkel, S.N. et al. (2015). Knowing your own heart: distinguishing interoceptive accuracy from interoceptive awareness. Biological Psychology, 104, 65–74.