Eating Pathology and Interoceptive Sensibility Using the Brief Multidimensional Assessment of Interoceptive Awareness-2: Can There be Too Much of a Good Thing?

This study evaluated the factorial structure and invariance of the Multidimensional Assessment of Interoceptive Awareness-v2 (MAIA-2). We also investigated incremental validity of the MAIA-2 factors for predicting eating pathology beyond appetite-based interoception. US-based online respondents (<i>N</i> = 1294; <i>M</i>_age=48.7 ± 18.4; 63% cis women; 78% White) were sampled. We conducted hierarchical stepwise regressions, dominance analysis, and multiple-group confirmatory factor analyses across age, gender, and eating disorder symptoms. An 8-factor, 24-item Brief MAIA-2 (BMAIA-2) model showed optimal fit. Using strict criteria (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mrow><mml:mi>Δ</mml:mi></mml:mrow></mml:math> CFI > 0.002), configural, metric, and scalar invariance were supported. After controlling for appetite-based interoception, higher scores on <i>body listening, noticing,</i> and <i>emotional awareness</i> unexpectedly predicted worse eating pathology, while higher scores on <i>not worrying, not distracting</i>, and <i>trusting</i> predicted less eating pathology, as hypothesized. Dominance analysis showed no subscales contributed >2% unique variance to global disordered eating beyond appetite-based interoception. For loss of control eating, however, <i>not worrying</i> was the dominant BMAIA-2 predictor, explaining 5% unique variance beyond appetite-based interoception. Research supported the relevance of multiple interoceptive sensibility dimensions captured by the BMAIA-2 to understanding eating-based pathology. Future studies should consider assessing its incremental validity using behavioral tasks and autonomic biomarkers of interoception to better understand the complex interplay among interoceptive skills and eating behavior.