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 (N = 1294; M_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 ($\Delta$ CFI > 0.002), configural, metric, and scalar invariance were supported. After controlling for appetite-based interoception, higher scores on body listening, noticing, and emotional awareness unexpectedly predicted worse eating pathology, while higher scores on not worrying, not distracting, and trusting 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, not worrying 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.