Interoceptive awareness in a clinical setting: the need to bring interoceptive perspectives into clinical evaluation.

Interoceptive awareness (IA) is crucial to understanding mental health. The Multidimensional Assessment of Interoceptive Awareness (MAIA) scale, available in approximately 30 languages, has gained global recognition for its research applicability. This review highlights the critical importance of integrating IA evaluation in clinical settings, advocating for the MAIA scale's potential as a screening tool. Through an examination of academic databases, including Scopus, PubMed, Google Scholar, and J-STOR, our analysis spans seven mental health domains: eating disorders (ED), depression, stress, anxiety, autism spectrum disorder (ASD), chronic pain, and suicide ideation (SI). Thirty-eight studies showed links between several dimensions of IA with different disorders. That is, ED was related to Body Trust and Self-Regulation; anxiety to Body Listening, Emotional Awareness, and Self-Regulation; depression to Noticing and Emotional Awareness; ASD to Trusting, Emotional Awareness, and Noticing; chronic pain to Not-Worrying and Self-Regulation; and SI with Trusting. These insights hold profound implications for both clinical practice and mental health research. Integrating IA assessments into standard clinical protocols has the potential to improve our understanding of pathology, enrich patient care, and enhance therapeutic strategies.

Mindfulness en el control del atracón, la perspectiva de un grupo de adultos chilenos / Mindfulness in the control of binge eating, the perspective of a Chilean adult group

Resumen Intervenciones basadas en mindfulness (atención plena [AP]) están siendo cada vez más utilizadas para tratar temas alimentarios, buscando mejorar la regulación emocional y la conciencia acerca de los estados internos (e.g., hambre, saciedad). El objetivo de este trabajo fue describir la percepción de la práctica de AP en el control de la conducta de atracón. Participaron siete adultos que presentaban conducta de atracón (20-52 años de edad), seis mujeres y un hombre. Como parte de este estudio, los participantes recibieron una intervención (taller) sobre AP y alimentación. Con base a un enfoque metodológico cualitativo, de alcance exploratorio y descriptivo, se realizaron entrevistas semiestructuradas pre-post intervención, las cuales fueron analizadas mediante codificación abierta. Antes de la intervención, los participantes sostenían una relación no consciente con la comida, presentando un modo de funcionar automático. Tras la intervención se reportaron cambios favorables, como el aumento de la conciencia y el reconocimiento cognitivo y emocional, lo cual supuso modificaciones en la conducta alimentaria. Los participantes realizaron una evaluación positiva del taller y del formato grupal, destacando que la AP fue interiorizada como una nueva herramienta para la vida diaria.

Abstract Interventions based on mindfulness are increasingly used for feeding issues, looking for an improvement in the emotional regulation and awareness of internal states (i.e., satiety, hunger). The objective of this paper was to describe the perception of mindfulness when controlling binge eating behavior. A total of seven adults with binge eating behavior (20-52 years old), six women and one men participated in the study. All participants receive a training (workshop) about mindfulness and feeding. Based on a qualitative methodological approach with exploratory and descriptive scope, semi-structured interviews were performed pre-post intervention and were analyzed by open coding. Before intervention participants had no awareness in their relationship with food showing an automatic response. After intervention participants reported favorable changes such as increased of awareness as well as cognitive and emotional recognition, which led to changes in eating behavior. The participants made a positive evaluation of the workshop and the group format, highlighting that mindfulness was internalized as a new tool for daily life.

Disentangling interoception: insights from focal strokes affecting the perception of external and internal milieus.

Interoception is the moment-to-moment sensing of the physiological condition of the body. The multimodal sources of interoception can be classified into two different streams of afferents: an internal pathway of signals arising from core structures (i.e., heart, blood vessels, and bronchi) and an external pathway of body-mapped sensations (i.e., chemosensation and pain) arising from peripersonal space. This study examines differential processing along these streams within the insular cortex (IC) and their subcortical tracts connecting frontotemporal networks. Two rare patients presenting focal lesions of the IC (insular lesion, IL) or its subcortical tracts (subcortical lesion, SL) were tested. Internally generated interoceptive streams were assessed through a heartbeat detection (HBD) task, while those externally triggered were tapped via taste, smell, and pain recognition tasks. A differential pattern was observed. The IC patient showed impaired internal signal processing while the SL patient exhibited external perception deficits. Such selective deficits remained even when comparing each patient with a group of healthy controls and a group of brain-damaged patients. These outcomes suggest the existence of distinguishable interoceptive streams. Results are discussed in relation with neuroanatomical substrates, involving a fronto-insulo-temporal network for interoceptive and cognitive contextual integration.

Psychometric properties of the multidimensional assessment of interoceptive awareness (MAIA) in a Chilean population.

The multidimensional assessment of interoceptive awareness (MAIA) is an instrument designed to assess interoceptive awareness. The aim of this study was to adapt the original MAIA scale to Spanish and to analyze its psychometric properties in a Chilean population. The MAIA was administered to 470 adults, aged 18-70 years, 76.6% women and 23.4% men, residents of the provinces of Valparaíso and Concepción, Chile. Exploratory factor analysis reduced the scale from 32 to 30 items. Confirmatory factor analysis supports a structure of eight interrelated factors (Noticing, Not-Distracting, Not-Worrying, Attention Regulation, Emotional Awareness, Self- Regulation, Body Listening, and Trusting), similar to the original scale (χ(2) (371) = 659.78, p = 0.0001; CFI = 0.92, TLI = 0.91, RMSEA = 0.056 and SRMR = 0.059). The Spanish version showed appropriate indicators of construct validity and reliability, with a Cronbach's α of 0.90 for the total scale, and values between 0.40 and 0.86 for the different subscales. Similar to previous studies, low reliability was observed in two of the eight scales (Not-Distracting and Not-Worrying), thus further revision of these subscales is suggested. The Spanish version of MAIA proved to be a valid and reliable tool to investigate interoceptive awareness in the Chilean population.