2.2.1 Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2)

The MAIA-2 questionnaire used in this study is an updated version of the 32-item MAIA which was translated and validated in German by Bornemann et al. [45]. In the present study, we translated 3 new items from the Not-Distracting scale and 2 new items from the Not-Worrying scale, which were taken from the recent revision of the English MAIA-2 [35]. The items were forward/backward translated by the first author in collaboration with W. Mehling (Osher Center for Integrative Medicine, University of California, San Francisco, USA) and checked for face validity. The item wording and scale assignments are shown in Table 2. During data collection, items were presented in a fixed order.

^a new item of MAIA-2 compared to MAIA.

Number of each item is identical with the English version of MAIA-2 (possible range of ratings: 0–5); items 5, 6, 7, 8, 9, 10, 11, 12 and 15 were reverse scored prior to averaging likert scales (formula: 5—item score).

M = arithmetic mean; SD = standard deviation; MD = median; ITC = item-total-correlation corrected for item overlap; Skew = skew; Kurt = kurtosis.

The MAIA-2 assesses multidimensional aspects of self-reported interoception and includes 37 items scoring on a six-point Likert scale (0 never, 5 always). Subscale scores are calculated by taking the arithmetic mean of the items on each scale. Higher scores indicate beneficial self-reported interoception. In a recently published validation study, the authors suggested an eight dimensional model of the MAIA-2, which was supported in a general population sample [35]. However, several authors have failed to replicate the eight-factorial model of the previous version (MAIA) across cultural contexts (for a review, see [34]). To the best of our knowledge, further dimensional investigations of MAIA-2 are not available yet. The MAIA-2 includes the following dimensions [35]: (i) Noticing (“awareness of uncomfortable, comfortable, and neutral body sensations”); (ii) Not-Distracting (“tendency not to ignore or distract oneself from sensations of pain or discomfort”); (iii) Not-Worrying (“tendency not to worry or experience emotional distress with sensations of pain or discomfort”); (iv) Attention Regulation (“ability to sustain and control attention to body sensations”); (v) Emotional Awareness (“awareness of the connection between body sensations and emotional states”); (vi) Self-Regulation (“ability to regulate distress by attention to body sensations”); (vii) Body Listening (“active listening to the body for insight”); (viii) Trusting (“experience of one’s body as safe and trustworthy”). The German version of the questionnaire as well as scoring instructions are provided in the supplementary material (S1 Questionnaire).