title: Self-reported interoceptive awareness in primary care patients with past or current low back pain.
abstract: BACKGROUND
  Mind-body interactions play a major role in the prognosis of chronic pain, and mind-body therapies such as meditation, yoga, Tai Chi, and Feldenkrais presumably provide benefits for pain patients. The Multidimensional Assessment of Interoceptive Awareness (MAIA) scales, designed to measure key aspects of mind-body interaction, were developed and validated with individuals practicing mind-body therapies, but have never been used in pain patients.
  
  
  METHODS
  We administered the MAIA to primary care patients with past or current low back pain and explored differences in the performance of the MAIA scales between this and the original validation sample. We compared scale means, exploratory item cluster and confirmatory factor analyses, scale-scale correlations, and internal-consistency reliability between the two samples and explored correlations with validity measures.
  
  
  RESULTS
  Responses were analyzed from 435 patients, of whom 40% reported current pain. Cross-sectional comparison between the two groups showed marked differences in eight aspects of interoceptive awareness. Factor and cluster analyses generally confirmed the conceptual model with its eight dimensions in a pain population. Correlations with validity measures were in the expected direction. Internal-consistency reliability was good for six of eight MAIA scales. We provided specific suggestions for their further development.
  
  
  CONCLUSIONS
  Self-reported aspects of interoceptive awareness differ between primary care patients with past or current low back pain and mind-body trained individuals, suggesting further research is warranted on the question whether mind-body therapies can alter interoceptive attentional styles with pain. The MAIA may be useful in assessing changes in aspects of interoceptive awareness and in exploring the mechanism of action in trials of mind-body interventions in pain patients.
authors.affiliation: Osher Center for Integrative Medicine, Institute for Health and Aging, University of California, San Francisco, CA, USA ; Department of Family and Community Medicine, Institute for Health and Aging, University of California, San Francisco, CA, USA.
authors.forename: Wolf E
authors.initials: WE
authors.lastname: Mehling
authors.forename: Jennifer
authors.initials: J
authors.lastname: Daubenmier
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Price
authors.forename: Mike
authors.initials: M
authors.lastname: Acree
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Bartmess
authors.forename: Anita L
authors.initials: AL
authors.lastname: Stewart
keywords: body awareness; interoception; low back pain; questionnaire