# Understanding interoception across emotional contexts: development and validation of the Emotion-Linked Interoceptive Awareness Scale

## TL;DR

This paper introduces a new scale to measure how people notice bodily sensations during specific emotions, showing it can distinguish between healthy and unhealthy attention patterns.

## Contribution

The novel ELIA scale assesses interoceptive awareness within emotional contexts and reveals distinct associations with psychological traits.

## Key findings

- The ELIA scale has a bifactor structure with a general and three emotional subscales.
- Positive Emotions subscale scores correlate with lower anxiety and alexithymia.
- Mind–body practitioners score higher on the ELIA, especially in positive emotions.

## Abstract

This research aimed to develop and validate the Emotion-Linked Interoceptive Awareness (ELIA) scale, a self-report measure assessing awareness of bodily sensations under specific emotional contexts, through four online studies. Study 1 generated items based on free-text reports of bodily sensations during specific emotions. Study 2 supported a bifactor structure comprising one general and three subgroup factors (namely, Positive Emotions, Anxiety, Irritation), thereby yielding a 39-item scale. The general factor reflected cross-emotion bodily awareness, with relatively stronger representation of positive emotional contexts. Study 3 demonstrated convergence with the Multidimensional Assessment of Interoceptive Awareness, particularly the Emotional Awareness subscale, and moderate test–retest reliability. Study 4 revealed that the ELIA Positive Emotions subscale scores were associated with lower trait anxiety and alexithymia, whereas the Anxiety and Irritation subscale scores were associated with higher levels of these traits. Mind–body practitioners scored higher on the ELIA, particularly on the Positive Emotions subscale, in matched comparisons. Mediation analyses indicated that the ELIA Positive Emotions subscale score mediated the associations of practitioner status with trait anxiety and with Externally Oriented Thinking, a facet of alexithymia, whereas the ELIA Total score mediated only the association with Externally Oriented Thinking. Overall, the ELIA provides an emotion-specific assessment that may help distinguish adaptive from maladaptive attentional styles of interoceptive sensibility and highlights the value of tracking bodily awareness within emotional contexts. More broadly, these findings suggest that developing and employing domain- and context-specific interoceptive self-report measures can yield deeper insights.