Elsevier

Biological Psychology

Volume 104, January 2015, Pages 193-198
Biological Psychology

Effects of heartbeat feedback on beliefs about heart rate and heartbeat counting: A cautionary tale about interoceptive awareness

https://doi.org/10.1016/j.biopsycho.2014.12.010Get rights and content

Highlights

  • The heartbeat counting task is commonly used to assess cardioception.

  • Heartbeat feedback assessed the effects of beliefs/knowledge on heartbeat counting.

  • Feedback improved perception scores by increasing heartbeat counts and beliefs.

  • The heartbeat counting task is not a valid method to assess interoceptive awareness.

Abstract

Heartbeat counting improves after exposure to heartbeat feedback either because feedback trains individuals to detect heartbeats or updates their knowledge/beliefs about heart rate. These possibilities were examined by assessing heartbeat counting, in different postures and following exercise, before and after exposure to immediate and delayed heartbeat feedback. Immediate and delayed feedback provided accurate information about heart rate and, therefore, either could update beliefs about heart rate. However, only immediate feedback marked each ventricular contraction and, thereby, could train participants to detect the beating of the heart by focusing attention on relevant internal sensations. Exposure to immediate and delayed feedback resulted in similar, significant increases in the accuracy of heartbeat counting, indicating that the feedback effect was mediated by non-sensory processes rather than by training participants to detect heartbeat sensations. The current findings demonstrate that the heartbeat counting task is not a valid method to assess cardioception.

Section snippets

Participants

Seventy-seven undergraduates (29 men, 48 women) with a mean age of 21 (SD = 3.3) years, a mean weight of 64 (SD = 14.6) kg, and a mean height of 1.68 (SD = 0.115) m received course credit for participating1.

Pre-feedback performance

The grand average perception scores, counted heart rates, actual heart rates, and believed heart rates in each condition of Part 1 (prior to the feedback manipulation) are presented in Table 1. A series of 4 Condition (Supine, Sit, Stand, Post-Exercise) repeated measures ANOVAs identified differences among the conditions in perception scores, F(3,74) = 32.79, p < .001, η2 = .571, counted heart rates, F(3,74) = 95.49, p < .001, η2 = .795, actual heart rates, F(3,74) = 263.72, p < .001, η2 = .914, and believed

Discussion

Heartbeat counting accuracy did not change in the absence of heartbeat feedback, and therefore improvements in heartbeat counting accuracy (i.e., increased perception scores) are attributable to feedback rather than to repeated exposure to the heartbeat counting task (i.e., practice). Since similar increases in heartbeat counting accuracy followed exposure to both cardiac-contingent and cardiac-noncontingent feedback, it is inferred that feedback-mediated improvements in heartbeat counting are

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