How Does Heartbeat Counting Task Performance Relate to Theoretically-Relevant Mental Health Outcomes? A Meta-Analysis

Abstract

The Heartbeat Counting Task (HCT) was designed and is intended to measure the objective ability to detect cardiac signals (also called cardiac interoceptive accuracy). Because interoceptive accuracy is thought to play a key role in biological (e.g., body mass index) and psychological (e.g., trait anxiety) risk factors and indicators of mental health, HCT scores should be associated with these outcomes. In order to examine this question, we performed a meta-analysis on these associations among adult participants. The final data set comprised 133 studies with 11,524 participants. We focused here on the seven most studied outcomes (i.e., outcomes that were studied in at least ten published studies). HCT performance was not significantly associated with trait anxiety, depression, and alexithymia. It was weakly and negatively associated with age after correction for publication bias, sex (male > female), heart rate, and body mass index. In addition, the quality assessment indicates that only a few studies reported sample size justification (6%), pre-registration (0.8%), and data in free access (6.8%). Theoretically expected associations between HCT performance and psychological indicators of mental health were not meta-analytically found. We discuss the implications of these findings for practice and theory.

Increasing familiarity with the heartbeat counting task does not affect performance

“…Taken together, the range of results that either contrast or cohere with those found in the current study highlights the variability present in the available literature. The lack of correlations with these scales found is, however, consistent with the findings of a recent meta-analysis that seeks to summarise the literature to date (Desmedt et al, 2022).…”

Acute physical-activity related increases in interoceptive ability are not enhanced with simultaneous interoceptive attention

“…Secondly, although the Heartbeat Counting Task (HCT) is a widely used research instrument to measure interoceptive processing, the quantification and significance of IAcc measured in this way remains in debate within the field of interoceptive research, with recent reviews failing to replicate previous associations to indices of mental health 18 . Whilst our findings begin to disentangle the mechanisms which lead to increases in IAcc as measured by the Heartbeat Counting Task (HCT), more research is needed to fully understand these processes and their relation to self-regulation and mental health.…”

“…Correspondingly, atypical cardiac IAcc scores have been implicated in the aetiology of numerous somatic-based mental health conditions, such as panic disorder, anxiety, and depression 13 – 15 , as well as sensory-based neurodevelopmental conditions, such as autism spectrum conditions 15 – 17 . Whilst convincing, these findings do not always replicate 18 , which may reflect differences in sample characteristics (e.g., age, symptom severity, intervention history) or methodology (e.g., inclusion criteria, task instructions, analysis decisions). Maintaining methodological control whilst also taking individual differences into consideration is therefore important for comparison across future research.…”

Brain-heart interactions in the neurobiology of consciousness

“…Whether the ability to accurately sense visceral activity can be used as a marker of health remains to be confirmed [66]. Before this can be done, an important challenge in current interoception research is to design methods to enable more comprehensive assessments of interoception based on behavior and selfreported measures, which may in turn lead to uncover their relationships with physiological processes [51,67].…”