The relevance of accuracy of heartbeat perception in noncardiac and cardiac chest pain

Professorship/Faculty: Lehrstuhl für Klinische Psychologie/Psychotherapie ; Professur für Pathopsychologie 
Author(s): Schroeder, Stefanie; Gerlach, Alexander L.; Achenbach, Stephan; Martin, Alexandra
Pages / Size: 258 - 267
Title of the Journal: International Journal of Behavioral Medicine : the official journal of the International Society of Behavioral Medicine
Language(s): English
ISSN: 1532-7558
Publisher Information: New York, NY
Volume: 22
Issue: 2
Publisher Information: Springer
Year of publication: 2015

The development and course of noncardiac chest pain are assumed to be influenced by interoceptive processes.

It was investigated whether heartbeat perception was enhanced in patients suffering from noncardiac chest pain and to what degree it was associated with self-reported cognitive–perceptual features and chest pain characteristics.

A total of 42 patients with noncardiac chest pain (NCCP), 35 patients with cardiac chest pain, and 52 healthy controls were recruited. Heartbeat perception was assessed using the Schandry task and a modified Brener–Kluvitse task. Self-report measures assessed anxiety sensitivity, somatosensory amplification, heart-focused anxiety, and chest pain characteristics.

Heartbeat perception was not more accurate in patients with NCCP, compared to patients with cardiac chest pain and healthy controls. However, in patients with NCCP, the error score (Schandry task) was significantly associated with stronger chest pain impairment, and the response bias (Brener–Kluvitse task) was associated with lower chest pain intensity.

Against assumptions of current etiological models, heartbeat perception was not enhanced in patients with NCCP. Chest pain characteristics and particularly their appraisal as threatening might be more relevant to NCCP than the perceptional accuracy of cardiac sensations and should be focused in psychological interventions. However, associations with chest pain impairment suggest cardiac interoception to influence the course of NCCP.
Keywords: Heartbeat perception, Interoception, Mental tracking, Noncardiac chest pain, Signal discrimination
URL:; 10.1007/s12529-014-9433-3
Peer Reviewed: Ja
International Distribution: Ja
Document Type: Article
Release date: 23. February 2016

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