Cardiac Interoception: A Novel Signal Detection Approach and Relations to Somatic Symptom Distress

Interoception is essential for the maintenance of physical and mental health. Paradigms assessing cardioceptive accuracy do not separate sensitivity from bias or are very demanding. We present the piloting (study 1; N = 60) and psychometric evaluation and validation (study 2; N = 84) of a novel task for the assessment of cardiac interoceptive perception following the principles of signal detection theory. By disentangling sensitivity and response bias, we demonstrate that the previously used interoceptive accuracy score of the heartbeat mental tracking task represents an amalgam of sensitivity and response bias. The new task demonstrated adequate test-retest reliabilities for sensitivity (d') and response bias (c). Sensitivity was inversely related (beta = -.36) to somatic symptom distress after statistically controlling for response bias. The novel cardiovascular signal detection task is easy to implement, feasible, and promising in terms of unraveling the role of (cardiac) interoceptive perception in psychopathology