Aberrant Cardiac Interoception in Psychosis

Jayson Jeganathan; Megan E.J. Campbell; Nicolas Legrand; Micah Allen; Michael Breakspear

doi:10.1093/schbul/sbae078

Aberrant Cardiac Interoception in Psychosis

Jayson Jeganathan, Megan E.J. Campbell, Nicolas Legrand, Micah Allen, Michael Breakspear

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

2 Citations (Scopus)

Abstract

BACKGROUND AND HYPOTHESIS: There is mounting evidence that cardiac interoception, the perception of one's heartbeat, is central to affective experiences. It has been proposed that symptoms of psychosis could arise from interoceptive dysfunction. Here we hypothesized that people with psychotic disorders would have a specific impairment in cardiac interoception, over and above broader perceptual deficits. STUDY DESIGN: 43 adults with a history of psychosis (31 schizophrenia, 12 schizoaffective disorder) and 41 matched control participants completed a heart rate discrimination task. Participants responded to whether they perceived a sequence of auditory tones to be faster or slower than their heart rate. By trialing a range of auditory tone rates, we estimated a threshold for each participant, the difference between perceived heart rate and actual heart rate. To test whether differences were specific to interoception, participants completed an exteroceptive control condition, testing their discrimination of the rate of 2 sets of audible sounds instead of heart rate. STUDY RESULTS: Participants with a history of psychosis had greater absolute differences between perceived and actual heart rate, indicating over- or under-estimation of heart rate compared to healthy controls. This difference was specific to the interoceptive condition, and not explained by group differences in exteroceptive perception. CONCLUSIONS: Psychotic disorders are associated with misestimation of heart rate. Further research may elucidate whether interoceptive abnormalities contribute to specific symptoms such as somatic delusions or affective features, and whether interoception could be a treatment target in psychotic disorders.

Original language	English
Journal	Schizophrenia Bulletin
Volume	51
Issue	1
Pages (from-to)	208-216
Number of pages	9
ISSN	0586-7614
DOIs	https://doi.org/10.1093/schbul/sbae078
Publication status	Published - Dec 2024

Keywords

cardiac interoception
interoception
interoceptive
psychosis
schizophrenia

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10.1093/schbul/sbae078Licence: CC BY-NC

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title = "Aberrant Cardiac Interoception in Psychosis",

abstract = "BACKGROUND AND HYPOTHESIS: There is mounting evidence that cardiac interoception, the perception of one's heartbeat, is central to affective experiences. It has been proposed that symptoms of psychosis could arise from interoceptive dysfunction. Here we hypothesized that people with psychotic disorders would have a specific impairment in cardiac interoception, over and above broader perceptual deficits. STUDY DESIGN: 43 adults with a history of psychosis (31 schizophrenia, 12 schizoaffective disorder) and 41 matched control participants completed a heart rate discrimination task. Participants responded to whether they perceived a sequence of auditory tones to be faster or slower than their heart rate. By trialing a range of auditory tone rates, we estimated a threshold for each participant, the difference between perceived heart rate and actual heart rate. To test whether differences were specific to interoception, participants completed an exteroceptive control condition, testing their discrimination of the rate of 2 sets of audible sounds instead of heart rate. STUDY RESULTS: Participants with a history of psychosis had greater absolute differences between perceived and actual heart rate, indicating over- or under-estimation of heart rate compared to healthy controls. This difference was specific to the interoceptive condition, and not explained by group differences in exteroceptive perception. CONCLUSIONS: Psychotic disorders are associated with misestimation of heart rate. Further research may elucidate whether interoceptive abnormalities contribute to specific symptoms such as somatic delusions or affective features, and whether interoception could be a treatment target in psychotic disorders.",

keywords = "cardiac interoception, interoception, interoceptive, psychosis, schizophrenia",

author = "Jayson Jeganathan and Campbell, {Megan E.J.} and Nicolas Legrand and Micah Allen and Michael Breakspear",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2024. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.",

year = "2024",

month = dec,

doi = "10.1093/schbul/sbae078",

language = "English",

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AU - Jeganathan, Jayson

AU - Campbell, Megan E.J.

AU - Legrand, Nicolas

AU - Allen, Micah

AU - Breakspear, Michael

N1 - Publisher Copyright: © The Author(s) 2024. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

PY - 2024/12

Y1 - 2024/12

N2 - BACKGROUND AND HYPOTHESIS: There is mounting evidence that cardiac interoception, the perception of one's heartbeat, is central to affective experiences. It has been proposed that symptoms of psychosis could arise from interoceptive dysfunction. Here we hypothesized that people with psychotic disorders would have a specific impairment in cardiac interoception, over and above broader perceptual deficits. STUDY DESIGN: 43 adults with a history of psychosis (31 schizophrenia, 12 schizoaffective disorder) and 41 matched control participants completed a heart rate discrimination task. Participants responded to whether they perceived a sequence of auditory tones to be faster or slower than their heart rate. By trialing a range of auditory tone rates, we estimated a threshold for each participant, the difference between perceived heart rate and actual heart rate. To test whether differences were specific to interoception, participants completed an exteroceptive control condition, testing their discrimination of the rate of 2 sets of audible sounds instead of heart rate. STUDY RESULTS: Participants with a history of psychosis had greater absolute differences between perceived and actual heart rate, indicating over- or under-estimation of heart rate compared to healthy controls. This difference was specific to the interoceptive condition, and not explained by group differences in exteroceptive perception. CONCLUSIONS: Psychotic disorders are associated with misestimation of heart rate. Further research may elucidate whether interoceptive abnormalities contribute to specific symptoms such as somatic delusions or affective features, and whether interoception could be a treatment target in psychotic disorders.

AB - BACKGROUND AND HYPOTHESIS: There is mounting evidence that cardiac interoception, the perception of one's heartbeat, is central to affective experiences. It has been proposed that symptoms of psychosis could arise from interoceptive dysfunction. Here we hypothesized that people with psychotic disorders would have a specific impairment in cardiac interoception, over and above broader perceptual deficits. STUDY DESIGN: 43 adults with a history of psychosis (31 schizophrenia, 12 schizoaffective disorder) and 41 matched control participants completed a heart rate discrimination task. Participants responded to whether they perceived a sequence of auditory tones to be faster or slower than their heart rate. By trialing a range of auditory tone rates, we estimated a threshold for each participant, the difference between perceived heart rate and actual heart rate. To test whether differences were specific to interoception, participants completed an exteroceptive control condition, testing their discrimination of the rate of 2 sets of audible sounds instead of heart rate. STUDY RESULTS: Participants with a history of psychosis had greater absolute differences between perceived and actual heart rate, indicating over- or under-estimation of heart rate compared to healthy controls. This difference was specific to the interoceptive condition, and not explained by group differences in exteroceptive perception. CONCLUSIONS: Psychotic disorders are associated with misestimation of heart rate. Further research may elucidate whether interoceptive abnormalities contribute to specific symptoms such as somatic delusions or affective features, and whether interoception could be a treatment target in psychotic disorders.

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Aberrant Cardiac Interoception in Psychosis

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