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.

中文翻译：

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精神病中的异常心脏内感受


背景和假设 越来越多的证据表明，心脏内感受，即对心跳的感知，是情感体验的核心。有人提出，精神病的症状可能由内感受功能障碍引起。在这里，我们假设患有精神障碍的人在心脏内感受方面会有特定的障碍，而不仅仅是更广泛的感知缺陷。研究设计 43 名有精神病病史的成年人（31 名精神分裂症，12 名分裂情感障碍）和 41 名匹配的对照参与者完成了一项心率辨别任务。参与者回答他们是否认为一系列听觉音调比他们的心率更快或更慢。通过试验一系列听觉音调率，我们估计了每个参与者的阈值，即感知心率和实际心率之间的差异。为了测试差异是否特定于内感受，参与者完成了一项外感受控制条件，测试他们对 2 组可听声音率而不是心率的辨别能力。研究结果有精神病病史的参与者在感知心率和实际心率之间的绝对差异更大，表明与健康对照组相比，心率被高估或低估。这种差异是特定于内感受条件的，而不是用外感受感知的群体差异来解释的。结论 精神障碍与心率估计错误有关。进一步的研究可能会阐明内感受异常是否会导致特定症状，例如躯体妄想或情感特征，以及内感受是否可以成为精神障碍的治疗目标。