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Biol Psychol. 2014 Sep;101:69-76. doi: 10.1016/j.biopsycho.2014.05.012. Epub 2014 Jul 17.

Improving heartbeat perception in patients with medically unexplained symptoms reduces symptom distress.

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Department of Clinical Psychology and Psychotherapy, Johannes Gutenberg University of Mainz, Mainz, Germany. Electronic address:
Department of Psychology, Johannes Gutenberg University of Mainz, Mainz, Germany.
Institute of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany.
Department of Clinical Psychology and Psychotherapy, Johannes Gutenberg University of Mainz, Mainz, Germany; Department of Health Psychology, University of Mannheim, Mannheim, Germany.


Distortions in interoceptive accuracy have been linked to somatoform disorders. In line with cognitive theories of symptom formation in somatoform disorders, decreases in interoceptive accuracy have recently been observed to co-occur with more severe symptom reports. The current study tested the hypothesis that experimentally increasing interoceptive accuracy should decrease symptom severity in somatoform disorders. Twenty-nine patients with somatoform disorders were instructed in a newly developed heartbeat perception training procedure. Heartbeat perception, as a proxy for interoceptive accuracy, was assessed with a mental tracking task. Although there were no significant differences between the training group and a waiting control group (n=23) regarding increases in heartbeat perception, health anxiety served as a moderator and significant reductions in state symptom reports were observed after training. These findings suggest a relation between lower interoceptive accuracy and the perception of bodily symptoms in somatoform disorders.


Heartbeat perception; Interoception; Medically unexplained symptoms; Somatoform disorders; Training procedure

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