Methodological recommendations for a heartbeat detection-based measure of interoceptive sensitivity
Open accessAbstract
Heartbeat detection tasks are often used to measure cardiac interoceptive sensitivity—the ability to detect sensations from one's heart. However, there is little work to guide decisions on the optimum number of trials to use, which should balance reliability and power against task duration and participant burden. Here, 174 participants completed 100 trials of a widely used heartbeat detection task where participants attempt to detect whether presented tones occurred synchronously or asynchronously with their heartbeats. First, we quantified measurement reliability of the participant's accuracy derived from differing numbers of trials of the task using a correlation metric; we found that at least 40–60 trials were required to yield sufficient reliability. Next, we quantified power by simulating how the number of trials influenced the ability to detect a correlation between cardiac interoceptive sensitivity and other variables that differ across participants, including a variable measured from our sample (body mass index) as well as simulated variables of varying effect sizes. Using these simulations, we quantified the trade‐offs between sample size, effect size, and number of trials in the heartbeat detection task such that a researcher can easily determine any one of these variables at given values of the other two variables. We conclude that using fewer than 40 trials is typically insufficient due to poor reliability and low power in estimating an effect size, although the optimal number of trials can differ by study.
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The heartbeat discrimination task requires a high number of trials to gain precise estimates of ability and may not be suitable for examining interoceptive accuracy at the lower range of ability.
“However, this task is not without limitations; for example, a high number of trials are required to gain precise estimates of ability (Kleckner et al., 2015), and concerns have been raised over the difficulty of this task, meaning that it may not be suitable for examining interoceptive accuracy at the lower range of ability (Brener and Ring, 2016).”
From Atypical interoception as a common risk factor for psychopathology: A review (2021) · cites this paper as Kleckner et al., 2015
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- Authors
- Kleckner, I. R., Wormwood, J. B., Simmons, W. K., Barrett, L. F., & Quigley, K. S.
- Affiliations
- Northeastern University (US)
- Laureate Institute for Brain Research (US)
- Corresponding author
- Kleckner, Ian R.
- Venue
- Psychophysiology
- Publisher
- Wiley
- Published
- 2015-08-12
- Volume
- 52
- Issue
- 11
- Pages
- 1432-1440
- ISSN
- 0048-5772 (ISSN-L)
- 1469-8986
- PMC
- PMC4821012
- OpenAlex
- W1576198198
- Semantic Scholar
- 8000fea071ec5f77bfc97eb707d812bdb2c22def
- Cited by
- 124
- References
- 54
- Citations by year
- 2026: 10 · 2025: 9 · 2024: 12 · 2023: 11 · 2022: 14 · 2021: 16 · 2020: 12 · 2019: 12 · 2018: 11 · 2017: 11 · 2016: 5 · 2015: 1
- FWCI
- 6.79
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychophysiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (F32MH096533, K01MH096175-01)
- National Institutes of Health (DP1OD003312)
- U.S. Army Research Laboratory (W5J9CQ-12-C-0049)
- Oklahoma Tobacco Research Center
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- heartbeat detection, cardiac interoception, interoceptive sensitivity, sample size determination, measurement reliability, statistical power, effect size, body mass index
- MeSH terms
- Acoustic Stimulation, Adolescent, Adult, Attention, Awareness, Female, Heart Rate, Humans, Male, Middle Aged, Pulse, Reproducibility of Results, Young Adult, Interoception
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