Accuracy of heartbeat perception in panic disorder, social phobia, and nonanxious subjects

Recent research on psychosocial models of panic disorder has demonstrated that panic patients become anxious about, and tend to focus on, the physical sensations of panic (e.g., palpitations, dizziness, and breathlessness). To assess whether patients' hypervigilance for panic sensations is associated with heightened awareness of internal sensations, subjects with panic disorder, social phobia, and no mental disorder were asked to count heartbeats at rest and following a period of exercise, while actual heartbeats were recorded using a polygraph. The groups did not differ in heartbeat awareness at rest. Following exercise, all groups became more aware of cardiac sensations, again with no between-group differences. Despite a lack of group differences, several variables were positively related to accuracy of heartbeat perception, including self-reported anxiety over relevant sensations and subjects' confidence in their estimations. In addition, actual heart rate was negatively related to accuracy of heartbeat tracking. The implications of these results are discussed.