Heart rate response after emotional picture presentation is modulated by interoceptive awareness

The perception of visceral signals plays a crucial role in many theories of emotions. The present study was designed to investigate the relationship between interoceptive awareness, emotional experience and heart rate responses in an emotional stimulation paradigm. Based on their performance in a heartbeat perception task 38 participants (16 males, 22 females) were classified as subjects with either high (n = 19; 8 males) or low interoceptive awareness (n = 19; 8 males). 120 pictures (40 pleasant, 40 unpleasant, 40 neutral slides) from the International Affective Picture System served as emotional stimuli. Heart rate changes were recorded during baseline and during slide presentation. After each slide, the subjects had to rate emotional valence and arousal on a 9-point self-report scale. Statistical analyses revealed significantly stronger heart rate responses to pleasant and unpleasant stimuli in subjects with high interoceptive awareness. Furthermore, subjects with high interoceptive awareness rated pleasant and unpleasant slides as significantly more arousing; no differences were found in the emotional valence ratings. Heartbeat perception scores correlated significantly positive with both the mean arousal rating and with the mean heart rate changes. Our results demonstrate a strong relationship between the perception of cardiac signals and the peripheral processing of emotional stimuli.