How does Heartbeat Counting Task performance relate to theoretically-relevant mental health outcomes? A meta-analysis

The Heartbeat Counting Task (HCT) was designed and is intended to measure the objective ability to detect cardiac signals (also called cardiac interoceptive accuracy). Because interoceptive accuracy is thought to play a key role in biological (e.g., body mass index) and psychological (e.g., trait anxiety) risk factors and indicators of mental health, HCT scores should be associated with these outcomes. In order to examine this question, we performed a meta-analysis on these associations among adult participants. The final data set comprised 133 studies with 11,524 participants. We focused here on the seven most studied outcomes (i.e., outcomes that were studied in at least ten published studies). HCT performance was not significantly associated with trait anxiety, depression, and alexithymia. It was weakly and negatively associated with age after correction for publication bias, sex (male > female), heart rate, and body mass index. In addition, the quality assessment indicates that only a few studies reported sample size justification (6%), pre-registration (0.8%), and data in free access (6.8%). Theoretically expected associations between HCT performance and psychological indicators of mental health were not meta-analytically found. We discuss the implications of these findings for practice and theory.