The relationship between social anxiety and heartbeat evoked potential amplitude

Past research suggests that social anxiety is associated with increased processing of cardiac activity. Cognitive theories propose that this is one aspect of self-focus, which is driven by concerns that features of the self, such as anxiety symptoms, will elicit evaluation from others. We investigated the relationship of social anxiety to the cortical processing of heartbeats as reflected in the heartbeat evoked potential (HEP) during false feedback of accelerated heart rate. Thirty-eight participants with high social anxiety (HSA; n = 19) and non-elevated social anxiety (NSA; n = 19) completed a cognitive task during which false feedback of accelerated heart rate was randomly provided on 50% of trials. HEP amplitude was larger in HSAs, but not NSAs, during false heartbeat acceleration cues compared to standard cues. HEP amplitude also was larger in HSAs compared to NSAs during acceleration cues. HEP amplitude during acceleration cues, but not standard cues correlated with social anxiety. Within the first second after the R-peak, social anxiety correlated with voltage at Fz from 223 to 305 ms. Social concerns about the consequences of anxiety symptoms accounted for an indirect relationship between social anxiety and the HEP. These data extend prior evidence of increased processing of cardiac activity in socially anxious individuals, providing support for cognitive theories.