Cardiac coping style, heartbeat detection, and the interpretation of cardiac events

Objectives. Vigilance to, and avoidance of, cardiac sensations and symptoms were explored in three studies. Design and methods. In the first study, a self-report measure of cardiac vigilance and cardiac avoidance, the Cardiac Coping Inventory (CCI), was administered to 453 students, and its factor structure, internal consistency, and test-retest reliability were established. In the second, 31 undergraduates completed the CCI, and their cardioceptive sensitivity was measured on a heartbeat detection task. In a third study of 91 patients with suspected myocardial infarction, the role of coping styles in symptom interpretations was analysed. Results. Cardiac avoidance and vigilance were independent of general symptom reporting tendencies, Cardiac vigilance was negatively correlated with heartbeat detection. Among the patients, delay in seeking treatment was predicted by the perceived importance of chest pain, which was influenced by the intensity of chest pain and cardiac vigilance. Conclusions. Although individuals high in cardiac vigilance do not seem to be good detectors of their heartbeats in the laboratory, they appear to attach importance to heart symptoms in real life, resulting in a health-protective behaviour.