51
|
Harris L, Lee VK, Thompson EH, Kranton R. Exploring the Generalization Process from Past Behavior to Predicting Future Behavior. JOURNAL OF BEHAVIORAL DECISION MAKING 2015. [DOI: 10.1002/bdm.1889] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Lasana Harris
- Psychology and Neuroscience; Duke University; Durham NC USA
| | | | | | | |
Collapse
|
52
|
Lelorain S, Brédart A, Dolbeault S, Cano A, Bonnaud-Antignac A, Cousson-Gélie F, Sultan S. How does a physician's accurate understanding of a cancer patient's unmet needs contribute to patient perception of physician empathy? PATIENT EDUCATION AND COUNSELING 2015; 98:734-741. [PMID: 25817423 DOI: 10.1016/j.pec.2015.03.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 02/19/2015] [Accepted: 03/07/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Unmet supportive care needs of patients decrease patient perception of physician empathy (PE). We explored whether the accurate physician understanding of a given patient's unmet needs (AU), could buffer the adverse effect of these unmet needs on PE. METHODS In a cross-sectional design, 28 physicians and 201 metastatic cancer patients independently assessed the unmet supportive care needs of patients. AU was calculated as the sum of items for which physicians correctly rated the level of patient needs. PE and covariates were assessed using self-reported questionnaires. Multilevel analyses were carried out. RESULTS AU did not directly affect PE but acted as a moderator. When patients were highly expressive and when physicians perceived poor rapport with the patient, a high AU moderated the adverse effect of patient unmet needs on PE. CONCLUSION Physician AU has the power to protect the doctor-patient relationship in spite of high patient unmet needs, but only in certain conditions. PRACTICE IMPLICATIONS Physicians should be encouraged toward AU but warned that high rapport and patient low emotional expression may impede an accurate reading of patients. In this latter case, they should request a formal assessment of their patients' needs.
Collapse
Affiliation(s)
- Sophie Lelorain
- Univ Lille Nord de France, Department of Psychology, Lille, France; UDL3, SCALab UMR CNRS 9193, Villeneuve d'Ascq, France.
| | - Anne Brédart
- Institut Curie, Psycho-oncology Unit, Paris, France; Paris Descartes University, LPPS EA 4057-IUPDP, Boulogne-Billancourt, France
| | - Sylvie Dolbeault
- Institut Curie, Psycho-oncology Unit, Paris, France; Inserm, U 669, Paris, France; Univ Paris-Sud and Univ Paris Descartes, UMR-S0669, Paris, France
| | | | - Angélique Bonnaud-Antignac
- University of Nantes, EA4275 SPHERE 'bioStatistics, Pharmacoepidemiology and Human sciEnces Research', Nantes, France
| | - Florence Cousson-Gélie
- University of Montpellier 3, Laboratory Epsylon 'Dynamics of Human Abilities & Health Behaviors', Montpellier, France; ICM, Institut Régional du Cancer de Montpellier, Epidaure Prevention and Education Cancer Center, Montpellier, France
| | - Serge Sultan
- University of Montreal, Sainte Justine University Hospital Research Center, Montreal, Canada
| |
Collapse
|
53
|
Some markers of mirroring appear intact in schizophrenia: evidence from mu suppression. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2015; 14:1049-60. [PMID: 24415272 DOI: 10.3758/s13415-013-0245-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Although schizophrenia is associated with impairments in social cognition, the scope and neural correlates of these disturbances are largely unknown. In this study, we investigated whether schizophrenia patients show impaired functioning of the mirror neuron system (MNS), as indexed by electroencephalographic (EEG) mu (8-13 Hz) suppression, a hypothesized biomarker of MNS activity that is sensitive to the degree of social interaction depicted in visual stimuli. A total of 32 outpatients and 26 healthy controls completed an EEG paradigm that included six action observation or execution conditions that differed in their degrees of social interaction. Participants also completed a validated empathy questionnaire. Across both groups, we found a significant linear increase in mu suppression across the conditions involving greater levels of social engagement and interaction, but no significant group or interaction effects. Patients self-reported diminished empathic concern and perspective taking, which showed some moderate relations to mu suppression levels. Thus, the schizophrenia group showed generally intact modulation of MNS functioning at the electrophysiological level, despite self-reporting empathic disturbances. The disturbances commonly seen on self-report, performance, and neuroimaging measures of mentalizing in schizophrenia may largely reflect difficulties with higher-level inferential processes about others' emotions, rather than a basic incapacity to share in these experiences.
Collapse
|
54
|
Fett AKJ, Shergill SS, Krabbendam L. Social neuroscience in psychiatry: unravelling the neural mechanisms of social dysfunction. Psychol Med 2015; 45:1145-1165. [PMID: 25335852 DOI: 10.1017/s0033291714002487] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Social neuroscience is a flourishing, interdisciplinary field that investigates the underlying biological processes of social cognition and behaviour. The recent application of social neuroscience to psychiatric research advances our understanding of various psychiatric illnesses that are characterized by impairments in social cognition and social functioning. In addition, the upcoming line of social neuroscience research provides new techniques to design and evaluate treatment interventions that are aimed at improving patients' social lives. This review provides a contemporary overview of social neuroscience in psychiatry. We draw together the major findings about the neural mechanisms of social cognitive processes directed at understanding others and social interactions in psychiatric illnesses and discuss their implications for future research and clinical practice.
Collapse
Affiliation(s)
- A K J Fett
- Department of Educational Neuroscience & Research Institute LEARN!,Faculty of Psychology and Education,VU University Amsterdam,Van der Boechorststraat 1,Amsterdam,The Netherlands
| | - S S Shergill
- Department of Psychosis Studies,Institute of Psychiatry, King's College London,De Crespigny Park,London,UK
| | - L Krabbendam
- Department of Educational Neuroscience & Research Institute LEARN!,Faculty of Psychology and Education,VU University Amsterdam,Van der Boechorststraat 1,Amsterdam,The Netherlands
| |
Collapse
|
55
|
Kafetsios K, Hess U. Are you looking at me? The influence of facial orientation and cultural focus salience on the perception of emotion expressions. COGENT PSYCHOLOGY 2015. [DOI: 10.1080/23311908.2015.1005493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
| | - Ursula Hess
- Psychology Department , Humboldt-Universität zu Berlin, Berlin, Germany
| |
Collapse
|
56
|
Smith MJ, Schroeder MP, Abram SV, Goldman MB, Parrish TB, Wang X, Derntl B, Habel U, Decety J, Reilly JL, Csernansky JG, Breiter HC. Alterations in brain activation during cognitive empathy are related to social functioning in schizophrenia. Schizophr Bull 2015; 41:211-22. [PMID: 24583906 PMCID: PMC4266286 DOI: 10.1093/schbul/sbu023] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Impaired cognitive empathy (ie, understanding the emotional experiences of others) is associated with poor social functioning in schizophrenia. However, it is unclear whether the neural activity underlying cognitive empathy relates to social functioning. This study examined the neural activation supporting cognitive empathy performance and whether empathy-related activation during correctly performed trials was associated with self-reported cognitive empathy and measures of social functioning. Thirty schizophrenia outpatients and 24 controls completed a cognitive empathy paradigm during functional magnetic resonance imaging. Neural activity corresponding to correct judgments about the expected emotional expression in a social interaction was compared in schizophrenia subjects relative to control subjects. Participants also completed a self-report measure of empathy and 2 social functioning measures (social competence and social attainment). Schizophrenia subjects demonstrated significantly lower accuracy in task performance and were characterized by hypoactivation in empathy-related frontal, temporal, and parietal regions as well as hyperactivation in occipital regions compared with control subjects during accurate cognitive empathy trials. A cluster with peak activation in the supplementary motor area (SMA) extending to the anterior midcingulate cortex (aMCC) correlated with social competence and social attainment in schizophrenia subjects but not controls. These results suggest that neural correlates of cognitive empathy may be promising targets for interventions aiming to improve social functioning and that brain activation in the SMA/aMCC region could be used as a biomarker for monitoring treatment response.
Collapse
Affiliation(s)
- Matthew J. Smith
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; ,Department of Psychiatry, Warren Wright Adolescent Center at Stone Institute of Psychiatry, Northwestern Memorial Hospital, Chicago, IL; ,*To whom correspondence should be addressed; Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N. Lakeshore Dr, Abbott Hall 13th floor, Chicago, IL 60611, US; tel: 1-312-503-2542, fax: 1-312-503-0527, e-mail:
| | - Matthew P. Schroeder
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | - Morris B. Goldman
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Todd B. Parrish
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Xue Wang
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Birgit Derntl
- Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen University (Germany), Aachen, Germany
| | - Ute Habel
- Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen University (Germany), Aachen, Germany
| | - Jean Decety
- Department of Psychology, University of Chicago, Chicago, IL; ,Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL
| | - James L. Reilly
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; ,Department of Psychiatry, Warren Wright Adolescent Center at Stone Institute of Psychiatry, Northwestern Memorial Hospital, Chicago, IL; , These authors shared senior authorship
| | - John G. Csernansky
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; , These authors shared senior authorship
| | - Hans C. Breiter
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; ,Department of Psychiatry, Warren Wright Adolescent Center at Stone Institute of Psychiatry, Northwestern Memorial Hospital, Chicago, IL; , These authors shared senior authorship
| |
Collapse
|
57
|
Horan WP, Reise SP, Kern RS, Lee J, Penn DL, Green MF. Structure and correlates of self-reported empathy in schizophrenia. J Psychiatr Res 2015; 66-67:60-6. [PMID: 25985922 PMCID: PMC4458171 DOI: 10.1016/j.jpsychires.2015.04.016] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 04/17/2015] [Accepted: 04/22/2015] [Indexed: 10/23/2022]
Abstract
Research on empathy in schizophrenia has relied on dated self-report scales that do not conform to contemporary social neuroscience models of empathy. The current study evaluated the structure and correlates of the recently-developed Questionnaire of Cognitive and Affective Empathy (QCAE) in schizophrenia. This measure, whose structure and validity was established in healthy individuals, includes separate scales to assess the two main components of empathy: Cognitive Empathy (assessed by two subscales) and Affective Empathy (assessed by three subscales). Stable outpatients with schizophrenia (n = 145) and healthy individuals (n = 45) completed the QCAE, alternative measures of empathy, and assessments of clinical symptoms, neurocognition, and functional outcome. Exploratory and confirmatory factor analyses provided consistent support for a two-factor solution in the schizophrenia group, justifying the use of separate cognitive and affective empathy scales in this population. However, one of the three Affective Empathy subscales was not psychometrically sound and was excluded from further analyses. Patients reported significantly lower Cognitive Empathy but higher Affective Empathy than controls. Among patients, the QCAE scales showed significant correlations with an alternative self-report empathy scale, but not with performance on an empathic accuracy task. The QCAE Cognitive Empathy subscales also showed significant, though modest, correlations with negative symptoms and functional outcome. These findings indicate that structure of self-reported empathy is similar in people with schizophrenia and healthy subjects, and can be meaningfully compared between groups. They also contribute to emerging evidence that some aspects of empathy may be intact or hyper-responsive in schizophrenia.
Collapse
Affiliation(s)
- William P. Horan
- VA Greater Los Angeles Healthcare System,Semel Institute for Neuroscience and Human Behavior, UCLA
| | | | - Robert S. Kern
- VA Greater Los Angeles Healthcare System,Semel Institute for Neuroscience and Human Behavior, UCLA
| | - Junghee Lee
- VA Greater Los Angeles Healthcare System,Semel Institute for Neuroscience and Human Behavior, UCLA
| | - David L. Penn
- University of North Carolina, Chapel Hill,Australian Catholic University, Melbourne, VI
| | - Michael F. Green
- VA Greater Los Angeles Healthcare System,Semel Institute for Neuroscience and Human Behavior, UCLA
| |
Collapse
|
58
|
Devlin HC, Zaki J, Ong DC, Gruber J. Not as good as you think? Trait positive emotion is associated with increased self-reported empathy but decreased empathic performance. PLoS One 2014; 9:e110470. [PMID: 25353635 PMCID: PMC4212943 DOI: 10.1371/journal.pone.0110470] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 08/08/2014] [Indexed: 01/10/2023] Open
Abstract
How is positive emotion associated with our ability to empathize with others? Extant research provides support for two competing predictions about this question. An empathy amplification hypothesis suggests positive emotion would be associated with greater empathy, as it often enhances other prosocial processes. A contrasting empathy attenuation hypothesis suggests positive emotion would be associated with lower empathy, because positive emotion promotes self-focused or antisocial behaviors. The present investigation tested these competing perspectives by examining associations between dispositional positive emotion and both subjective (i.e., self-report) and objective (i.e., task performance) measures of empathy. Findings revealed that although trait positive emotion was associated with increased subjective beliefs about empathic tendencies, it was associated with both increases and decreases in task-based empathic performance depending on the target’s emotional state. More specifically, trait positive emotion was linked to lower overall empathic accuracy toward a high-intensity negative target, but also a higher sensitivity to emotion upshifts (i.e., shifts in emotion from negative to positive) toward positive targets. This suggests that trait positive affect may be associated with decreased objective empathy in the context of mood incongruent (i.e., negative) emotional stimuli, but may increase some aspects of empathic performance in the context of mood congruent (i.e., positive) stimuli. Taken together, these findings suggest that trait positive emotion engenders a compelling subjective-objective gap regarding its association with empathy, in being related to a heightened perception of empathic tendencies, despite being linked to mixed abilities in regards to empathic performance. (Word count: 242).
Collapse
Affiliation(s)
- Hillary C. Devlin
- Department of Psychology, Yale University, New Haven, Connecticut, United States of America
| | - Jamil Zaki
- Department of Psychology, Stanford University, Stanford, California, United States of America
| | - Desmond C. Ong
- Department of Psychology, Stanford University, Stanford, California, United States of America
| | - June Gruber
- Department of Psychology, Yale University, New Haven, Connecticut, United States of America
- Department of Psychology and Neuroscience, University of Colorado at Boulder, Boulder, Colorado, United States of America
- * E-mail:
| |
Collapse
|
59
|
Michaels TM, Horan WP, Ginger EJ, Martinovich Z, Pinkham AE, Smith MJ. Cognitive empathy contributes to poor social functioning in schizophrenia: Evidence from a new self-report measure of cognitive and affective empathy. Psychiatry Res 2014; 220:S0165-1781(14)00751-3. [PMID: 25412980 DOI: 10.1016/j.psychres.2014.08.054] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 08/25/2014] [Accepted: 08/26/2014] [Indexed: 01/10/2023]
Abstract
Cognitive empathy impairments have been linked to poor social functioning in schizophrenia. However, prior studies primarily used self-reported empathy measures developed decades ago that are not well-aligned with contemporary models of empathy. We evaluated empathy and its relationship to social functioning in schizophrenia using the recently developed Questionnaire of Cognitive and Affective Empathy (QCAE). Schizophrenia (n=52) and healthy comparison (n=37) subjects completed the QCAE, Interpersonal Reactivity Index (IRI), and measures of neurocognition, symptoms, and social functioning. Between-group differences on the QCAE, and relationships between QCAE and IRI subscales, neurocognition, symptoms, and social functioning were examined. The schizophrenia group reported significantly lower cognitive empathy than comparison subjects, which was driven by low online simulation scores. Cognitive empathy explained significant variance in social functioning after accounting for neurocognition and symptoms. Group differences for affective empathy were variable; the schizophrenia group reported similar proximal responsivity, but elevated emotion contagion relative to comparison subjects. These findings bolster support for the presence and functional significance of impaired cognitive empathy in schizophrenia using a contemporary measure of empathy. Emerging evidence that some aspects of affective empathy may be unimpaired or hyper-responsive in schizophrenia and implications for the assessment and treatment of empathy in schizophrenia are discussed.
Collapse
Affiliation(s)
- Tania M Michaels
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - William P Horan
- Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at University of California at Los Angeles, USA; VA Greater Los Angeles Healthcare System, VISN22 MIRECC, USA
| | - Emily J Ginger
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Zoran Martinovich
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Amy E Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA
| | - Matthew J Smith
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Warren Wright Adolescent Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| |
Collapse
|
60
|
Davis MC, Green MF, Lee J, Horan WP, Senturk D, Clarke AD, Marder SR. Oxytocin-augmented social cognitive skills training in schizophrenia. Neuropsychopharmacology 2014; 39:2070-7. [PMID: 24637803 PMCID: PMC4104336 DOI: 10.1038/npp.2014.68] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 02/20/2014] [Accepted: 03/13/2014] [Indexed: 12/12/2022]
Abstract
Impairments in social cognition are common in schizophrenia and predict poor functional outcome. The purpose of this proof-of-concept randomized, parallel group clinical trial was to assess whether intranasal oxytocin (OT), given before social cognitive training, enhances learning of social cognitive skills. Twenty seven male outpatients with schizophrenia participated in a 6-week (12 session) training on social cognitive skills. Training focused on three domains: facial affect recognition, social perception, and empathy. Subjects were randomly assigned (double blind) to receive either intranasal OTor placebo 30 min before each session. Participants did not receive OT between sessions or on the day of assessments. We evaluated scores on social-cognition measures, as well as clinical symptoms and neurocognition, at baseline, 1 week following the final training session, and 1 month later. Our prespecified primary outcome measure was a social-cognition composite score comprised of five individual measures. There were main effects of time (indicating improvement across the combined-treatment groups) on the social-cognition composite score at both 1 week and 1 month following completion of training. Subjects receiving OT demonstrated significantly greater improvements in empathic accuracy than those receiving placebo at both posttreatment and 1 month follow up. There were no OT-related effects for the other social cognitive tests, clinical symptoms, or neurocognition. This study provides initial support for the idea that OT enhances the effectiveness of training when administered shortly before social cognitive training sessions. The effects were most pronounced on empathic accuracy, a high-level social cognitive process that is not easily improved in current social cognitive remediation programs.
Collapse
Affiliation(s)
- Michael C Davis
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA,VA Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA,VA Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
| | - Junghee Lee
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA,VA Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
| | - William P Horan
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA,VA Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
| | - Damla Senturk
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Angelika D Clarke
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA,VA Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
| | - Stephen R Marder
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA,VA Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA,VA Desert Pacific Mental Illness Research, Education, and Clinical Center, 11301 Wilshire Boulevard, Building 210A, Los Angeles, CA 90073, USA, Tel: +310 268 3647, Fax: +310 268 4056, E-mail:
| |
Collapse
|
61
|
Smith MJ, Horan WP, Cobia DJ, Karpouzian TM, Fox JM, Reilly JL, Breiter HC. Performance-based empathy mediates the influence of working memory on social competence in schizophrenia. Schizophr Bull 2014; 40:824-34. [PMID: 23770935 PMCID: PMC4059427 DOI: 10.1093/schbul/sbt084] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Empathic deficits have been linked to poor functioning in schizophrenia, but this work is mostly limited to self-report data. This study examined whether performance-based empathy measures account for incremental variance in social competence and social attainment above and beyond self-reported empathy, neurocognition, and clinical symptoms. Given the importance of working memory in theoretical models of empathy and in the prediction of functioning in schizophrenia, we also examined whether empathy mediates the relationship between working memory and functioning. Sixty outpatients and 45 healthy controls were compared on performance-based measures of 3 key components of empathic responding, including facial affect perception, emotional empathy (affective responsiveness), and cognitive empathy (emotional perspective-taking). Participants also completed measures of self-reported empathy, neurocognition, clinical symptoms, and social competence and attainment. Patients demonstrated lower accuracy than controls across the 3 performance-based empathy measures. Among patients, these measures showed minimal relations to self-reported empathy but significantly correlated with working memory and other neurocognitive functions as well as symptom levels. Furthermore, cognitive empathy explained significant incremental variance in social competence (∆R (2) = .07, P < .05) and was found to mediate the relation between working memory and social competence. Performance-based measures of empathy were sensitive to functionally relevant disturbances in schizophrenia. Working memory deficits appear to have an important effect on these disruptions in empathy. Empathy is emerging as a promising new area for social cognitive research and for novel recovery-oriented treatment development.
Collapse
Affiliation(s)
- Matthew J. Smith
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL;,*To whom correspondence should be addressed; Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 446 E. Ontario, Suite 7-100, Chicago, IL 60611, US; tel: 1-312-503-2542, fax: 1-312-503-0527, e-mail:
| | - William P. Horan
- Department of Psychaitry & Biobehavioral Sciences, Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA;,VA Greater Los Angeles Healthcare System, VISN22 MIRECC, Los Angeles, CA
| | - Derin J. Cobia
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Tatiana M. Karpouzian
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Jaclyn M. Fox
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - James L. Reilly
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Hans C. Breiter
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL;,Warren Wright Adolescent Center, Northwestern University Feinberg School of Medicine, Chicago, IL
| |
Collapse
|
62
|
Abramowitz AC, Ginger EJ, Gollan JK, Smith MJ. Empathy, depressive symptoms, and social functioning among individuals with schizophrenia. Psychiatry Res 2014; 216:325-32. [PMID: 24636245 DOI: 10.1016/j.psychres.2014.02.028] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 02/13/2014] [Accepted: 02/19/2014] [Indexed: 11/16/2022]
Abstract
Empathy deficits have been associated with schizophrenia and depression. We compared whether individuals with schizophrenia with and without co-occurring depressive symptoms differed on self-reported and performance-based measures of empathy and social functioning. We also examined the relationships among depressive symptoms, empathy, clinical symptoms, and social functioning. Twenty-eight individuals with schizophrenia and depressive symptoms, 32 individuals with schizophrenia without depressive symptoms, and 44 control subjects were compared on assessments of depressive symptoms, empathy, global neurocognition, clinical symptoms, and social functioning. Both groups of individuals with schizophrenia scored higher than controls on the Interpersonal Reactivity Index personal distress subscale. Individuals with schizophrenia and co-occurring depressive symptoms scored significantly higher than individuals with schizophrenia without depressive symptoms on the personal distress subscale. Personal distress and depressive symptoms were significantly correlated among individuals with schizophrenia and co-occurring depressive symptoms, while both measures negatively correlated with social functioning. Emotional empathy was related to clinical symptoms in both groups of individuals with schizophrenia. Personal distress partially mediated the relationship between co-occurring depressive symptoms and social functioning. Personal distress may be an important implication for social functioning among individuals with schizophrenia and co-occurring depressive symptoms, and should be examined further as a potential treatment target.
Collapse
Affiliation(s)
- Amy C Abramowitz
- Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, 446 E. Ontario, Suite 7-100, Chicago, IL 60611, USA
| | - Emily J Ginger
- Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, 446 E. Ontario, Suite 7-100, Chicago, IL 60611, USA
| | - Jackie K Gollan
- Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, 446 E. Ontario, Suite 7-100, Chicago, IL 60611, USA
| | - Matthew J Smith
- Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, 446 E. Ontario, Suite 7-100, Chicago, IL 60611, USA.
| |
Collapse
|
63
|
Shin YS, Kim HY, Han S. Neural correlates of social perception on response bias. Brain Cogn 2014; 88:55-64. [PMID: 24859091 DOI: 10.1016/j.bandc.2014.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 03/24/2014] [Accepted: 04/27/2014] [Indexed: 11/28/2022]
Abstract
Accurate person perception is crucial in social decision-making. One of the central elements in successful social perception is the ability to understand another's response bias; this is because the same behavior can represent different inner states depending on whether other people are yea-sayers or naysayers. In the present study, we have tried to investigate how the internal biases of others are perceived. Using a multi-trial learning paradigm, perceivers made predictions about a target's responses to various suggested activities and then received feedback for each prediction trial-by-trial. Our hypotheses were that (1) the internal decision criterion of the targets would be realized through repeated experiences, and (2) due to positive-negative asymmetry, yea-sayers would be recognized more gradually than naysayers through the probabilistic integration of repeated experiences. To find neural evidence that tracks probabilistic integration when forming person knowledge on response biases, we employed a model-based fMRI with a State-Space Model. We discovered that person knowledge about yea-sayers modulated several brain regions, including caudate nucleus, DLPFC, hippocampus, etc. Moreover, when person knowledge was updated with incorrect performance feedback, brain regions including the caudate nucleus, DLPFC, dmPFC, and TPJ were also involved. There were overlapping regions for both processes, caudate nucleus and DLPFC, suggesting that these regions take crucial roles in forming person knowledge with repeated feedback, while reflecting acquired information up to the current prediction.
Collapse
Affiliation(s)
- Yeon Soon Shin
- Department of Psychology, Yonsei University, Seoul 120-749, Republic of Korea.
| | - Hye-Young Kim
- Department of Psychology, Yonsei University, Seoul 120-749, Republic of Korea.
| | - Sanghoon Han
- Department of Psychology, Yonsei University, Seoul 120-749, Republic of Korea.
| |
Collapse
|
64
|
Weinstein L, Perez-Rodriguez MM, Siever L. Personality disorders, attachment and psychodynamic psychotherapy. Psychopathology 2014; 47:425-36. [PMID: 25376756 DOI: 10.1159/000366135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 07/24/2014] [Indexed: 01/10/2023]
Abstract
While attachment has been a fruitful and critical concept in understanding enduring individual templates for interpersonal relationships, it does not have a well-understood relationship to personality disorders, where impairment of interpersonal functioning is paramount. Despite the recognition that attachment disturbances do not simply reflect nonoptimal caretaking environments, the relationship of underlying temperamental factors to these environmental insults has not been fully explored. In this paper we provide an alternate model for the role of neurobiological temperamental factors, including brain circuitry and neuropeptide modulation, in mediating social cognition and the internalization and maintenance of attachment patterns. The implications of these altered attachment patterns on personality disorders and their neurobiological and environmental roots for psychoanalytically based treatment models designed to ameliorate difficulties in interpersonal functioning through the medium of increased access to mature forms of mentalization is discussed.
Collapse
Affiliation(s)
- Lissa Weinstein
- Doctoral Program in Clinical Psychology, City College of New York and Graduate Center, New York, N.Y., USA
| | | | | |
Collapse
|
65
|
Ripoll LH, Zaki J, Perez-Rodriguez MM, Snyder R, Strike KS, Boussi A, Bartz JA, Ochsner KN, Siever LJ, New AS. Empathic accuracy and cognition in schizotypal personality disorder. Psychiatry Res 2013; 210:232-41. [PMID: 23810511 DOI: 10.1016/j.psychres.2013.05.025] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 05/14/2013] [Accepted: 05/19/2013] [Indexed: 01/10/2023]
Abstract
Interpersonal dysfunction contributes to significant disability in the schizophrenia spectrum. Schizotypal Personality Disorder (SPD) is a schizophrenia-related personality demonstrating social cognitive impairment in the absence of frank psychosis. Past research indicates that cognitive dysfunction or schizotypy may account for social cognitive dysfunction in this population. We tested SPD subjects and healthy controls on the Empathic Accuracy (EA) paradigm and the Reading of the Mind in the Eyes Test (RMET), assessing the impact of EA on social support. We also explored whether EA differences could be explained by intelligence, working memory, trait empathy, or attachment avoidance. SPD subjects did not differ from controls in RMET, but demonstrated lower EA during negative valence videos, associated with lower social support. Dynamic, multimodal EA paradigms may be more effective at capturing interpersonal dysfunction than static image tasks such as RMET. Schizotypal severity, trait empathy, and cognitive dysfunction did not account for empathic dysfunction in SPD, although attachment avoidance is related to empathic differences. Empathic dysfunction for negative affect contributes to decreased social support in the schizophrenia spectrum. Future research may shed further light on potential links between attachment avoidance, empathic dysfunction, and social support.
Collapse
Affiliation(s)
- Luis H Ripoll
- Mount Sinai School of Medicine, Department of Psychiatry, One Gustave L. Levy Place, Box 1230, NY 10029, United States; James J. Peters VA Medical Center, Mental Illness Research Education and Clinical Center (MIRECC), 130 West Kingsbridge Rd., Bronx, NY 10468, United States.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
66
|
Shin DH, Ahn D. Associations Between Game Use and Cognitive Empathy: A Cross-Generational Study. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2013; 16:599-603. [DOI: 10.1089/cyber.2012.0639] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Dong-Hee Shin
- Department of Interaction Science, Sungkyunkwan University, Jongno-gu, Seoul, South Korea
| | - Dohyun Ahn
- Graduate School of Mass Communication, Sogang University, Mapo-gu, Seoul, South Korea
| |
Collapse
|
67
|
Harvey PO, Zaki J, Lee J, Ochsner K, Green MF. Neural substrates of empathic accuracy in people with schizophrenia. Schizophr Bull 2013; 39:617-28. [PMID: 22451493 PMCID: PMC3627780 DOI: 10.1093/schbul/sbs042] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Empathic deficits in schizophrenia may lead to social dysfunction, but previous studies of schizophrenia have not modeled empathy through paradigms that (1) present participants with naturalistic social stimuli and (2) link brain activity to "accuracy" about inferring other's emotional states. This study addressed this gap by investigating the neural correlates of empathic accuracy (EA) in schizophrenia. METHODS Fifteen schizophrenia patients and 15 controls were scanned while continuously rating the affective state of another person shown in a series of videos (ie, targets). These ratings were compared with targets' own self-rated affect, and EA was defined as the correlation between participants' ratings and targets' self-ratings. Targets' self-reported emotional expressivity also was measured. We searched for brain regions whose activity tracked parametrically with (1) perceivers' EA and (2) targets' expressivity. RESULTS Patients showed reduced EA compared with controls. The left precuneus, left middle frontal gyrus, and bilateral thalamus were significantly more correlated with EA in controls compared with patients. High expressivity in targets was associated with better EA in controls but not in patients. High expressivity was associated with increased brain activity in a large set of regions in controls (eg, fusiform gyrus, medial prefrontal cortex) but not in patients. DISCUSSION These results use a naturalistic performance measure to confirm that schizophrenic patients demonstrate impaired ability to understand others' internal states. They provide novel evidence about a potential mechanism for this impairment: schizophrenic patients failed to capitalize on targets' emotional expressivity and also demonstrate reduced neural sensitivity to targets' affective cues.
Collapse
Affiliation(s)
- Philippe-Olivier Harvey
- Douglas Mental Health University Institute, 6875 LaSalle Boulevard, Montréal, Québec H4H 1R3, Canada.
| | - Jamil Zaki
- Department of Psychology, Harvard University, Cambridge, MA
| | - Junghee Lee
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA,VA Greater Los Angeles, Healthcare Center System, Los Angeles, CA
| | - Kevin Ochsner
- Department of Psychology, Columbia University, New York, NY
| | - Michael F. Green
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA,VA Greater Los Angeles, Healthcare Center System, Los Angeles, CA
| |
Collapse
|
68
|
Kafetsios K, Hess U. Effects of Activated and Dispositional Self-Construal on Emotion Decoding Accuracy. JOURNAL OF NONVERBAL BEHAVIOR 2013. [DOI: 10.1007/s10919-013-0149-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
69
|
Ochsner KN, Silvers JA, Buhle JT. Functional imaging studies of emotion regulation: a synthetic review and evolving model of the cognitive control of emotion. Ann N Y Acad Sci 2012; 1251:E1-24. [PMID: 23025352 DOI: 10.1111/j.1749-6632.2012.06751.x] [Citation(s) in RCA: 1180] [Impact Index Per Article: 98.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This paper reviews and synthesizes functional imaging research that over the past decade has begun to offer new insights into the brain mechanisms underlying emotion regulation. Toward that end, the first section of the paper outlines a model of the processes and neural systems involved in emotion generation and regulation. The second section surveys recent research supporting and elaborating the model, focusing primarily on studies of the most commonly investigated strategy, which is known as reappraisal. At its core, the model specifies how prefrontal and cingulate control systems modulate activity in perceptual, semantic, and affect systems as a function of one's regulatory goals, tactics, and the nature of the stimuli and emotions being regulated. This section also shows how the model can be generalized to understand the brain mechanisms underlying other emotion regulation strategies as well as a range of other allied phenomena. The third and last section considers directions for future research, including how basic models of emotion regulation can be translated to understand changes in emotion across the life span and in clinical disorders.
Collapse
Affiliation(s)
- Kevin N Ochsner
- Department of Psychology, Columbia University, New York, New York 10027, USA.
| | | | | |
Collapse
|
70
|
Zaki J, Davis JI, Ochsner KN. Overlapping activity in anterior insula during interoception and emotional experience. Neuroimage 2012; 62:493-9. [PMID: 22587900 PMCID: PMC6558972 DOI: 10.1016/j.neuroimage.2012.05.012] [Citation(s) in RCA: 300] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2012] [Revised: 04/27/2012] [Accepted: 05/05/2012] [Indexed: 01/10/2023] Open
Abstract
Classic theories of emotion posit that awareness of one's internal bodily states (interoception) is a key component of emotional experience. This view has been indirectly supported by data demonstrating similar patterns of brain activity - most importantly, in the anterior insula - during both interoception and emotion elicitation. However, no study has directly compared these two phenomena within participants, leaving it unclear whether interoception and emotional experience truly share the same functional neural architecture. The current study addressed this gap in knowledge by examining the neural convergence of these two phenomena within the same population. In one task, participants monitored their own heartbeat; in another task they watched emotional video clips and rated their own emotional responses to the videos. Consistent with prior research, heartbeat monitoring engaged a circumscribed area spanning insular cortex and adjacent inferior frontal operculum. Critically, this interoception-related cluster also was engaged when participants rated their own emotion, and activity here correlated with the trial-by-trial intensity of participants' emotional experience. These findings held across both group-level and individual participant-level approaches to localizing interoceptive cortex. Together, these data further clarify the functional role of the anterior insula and provide novel insights about the connection between bodily awareness and emotion.
Collapse
Affiliation(s)
- Jamil Zaki
- Department of Psychology, Harvard University Cambridge, MA 02138, USA.
| | | | | |
Collapse
|
71
|
Accuracy of Inferring Self- and Other-Preferences from Spontaneous Facial Expressions. JOURNAL OF NONVERBAL BEHAVIOR 2012. [DOI: 10.1007/s10919-012-0137-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
72
|
Abstract
The last decade has witnessed enormous growth in the neuroscience of empathy. Here, we survey research in this domain with an eye toward evaluating its strengths and weaknesses. First, we take stock of the notable progress made by early research in characterizing the neural systems supporting two empathic sub-processes: sharing others' internal states and explicitly considering those states. Second, we describe methodological and conceptual pitfalls into which this work has sometimes fallen, which can limit its validity. These include the use of relatively artificial stimuli that differ qualitatively from the social cues people typically encounter and a lack of focus on the relationship between brain activity and social behavior. Finally, we describe current research trends that are overcoming these pitfalls through simple but important adjustments in focus, and the future promise of empathy research if these trends continue and expand.
Collapse
|
73
|
Ronay R, Carney DR. Testosterone’s Negative Relationship With Empathic Accuracy and Perceived Leadership Ability. SOCIAL PSYCHOLOGICAL AND PERSONALITY SCIENCE 2012. [DOI: 10.1177/1948550612442395] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
74
|
Spunt RP, Lieberman MD. An integrative model of the neural systems supporting the comprehension of observed emotional behavior. Neuroimage 2012; 59:3050-9. [PMID: 22019857 DOI: 10.1016/j.neuroimage.2011.10.005] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Revised: 09/07/2011] [Accepted: 10/04/2011] [Indexed: 10/16/2022] Open
|