Empathy and emotion regulation: An integrative account

Understanding empathy deficits and emotion dysregulation in psychopathy: The mediating role of alexithymia

Psychopathy is a severe personality disorder marked by a wide range of emotional deficits, including a lack of empathy, emotion dysregulation, and alexithymia. Previous research has largely examined these emotional impairments in isolation, ignoring their influence on each other. Thus, we examined the concurrent interrelationship between emotional impairments in psychopathy, with a particular focus on the mediating role of alexithymia. Using path analyses with cross-sectional data from a community sample (N = 315) and a forensic sample (N = 50), our results yielded a statistically significant mediating effect of alexithymia on the relationship between psychopathy and empathy (community and forensic) and between psychopathy and emotion dysregulation (community). Moreover, replacing psychopathy with its three dimensions (i.e., meanness, disinhibition, and boldness) in the community sample revealed that boldness may function as an adaptive trait, with lower levels of alexithymia counteracting deficits in empathy and emotion dysregulation. Overall, our findings indicate that psychopathic individuals' limited understanding of their own emotions contributes to their lack of empathy and emotion dysregulation. This underscores the potential benefits of improving emotional awareness in the treatment of individuals with psychopathy.

CAEVR: Biosignals-Driven Context-Aware Empathy in Virtual Reality

There is little research on how Virtual Reality (VR) applications can identify and respond meaningfully to users' emotional changes. In this paper, we investigate the impact of Context-Aware Empathic VR (CAEVR) on the emotional and cognitive aspects of user experience in VR. We developed a real-time emotion prediction model using electroencephalography (EEG), electrodermal activity (EDA), and heart rate variability (HRV) and used this in personalized and generalized models for emotion recognition. We then explored the application of this model in a context-aware empathic (CAE) virtual agent and an emotion-adaptive (EA) VR environment. We found a significant increase in positive emotions, cognitive load, and empathy toward the CAE agent, suggesting the potential of CAEVR environments to refine user-agent interactions. We identify lessons learned from this study and directions for future work.

A neural signature of social support mitigates negative emotion

Social support can mitigate the impact of distressing events. Such stress buffering elicits activity in many brain regions, but it remains unclear (1) whether this activity constitutes a stable brain signature, and (2) whether brain activity can predict buffering across people. Here, we developed a neural signature that predicted social buffering of negative emotion in response to real life stressors. During neuroimaging, participants (n = 95) responded to stressful autobiographical memories either naturally, or by imagining a conversation with a peer. Using supervised dimensionality reduction and machine learning techniques, we identified a spatio-temporal neural signature that distinguished between these two trials. Activation of this signature was associated with less negative affect across trials, and people who most activated the signature reported more supportive social connections and lower loneliness outside the lab. Together, this work provides a behaviorally relevant neurophysiological marker for social support that underlies stress buffering.

Cognitive reappraisal and empathy chain-mediate the association between relative deprivation and prosocial behavior in adolescents

Background

Relative deprivation is one of the factors that influences the development of personality and behavior. However, it is still unclear whether and how relative deprivation decreases the prosocial behavior in adolescents. This study aimed to examine the association between relative deprivation and adolescent prosocial behavior and the role of emotion regulation strategies and empathy in modifying this association.

Methods

The present study included 609 secondary school students (M = 15.42 years, SD = 0.653) in Fujian Province, China. All participants completed the Relative Deprivation Questionnaire, Emotion Regulation Scale, the Basic Empathy Scale, and Prosocial Behavior Scale. The collected data were analyzed using SPSS 25.0 and Mplus 7.4.

Results

Relative deprivation was negatively correlated with cognitive reappraisal, but positively correlated with expressive suppression. Cognitive reappraisal was positively correlated with empathy and prosocial behavior, but expressive suppression was not. Empathy was positively correlated with prosocial behavior. Relative deprivation decreased prosocial behavior through (a) cognitive reappraisal, (b) empathy, and (c) chain mediation of cognitive reappraisal and empathy. No significant mediating effect of expressive suppression was found.

Conclusion

The results indicate that relative deprivation decreases adolescent prosocial behavior, and that cognitive reappraisal and empathy are the potential psychological mechanisms that affect the association between relative deprivation and adolescent prosocial behavior.

Emotion regulation and reactivity are associated with cortical thickness in early to mid-childhood

This study explored the neural correlates of emotion regulation and emotional reactivity in early to mid-childhood. A sample of 96 children (70% White, mid-to-high socioeconomic status) aged 3-8 years provided structural neuroimaging data and caregivers reported on emotion regulation and emotional reactivity. The amygdala, insula, inferior frontal gyrus, anterior cingulate cortex, and medial orbitofrontal cortex were explored as a priori regions of interest (ROIs). ROI analyses revealed that emotion regulation was positively associated with cortical thickness in the insula, whereas emotional reactivity was negatively associated with cortical thickness in the inferior frontal gyrus. Exploratory whole-brain analyses suggested positive associations between emotion regulation and both left superior temporal thickness and right inferior temporal thickness, as well as negative associations between emotional reactivity and left superior temporal thickness. There were no significant associations between emotional regulation or reactivity and amygdala volume or cortical surface area. These findings support the notion that surface area and cortical thickness are distinct measures of brain maturation. In sum, these findings suggest that children may rely on a wider set of neural regions for emotion regulation and reactivity than adults, which is consistent with theories of interactive specialization across the life span.

Working nurses' empathy with patients in public hospitals

OBJECTIVE

to determine the levels of empathy in professional nurses of a high-complexity hospital, to relate age to empathy (and each one of its dimensions), and to establish if there are differences between these levels according to the type of working schedules.

METHOD

comparative, correlational and cross-sectional design. The sample used (n=271) constituted 40.9% of the total number of nursing professionals. Psychometric properties of the Jefferson Scale of Empathy for Health Professionals were studied. Descriptive statistics were calculated: mean and standard deviation. The association between empathy and age was estimated using regression equations and statistical significance of the regression coefficients, after evaluating the type of curve using variance analysis.

RESULTS

the underlying model of three dimensions of empathy was identified. The values of the descriptive statistics observed were relatively low in empathy and its dimensions. Empathy levels were not associated with the age range. No differences in empathy were found between the types of work schedules. Variability was found in the dimensions: "compassionate care" and "Walking on the patient's shoes".

CONCLUSION

these results show that the levels of empathy observed may imply a deficient performance in empathetic care for patients. (1) The levels of empathy are low in the nursing professionals studied. (2) These levels are not associated with age and type of work performed. (3) Low levels of empathy could imply a negative alteration of humanized attention.

Multifaceted Empathy Test (MET): Validity evidence for the Brazilian population concerning the computer-based (face-to-face) and online versions

BACKGROUND

The lack of empathy is associated with several psychological and behavioral disorders, and it is important to assess this construct broadly, through multi-methods.

OBJECTIVE

To conduct a psychometric analysis of the Brazilian version of the Multifaceted Empathy Test (MET), a computerized task that assesses emotional and cognitive empathy.

METHODS

The samples were recruited from the community using the snowball method (phase 1: face-to-face; N = 142) and through social media (phase 2: online; N = 519). The participants completed the MET and the Interpersonal Reactivity Index (IRI) to assess the convergent validity between the instruments. To assess validity with correlated constructs (resilient coping and stress), the Brief Resilient Coping Scale and Perceived Stress Scale were used. A task was also implemented in the face-to-face application to assess facial emotions. The retest was applied 25 days later to a portion of the sample (face-to-face: N = 31; online: N = 102).

RESULTS

It was observed adequate test-retest reliability for most items (ICC = 0.49-0.98), satisfactory infit and outfit indexes, discriminatory ability between sexes, weak convergent validity with empathy measures (r = 0.17-0.36), and correlate constructs (r = 0.12-0.46). MET presented good psychometric indicators, confirming its use in face-to-face/computer-based and online formats in clinical and research contexts. However, weaknesses were found regarding the cognitive subscale, demanding future studies to address larger samples to enable more robust conclusions concerning its adequacy. Further research on the instrument's internal structure can also contribute to its improvement.

Do Bad People Deserve Empathy? Selective Empathy Based on Targets' Moral Characteristics

The relation between empathy and morality is a widely discussed topic. However, previous discussions mainly focused on whether and how empathy influences moral cognition and moral behaviors, with limited attention to the reverse influence of morality on empathy. This review summarized how morality influences empathy by drawing together a number of hitherto scattered studies illustrating the influence of targets' moral characteristics on empathy. To explain why empathy is morally selective, we discuss its ultimate cause, to increase survival rates, and five proximate causes based on similarity, affective bonds, the appraisal of deservingness, dehumanization, and potential group membership. To explain how empathy becomes morally selective, we consider three different pathways (automatic, regulative, and mixed) based on previous findings. Finally, we discuss future directions, including the reverse influence of selective empathy on moral cognition, the moral selectivity of positive empathy, and the role of selective empathy in selective helping and third-party punishment.

Empathic disequilibrium as a new framework for understanding individual differences in psychopathology

Introduction

Empathy is part of basic social cognition and is central to everyday interactions. Indeed, emotional and cognitive empathy deficits are related to various psychopathologies, yet the links reported have been inconsistent. Thus, the mechanism underlying these inconsistent links is poorly understood. At least a partial answer may lie in that the dependency between cognitive and emotional empathy has been overlooked. Here, we examined the (dis)equilibrium between emotional and cognitive empathy and how it relates to individual differences in clinical traits. We further examined a possible mediator of these links-emotional reactivity.

Methods

Participants (N = 425) from the general population reported on their empathy, emotional reactivity, autistic traits, psychopathic tendencies, and symptoms of depression and anxiety.

Results

Beyond empathy, both extremes of empathic disequilibrium were associated with various features of clinical conditions; Higher emotional relative to cognitive empathy was related to the social domain of autism and anxiety, while higher cognitive relative to emotional empathy was related to the non-social domain of autism, depression symptoms, and psychopathic tendencies. The associations with autistic traits, anxiety, and psychopathic tendencies were mediated by emotional reactivity.

Discussion

Our findings suggest a new framework for understanding how individual variability in empathy is expressed in various psychopathologies.

Four attachment-based categories of emotion regulation in adolescent psychic troubles

Introduction

Emotion regulation is altered in many psychiatric disorders in adolescence, but the understanding of mechanisms that underlie this alteration is still poor.

Methods

The PERCEPT study explores alexithymia, empathy, facial emotion recognition (FER) and defence mechanisms in a sample of adolescents in psychiatric care (n = 61, 74% of girls, mean age = 15.03 y.o.), in relation with participants' attachment styles.

Results

Results revealed correlations between attachment dimensions and all of the emotion regulation variables, suggesting that attachment modalities have functional links with emotional regulation at its different levels: FER accuracy was inversely correlated with avoidant attachment, while affective empathy, difficulty in identifying feelings (alexithymia) and immature as well as neurotic defence mechanisms were positively correlated with anxious attachment. Moreover, attachment categories delineated distinct emotional perception profiles. In particular, preoccupied attachment included adolescents with the highest levels of facial emotion perception (sensitivity and accuracy) and of affective empathy, whereas detached attachment included adolescents with the lowest levels of these variables. Neurotic defence mechanisms and difficulty to identify feelings were correlated with preoccupied attachment; immature defence mechanisms and difficulty to describe feelings to others characterized fearful attachment.

Discussion

These results suggest that attachment categories underlie emotion regulation processes in psychiatric disorders in adolescence. Theoretical and clinical implications are discussed.

Emotion regulation in bipolar disorder type-I: multivariate analysis of fMRI data

BACKGROUND

Bipolar disorder type-I (BD-I) patients are known to show emotion regulation abnormalities. In a previous fMRI study using an explicit emotion regulation paradigm, we compared responses from 19 BD-I patients and 17 matched healthy controls (HC). A standard general linear model-based univariate analysis revealed that BD patients showed increased activations in inferior frontal gyrus when instructed to decrease their emotional response as elicited by neutral images. We implemented multivariate pattern recognition analyses on the same data to examine if we could classify conditions within-group as well as HC versus BD.

METHODS

We reanalyzed explicit emotion regulation data using a multivariate pattern recognition approach, as implemented in PRONTO software. The original experimental paradigm consisted of a full 2 × 2 factorial design, with valence (Negative/Neutral) and instruction (Look/Decrease) as within subject factors.

RESULTS

The multivariate models were able to accurately classify different task conditions when HC and BD were analyzed separately (63.24%-75.00%, p = 0.001-0.012). In addition, the models were able to correctly classify HC versus BD with significant accuracy in conditions where subjects were instructed to downregulate their felt emotion (59.60%-60.84%, p = 0.014-0.018). The results for HC versus BD classification demonstrated contributions from the salience network, several occipital and frontal regions, inferior parietal lobes, as well as other cortical regions, to achieve above-chance classifications.

CONCLUSIONS

Our multivariate analysis successfully reproduced some of the main results obtained in the previous univariate analysis, confirming that these findings are not dependent on the analysis approach. In particular, both types of analyses suggest that there is a significant difference of neural patterns between conditions within each subject group. The multivariate approach also revealed that reappraisal conditions provide the most informative activity for differentiating HC versus BD, irrespective of emotional valence (negative or neutral). The current results illustrate the importance of investigating the cognitive control of emotion in BD. We also propose a set of candidate regions for further study of emotional control in BD.

The role of empathy in shared intentionality: Contributions from Inter-Processual Self theory

Research in psychology related to the conceptualization of empathy has been on the rise in the last decades. However, we argue that there is still space for further research to help capture the important notion of empathy and its theoretical and conceptual depth. Following a critical review of the current state of the research that conceptualizes and measures empathy, we focus on works that highlight the importance of a shared vision and its relevance in psychology and neuroscience. Considering the state of the art of current neuroscientific and psychological approaches to empathy, we argue for the relevance of shared intention and shared vision in empathy-related actions. Upon review of different models that emphasize a shared vision for informing research on empathy, we suggest that a newly developed theory of self, human growth and action–the so-called Inter-Processual Self theory (IPS)–can significantly and novelly inform the theorization on empathy beyond what the literature has stated to date. Then, we show how an understanding of integrity as a relational act that requires empathy is an essential mechanism for current key research on empathy and its related concepts and models. Ultimately, we aim to present IPS as a distinctive proposal to expand upon the conceptualization of empathy.

Cognitive flexibility as a protective factor for empathy

Although cognitive flexibility has always been considered essential to empathy, the relevant findings have been inconsistent. Inconsistent results may be because cognitive flexibility is a multi-level structure, while empathy is also a multilayer structure, and there are differences in how researchers define and measure cognitive flexibility. Therefore, the study explores the relationship between cognitive flexibility and empathy from a multi-dimensional perspective. This study involved 105 China students aged between 18 and 22 (M age = 20.26, SD = 2.00) who completed the Cognitive Flexibility Scale (cognitive flexibility trait, cognitive flexibility at the individual level), perspective-switching flexibility task (perspective-switching flexibility, cognitive flexibility at the cognitive level), the Interpersonal Reactivity Index scale (IRI, traits empathy), Multi-dimensional Empathy Test (state empathy), 2-back task (inhibitory control), and Stroop task (working memory). After controlling for additional variables, the results showed that: (1) Cognitive flexibility traits negatively predicted trait cognitive (IRI-PT) and affective empathy (IRI-EC). (2) The Other/Self perspective-switching flexibility negatively predicted the affective component of state empathy. (3) Cognitive flexibility traits and Other/Self perspective-switching flexibility negatively predicted empathy even after controlling for one of these. The study's results suggested that cognitive flexibility negatively predicts empathy and is a protective factor for reducing the cost of empathy and promoting emotion regulation.

Physiological and neural synchrony in emotional and neutral stimulus processing: A study protocol

Background

As psychotherapy involves at least two individuals, it is essential to include the interaction perspective research. During interaction, synchrony, i.e., the occurrence of simultaneous responses, can be observed at the physiological, neural, and behavioral level. Physiological responses include heart rate and electrodermal activity; neural markers can be measured using electroencephalogram. Emotionally arousing stimuli are allocated more attentional resources (motivated attention), which is reflected in physiological activation and brain potentials. Here we present a protocol for a pilot study implementing a new research methodology, and replication of the motivated attention to emotion effect in in dyads. There is evidence that higher synchrony is associated with more positive (therapeutic) relationships. Thus, the secondary outcome will be the association between physiological and neural synchrony and subjective ratings.

Methods and design

Individuals (18-30 years) will participate in same-sex pairs in two experiments. In the first experiment (triadic interaction), both participants attentively watch unpleasant, neutral and pleasant pictures, and read/listen to standardized scripts (unpleasant, neutral, and pleasant, respectively) for the imagination task. In the second experiment, participants will read out three scripts (unpleasant, neutral, pleasant) to each other, followed by a joint imagination period. Stimuli will be presented in counterbalanced orders. After each picture and imagination, participants rate their subjective arousal and valence. In the beginning and in the end of the procedure, dyads rate their relationship, sympathy, and bonds (Working Alliance Inventory subscale). Heart rate, electrodermal activity and electroencephalogram will be continuously measured during both experiments using portable devices (EcgMove4 and EdaMove4, nine-channel B-Alert X-Series mobile-wireless EEG). Synchrony analyses will include the dual electroencephalography analysis pipeline, correlational analyses and Actor-Partner Interdependence Models.

Discussion

The present study protocol provides an experimental approach to investigate interpersonal synchrony during emotion processing, allowing for the establishment of research methods in a pilot study, which can later be translated into real-life psychotherapy research. In the future, fundamental understanding of such mechanisms in dyadic interactions is essential in order to promote therapeutic relationships, and thus, treatment effectiveness and efficiency.

Eliciting empathetic drives to prosocial behavior during stressful events

In the current pandemic situation, psychological science is increasingly considered by public health policy. Empathy is mainly recognized as a crucial drive for prosocial behavior. However, this rich body of evidence still lacks visibility and implementation. Effective social programs are needed, and little is known about how to elicit empathetic drives. The paper gives first a clear foundation to the role of empathy during stressful events. It provides then a comprehensive overview of innovative interventions triggering empathic response in the public such as fiction, film, and theater. Moreover, it integrates interactive ways of sharing personal views that could elicit empathetic feelings in different people. Advances deriving from this perspective could be of significant public interest in the current and future health crises and help authorities develop innovative social programs, which should be the focus of further scientific inquiry.

Emotion regulation and delusion-proneness relate to empathetic tendencies in a transdiagnostic sample

Empathetic tendencies (i.e., perspective taking and empathic concern) are a key factor in interpersonal relationships, which may be impacted by emotion regulation (i.e., reappraisal and suppression) and mental health symptoms, such as psychotic-like experiences. However, it is unclear if certain psychotic-like experiences, such as delusion-proneness, are still associated with reduced empathetic tendencies after accounting for emotion regulation style and dimensions of psychopathology that are often comorbid. In the current study, linear models tested these associations in a transdiagnostic community sample (N = 128), using the Interpersonal Reactivity Index (IRI), Emotion Regulation Questionnaire, and the Peter's Delusion Inventory. Results indicated that perspective taking was positively associated with reappraisal and negatively associated with delusion-proneness, after controlling for age, sex, race, intelligence, and symptoms of anxiety and depression. A significant change in R 2 supported the addition of delusion-proneness in this model. Specificity analyses demonstrated perspective taking was also negatively associated with suppression, but this relationship did not remain after accounting for the effects of reappraisal and delusion-proneness. Additional specificity analyses found no association between empathic concern and reappraisal or delusion-proneness but replicated previous findings that empathic concern was negatively associated with suppression. Taken together, delusion-proneness accounts for unique variance in perspective taking, which can inform future experimental research and may have important implications for psychosocial interventions.

The association between attachment orientations and empathy: The mediation effect of self-concept clarity

Although earlier research had demonstrated significant links between attachment and self-concept clarity; attachment and empathy; and self-concept clarity and empathy respectively, there had been no studies examining these associations in conjunction with one another. Therefore, the present studies explored whether individual differences in self-concept clarity would mediate the relationship between attachment orientation (i.e., attachment anxiety and attachment avoidance) and empathy (i.e., empathic concern and personal distress). In Study 1, the association between attachment orientation and self-concept clarity was examined among 602 Hungarian university students. In Study 2, the relationship between attachment and empathy was investigated through self-concept clarity among 1000 Hungarian adults. The findings from both samples revealed that attachment avoidance and anxiety were negatively related to self-concept clarity. In Study 2, individuals with greater self-concept clarity showed greater empathic concern and lower personal distress. Attachment avoidance was associated with lower empathic concern, whereas there was no significant association with personal distress. Attachment anxiety was positively related to empathic concern and personal distress. Self-concept clarity partially mediated associations with attachment anxiety and aspects of empathy. These findings suggest the importance of attachment orientations in terms of their influence on the self with regard to interpersonal relations.

An integrative review of negative emotions of older adults in later life

BACKGROUND

Older adults are one of the most vulnerable populations requiring scientific, psychological, and clinical attention. Although several studies have explored psychoemotional needs in later life, one critical gap in the literature is a shortage of studies comprehensively reviewing negative emotional experiences and their antecedents associated with later life.

AIM

This integrative review aims to identify negative emotional experiences during older adult years.

METHODS

This review of articles from Medline, CINAHL, Science Direct, Web of Science, ProQuest, and Taylor and Francis synthesized negative emotional experiences during older adult years. Across these six electronic databases, we searched and identified 17 relevant articles from 2005 to 2020 containing quantitative, qualitative, and mixed-method studies.

RESULTS

Based on the review, we identified five negative emotions (sadness, anxiety, frustration, anger, and loneliness). These negative emotions were rooted in marital problems, separation from families, medical problems, physical functioning and disability, and financial limitations. Additionally, we identified common antecedents of negative emotions.

CONCLUSION

At the center of numerous interventions, older adults are reinvigorated to understand the antecedents of negative emotions. The complex array of emotions, specifically regrets and frustration in later life, is depicted by more negativity than positivity. Such array of emotions could help develop strategies to prevent the causes of regret and frustration that nurses see when working with older adults in a clinical practice setting.

The "Ifs" and "Hows" of the Role of Music on the Implementation of Emotional Regulation Strategies

Music is believed to aid the implementation of emotion regulation strategies like distraction or reappraisal, but empirical studies have shown null results. However, the moderating role of one’s relation with music (musical sophistication) and/or executive functioning skills has not been considered yet. In addition, little is known about how music acts. In the present study, we induced anger in a group of participants characterized by musical sophistication and executive functioning. We asked them to regulate their emotional state and measured regulation efficacy. Participants were split into four groups, defined by regulation strategy (distraction vs. reappraisal) and music (with vs. without). Results indicated music effects in higher, but not in lower musical sophistication participants. In the former, music benefitted from reappraisal but was an impaired distraction. Two different executive functions—working memory and affective flexibility—had opposite effects: higher, but not lower working memory participants benefited from music; lower, but not higher, effective flexibility participants took advantage of music. Reports of subjective experience suggested that music favors more empathic reappraisals, and that these may be more long-lasting. Our findings support the idea that music effects depend on listeners’ characteristics, and they raise new hypotheses concerning the specificity of emotional regulation aided by music.

Trait Empathy Modulates Patterns of Personal and Social Emotions During the COVID-19 Pandemic

The COVID-19 pandemic has caused profound consequences on people's personal and social feelings worldwide. However, little is known about whether individual differences in empathy, a prosocial trait, may affect the emotional feelings under such threat. To address this, we measured 345 Chinese participants' personal emotions (e.g., active, nervous), social emotions (i.e., fearful and empathetic feelings about various social groups), and their empathy traits during the COVID-19 pandemic. Using the representational similarity analysis (RSA), we calculated the pattern similarity of personal emotions and found the similarity between the positive and negative emotions was less in the high vs. low empathy groups. In addition, people with high (vs. low) empathy traits were more likely to have fearful and sympathetic feelings about the disease-related people (i.e., depression patients, suspected COVID-19 patients, COVID-19 patients, flu patients, SARS patients, AIDS patients, schizophrenic patients) and showed more pattern dissimilarity in the two social feelings toward the disease-related people. These findings suggest a prominent role of trait empathy in modulating emotions across different domains, strengthening the polarization of personal emotions as well as enlarging social feelings toward a set of stigmatized groups when facing a pandemic threat.

Mediating role of emotion regulation in the relationship between schizotypy and empathy

Schizotypy is a set of personality traits existing in the general population that represents vulnerability for developing psychosis. Previous studies have suggested that negative schizotypy correlates with empathy, but mixed results have been shown for positive schizotypy. The present study aimed to explore the potential mediating role of emotion regulation upon schizotypy and empathy. The valid sample consisted of 595 college students who completed the Interpersonal Reactivity Index, the Emotion Regulation Questionnaire, and the Chapman Psychosis Proneness Scales. Pearson correlations between schizotypy, emotion regulation, and empathy were performed to build potential mediating models. Structural equation modeling and bootstrap analyses were used to examine the mediation effects of emotion regulation. Our results showed that negative schizotypy was correlated with both cognitive and affective empathy whereas positive schizotypy only correlated with the Fantasy and Personal Distress subscales after multiple comparisons corrections. The Cognitive Reappraisal subscale of the Emotion Regulation Questionnaire was positively correlated with empathy whereas the Expressive Suppression subscale was negatively associated with affective empathy. More importantly, there was a significant mediating effect of cognitive reappraisal on the relationship between negative schizotypy and cognitive empathy. Our findings suggest that a higher level of negative schizotypy is associated with poorer cognitive and affective empathy, and cognitive reappraisal may mediate the effect of negative schizotypy on cognitive empathy. These findings highlight the optimal usage of cognitive reappraisal in social interactions, and may help to improve empathy, especially for individuals with a high level of negative schizotypy.

Reappraisal and empathic perspective-taking - More alike than meets the eyes

Emotion regulation and empathy represent highly intertwined psychological processes sharing common conceptual ground. Despite the wealth of research in these fields, the joint and distinct functional nature and topological features of these constructs have not yet been investigated using the same experimental approach. This study investigated the common and distinct neural correlates of emotion regulation and empathy using a meta-analytic approach. The regions that were jointly activated were then characterized using meta-analytic connectivity modeling and functional decoding of metadata terms. The results revealed convergent activity within the ventrolateral and dorsomedial prefrontal cortex as well as temporal regions. The functional decoding analysis demonstrated that emotion regulation and empathy were related to highly similar executive and internally oriented processes. This synthesis underlining strong functional and neuronal correspondence between emotion regulation and empathy could (i) facilitate greater integration of these two separate lines of literature, (ii) accelerate progress toward elucidating the neural mechanisms that support social cognition, and (iii) push forward the development of a common theoretical framework for these psychological processes essential to human social interactions.

Application of empathy map on educational actions carried out by nursing professionals

ABSTRACT Objective: to apply an empathy map to assess nursing professionals’ needs, desires, frustrations and aspirations regarding educational actions. Methods: a cross-sectional study, carried out in a hospital institution with 164 nursing professionals, who responded to the empathy map, which clarified their participation in institutional educational actions, which were collected from 2019 to 2020, and analyzed using descriptive statistics. Results: when using the empathy map, educational actions focused on routines predominated, with the sharing of knowledge; promotion of improvements in care; agreement of commitment with proposed actions; insufficient compliance; little incentive to participate; dispersed guidelines among professionals; increased labor demand; and educational activity during the working day. Conclusions: the empathy map, applied as an instrument for assessing the institutional educational process, qualified as appropriate educational actions or opportunities to improve significant learning for professional nursing education.

Cognitive and Affective Empathy Relate Differentially to Emotion Regulation

The constructs of empathy (i.e., understanding and/or sharing another's emotion) and emotion regulation (i.e., the processes by which one manages emotions) have largely been studied in relative isolation of one another. To better understand the interrelationships between their various component processes, this manuscript reports two studies that examined the relationship between empathy and emotion regulation using a combination of self-report and task measures. In study 1 (N = 137), trait cognitive empathy and affective empathy were found to share divergent relationships with self-reported emotion dysregulation. Trait emotion dysregulation was negatively related to cognitive empathy but did not show a significant relationship with affective empathy. In the second study (N = 92), the magnitude of emotion interference effects (i.e., the extent to which inhibitory control was impacted by emotional relative to neutral stimuli) in variants of a Go/NoGo and Stroop task were used as proxy measures of implicit emotion regulation abilities. Trait cognitive and affective empathy were differentially related to both task metrics. Higher affective empathy was associated with increased emotional interference in the Emotional Go/NoGo task; no such relationship was observed for trait cognitive empathy. In the Emotional Stroop task, higher cognitive empathy was associated with reduced emotional interference; no such relationship was observed for affective empathy. Together, these studies demonstrate that greater cognitive empathy was broadly associated with improved emotion regulation abilities, while greater affective empathy was typically associated with increased difficulties with emotion regulation. These findings point to the need for assessing the different components of empathy in psychopathological conditions marked by difficulties in emotion regulation.

Supplementary Information

The online version contains supplementary material available at 10.1007/s42761-021-00062-w.

Relationship between emotional intelligence and job well-being in Chinese clinical nurses: multiple mediating effects of empathy and communication satisfaction

BACKGROUND

Nursing work is associated with great pressure, and nurses are often overwhelmed. Therefore, correct emotional regulation is essential to improve nurses' job well-being and promote better engagement in nursing work. The purpose of this study was to establish a structural model to estimate the impact of Chinese clinical nurses' emotional intelligence on job well-being, using multiple intermediaries to explain the internal mechanisms underlying the relationship.

METHODS

This was a cross-sectional study of 1475 registered nurses from a Chinese hospital who provided responses to emotional intelligence, empathy, communication satisfaction, and job well-being scales. Path analysis using a multiple mediation model was performed using AMOS 23.0.

RESULTS

Among all clinical nurses who participated in the survey, 1475 (98.33 %) completed the questionnaire. The nurses' job well-being score was 83.61 ± 12.63. There was a significant positive correlation between job well-being and communication satisfaction, emotional intelligence, and empathy ability (r = 0.346-0.570, P < 0.001). Empathy and communication satisfaction partially mediated the relationship between emotional intelligence and job well-being, with effect sizes of 0.047 and 0.227, respectively. The chain mediating effect of empathy and communication satisfaction had a value of 0.045.

CONCLUSIONS

It is recommended that hospital managers take actions to improve nurses' emotional intelligence level, and conduct professional psychological training to improve nurses' empathy and communication satisfaction, and ultimately improve their job well-being.

Feeling you, when you feel me: attachment, empathic concern, and interpersonal emotion regulation

Empathic concern is an important part of social relationships. Attachment orientation may explain individual differences in empathic concern. However, the circumstances under which attachment orientation is related to empathic concern remain unexamined. This exploratory study investigated the moderating role of a novel aspect of emotion regulation, interpersonal emotion regulation, in the relationship between attachment orientation and empathic concern. Study 1 (N = 179) and Study 2 (direct replication, N = 202) yielded consistent main effects for emotion regulation. Interpersonal emotion regulation efficacy (people's belief that interpersonal emotion regulation can effectively change their negative and positive emotions) was positively associated with empathic concern. Avoidant attachment showed a moderately consistent negative association with empathic concern. Negative efficacy moderated the association between anxious attachment and empathic concern only in Study 1. The findings focus attention on the importance of interpersonal emotion regulation efficacy to empathic concern and on the complex relationship between attachment and empathic concern.

Development and validation of film stimuli to assess empathy in the work context

A growing body of research suggests that empathy predicts important work outcomes, yet limitations in existing measures to assess empathy have been noted. Extending past work on the assessment of empathy, this study introduces a newly developed set of emotion-eliciting film clips that can be used to assess both cognitive (emotion perception) and affective (emotional congruence and sympathy) facets of empathy in vivo. Using the relived emotions paradigm, film protagonists were instructed to think aloud about an autobiographical, emotional event from working life and relive their emotions while being videotaped. Subsequently, protagonists were asked to provide self-reports of the intensity of their emotions during retelling their event. In a first study with 128 employees, who watched the film clips and rated their own as well as the protagonists’ emotions, we found that the film clips are effective in eliciting moderate levels of emotions as well as sympathy in the test taker and can be used to calculate reliable convergence scores of emotion perception and emotional congruence. Using a selected subset of six film clips, a second two-wave study with 99 employees revealed that all facet-specific measures of empathy had moderate-to-high internal consistencies and test–retest reliabilities, and correlated in expected ways with other self-report and test-based empathy tests, cognition, and demographic variables. With these films, we expand the choice of testing materials for empathy in organizational research to cover a larger array of research questions.

Feeling for the Other With Ease: Prospective Actors Show High Levels of Emotion Recognition and Report Above Average Empathic Concern, but Do Not Experience Strong Distress

Differences in empathic abilities between acting, dance, and psychology students were explored, in addition to the appropriateness of existing empathy measures in the context of these cohorts. Students (N = 176) across Higher Education Institutions in the United Kingdom and Europe were included in the online survey analysis, consisting of the Reading the Mind in the Eyes (RME) test, the Interpersonal Reactivity Index (IRI), the Empathy Quotient (EQ), and the E-drawing test (EDT), each measuring particular facets of empathy. Based on existing evidence and our understanding of the discipline practices, we predicted that acting students would perform the best at identifying people’s emotional expressions but might lack other cognitive or affective empathy skills, particularly those related to emotional reactions. This cohort thus provides an opportunity to evaluate different empathy measures. While actors showed significantly higher RME scores than dancers, the difference between actors and psychologists was marginal. Moreover, actors’ scores did not differ significantly on other empathy measures, such as their concern for others’ emotional wellbeing or fantasy, both measured by IRI subscales. Psychology students scored highest in the IRI perspective taking subscale and the data supported anecdotal evidence that psychologists were more concerned for others’ emotional wellbeing than dancers or actors. Dancers seemed the least concerned with others’ perspectives and emotional states, which we explained through a somatosensory ‘inward’ focus required by their art form. Nevertheless, compared to the general population, our groups reported higher empathic abilities on all IRI subscales except for personal distress. Altogether, our study shows that the RME, the IRI, and the EDT vary in their susceptibility to different facets of empathic abilities in acting, dance, and psychology students whereas the EQ does not. Emotions can be expressed and perceived through language, facial expressions, or behavior. As many empathy tests focus on one type of signal they might miss other strategies. Where empathy tests are applied to individuals that have a predominance to read or respond to others in a particular way, as we showed through these three disciplines, they might not capture these empathic strategies. We thus propose that empathy tests must evolve by means of integrating varied forms of communication.

Emotional and Cognitive Empathy in Caregivers of Persons with Neurodegenerative Disease: Relationships with Caregiver Mental Health

Caregiving for a person with dementia or neurodegenerative disease (PWD) is associated with increased rates of depression and anxiety. As the population ages and dementia prevalence increases worldwide, mental health problems related to dementia caregiving will become an even more pressing public health concern. The present study assessed emotional empathy (physiological, behavioral, and self-reported emotional responses to a film depicting others suffering) and two measures of cognitive empathy (identifying the primary emotion experienced by another person; providing continuous ratings of the valence of another person's changing emotions) in relation to mental health (standard questionnaires) in 78 caregivers of PWDs. Greater emotional empathy (self-reported emotional responses) was associated with worse mental health, even after accounting for known risk factors. Neither measure of cognitive empathy was associated with mental health. A relationship between high levels of emotional empathy and poor mental health in caregivers suggests possible risk indicators and intervention targets.

Emotion regulation of others' positive and negative emotions is related to distinct patterns of heart rate variability and situational empathy

Although emotion regulation has been proposed to be crucial for empathy, investigations on emotion regulation have been primarily limited to intrapersonal processes, leaving the interpersonal processes of self-regulation rather unexplored. Moreover, studies showed that emotion regulation and empathy are related with increased autonomic activation. How emotion regulation and empathy are related at the autonomic level, and more specifically during differently valenced social situations remains an open question. Healthy adults viewed a series of short videos illustrating a target who was expressing positive, negative, or no emotions during a social situation (Positive, Negative, or Neutral Social Scenes). Prior to each video, participants were instructed to reappraise their own emotions (Up-regulation, Down-regulation, or No-regulation). To assess autonomic activation, RR intervals (RRI), high frequency (HF) components of heart rate variability (HRV), and electrodermal activity phasic responses (EDRs) were calculated. Situational empathy was measured through a visual analogue scale. Participants rated how empathic they felt for a specific target. Up- and Down-regulation were related to an increase and a decrease in situational empathy and an increase in RRI and HF, respectively, compared to the control condition (No-regulation). This suggests increased activity of the parasympathetic branch during emotion regulation of situational empathic responses. Positive compared to Negative Social Scenes were associated with decreased situational empathy, in addition to a slightly but non-significantly increased HF. Altogether, this study demonstrates that emotion regulation may be associated with changes in situational empathy and autonomic responses, preferentially dominated by the parasympathetic branch and possibly reflecting an increase of regulatory processes. Furthermore, the current study provides evidence that empathy for different emotional valences is associated with distinct changes in situational empathy and autonomic responses.

Why we heal: The evolution of psychological healing and implications for global mental health

Why do humans heal one another? Evolutionary psychology has advanced our understanding of why humans suffer psychological distress and mental illness. However, to date, the evolutionary origins of what drives humans to alleviate the suffering of others has received limited attention. Therefore, we draw upon evolutionary theory to assess why humans psychologically support one another, focusing on the interpersonal regulation of emotions that shapes how humans heal and console one another when in psychosocial distress. To understand why we engage in psychological healing, we review the evolution of cooperation among social species and the roles of emotional contagion, empathy, and self-regulation. We discuss key aspects of human biocultural evolution that have contributed to healing behaviors: symbolic logic including language, complex social networks, and the long period of childhood that necessitates identifying and responding to others in distress. However, both biological and cultural evolution also have led to social context when empathy and consoling are impeded. Ultimately, by understanding the evolutionary processes shaping why humans psychologically do or do not heal one another, we can improve our current approaches in global mental health and uncover new opportunities to improve the treatment of mental illness across cultures and context around the world.

Development and validation of Temperance Scale in Pakistan

The purpose of the present research was to construct and validate a measure of temperance-one's capability of moderation or voluntary self-restraint. This research comprised two studies. In Study I, an item pool of 83 items was generated, 75 items were finalized by a committee of experts, and then these items were administered on a purposive sample of university students (n = 250). Exploratory factor analysis (EFA) revealed a four-factor solution with 24 items and the factors were named as Self-regulation (α = .72), Prudence (α = .71), Humility (α = .79), and Forgiveness (α = .73). Study II of the present research confirmed the factorial structure of the Temperance Scale in an independent sample of university students (n = 268). The Temperance Scale, Academic Procrastination Scale, and Empathy Quotient Short Form were administered to the participants. Confirmatory factor analysis of the Temperance Scale demonstrated a good model fit to the data with the same four factors as established during the EFA. The Temperance Scale was positively correlated with empathy and it had a nonsignificant relationship with academic procrastination. The results support that the newly developed scale has promising validity.

Effects of parental empathy and emotion regulation on social competence and emotional/behavioral problems of school-age children

IMPORTANCE

Parents take the lead in parent-child interactions and their emotion regulation ability and empathy during parenting may be associated with children's emotional/behavioral problems. However, the specific mechanisms underlying these associations remain unclear.

OBJECTIVE

The present study aimed to explore the effect of parental empathy and emotional regulation on social competence and emotional/behavioral problems in school-age children.

METHODS

A questionnaire-based survey was conducted with 274 parents of 8-11-year-old children using Achenbach's Child Behavior Checklist, the Emotion Regulation Questionnaire, and the Questionnaire of Cognitive and Affective Empathy.

RESULTS

Children with emotional/behavioral problems (n = 37) had relatively lower social competence than children in a matched control group (n = 37). Compared with the parents of children in the control group, parents of children with emotional/behavioral problems had significantly lower cognitive empathy scores, mainly manifested by low perspective-taking and online simulation abilities. Mediation analysis showed that parental cognitive empathy had an indirect effect on children's emotional/behavioral problems through children's social competence.

INTERPRETATION

Parental empathy may have a subtle influence on the social competence of school-aged children, which further affects the severity of children's emotional/behavioral problems.

Vagal Tone Differences in Empathy Level Elicited by Different Emotions and a Co-Viewer

Empathy can bring different benefits depending on what kind of emotions people empathize with. For example, empathy with negative emotions can raise donations to charity while empathy with positive emotions can increase participation during remote education. However, few studies have focused on the physiological differences depending on what kind of emotions people empathize with. Furthermore, co-viewer can influence the elicitation of different levels of empathy, but this has been less discussed. Therefore, this study investigated vagal response differences according to each empathy factor level elicited by different emotions and co-viewer. Fifty-nine participants were asked to watch 4 videos and to evaluate subjective valence, arousal scores, and undertake an empathy questionnaire, which included cognitive, affective and identification empathy. Half of the participants watched the videos alone and the other half watched the videos with a co-viewer. Valence and arousal scores were categorized into three levels to figure out what kind of emotions they empathized with. Empathy level (high vs. low) was determined based on the self-report scores. Two-way MANOVA revealed an interaction effect of empathy level and emotions. High affective empathy level is associated with higher vagal response regardless of what kind of emotions they empathized with. However, vagal response differences in other empathy factor level showed a different pattern depending on what kind of emotions that participant empathized with. A high cognitive empathy level showed lower vagal responses when participants felt negative or positive valence. High identification level also showed increased cognitive burden when participants empathized with negative and neutral valence. The results implied that emotions and types of empathy should be considered when measuring empathic responses using vagal tone. Two-way MANOVA revealed empathic response differences between co-viewer condition and emotion. Participants with a co-viewer felt higher vagal responses and self-reporting empathy scores only when participants empathized with arousal. This implied that the effect of a co-viewer may impact on empathic responses only when participants felt higher emotional intensity.