Neural correlates of prosocial behavior towards persons in pain in healthcare providers

Remote work arrangement: a blessing in disguise for socially anxious individuals

This research examines the link between social anxiety disorder (SAD), psychological distance (PD), and burnout using survey data from 463 software development workers who are currently working remotely. According to the results of the study, SAD was associated with higher PD, but, in contrast to what had been shown in earlier studies, this higher PD had no effect on the participants' reported levels of burnout. Both psychological safety and workplace attachment orientation (WAO) were tested for their moderating effects in this study. According to the study's findings, the link between SAD and PD was moderated by WAO but not by psychological safety. The findings of this study underscore the importance of conducting additional research on the challenges faced by people with social anxiety in the workplace and the steps that can be taken by employers to better accommodate them.

Effect of Prosocial Behaviors on e-Consultations in a Web-Based Health Care Community: Panel Data Analysis

BACKGROUND

Patients using web-based health care communities for e-consultation services have the option to choose their service providers from an extensive digital market. To stand out in this crowded field, doctors in web-based health care communities often engage in prosocial behaviors, such as proactive and reactive actions, to attract more users. However, the effect of these behaviors on the volume of e-consultations remains unclear and warrants further exploration.

OBJECTIVE

This study investigates the impact of various prosocial behaviors on doctors' e-consultation volume in web-based health care communities and the moderating effects of doctors' digital and offline reputations.

METHODS

A panel data set containing information on 2880 doctors over a 22-month period was obtained from one of the largest web-based health care communities in China. Data analysis was conducted using a 2-way fixed effects model with robust clustered SEs. A series of robustness checks were also performed, including alternative measurements of independent variables and estimation methods.

RESULTS

Results indicated that both types of doctors' prosocial behaviors, namely, proactive and reactive actions, positively impacted their e-consultation volume. In terms of the moderating effects of external reputation, doctors' offline professional titles were found to negatively moderate the relationship between their proactive behaviors and their e-consultation volume. However, these titles did not significantly affect the relationship between doctors' reactive behaviors and their e-consultation volume (P=.45). Additionally, doctors' digital recommendations from patients negatively moderated both the relationship between doctors' proactive behaviors and e-consultation volume and the relationship between doctors' reactive behaviors and e-consultation volume.

CONCLUSIONS

Drawing upon functional motives theory and social exchange theory, this study categorizes doctors' prosocial behaviors into proactive and reactive actions. It provides empirical evidence that prosocial behaviors can lead to an increase in e-consultation volume. This study also illuminates the moderating roles doctors' digital and offline reputations play in the relationships between prosocial behaviors and e-consultation volume.

The alterations in event-related potential responses to pain empathy in breast cancer survivors treated with chemotherapy

Background

Previous findings indicated that breast cancer patients often have dysfunction in empathy and other cognitive functions during or after chemotherapy. However, the manifestations and possible neuro-electrophysiological mechanisms of pain empathy impairment in breast cancer patients after chemotherapy were still unknown.

Objective

The current study aimed to investigate the potential correlations between pain empathy impairment and event-related potentials (ERP) in breast cancer patients undergoing chemotherapy.

Methods

Twenty-two breast cancer patients were evaluated on a neuropsychological test and pain empathy paradigm before and after chemotherapy, containing the Chinese version of the Interpersonal Reactivity Index (IRI-C), while recording ERP data.

Results

The empathic concern scores were lower and personal distress scores were higher on IRI-C task compared with those before chemotherapy (t = 3.039, p < 0.01; t = −2.324, p < 0.05, respectively). Meanwhile, the accuracy rates were lower than those before chemotherapy for both pain and laterality tasks on the pain empathy paradigm (F = 5.099, P = 0.035). However, the response time was no significant differences before and after chemotherapy (F = 0.543, P = 0.469). Further, the amplitude of the N1 component was significantly increased (F = 38.091, P < 0.001), and the amplitude of the P2 component was significantly decreased (F = 15.046, P = 0.001) in the subsequent ERP study. A linear mixed effect model was used to analyze the correlation, the average amplitude of N1 and P2 were positively correlated with the accuracy rates in laterality tasks (r = 1.765, r = 1.125, respectively, P < 0.05).

Conclusion

The results indicated that pain empathy impairment was performed in chemotherapeutic breast cancer patients, which was possibly correlated to the changes of N1 and P2 components in ERP. These findings provide neuro-electrophysiological information about chemo-brain in breast cancer patients.

Meta-analysis of functional neuroimaging and dispositional variables for clinical empathy

Clinical empathy refers to the ability of healthcare providers (HP) to recognize and understand what patients feel. While neuroimaging investigations have identified a neural network of empathy, activation consistency of brain regions and their specific functions in clinical empathy remains unclear. Herein, we conducted meta-analyses of dispositional assessments using random-effects models and functional neuroimaging using Seed-based d Mapping with Permutation of Subject Images to ascertain the shared neural processes consistently identified as relevant to clinical empathy. The dispositional meta-analysis (n = 15) revealed that HP exhibited higher scores on empathic concern and perspective taking. The HP neuroimaging meta-analysis (n = 11) identified consistent activation of the anterior mid-cingulate cortex, anterior insula, and ventrolateral prefrontal cortex (vlPFC) while HP vs. controls comparison (n = 9) did not yield robust alterations. The vlPFC mediated positive and negative functional connectivity of the insula. We revisited the framework of emotion regulation in clinical empathy. The empathetic agent flexibly shifts between affective regulatory strategies to meet contextual demands, with vlPFC figuring as the key region where this neural mechanism takes place.

Regulating mirroring of emotions A social-specific mechanism?

There is evidence that humans mirror others’ emotional responses: brain responses to observed and experienced emotion overlap, and reaction time costs of observing others’ pain suggest that others’ emotional states interfere with our own. Such emotional mirroring requires regulation to prevent personal distress. However, currently it is unclear whether this “empathic interference effect” is uniquely social, arising only from the observation of human actors, or also from the observation of non-biological objects in “painful” states. Moreover, the degree to which this interference relates to individual differences in self-reported levels of empathy is yet to be revealed. We introduce a modified pain observation task, measuring empathic interference effects induced by observation of painful states applied to both biological and non-biological stimuli. An initial validation study (N = 50) confirmed that painful states applied to biological stimuli were rated explicitly as more painful than non-painful states applied to biological stimuli, and also than both painful and non-painful states applied to non-biological stimuli. Subsequently, across two independent discovery (N = 83) and replication (N = 80) samples, the task elicited slowing of response times during the observation of painful states when compared to non-painful states, but the magnitude of this effect did not differ between biological and non-biological stimuli. Little evidence was found for reliable relationships between empathic interference and self-reported empathy. Caution should therefore be taken in using the current task to pursue an individual differences approach to empathic interference, but the task shows promise for investigating the specificity of the mechanism involved in regulating emotional mirroring.

Pain evaluation and prosocial behaviour are affected by age and sex

BACKGROUND

Pain assessment and pain care are influenced by the characteristics of both the patient and the caregiver. Some studies suggest that the pain of older persons and of females may be underestimated to a greater extent than the pain of younger and male individuals.

AIMS

This study investigated the effect of age and sex on prosocial behavior and pain evaluation.

METHODS

40 young (18-30 y/o; 20 women) and 40 older adults (55-82 y/o; 20 women) acted as healthcare professionals rating the pain and offering help to patients of both age groups. Trait empathy and social desirability were measured with questionnaires.

RESULTS

Linear mixed models showed that older and male patients were offered more help and were perceived as being in more intense pain than younger and female patients.

CONCLUSION

The characteristics of the patients seem to have a greater impact on prosocial behavior and pain assessment compared to those of the observers, which bears significant implications for the treatment of pain in clinical contexts.

Practicing "Reflective listening" is a mandatory prerequisite for empathy

We must humbly acknowledge that the healthcare system is less and less about empathy despite interacting with patients is a prerequisite for care: shared decision making is the cornerstone for compliance to treatment and therefore its -effectiveness. Empathy is not about tricks, it is about "client-centred therapy" a term coined by Carl Rogers. The key is "reflective listening". Simply summarize what the patient said by using his own words rather than paraphrasing and without digressing to other subjects. This reinforces patients' own expressions of problems, recognition of concerns, complaints and, values and reveals potential misunderstanding of patient's concerns. New technologies can help to understand patient's experiences as a program for professionals caring for inflammatory bowel diseases: they receive on their a smartphone daily recurring messages such as "You have ten minutes to go to the toilet" and must send a photo of a lavatory door within few minutes.

Empathy in Medicine: What It Is, and How Much We Really Need It

It is acknowledged that empathy plays a critical role in the physician-patient relationship and has a positive impact on health outcomes. However, as the field of empathy expands, the lack of conceptual coherence challenges advances in medicine. In fact, in some medical settings, there is little added theoretical or clinical value in applying the all-encompassing term of empathy, which is by nature multidimensional, interpersonal, and modulated by context. Functional neuroimaging studies of health professionals, designed to examine patterns of brain activation in response to empathy-eliciting situations, bring theoretical clarity to the neurocognitive mechanisms that underlie interpersonal sensitivity, emotional empathy, cognitive empathy, and caring. These components are relatively independent but often interact and are deeply interwoven in the fabric of the brain. Nevertheless, it seems clear from this review that cultivating empathic concern or compassion in today's medicine is more important than other aspects of empathy, like vicariously experiencing and introspecting about patients' emotions. Specific neurobiological mechanisms explain the benefit to patients of their physicians' perceived empathy.

A meta-analysis of neuroimaging studies on pain empathy: investigating the role of visual information and observers' perspective

Empathy relies on brain systems that support the interaction between an observer's mental state and cues about the others' experience. Beyond the core brain areas typically activated in pain empathy studies (insular and anterior cingulate cortices), the diversity of paradigms used may reveal secondary networks that subserve other more specific processes. A coordinate-based meta-analysis of fMRI experiments on pain empathy was conducted to obtain activation likelihood estimates along three factors and seven conditions: visual cues (body parts, facial expressions), visuospatial (first-person, thirdperson), and cognitive (self-, stimuli-, other-oriented tasks) perspectives. The core network was found across cues and perspectives, and common activation was observed in higher-order visual areas. Body-parts distinctly activated areas related with sensorimotor processing (superior and inferior parietal lobules, anterior insula) while facial expression distinctly involved the inferior frontal gyrus. Self- compared to other-perspective produced distinct activations in the left insula while stimulus- versus other-perspective produced distinctive responses in the inferior frontal and parietal lobules, precentral gyrus, and cerebellum. Pain empathy relies on a core network which is modulated by several secondary networks. The involvement of the latter seems to depend on the visual cues available and the observer's mental state that can be influenced by specific instructions.

Alexithymia explains increased empathic personal distress in individuals with and without eating disorders

It is often assumed that empathy impairments are common in individuals with eating disorders (EDs), but empirical work has been limited and produced mixed results, making the clinical features and treatment needs of this population difficult to determine. Alexithymia, characterised by difficulties identifying and describing one’s own emotions, frequently co-occurs with EDs and is associated with atypical recognition of, and empathy for, others’ emotions. This study used an existing empathy for pain paradigm to determine whether atypical empathy in EDs stems from co-occurring alexithymia, rather than EDs per se. Empathy (specifically personal distress in response to others’ pain) was assessed in individuals with EDs ( N = 21) and an alexithymia-matched control group ( N = 22). Participants were simultaneously members of a high alexithymia ( N = 16) or low alexithymia ( N = 27) group, allowing the independent contributions of alexithymia and EDs to be determined. Participants judged the laterality of hands and feet in painful and non-painful situations, and the degree of empathic interference on response times was measured. Results indicated that observation of painful stimuli affected task performance in those with high levels of alexithymia more than those with low levels, but no effect of ED diagnosis was observed. These findings suggest that co-occurring alexithymia explains increased empathic personal distress in ED populations. Atypical empathy may therefore not be a core feature of EDs, and interventions aimed at improving empathy-related social functioning may only be necessary for patients who also have alexithymia. These findings emphasise the importance of determining the influence of co-occurring alexithymia when assessing empathy in clinical populations.