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Kade SA, du Toit SA, Danielson CT, Schweizer S, Morrison AS, Ong DC, Prasad A, Holder LJ, Han J, Torok M, Wong QJJ. Aberrant cognitive empathy in individuals with elevated social anxiety and regulation with emotional working memory training. Cogn Emot 2024; 38:605-623. [PMID: 38349272 DOI: 10.1080/02699931.2024.2314981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 01/04/2024] [Indexed: 06/15/2024]
Abstract
Social anxiety may disrupt the empathic process, and well-regulated empathy is critical for navigating the social world. Two studies aimed to further understand empathy in the context of social anxiety. Study 1 compared individuals with elevated or normative social anxiety on a measure assessing cognitive and affective empathy for positive and negative emotions conveyed by other people ("targets"), completed under social threat. Relative to individuals with normative social anxiety, individuals with elevated social anxiety had greater cognitive empathy and no differences in affective empathy, regardless of emotion type. As greater cognitive empathy can be maladaptive, Study 2 tested whether this could be down-regulated. Individuals with elevated social anxiety underwent emotional working memory training (eWMT) for negative emotional information, or control training (CT). Effects on an empathy measure completed under social threat were assessed. Cognitive empathy for negative emotions decreased following eWMT but not CT, and this was only evident for those with higher pre-training working memory capacity. Cognitive empathy for positive emotions and affective empathy were not affected. Overall, social anxiety is associated with aberrant elevated cognitive empathy for negative and positive emotions, and the deviation in cognitive empathy for negative emotions can be regulated with eWMT for certain individuals.Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12618001196235..
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Affiliation(s)
- Saif A Kade
- School of Psychology, Western Sydney University, Sydney, Australia
| | - Simone A du Toit
- School of Psychology, Western Sydney University, Sydney, Australia
| | | | - Susanne Schweizer
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Amanda S Morrison
- Department of Psychology, California State University, Hayward, CA, USA
| | - Desmond C Ong
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Ashni Prasad
- School of Psychology, Western Sydney University, Sydney, Australia
| | - Lauren J Holder
- School of Psychology, Western Sydney University, Sydney, Australia
| | - Jin Han
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Quincy J J Wong
- School of Psychology, Western Sydney University, Sydney, Australia
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2
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Israelashvili J, Dijk C, Fischer AH. Social anxiety is associated with personal distress and disrupted recognition of negative emotions. Heliyon 2024; 10:e24587. [PMID: 38317896 PMCID: PMC10839860 DOI: 10.1016/j.heliyon.2024.e24587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 11/29/2023] [Accepted: 01/10/2024] [Indexed: 02/07/2024] Open
Abstract
Past research investigating the relation between social anxiety (SA), empathy and emotion recognition is marked by conceptual and methodological issues. In the present study, we aim to overcome these limitations by examining whether individuals with high (n = 40) vs. low (n = 43) social anxiety differed across these two facets of empathy and whether this could be related to their recognition of emotions. We employed a naturalistic emotion recognition paradigm in which participants watched short videos of individuals (targets) sharing authentic emotional experiences. After each video, we measured self-reported empathic concern and distress, as well as their ability to recognize the emotions expressed by the targets in the videos. Our results show that individuals with high social anxiety recognized the targets' emotions less accurately. Furthermore, high socially anxious individuals reported more personal distress than low socially anxious individuals, whereas no significant difference was found for empathic concern. The findings suggest that reduced recognition of emotions among SA individuals can be better explained by the negative effects of social stress than by a general deficit in empathy.
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3
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Uğurpala C, Tükel R, Ziylan EÇ, Ertekin E, Berberoğlu E. Social Cognition and Functioning in Patients With Social Anxiety Disorder and/or Attention-Deficit/Hyperactivity Disorder. J Nerv Ment Dis 2023; 211:828-834. [PMID: 37432028 DOI: 10.1097/nmd.0000000000001696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
ABSTRACT In recent years, social cognition and one of its dimensions, the theory of mind, have been more commonly investigated in patients with social anxiety disorder (SAD) and attention-deficit/hyperactivity disorder (ADHD). In this study, SAD, ADHD, comorbid SAD-ADHD, and healthy control (HC) groups, each consisting of 30 participants, were included and compared in terms of social cognition and functionality. Mean global functioning assessment scores were found to be significantly higher in the HC group compared with the other three groups and in the ADHD group compared with the SAD and SAD-ADHD groups. Mean Dokuz Eylül Theory of Mind Index total scores were found to be significantly higher in the HC group compared with the other three groups and in the SAD and SAD-ADHD groups compared with the ADHD group. These findings suggest that SAD patients with or without ADHD show better social cognition but worse functioning compared with pure ADHD patients.
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Affiliation(s)
- Can Uğurpala
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| | - Raşit Tükel
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| | - Ege Çağın Ziylan
- Physiology and Pharmacology Laboratory, Beykent University Faculty of Medicine, Beykent University, Büyükçekmece, Istanbul, Turkey
| | - Erhan Ertekin
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| | - Ertuğ Berberoğlu
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
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4
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Tan X, Yang Y, Yu M. Longitudinal relationship of empathy and social anxiety among adolescents: The mediation roles of psychological inflexibility and rejection sensitivity. J Affect Disord 2023; 339:867-876. [PMID: 37467804 DOI: 10.1016/j.jad.2023.07.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 06/17/2023] [Accepted: 07/14/2023] [Indexed: 07/21/2023]
Abstract
INTRODUCTION The purpose of study was to explore the roles of psychological inflexibility and rejection sensitivity in the relationship between (cognitive and affective) empathy and social anxiety among adolescents. METHODS A two-wave longitudinal design was adopted in the present study. A total of 2481 participants (41.60 % male; Mage = 16.48) aged from 13 to 21 in 2021 completed the Chinese Version of Interpersonal Reactivity Index (IRI-C), Short Mood and Feelings Questionnaire (SMFQ), Chinese version of the Acceptance and Action Questionnaire-II (AAQ-II), Avoidance and Fusion Questionnaire for Youth (AFQ-Y8), Child Rejection Sensitivity Questionnaire (CRSQ), and Social Anxiety Scale for Adolescent (SAS-A) at baseline assessment (T1), and completed the SAS-A again three months later (T2). RESULTS (1) Results showed, personal distress at T1 could significantly and positively predict social anxiety at T2. (2) Mediation analyses results demonstrated that adolescents' experience avoidance and rejection sensitivity at T1 were significant mediators between cognitive empathy at T1 and social anxiety at T2, but with the opposite effect. As for affective empathy, rejection sensitivity at T1 significantly mediated the relationship between adolescents' empathic concern at T1 and social anxiety at T2. Furthermore, experience avoidance and rejection sensitivity at T1 significantly mediated the association between personal distress at T1 and social anxiety at T2. CONCLUSIONS Cognitive and affective empathy had different roles in contributing to adolescents' social anxiety. The findings in the current study can also provide empirical support for targeting adolescents' social anxiety by reducing personal distress directly and decreasing experiential avoidance and rejection sensitivity indirectly.
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Affiliation(s)
- Xing Tan
- School of Psychology, South China Normal University, Guangzhou, Guangdong 510631, PR China; The Guidance Centre for Student Development, Dongguan High School, Dongguan, Guangdong 523120, PR China
| | - Youtian Yang
- Centre for Psychological Health Education, Zhongshan Technician College, Zhongshan, Guangdong 528400, PR China
| | - Meng Yu
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou 510515, PR China; Department of Psychiatry, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, PR China.
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5
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Howe-Davies H, Hobson C, Waters C, van Goozen SHM. Emotional and socio-cognitive processing in young children with symptoms of anxiety. Eur Child Adolesc Psychiatry 2023; 32:2077-2088. [PMID: 35861892 PMCID: PMC10533571 DOI: 10.1007/s00787-022-02050-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/10/2022] [Indexed: 11/24/2022]
Abstract
Many children with anxiety disorders exhibit significant and persistent impairments in their social and interpersonal functioning. Two components essential for successful social interaction are empathy and theory of mind (ToM). Both constructs develop rapidly in childhood, but no study has simultaneously examined these skills in young children with emerging mental health problems, including those with symptoms of anxiety. This study investigated empathy and ToM in children with anxiety symptomatology and examined their relationship with anxiety severity. A cross-sectional study was carried out with 174 children aged 4-8 years with emerging mental health difficulties who were referred by school teachers for an assessment because of emotional, cognitive, or behavioural problems at school. Participants completed empathy and ToM tasks. Parents were interviewed and rated children's emotional and behavioural problems. Correlational analyses indicated that elevated anxiety was associated with better cognitive ToM and worse affective empathy; there were no associations between anxiety and either cognitive empathy or affective ToM. Subsequent regression analyses demonstrated that whilst enhanced cognitive ToM was explained by age and verbal IQ, anxiety symptoms uniquely predicted impaired affective empathy. These results indicate that children with symptoms of anxiety have difficulty in sharing in other people's emotions. As a result, they may find it difficult to behave in socially adequate ways in interactions with others that involve affective sharing. These findings encourage the use of early and targeted interventions that improve affective empathy development in children with anxiety symptoms.
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Affiliation(s)
| | | | | | - Stephanie H M van Goozen
- School of Psychology, Cardiff University, Wales, UK.
- Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, Netherlands.
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6
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Winters DE, Pruitt PJ, Gambin M, Fukui S, Cyders MA, Pierce BJ, Lay K, Damoiseaux JS. Cognitive and Affective Empathy as Indirect Paths Between Heterogeneous Depression Symptoms on Default Mode and Salience Network Connectivity in Adolescents. Child Psychiatry Hum Dev 2023; 54:213-222. [PMID: 34518947 PMCID: PMC8918056 DOI: 10.1007/s10578-021-01242-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2021] [Indexed: 01/25/2023]
Abstract
Depression amongst adolescents is a prevalent disorder consisting of heterogeneous emotional and functional symptoms-often involving impairments in social domains such as empathy. Cognitive and affective components of empathy as well as their associated neural networks (default mode network for cognitive empathy and salience network for affective empathy) are affected by depression. Depression commonly onsets during adolescence, a critical period for brain development underlying empathy. However, the available research in this area conceptualizes depression as a homogenous construct, and thereby miss to represent the full spectrum of symptoms. The present study aims to extend previous literature by testing whether cognitive and affective empathy indirectly account for associations between brain network connectivity and heterogeneous depression symptoms in adolescents. Heterogeneous functional and emotional symptoms of depression were measured using the child depression inventory. Our results indicate that cognitive empathy mediates the association between default mode network functional connectivity and emotional symptoms of depression. More specifically, that adolescents with a stronger positive association between the default mode network and cognitive empathy show lower emotional depression symptoms. This finding highlights the importance of cognitive empathy in the relationship between brain function and depression symptoms, which may be an important consideration for existing models of depression in adolescents.
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Affiliation(s)
- Drew E Winters
- Department of Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA.
| | - Patrick J Pruitt
- Department of Psychology and Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | | | - Sadaaki Fukui
- Indiana University School of Social Work, Indianapolis, IN, USA
| | - Melissa A Cyders
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
| | | | - Kathy Lay
- Indiana University School of Social Work, Indianapolis, IN, USA
| | - Jessica S Damoiseaux
- Department of Psychology and Institute of Gerontology, Wayne State University, Detroit, MI, USA
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7
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Alvi T, Rosenfield D, Sunahara CS, Wallmark Z, Lee J, Tabak BA. Examining Unique Associations of Social Anxiety and Depression on Behaviorally Assessed Affective Empathy. Clin Psychol Sci 2022:216770262211047. [DOI: 10.1177/21677026221104735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
A growing body of research suggests that cognitive empathy (i.e., understanding other people’s mental states) may be impaired in socially anxious and depressed individuals. However, few studies have examined whether affective empathy (i.e., sharing other people’s emotional states, referred to as “affect sharing”) may likewise be impaired in either form of psychopathology. In Study 1 ( n = 202), we examined the unique association between social anxiety (or depression) and affect sharing and the moderating role of anhedonia and stimuli valence above and beyond depression (or social anxiety). No main or interaction effects were found for social anxiety or depression in the prediction of affect sharing. In Study 2, we conducted a direct replication of Study 1 with a larger sample ( n = 324), which confirmed our findings from Study 1. Thus, the unique effects of social anxiety and depression may be more related to difficulties in cognitive, rather than affective, empathic processes.
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Affiliation(s)
- Talha Alvi
- Department of Psychology, Southern Methodist University
| | | | | | - Zachary Wallmark
- Department of Musicology and Ethnomusicology, University of Oregon
| | - Junghee Lee
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham
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Nan J, Balasubramani PP, Ramanathan D, Mishra J. Neural dynamics during emotional video engagement relate to anxiety. Front Hum Neurosci 2022; 16:993606. [PMID: 36438632 PMCID: PMC9691839 DOI: 10.3389/fnhum.2022.993606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/27/2022] [Indexed: 04/07/2024] Open
Abstract
Inter-subject correlations (ISCs) of physiological data can reveal common stimulus-driven processing across subjects. ISC has been applied to passive video viewing in small samples to measure common engagement and emotional processing. Here, in a large sample study of healthy adults (N = 163) who watched an emotional film (The Lion Cage by Charlie Chaplin), we recorded electroencephalography (EEG) across participants and measured ISC in theta, alpha and beta frequency bands. Peak ISC on the emotionally engaging video was observed three-quarters into the film clip, during a time period which potentially elicited a positive emotion of relief. Peak ISC in all frequency bands was focused over centro-parietal electrodes localizing to superior parietal cortex. ISC in both alpha and beta frequencies had a significant inverse relationship with anxiety symptoms. Our study suggests that ISC measured during continuous non-event-locked passive viewing may serve as a useful marker for anxious mood.
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Affiliation(s)
- Jason Nan
- Neural Engineering and Translation Labs, Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
- Department of Bioengineering, University of California, San Diego, San Diego, CA, United States
| | - Pragathi P. Balasubramani
- Neural Engineering and Translation Labs, Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
- Department of Cognitive Science, Indian Institute of Technology Kanpur, Kanpur, India
| | - Dhakshin Ramanathan
- Neural Engineering and Translation Labs, Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
- Department of Mental Health, VA San Diego Medical Center, San Diego, CA, United States
- Center of Excellence for Stress and Mental Health, VA San Diego Medical Center, San Diego, CA, United States
| | - Jyoti Mishra
- Neural Engineering and Translation Labs, Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
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9
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Holtmann O, Schloßmacher I, Franz M, Moenig C, Tenberge JG, Preul C, Schwindt W, Bruchmann M, Melzer N, Miltner WHR, Straube T. Effects of emotional valence and intensity on cognitive and affective empathy after insula lesions. Cereb Cortex 2022; 33:4562-4573. [PMID: 36124830 DOI: 10.1093/cercor/bhac362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/11/2022] [Accepted: 08/22/2022] [Indexed: 01/10/2023] Open
Abstract
The insula plays a central role in empathy. However, the complex structure of cognitive (CE) and affective empathy (AE) deficits following insular damage is not fully understood. In the present study, patients with insular lesions (n = 20) and demographically matched healthy controls (n = 24) viewed ecologically valid videos that varied in terms of valence and emotional intensity. The videos showed a person (target) narrating a personal life event. In CE conditions, subjects continuously rated the affective state of the target, while in AE conditions, they continuously rated their own affect. Mean squared error (MSE) assessed deviations between subject and target ratings. Patients differed from controls only in negative, low-intensity AE, rating their own affective state less negative than the target. This deficit was not related to trait empathy, neuropsychological or clinical parameters, or laterality of lesion. Empathic functions may be widely spared after insular damage in a naturalistic, dynamic setting, potentially due to the intact interpretation of social context by residual networks outside the lesion. The particular role of the insula in AE for negative states may evolve specifically in situations that bear higher uncertainty pointing to a threshold role of the insula in online ratings of AE.
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Affiliation(s)
- Olga Holtmann
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Straße 52, Muenster 48149, Germany.,Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Fliednerstraße 21, Muenster 48149, Germany
| | - Insa Schloßmacher
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Straße 52, Muenster 48149, Germany.,Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Fliednerstraße 21, Muenster 48149, Germany
| | - Marcel Franz
- Department of Clinical Psychology, Friedrich Schiller University Jena, Am Steiger 3, Jena 07743, Germany
| | - Constanze Moenig
- Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Muenster 48149, Germany
| | - Jan-Gerd Tenberge
- Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Muenster 48149, Germany
| | - Christoph Preul
- Department of Neurology, University Hospital Jena, Am Klinikum 1, Jena 07747, Germany
| | - Wolfram Schwindt
- Institute of Clinical Radiology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Muenster 48149, Germany
| | - Maximilian Bruchmann
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Straße 52, Muenster 48149, Germany.,Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Fliednerstraße 21, Muenster 48149, Germany
| | - Nico Melzer
- Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Muenster 48149, Germany.,Department of Neurology, Heinrich-Heine University of Düsseldorf, Moorenstraße 5, Düsseldorf 40225, Germany
| | - Wolfgang H R Miltner
- Department of Clinical Psychology, Friedrich Schiller University Jena, Am Steiger 3, Jena 07743, Germany
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Straße 52, Muenster 48149, Germany.,Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Fliednerstraße 21, Muenster 48149, Germany
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10
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Dillon-Owens C, Findley-Van Nostrand D, Ojanen T, Buchholz C, Valdes O. Early Adolescent Cognitive and Affective Empathy. SOCIAL PSYCHOLOGY 2022. [DOI: 10.1027/1864-9335/a000499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Abstract. Cognitive and affective empathy have diverging relations to social–emotional adjustment. However, particularly during adolescence, these associations are not thoroughly understood. Using the Basic Empathy Scale (BES), we examined cognitive and affective empathy (including emotional contagion and emotional disconnection) in association with social–emotional adjustment (negative affect, shyness, social self-efficacy, friendship quality, and peer victimization) in early adolescents ( N = 321). Cognitive empathy and emotional contagion showed divergent links (cognitive empathy was related to positive adjustment, while emotional contagion was related to negative adjustment but also higher friendship quality). Emotional disconnection was negatively associated with social self-efficacy, supporting affective empathy as having multiple factors itself. The findings further validate the BES as a three-factor measure and have implications for understanding social–emotional adjustment in youth.
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Affiliation(s)
- Cody Dillon-Owens
- Department of Psychology, University of North Carolina-Charlotte, Charlotte, NC, USA
| | | | - Tiina Ojanen
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | | | - Olivia Valdes
- Department of Psychology, Florida Atlantic University, Ft. Lauderdale, FL, USA
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11
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Associations between Empathy and social anxiety in Childhood: the moderating role of mother-child conflict and peer rejection. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03537-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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12
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Alvi T, Kumar D, Tabak BA. Social anxiety and behavioral assessments of social cognition: A systematic review. J Affect Disord 2022; 311:17-30. [PMID: 35490878 PMCID: PMC9754122 DOI: 10.1016/j.jad.2022.04.130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 04/17/2022] [Accepted: 04/19/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Social anxiety is highly prevalent and has increased in young adults during the COVID-19 pandemic. Since social anxiety negatively impacts interpersonal functioning, identifying aspects of social cognition that may be impaired can increase our understanding of the development and maintenance of social anxiety disorder. However, to date, studies examining associations between social anxiety and social cognition have resulted in mixed findings. METHODS The aim of this systematic review was to summarize the literature on the association between social anxiety and social cognition, while also considering several potential moderators and covariates that may influence findings. RESULTS A systematic search identified 52 studies. Results showed mixed evidence for the association between social anxiety and lower-level social cognitive processes (emotion recognition and affect sharing) and a trend for a negative association with higher-level social cognitive processes (theory of mind and empathic accuracy). Most studies examining valence-specific effects found a significant negative association for positive and neutral stimuli. LIMITATIONS Not all aspects of social cognition were included (e.g., attributional bias) and we focused on adults and not children, limiting the scope of the review. CONCLUSIONS Future studies would benefit from the inclusion of relevant moderators and covariates, multiple well-validated measures within the same domain of social cognition, and assessments of interpersonal functioning outside of the laboratory. Additional research examining the moderating role of attention or interpretation biases on social cognitive performance, and the potential benefit of social cognitive skills training for social anxiety, could inform and improve existing cognitive behavioral interventions.
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Affiliation(s)
| | | | - Benjamin A. Tabak
- Corresponding author at: Department of Psychology, Southern Methodist University, 6116 N. Central Expressway, Suite 1300, Dallas, TX 75206, USA
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13
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Miller JG, Bartholomay KL, Lee CH, Bruno JL, Lightbody AA, Reiss AL. Empathy and Anxiety in Young Girls with Fragile X Syndrome. J Autism Dev Disord 2022; 52:2213-2223. [PMID: 34081299 PMCID: PMC8639840 DOI: 10.1007/s10803-021-05105-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2021] [Indexed: 01/10/2023]
Abstract
We tested whether empathy is impaired and associated with anxiety in girls with fragile X syndrome (FXS). We measured parent-reported empathy and self-reported anxiety in young girls with FXS and in a developmentally-matched comparison group. Girls with FXS received higher parent-reported scores on cognitive and affective empathy but also self-reported more severe anxiety symptoms, particularly separation anxiety and phobia symptoms, than girls in the comparison group. Girls with FXS who received higher cognitive empathy scores, however, appeared buffered against risk for separation anxiety and phobia symptoms. Girls with FXS experience elevated empathy and anxiety relative to their developmentally-matched peers. Higher cognitive empathy in girls with FXS may indicate resilience against specific forms of anxiety that are commonly observed in FXS.
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Affiliation(s)
- Jonas G Miller
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, 94305, USA.
| | - Kristi L Bartholomay
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, 94305, USA
| | - Cindy H Lee
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, 94305, USA
| | - Jennifer L Bruno
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, 94305, USA
| | - Amy A Lightbody
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, 94305, USA
| | - Allan L Reiss
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, 94305, USA
- Department of Radiology, Stanford University, Stanford, CA, 94305, USA
- Department of Pediatrics, Stanford University, Stanford, CA, 94305, USA
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14
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Brett JD, Becerra R, Maybery MT, Preece DA. The Psychometric Assessment of Empathy: Development and Validation of the Perth Empathy Scale. Assessment 2022; 30:1140-1156. [PMID: 35435013 DOI: 10.1177/10731911221086987] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Empathy, the ability to infer and share others' affective states, plays a vital role in social interactions. However, no existing scale comprehensively assesses empathy's cognitive and affective components across positive and negative emotional valence domains. This article explores the latent structure of the empathy construct and attempts to remedy past measurement limitations by developing and validating a new 20-item self-report measure, the Perth Empathy Scale (PES). In Study 1 (N = 316), factor analyses revealed a coherent empathy construct comprised of cognitive and valence-specific affective components. Study 2 (N = 331) replicated this factor structure, showed measurement invariance between males and females, and highlighted the importance of assessing negative and positive emotions in empathy. The PES showed convergent and discriminant validity from comparisons with alexithymia and other empathy measures. Overall, this article empirically establishes a conceptually clear structure of the multidimensional empathy construct, which the PES reliably and validly measures.
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Affiliation(s)
| | | | | | - David A Preece
- University of Western Australia, Perth, USA.,Curtin University, Perth, WA, USA
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15
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Öztürk Y, Özyurt G, Turan S, Mutlu C, Tufan AE, Pekcanlar Akay A. Association of theory of mind and empathy abilities in adolescents with social anxiety disorder. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00707-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Nghiem LH, Tabak BA, Wallmark Z, Alvi T, Cao J. A Bayesian Latent Variable Model for Analysis of Empathic Accuracy. RECENT ADVANCES ON SAMPLING METHODS AND EDUCATIONAL STATISTICS 2022:201-214. [DOI: 10.1007/978-3-031-14525-4_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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17
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Umutlu D, Memis CO, Umutlu Y, Sevincok D, Sevincok L. Empathy in Social Anxiety Disorder: The Association with Attention Deficit Hyperactivity Disorder. Psychiatry 2022; 85:72-85. [PMID: 34338620 DOI: 10.1080/00332747.2021.1952034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objectives: Our main hypothesis in this study was that patients with social anxiety disorder (SAD) and comorbid attention deficit hyperactivity disorder (ADHD) had lower empathy levels than those without ADHD. Also, after controlling for the severity of SAD and depression, we hypothesized that ADHD symptoms contributed to lower levels of empathy in SAD patients.Methods: 72 patients (46 females, 32 males) with SAD between the ages of 18-65 years were divided into two groups as those with (n = 32) and those without ADHD (n = 40). Participants were evaluated using the Liebowitz Social Anxiety Scale (LSAS), Turgay's Adult Attention-Deficit/Hyperactivity Disorder, Beck Depression Inventory (BDI), and Empathy Quotient. In this study, Mann Whitney-U test, Spearman correlation test, logistic and multiple regression analysis were used.Results: Education level (U = 371.5, p = .002) and empathy scores (U = 259.5, p < .0001) of SAD patients with ADHD were significantly lower than those without ADHD. BDI (U = 206.5, p < .0001), LSAS total (U = 454.5, p = .036), fear (U = 457.0, p = .038), and avoidance scores (U = 453.0, p = .034) were higher in SAD patients with ADHD than those without ADHD. Low levels of empathy (B = - 0.119, Exp(B) = 0.895, p = .014) and high severity of current depression (B = 0.119, Exp(B) = 1.127, p = .001) were significantly associated with comorbidity between SAD and ADHD. ADHD-inattention (β = -0.369, Exp(B) = -0.541, p = .004), and depression (β = -0.262, Exp(B) = -0.212, p = .036) negatively predicted empathy levels.Conclusions: Our findings may provide some evidence for the contribution of ADHD-inattention and depression to poor empathy in SAD patients. Therefore, it is recommended that symptoms of ADHD-inattention and depression should be carefully evaluated in SAD patients with low empathy.
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Cosmoiu A, Nedelcea C. Factors impacting the experience of empathic distress in social anxiety: a path analysis approach. The Journal of Social Psychology 2021; 162:57-70. [PMID: 34913406 DOI: 10.1080/00224545.2021.2003284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Personal distress is a manifestation of empathy characterized by a tendency to respond to others' difficulties by increasing one's distress. Previous work on socially anxious individuals has shown mixed results, consistent with a model of social anxiety symptomatology characterized by increased personal distress in empathy eliciting situations, which is driven by emotional dysregulation. The current study aimed to test a serial mediation model to uncover the role of emotional dysregulation in the relationship between social anxiety and empathic distress. 330 young adults were included in the sample. Social anxiety symptomatology, difficulty identifying one's feelings, expressive suppression, and empathic distress were analyzed through Structural Equation Modeling. Measurement and structural models were supported by data, with social anxiety exhibiting direct and indirect effects on empathic distress. Results also suggest that expressive suppression exhibits a negative effect on the distress exhibited in empathy eliciting situations, which brings forth relevant theoretical and clinical implications.
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Affiliation(s)
- Ana Cosmoiu
- Department of Psychology and Cognitive Sciences, Faculty of Psychology and Educational Sciences, University of Bucharest, Bucharest, Romania
| | - Cătălin Nedelcea
- Department of Psychology and Cognitive Sciences, Faculty of Psychology and Educational Sciences, University of Bucharest, Bucharest, Romania
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Examining Individual Differences in Social Reward Valuation: a Person-Based Approach. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021. [DOI: 10.1007/s10862-021-09934-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractSocial reward refers to the motivational and pleasurable aspects of our interactions with other people. While some people experience social encounters as pleasurable, others experience them as aversive. However, the current knowledge on individual differences in social reward valuation in relation to pro- and antisocial personality characteristics is limited. The Social Reward Questionnaire (SRQ) was developed to assess individual differences in the value of different types of social rewards. First, the present study examined the validity and reliability of the Dutch version of the SRQ in a Dutch and Flemish community sample (N = 1892). Second, using latent profile analysis (LPA), it was investigated whether subgroups of participants existed with distinctive patterns of social reward valuation, and whether these subgroups differed in their level of psychopathic traits, aggression, and social anxiety. The results confirmed the original six-factor structure and showed good reliability and validity. The LPA identified four classes of individuals, labelled as: Low Social Interest, High Social Interest, Undifferentiated Social Reward-seekers, and Socially Cruel. These classes were further typified by distinct levels of psychopathy, reactive and proactive aggression, and social anxiety. The present findings contribute to our understanding of individual variability in the underlying motives of social behaviors.
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20
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Kiraga MK, Mason NL, Uthaug MV, van Oorsouw KIM, Toennes SW, Ramaekers JG, Kuypers KPC. Persisting Effects of Ayahuasca on Empathy, Creative Thinking, Decentering, Personality, and Well-Being. Front Pharmacol 2021; 12:721537. [PMID: 34658861 PMCID: PMC8517265 DOI: 10.3389/fphar.2021.721537] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/20/2021] [Indexed: 01/02/2023] Open
Abstract
Background: Naturalistic and placebo-controlled studies have suggested that ayahuasca, a traditional Amazonian beverage, could be helpful in the treatment of psychopathologies like depression and anxiety disorders by changing otherwise disturbed cognitive and emotional processes. To better understand its full therapeutic potential, one way is to study the effects on processes like flexible thinking, empathy, and well-being, which are normally compromised in stress-related psychopathologies. Materials and Methods: Volunteers attending ayahuasca ceremonies were asked to complete a test battery at three separate occasions: baseline, the morning after, and 1 week after the ceremony. We included the constructs of creative thinking (measured by Picture Concept Test), empathy (Multifaceted Empathy Test), satisfaction with life (Satisfaction with Life Scale), decentering (Experiences Questionnaire), and personality (Big Five Inventory) into the test battery. Additionally, the psychedelic experience was quantified with the Persisting Effects Questionnaire, the Ego Dissolution Scale, and Visual Analogue Scales. Results: In total, 43 attendees (males = 22; females = 21) completed parts of the baseline assessment, 20 (males = 12; females = 8) completed assessments in the morning after the ceremony, and 19 (males = 14; females = 5) completed assessments at the 1-week follow-up. At one and 7 days post-ceremony, cognitive empathy, satisfaction with life, and decentering increased, while divergent thinking (Fluency corrected for Originality) decreased, when compared to baseline. Implicit emotional empathy increased at 1-week follow-up, whereas ratings of the trait neuroticism decreased. Conclusion: The study suggests that a single ingestion of ayahuasca in a social setting is associated with enhancement of subjective well-being, an enhanced ability to take an objective and non-judging stance towards the self (decentering), and the ability to correctly recognize emotions in others, compared to baseline, lasting up to 1 week post-ceremony. To understand the therapeutic potential related to these effects, further research with clinical populations is needed in which these effects can be assessed, including its link with therapeutic outcomes. Together, this will increase our understanding of the effectiveness and breadth of future therapeutic options.
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Affiliation(s)
- Maggie K Kiraga
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Natasha L Mason
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Malin V Uthaug
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Kim I M van Oorsouw
- Department of Clinical Sciences, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Stefan W Toennes
- Institute of Legal Medicine, University of Frankfurt, Frankfurt, Germany
| | - Johannes G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Kim P C Kuypers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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21
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Luoma J, Lear MK. MDMA-Assisted Therapy as a Means to Alter Affective, Cognitive, Behavioral, and Neurological Systems Underlying Social Dysfunction in Social Anxiety Disorder. Front Psychiatry 2021; 12:733893. [PMID: 34646176 PMCID: PMC8502812 DOI: 10.3389/fpsyt.2021.733893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
Social anxiety disorder (SAD) is a prevalent and often debilitating psychiatric disorder that can assume a chronic course even when treated. Despite the identification of evidence-based pharmacological and behavioral treatments for SAD, much room for improved outcomes exists and 3,4-methylenedioxymethamphetamine (MDMA) has been proposed as a promising adjunctive treatment to psychological interventions for disorders characterized by social dysfunction. A small randomized, placebo-controlled trial of MDMA-assisted therapy (MDMA-AT) for social anxiety in autistic adults offered encouraging results, but more research is sorely needed to explore the potential for MDMA-AT in treating SAD. This review aims to stimulate future study by summarizing research on disruptions in neurological, perceptual, receptive, and expressive systems regulating social behavior in SAD and proposing how MDMA-AT may alter these systems across four domains. First, we review research highlighting the roles of social anhedonia and reduced social reward sensitivity in maintaining SAD, with specific attention to the reduction in positive affect in social situations, infrequent social approach behaviors, and related social skills deficits. We posit that MDMA-AT may enhance motivation to connect with others and alter perceptions of social reward for an extended period following administration, thereby potentiating extinction processes, and increasing the reinforcement value of social interactions. Second, we review evidence for the central role of heightened social evaluative threat perception in the development and maintenance of SAD and consider how MDMA-AT may enhance experiences of affiliation and safety when interacting with others. Third, we consider the influence of shame and the rigid application of shame regulation strategies as important intrapersonal processes maintaining SAD and propose the generation of self-transcendent emotions during MDMA sessions as a mechanism of shame reduction that may result in corrective emotional experiences and boost memory reconsolidation. Finally, we review research on the role of dysfunctional interpersonal behaviors in SAD that interfere with social functioning and, in particular, the development and maintenance of close and secure relationships. We discuss the hypothesized role of MDMA-AT in improving social skills to elicit positive interpersonal responses from others, creating a greater sense of belonging, acceptance, and social efficacy.
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Affiliation(s)
- Jason Luoma
- Portland Psychotherapy Clinic, Research, and Training Center, Portland, OR, United States
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22
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Lord KA, Suvak MK, Liverant GI. Social anxiety, rejection sensitivity, and theory of mind decoding ability. J Clin Psychol 2021; 78:656-670. [PMID: 34487356 DOI: 10.1002/jclp.23242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 06/29/2021] [Accepted: 08/15/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Recent initiatives have highlighted the importance of investigating clinically relevant variations in social processes that contribute to mental illness. Surprisingly little research has examined the associations between socially and clinically relevant transdiagnostic factors, such as social anxity (SA) and rejection sensitvity (RS), on theory of mind (ToM) decoding ability. METHODS The Reading the Mind in the Eyes Task and self-report measures of SA and RS were completed by 199 adult participants. RESULTS Linear regression analyses suggest a specific difficulty decoding positive emotion associated with SA and global decrements in ToM associated with RS that may reflect a negative interpretation bias. CONCLUSIONS These findings may have important implications for understanding how those with SA and RS perceive and navigate social interactions, which may contribute to the maintenance of symptoms and decreased psychosocial functioning.
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24
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Bray KO, Anderson V, Pantelis C, Pozzi E, Schwartz OS, Vijayakumar N, Richmond S, Deane C, Allen NB, Whittle S. Associations between cognitive and affective empathy and internalizing symptoms in late childhood. J Affect Disord 2021; 290:245-253. [PMID: 34010749 DOI: 10.1016/j.jad.2021.04.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/26/2021] [Accepted: 04/20/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Empathy is a multidimensional construct, which includes cognitive and affective components. Studies in adults have demonstrated that both cognitive and affective empathy are associated with anxious and depressive symptoms. The aim of this study was to examine these associations in childhood. METHODS Participants were 127 9- and 10-year-old children, recruited from the community. Self-report measures of cognitive and affective empathy, and internalizing symptoms were administered, as well as a task-based measure of cognitive empathy. RESULTS Canonical correlation analysis demonstrated that components of affective empathy, specifically affective sharing and empathic distress, were associated with internalizing (particularly social anxiety) symptoms (Rc = 0.63, non-parametric p < .001). Cognitive empathy was not associated with internalizing symptoms. LIMITATIONS Most of our findings were based around self-report measures of empathy, which may not accurately reflect empathy ability. CONCLUSIONS Findings suggests that children who share each other's emotions strongly are more likely to experience anxiety, particularly of a social nature.
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Affiliation(s)
- Katherine O Bray
- Melbourne Neuropsychiatry Centre (MNC), Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
| | - Vicki Anderson
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia; Murdoch Children's Research Centre, Melbourne, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre (MNC), Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia
| | - Elena Pozzi
- Melbourne Neuropsychiatry Centre (MNC), Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia; Orygen, Melbourne Australia, Centre for Youth Mental Health, University of Melbourne, Australia
| | - Orli S Schwartz
- Orygen, Melbourne Australia, Centre for Youth Mental Health, University of Melbourne, Australia
| | | | - Sally Richmond
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Camille Deane
- School of Psychology, Deakin University, Melbourne, Australia
| | | | - Sarah Whittle
- Melbourne Neuropsychiatry Centre (MNC), Department of Psychiatry, The University of Melbourne & Melbourne Health, Melbourne, Australia
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25
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Affective empathy and prosocial behavior in rodents. Curr Opin Neurobiol 2021; 68:181-189. [PMID: 34091136 DOI: 10.1016/j.conb.2021.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 12/30/2022]
Abstract
Empathy is an essential function for humans as social animals. Emotional contagion, the basic form of afffective empathy, comprises the cognitive process of perceiving and sharing the affective state of others. The observational fear assay, an animal model of emotional contagion, has enabled researchers to undertake molecular, cellular, and circuit mechanism of this behavior. Such studies have revealed that observational fear is mediated through neural circuits involved in processing the affective dimension of direct pain experiences. A mouse can also respond to milder social stimuli induced by either positive or negative emotional changes in another mouse, which seems not dependent on the affective pain circuits. Further studies should explore how different neural circuits contribute to integrating different dimensions of affective empathy.
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26
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Simonsen S, Bo S. Awakening to recognize the detrimental effects of social avoidance and the possibility of healing through reconnection. J Clin Psychol 2021; 77:1153-1161. [PMID: 33821501 DOI: 10.1002/jclp.23136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/10/2021] [Accepted: 03/12/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Loneliness and social avoidance are widespread and serious mental health problems. People experiencing loneliness or social avoidance have difficulties maintaining ordinary life activities and often experience profound suffering. How do we as clinicians deal with or help people out of loneliness and social avoidance? AIMS In this paper, we introduce the issue on loneliness and social avoidance. We do so by first defining loneliness and social avoidance and outlining the impact on mental health issues of these phenomena. Next, we introduce the six papers central to the special issue along with some thoughts on how to understand therapy and treatment of social avoidance. DISCUSSION We discuss new directions and how to move beyond more conventional therapeutic approaches to these problems.
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Affiliation(s)
| | - Sune Bo
- Psychiatric Research Unit, Region Zealand Psychiatry, Slagelse, Denmark.,Department of Child and Adolescent Psychiatry, Region Zealand Psychiatry, Roskilde, Denmark
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27
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Kimmig ACS, Wildgruber D, Wendel SMU, Sundström-Poromaa I, Derntl B. Friend vs. Foe: Cognitive and Affective Empathy in Women With Different Hormonal States. Front Neurosci 2021; 15:608768. [PMID: 33762905 PMCID: PMC7982725 DOI: 10.3389/fnins.2021.608768] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 02/09/2021] [Indexed: 01/10/2023] Open
Abstract
Empathy is crucial for social functioning as well as social coherence. It can be influenced by modulatory factors such as familiarity and liking (i.e., emotional closeness). Furthermore, there are first hints that hormonal status may modulate affective but not cognitive empathy in women. The aim of this study was to investigate potential separate as well as combined modulatory effects of emotional closeness and hormonal status on female cognitive and affective empathy. Three hormonal status groups of women (n = 62) were studied: (1) naturally-cycling (NC) women in the early follicular phase (fNC), (2) NC women during periovulatory phase (oNC), and (3) oral contraceptive (OC) users. All women underwent a newly developed empathy task (i.e., Tübinger Empathy Test, TET) presenting textual descriptions of positive and negative emotional scenes relating to three different perspectives (i.e., self vs. friend vs. enemy/disliked person). Regardless of hormonal status, empathic responses were higher for the friend compared to the enemy perspective for both empathy components. However, cognitive empathy was less affected by varying emotional closeness toward the target person than affective empathy. Hormonal status modulated only affective empathy. OC users showed significantly less affective empathy toward the enemy compared to the fNC women. Overall, affective empathy seems more sensitive to modulatory effects of emotional closeness and hormonal status than cognitive empathy. Possible implications of this current investigation for future research on empathy and OC use, contraceptive education as well as for other clinical applications are discussed.
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Affiliation(s)
- Ann-Christin Sophie Kimmig
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.,International Max Planck Research School for Cognitive and Systems Neuroscience, University of Tübingen, Tübingen, Germany
| | - Dirk Wildgruber
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Sina-Maria Ute Wendel
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | | | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany.,LEAD Graduate School and Research Network, University of Tübingen, Tübingen, Germany.,Tübingen Neuro Campus, University of Tübingen, Tübingen, Germany
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28
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Pittelkow MM, Aan Het Rot M, Seidel LJ, Feyel N, Roest AM. Social Anxiety and Empathy: A Systematic Review and Meta-analysis. J Anxiety Disord 2021; 78:102357. [PMID: 33588287 DOI: 10.1016/j.janxdis.2021.102357] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 10/26/2020] [Accepted: 01/05/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This systematic review and meta-analysis aimed to clarify the association between social anxiety and affective (AE) and cognitive empathy (CE). METHODS 1442 studies from PsycINFO, Medline, and EMBASE (inception-January 2020) were systematically reviewed. Included studies (N = 48) either predicted variance in empathy using social anxiety scores or compared empathy scores between socially anxious individuals and a control group. RESULTS Social anxiety and AE were statistically significantly positively associated, k = 14, r = .103 (95%CI [.003, .203]), z = 2.03, p = .043. Sex (QM (2) = 18.79, p < .0001), and type of measures (QM (1 = 7.34, p = .007) moderated the association. Correlations were significant for male samples (rmale = .316, (95%CI [.200, .432])) and studies using self-report measures (rself-report = .162 (95%CI [.070, .254])). Overall, social anxiety and CE were not significantly associated, k = 52, r =-.021 (95%CI [-.075, .034]), z= -0.74, p = .459. Sample type moderated the association (QM (1) = 5.03, p < .0001). For clinical samples the association was negative (rclinical= -.112, (95%CI [-.201, -.017]). CONCLUSION There was evidence for a positive association between social anxiety and AE, but future studies are needed to verify the moderating roles of sex and type of measure. Besides, low CE might only hold for patients with SAD.
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Affiliation(s)
| | - Marije Aan Het Rot
- Department of Psychology, University of Groningen, Netherlands; School Behavioural and Cognitive Neuroscience, University of Groningen, Netherlands; Interdisciplinary Centre for Psychopathology and Emotion regulation (ICPE), University of Groningen, Netherlands
| | | | - Nils Feyel
- Department of Psychology, University of Groningen, Netherlands
| | - Annelieke M Roest
- Department of Psychology, University of Groningen, Netherlands; Interdisciplinary Centre for Psychopathology and Emotion regulation (ICPE), University of Groningen, Netherlands
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Look at me: The relation between empathy and fixation on the emotional eye-region in low vs. high social anxiety. J Behav Ther Exp Psychiatry 2021; 70:101610. [PMID: 32861912 DOI: 10.1016/j.jbtep.2020.101610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 08/11/2020] [Accepted: 08/17/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Fixation on another person's eye-region may be an effective measure of one's level of empathy. In the present study, we tested the hypothesis that this type of empathy measure may not be appropriate for individuals with high levels of social anxiety, since avoidance or hypervigilance attentional biases towards emotional faces are frequent in this condition. METHODS Using eye-tracking, we measured fixation time on the eye-region of another person in participants with low vs. high social anxiety, and we correlated this measure with empathy levels. In a second eye-tracking task, the two groups of participants were presented with pairs of emotional-neutral faces to determine the presence of attentional biases. RESULTS While participants with low social anxiety showed an association between empathy and fixation time on the other person's eyes, the association was null for participants with high social anxiety. Attentional biases towards emotional faces were absent in high social anxiety, but social anxiety correlated negatively with fixation on the eye region. LIMITATIONS Our sample was made up of Psychology undergraduates, and this may have had an influence on gaze behavior towards the eye region. CONCLUSION Fixation on the eye region is not a valid measure of empathy in high social anxiety, possibly due to systematic eye-region avoidance.
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A placebo-controlled study of the effects of ayahuasca, set and setting on mental health of participants in ayahuasca group retreats. Psychopharmacology (Berl) 2021; 238:1899-1910. [PMID: 33694031 PMCID: PMC8233273 DOI: 10.1007/s00213-021-05817-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/01/2021] [Indexed: 12/22/2022]
Abstract
Ayahuasca is a plant concoction containing N,N-dimethyltryptamine (DMT) and certain β-carboline alkaloids from South America. Previous research in naturalistic settings has suggested that ingestion of ayahuasca can improve mental health and well-being; however, these studies were not placebo controlled and did not control for the possibility of expectation bias. This naturalistic observational study was designed to assess whether mental health changes were produced by ayahuasca or by set and setting. Assessments were made pre- and post-ayahuasca sessions in 30 experienced participants of ayahuasca retreats hosted in the Netherlands, Spain, and Germany. Participants consumed ayahuasca (N = 14) or placebo (N = 16). Analysis revealed a main effect of time on symptoms of depression, anxiety, and stress. Compared to baseline, symptoms reduced in both groups after the ceremony, independent of treatment. There was a main treatment × time interaction on implicit emotional empathy, indicating that ayahuasca increased emotional empathy to negative stimuli. The current findings suggest that improvements in mental health of participants of ayahuasca ceremonies can be driven by non-pharmacological factors that constitute a placebo response but also by pharmacological factors that are related to the use of ayahuasca. These findings stress the importance of placebo-controlled designs in psychedelic research and the need to further explore the contribution of non-pharmacological factors to the psychedelic experience.
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Feeling through another's eyes: Perceived gaze direction impacts ERP and behavioural measures of positive and negative affective empathy. Neuroimage 2020; 226:117605. [PMID: 33271267 DOI: 10.1016/j.neuroimage.2020.117605] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/06/2020] [Accepted: 11/25/2020] [Indexed: 12/19/2022] Open
Abstract
Looking at the eyes informs us about the thoughts and emotions of those around us, and impacts our own emotional state. However, it is unknown how perceiving direct and averted gaze impacts our ability to share the gazer's positive and negative emotions, abilities referred to as positive and negative affective empathy. We presented 44 participants with contextual sentences describing positive, negative and neutral events happening to other people (e.g. "Her newborn was saved/killed/fed yesterday afternoon."). These were designed to elicit positive, negative, or little to no empathy, and were followed by direct or averted gaze images of the individuals described. Participants rated their affective empathy for the individual and their own emotional valence on each trial. Event-related potentials time-locked to face-onset and associated with empathy and emotional processing were recorded to investigate whether they were modulated by gaze direction. Relative to averted gaze, direct gaze was associated with increased positive valence in the positive and neutral conditions and with increased positive empathy ratings. A similar pattern was found at the neural level, using robust mass-univariate statistics. The N100, thought to reflect an automatic activation of emotion areas, was modulated by gaze in the affective empathy conditions, with opposite effect directions in positive and negative conditions.. The P200, an ERP component sensitive to positive stimuli, was modulated by gaze direction only in the positive empathy condition. Positive and negative trials were processed similarly at the early N200 processing stage, but later diverged, with only negative trials modulating the EPN, P300 and LPP components. These results suggest that positive and negative affective empathy are associated with distinct time-courses, and that perceived gaze direction uniquely modulates positive empathy, highlighting the importance of studying empathy with face stimuli.
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Berg SK, Bedwell JS, Dvorak RD, Tone EB. Higher Social Anxiety Severity Predicts Better Cognitive Empathy Performance in Women but Not Men. Psychol Rep 2020; 124:2549-2566. [PMID: 33050799 DOI: 10.1177/0033294120965496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Findings regarding relationships between social anxiety and subtypes of empathy have been mixed, and one study suggested that this may be due to moderation by biological sex. The present study examined whether accounting for general anxiety and biological sex clarifies these relationships. Undergraduates (N = 701, 76% female) completed online self-report measures of cognitive and affective empathy, social and general anxiety severity, and a behavioral measure of cognitive empathy (Reading the Mind in the Eyes Task; MIE). Path analysis examined relationships among social and general anxiety severity and affective and cognitive empathy. Model modification indices showed a significant influence of sex on the path from social anxiety severity to MIE accuracy. When the model was re-estimated with this path freed, more socially anxious women, but not men, showed greater MIE accuracy. Across both sexes, general anxiety severity related negatively to self-reported and behavioral (MIE) cognitive empathy. Affective empathy did not relate to either type of anxiety. The use of path analysis to simultaneously account for overlapping variance among measures of anxiety and empathy helps clarify earlier mixed findings on relationships between social anxiety and empathy subtypes.
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Affiliation(s)
| | | | - Robert D Dvorak
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Erin B Tone
- Department of Psychology, Georgia State University, Atlanta, GA, USA
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Psychiatric symptoms and quality of life in older adults with schizophrenia spectrum disorder: results from a multicenter study. Eur Arch Psychiatry Clin Neurosci 2020; 270:673-688. [PMID: 31134378 DOI: 10.1007/s00406-019-01026-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 05/15/2019] [Indexed: 12/16/2022]
Abstract
The severity of psychopathology has a strong negative impact on quality of life (QoL) among older adults with schizophrenia spectrum disorder. However, because these subjects generally experience multiple psychiatric symptoms, it remains unclear whether decreased QoL in this population is due to specific symptoms (e.g., hallucinations), specific dimensions of psychopathology (e.g., negative symptoms), a general psychopathology dimension representing the shared effect across all psychiatric symptoms, or a combination of these explanations. Data were derived from the Cohort of individuals with Schizophrenia Aged 55 years or more (CSA) study, a large (N = 353) multicenter sample of older adults with schizophrenia spectrum disorder recruited from French public-sector psychiatric departments. We used structural equation modeling to examine the shared and specific effects of psychiatric symptoms on QoL, while adjusting for sociodemographic characteristics, general medical conditions, global cognitive functioning and psychotropic medications. Psychiatric symptoms and QoL were assessed face-to-face by psychiatrists using the Brief Psychiatric Rating Scale (BPRS) and the Quality of Life Scale (QLS). Among older adults with schizophrenia spectrum disorder, effects of psychiatric symptoms on QoL were exerted mostly through a general psychopathology dimension (β = - 0.43, p < 0.01). Negative symptom dimension had an additional negative effect on QoL beyond the effect of that factor (β = - 0.28, p < 0.01). Because psychiatric symptoms affect QoL mainly through two dimensions of psychopathology, i.e., a general psychopathology dimension and a negative symptom dimension, mechanisms underlying those dimensions should be considered as promising targets for therapeutic interventions to substantially improve quality of life of this vulnerable population.
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Santiesteban I, Gibbard C, Drucks H, Clayton N, Banissy MJ, Bird G. Individuals with Autism Share Others’ Emotions: Evidence from the Continuous Affective Rating and Empathic Responses (CARER) Task. J Autism Dev Disord 2020; 51:391-404. [DOI: 10.1007/s10803-020-04535-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Effect of Anxiety on Empathy: An Observational Study Among Nurses. Healthcare (Basel) 2020; 8:healthcare8020140. [PMID: 32455779 PMCID: PMC7348913 DOI: 10.3390/healthcare8020140] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/13/2020] [Accepted: 05/19/2020] [Indexed: 12/03/2022] Open
Abstract
Empathy, defined as an emotional ability to put oneself in the place of others, read their state of mind, and think how they are feeling, is an essential pillar of nursing care. On the other hand, anxiety is a frequent emotion that can be generated in stressful work environments, like nurses developing their activity. The aim of the present study is to explore the value of empathy and anxiety personal traits in staff nurses. The sample was comprised of 197 staff nurses from tertiary level hospitals from Madrid, Spain, where 79.2% were women and 20.8% were men in the present study. The instrument used for analysis was the Spanish adaptation of the 16PF5 questionnaire. The results showed the following measurements to warmth (5.58), lively (5.25), socially bold (5.6), privacy (5.82), open to change (5.62), self-reliance (6.12), and anxiety (6.38). Furthermore, anxiety affects positively to warmth (t: 2.66; p > 0.0001) and lively (t = 2.36; p < 0.05), but in a negative way to social bold (t = −3.17; p < 0.001) or open to change (t = −5.81; p < 0.0001). However, it was not seen to have any effect over privacy (t = 1.96; p = 0.052) and self-reliance (t = 1.19; p = 0.234). Finally, it is recommended that healthcare professionals reinforce their personal competencies to strengthen their skills to manage anxiety and improve their empathy competencies.
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Abramson L, Uzefovsky F, Toccaceli V, Knafo-Noam A. The genetic and environmental origins of emotional and cognitive empathy: Review and meta-analyses of twin studies. Neurosci Biobehav Rev 2020; 114:113-133. [PMID: 32353470 DOI: 10.1016/j.neubiorev.2020.03.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 02/20/2020] [Accepted: 03/24/2020] [Indexed: 01/10/2023]
Abstract
Empathy is considered a cornerstone of human social experience, and as such has been widely investigated from psychological and neuroscientific approaches. To better understand the factors influencing individual differences in empathy, we reviewed and meta-analyzed the behavioral genetic literature of emotional empathy- sharing others' emotions (k=13), and cognitive empathy- understanding others' emotions (k = 15), as manifested in twin studies. Results showed that emotional empathy is more heritable, 48.3 % [41.3 %-50.6 %], than cognitive empathy, 26.9 % [18.1 %-35.8 %]. Moreover, cognitive empathy as examined by performance tests was affected by the environment shared by family members, 11.9 % [2.6 %-21.0 %], suggesting that emotional understanding is influenced, to some degree, by environmental factors that have similar effects on family members beyond their genetic relatedness. The effects of participants' age and the method used to asses empathy on the etiology of empathy were also examined. These findings have implications for understanding how individual differences in empathy are formed. After discussing these implications, we suggest theoretical and methodological future research directions that could potentially elucidate the relations between genes, brain, and empathy.
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Bayraktutan M, Oğuzhanoğlu NK, Uğurlu TT. Sympathetic Skin Response in Social Anxiety Disorder and Its Relationship with Empathy Skills, Alexithymia. Noro Psikiyatr Ars 2020; 57:18-22. [PMID: 32110145 PMCID: PMC7024831 DOI: 10.29399/npa.24719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/19/2019] [Indexed: 06/07/2023] Open
Abstract
INTRODUCTION Psycho-behavioral studies have shown that sympathetic skin response (SSR), which is an indicator of sympathetic function, is associated with emotional responses. It has been reported that SSR, which is claimed to be a biological indicator of empathy, has increased in Social Anxiety Disorder (SAD) patients. The aim of this study was to evaluate the relationship between SSR and alexithymia, empathy in patients with SAD. METHOD SAD patients and control group were applied Liebowitz Social Anxiety Scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Toronto Alexithymia Scale, Empathy Quotient, Facial Emotion Identification and Discrimination tests (FID, FDSC); during the application FID, SSR were measured. The relationship between alexithymia and empathy levels were investigated. RESULTS The number of SSR was higher in all visual stimuli of SAD patients (11.13±3.01) compared to the control group (7.4±3.57). More autonomous activity to negative stimuli (SAD: 10.55±2.82, control: 6.36±3.64), sensitivity to positive stimuli (SAD: 0.58±0.69, control: 1.03±0.8) was less than control group. While 41.7% of SAD patients had alexithymic features, 36.1% were diagnosed with depressive disorder. CONCLUSION It was thought that depressive and alexithymic features may have contributed to increased sympathetic sensitivity to negative stimuli in SAD patients. Further studies are needed to examine the effects of this situation on the selection and creation of the treatment modalities.
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Affiliation(s)
| | | | - Tuğçe Toker Uğurlu
- Pamukkale University Faculty of Medicine, Psychiatry Department, Denizli, Turkey
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Brain and behavioral alterations in subjects with social anxiety dominated by empathic embarrassment. Proc Natl Acad Sci U S A 2020; 117:4385-4391. [PMID: 32041879 PMCID: PMC7049137 DOI: 10.1073/pnas.1918081117] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
People are increasingly affected by social anxiety that includes emotional hypersensitivity and inaccurate interpretation of social encounters, and varies markedly in its subjective manifestations. We searched for insights into the underlying neurocognitive mechanisms of Taijin-kyofusho (TKS), a specific subtype of social-anxiety disorder common in East Asia and dominated by empathic or other-oriented embarrassment. We found TKS to be characterized by enhanced affective and reduced cognitive empathy. Moreover, analysis of functional MRI data—collected while subjects viewed videos of badly singing people—revealed disruption of the cognitive–empathy network, possibly obstructing flexible inference of others’ perspective or augmenting maladaptive feelings of embarrassment. Our findings shed light on how altered affective and cognitive processing can contribute to the development of imaginary fears. Social-anxiety disorder involves a fear of embarrassing oneself in the presence of others. Taijin-kyofusho (TKS), a subtype common in East Asia, additionally includes a fear of embarrassing others. TKS individuals are hypersensitive to others’ feelings and worry that their physical or behavioral defects humiliate others. To explore the underlying neurocognitive mechanisms, we compared TKS ratings with questionnaire-based empathic disposition, cognitive flexibility (set-shifting), and empathy-associated brain activity in 23 Japanese adults. During 3-tesla functional MRI, subjects watched video clips of badly singing people who expressed either authentic embarrassment (EMBAR) or hubristic pride (PRIDE). We expected the EMBAR singers to embarrass the viewers via emotion-sharing involving affective empathy (affEMP), and the PRIDE singers to embarrass via perspective-taking involving cognitive empathy (cogEMP). During affEMP (EMBAR > PRIDE), TKS scores correlated positively with dispositional affEMP (personal-distress dimension) and with amygdala activity. During cogEMP (EMBAR < PRIDE), TKS scores correlated negatively with cognitive flexibility and with activity of the posterior superior temporal sulcus/temporoparietal junction (pSTS/TPJ). Intersubject correlation analysis implied stronger involvement of the anterior insula, inferior frontal gyrus, and premotor cortex during affEMP than cogEMP and stronger involvement of the medial prefrontal cortex, posterior cingulate cortex, and pSTS/TPJ during cogEMP than affEMP. During cogEMP, the whole-brain functional connectivity was weaker the higher the TKS scores. The observed imbalance between affEMP and cogEMP, and the disruption of functional brain connectivity, likely deteriorate cognitive processing during embarrassing situations in persons who suffer from other-oriented social anxiety dominated by empathic embarrassment.
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Nonattachment Predicts Empathy, Rejection Sensitivity, and Symptom Reduction After a Mindfulness-Based Intervention Among Young Adults with a History of Childhood Maltreatment. Mindfulness (N Y) 2020; 11:975-990. [PMID: 32382357 DOI: 10.1007/s12671-020-01322-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objectives Individuals with a childhood maltreatment history tend to have various psychological symptoms and impaired social functioning. This study aimed to investigate the related therapeutic effects of a mindfulness-based intervention in this population. Methods We analyzed self-report questionnaire scores of the Mindful Attention Awareness Scale (MAAS), Non-Attachment Scale (NAS), Adult Rejection Sensitivity Questionnaire (A-RSQ), Interpersonal Reactivity Index (IRI), PTSD CheckList (PCL), and Anxiety Sensitivity Index (ASI), from 16 (3 males) young adults (age range 22-29) with mild to moderate childhood maltreatment, compared to 18 matched participants (6 males) on a waiting list, during both pre- and post-intervention/waiting periods. Analyses were conducted with linear mixed effects models, partial correlation analyses and t-tests. Results There were group by time interaction effects with the scores of MAAS, NAS, PCL, IRI-Fantasy, and A-RSQ (p < .05). The mindfulness group had significant increase in MAAS (17.325%) and NAS (8.957%) scores, as well as reduction in PCL (15.599%) and A-RSQ (23.189%) scores (p < .05). Changes in non-attachment, but not mindfulness, had significant contributions to the score changes of PCL (16.375%), ASI (36.244%), IRI-Personal Distress (24.141%), IRI-Empathic Concern (16.830%), and A-RSQ (10.826%) (p < .05). The number of intervention sessions attended was correlated with score changes of NAS (r = .955, p < .001), and ASI (r = -.887, p < .001), suggesting a dose-dependent effect. Conclusions Findings from this pilot study suggest that the mindfulness-based intervention improved mindfulness, non-attachment and empathy, which contributed to reduced interpersonal distress, rejection sensitivity and other psychological symptoms.
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Abstract
Empathy, broadly defined as the ability to understand the other and to share others' emotions, motivates prosocial behavior and underlies successful interpersonal relations. Dysfunctions in this ability may cause fundamental difficulties in social communication. Empathy has been measured in various ways, from self-report questionnaires to laboratory objective performance tests. Empathic accuracy (EA), i.e., the ability to accurately empathize, is measured using more complex and ecological paradigms, such as asking participants to infer filmed interactions, or having people narrate personal emotional stories then assessing the correspondence between the perceiver and the target of empathy as the criteria for empathic ability. This measure is particularly useful in the study of clinical populations, where deconstructing the multifaceted concept of empathy may contribute to a more complete understanding of specific clinical profiles. This paper presents a scoping review of the literature on EA in clinical populations, and on EA and clinical traits and states in nonclinical or high-risk populations. Following an exhaustive literature search, 34 studies were found eligible to be included in this review. The largest category was studies focused on EA in people with schizophrenia (31%; 11 papers), followed by studies focused on EA in autism spectrum disorders (ASD) and autistic traits in a nonclinical population (22%; 8 papers). Studies were also found on EA and depression tendencies, psychopathy, social anxiety, behavior disorders, and personality disorders, and a few other clinical conditions. The included studies varied on research aims, designs, sample sizes, and male:female ratios. The overall synthesized results suggest that EA is reduced in schizophrenia and ASD. In other clinical populations, the number of studies was very limited. We urge researchers to further examine EA in these less-studied populations. The review reveals a general underrepresentation of female participants in studies on EA in clinical populations. We suggest that future research address understudied clinical populations, such as those diagnosed with psychopathy. Subject, target, and situational variables should also be considered, with special attention to gender differences (and similarities), the association between EA abilities and adaptive functioning, and the study of individuals with clinical conditions as targets, not just observers, in EA tasks.
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Affiliation(s)
- Yonat Rum
- Psychology Department, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Anat Perry
- Psychology Department, The Hebrew University of Jerusalem, Jerusalem, Israel
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Gruber J, Villanueva C, Burr E, Purcell JR, Karoly H. Understanding and Taking Stock of Positive Emotion Disturbance. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2020; 14:e12515. [PMID: 37636238 PMCID: PMC10456988 DOI: 10.1111/spc3.12515] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The prevailing view on positive emotions is that they correlate with and confer psychological health benefits for the individual, including improved social, physical and cognitive functioning. Yet an emerging wave of scientific work suggests that positive emotions are also related to a range of suboptimal psychological health outcomes, especially when the intensity, duration, or context do not optimize the individual's goals or meet current environmental demands. This paper provides an overview of the 'other side' of positive emotion, by describing and reviewing evidence supporting the emerging field of Positive Emotion Disturbance (PED). We review relevant emotion processes and key themes of PED and apply this framework to example emotional disorders, and discuss implications for psychological change and future research agendas.
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Affiliation(s)
- June Gruber
- Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Cynthia Villanueva
- Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Emily Burr
- Department of Psychology and Neuroscience, University of Colorado Boulder
| | - John R. Purcell
- Department of Psychological & Brain Sciences, Indiana University
| | - Hollis Karoly
- Department of Psychology and Neuroscience, University of Colorado Boulder
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Morrison AS, Mateen MA, Brozovich FA, Zaki J, Goldin PR, Heimberg RG, Gross JJ. Changes in Empathy Mediate the Effects of Cognitive-Behavioral Group Therapy but Not Mindfulness-Based Stress Reduction for Social Anxiety Disorder. Behav Ther 2019; 50:1098-1111. [PMID: 31735245 DOI: 10.1016/j.beth.2019.05.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 04/26/2019] [Accepted: 05/07/2019] [Indexed: 01/10/2023]
Abstract
Social anxiety disorder (SAD) has been shown to be associated with difficulty in the ability to vicariously share others' positive emotions (positive affective empathy). Mixed evidence also suggests potentially impaired recognition of the positive and negative emotions of others (cognitive empathy) and impaired or enhanced sharing of the negative emotions of others (negative affective empathy). Therefore, we examined whether two efficacious treatments for SAD, cognitive-behavioral group therapy (CBGT) and mindfulness-based stress reduction (MBSR), improve empathy in SAD relative to a wait-list condition and whether improvements in empathy mediate improvements in social anxiety. In the context of a randomized controlled trial, participants with SAD completed an empathy task at baseline, posttreatment/wait-list (N = 81), and 1-year follow-up (N = 37). Relative to both MBSR and wait-list, CBGT resulted in significant improvements in positive affective empathy. CBGT-related changes in positive affective empathy also mediated improvements in social anxiety at both posttreatment/wait-list and at 1-year follow-up. Other indices of empathy did not change differentially across the three conditions. Therefore, one way in which CBGT may specifically confer benefits to individuals with SAD is through increasing their ability or willingness to share in the positive emotions of others.
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Wagers KB, Kiel EJ. The influence of parenting and temperament on empathy development in toddlers. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2019; 33:391-400. [PMID: 30730181 PMCID: PMC6533135 DOI: 10.1037/fam0000505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Empathy is a critical ability in developing relationships, and deficits in empathy have been associated with various maladaptive social outcomes. Although specific parenting styles and behaviors (including warmth and reasoning) are expected to be related to the development of child empathy, these may function differently for children with an inhibited temperament. Children with an inhibited temperament, who are at risk for developing an anxiety disorder, may also struggle with expressing empathic behaviors. These relations were tested in a longitudinal study including mothers and their toddlers. Dyads participated at time points approximately 1 year apart when toddlers were 24 and 36 months old. Moderating effects were found for parental warmth and reasoning, as well as authoritative parenting broadly. Maternal warmth was related to higher levels of empathy for only children with low levels of inhibited temperament. Maternal reasoning was related to lower levels of empathy for children with high levels of inhibited temperament. Thus, for children with low levels of inhibited temperament, warmth predicts higher empathy, and for children with high levels of inhibited temperament, reasoning predicts lower empathy. These findings are discussed within a goodness of fit framework, suggesting that children's positive outcomes depend on the match between parenting behavior and temperament. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Compassion and Loving-Kindness Meditation: An Overview and Prospects for the Application in Clinical Samples. Harv Rev Psychiatry 2019; 26:201-215. [PMID: 29975338 DOI: 10.1097/hrp.0000000000000192] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This article presents a brief overview of the empirical evidence of well-established mindfulness interventions and an in-depth review of less-established compassion-based interventions (CBIs) and loving-kindness meditation (LKM). Definitions, cognitive and physiological mechanisms, and methods of assessment are discussed. METHOD A literature review using the databases Google Scholar, PsycINFO, and PubMed was conducted. RESULTS Whereas the efficacy of mindfulness-based stress reduction and mindfulness-based cognitive therapy has been documented in many trials, only seven randomized, controlled trials have been completed on CBIs and LKM. In these trials, CBIs were effective in treating psychotic disorders, affective disorders with psychotic features, major depressive disorder, eating disorders, and patients with suicide attempts in the past year; LKM was effective in treating chronic pain; and a combination of both was effective for borderline personality disorder. A larger number of nonrandomized studies indicate that CBIs and LKM may be effective in treating a wide range of clinical conditions, including depression, anxiety disorders, chronic pain, and posttraumatic stress disorder. CONCLUSIONS Further studies are needed to confirm the promising effects of CBIs and LKM. Preliminary evidence suggests that both approaches might be beneficial across various clinical populations. Future studies need to clarify whether these approaches might be options as stand-alone treatments or as adjuncts or augmentation of evidence-based methods in psychotherapy.
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Mason NL, Mischler E, Uthaug MV, Kuypers KPC. Sub-Acute Effects of Psilocybin on Empathy, Creative Thinking, and Subjective Well-Being. J Psychoactive Drugs 2019; 51:123-134. [DOI: 10.1080/02791072.2019.1580804] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Natasha L. Mason
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Elisabeth Mischler
- Central Customs Authority, Centre of Education and Science, Cologne, Germany
| | - Malin V. Uthaug
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Kim P. C. Kuypers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Bajouk O, Hansenne M. Dispositional Perspective-Taking and Empathic Concern Modulate the Impact of Cognitive Load on Empathy for Facial Emotions. Psychol Rep 2018; 122:2201-2219. [PMID: 30211661 DOI: 10.1177/0033294118799337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Meeting other people involves the importance to share their experiences and to understand their perspectives or, more simply, to empathize with them. Empathy research distinguishes two main dimensions of empathy, the affective sharing and the cognitive understanding. In the present study, we focus on the impact of cognitive load on empathy to pain, fear, happiness, and neutral facial emotions. Participants had to judge the intensity of the emotion when looking to facial expressions (empathize group), or with an additional eight-digit memory task (cognitive load group). While we assumed that cognitive load would reduce empathy, inconsistently with previous findings, our results did not show any significant effect of group. Interestingly, regression analyses showed that perspective-taking and empathic concern were positively related to pain, fear, and happiness ratings within the cognitive load group. These results reveal that when judging empathy under high cognitive load, dispositional empathic concern and perspective-taking could allow individuals to override the supposed deleterious cognitive load effect on empathy.
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Affiliation(s)
- Omar Bajouk
- Department of Psychology, PsyNCog Research Unit, Liège University, Belgium
| | - Michel Hansenne
- Department of Psychology, PsyNCog Research Unit, Liège University, Belgium
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Bilevicius E, Kolesar TA, Smith SD, Trapnell PD, Kornelsen J. Trait Emotional Empathy and Resting State Functional Connectivity in Default Mode, Salience, and Central Executive Networks. Brain Sci 2018; 8:brainsci8070128. [PMID: 29986390 PMCID: PMC6071260 DOI: 10.3390/brainsci8070128] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 06/27/2018] [Accepted: 07/03/2018] [Indexed: 12/30/2022] Open
Abstract
Emotional empathy is the ability to experience and/or share another person’s emotional states and responses. Although some research has examined the neural correlates of emotional empathy, there has been little research investigating whether this component of empathy is related to the functional connectivity of resting state networks in the brain. In the current study, 32 participants answered a trait emotional empathy questionnaire in a session previous to their functional magnetic resonance imaging scan. Results indicate that emotional empathy scores were correlated with different patterns of functional connectivity in the default mode network (DMN), salience network (SN), and left and right central executive networks. For example, within the DMN, emotional empathy scores positively correlated with connectivity in the premotor cortex. Within the SN, empathy scores were positively correlated with the fusiform gyrus and cuneus. These findings demonstrate that emotional empathy is associated with unique patterns of functional connectivity in four of the brain’s resting state networks.
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Affiliation(s)
- Elena Bilevicius
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB R3E 0J9, Canada.
- St. Boniface Hospital Research, Catholic Health Corporation of Manitoba, Compassion Project, Winnipeg, MB R2H 2A6, Canada.
- Department of Psychology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
| | - Tiffany A Kolesar
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB R3E 0J9, Canada.
- St. Boniface Hospital Research, Catholic Health Corporation of Manitoba, Compassion Project, Winnipeg, MB R2H 2A6, Canada.
| | - Stephen D Smith
- Department of Psychology, University of Winnipeg, Winnipeg, MB R3B 2E9, Canada.
| | - Paul D Trapnell
- Department of Psychology, University of Winnipeg, Winnipeg, MB R3B 2E9, Canada.
| | - Jennifer Kornelsen
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB R3E 0J9, Canada.
- St. Boniface Hospital Research, Catholic Health Corporation of Manitoba, Compassion Project, Winnipeg, MB R2H 2A6, Canada.
- Department of Radiology, University of Manitoba, Winnipeg, MB R3A 1R9, Canada.
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