Do I feel or do I know? Neuroimaging meta-analyses on the multiple facets of empathy

Dissecting shared pain representations to understand their behavioral and clinical relevance

Accounts of shared representations posit that the experience of pain and pain empathy rely on similar neural mechanisms. Experimental research employing novel analytical and methodological approaches has made significant advances in both the identification and targeted manipulation of such shared experiences and their neural underpinnings. This revealed that painful experiences can be shared on different representational levels, from pain-specific to domain-general features, such as negative affect and its regulation. In view of direct links between such representations and social behaviors such as prosocial behavior, conditions characterized by aberrant pain processing may come along with heavy impairments in the social domain, depending on the affected representational level. This has wide potential implications in light of the high prevalence of pain-related clinical conditions, their management, and the overuse of pain medication. In this review and opinion paper, we aim to chart the path toward a better understanding of the link between shared affect and prosocial behavior.

The impact of acute violent videogame exposure on neurocognitive markers of empathic concern

Research examining the purported association between violent gaming and aggression remains controversial due to concerns related to methodology, unclear neurocognitive mechanisms, and the failure to adequately consider the role of individual differences in susceptibility. To help address these concerns, we used fMRI and an emotional empathy task to examine whether acute and cumulative violent gaming exposure were associated with abnormalities in emotional empathy as a function of trait-empathy. Emotional empathy was targeted given its involvement in regulating not only aggression, but also other important social functions such as compassion and prosocial behaviour. We hypothesized that violent gaming exposure increases the risk of aberrant social behaviour by altering the aversive value of distress cues. Contrary to expectations, neither behavioural ratings nor empathy-related brain activity varied as a function of violent gaming exposure. Notably, however, activation patterns in somatosensory and motor cortices reflected an interaction between violent gaming exposure and trait empathy. Thus, our results are inconsistent with a straightforward relationship between violent gaming exposure and reduced empathy. Furthermore, they highlight the importance of considering both individual differences in susceptibility and other aspects of cognition related to social functioning to best inform public concern regarding safe gaming practices.

Affective music during episodic memory recollection modulates subsequent false emotional memory traces: an fMRI study

Music is a powerful medium that influences our emotions and memories. Neuroscience research has demonstrated music's ability to engage brain regions associated with emotion, reward, motivation, and autobiographical memory. While music's role in modulating emotions has been explored extensively, our study investigates whether music can alter the emotional content of memories. Building on the theory that memories can be updated upon retrieval, we tested whether introducing emotional music during memory recollection might introduce false emotional elements into the original memory trace. We developed a 3-day episodic memory task with separate encoding, recollection, and retrieval phases. Our primary hypothesis was that emotional music played during memory recollection would increase the likelihood of introducing novel emotional components into the original memory. Behavioral findings revealed two key outcomes: 1) participants exposed to music during memory recollection were more likely to incorporate novel emotional components congruent with the paired music valence, and 2) memories retrieved 1 day later exhibited a stronger emotional tone than the original memory, congruent with the valence of the music paired during the previous day's recollection. Furthermore, fMRI results revealed altered neural engagement during story recollection with music, including the amygdala, anterior hippocampus, and inferior parietal lobule. Enhanced connectivity between the amygdala and other brain regions, including the frontal and visual cortex, was observed during recollection with music, potentially contributing to more emotionally charged story reconstructions. These findings illuminate the interplay between music, emotion, and memory, offering insights into the consequences of infusing emotional music into memory recollection processes.

Neuronal Correlates of Empathy: A Systematic Review of Event-Related Potentials Studies in Perceptual Tasks

Empathy is a crucial component to infer and understand others' emotions. However, a synthesis of studies regarding empathy and its neuronal correlates in perceptual tasks using event-related potentials (ERPs) has yet to occur. The current systematic review aimed to provide that overview. Upon bibliographic research, 30 studies featuring empathy assessments and at least one perceptual task measuring ERP components in healthy participants were included. Four main focus categories were identified, as follows: Affective Pictures, Facial Stimuli, Mental States, and Social Language. The Late Positive Potential was the most analyzed in Affective Pictures and was reported to be positively correlated with cognitive and affective empathy, along with other late components. In contrast, for Facial Stimuli, early components presented significant correlations with empathy scales. Particularly, the N170 presented negative correlations with cognitive and affective empathy. Finally, augmented N400 was suggested to be associated with higher empathy scores in the Mental States and Social Language categories. These findings highlight the relevance of early perceptual stages of empathic processing and how different EEG/ERP methodologies provide relevant information.

Neural correlates of individual differences in moral identity and its positive moral function

Moral identity is an important moral variable which has positive moral functions, such as contributing to prosocial behaviours, reducing antisocial behaviours, and resisting the risk factors of antisocial behaviours. However, little is known about the neural correlates of moral identity and the neural basis of the effect of moral identity on the risk factors of antisocial behaviours, including moral disengagement. In this study, we explored these issues in 142 college students by estimating the regional homogeneity (ReHo) through resting-state functional magnetic resonance imaging (fMRI). The whole-brain correlation analyses found that higher internalized moral identity was correlated with higher ReHo in the precuneus. Furthermore, the ReHo in the precuneus was negatively correlated with moral disengagement, suggesting positive moral functions of the neural mechanisms of moral identity. These findings deepen our understanding of individual differences in moral identity and provide inspiration for the education of moral identity and the intervention for moral disengagement from the perspective of the brain.

Higher-order sensorimotor circuit of the whole-brain functional network involved in pruritus regulation in atopic dermatitis

BACKGROUND

Little is known about the neural mechanisms underlying pruritus regulation in Atopic dermatitis (AD).

OBJECTIVE

To investigate the functional changes of the resting-state whole brain network of AD participants and the mechanisms by which they were involved in pruritus regulation.

METHOD

Based on the functional magnetic resonance imaging data from 19 AD participants and 37 healthy controls (HC), a graph-theoretical measure of degree centrality (DC) conjoined with a voxel-level seed-based functional connectivity (FC) method was used to identify abnormal higher-order nodes and the functionally relevant circuit in AD participants compared to healthy controls (HC).

RESULTS

Of 64 participants screened, 19 AD participants (12M/7F, median [IQR] age, 27 [14] years) and 36 HCs (13M/23F, median [IQR] age, 20 [1] years) were enrolled. DC values of the left superior frontal gyrus (LSFG) increased in AD participants and exhibited a negative correlation with the SCORAD score (r = -0.561, p = 0.012) compared with HC. In the FC analysis with LSFG as the seed, FC values of several sensory and motor regions increased in AD participants, highly overlapping with the anatomical distribution of the inferior fronto-occipital fascicle (IFOF). AD participants with severe pruritus exhibited lower levels of DC (T = -2.316, p = 0.033) and FC between the LSFG and left insula (T = -2.203, p = 0.042) than those with mild-to- moderate pruritus.

CONCLUSIONS AND RELEVANCE

LSFG was involved in pruritus regulation in AD by forming a high-order sensorimotor circuit through the IFOF, a white matter fascicle that proved to provide multimodal integration in motor control and sensory information processing. These results offer more mechanism-guided treatment targets for severe pruritus in AD.

Patterns of neural activity in response to threatening faces are predictive of autistic traits: modulatory effects of oxytocin receptor genotype

Autistic individuals generally demonstrate impaired emotion recognition but it is unclear whether effects are emotion-specific or influenced by oxytocin receptor (OXTR) genotype. Here we implemented a dimensional approach using an implicit emotion recognition task together with functional MRI in a large cohort of neurotypical adult participants (N = 255, male = 131, aged 17-29 years) to establish associations between autistic traits and neural and behavioral responses to specific face emotions, together with modulatory effects of OXTR genotype. A searchlight-based multivariate pattern analysis (MVPA) revealed an extensive network of frontal, basal ganglia, cingulate and limbic regions exhibiting significant predictability for autistic traits from patterns of responses to angry relative to neutral expression faces. Functional connectivity analyses revealed a genotype interaction (OXTR SNPs rs2254298, rs2268491) for coupling between the orbitofrontal cortex and mid-cingulate during angry expression processing, with a negative association between coupling and autistic traits in the risk-allele group and a positive one in the non-risk allele group. Overall, results indicate extensive emotion-specific associations primarily between patterns of neural responses to angry faces and autistic traits in regions processing motivation, reward and salience but not in early visual processing. Functional connections between these identified regions were not only associated with autistic traits but also influenced by OXTR genotype. Thus, altered patterns of neural responses to threatening faces may be a potential biomarker for autistic symptoms although modulatory influences of OXTR genotype need to be taken into account.

Female Cerebellum Seems Sociable; An iTBS Investigation

The cerebellum has been shown to be engaged in tasks other than motor control, including cognitive and affective functions. Prior neuroimaging studies have documented the role of this area in social cognition and despite these findings, no studies have yet examined the causal relationship between the cerebellum and social cognition. This study aimed to investigate the role of the cerebellum in empathy and theory of mind (ToM) in a randomized, placebo-controlled, double-blind, parallel study. 32 healthy participants were assigned to either a sham or active group. For the active group, an intermittent theta-burst stimulation (iTBS) protocol at 100% of the motor threshold was applied to the cerebellum, while the control group received sham stimulation. An eyes-closed EEG session, the Empathy Quotient (EQ) test, and the Reading the Mind in the Eyes Test (RMET) were administered before and after the iTBS session. The results demonstrated differences in cognitive empathy, ToM, and a decrease in the activity of the default mode network (DMN) between the active and sham groups in females. Females also showed a decrease in the activity of the affective empathy network and connectivity in the DMN. We conclude that cognitive empathy and ToM are associated with cerebellar activity, and due to sex-related differences in the cortical organization of this area which is modulated by sex hormones, the stimulation of the cerebellum in males and females yields different results.

Basolateral Amygdala Functional Connectivity in Alexithymia: Linking Interoceptive Sensibility and Cognitive Empathy

Emotions rely on bodily states, and perceiving the emotions of others depends on awareness of one's own emotional state. However, the intercorrelations among interoception, alexithymia, and empathy are not well understood, and the neural mechanisms behind this connection are also largely unknown. To address these issues, 297 college students participated in this study, completing measures of interoceptive sensibility (IS), empathy and alexithymia and undergoing resting-state fMRI scans. The functional connectivity of the amygdala was analysed to identify the neural substrates of alexithymia, and mediation analyses were conducted to examine the mediation effect of alexithymia and alexithymia-specific amygdala functional connectivity on the relationship between IS and empathy. The results showed that higher levels of IS were associated with increased cognitive empathy through weakened alexithymia. Functional connectivity analysis indicated that right basolateral amygdala (BLA)-left precuneus connectivity was negatively related to alexithymia, while right BLA-left precentral gyrus connectivity was positively related to alexithymia. Furthermore, right BLA-left precuneus connectivity was found to mediate the impact of interoception on cognitive empathy. In conclusion, this study provides valuable insights into the relationships among IS, alexithymia, and empathy. The right BLA-left precuneus connectivity may serve as a shared neural substrate between interoception and cognitive empathy.

Can people empathize with offenders and victims during violent scenes? Behavioral and brain correlates of affective and cognitive empathy considering victim vs. offender perspective using the Bochumer affective and cognitive empathy task (BACET)

Empathy is defined as the capacity to resonate with others' emotions and can be subdivided into affective and cognitive components. Few studies have focused on the role of perspective-taking within this ability. Utilizing the novel Bochumer Affective and Cognitive Empathy Task (BACET), the present study aims to determine the characteristics of specific empathy components, as well as the impact of offender vs. victim perspective-taking. A total of 21 male participants (mean age = 30.6) underwent functional magnetic resonance imaging (fMRI) while watching 60 videos showing two protagonists in neutral (n = 30) or violent interactions (n = 30) thereby adopting the perspective of the (later) offender or victim. Our data show that videos showing emotional (violent) content, compared to those with neutral content, were rated more emotionally negative and induced higher affective empathic involvement, particularly when adopting the victim's perspective compared to the offender's point of view. The correct assignment of people's appropriate emotion (cognitive empathy) was found to be more accurate and faster in the emotional condition relative to the neutral one. However, no significant differences in cognitive empathy performance were observed when comparing victim vs offender conditions. On a neural level, affective empathy processing, during emotional compared to neutral videos, was related to brain areas generally involved in social information processing, particularly in occipital, parietal, insular, and frontal regions. Cognitive aspects of empathy, relative to factual reasoning questions, were located in inferior occipital areas, fusiform gyrus, temporal pole, and frontal cortex. Neural differences were found depending on the perspective, i.e., empathizing with the victim, compared to the offender, during affective empathy activated parts of the right temporal lobe, whereas empathy towards the role of the offender revealed stronger activation in the right lingual gyrus. During cognitive empathy, empathy toward the victim, relative to the offender, enhanced activity of the right supramarginal and left precentral gyri. The opposite contrast did not show any significant differences. We conclude that the BACET can be a useful tool for further studying behavioral and neurobiological underpinnings of affective and cognitive empathy, especially in forensic populations since response patterns point to a significant impact of the observer's perspective.

Healthcare experience affects pain-specific responses to others' suffering in the anterior insula

Medical students and professional healthcare providers often underestimate patients' pain, together with decreased neural responses to pain information in the anterior insula (AI), a brain region implicated in self-pain processing and negative affect. However, the functional significance and specificity of these neural changes remains debated. Across two experiments, we recruited university medical students and emergency nurses to test the role of healthcare experience on the brain reactivity to other's pain, emotions, and beliefs, using both pictorial and verbal cues. Brain responses to self-pain was also assessed and compared with those to observed pain. Our results confirmed that healthcare experience decreased the activity in AI in response to others' suffering. This effect was independent from stimulus modality (pictures or texts), but specific for pain, as it did not generalize to inferences about other mental or affective states. Furthermore, representational similarity and multivariate pattern analysis revealed that healthcare experience impacted specifically a component of the neural representation of others' pain that is shared with that of first-hand nociception, and related more to AI than to other pain-responsive regions. Taken together, our study suggests a decreased propensity to appraise others' suffering as one's own, associated with a reduced recruitment of pain-specific information in AI. These findings provide new insights into neural mechanisms leading to pain underestimation by caregivers in clinical settings.

A pill as a quick solution: association between painkiller intake, empathy, and prosocial behavior

Previous research has demonstrated a link between the administration of analgesic drugs and the reduction of empathy levels in humans. This apparent blunting effect of pain medication has been explained through shared neural mechanisms for the first-hand and the empathic experience of pain (simulation theory). Considering that analgesics are among the most consumed drugs in the world and the ability to empathize with others is fundamental to human social interactions, the aim of the present study was to investigate whether the typical day-to-day analgesic consumption rate in Austria and Germany is associated with a reduction in empathy and prosocial behavior. We therefore collected self-reports of analgesic consumption behavior as well as empathy for pain and prosocial behavior measures in an online survey (n = 940). Analyses revealed no significant association between the analgesic intake frequency and measures of empathy or prosocial behavior. However, liberal intake of analgesics (i.e. mind-set of "a pill is a quick solution") was linked to lower empathic concern and helping behavior, which may hint towards a negative effect in people who take pain medication for non-pain related issues or episodes of low pain. Nevertheless, further research is needed to investigate the effects of analgesic drugs in high frequency users.

Dissociating cognitive and affective empathy across psychopathy dimensions: The role of interoception and alexithymia

This study examined the associations between psychopathy dimensions (triarchic phenotypes and classical factors), empathy domains (cognitive and affective), and interoception (interoceptive attention and accuracy) while accounting for the putative role of alexithymia. A community sample (n = 515) completed an online survey encompassing: Triarchic Psychopathy Measure (boldness, meanness, disinhibition); Levenson Self-Report Psychopathy Scale (primary and secondary psychopathy); Body Perception Questionnaire (interoceptive attention); Interoceptive Accuracy Scale; Toronto Alexithymia Scale. Hierarchical linear regression models were implemented for hypothesis-driven analyses examining the associations between psychopathy, empathy, and interoception while controlling for sex, age, and alexithymia. Exploratory path models were employed to investigate alexithymia and/or cognitive empathy as mediators between interoception and psychopathy. Our results largely confirmed the postulated empathy profiles across psychopathy dimensions, as meanness and primary psychopathy displayed a broad empathy impairment, while disinhibition and secondary psychopathy were only associated with diminished cognitive empathy. Importantly, boldness displayed a unique pattern (enhanced cognitive empathy and reduced affective empathy), further reinforcing its importance within the constellation of psychopathy traits. Contrary to our hypotheses, self-perceived interoceptive attention and accuracy were not associated with either psychopathy dimension after controlling for alexithymia. However, interoceptive accuracy and alexithymia were associated with cognitive empathy, while alexithymia was also positively related to all psychopathy dimensions (as expected), despite the unexpected strong and negative association with boldness. Exploratory analyses suggested significant indirect effects (mediation) between interoceptive accuracy and psychopathy via alexithymia and/or cognitive empathy. These mediating effects must be interpreted with caution and future studies should be designed to formally test this model.

Cognitive exertion affects the appraisal of one's own and other people's pain

Correctly evaluating others' pain is a crucial prosocial ability. In both clinical and private settings, caregivers assess their other people's pain, sometimes under the effect of poor sleep and high workload and fatigue. However, the effect played by such cognitive strain in the appraisal of others' pain remains unclear. Fifty participants underwent one of two demanding tasks, involving either working memory (Experiment 1: N-Back task) or cognitive interference (Experiment 2: Stroop task). After each task, participants were exposed to painful laser stimulations at three intensity levels (low, medium, high), or video-clips of patients experiencing three intensity levels of pain (low, medium, high). Participants rated the intensity of each pain event on a visual analogue scale. We found that the two tasks influenced rating of both one's own and others' pain, by decreasing the sensitivity to medium and high events. This was observed either when comparing the demanding condition to a control (Stroop), or when modelling linearly the difficulty/performance of each depleting task (N-Back). We provide converging evidence that cognitive exertion affects the subsequent appraisal of one's own and likewise others' pain.

Hormonal contraception & face processing: Examining face gender, androgenicity & treatment duration

Previous cross-sectional studies observed differences between users and non-users of combined oral contraceptives (COCs) in both the structure and function of the fusiform face area (FFA) related to face processing. For the present study 120 female participants performed high-resolution structural, as well as functional scans at rest, during face encoding and face recognition. Participants were either never-users of COCs (26), current first-time users of androgenic (29) or anti-androgenic COCs (23) or previous users of androgenic (21) or anti-androgenic COCs (21). Results suggest that associations between COC-use and face processing are modulated by androgenicity, but do not persist beyond the duration of COC use. The majority of findings concern the connectivity of the left FFA to the left supramarginal gyrus (SMG), which is a key region in cognitive empathy. While connectivity in anti-androgenic COC users differs from never users irrespective of the duration of COC use already at rest, connectivity in androgenic COC users decreases with longer duration of use during face recognition. Furthermore, longer duration of androgenic COC use was related to reduced identification accuracy, as well as increased connectivity of the left FFA to the right orbitofrontal cortex. Accordingly, the FFA and SMG emerge as promising ROIs for future randomized controlled trials on the effects of COC use on face processing.

Neural bases of loss aversion when choosing for oneself versus known or unknown others

Despite the ubiquitous interdependence between one's own decisions and others' welfare, and the controversial evidence on the behavioral effect of choosing for others, the neural bases of making decisions for another versus oneself remain unexplored. We investigated whether loss aversion (LA; the tendency to avoid losses over approaching equivalent gains) is modulated by (i) choosing for oneself, other individuals, or both; (ii) knowing or not knowing the other recipients; or (iii) an interaction between these factors. We used fMRI to assess the brain activations associated with choosing whether to accept or reject mixed gambles, either for oneself, for another player, or both, in 2 groups of 28 participants who had or had not briefly interacted with the other players before scanning. Participants displayed higher LA for choices involving their payoff compared with those affecting only the payoff of other, known, players. This "social" modulation of decision-making was found to engage the dorsomedial prefrontal cortex and its inhibitory connectivity to the middle cingulate cortex. This pattern might underpin decision-making for known others via self-other distinction processes associated with dorsomedial prefrontal areas, with this in turn promoting the inhibition of socially oriented responses through the downregulation of the midcingulate node of the empathy network.

Emotional descriptions increase accidental harm punishment and its cortico-limbic signatures during moral judgment in autism

Individuals with autism spectrum disorder (ASD) present difficulties in integrating mental state information in complex moral tasks. Yet, ASD research has not examined whether this process is influenced by emotions, let alone while capturing its neural bases. We investigated how language-induced emotions modulate intent-based moral judgment in ASD. In a fMRI task, 30 adults with ASD and 27 neurotypical controls read vignettes whose protagonists commit harm either accidentally or intentionally, and then decided how much punishment the protagonist deserved. Emotional content was manipulated across scenarios through the use of graphic language (designed to trigger arousing negative responses) vs. plain (just-the-facts, emotionless) language. Off-line functional connectivity correlates of task performance were also analyzed. In ASD, emotional (graphic) descriptions amplified punishment ratings of accidental harms, associated with increased activity in fronto-temporo-limbic, precentral, and postcentral/supramarginal regions (critical for emotional and empathic processes), and reduced connectivity among the orbitofrontal cortex and the angular gyrus (involved in mentalizing). Language manipulation did not influence intentional harm processing in ASD. In conclusion, in arousing and ambiguous social situations that lack intentionality clues (i.e. graphic accidental harm scenarios), individuals with ASD would misuse their emotional responses as the main source of information to guide their moral decisions. Conversely, in face of explicit harmful intentions, they would be able to compensate their socioemotional alterations and assign punishment through non-emotional pathways. Despite limitations, such as the small sample size and low ecological validity of the task, results of the present study proved reliable and have relevant theoretical and translational implications.

The validation of a Mandarin version of the Empathy Components Questionnaire (ECQ-Chinese) in Chinese samples

Empathy involves both empathic ability and empathic motivation. An important topic has been how to measure empathic ability and motivation simultaneously in both clinical and non-clinical samples and across different cultures. The Empathy Components Questionnaire (ECQ) is a self-report questionnaire that measures empathic ability and motivation in a questionnaire. The current study aimed to validate the Mandarin Chinese version of the ECQ (ECQ-Chinese) in three Chinese samples. In study 1, a total of 538 Chinese participants (Sample 1) completed the ECQ-Chinese via an online survey, and existing measures of empathy and related constructs which were used for criterion validity. In study 2, a total of 104 participants (Sample 2) were recruited again from sample 1 and completed the ECQ-Chinese three weeks later to investigate test-retest reliability. In study 3, a further 324 participants (Sample 3) completed the ECQ-Chinese for confirmatory factor analysis. The results showed that the ECQ-Chinese has a good internal consistency reliability, split-half reliability, and criterion validity (Study 1), and a good test-retest reliability (Study 2). Further, Study 3 found that a 22-item ECQ-Chinese consisting of five subscales had a good construct validity, convergence validity and discriminate validity, demonstrating it to be a suitable tool for the measurement of empathic ability and motivation in Chinese samples and to carry out cross-cultural studies of empathy and its components.

The association between acute stress & empathy: A systematic literature review

Empathy is a fundamental component of our social-emotional experience. Over the last decade, there has been increased interest in understanding the effects of acute stress on empathy. We provide a first comprehensive-and systematic-overview identifying emerging patterns and gaps in this literature. Regarding affective empathy, there is abundant evidence for stress contagion-the 'spillover' of stress from a stressed target to an unstressed perceiver. We highlight contextual factors that can facilitate and/or undermine these effects. Fewer studies have investigated the effects of acute stress on affective empathy, revealing a nuanced picture, some evidence suggests acute stress can block contagion of other's emotions; but again contextual differences need to be considered. Regarding cognitive empathy, most studies find no conclusive effects for simplistic measures of emotion recognition; however, studies using more complex empathy tasks find that acute stress might affect cognitive empathy differentially for men and women. This review provides an important first step towards understanding how acute stress can impact social-togetherness, and aims to aid future research by highlighting (in)congruencies and outstanding questions.

Stress and the brain: Emotional support mediates the association between myelination in the right supramarginal gyrus and perceived chronic stress

Perceived stress, which refers to people's evaluation of a stressful event and their ability to cope with it, has emerged as a stable predictor for physical and mental health outcomes. Increasing evidence has suggested the buffering effect of social support on perceived stress. Although previous studies have investigated the brain structural features (e.g., gray matter volume) associated with perceived stress, less is known about the association between perceived chronic stress and intra-cortical myelin (ICM), which is an important microstructure of brain and is essential for healthy brain functions, and the role of social support in this association. Using a sample of 1076 healthy young adults drawn from the Human Connectome Project, we quantified the ICMby the contrast of T1w and T2w images and examined its association with perceived chronic stress during the last month and social support. Behavioral results showed that perceived chronic stress was negatively associated with both emotional support and instrumental support. Vertex-wise multiple regression analyses revealed that higher level of perceived chronic stress was significantly associated with lower ICM content of a cluster in the right supramarginal gyrus (rSMG). Interestingly, the emotional support, but not the instrumental support, significantly mediated the association of perceived chronic stress with ICM in the rSMG. Overall, the present study provides novel evidence for the cortical myelination of perceived chronic stress in humans and highlights the essential role of the rSMG in perceived chronic stress and emotional support.

Audiovisual integration in the human brain: a coordinate-based meta-analysis

People can seamlessly integrate a vast array of information from what they see and hear in the noisy and uncertain world. However, the neural underpinnings of audiovisual integration continue to be a topic of debate. Using strict inclusion criteria, we performed an activation likelihood estimation meta-analysis on 121 neuroimaging experiments with a total of 2,092 participants. We found that audiovisual integration is linked with the coexistence of multiple integration sites, including early cortical, subcortical, and higher association areas. Although activity was consistently found within the superior temporal cortex, different portions of this cortical region were identified depending on the analytical contrast used, complexity of the stimuli, and modality within which attention was directed. The context-dependent neural activity related to audiovisual integration suggests a flexible rather than fixed neural pathway for audiovisual integration. Together, our findings highlight a flexible multiple pathways model for audiovisual integration, with superior temporal cortex as the central node in these neural assemblies.

Face beauty or soul beauty? The influence of facial attractiveness and moral judgment on pain empathy

Previous studies indicated that both facial attractiveness (face beauty) and moral judgment (soul beauty) would impact the responses to others’ pain, however, the effects from facial attractiveness were in controversial. Furthermore, whether facial attractiveness would increase or decrease the effects of moral judgment on pain empathy were still unknown. Based on the videos in which actors with high versus low facial attractiveness under pain or non-pain conditions, study 1 recruited 26 undergraduates to assess the effects of facial attractiveness on participants’ pain intensity rating scores. Then study 2 recruited 85 undergraduates to examine the effects of facial attractiveness and moral judgment on pain empathy by assessing pain intensity and self-uncomfortableness rating scores. Study 1 found that participants rated higher pain intensity scores to actors with high facial attractiveness compared to low facial attractive actors under pain condition. Study 2 found that participants showed higher pain empathic responses for actors with high moral judgment, no matter their facial attractiveness were high or low. For actors with low moral judgment under pain condition, participants showed higher pain empathy to those with high facial attractiveness compared to those with low facial attractiveness. In conclusion, facial attractiveness could facilitate the empathy responses for other’s pain. High facial attractiveness would increase the pain empathic responses to individuals with low moral judgment, however, low facial attractiveness would not decrease the pain empathic responses to individuals with high moral judgment.

Acute tryptophan depletion balances altered resting-state functional connectivity of the salience network in female patients recovered from anorexia nervosa

BACKGROUND

It has been suggested that individuals predisposed to or recovered from anorexia nervosa experience a hyperserotonergic state associated with anxiety that might be mitigated by restricted food intake, because diminished levels of the tryptophan precursor lower the central availability of serotonin (5-HT). At the neural level, the salience network is a system of functionally connected brain regions; it has been closely associated with 5-HT functioning and mental disorders (including anorexia nervosa). The aim of the present study was to investigate the effect on the salience network of a temporary dietary manipulation of 5-HT synthesis in patients with anorexia nervosa.

METHODS

In this double-blind crossover study, we obtained data on resting-state functional connectivity from 22 weight-recovered female patients with a history of anorexia nervosa, and 22 age-matched female healthy controls. The study procedure included acute tryptophan depletion (a dietary intervention that lowers the central 5-HT synthesis rate) and a sham condition.

RESULTS

We identified an interaction of group and experimental condition in resting-state functional connectivity between the salience network and the orbitofrontal cortex extending to the frontal pole (F _1,42 = 12.52; p _FWE = 0.026). Further analysis revealed increased resting-state functional connectivity during acute tryptophan depletion in patients recovered from anorexia nervosa, resembling that of healthy controls during the sham condition (T ₄₂ = -0.66; p = 0.51).

LIMITATIONS

The effect of acute tryptophan depletion on the central availability of 5-HT can be judged only indirectly using plasma ratios of tryptophan to large neutral amino acids. Moreover, the definition of anorexia nervosa recovery varies widely across studies, limiting comparability.

CONCLUSION

Taken together, our findings support the notion of 5-HT dysregulation in anorexia nervosa and indicate that reduced 5-HT synthesis and availability during acute tryptophan depletion (and possibly with food restriction) may balance hyperserotonergic functioning and the associated resting-state functional connectivity of the salience network.

Sex difference in trait empathy is encoded in the human anterior insula

Females are considered the more empathic sex. This conventional view, however, has been challenged in the past few decades with mixed findings. These heterogeneous findings could be caused by the fact that empathy is a complex and multifaceted construct. To clarify whether sex differences exist in certain dimensions of empathy and whether they are associated with specific neural bases, this study measured trait empathy using the interpersonal reactivity index (IRI) and collected brain structural and functional magnetic resonance imaging data in a large sample of healthy participants (206 males vs. 302 females). We found that females scored higher in the personal distress (PD) subscale than males, but they were comparable to males in other IRI subscales. Sex difference in PD was encoded by brain structural (e.g. gray matter volume in left anterior insula [AI]) and functional (e.g. resting-state functional connectivity between left AI and temporoparietal junction/inferior frontal gyrus) characteristics. Notably, the relationship between sex and PD was indirect-only and serially mediated by AI-associated structural and functional characteristics. Altogether, our results suggested that sex difference existed in self-oriented affective empathy (i.e. PD) and highlighted the importance of the AI, both structurally and functionally, in mediating the sex difference in trait empathy.

Lower affective empathy in oral contraceptive users: a cross-sectional fMRI study

Evidence accumulates that oral contraceptive (OC) use modulates various socio-affective behaviors, including empathic abilities. Endogenous and synthetic sex hormones, such as estrogens and progestogens, bind to receptor sites in brain regions (i.e. frontal, limbic, and cerebellar) involved in socio-affective processing. Therefore, the aim of this study was to investigate the role of OC use in empathy. In a cross-sectional functional magnetic resonance imaging study, women in different hormonal states, including OC use (n = 46) or being naturally cycling in the early follicular (fNC: n = 37) or peri-ovulatory phase (oNC: n = 28), performed a visual, sentence-based empathy task. Behaviorally, OC users had lower empathy ratings than oNC women. Congruently, whole-brain analysis revealed significantly larger task-related activation of several brain regions, including the left dorsomedial prefrontal gyrus (dmPFG), left precentral gyrus, and left temporoparietal junction in oNC compared to OC women. In OC users, the activity of the left dmPFG and precentral gyrus was negatively associated with behavioral and self-reported affective empathy. Furthermore, empathy-related region-of-interest analysis indicated negative associations of brain activation with synthetic hormone levels in OC women. Overall, this multimodal, cross-sectional investigation of empathy suggests a role of OC intake in especially affective empathy and highlights the importance of including synthetic hormone levels in OC-related analyses.

The association between ballroom dance training and empathic concern: Behavioral and brain evidence

Dance is unique in that it is a sport and an art simultaneously. Beyond improving sensorimotor functions, dance training could benefit high-level emotional and cognitive functions. Duo dances also confer the possibility for dancers to develop the abilities to recognize, understand, and share the thoughts and feelings of their dance partners during the long-term dance training. To test this possibility, we collected high-resolution structural and resting-state functional magnetic resonance imaging (MRI) data from 43 expert-level ballroom dancers (a model of long-term exposure to duo dance training) and 40 age-matched and sex-matched nondancers, and measured their empathic ability using a self-report trait empathy scale. We found that ballroom dancers showed higher scores of empathic concern (EC) than controls. The EC scores were positively correlated with years with dance partners but negatively correlated with the number of dance partners for ballroom dancers. These behavioral results were supported by the structural and functional MRI data. Structurally, we observed that the gray matter volumes in the subgenual anterior cingulate cortex (ACC) and EC scores were positively correlated. Functionally, the connectivity between ACC and occipital gyrus was positively correlated with both EC scores and years with dance partners. In addition, the relationship between years with dance partners and EC scores was indirect-only mediated by the ACC-occipital gyrus functional connectivity. Therefore, our findings provided solid evidence for the close link between long-term ballroom dance training and empathy, which deepens our understanding of the neural mechanisms underlying this phenomenon.

Neural mechanisms underlying empathy during alcohol abstinence: evidence from connectome-based predictive modeling

Empathy impairments have been linked to alcohol dependence even during abstinent periods. Nonetheless, the neural underpinnings of abstinence-induced empathy deficits remain unclear. In this study, we employed connectome-based predictive modeling (CPM) by using whole brain resting-state functional connectivity (rs-FC) to predict empathy capability of abstinent alcoholics (n = 47) versus healthy controls (n = 59). In addition, the generalizability of the predictive model (i.e., one group treated as a training dataset and another one treated as a test dataset) was performed to determine whether healthy controls and abstinent alcoholics share common neural fingerprints of empathy. Our results showed that abstinent alcoholics relative to healthy controls had decreased empathy capacity. Although no predictive models were observed in the abstinence group, we found that individual empathy scores in the healthy group can be reliably predicted by functional connectivity from the default mode network (DMN) to the sensorimotor network (SMN), occipital network, and cingulo-opercular network (CON). Moreover, the identified connectivity fingerprints of healthy controls could be generalized to predict empathy in the abstinence group. These findings indicate that neural circuits accounting for empathy may be disrupted by alcohol use and the impaired degree varies greatly among abstinent individuals. The large inter-individual variation may impede identification of the predictive model of empathy in alcohol abstainers.

Dissociable effects of acute versus cumulative violent video game exposure on the action simulation circuit in university students

There is an ongoing debate as to whether violent video game exposure (VGE) has a negative impact on social functioning. This debate continues in part because of methodological concerns and the paucity of identifiable neurocognitive mechanisms. Also, little attention has been given to how specific personality characteristics may influence susceptibility to the purported effects. Using a combined experimental and cross-sectional approach, we examined the impact of VGE on action simulation as a function of trait coldheartedness in a sample of university students. Healthy adults played a violent or nonviolent version of Grand Theft Auto V before completing an fMRI measure of action simulation circuit (ASC) activity. Simulation-related activity was not significantly different between groups; however, greater overall activation was observed in left inferior frontal gyrus for those in the violent condition. Contrary to predictions, no evidence was observed that trait coldheartedness significantly interacts with violent gaming to influence ASC activation. However, prior cumulative VGE was negatively correlated with simulation-related activity in a subsection of the ASC. This study highlights a potential dissociation between the effects of acute versus cumulative violent gaming and may challenge assumptions that the directionality of effects for cross-sectional associations always mirror those of acute exposure.

Are empathic processes mechanisms of pregnancy's protective effect on smoking? Identification of a novel target for preventive intervention

BACKGROUND

Spontaneous cessation and reduction in smoking by pregnant women suggest that concern about others, or empathy, could be a malleable target for intervention. We examined various empathy-related processes in relations to reported and biochemically assessed smoking during pregnancy.

METHODS

Participants were 154 pregnant women (M = 12.4 weeks gestation, SD = 4.6) who were smoking cigarettes immediately prior to pregnancy recognition (85 had quit and 69 were still smoking at enrollment). Empathy-related processes were measured with performance-based paradigms (affect sharing, empathic concern, and theory of mind) and a speech sample (expressed emotion). Smoking was assessed with timeline follow back interviews and urine cotinine assays. Using zero-inflated Poisson regression models, we tested direct and interactive effects of empathy-related processes with respect to biologically verified smoking cessation (zero portion); and mean cigarettes/day smoked after pregnancy recognition among persistent smokers (count portion).

RESULTS

Affect sharing was inversely related to post-recognition cigarettes/day (B(SE) = -0.17(0.07), 95%C.I. -0.30,-0.04, p = .011) and moderated the relationship between pre-recognition smoking and post-recognition smoking consistent with a buffering effect (B(SE) = -.17(0.05); 95%C.I. - 0.28,-0.06; p = .002). Other empathy related processes showed neither direct nor interactive effects on smoking outcomes.

CONCLUSIONS

Further research is recommended to clarify the role of empathy in pregnancy smoking.

Motherhood and theory of mind: increased activation in the posterior cingulate cortex and insulae

Despite growing evidence on effects of parenthood on social understanding, little is known about the influence of parenthood on theory of mind (ToM), the capacity to infer mental and affective states of others. It is also unclear whether any possible effects of parenthood on ToM would generalise to inferring states of adults or are specific to children. We investigated neural activation in mothers and women without children while they predicted action intentions from child and adult faces. Region-of-interest analyses showed stronger activation in mothers in the bilateral posterior cingulate cortex, precuneus (ToM-related areas) and insulae (emotion-related areas). Whole-brain analyses revealed that mothers compared to non-mothers more strongly activated areas including the left angular gyrus and the ventral prefrontal cortex but less strongly activated the right supramarginal gyrus and the dorsal prefrontal cortex. These differences were not specific to child stimuli but occurred in response to both adult and child stimuli and might indicate that mothers and non-mothers employ different strategies to infer action intentions from affective faces. Whether these general differences in affective ToM between mothers and non-mothers are due to biological or experience-related changes should be subject of further investigation.

Altruism under Stress: Cortisol Negatively Predicts Charitable Giving and Neural Value Representations Depending on Mentalizing Capacity

Altruism, defined as costly other-regarding behavior, varies considerably across people and contexts. One prominent context in which people frequently must decide on how to socially act is under stress. How does stress affect altruistic decision-making and through which neurocognitive mechanisms? To address these questions, we assessed neural activity associated with charitable giving under stress. Human participants (males and females) completed a charitable donation task before and after they underwent either a psychosocial stressor or a control manipulation, while their brain activity was measured using functional magnetic resonance imaging. As the ability to infer other people's mental states (i.e., mentalizing) predicts prosocial giving and may be susceptible to stress, we examined whether stress effects on altruism depend on participants' general capacity to mentalize, as assessed in an independent task. Although our stress manipulation per se had no influence on charitable giving, increases in the stress hormone cortisol were associated with reductions in donations in participants with high mentalizing capacity, but not in low mentalizers. Multivariate neural response patterns in the right dorsolateral prefrontal cortex (DLPFC) were less predictive of postmanipulation donations in high mentalizers with increased cortisol, indicating decreased value coding, and this effect mediated the (moderated) association between cortisol increases and reduced donations. Our findings provide novel insights into the modulation of altruistic decision-making by suggesting an impact of the stress hormone cortisol on mentalizing-related neurocognitive processes, which in turn results in decreased altruism. The DLPFC appears to play a key role in mediating this cortisol-related shift in altruism.SIGNIFICANCE STATEMENT Altruism is a fundamental building block of our society. Emerging evidence indicates a major role of acute stress and stress-related neuromodulators in social behavior and decision-making. How and through which mechanisms stress may impact altruism remains elusive. We observed that the stress hormone cortisol was linked to diminished altruistic behavior. This effect was mediated by reduced value representations in the right dorsolateral prefrontal cortex and critically depended on the individual capacity to infer mental states of others. Our findings provide novel insights into the modulation of human altruism linked to stress-hormone dynamics and into the involved sociocognitive and neural mechanisms, with important implications for future developments of more targeted interventions for stress-related decrements in social behavior and social cognition.

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

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

Increased child‐evoked activation in the precuneus during facial affect recognition in mothers

Successful parenting requires constant inferring of affective states. Especially vital is the correct identification of facial affect. Previous studies have shown that infant faces are processed preferentially compared to adult faces both on the behavioural and the neural level. This study specifically investigates the child‐evoked neural responses to affective faces and their modulation by motherhood and attention to affect. To do so, we used a paradigm to measure neural responses during both explicit and implicit facial affect recognition (FAR) in mothers and non‐mothers using child and adult faces. Increased activation to child compared to adult faces was found for mothers and non‐mothers in face processing areas (bilateral fusiform gyri) and areas associated with social understanding (bilateral insulae and medial superior frontal gyrus) when pooling implicit and explicit affect recognition. Furthermore, this child‐evoked activation was modulated by motherhood with an increase in mothers compared to non‐mothers in the left precuneus. Additionally, explicitly recognising the affect increased child‐evoked activation in the medial superior frontal gyrus in both mothers and non‐mothers. These results suggest preferential treatment of affective child over adult faces, modulated by motherhood and attention to affect.

Altered activation in the action observation system during synchronization in high loneliness individuals

Lonely people tend to evaluate social exchanges negatively and to display difficulties in interactions. Interpersonal synchronization is crucial for achieving positive interactions, promoting affinity, closeness, and satisfaction. However, little is known about lonely individuals' ability to synchronize and about their brain activity while synchronizing. Following the screening of 303 participants, we recruited 32 low and 32 high loneliness participants. They were scanned while engaged in movement synchronization, using a novel dyadic interaction paradigm. Results showed that high loneliness individuals exhibited a reduced ability to adapt their movement to their partner's movement. Intriguingly, during movement adaptation periods, high loneliness individuals showed increased activation in the action observation (AO) system, specifically in the inferior frontal gyrus and the inferior parietal lobule. They did not show increased activation in the dorsomedial prefrontal cortex, which in the context of synchronization was suggested to be related to gap-monitoring. Based on these findings, we propose a model according to which lonely people may require stronger activation of their AO system for alignment, to compensate for some deficiency in their synchronization ability. Despite this hyperactivation, they still suffer from reduced synchronization capacity. Consequently, synchronization may be a relevant intervention area for the amelioration of loneliness.

Correlations between facial emotion processing and biochemical abnormalities in untreated adolescent patients with major depressive disorder: A proton magnetic resonance spectroscopy study

BACKGROUND

Studies show that disturbances of the fronto-striato-thalamic-cerebellar circuit could be correlated to facial emotion processing (FEP) biases in major depressive disorder (MDD). Nevertheless, the underlying mechanism of natural metabolism-emotion relationships in adolescent MDD remains unclear.

METHODS

Thirty-seven adolescent patients with MDD and 30 healthy controls completed FEP tasks using the Chinese Facial Affective Picture System (CAFPS). Proton magnetic resonance spectroscopy (¹H-MRS) was also used to obtain ratios of N-acetylaspartate (NAA) /creatine (Cr) and choline (Cho) /Cr ratios in the prefrontal cortex (PFC), anterior cingulate cortex (ACC), putamen, thalamus and cerebellum. Correlations between abnormal neurometabolic ratios and FEP were also computed.

RESULTS

Compared with the control group, the MDD group had significantly lower accuracy and perception intensity of happiness, and significantly higher accuracy of disgust and perception intensity of sad and fearful faces in FEP tasks. Compared to healthy controls, adolescent patients with MDD showed significantly lower NAA/Cr ratios in the left PFC, higher NAA/Cr ratios in the right thalamus, and higher Cho/Cr ratios in the right putamen, although there were no significant differences in metabolites in the ACC and cerebellum between two groups. In the MDD group, NAA/Cr ratios of the right thalamus were negatively correlated with happy reaction time and positively correlated with sad, anger, and fear intensity; Cho/Cr ratios in the right putamen were positively correlated with fear reaction time.

CONCLUSIONS

Our findings suggest that FEP bias may exist in adolescents with MDD, while the impairment of FEP may be associated with abnormal metabolites in the fronto-striato-thalamic circuit.

Organization of the social cognition network predicts future depression and interpersonal impairment: a prospective family-based study

Deficits in social cognition and functioning are common in major depressive disorder (MDD). Still, no study into the pathophysiology of MDD has examined the social cognition-related neural pathways through which familial risk for MDD leads to depression and interpersonal impairments. Using resting-state fMRI, we applied a graph theoretical analysis to quantify the influence of nodes within the fronto-temporo-parietal cortical social cognition network in 108 generation 2 and generation 3 offspring at high and low-risk for MDD, defined by the presence or absence, respectively, of moderate to severe MDD in generation 1. New MDD episodes, future depressive symptoms, and interpersonal impairments were tested for associations with social cognition nodal influence, using regression analyses applied in a generalized estimating equations approach. Increased familial risk was associated with reduced nodal influence within the network, and this predicted new depressive episodes, worsening depressive symptomatology, and interpersonal impairments, 5-8 years later. Findings remained significant after controlling for current depressive/anxiety symptoms and current/lifetime MDD and anxiety disorders. Path-analysis models indicate that increased familial risk impacted offspring's brain function in two ways. First, high familial risk was indirectly associated with future depression, both new MDD episodes and symptomatology, via reduced nodal influence of the right posterior superior temporal gyrus (pSTG). Second, high familial risk was indirectly associated with future interpersonal impairments via reduced nodal influence of right inferior frontal gyrus (IFG). Finally, reduced nodal influence was associated with high familial risk in (1) those who had never had MDD at the time of scanning and (2) a subsample (n = 52) rescanned 8 years later. Together, findings reveal a potential pathway for the intergenerational transmission of vulnerability via the aberrant social cognition network organization and suggest using the connectome of neural network related to social cognition to identify intervention and prevention targets for those particularly at risk.

Non-academic factors influencing the development of empathy in undergraduate nursing students: a cross-sectional study

BACKGROUND

Empathy is described as a core competence of nursing. There is abundant research evidence supporting that empathy varies according to personal characteristics and targeted training. The aim of this study was to characterize non-academic factors (personal and environmental) influencing the development of empathy in undergraduate nursing studies who are not receiving a targeted training in empathetic abilities in their nursing schools.

METHODS

A cross-sectional study was performed in the three nursing schools located in Cusco city, Peru (two private and one public). The Jefferson Scales of Empathy, Attitudes toward Physician-Nurse Collaboration, and Lifelong Learning, the Emotional Loneliness Scale for Adults, and the Scale of Life Satisfaction, were applied as the main measures. Also, information regarding gender, nursing school, and age, were collected. After psychometric properties were assessed, all measures were used in the development of a multivariate regression model to characterize factors of influence in empathy.

RESULTS

In a sample composed by 700 undergraduate nursing students (72 males and 628 females), a multivariate linear regression model was created. This model explained the 53% of variance of empathy and fitted all conditions necessary for inference estimations. Teamwork abilities, loneliness, age, sex, subjective well-being, and nursing school, appeared as factors influencing the development of empathy in patients' care.

CONCLUSIONS

Findings have indicated that, in absence of a targeted training, individual characteristics and characteristics associated with social and family environments play an important role of influence in the development of empathy in nursing students. These findings are also in consonance with others previously reported in different cultural settings including high-, middle- and low-income countries.

Increased activation in the bilateral anterior insulae in response to others in pain in mothers compared to non-mothers

Empathy allows us to share emotions and encourages us to help others. It is especially important in the context of parenting where children's wellbeing is dependent on their parents' understanding and fulfilment of their needs. To date, little is known about differences in empathy responses of parents and non-parents. Using stimuli depicting adults and children in pain, this study focuses on the interaction of motherhood and neural responses in areas associated with empathy. Mothers showed higher activation to both adults and children in pain in the bilateral anterior insulae, key regions of empathy for pain. Additionally, mothers more strongly activated the inferior frontal, superior temporal and the medial superior frontal gyrus. Differences between adult and child stimuli were only found in occipital areas in both mothers and non-mothers. Our results suggest a stronger neural response to others in pain in mothers than non-mothers regardless of whether the person is a child or an adult. This could indicate a possible influence of motherhood on overall neural responses to others in pain rather than motherhood specifically shaping child-related responses. Alternatively, stronger responses to others in pain could increase the likelihood for women to be in a relationship and subsequently to have a child.

A Feature-Based Network Analysis and fMRI Meta-Analysis Reveal Three Distinct Types of Prosocial Decisions

Tasks that measure correlates of prosocial decision-making share one common feature: agents can make choices that increase the welfare of a beneficiary. However, prosocial decisions vary widely as a function of other task features. The diverse ways that prosociality is defined and the heterogeneity of prosocial decisions have created challenges for interpreting findings across studies and identifying their neural correlates. To overcome these challenges, we aimed to organize the prosocial decision-making task space of neuroimaging studies. We conducted a systematic search for studies in which participants made decisions to increase the welfare of others during functional magnetic resonance imaging. We identified shared and distinct features of these tasks and employed an unsupervised graph-based approach to assess how various forms of prosocial decision-making are related in terms of their low-level components (e.g. task features like potential cost to the agent or potential for reciprocity). Analyses uncovered three clusters of prosocial decisions, which we labeled as cooperation, equity and altruism. This feature-based representation of the task structure was supported by results of a neuroimaging meta-analysis that each type of prosocial decisions recruited diverging neural systems. Results clarify some of the existing heterogeneity in how prosociality is conceptualized and generate insight for future research and task paradigm development.

Musical Training in the Development of Empathy and Prosocial Behaviors

Music not only regulates mood but also promotes the development and maintenance of empathy and social understanding. Since empathy is crucial for well-being and indispensable in social life, it is necessary to develop strategies to improve empathy and prosocial behaviors. To fulfill this aim, researchers have extensively investigated the effect of intensive musical training on the development of empathy. Here, we first summarize evidence showing the powerful influence of musical training on the development of empathy and then discuss psychological mechanisms responsible for those observations. The conclusions drawn from most previous studies were mainly based on behavioral measurements, while the neural basis of musical training in the development of the empathic brain is still unclear. Fortunately, brain imaging research has contributed greatly to our understanding of the neural underpinnings associated with musical training and its possible connection to the development of the empathic brain. One of the most distinctive signatures of musical training is structural and functional changes of multiple brain regions, and such changes might be related to some of the empathic behaviors observed in musically trained children. Therefore, intensive musical training in childhood may increase levels of empathy, and applied research is required to optimize the training strategy before implementing music education in empathy regulation. Moreover, future longitudinal studies are needed to better understand neural mechanisms underlying the causal effect of musical training on empathy development. These findings have important implications for understanding the development of the empathic brain and for improving prosocial behaviors.

Medical education and distrust modulate the response of insular-cingulate network and ventral striatum in pain diagnosis

Healthcare providers often underestimate patients’ pain, sometimes even when aware of their reports. This could be the effect of experience reducing sensitivity to others pain, or distrust toward patients’ self-evaluations. Across multiple experiments (375 participants), we tested whether senior medical students differed from younger colleagues and lay controls in the way they assess people’s pain and take into consideration their feedback. We found that medical training affected the sensitivity to pain faces, an effect shown by the lower ratings and highlighted by a decrease in neural response of the insula and cingulate cortex. Instead, distrust toward the expressions’ authenticity affected the processing of feedbacks, by decreasing activity in the ventral striatum whenever patients’ self-reports matched participants’ evaluations, and by promoting strong reliance on the opinion of other doctors. Overall, our study underscores the multiple processes which might influence the evaluation of others’ pain at the early stages of medical career.

Representation of social content in dorsomedial prefrontal cortex underlies individual differences in agreeableness trait

Personality traits reflect key aspects of individual variability in different psychological domains. Understanding the mechanisms that give rise to these differences requires an exhaustive investigation of the behaviors associated with such traits, and their underlying neural sources. Here we investigated the mechanisms underlying agreeableness, one of the five major dimensions of personality, which has been linked mainly to socio-cognitive functions. In particular, we examined whether individual differences in the neural representations of social information are related to differences in agreeableness of individuals. To this end, we adopted a multivariate representational similarity approach that captured within single individuals the activation pattern similarity of social and non-social content, and tested its relation to the agreeableness trait in a hypothesis-driven manner. The main result confirmed our prediction: processing social and non-social content led to similar patterns of activation in individuals with low agreeableness, while in more agreeable individuals these patterns were more dissimilar. Critically, this association between agreeableness and encoding similarity of social and random content was significant only in the dorsomedial prefrontal cortex, a brain region consistently involved during attributions of mental states. The present finding reveals the link between neural mechanisms underlying social information processing and agreeableness, a personality trait highly related to socio-cognitive abilities, thereby providing a step forward in characterizing its neural determinants. Furthermore, it emphasizes the advantage of multivariate pattern analysis approaches in capturing and understanding the neural sources of individual variations.

Friend vs. Foe: Cognitive and Affective Empathy in Women With Different Hormonal States

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.

Neural signatures of parental empathic responses to imagined suffering of their adolescent child

Empathy is deemed indispensable for sensitive caregiving. Neuroimaging studies have identified canonical empathy networks consisting of regions supporting cognitive and affective aspects of empathy. However, not much is known about how these regions support empathy towards one's own offspring and how this neural activity relates to parental caregiving. We introduce a novel task to assess affective and neural responses to the suffering of one's own adolescent child. While in the scanner, 60 parents (n = 35 mothers, n = 25 fathers) were confronted with unpleasant situations involving their own child, an unfamiliar child, and themselves. Parents were asked to vividly imagine these situations and indicate their levels of distress. Parents reported higher levels of distress when imagining suffering for their own child relative to an unfamiliar child or themselves. Neuroimaging results showed increased activation within the cognitive empathy network (i.e., temporoparietal junction, dorsomedial- and ventromedial prefrontal cortex) when contrasting suffering of one's own child versus an unfamiliar child or the self. The task also engaged regions of the affective empathy network (i.e., anterior insula and anterior mid-cingulate cortex), which was however not modulated by whether suffering was for the self, one's own child, or an unfamiliar child. Parental care did not co-vary with activity in the empathy networks, but parents who were perceived as less caring exhibited increased activity in anterior prefrontal regions when imagining their own child suffering. These results provide new insights into neural processes supporting parental empathy, highlighting the importance of regions in the cognitive empathy network when confronted with the suffering of their own adolescent child, and suggest that additional (i.e., emotion regulation) networks may be relevant for parental caring behavior in daily life.

Yoga for Caregiving Dyads Experiencing Chronic Pain: Protocol Development for Merging Yoga and Self-Management to Develop Skills Intervention

CONTEXT

Caregivers often provide unpaid care for family members and friends with physical disabilities, often to the detriment of their health and well-being. Caregivers often experience pain, and individuals with physical disabilities also are likely to experience pain. Merging yoga and self-management to Develop Skills Study (MY-Skills) is an intervention that merges self-management education with yoga for dyads experiencing chronic pain.

AIM

This article presents the yoga protocol for the MY-Skills intervention.

METHODS

The yoga protocol was revised based on feedback from six caregiving dyads. The protocol focuses on reducing pain interference and supporting the caregiving dyad.

RESULTS

The final yoga protocol incorporated the following elements: Centering and mantra, prana vidya and pranayama, asanas, mudra, and guided savasana/dhyana.

CONCLUSION

The MY-Skills yoga protocol was modified by a yoga therapist with feedback from study participants. Revisions focused on the caregiving dyad, with specific attention to reducing pain interference.

A Pilot Study on Playback Theatre as a Therapeutic Aid after Natural Disasters: Brain Connectivity Mechanisms of Effects on Anxiety

Background

Natural disasters can affect mental health and result in symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD). Playback Theatre (PT) is a form of improvisation where actors play-back personal stories told by audience members. Whether PT can be therapeutic in post-disaster settings is not known.

Method

We used a series of PT performances and studied levels of depression, anxiety, and PTSD symptoms in a sample of 13 people affected by Hurricane Harvey that happened in Houston, TX, August 2017. Brain imaging, specifically resting state functional connectivity of the amygdala was also studied before and after the PT performances.

Results

Both anxiety (p = .001, Cohen’s d = –1.25) and PTSD (p = .002, Cohen’s d = –1.0) symptoms significantly decreased after a series of 4 PT performances from January 2019 – February 2019. Depression reduction was not significant. We performed resting state functional connectivity (RSFC) MRI before and after the series of performances. We used the right and left amygdala as seeds for RSFC analysis and found that the connectivity between the left amygdala and the bilateral supramarginal gyri was increased after PT. The bilateral supramarginal connectivity with the default mode and the saliency networks increased too, which correlated with reduction in anxiety scores.

Conclusions

PT may offer a form of intervention for anxiety caused by disasters. An increase in left amygdala/supramarginal gyri connectivity may be the underlying mechanism.

Empathy Enhancement Based on a Semiotics Training Program: A Longitudinal Study in Peruvian Medical Students

Background

Empathy, as a core element of medical professionalism, is part of leadership in medicine. This attribute, predominantly cognitive, involves understanding and communication capacity. Empathy can be enhanced with courses on medical semiotics. It appears adequate to apply this enhancement in the early stages of professional training. Based on this, this study was performed with the purpose of demonstrating the positive effect that an academic course on medical semiotics has on the development of empathy in medical students.

Methods

A quasi-experimental study was conducted in one School of Medicine in Peru, where medical students had to attend a 17-week course on medical semiotics as part of their regular training. The sample, composed by 269 students, included two cohorts of third-year medical students. As main measures, the Jefferson Scales of Empathy (JSE), inter-professional collaboration (JSAPNC), and lifelong learning (JeffSPLL), were used. In addition, students’ scores evaluating theoretical and practical aspects of the course were collected once the course was finished. Pre- and post-tests were administered in week 1 and in week 17. Analyses compared measures in both moments and in time. Inter-professional collaboration and lifelong learning scores and empathy scores were used as discriminant and convergent validity measures of students’ course scores, respectively.

Results

Gender differences on empathy appeared, but only at the beginning. In the entire sample, empathy enhancement was confirmed in time (p < 0.001), with a large effect size (r = 0.45). This effect was also observed in both gender groups, separately. On the contrary, no changes appeared in inter-professional collaboration and in lifelong learning abilities in time. In addition, a positive correlation was observed among empathy, inter-professional collaboration and lifelong learning abilities at the beginning and at the end, confirming that the improvement observed was specific for empathy and explained by the educational intervention assessed.

Conclusion

These findings bring empiric evidence supporting the positive effect that training in medical semiotics has on empathy. In addition, these findings highlight some gender differences in the development of empathy in medical students.