Validation of a modified version of Interpersonal Reactivity Index for medical students using Rasch analysis

Construct: Empathy has been accepted to interweave both cognitive aspects (the ability to put oneself in another person's place), and affective (or emotional) aspects, indicating an emotional reaction or response to another person's emotional state. Literature supports the positive influences of empathy on doctor-patient relationship, patient satisfaction, and positive clinical outcomes. Background: Many studies have dealt with the development of empathy measurement tools for physicians and medical students. A frequently used empathy measuring instrument for medical students is the "Interpersonal Reactivity Index" (IRI) which was designed to measure the multi-dimensional aspects of empathy in the general adult population. Most previous literature which validated IRI for medical students has used factor analysis, whilst studies applying Rasch models have been limited. Our study aimed to investigate the psychometric properties of a modified version of IRI for medical students using Rasch analysis. Approach: Medical students (1,293) from 15 medical schools in South Korea participated in an online questionnaire consisting of 28 items of the Korean translated version of IRI. We applied exploratory factor analysis (EFA) using polychoric correlation matrix to determine the optimal number of factors followed by Rasch analysis and McDonald's Omega calculation. Findings: The adapted IRI-MS (IRI for medical students) consisted of 17 items in four dimensions: empathic concern (5), fictitious situation (4), perspective taking (4), and personal distress (4). The overall fit of IRI-MS revealed an acceptable goodness-of-fit for all 17 items and a positive point measure correlation for all items. Reliability indices from the Rasch modeling and McDonald's Omega values of all four dimensions were satisfactory for research. We found the Wright-Andrich maps and category probability curves of the IRI's four dimensions to be less than optimal in measuring empathy levels with adequate precision. Conclusions: Rasch analysis of IRI-MS fell short from being able to prove satisfactory validity in measuring the multidimensional nature of empathy in medical students. However, our study applying Rasch analysis may serve as groundwork for future studies, to further develop from the shortcomings of our findings.

A Modifying Effect of Trait Empathy on Frustration-Related Attentional Processing of Aggression-Related Words

Abstract. This study describes two experiments conducted to investigate the modifying effect of trait empathy on attentional processing of emotionally laden (i.e., aggression-related) words in frustrating situations. A dot-probe task was used in the first experiment. The results showed that low-empathy individuals exhibited attentional bias toward aggressive words under both frustrating and nonfrustrating conditions. High-empathy individuals demonstrated attentional bias only under frustrating conditions. In the second experiment, the effect of frustration on high-empathy individuals’ aggression was reflected by N200, P300, and late positive potential amplitudes. It was discussed that these amplitudes might indicate that frustrating situations caused high-empathy individuals to show attentional bias toward aggressive words. Our findings suggested that high-empathy individuals were sensitive to emotionally laden (i.e., aggression-related) stimuli under frustrating conditions.

Effects of psychosocial stress on prosociality: the moderating role of current life stress and thought control

To date, only a few studies have examined whether and when stressed individuals are still prosocially motivated and willing to help others, which is in contrast to the relevance and importance that helping others has for our society. The present study investigates the impact of affective and biopsychological acute stress responses on prosociality (prosocial motivation, helping behavior) under controlled laboratory conditions. In addition, it was examined whether this relationship is affected by individuals' current life stress and the cognitive ability to keep stress-related thoughts at bay. To induce acute stress responses (heart rate, negative affect, salivary alpha-amylase, cortisol), 55 individuals (28 women, M = 24 years old, SD = 4.53) were exposed to the Trier Social Stress Test (TSST). Current life stress (cortisol) was assessed over two days of participants' everyday lives. Thought control ability was assessed with the think/no-think paradigm and was additionally manipulated after the acute stress intervention (TSST) via instructions. The results showed that acute stress was positively associated with prosociality. Specifically, negative affect was positively related to prosocial motivation and salivary alpha-amylase was positively associated with helping behavior. Current life stress moderated the relationship between salivary cortisol and helping behavior: the association was positive at low levels of current life stress. The instruction to control one's thoughts but not participants' general ability to do so reduced stress responses (negative affect). In sum, the findings suggest that prosociality increases following acute stress and that this effect depends on the level of current life stress. Additionally, adopting the strategy of controlling stress-related thoughts was found to be promising for attenuating individuals' stress responses.

Empathy: Assessment Instruments and Psychometric Quality - A Systematic Literature Review With a Meta-Analysis of the Past Ten Years

Objective: To verify the psychometric qualities and adequacy of the instruments available in the literature from 2009 to 2019 to assess empathy in the general population. Methods: The following databases were searched: PubMed, PsycInfo, Web of Science, Scielo, and LILACS using the keywords "empathy" AND "valid∗" OR "reliability" OR "psychometr∗." A qualitative synthesis was performed with the findings, and meta-analytic measures were used for reliability and convergent validity. Results: Fifty studies were assessed, which comprised 23 assessment instruments. Of these, 13 proposed new instruments, 18 investigated the psychometric properties of instruments previously developed, and 19 reported cross-cultural adaptations. The Empathy Quotient, Interpersonal Reactivity Index, and Questionnaire of Cognitive and Affective Empathy were the instruments most frequently addressed. They presented good meta-analytic indicators of internal consistency [reliability, generalization meta-analyses (Cronbach's alpha): 0.61 to 0.86], but weak evidence of validity [weak structural validity; low to moderate convergent validity (0.27 to 0.45)]. Few studies analyzed standardization, prediction, or responsiveness for the new and old instruments. The new instruments proposed few innovations, and their psychometric properties did not improve. In general, cross-cultural studies reported adequate adaptation processes and equivalent psychometric indicators, though there was a lack of studies addressing cultural invariance. Conclusion: Despite the diversity of instruments assessing empathy and the many associated psychometric studies, there remain limitations, especially in terms of validity. Thus far, we cannot yet nominate a gold-standard instrument.

Perceived Characteristics of Life Events—Short-Term Changes in Prosociality and Empathy?

Post-traumatic growth can be understood as positive change in desirable personality traits after adverse life events. However, recent research questioned whether adversity is a relevant, necessary, and sufficient condition for change in desirable personality traits. Using five-wave longitudinal data, this study explored changes in the desirable personality traits prosociality and empathy before and after life events. We included all life events participants had experienced between the second and third assessment, that is, adverse, ambiguous, and positive events. Participants rated their life events on the Event Characteristics Questionnaire which assesses the individual perception of life events on nine continuous dimensions: challenge, emotional significance, extraordinariness, external control, impact, valence, social status change, predictability, and change in world views. We used multilevel growth curve models to explore changes in prosociality and empathy as a function of these event characteristics. Prosociality and empathy remained stable in the assessment period of 6 to 9 months after the reported life event, independently of whether the event had been perceived as adverse or not. We discuss our findings with respect to the inclusion of positive and ambiguous events as predictors of personality change and with respect to its theoretical implications for post-traumatic growth and personality development more broadly.

Effect of leader mindfulness on hindrance stress in nurses: The social mindfulness information processing path

AIM

This study aimed to explore the influence of leader mindfulness on hindrance stress in nurses. Based on the social mindfulness framework, the mediating effects of nurses' perceptions of their leaders' perspective taking and empathic concern and how they are moderated by mindfulness of nurses were investigated.

DESIGN

A time-lagged cross-sectional survey was conducted.

METHODS

The convenience sampling method was adopted. Data were collected at three time points from January to September 2020. A total of 393 paired datasets of nurses and their leaders were collected from 28 Chinese 3A grade hospitals. SPSS 23.0 and AMOS 23.0 were used for data analysis and hypotheses testing.

RESULTS

(1) Leader mindfulness significantly reduced nurse hindrance stress. (2) Both nurses' perceptions of their leaders' perspective taking and empathic concern mediated the relationship between leader mindfulness and nurse hindrance stress. Empathic concern was more effective than perspective taking in the process of leader mindfulness for reducing nurse hindrance stress. Nurses' perceptions of their leaders' perspective taking completely mediated the relationship between empathic concern and nurse hindrance stress. (3) Nurse mindfulness moderated the relationship between leader mindfulness and nurses' perceptions of their leaders' empathic concern but had no significant effect on the relationship between leader mindfulness and nurses' perceptions of their leaders' perspective taking.

CONCLUSION

Leader mindfulness was an important interpersonal factor for reducing nurse hindrance stress. Nurses' perceptions of their leaders' perspective taking and empathic concern were pivotal mechanisms underlying the effectiveness of leader mindfulness. Nurse mindfulness is a situational factor that contributes to the effectiveness of leader mindfulness.

IMPACT

Hospitals can benefit from mindfulness interventions by improving the mindfulness of leaders and nurses. Nurse managers are encouraged to promote social mindfulness, which will enable perspective taking and empathic concern by nurses and thus reduce hindrance stress on nurses during the pandemic.

Disentangling effects of expectancy, accuracy, and empathy on the processing of observed actions

A number of studies suggest that event-related potential (ERP) components previously associated with error processing might represent expectation violation instead of valence. When observing others, these processes might further be modulated by trait empathy. We suggest that trait empathy modulates expectancy formation and that these expectancies then influence observed response processing as reflected in a frontocentral negative ERP component resembling the previously described observer error-related negativity. We acquired single trial ERPs of participants who observed another person in a true- or false-belief condition answering correctly or erroneously. Additionally, we prompted participants' expectancy in some trials. Using linear mixed model analyses, we found that for low empathy participants, expectations for the false-belief condition decreased throughout the experiment, so that expectations were more pronounced in participants with higher empathy toward the end of the experiment. We also found that single trial expectancy measures derived from regression models of the measured expectancies predicted the amplitude of the frontocentral negative ERP component, and that neither the addition of empathy nor accuracy or trial type (true- or false-belief) led to the explanation of significantly more variance compared with the model just containing expectancy as predictor. These results suggest that empathy modulates the processing of observed responses indirectly via its effect on expectancy of the response.

The role of trait empathy in the processing of observed actions in a false-belief task

Empathic brain responses are characterized by overlapping activations between active experience and observation of an emotion in another person, with the pattern for observation being modulated by trait empathy. Also for self-performed and observed errors, similar brain activity has been described, but findings concerning the role of empathy are mixed. We hypothesized that trait empathy modulates the processing of observed responses if expectations concerning the response are based on the beliefs of the observed person. In the present study, we utilized a false-belief task in which observed person’s and observer’s task-related knowledge were dissociated and errors and correct responses could be expected or unexpected. While theta power was generally modulated by the expectancy of the observed response, a negative mediofrontal event-related potential (ERP) component was more pronounced for unexpected observed actions only in participants with higher trait empathy (assessed by the Empathy Quotient), as revealed by linear mixed effects analyses. Cognitive and affective empathy, assessed by the Interpersonal Reactivity Index, were not significantly related to the ERP component. The results suggest that trait empathy can facilitate the generation of predictions and thereby modulate specific aspects of the processing of observed actions, while the contributions of specific empathy components remain unclear.

The influence of team mindfulness on nurses' presenteeism: A cross-sectional study from the perspective of sensemaking

AIM

This study explores the influence of team mindfulness on nurses' presenteeism. The mediation effect of perceived empathic concern and perceived insider status and the moderating effect of organisational formalization are assessed.

BACKGROUND

Nurses are prone to presenteeism. Few studies have explored the influence of the organisational environment on nurses' presenteeism. Studies that consider organisational, work-related and person-related factors on the decision-making process influencing nurses' presenteeism are scarce.

METHODS

Using a cross-sectional survey, data from 396 nurses were gathered from three time points and multiple regression analyses were used to test each hypothesis.

RESULTS

(a) Team mindfulness reduces nurses' presenteeism. (b) Both perceived empathic concern and perceived insider status mediate the relationship between team mindfulness and nurses' presenteeism. (c) Organisational formalization exerts a positive moderating effect on the relationship between team mindfulness and perceived empathic concern.

CONCLUSIONS

Team mindfulness reduces nurses' presenteeism through affective (perceived empathic concern) and cognitive (perceived insider status) sensemaking paths. Organisational formalization is a situational factor to improve the effectiveness of team mindfulness.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers need to devote themselves to cultivating team mindfulness, building an atmosphere to promote perceived empathic concern and perceived insider status, and promoting a formal organisational structure.

Neural Correlates of Interpersonal Space Permeability and Flexibility in Autism Spectrum Disorder

Previous research indicates that the size of interpersonal space at which the other is perceived as intrusive (permeability) and the ability to adapt interpersonal distance based on contextual factors (flexibility) are altered in Autism Spectrum Disorder (ASD). However, the neurophysiological basis of these alterations remains poorly understood. To fill this gap, we used fMRI and assessed interpersonal space preferences of individuals with ASD before and after engaging in cooperative and non-cooperative social interactions. Compared to matched controls, ASDs showed lower comfort in response to an approaching confederate, indicating preference for larger interpersonal space in autism (altered permeability). This preference was accompanied by reduced activity in bilateral dorsal intraparietal sulcus (dIPS) and left fusiform face area (FFA), regions previously shown to be involved in interpersonal space regulation. Furthermore, we observed differences in effective connectivity among dIPS, FFA, and amygdala in ASDs compared to controls, depending on the level of experienced comfort. No differences between groups were observed in interpersonal space regulation after an experienced social interaction (flexibility). Taken together, the present findings suggest that a dysregulation of the activity and connectivity of brain areas involved in interpersonal space processing may contribute to avoidance of physical proximity and social impairments in ASD.

Acute stress alters neural patterns of value representation for others

Acute stress is often evoked during social interactions, by feelings of threat or negative evaluation by other people. We also constantly interact with others while under stress - in the workplace or in private alike. However, it is not clear how stress affects social interactions. For one, individuals could become more selfish and focused on their own goals. On the other hand, individuals might also become more focused on affiliating with potential social partners, in order to secure their support. There is, indeed, accumulating behavioral evidence that prosocial behaviors increase rather than decrease under stress. Here, we tested the underlying brain processes of such findings, by assessing the effects of stress on the neural representations of (monetary) value for self and other. Participants (N ​= ​30; male, 18-40 years) played a gambling task for themselves and for another participant while undergoing functional magnetic resonance imaging (fMRI). Each participant played the gambling task twice: once immediately following acute stress induction, and once in a control session. We compared neural patterns of value representation in the dorsomedial prefrontal cortex (dmPFC), ventromedial prefrontal cortex (vmPFC) and striatum using representational similarity analysis (RSA). We found that under stress, dmPFC and striatum showed higher dissimilarity between neural patterns underlying high and low value for the other. Dissimilarity of neural patterns underlying high and low value for the self was unaffected by stress. These findings suggest that participants track the magnitude of possible rewards for others more under stress, suggesting increased prosocial orientation.

Friendship Quality in Youth With and Without Disruptive Behavior Disorders: The Role of Empathy, Aggression, and Callousness

Youth with disruptive behavior disorders (DBD; Oppositional defiant disorder and/or conduct disorder) are known to show impaired social relationships. Little is known about positive (PFQ) and negative best friendship quality (NFQ) in youth with DBD, and their relations with DBD specific symptoms such as aggression subtypes, empathic abilities, and callous unemotional (CU)-traits. The current study includes N = 115 youth with and N = 146 without DBD (M_age = 13.98, SD = 2.2). A diagnostic interview and self-rating questionnaires assessed ODD/CD diagnosis, friendship quality, aggression, empathy, and CU-traits. When examined on a categorical level, youth with and without DBD did not differ in friendship quality. On a dimensional level across groups, perspective taking was positively associated with PFQ. Proactive aggression was positively associated with NFQ. CU-traits in females were positively, while CU-traits in males were negatively, associated with NFQ. Results highlight that behavioral and cognitive symptoms, rather than clinical categories, are important to consider when discussing friendship qualities.

A bidimensional measure of empathy: Empathic Experience Scale

Empathy is a key notion in the study of sociality. A phenomenological perspective on empathy as intersubjective understanding offers a common ground for multiple dimensions. Corresponding to the dichotomy between perceptual and cognitive levels, two constructs can be distinguished: vicariously experiencing and intuitively understanding others’ emotions. We developed and validated a new questionnaire for the assessment of individual differences in empathy. In a first study (N = 921), we created a questionnaire measuring empathy consisting of a pool of 75 items. Exploratory factor analysis suggested to retain two factors (“Intuitive Understanding” and “Vicarious Experience”), whereas a 30-item version of the questionnaire had satisfactory psychometric properties. In a second study (N = 504), we administered the 30-items questionnaire and several concurrent/divergent measures. Confirmatory factor analysis indicated that a two-factor structure best represented its latent factor structure. The results show that our questionnaire could be considered a reliable and valid measure of empathy with internal consistencies of 0.93 and 0.95 for Vicarious Experience and Intuitive Intuitive Understanding, respectively. Whereas our questionnaire mostly showed the expected convergence with existing scales of empathy, the correlations also suggest that it adds valuable new information to the assessment of empathy. The two-factor structure suggests that the perceptual (vicarious) experience and the basic (non-effortful) cognitive awareness of others’ emotions can be assessed as distinct constructs. This bidimensional structure that distinguishes between the perceptual experience and the basic cognitive awareness of others’ emotional states connects theoretical, empirical, and clinical data from psychology and neuroscience.

Deutsche Adaptation der Prosocial and Antisocial Behavior in Sport Scale (PABSS)

Zusammenfassung. In dieser Studie (N = 759) wurde die deutsche Adaptation der Prosocial and Antisocial Behavior in Sport Scale (PABSS) anhand von explorativen Strukturgleichungsmodellen (Exploratory Structural Equation Modeling, ESEM) evaluiert. Die Ergebnisse replizieren die vierfaktorielle Struktur der englischsprachigen Version. Der Modell-Fit des ESEM war akzeptabel und resultierte in gut differenzierten (wenig korrelierten) Faktoren. Die Ergebnisse bestätigen die Reliabilität der Skalen und die partielle Messinvarianz über Geschlecht und unterschiedliche Mannschaftssportarten (Fußball, Rugby / Football, Hockey / Floorball, Basketball und Handball). Die analysierten Geschlechtsunterschiede sowie die Zusammenhänge mit konzeptuell ähnlichen Skalen weisen auf die Konstruktvalidität hin.

The role of empathy in the neural responses to observed human social touch

One of the ways in which individuals convey feelings and thoughts to one another is through touch. Although the neural responses to felt and observed tactile stimuli between an inanimate object and a part of the human body have been vastly explored, the neural responses to observed human interaction involving touch are not well understood. Considering that the observation of social touch involves vicarious sharing of emotions, we hypothesized that levels of empathic traits modulate the neural responses to observed touch and focused on the attenuation in the mu\alpha rhythm (8-13Hz), a neural marker that has been related to sensorimotor resonance. Fifty-four participants observed photos depicting social touch, nonsocial touch, or no touch while their electroencephalography (EEG) activity was recorded. Results showed that interindividual differences in levels of empathic traits modulated both behavioral and electrophysiological responses to human social touch, such that highly empathic participants evaluated human social touch as inducing more pleasant emotions and exhibited greater mu suppression upon observation of human social touch compared to less empathic participants. Specifically, both the behavioral and the electrophysiological responses to observed social touch were predicted by levels of personal distress, a measure of emotional contagion. These findings indicate that the behavioral and electrophysiological responses to observed social touch are modulated by levels of empathy.

What Do You Think You Are Measuring? A Mixed-Methods Procedure for Assessing the Content Validity of Test Items and Theory-Based Scaling

The valid measurement of latent constructs is crucial for psychological research. Here, we present a mixed-methods procedure for improving the precision of construct definitions, determining the content validity of items, evaluating the representativeness of items for the target construct, generating test items, and analyzing items on a theoretical basis. To illustrate the mixed-methods content-scaling-structure (CSS) procedure, we analyze the Adult Self-Transcendence Inventory, a self-report measure of wisdom (ASTI, Levenson et al., 2005). A content-validity analysis of the ASTI items was used as the basis of psychometric analyses using multidimensional item response models (N = 1215). We found that the new procedure produced important suggestions concerning five subdimensions of the ASTI that were not identifiable using exploratory methods. The study shows that the application of the suggested procedure leads to a deeper understanding of latent constructs. It also demonstrates the advantages of theory-based item analysis.

M. Davis Empathy test: content validity and adaptation in cross-cultural context

The article analyzes the results of adaptation and validation of empathy test of M. Davis (IRI) on the Russian-speaking population in Russia and Belarus, as well as adaptation in foreign countries. The test is recognized as a reliable and valid method of diagnosis of empathy and is translated into major languages (German, French, Spanish, Chinese, Russian, etc.). The aim of the article is to clarify the substantive content of the questionnaire scales. The results of researches conducted with IRI in Russia and Belarus are given. The nature of empathic processes reflectied by scales of the test is hypothesized. The analysis is carried out in the context of the adequacy of differentiation “cognitive — affective empathy” and the allocation of other parameters for effective study of empathic phenomena. This article was prepared with the financial support of the Russian Foundation of Hu- manities (project № 15-26-01007) and Belarusian Republican Foundation for Fundamental Research (project №Г15Р-028), international project “Empathy development in socionomic (“helping”) professions”.