Individual differences in empathy are associated with apathy-motivation

Probing apathy in children and adolescents with the Apathy Motivation Index-Child version

Apathy is linked to mental health and altered neurocognitive functions such as learning and decision-making in healthy adults. Mental health problems typically begin to emerge during adolescence, yet little is known about how apathy develops due to an absence of quantitative measurements specific to young people. Here, we present and evaluate the Apathy Motivation Index-Child Version (AMI-CV) for children and adolescents. We show across two samples of young people (aged 8 to 17 years, total N = 191) tested in schools in the UK and on a smartphone app, that the AMI-CV is a short, psychometrically sound measure to assess levels of apathy and motivation in young people. Similar to adult versions, the AMI-CV captures three distinct apathy domains: Behavioural Activation, Social Motivation and Emotional Sensitivity. The AMI-CV showed excellent construct validity with an alternative measure of apathy and external validity replicating specific links with related mental health traits shown in adults. Our results provide a short measure of self-reported apathy in young people that enables research into apathy development. The AMI-CV can be used in conjunction with the adult version to investigate the impact of levels of apathy across the lifespan.

Empathy as a crucial skill in disrupting disparities in global brain health

Brain health refers to the state of a person's brain function across various domains, including cognitive, behavioral and motor functions. Healthy brains are associated with better individual health, increased creativity, and enhanced productivity. A person's brain health is intricately connected to personal, social and environmental factors. Racial, ethnic, and social disparities affect brain health and on the global scale these disparities within and between regions present a hurdle to brain health. To overcome global disparities, greater collaboration between practitioners and healthcare providers and the people they serve is essential. This requires cultural humility driven by empathy. Empathy is a core prosocial value, a cognitive-emotional skill that helps us understand ourselves and others. This position paper aims to provide an overview of the vital roles of empathy, cooperation, and interdisciplinary partnerships. By consciously integrating this understanding in practice, leaders can better position themselves to address the diverse challenges faced by communities, promote inclusivity in policies and practices, and further more equitable solutions to the problem of global brain health.

Validation study of the apathy motivation index in French adults

Objective

Apathy is present in many brain disorders, but it is also prevalent to varying degrees in healthy people. While many tools have been developed to assess levels of apathy in pathology, no standardized measure of apathy in healthy people exists.

Method

Therefore, this study aimed to validate the French version of the Apathy Motivation Index (f-AMI). The results of 729 participants were analyzed using an exploratory factorial analysis.

Results

Preliminary analyses suggested that the three domains of apathy extracted in the original AMI scale-behavioral activation (BA), social motivation (SM), and emotional sensitivity (ES)-could be found also in the f-AMI. A further exploratory analysis showed that a higher number of factors could be extracted, particularly for women. Specifically, both social and emotional factors could be divided into two sub-factors: (1) social motivation toward strangers or toward an acquaintance and (2) self-directed emotional sensitivity directed toward others. Regarding construct validity, the scores of f-AMI were correlated with the French Dimensional Apathy Scale results. Concerning the divergent validity, emotional sensitivity in apathy is different from depression, anhedonia, and fatigue levels.

Conclusion

These results suggest that the f-AMI can be used to assess levels of apathy in healthy adults.

A, Srivastava P. Empathic Accuracy Task: Indian Adaptation and Validation

Background

The Empathic Accuracy Task (EAT) is an objective measure to assess empathic accuracy. Due to the variability in the number and linked emotions of the narrated events, we adapted EAT for the Indian sociocultural setting as Indian EAT (I-EAT).

Methods

Eight videos were adapted in three languages (English, Hindi, and Kannada), narrating emotional events with a uniform representation of age groups, different emotions, and sex. The adapted I-EAT was then validated by cross-sectional comparison with different tests similar to EAT and those that assessed concepts different from or similar to empathy, in 29 healthy young adults, 23 healthy older adults (aged ≥60 years) along with clinical groups of 15 young people with depression, 15 older people with depression, and 15 young people with schizophrenia.

Results

We selected eight videos with good content validity and internal consistency (Cronbach's alpha = 0.73. We obtained satisfactory concurrent validity of the EAT scores with the self-reported empathic assessments using the Questionnaire of Cognitive and Affective Empathy (Cognitive empathy score = 0.29, p = .034; Total score = 0.29, p = .035) and Interpersonal Reactivity Index (Empathic concern score = 0.45, p = .001). Good divergent validity was revealed in the high inverse correlation recorded with the Apathy Evaluation Scale ( = -0.67, p < .001). I-EAT did not correlate significantly with measures of social cognition. Known-groups validity was adequate in young adults with the significantly lower EAT scores (Cohen's d: 0.77 to 1.15) in the Schizophrenia group and higher EAT-N scores (Cohen's d: 0.51) in the Depression group, compared to the Healthy group. The Healthy group of the geriatric population also achieved significantly higher EAT scores (Cohen's d: 0.71 to 0.85) than the Depression group.

Conclusion

With a good validity and internal consistency, I-EAT can be used in the Indian population to assess empathic accuracy without compromising performance of the original EAT.

Social cognition and apathy between two cognitive subtypes of schizophrenia: Are there the same or different profiles?

Objective

Cognitive impairment is an essential feature of schizophrenia, and it involves a broad array of nonsocial and social cognitive domains. This study aimed to examine whether there are the same or different social cognition profiles between two cognitive subtypes of schizophrenia.

Method

There were one hundred and two chronic and institutionalized patients with schizophrenia from two referral tracks. One group is "Cognitively Normal Range" (CNR) (N = 52), and another group is "Below Normal Range" (BNR) (N = 50). We assessed or collected their apathy, emotional perception judgment, facial expression judgment, and empathy by the Apathy Evaluation Scale, the International Affective Picture System, the Japanese and Caucasian Facial Expression of Emotion, and the Interpersonal Reactivity Index, respectively.

Results

We found different impairment profiles depending on the cognitive subtypes of the patient with schizophrenia. Surprisingly, the CNR presented impairments in apathy, emotional perception judgment, facial expression judgment, and empathy and feature impairment in empathy and affective apathy. In contrast, even though the BNR had significant neurocognition impairments, they had almost intact empathy with significantly impaired cognitive apathy. Both groups' global deficit scores (GDSs) were comparable, and all reached at least a mild impairment level.

Conclusions

The CNR and the BNR had similar abilities in emotional perception judgment and facial emotion recognition. They also had differentiable deficits in apathy and empathy. Our findings provide important clinical implications for neuropsychological pathology and treatment in schizophrenia.

Altered empathy correlates with reduced social and non-social reward anticipation in individuals with high social anhedonia

This study examined the correlations of affective and cognitive components of empathy with reward anticipation toward monetary and social incentives in individuals with social anhedonia (SocAnh). According to the scores on the Revised Social Anhedonia Scale, 109 participants were divided into high (n = 57) and low (n = 52) SocAnh groups. Empathy was assessed with the Questionnaire of Cognitive and Affective Empathy (QCAE) and the Interpersonal Reactivity Index (IRI) Scale. Social and non-social reward anticipations were assessed by the Social and Monetary Incentive Delay Tasks, respectively. We performed independent-sample t tests and repeated-measures ANOVAs to examine the group differences on empathy and reward anticipation. Correlation analyses between empathy and reward anticipation were conducted. Results showed that the high SocAnh group reported reduced scores on empathy and reward anticipation for monetary and social incentives compared to their low SocAnh counterparts. Correlation analysis further indicated that monetary reward anticipation correlated with cognitive empathy, while social reward anticipation correlated with affective empathy. Our findings suggested that participants with high SocAnh exhibited poorer empathy and reduced reward anticipation than those with low SocAnh level. More importantly, social and non-social reward anticipation may distinctly contribute to affective and cognitive components of empathy.

The computational psychiatry of antisocial behaviour and psychopathy

Antisocial behaviours such as disobedience, lying, stealing, destruction of property, and aggression towards others are common to multiple disorders of childhood and adulthood, including conduct disorder, oppositional defiant disorder, psychopathy, and antisocial personality disorder. These disorders have a significant negative impact for individuals and for society, but whether they represent clinically different phenomena, or simply different approaches to diagnosing the same underlying psychopathology is highly debated. Computational psychiatry, with its dual focus on identifying different classes of disorder and health (data-driven) and latent cognitive and neurobiological mechanisms (theory-driven), is well placed to address these questions. The elucidation of mechanisms that might characterise latent processes across different disorders of antisocial behaviour can also provide important advances. In this review, we critically discuss the contribution of computational research to our understanding of various antisocial behaviour disorders, and highlight suggestions for how computational psychiatry can address important clinical and scientific questions about these disorders in the future.

Influence of agent's self-disclosure on human empathy

As AI technologies progress, social acceptance of AI agents, including intelligent virtual agents and robots, is becoming even more important for more applications of AI in human society. One way to improve the relationship between humans and anthropomorphic agents is to have humans empathize with the agents. By empathizing, humans act positively and kindly toward agents, which makes it easier for them to accept the agents. In this study, we focus on self-disclosure from agents to humans in order to increase empathy felt by humans toward anthropomorphic agents. We experimentally investigate the possibility that self-disclosure from an agent facilitates human empathy. We formulate hypotheses and experimentally analyze and discuss the conditions in which humans have more empathy toward agents. Experiments were conducted with a three-way mixed plan, and the factors were the agents' appearance (human, robot), self-disclosure (high-relevance self-disclosure, low-relevance self-disclosure, no self-disclosure), and empathy before/after a video stimulus. An analysis of variance (ANOVA) was performed using data from 918 participants. We found that the appearance factor did not have a main effect, and self-disclosure that was highly relevant to the scenario used facilitated more human empathy with a statistically significant difference. We also found that no self-disclosure suppressed empathy. These results support our hypotheses. This study reveals that self-disclosure represents an important characteristic of anthropomorphic agents which helps humans to accept them.

Placebo Analgesia Reduces Costly Prosocial Helping to Lower Another Person's Pain

Painkiller administration lowers pain empathy, but whether this also reduces prosocial behavior is unknown. In this preregistered study, we investigated whether inducing analgesia through a placebo painkiller reduced effortful helping. When given the opportunity to reduce the pain of another person, individuals experiencing placebo analgesia (n = 45 adults from Austria; 21 male, 24 female) made fewer prosocial choices at the lowest helping level and exerted less physical effort when helping, compared with controls whose pain sensitivity was unaltered (n = 45; 21 male, 24 female). Self-reported empathic unpleasantness positively correlated with prosocial choices across the whole sample. While not replicating group differences in empathy, a mediation analysis revealed that the level of unpleasantness to other people's pain fully mediated the effect of placebo analgesia on prosocial choices. Given the importance of prosociality for social cohesion, these findings have broad potential implications both for individuals under the influence of painkillers and for society at large.

Gender biases in the training methods of affective computing: Redesign and validation of the Self-Assessment Manikin in measuring emotions via audiovisual clips

Audiovisual communication is greatly contributing to the emerging research field of affective computing. The use of audiovisual stimuli within immersive virtual reality environments is providing very intense emotional reactions, which provoke spontaneous physical and physiological changes that can be assimilated into real responses. In order to ensure high-quality recognition, the artificial intelligence (AI) system must be trained with adequate data sets, including not only those gathered by smart sensors but also the tags related to the elicited emotion. Currently, there are very few techniques available for the labeling of emotions. Among them, the Self-Assessment Manikin (SAM) devised by Lang is one of the most popular. This study shows experimentally that the graphic proposal for the original SAM labelling system, as devised by Lang, is not neutral to gender and contains gender biases in its design and representation. Therefore, a new graphic design has been proposed and tested according to the guidelines of expert judges. The results of the experiment show an overall improvement in the labeling of emotions in the pleasure–arousal–dominance (PAD) affective space, particularly, for women. This research proves the relevance of applying the gender perspective in the validation of tools used throughout the years.

Distinct neural representations for prosocial and self-benefiting effort

Prosocial behaviors-actions that benefit others-are central to individual and societal well-being. Although the mechanisms underlying the financial and moral costs of prosocial behaviors are increasingly understood, this work has often ignored a key influence on behavior: effort. Many prosocial acts are effortful, and people are averse to the costs of exerting them. However, how the brain encodes effort costs when actions benefit others is unknown. During fMRI, participants completed a decision-making task where they chose in each trial whether to "work" and exert force (30%-70% of maximum grip strength) or "rest" (no effort) for rewards (2-10 credits). Crucially, on separate trials, they made these decisions either to benefit another person or themselves. We used a combination of multivariate representational similarity analysis and model-based univariate analysis to reveal how the costs of prosocial and self-benefiting efforts are processed. Strikingly, we identified a unique neural signature of effort in the anterior cingulate gyrus (ACCg) for prosocial acts, both when choosing to help others and when exerting force to benefit them. This pattern was absent for self-benefiting behaviors. Moreover, stronger, specific representations of prosocial effort in the ACCg were linked to higher levels of empathy and higher subsequent exerted force to benefit others. In contrast, the ventral tegmental area and ventral insula represented value preferentially when choosing for oneself and not for prosocial acts. These findings advance our understanding of the neural mechanisms of prosocial behavior, highlighting the critical role that effort has in the brain circuits that guide helping others.

Prosocial behavior is associated with transdiagnostic markers of affective sensitivity in multiple domains

Prosocial behaviors-actions that benefit others-fundamentally shape our interpersonal interactions. Psychiatric disorders have been suggested to be related to prosocial disturbances, which may underlie many of their social impairments. However, broader affective traits, present to different degrees in both psychiatric and healthy populations, also have been linked to variability in prosociality. Therefore, it is unclear to what extent prosocial variability is explained by specific psychiatric disorders relative to broad affective traits. Using a computational, transdiagnostic approach in two online studies, we found that participants who reported being more affectively reactive across a broad cluster of traits manifested greater frequencies of prosocial actions in two different contexts: They reported being more averse to harming others for profit, and they were more willing to exert effort to benefit others. These findings help illuminate the profile of prosociality across psychiatric conditions as well as the architecture of prosocial behavior in healthy individuals. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A cross-sectional study of student empathy across four medical schools in Denmark-associations between empathy level and age, sex, specialty preferences and motivation

BACKGROUND

Professional empathy has been associated with a range of positive patient- and clinician outcomes and is therefore considered important to develop for future physicians. Measuring changes in empathy scores among medical students by using the Jefferson Scale of Empathy (Student version) (JSE-S) has led to mixed results. So far, no investigation of Danish medical students' empathy development has been conducted. The aim of this study was therefore to examine the associations between empathy scores among Danish medical students and medical school, year of curriculum, age, sex, co-habitation, and parental status, specialty preferences and motivations for choosing medicine as a future profession.

METHODS

This was a cross-sectional questionnaire study. All medical students from four medical schools in Denmark in their first, third and sixth year (N = 4,178) were invited to participate in the study in October 2020. The associations between JSE-S sum score and the above explanatory factors were analysed by uni- and multivariable linear regression models.

RESULTS

The JSE-S was completed by 672 medical students. The overall mean score was 112.7. There were no statistically significant differences in empathy between medical schools, first, third- and sixth- year medical students, age groups or parental status. Female students and students living with a spouse or partner scored higher on JSE-S than male students or students living alone, and the sex difference remained statistically significant in the multivariable regression. In both the univariable and multivariable setting, preference for future medical specialty was statistically significant, with a decrease in scores for students choosing surgery-specialties. Motivational factors were not statistically significantly associated with empathy, although there was a slight upwards trend for one of the motivational categories, named "personal experiences".

CONCLUSIONS

Overall, our results showed neither decrease nor increase but instead rather stable empathy scores across years of curriculum of medical students in Denmark, adding to the mixed picture of empathy development among medical students. Our findings are consistent with positive associations found in international studies between empathy scores and higher age, female sex, specialty preferences for psychiatry and general practice and altruistic motivations for choosing to enroll. Although specialty preferences are changing during medical education, they may be used meaningfully as predictors of individual student empathy levels.

The stability of multidimensional subclinical apathy during a pandemic and its relations to psycho-behavioral factors

Apathy is a clinical symptom prevalent in many neuropsychiatric pathologies. Subclinical apathy is found in 35% of the general population. Despite high prevalence and negative consequences, underlying mechanisms are poorly understood, perhaps because the concept of apathy is one-dimensional. The current investigation aims to address the incidence of multidimensional apathetic trait in three distinct forms in a student population, to specify its determinants and to evaluate its stability during a global pandemic. Two online surveys, conducted 1 year apart on two separate cohorts of university students, with qualitative measures and validated scales. The final analysis included, respectively, 2789 and 1678 students. The three forms of apathetic trait were present, with the same debilitating consequences as apathetic symptom but independent determinants. Executive apathy was predicted by depressive symptoms, emotional apathy by motivational deficit and initiative apathy comprised a mixed executive-emotional form and a pure deficit of action initiation. The three forms of subclinical apathy remained similar in the context of increased depressive symptoms due to a global pandemic. This study confirmed the presence and independence of three forms of subclinical apathy in healthy students, which remained similar even in the light of increased depressive scores. These results shed light on cognitive and neuronal mechanisms underlying multidimensional apathy, allowing new, targeted treatments.

Attitudes, self-efficacy, and practices related to opioid risk assessment and mitigation: A comparison of health care professionals in rural communities

Background: Health care professionals (HCPs) play an important role in opioid misuse and opioid use disorder (OUD) screening/identification, mitigation, and referral to treatment. This study compared attitudes, self-efficacy, and practices related to opioid risk assessment and mitigation among pregnancy and non-pregnancy HCPs in rural communities. Methods: We conducted a secondary analysis of cross-sectional, self-report survey data of HCPs in two rural counties in southern Utah. Pregnancy HCPs were identified by a question asking whether they provide care to pregnant patients. HCPs' attitudes toward their patients with opioid misuse/OUD were measured using the Survey of Attitudes and Perceptions questionnaire. Self-efficacy and practices related to opioid risk assessment and mitigation were captured with questions asking about assessment and screening of opioid use, advisement to change opioid use behavior, and referral to treatment for OUD. We used linear regression analyses to estimate associations between HCPs' attitudes toward patients with opioid misuse/OUD and their self-efficacy and use of opioid risk assessment and mitigation practices. Results: This sample included a total of 132 HCPs, including 82 pregnancy HCPs and 50 non-pregnancy HCPs. Attitudes domains were similar among pregnancy and non-pregnancy HCPs. Among pregnancy HCPs, role adequacy (β = .48, 95% CI = .16-.80), role legitimacy (β = .72, 95% CI = .21-1.22), motivation (β = .68, 95% CI = .14-1.21), and positive task-specific self-esteem (β = 1.52, 95% CI = .70-2.35) were positively associated with more frequent use of opioid risk assessment and mitigation practices, while attitudes were not associated with these practices among non-pregnancy HCPs. Conclusions: Training initiatives that lead to improved HCP attitudes could improve opioid care management among rural pregnancy HCPs. More research is needed to determine approaches to increase the use of opioid risk assessment and mitigation practices among rural non-pregnancy HCPs.

"Self" and "other": A conceptual bridge linking normal with pathological personality

The goal of this paper is to try and close the gap between the ways in which pathological and normal personality, including their development, are conceptualized. To this end, attention is drawn to parallels that exist between the ways self-function is conceptualized in contemporary personality psychology and in recent iterations of the major psychiatric nosologies, particularly ICD-11. Conceptualizations in both normal and abnormal personality see a fundamental dichotomy between self as identity and self as socially interdependent (vs autonomous). Evidence is reviewed supporting a basic dichotomy between two categories of personality pathology that can be subsumed under the labels "Acting Out" and "Anxious-Inhibited." It is suggested that fundamental to the personality pathology subsumed under "Acting Out" is a deficient interdependent self, while a defective self-identity is proposed to underlie the personality pathology subsumed under "Anxious-Inhibited."

The Theories of the Development of Students: A Factor to Shape Teacher Empathy From the Perspective of Motivation

Empathy represents an essential prerequisite for developing effective interpersonal behavior and maintaining interpersonal relationships. Education is a result of teacher-student interaction, and, therefore, it is worth noting that teaching empathy is critical for the development of students and the professional growth of teachers. Recently, researchers began to explore the influential factors of empathy (e.g., empathic mindsets) based on motivation. Beyond their empathic attitudes, teachers also have a mindset toward the development of students. A survey study was adopted to explore the relationship between the theories of the growth of students and teacher empathy. Four hundred and eighty-four Chinese teachers completed the student development scale, the teacher empathic motivation scale, and the teacher empathy scale. The mediation model results showed that the theories of the development of students could significantly predict teacher empathy and teacher empathic motivation. The teacher empathic motivation mediated the positive relationship between the theories of the development of students and teacher empathy. This study proposes a new concept and method for teacher empathy intervention in future.

Investigating individual differences in emotion recognition ability using the ERAM test

Individuals vary in emotion recognition ability (ERA), but the causes and correlates of this variability are not well understood. Previous studies have largely focused on unimodal facial or vocal expressions and a small number of emotion categories, which may not reflect how emotions are expressed in everyday interactions. We investigated individual differences in ERA using a brief test containing dynamic multimodal (facial and vocal) expressions of 5 positive and 7 negative emotions (the ERAM test). Study 1 (N = 593) showed that ERA was positively correlated with emotional understanding, empathy, and openness, and negatively correlated with alexithymia. Women also had higher ERA than men. Study 2 was conducted online and replicated the recognition rates from Study 1 (which was conducted in lab) in a different sample (N = 106). Study 2 also showed that participants who had higher ERA were more accurate in their meta-cognitive judgments about their own accuracy. Recognition rates for visual, auditory, and audio-visual expressions were substantially correlated in both studies. Results provide further clues about the underlying structure of ERA and its links to broader affective processes. The ERAM test can be used for both lab and online research, and is freely available for academic research.

Ageing is associated with disrupted reinforcement learning whilst learning to help others is preserved

Reinforcement learning is a fundamental mechanism displayed by many species. However, adaptive behaviour depends not only on learning about actions and outcomes that affect ourselves, but also those that affect others. Using computational reinforcement learning models, we tested whether young (age 18-36) and older (age 60-80, total n = 152) adults learn to gain rewards for themselves, another person (prosocial), or neither individual (control). Detailed model comparison showed that a model with separate learning rates for each recipient best explained behaviour. Young adults learned faster when their actions benefitted themselves, compared to others. Compared to young adults, older adults showed reduced self-relevant learning rates but preserved prosocial learning. Moreover, levels of subclinical self-reported psychopathic traits (including lack of concern for others) were lower in older adults and the core affective-interpersonal component of this measure negatively correlated with prosocial learning. These findings suggest learning to benefit others is preserved across the lifespan with implications for reinforcement learning and theories of healthy ageing.

Willing and able? Theory of mind, social motivation, and social competence in middle childhood and early adolescence

This study investigated the links between theory of mind, social motivation, and children's social competence in middle childhood and early adolescence. Two hundred and sixty four children (136 girls, 128 boys) aged between 8 and 13 years (M Age = 10.88 years, SD = 1.45) completed theory-of-mind tests and self-report questionnaires measuring social motivation. Teachers rated children's social competence at school. Teacher-rated social competence was associated with individual differences in both theory of mind and children's motivation to develop and maintain social relationships. Results suggest that while individual differences in social motivation and theory of mind are partially overlapping, both theory of mind ability and social motivation contribute to successful social interaction at school.

Apathy is Associated with Critical Psychological Determinants of Medication Adherence in HIV Disease

Apathy is common in HIV, separable from depression, and has been associated with non-adherence to antiretroviral therapy (ART). We examined the associations between apathy and critical psychological determinants of ART adherence, as per the information-motivation-behavioral model, in 85 persons living with HIV. Apathy was measured using a composite of the apathy subscale of the Frontal Systems Behavioral Scale and the vigor-activation scale of the Profile of Mood States. Independent of major depressive disorder, apathy was related at small-to-medium effect sizes with motivation to adhere and self-efficacy for health-related decision-making and medication management, but not with HIV knowledge or medication management skills. These findings suggest that apathy plays a unique role in several critical health adherence determinants and support the importance of assessment and management of apathy to maximize health outcomes among individuals with HIV disease.

Aging Increases Prosocial Motivation for Effort

Social cohesion relies on prosociality in increasingly aging populations. Helping other people requires effort, yet how willing people are to exert effort to benefit themselves and others, and whether such behaviors shift across the life span, is poorly understood. Using computational modeling, we tested the willingness of 95 younger adults (18-36 years old) and 92 older adults (55-84 years old) to put physical effort into self- and other-benefiting acts. Participants chose whether to work and exert force (30%-70% of maximum grip strength) for rewards (2-10 credits) accrued for themselves or, prosocially, for another. Younger adults were somewhat selfish, choosing to work more at higher effort levels for themselves, and exerted less force in prosocial work. Strikingly, compared with younger adults, older people were more willing to put in effort for others and exerted equal force for themselves and others. Increased prosociality in older people has important implications for human behavior and societal structure.

Can Social Cognition Measurements Differentiate Behavioral Variant Frontotemporal Dementia from Alzheimer's Disease Regardless of Apathy?

BACKGROUND

Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) share cognitive and behavioral symptoms, such as apathy. Social cognition measurements are useful in distinguishing bvFTD from AD, but their accuracies may be affected by apathy.

OBJECTIVE

To investigate whether social cognition measurements can distinguish bvFTD from either apathetic or non-apathetic AD patients.

METHODS

Three groups of participants were enrolled in the present study: bvFTD (n = 22), AD (n = 20), and healthy controls (HC, n = 23). The AD group was divided into apathetic (n = 10) and non-apathetic (n = 10). All subjects underwent comprehensive neuropsychological examination, including the short version of the Social and Emotional Assessment (Mini-SEA), which comprises the facial emotion recognition test and the faux-pas recognition test (Faux-Pas Test). Apathy was assessed according to the Starkstein's Apathy (SA) Scale.

RESULTS

The bvFTD and AD groups did not differ on global cognitive efficiency and on executive functions. In comparison to the whole AD group, bvFTD displayed lower Faux-Pas Test and Mini-SEA scores. Both AD subgroups, apathetic or non-apathetic, exhibited similar performance on all social cognition measurements. In comparison to either apathetic AD or non-apathetic AD, bvFTD patients underperformed on the Faux-Pas Test and on the Mini-SEA. The area under the curve values for the Mini-SEA total score were 0.87 (bvFTD versus AD), 0.90 (bvFTD versus apathetic AD), and 0.83 (bvFTD versus non-apathetic AD).

CONCLUSION

Social cognition tests provide accurate distinction between bvFTD against either apathetic AD or non-apathetic AD. Social cognition measurements did not correlate with apathy severity.

Grasping Social Apathy: The Role of Reach-To-Grasp Action Kinematics for the Assessment of Social Apathy in Mild Neurocognitive Disorders

BACKGROUND

Social apathy, a reduction in initiative in proposing or engaging in social activities or interactions, is common in mild neurocognitive disorders (MND). Current apathy assessment relies on self-reports or clinical scales, but growing attention is devoted to defining more objective, measurable and non-invasive apathy proxies.

OBJECTIVE

In the present study we investigated the interest of recording action kinematics in a social reach-to-grasp task for the assessment of social apathy.

METHODS

Thirty participants took part in the study: 11 healthy controls (HC; 6 females, mean age = 68.3±10.5 years) and 19 subjects with MND (13 females, mean age = 75.7±6.3 years). Based on the Diagnostic Criteria for Apathy, MND subjects were classified as socially apathetic (A-MND, N = 9) versus non-apathetic (NA-MND, N = 10). SensRing, a ring-shaped wearable sensor, was placed on their index finger, and subjects were asked to reach and grasp a can to place it into a cup (individual condition) and pass it to a partner (social condition).

RESULTS

In the reach-to-grasp phase of the action, HC and NA-MND showed different acceleration and velocity profiles in the social versus individual condition. No differences were found for A-MND.

CONCLUSION

Previous studies showed the interest of recording patients' level of weekly motor activity for apathy assessment. Here we showed that a 10-min reach-to-grasp task may provide information to differentiate socially apathetic and non-apathetic subjects with MND, thus providing a tool easily usable in the clinical practice. Future studies with a bigger sample are needed to better characterize these findings.

The relationship between apathy and impulsivity in large population samples

Apathy and impulsivity are debilitating conditions associated with many neuropsychiatric conditions, and expressed to variable degrees in healthy people. While some theories suggest that they lie at different ends of a continuum, others suggest their possible co-existence. Surprisingly little is known, however, about their empirical association in the general population. Here, gathering data from six large studies (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$n = 3755$$\end{document}n=3755), we investigated the relationship between measures of apathy and impulsivity in young adults. The questionnaires included commonly used self-assessment tools—Apathy Evaluation Scale, Barratt Impulsiveness Scale (BIS-11) and UPPS-P Scale—as well as a more recent addition, the Apathy Motivation Index (AMI). Remarkably, across datasets and assessment tools, global measures of apathy and impulsivity correlated positively. However, analysis of sub-scale scores revealed a more complex relationship. Although most dimensions correlated positively with one another, there were two important exceptions revealed using the AMI scale. Social apathy was mostly negatively correlated with impulsive behaviour, and emotional apathy was orthogonal to all other sub-domains. These results suggest that at a global level, apathy and impulsivity do not exist at distinct ends of a continuum. Instead, paradoxically, they most often co-exist in young adults. Processes underlying social and emotional apathy, however, appear to be different and dissociable from behavioural apathy and impulsivity.

Emotion Elicitation Under Audiovisual Stimuli Reception: Should Artificial Intelligence Consider the Gender Perspective?

Identification of emotions triggered by different sourced stimuli can be applied to automatic systems that help, relieve or protect vulnerable groups of population. The selection of the best stimuli allows to train these artificial intelligence-based systems in a more efficient and precise manner in order to discern different risky situations, characterized either by panic or fear emotions, in a clear and accurate way. The presented research study has produced a dataset of audiovisual stimuli (UC3M4Safety database) that triggers a complete range of emotions, with a high level of agreement and with a discrete emotional categorization, as well as quantitative categorization in the Pleasure-Arousal-Dominance Affective space. This database is adequate for the machine learning algorithms contained in these automatic systems. Furthermore, this work analyses the effects of gender in the emotion elicitation under audiovisual stimuli, which can help to better design the final solution. Particularly, the focus is set on emotional responses to audiovisual stimuli reproducing situations experienced by women, such as gender-based violence. A statistical study of gender differences in emotional response was carried out on 1332 participants (811 women and 521 men). The average responses per video is around 84 (SD = 22). Data analysis was carried out with RStudio^®.

Social cognition in cervical dystonia: phenotype and relationship to anxiety and depression

BACKGROUND AND PURPOSE

Anxiety and depression are common disabling comorbidities in cervical dystonia (CD) and may predispose to social withdrawal and social cognitive impairments. The relationship between social cognition and depressive/anxiety symptoms in CD is under-investigated.

METHODS

Forty-six CD patients (40 women; mean age ± SD, 55.57 ± 10.84 years) were administered the following social cognition battery: Affect Naming, Prosody Face and Pair Matching subtests from the Wechsler Adult Intelligence Scale IV and Wechsler Memory Scale IV (social perception), reality-known and reality-unknown false belief reasoning tasks (theory of mind), Empathy Quotient and Social Norms Questionnaire 22 (social behaviour), alongside the Benton Facial Recognition Task (non-emotional facial discrimination). Alongside CD severity, the Hospital Anxiety and Depression Scale measured depressive/anxiety comorbid diagnostic status and severity, and the Liebowitz Social Anxiety Scale assessed social phobia. Social cognition tasks were standardized using published normative data and a cut-off of z < -1.5 for impairment.

RESULTS

More than 90% of our CD patients performed normally on social perception and social behaviour tests. Performance on impaired belief reasoning (theory of mind) was impaired in 10 of 46 (21.74%); five of 46 (10.87%) were impaired on the Empathy Quotient. Better performance on the Affect Naming task was associated with comorbid anxiety (η²  = 0.09, medium-to-large effect size) and greater anxiety, depression and social phobia severity. Worse performance on the Empathy Quotient was associated with comorbid depression (η²  = 0.11, medium-to-large effect size) and greater depression severity. CD patients had significantly more difficulties with fearful face identification (P < 0.001).

CONCLUSIONS

Greater social perception abilities in CD patients with more severe anxiety and depression suggest efficient modulation and self-adaptation of social cognitive skills.

Model of Empathic Pain Assessment and Treatment in Persons With Dementia

The current article presents an evidence-based model for understanding clinical empathy's relationship with the assessment and treatment of pain in persons with advanced dementia. A literature review informed creation of an interdisciplinary conceptual framework of clinician empathy in pain assessment and treatment among persons with advanced dementia. Driven by observation of behaviors indicating pain in persons with dementia unable to self-report, the model represents the cognitive, affective, ethical, and behavioral components of clinical empathy involved in assessing and treating pain, relevant patient outcomes, and contextual factors influencing empathy and outcomes; and provides a framework for testing clinical empathy interventions to improve adverse outcomes in persons with advanced dementia. Understanding the relationship between clinician empathy and the assessment and treatment of pain in persons with advanced dementia may improve care quality and help reduce pain behaviors in this patient population. This model may be used to inform pain research in persons with dementia and develop clinical interventions and clinician education programs. [Research in Gerontological Nursing, 13(5), 264-276.].

Effort shapes social cognition and behaviour: A neuro-cognitive framework

Theoretical accounts typically posit that variability in social behaviour is a function of capacity limits. We argue that many social behaviours are goal-directed and effortful, and thus variability is not just a function of capacity, but also motivation. Leveraging recent work examining the cognitive, computational and neural basis of effort processing, we put forward a framework for motivated social cognition. We argue that social cognition is demanding, people avoid its effort costs, and a core-circuit of brain areas that guides effort-based decisions in non-social situations may similarly evaluate whether social behaviours are worth the effort. Thus, effort sensitivity dissociates capacity limits from social motivation, and may be a driver of individual differences and pathological impairments in social cognition.

Civic-Mindedness Sustains Empathy in a Cohort of Physical Therapy Students: A Pilot Cohort Study

Background:

Empathy is critical to patient-centered care and thus is a valued trait in graduate health-care students. The relationship between empathy and civic-mindedness in health professions has not previously been explored.

Objectives:

(a) To determine whether significant differences occurred on the Jefferson Scale for Empathy–Health Professions Student Version (JSE-HPS) and Civic-Minded Professional scale (CMP) and its subscales across the curriculum, (b) to explore a potential relationship between civic-mindedness and empathy in a cohort of graduate physical therapy (PT) students at regular intervals, and (c) to explore the predictive ability of civic-mindedness on empathy scores.

Methods:

This study was a convenience sample of a cohort of 48 PT students who completed both the JSE-HPS and the CMP at 4 points of a service-learning intensive curriculum. Statistical analysis included descriptive statistics, a Friedman’s analysis of variance with Wilcoxon signed-ranks post hoc testing, and Spearman correlations with stepwise linear regressions.

Results:

Statistically significant differences were not found for the JSE-HPS. Civic-Minded Professional scores increased across the curriculum. The JSE-HPS, the CMP, and various CMP subscales were significantly correlated. The JSE-HPS pretest scores were predictive of the year 1 and 2 posttest JSE-HPS scores.

Conclusion:

This study’s findings indicate that service-learning and the resulting development of civic-mindedness supports empathy. Programs could use JSE-HPS pretests to identify individual graduate students need for empathy mentorship upon program entrance or as one admission criterion.

Atypical Frontotemporal Connectivity of Cognitive Empathy in Male Adolescents With Conduct Disorder

Background: It has been suggested that adolescents with conduct disorder (CD) may have a deficit in the affective and cognitive domains empathy, but studies exploring networks within the key brain regions of affective and cognitive empathy in adolescents with CD are lacking.

Methods: Functional connectivity (FC) analyses among key brain regions of the affective and cognitive empathy with resting-state functional magnetic resonance imaging (fMRI) were conducted in 30 adolescent boys with CD and 33 demographically matched healthy controls (HCs).

Results: Atypical FC within the key brain regions of affective empathy was not observed in CD adolescents. However, we found that CD adolescents showed decreased frontotemporal connectivity within the key brain regions of cognitive empathy in relation to HCs, that is, the FCs between right temporoparietal junction and ventromedial prefrontal cortex as well as dorsomedial prefrontal cortex.

Conclusion: These findings may provide insight into neural mechanism underlying a cognitive empathy deficiency of CD adolescents from the perspective of FC.

Differential impact of behavioral, social, and emotional apathy on Parkinson's disease

Apathy is highly prevalent in Parkinson's disease. New findings suggest the syndrome is multifaceted. Here, we investigate whether all aspects of apathy are equally affected in Parkinson's disease and whether different dimensions of apathy were associated with depression and anhedonia. On the Apathy Motivation Index, while behavioral apathy and social apathy were elevated, emotional motivation was relatively preserved in Parkinson's disease, although a few patients did show impaired emotional sensitivity. Behavioral and social, but not emotional, apathy was associated with depression and anhedonia. These findings suggest aspects of motivation can be selectively impaired in Parkinson's disease and may have implications for guiding treatment.

Alexithymia in Amyotrophic Lateral Sclerosis and Its Neural Correlates

Introduction: Amyotrophic lateral sclerosis (ALS) is a severe neurodegenerative disease that causes progressive and extensive motor deficits. Patients may also have cognitive impairments or alteration of emotional processing. Very few studies, however, have looked at deficits in how they experience their own feelings (alexithymia).

Methods: We assessed alexithymia in 28 patients with ALS using the 20-item Toronto Alexithymia Scale (TAS-20), comparing them with a control group matched for sex, age, and education level. We took into account both the total score of the TAS-20 and its three subscores corresponding to the three dimensions of alexithymia: Difficulty Identifying Feelings (DIF), Difficulty Describing Feelings (DDF), and Externally Oriented Thinking (EOT). Patients also underwent a neuropsychological assessment and anatomical magnetic resonance imaging (MRI) in order to correlate cognitive performances and gray matter volume and level of alexithymia.

Results: On average, ALS subjects had a significantly higher total score and DIF sub-score of the TAS-20 than controls indicating an increased alexithymia in patients. Total and DIF Scores correlated significantly and negatively to gray matter volume of the prefrontal cortex, right superior temporal pole and parahippocampal gyri. No correlations were found between scores on executive functions and those on the TAS-20.

Conclusion: The first stage of one's own emotional processing seems to be affected in ALS independently of executive dysfunction. This trouble seems to be underpinned by cerebral regions that are well known to be both implicated in alexithymia in healthy subjects and altered in ALS.

Individual differences in emotion regulation moderate the associations between empathy and affective distress

Individual differences in empathy can have positive and negative psychological outcomes. Yet, individual differences in the processing and regulation of empathy-induced emotion have not been fully explored within this dynamic. This study was designed to explore whether individual differences in emotion regulation strategies moderated the effects of empathy on common forms of affective distress. Eight hundred and forty four participants completed survey measures of trait empathy, emotion regulation strategies, and symptoms of depression, anxiety, and stress. Affective empathy typically predicted greater affective distress, but the effects on depression and anxiety were offset when people were effective at reappraising their emotions. Cognitive empathy predicted lower distress on average, but this beneficial effect on anxiety and stress was absent in those who typically suppressed their emotions. Finally, suppression unexpectedly reduced the depression and stress reported for people high in affective empathy. Individual differences in emotion regulation are an important moderator between empathy and psychological health, and thus a useful target for intervention.