Responsibility and the sense of agency enhance empathy for pain

Nearsighted empathy: exploring the effect of empathy on distance perception, with eye movements as modulators

Empathy, a cornerstone of social interaction, involves shared representation, eliciting vicarious emotions. However, its influence on shared perceptual representations, particularly in foundational domains such as distance perception, remains unexplored. In this study, we introduce a novel adaptation of the empathy for pain task to investigate empathy's influence on distance perception. We also examine how two personality traits, trait empathy and alexithymia, modulate this relationship. Utilizing eye-tracking technology, we examine how attention allocation to different facial and bodily features affects empathy's impact on distance perception. Our findings indicate that empathy biases individuals to perceive targets as closer, with trait empathy reinforcing this effect and alexithymia attenuating it. Furthermore, we demonstrate that heightened attention to eyes and face correlates with perceiving targets as closer, while attention to hand shows the opposite trend. These results underscore the broader influence of empathy beyond shared emotions, revealing its capacity to alter perceptual processes. By elucidating the interplay between personality traits and visual inputs in shaping these alterations, our study offers valuable insights for future research exploring the role of shared representation in empathy across various perceptual domains.

Visual perspective and body ownership modulate vicarious pain and touch: A systematic review

We conducted a systematic review investigating the influence of visual perspective and body ownership (BO) on vicarious brain resonance and vicarious sensations during the observation of pain and touch. Indeed, the way in which brain reactivity and the phenomenological experience can be modulated by blurring the bodily boundaries of self-other distinction is still unclear. We screened Scopus and WebOfScience, and identified 31 articles, published from 2000 to 2022. Results show that assuming an egocentric perspective enhances vicarious resonance and vicarious sensations. Studies on synaesthetes suggest that vicarious conscious experiences are associated with an increased tendency to embody fake body parts, even in the absence of congruent multisensory stimulation. Moreover, immersive virtual reality studies show that the type of embodied virtual body can affect high-order sensations such as appropriateness, unpleasantness, and erogeneity, associated with the touched body part and the toucher's social identity. We conclude that perspective plays a key role in the resonance with others' pain and touch, and full-BO over virtual avatars allows investigation of complex aspects of pain and touch perception which would not be possible in reality.

Does the cowl make the monk? The effect of military and Red Cross uniforms on empathy for pain, sense of agency and moral behaviors

According to the embodied cognition framework, cognitive functions are not confined to the brain but are also shaped by the mutual interactions between the brain, body, and external environment. In this regard, a theory developed in 2012, called enclothed cognition, suggests an effect on wearing specific clothing on various psychological processes. However, the neuro-cognitive mechanisms underlying the impact of clothing on behavior have received less systematic investigation. The present study examined the influence of clothing on prosocial behaviors, and focused on sense of agency, and empathy for pain as neuro-cognitive processes of interest. Participants (40 in total) wore civilian, military, and Red Cross uniforms. They were paired up and assigned as either agents or victims. Agents had the option to administer real electric shocks to victims for a monetary reward of +€0.05. They could choose to shock freely (free condition) or follow the experimenter's instructions (coerced condition). We measured prosocial behavior by counting the number of shocks prevented, neural empathic response using electroencephalography with the P3 and the LPP, and sense of agency through an implicit method based on interval estimates. Findings showed that wearing the Red Cross uniform led to more prosocial behavior compared to civilian clothing. The Red Cross uniform also increased neural response to pain when participants witnessed shocks, compared to civilian or military clothing. Moreover, wearing a military uniform increased the sense of agency in the free condition, as compared to civilian clothing. This study broadens our knowledge on the impact of enclothed cognition on cognitive and psychological processes.

Consensus on Feedback Statements That Create Responsibility Among People With Parkinson's Disease: A Delphi Study

IMPORTANCE

Sense of agency is associated with a sense of responsibility, which is essential to performing goal-directed occupations.

OBJECTIVE

To reach consensus on a set of extrinsic feedback statements that have the potential to create a sense of responsibility among patients with neurological disorders in the course of performing daily or social occupations.

DESIGN

Anonymous Delphi study with two rounds with international experts and one round with Irani patients with Parkinson's disease (PD).

SETTING

Electronic survey.

PARTICIPANTS

One hundred experts and 73 patients with idiopathic PD.

OUTCOMES AND MEASURES

Experts and patients anonymously rated (5 = strongly agree/very effective, 4 = agree/effective, 3 = neither agree nor disagree/uncertain, 2 = disagree/ineffective, 1 = strongly disagree/very ineffective) their level of agreement with each survey statement and the effectiveness of each statement in creating a sense of responsibility in the course of performing daily or social occupations. Consensus was set as an interquartile range of ≤1 and ≥70% agreement in two adjacent categories of a Likert scale.

RESULTS

In the experts' first round, consensus was reached on the level of agreement and effectiveness of 18 statements. In the second round, final consensus was achieved on all statements. In the one patient round, patients reached consensus on all statements. Finally, 34 statements were rated as 4 or 5 in terms of agreement and effectiveness, based on the opinions of experts and patients.

CONCLUSIONS AND RELEVANCE

This study has produced a collection of feedback statements that might be useful in occupation-based interventions. What This Article Adds: Extrinsic responsibility feedback delivered while administering occupation-based interventions may increase volition, motivation, and engagement.

The impact of facial expression and communicative gaze of a humanoid robot on individual Sense of Agency

Sense of Agency (SoA) is the feeling of control over one's actions and their outcomes. A well-established implicit measure of SoA is the temporal interval estimation paradigm, in which participants estimate the time interval between a voluntary action and its sensory consequence. In the present study, we aimed to investigate whether the valence of action outcome modulated implicit SoA. The valence was manipulated through interaction partner's (i) positive/negative facial expression, or (ii) type of gaze (gaze contact or averted gaze). The interaction partner was the humanoid robot iCub. In Experiment 1, participants estimated the time interval between the onset of their action (head movement towards the robot), and the robot's facial expression (happy vs. sad face). Experiment 2 was identical, but the outcome of participants' action was the type of robot's gaze (gaze contact vs. averted). In Experiment 3, we assessed-in a within-subject design-the combined effect of robot's type of facial expression and type of gaze. Results showed that, while the robot's facial expression did not affect participants' SoA (Experiment 1), the type of gaze affected SoA in both Experiment 2 and Experiment 3. Overall, our findings showed that the robot's gaze is a more potent factor than facial expression in modulating participants' implicit SoA.

Action prediction modulates self-other integration in joint action

People often coordinate actions with others, requiring an adjustable amount of self-other integration between actor's and co-actor's actions. Previous research suggests that such self-other integration (indexed by the joint Simon effect) is enhanced by agent similarity of the co-actor (e.g., high in intentionality). In this study, we aimed to extend this line of research by testing whether experiencing agency over a co-actor's actions (vicarious agency) and/or action prediction strengthens the joint Simon effect. For this purpose, we manipulated experienced agency by varying the experienced control over a co-actor's actions (Experiment 1), and action prediction regarding the co-actor's actions (Experiment 2). Vicarious agency could effectively be induced, but did not modulate the size of the joint Simon effect. The joint Simon effect was decreased when the co-actor's actions were unpredictable (vs. predictable) during joint task performance. These findings suggest social agency can be induced and effectively measured in joint action. Action prediction can act as an effective agency cue modulating the amount of self-other integration in joint action.

Sense of agency predicts severity of moral judgments

Sense of Agency (SoA) refers to the awareness of being the agent of our own actions. A key feature of SoA relies on the perceived temporal compression between our own actions and their sensory consequences, a phenomenon known as "Intentional Binding." Prior studies have linked SoA to the sense of responsibility for our own actions. However, it is unclear whether SoA predicts the way we judge the actions of others - including judgments of morally wrong actions like harming others. To address this issue, we ran an on-line pilot experiment where participants underwent two different tasks designed to tap into SoA and moral cognition. SoA was measured using the Intentional Binding task which allowed us to obtain both implicit (Intentional Binding) and explicit (Agency Rating) measures of SoA. Moral cognition was assessed by asking the same participants to evaluate videoclips where an agent could deliberately or inadvertently cause suffering to a victim (Intentional vs. Accidental Harm) compared with Neutral scenarios. Results showed a significant relation between both implicit and explicit measures of SoA and moral evaluation of the Accidental Harm scenarios, with stronger SoA predicting stricter moral judgments. These findings suggest that our capacity to feel in control of our actions predicts the way we judge others' actions, with stronger feelings of responsibility over our own actions predicting the severity of our moral evaluations of other actions. This was particularly true in ambiguous scenarios characterized by an incongruency between an apparently innocent intention and a negative action outcome.

Commanding or Being a Simple Intermediary: How Does It Affect Moral Behavior and Related Brain Mechanisms?

Psychology and neuroscience research have shown that fractioning operations among several individuals along a hierarchical chain allows diffusing responsibility between components of the chain, which has the potential to disinhibit antisocial actions. Here, we present two studies, one using fMRI (Study 1) and one using EEG (Study 2), designed to help understand how commanding or being in an intermediary position impacts the sense of agency and empathy for pain. In the age of military drones, we also explored whether commanding a human or robot agent influences these measures. This was done within a single behavioral paradigm in which participants could freely decide whether or not to send painful shocks to another participant in exchange for money. In Study 1, fMRI reveals that activation in social cognition-related and empathy-related brain regions was equally low when witnessing a victim receive a painful shock while participants were either commander or simple intermediary transmitting an order, compared with being the agent directly delivering the shock. In Study 2, results indicated that the sense of agency did not differ between commanders and intermediary, no matter whether the executing agent was a robot or a human. However, we observed that the neural response over P3 event-related potential was higher when the executing agent was a robot compared with a human. Source reconstruction of the EEG signal revealed that this effect was mediated by areas including the insula and ACC. Results are discussed regarding the interplay between the sense of agency and empathy for pain for decision-making.

Affective dimensions of pain and region -specific involvement of nitric oxide in the development of empathic hyperalgesia

Empathy for pain depends on the ability to feel, recognize, comprehend and share painful emotional conditions of others. In this study, we investigated the role of NO in a rat model of empathic pain. Pain was socially transferred from the sibling demonstrator (SD) who experienced five formalin injection to the naïve sibling observer (SO) through observation. SO rats received L-NAME (a nonspecific NO synthase inhibitor) or L-arginine (a precursor of NO) prior to observing the SD. Nociception, and concentrations of NO metabolites (NOx) in the serum, left and right hippocampus, prefrontal cortex, and cerebellum were evaluated. Nociceptive responses were significantly increased in the pain-observing groups. NOx levels measured 24 h after the last pain observation using the Griess method, were indicative of NOx concentration decreases and increases in the left hippocampus and cerebellum, respectively. There was an increase in tissue concentration of NOx in cerebellum and prefrontal cortex in both pain and observer groups 7 days after the fifth formalin injection. Our results suggest that NO is involved in development of empathic hyperalgesia, and observation of sibling’s pain can change NO metabolites in different brain regions in observer rats.

A Generalizable Multivariate Brain Pattern for Interpersonal Guilt

Feeling guilty when we have wronged another is a crucial aspect of prosociality, but its neurobiological bases are elusive. Although multivariate patterns of brain activity show promise for developing brain measures linked to specific emotions, it is less clear whether brain activity can be trained to detect more complex social emotional states such as guilt. Here, we identified a distributed guilt-related brain signature (GRBS) across two independent neuroimaging datasets that used interpersonal interactions to evoke guilt. This signature discriminated conditions associated with interpersonal guilt from closely matched control conditions in a cross-validated training sample (N = 24; Chinese population) and in an independent test sample (N = 19; Swiss population). However, it did not respond to observed or experienced pain, or recalled guilt. Moreover, the GRBS only exhibited weak spatial similarity with other brain signatures of social-affective processes, further indicating the specificity of the brain state it represents. These findings provide a step toward developing biological markers of social emotions, which could serve as important tools to investigate guilt-related brain processes in both healthy and clinical populations.

Empathic Responses for Pain in Facial Muscles Are Modulated by Actor's Attractiveness and Gender, and Perspective Taken by Observer

Although empathy for pain is an often studied phenomenon, only few studies employing electromyography (EMG) have investigated either emotional responses to the pain of others or factors that modulate these responses. The present study investigated whether the sex and attractiveness of persons experiencing pain affected muscle activity associated with empathy for pain, the corrugator supercili (CS) and orbicularis oculi (OO) muscles, in male and female participants in two conditions: adopting a perspective of “the other” or “the self.” Fifty one participants (27 females) watched movies showing situations that included the expression of pain, with female and male and more and less attractive actors under both conditions, while the CS and OO EMG were recorded. Perspective did not affect CS muscle activity, but OO muscle activity tended to be higher in women than men under the imagine-self condition. CS muscle activity, but not OO muscle activity, was modulated by the actors’ gender and attractiveness. CS muscle activity was stronger in response to the pain of less attractive than more attractive actors, and to the pain of female actors compared to male actors. Moreover, a positive correlation was found between empathic concern, as a trait, and CS muscle activity, but only in the imagine-self condition.

Neural Mechanisms With Respect to Different Paradigms and Relevant Regulatory Factors in Empathy for Pain

Empathy for pain is thought to activate the affective-motivational components of the pain matrix, which includes the anterior insula and middle and anterior cingulate cortices, as indicated by functional magnetic resonance imaging and other methodologies. Activity in this core neural network reflects the affective experience that activates our responses to pain and lays the neural foundation for our understanding of our own emotions and those of others. Furthermore, although picture-based paradigms can activate somatosensory components of directly experienced pain, cue-based paradigms cannot. In addition to this difference, the two paradigms evoke other distinct neuronal responses. Although the automatic “perception-action” model has long been the dominant theory for pain empathy, a “bottom-up, top-down” mechanism seems to be more comprehensive and persuasive. Indeed, a variety of factors can regulate the intensity of empathy for pain through “top-down” processes. In this paper, we integrate and generalize knowledge regarding pain empathy and introduce the findings from recent studies. We also present ideas for future research into the neural mechanisms underlying pain empathy.

Coercion Changes the Sense of Agency in the Human Brain

People may deny responsibility for negative consequences of their actions by claiming that they were “only obeying orders.” The “Nuremberg defense” offers one extreme example, though it is often dismissed as merely an attempt to avoid responsibility. Milgram’s classic laboratory studies reported widespread obedience to an instruction to harm, suggesting that social coercion may alter mechanisms of voluntary agency, and hence abolish the normal experience of being in control of one’s own actions. However, Milgram’s and other studies relied on dissembling and on explicit measures of agency, which are known to be biased by social norms. Here, we combined coercive instructions to administer harm to a co-participant, with implicit measures of sense of agency, based on perceived compression of time intervals between voluntary actions and their outcomes, and with electrophysiological recordings. In two experiments, an experimenter ordered a volunteer to make a key-press action that caused either financial penalty or demonstrably painful electric shock to their co-participant, thereby increasing their own financial gain. Coercion increased the perceived interval between action and outcome, relative to a situation where participants freely chose to inflict the same harms. Interestingly, coercion also reduced the neural processing of the outcomes of one’s own action. Thus, people who obey orders may subjectively experience their actions as closer to passive movements than fully voluntary actions. Our results highlight the complex relation between the brain mechanisms that generate the subjective experience of voluntary actions and social constructs, such as responsibility.

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Responsibility for action is a key feature of human societies

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It depends on association between actions and outcomes in the brain

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Claims of reduced responsibility are sometimes based on “only obeying orders”

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Two experiments suggest coercion can reduce implicit measures of sense of agency

Emotional mimicry signals pain empathy as evidenced by facial electromyography

Facial mimicry has been suggested to be a behavioral index for emotional empathy. The present study is the first to investigate the link between facial muscle activity and empathy for pain by facial electromyographic (EMG) recording while observers watched videos depicting real-life painful events. Three types of visual stimulus were used: an intact painful scene and arm-only (needle injection) and face only (painful expression) scenes. Enhanced EMG activity of the corrugator supercilii (CS) and zygomaticus major (ZM) muscles was found when observers viewed others in pain, supporting a unique pain expression that is distinct from the expression of basic emotions. In the intact video stimulus condition, CS activity was correlated positively with the empathic concern score and ZM activity, suggesting facial mimicry mediated empathy for pain. Cluster analysis of facial EMG responses revealed markedly different patterns among stimulus types, including response category, ratio, and temporal dynamics, indicating greater ecological validity of the intact scene in eliciting pain empathy as compared with partial scenes. This study is the first to quantitatively describe pain empathy in terms of facial EMG data. It may provide important evidence for facial mimicry as a behavioral indicator of pain empathy.

When your error becomes my error: anterior insula activation in response to observed errors is modulated by agency

Research on error observation has focused predominantly on situations in which individuals are passive observers of errors. In daily life, however, we are often jointly responsible for the mistakes of others. In the current study, we examined how information on agency is integrated in the error observation network. It was found that activation in the anterior insula but not in the posterior medial frontal cortex or lateral prefrontal cortex differentiates between observed errors for which we are partly responsible or not. Interestingly, the activation pattern of the AI was mirrored by feelings of guilt and shame. These results suggest that the anterior insula is crucially involved in evaluating the consequences of our actions for other persons. Consequently, this region may be thought of as critical in guiding social behavior.