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Huang C, Wu Z, Sha S, Liu C, Yang L, Jiang P, Zhang H, Yang C. The Dark Side of Empathy: the Role of Excessive Affective Empathy on Mental Health Disorders. Biol Psychiatry 2025:S0006-3223(25)00021-6. [PMID: 39793690 DOI: 10.1016/j.biopsych.2024.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2024] [Revised: 12/22/2024] [Accepted: 12/24/2024] [Indexed: 01/13/2025]
Abstract
Empathy, typically regarded as a positive attribute, is now being critically evaluated for its potential negative implications on mental health. A growing body of research indicates that excessive empathy, particularly high level of affective empathy, can lead to overwhelming emotional states, increasing susceptibility to psychological distress and psychiatric disorders. This review aims to explore the negative effects of empathy on mental health. We review both human and animal studies concerning the relationship between empathy and psychological disorders, revealing that while empathy enhances social interactions and emotional understanding, it may also heighten empathic distress and potentially contribute to the development of pain, internalizing disorders, depression, anxiety, emotional over-involvement, burnout, vicarious trauma and post-traumatic stress disorder. This review contributes to the broader discourse on empathy by delineating its dual impacts, integrating insights from neurobiology, psychology, and behavioral studies. This review may enhance our understanding of empathy's complex role in mental health, offering a nuanced perspective that acknowledges both its beneficial and detrimental impacts.
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Affiliation(s)
- Chaoli Huang
- Department of Anesthesiology, Affiliated Hospital of Jiangsu University, Zhenjiang 210031, China; Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zifeng Wu
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Sha Sha
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou 221004, China; Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou 221004, China; NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China
| | - Cunming Liu
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Ling Yang
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
| | - Peng Jiang
- Department of Anesthesiology, Affiliated Hospital of Jiangsu University, Zhenjiang 210031, China
| | - Hongxing Zhang
- Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou 221004, China; Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical University, Xuzhou 221004, China; NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, Xuzhou Medical University, Xuzhou 221004, China.
| | - Chun Yang
- Department of Anesthesiology, Affiliated Hospital of Jiangsu University, Zhenjiang 210031, China; Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
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Tang Q, Zou X, Li Y, Xu Y, Lv Y, Liu X, Liu G, Tao Y. Insomnia mediates the relation between empathy and anxiety among nursing students: a latent moderated mediation model of self-compassion. BMC Nurs 2024; 23:570. [PMID: 39152435 PMCID: PMC11330050 DOI: 10.1186/s12912-024-02238-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 08/07/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Nursing students are faced with multiple challenges and have a higher probability of suffering from anxiety. The current study aims to explore the relation between empathy and anxiety, examining the mediation and moderation effects of insomnia and self-compassion, respectively. METHODS This study employed a convenient sampling method, recruiting 1,161 nursing students (female = 923, male = 238, Meanage = 18.37, SDage = 2.38) from three universities in China. These students completed the questionnaires online, including General Anxiety Disorder -7 (GAD-7), Jefferson Scale of Physician Empathy-Nursing student (JSPE-NS), Youth Self-rating Insomnia Scale -8 (YSIS-8), and Self-Compassion Scale (SCS). The study employed latent variable structural equation models to analyze the relation and mechanisms between empathy and anxiety. Then, the mediated role of insomnia and the moderated role of self-compassion were examined. RESULTS The prevalence rates of anxiety and insomnia in the current sample are 18.24% and 26.76%, respectively. The results showed that empathy could negatively predict anxiety, with a significant mediating effect of insomnia between them (B = -0.081, p < 0.05, 95% CI [-0.197, -0.063]). Additionally, it was proven that self-compassion moderated the positive relation between insomnia and anxiety. With a higher level of self-compassion, the indirect effect of empathy on anxiety through insomnia was weaker (B = -0.053, p < 0.01, 95% CI [-0.095, -0.019]). When individuals showed a lower level of self-compassion, the indirect effect of empathy on anxiety through insomnia was stronger (B = -0.144, p < 0.01, 95% CI [-0.255, -0.059]). CONCLUSION The analysis of this research proved that empathy was negatively related to anxiety, and insomnia served as a mediator between empathy and anxiety. Besides, the protective role of self-compassion on individuals' mental health was identified. The findings of the study suggest that the education of nursing students should highlight the significance of fostering empathy and self-compassion. The intervention on insomnia may be helpful in reducing the levels of anxiety since insomnia is a risky factor for anxiety.
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Affiliation(s)
- Qihui Tang
- Faculty of Psychology, Beijing Normal University, NO.19, Xinjiekouwai Street, Beijing, 100875, China
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, 100875, China
| | - Xinyuan Zou
- Faculty of Psychology, Beijing Normal University, NO.19, Xinjiekouwai Street, Beijing, 100875, China
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, 100875, China
| | - Yifang Li
- Department of Chinese Medicine Nursing, School of Nursing, Anhui University of Chinese Medicine, Hefei, 230012, Anhui, China
| | - Yingying Xu
- Department of Nursing, Xuzhou Pharmaceutical Vocational College, Xuzhou, 221116, Jiangsu, China
| | - Yichao Lv
- Faculty of Psychology, Beijing Normal University, NO.19, Xinjiekouwai Street, Beijing, 100875, China
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, 100875, China
| | - Xiangping Liu
- Faculty of Psychology, Beijing Normal University, NO.19, Xinjiekouwai Street, Beijing, 100875, China
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, 100875, China
| | - Gang Liu
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210024, Jiangsu, China.
| | - Yanqiang Tao
- Faculty of Psychology, Beijing Normal University, NO.19, Xinjiekouwai Street, Beijing, 100875, China.
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Beijing, 100875, China.
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Shabahang R, Shim H, Aruguete MS, Zsila Á. Oversharing on Social Media: Anxiety, Attention-Seeking, and Social Media Addiction Predict the Breadth and Depth of Sharing. Psychol Rep 2024; 127:513-530. [PMID: 35993372 DOI: 10.1177/00332941221122861] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Oversharing on social media by adolescents is a considerable problem in the digital age, and has the potential to instigate online shaming, cyberbullying, identity theft, and other security risks. To date, oversharing has not been comprehensively studied and there is scarce understanding of the possible psychological conditions that may underlie this maladaptive online behavior. This study aimed to measure online oversharing and its potential psychological correlates among adolescents. Data were collected from 352 Iranian adolescent social media users (270 girls and 82 boys; Mage = 16.38, SD = 1.71). The Online Oversharing Inventory, developed for this study, demonstrated unidimensionality and excellent internal consistency. Further results showed that boys overshared significantly more on social media than girls did. Anxiety, attention-seeking, and social media addiction were significantly associated with elevated levels of online oversharing. Results show that the Online Oversharing Inventory is a brief and robust tool for the assessment of high frequency self-disclosure on social media. The findings suggest that anxiety, attention-seeking, and problematic use of social media may predispose adolescents to overshare personal information online.
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Affiliation(s)
| | | | | | - Ágnes Zsila
- Institute of Psychology, Pázmány Péter Catholic University, Budapest, Hungary
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Nair TK, Waslin SM, Rodrigues GA, Datta S, Moore MT, Brumariu LE. A meta-analytic review of the relations between anxiety and empathy. J Anxiety Disord 2024; 101:102795. [PMID: 38039916 DOI: 10.1016/j.janxdis.2023.102795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 10/27/2023] [Accepted: 11/08/2023] [Indexed: 12/03/2023]
Abstract
Although theory suggests that empathy may signal a risk for anxiety (Tone & Tully, 2014), the relation between these constructs remains unclear due to the lack of a quantitative synthesis of empirical findings. We addressed this question by conducting three meta-analyses assessing anxiety and general, cognitive, and affective empathy (k's = 70-102 samples; N's = 19,410-25,102 participants). Results suggest that anxiety has a small and significant association with general empathy (r = .08). The relation of clinical anxiety with cognitive empathy was significant but very weak (r = -.03), and small for affective empathy (r = .16). Geographic region and the type of cognitive (e.g., perspective taking, fantasy) and affective empathy (e.g., affective resonance, empathic concern) emerged as moderators. Results suggest that anxiety has a weaker association with general empathy but a stronger association with affective empathy in participants from predominantly collectivistic geographic regions. Further, greater anxiety was weakly associated with less perspective-taking and greater fantasy, and anxiety had a more modest association with empathic concern than other types of affective empathy. Targeting affective empathy (e.g., promoting coping strategies when faced with others' distress) in interventions for anxiety may be beneficial.
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Affiliation(s)
- Travis K Nair
- Adelphi University, Gordon F. Derner School of Psychology, 58 Cambridge Ave, Garden City, NY 11530 USA.
| | - Stephanie M Waslin
- Adelphi University, Gordon F. Derner School of Psychology, 58 Cambridge Ave, Garden City, NY 11530 USA
| | - Gabriela A Rodrigues
- Adelphi University, Gordon F. Derner School of Psychology, 58 Cambridge Ave, Garden City, NY 11530 USA
| | - Saumya Datta
- Adelphi University, Gordon F. Derner School of Psychology, 58 Cambridge Ave, Garden City, NY 11530 USA
| | - Michael T Moore
- Adelphi University, Gordon F. Derner School of Psychology, 58 Cambridge Ave, Garden City, NY 11530 USA
| | - Laura E Brumariu
- Adelphi University, Gordon F. Derner School of Psychology, 58 Cambridge Ave, Garden City, NY 11530 USA
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Zhang Y, Liang T, Gan X, Zheng X, Li H, Zhang J. Social Self-Efficacy and Internet Gaming Disorder Among Chinese Undergraduates: The Mediating Role of Alexithymia and the Moderating Role of Empathy. Front Psychol 2022; 13:898554. [PMID: 35865686 PMCID: PMC9294543 DOI: 10.3389/fpsyg.2022.898554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
As an increasingly serious social problem, Internet gaming disorder (IGD) of college students may be related to their social self-efficacy. However, the relationship and its internal mechanisms underlying are still unclear. The current study tested the mediating effect of alexithymia in the association between social self-efficacy and IGD, and whether this mediating process was moderated by empathy. Social Self-Efficacy Scale (PSSE), Chinese version of Internet Game Addiction Scale (IGAS-C), Toronto Alexithymia Scale (TAS-20) and Interpersonal Response Scale (IRI-C) were adopted to examine the model on 888 Chinese college students. The results indicated that social self-efficacy was significantly negatively associate with IGD. Mediation analysis illustrated that alexithymia mediated the association between social self-efficacy and IGD. Further, moderated mediation analysis manifested that the mediated effects was stronger for lower level of empathy. The conclusions corroborate and clarify the mechanisms that alexithymia mediated the association between social self-efficacy and IGD, and the mediation effects is moderated via empathy. Besides, these findings provide available references for colleges to conduct educational activities, and at the same time provide scientific suggestions for preventing IGD among undergraduates.
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Affiliation(s)
| | | | - Xiong Gan
- Department of Psychology, College of Education and Sports Sciences, Yangtze University, Jingzhou, China
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