Recognition of others' interoceptive states in those with and without eating disorders

BACKGROUND

The ability to recognize one's own emotions is associated with one's ability to recognize others' emotions. Beyond the domain of emotion, however, the relationship between recognition of one's own internal states (interoception) and others' interoceptive states has not been investigated, either in the typical population or clinical groups with interoceptive difficulties (e.g. eating disorders; EDs).

METHOD

This study investigated recognition of one's own and others' internal states in adults with and without eating disorders, using a high frequency visual noise paradigm. Participants completed self-report measures of interoception, alexithymia (difficulties recognising one's own emotional internal states) and ED symptomatology, and the Heartbeat Counting Task measure of cardiac interoceptive accuracy.

RESULTS

Alexithymia was significantly negatively correlated with recognition of others' interoceptive states. EDs were not associated with difficulties recognising others' interoceptive states.

CONCLUSIONS

The ability to recognise one's own emotional internal states is associated with the recognition of others' interoceptive states, which may contribute to social skills and the ability to care for others.

Relationships between alexithymia, interoception, and emotional empathy in autism spectrum disorder

LAY ABSTRACT

Empathy, the ability to understand and share the emotions of others, is a necessary skill for social functioning and can be categorized into cognitive and emotional empathy. There is evidence to suggest that individuals with autism spectrum disorder have difficulties with cognitive empathy, the ability to imagine how another person is thinking or feeling. However, it is unclear if individuals with autism spectrum disorder struggle with emotional empathy, the ability to share and feel emotions others are experiencing. Self-report and interview data were collected to explore the relationships between interoception (individuals' self-reported awareness of sensation from their body such as thirst, heartbeat, etc.), alexithymia (an individual's ability to describe and distinguish between their own emotions), and emotional empathy in 35 youth with autism spectrum disorder and 40 typically developing youth. Greater personal distress to others' emotions and greater difficulty describing and recognizing self-emotions were associated with reporting fewer physical sensations in the body when experiencing emotion in the autism spectrum disorder group. The results of this study suggest that while autism spectrum disorder youth with concomitant alexithymia may experience emotional empathy differently, it should not be characterized as an absence of a capacity for emotional empathy.

Alexithymia and sensory processing sensitivity account for unique variance in the prediction of emotional contagion and empathy

Introduction

Empathy-the ability to identify and share another person's emotional state-is an important socio-emotional process arising, in part, from emotional contagion. In the current study, we assessed unique variance in emotional contagion and other empathy-related constructs accounted for by two personality traits, alexithymia and sensory processing sensitivity (SPS), when controlling for childhood emotional abuse and current depressed mood.

Methods

A sample of 305 adults (M _age = 20.1 years) watched brief film clips chosen to induce various emotional states. After each film, the participants rated how strongly they experienced each of nine different emotions. They then completed self-report measures of alexithymia, SPS, empathy-related constructs, childhood emotional abuse, and current mood.

Results

Those scoring high (vs. low) on SPS reported stronger primary emotions and a larger range of emotions when watching the films and were more apt to believe that their emotions matched those of the individuals featured in the films. They also scored higher on both self-oriented processes (such as the tendency to feel personal distress in tense situations) and other-oriented processes (such as perspective taking and empathic concern) related to empathy. Individuals scoring high (vs. low) on alexithymia reported feeling a larger range of emotions while watching the films but scored lower on other-oriented processes related to empathy. After controlling for SPS and alexithymia, current depressed mood predicted experiencing less varied reactions to mixed valence films that elicited strong feelings of embarrassment/humiliation, and less amusement when watching positive films. Childhood emotional abuse did not emerge as a predictor of emotional contagion or empathy.

Discussion

We propose that the strong and nuanced feelings elicited in those scoring high on SPS by observing others support their personal view that they are highly empathic. In contrast, by failing to closely examine their own mixed reactions to others, individuals with alexithymia may find it difficult to connect with, understand, and respond to others' feelings.

Atypical interoception as a common risk factor for psychopathology: A review

The inadequacy of a categorial approach to mental health diagnosis is now well-recognised, with many authors, diagnostic manuals and funding bodies advocating a dimensional, trans-diagnostic approach to mental health research. Variance in interoception, the ability to perceive one's internal bodily state, is reported across diagnostic boundaries, and is associated with atypical functioning across symptom categories. Drawing on behavioural and neuroscientific evidence, we outline current research on the contribution of interoception to numerous cognitive and affective abilities (in both typical and clinical populations), and describe the interoceptive atypicalities seen in a range of psychiatric conditions. We discuss the role that interoception may play in the development and maintenance of psychopathology, as well as the ways in which interoception may differ across clinical presentations. A number of important areas for further research on the role of interoception in psychopathology are highlighted.

Regulating mirroring of emotions A social-specific mechanism?

There is evidence that humans mirror others’ emotional responses: brain responses to observed and experienced emotion overlap, and reaction time costs of observing others’ pain suggest that others’ emotional states interfere with our own. Such emotional mirroring requires regulation to prevent personal distress. However, currently it is unclear whether this “empathic interference effect” is uniquely social, arising only from the observation of human actors, or also from the observation of non-biological objects in “painful” states. Moreover, the degree to which this interference relates to individual differences in self-reported levels of empathy is yet to be revealed. We introduce a modified pain observation task, measuring empathic interference effects induced by observation of painful states applied to both biological and non-biological stimuli. An initial validation study (N = 50) confirmed that painful states applied to biological stimuli were rated explicitly as more painful than non-painful states applied to biological stimuli, and also than both painful and non-painful states applied to non-biological stimuli. Subsequently, across two independent discovery (N = 83) and replication (N = 80) samples, the task elicited slowing of response times during the observation of painful states when compared to non-painful states, but the magnitude of this effect did not differ between biological and non-biological stimuli. Little evidence was found for reliable relationships between empathic interference and self-reported empathy. Caution should therefore be taken in using the current task to pursue an individual differences approach to empathic interference, but the task shows promise for investigating the specificity of the mechanism involved in regulating emotional mirroring.

Socio-cognitive processing in people with eating disorders: Computerized tests of mentalizing, empathy and imitation skills

OBJECTIVE

Eating disorders are psychiatric illnesses characterized by extreme eating behaviors, such as sustained food restriction or loss of control over eating. Symptoms are thought to be maintained by a variety of mechanisms, one of which may be the socio-cognitive impairments associated with eating disorders. While some previous work has addressed socio-cognitive impairments in eating disorders, this work has relied mostly on self-report data.

METHOD

Here we employed computerized tests of (a) mentalizing (ability to infer the mental states of others); (b) empathy (the degree to which the emotional states of others can be identified and the degree to which the states of others impact one's own emotional state); and (c) imitation (the degree to which observation of another's actions prompts the performance of those actions); in a group of 78 women with an eating disorder and a matched control group of 66 healthy women.

RESULTS

People with eating disorders showed both hyper- and hypo-mentalizing and reduced accuracy of emotional and cognitive mental state inference. They displayed less imitation of observed actions, but no differences in empathy compared to healthy controls. Although anxiety and depressive symptoms had significant effects on mentalizing, most of the observed inter-group differences persisted.

DISCUSSION

Women with eating disorders have difficulties mentalizing and imitating observed actions despite intact non-social automatic imitation, compared to healthy controls. These findings provide an indication that intervention modules to strengthen specific areas of social cognition might be helpful to improve patients' social skills.

Autism spectrum disorder traits are associated with empathic abilities in adults with anorexia nervosa

BACKGROUND

Social and emotional difficulties have been identified as key factors in the development and maintenance of anorexia nervosa (AN). However, few studies have investigated the influence of comorbid psychopathology on social cognition. The aim of the current study was to examine perception of nonverbal communication and empathy in AN using ecologically valid, performance-based measures, and to explore associations with comorbid psychopathology (anxiety, depression, autism spectrum disorder (ASD) traits, alexithymia, and social anxiety).

METHODS

In this cross-sectional study, the Multifaceted Empathy Test (MET) and the Mini Profile of Nonverbal Sensitivity (MiniPONS) were administered to 51 adults with AN, 51 recovered AN (REC), and 51 healthy controls (HCs). Comorbid psychopathological traits were assessed using self-report questionnaires and the Autism Diagnostic Observation Schedule - 2nd edition (ADOS-2).

RESULTS

Individuals with AN showed reduced affective empathy to positive stimuli compared to HCs, and a trend towards lower vocal prosody recognition scores relative to REC. Around a quarter of AN and REC scored above the clinical cut-off for ASD on the ADOS-2, and high ASD symptoms predicted lower cognitive and affective empathy scores.

LIMITATIONS

The study is cross-sectional, future research would benefit from examining social-cognition performance and comorbid psychopathology longitudinally.

CONCLUSIONS

The findings highlight the importance of ASD symptoms in empathy dysfunction in those with a lifetime history of AN. Future research should explore whether treatment adaptations to accommodate for differences in social-cognitive abilities may be helpful in the treatment of AN.