A Dual Route Model of Empathy: A Neurobiological Prospective

The dual roles of empathy in mediating structural empowerment and compassion fatigue among Chinese nurses

BACKGROUND

Nurses in dynamic healthcare environments face escalating challenges that impact their efficacy and well-being. These challenges arise from both the increasing complexity of medical procedures and the intense emotional demands of caregiving, often leading to compassion fatigue. A global prevalence of burnout at 30.0% was observed over the past decade. This study examines the relationship between structural empowerment, empathy (cognitive and affective), and compassion fatigue among Chinese nurses. Understanding these relationships is crucial for developing strategies to mitigate compassion fatigue. It also contributes to enhancing nurses' well-being.

METHODS

Conducted at a public hospital in Shanghai, this cross-sectional study surveyed 305 nurses, with 277 valid responses. Structural empowerment was measured using the Conditions for Work Effectiveness Questionnaire-II, empathy with the Kiersma-Chen Empathy Scale, and compassion fatigue with the Compassion Fatigue Short Scale. We performed correlation and mediation analyses to explore the direct and indirect effects of structural empowerment on compassion fatigue through empathy.

RESULTS

A significant negative direct effect of structural empowerment on compassion fatigue was evidenced by a coefficient of -0.165 (confidence interval: [-0.311, -0.013]). Further analysis revealed a negative indirect effect through cognitive empathy, indicated by an effect of -0.103 (confidence interval: [-0.220, -0.008]). Increased structural empowerment was linked to higher levels of cognitive empathy, which correlated with decreased compassion fatigue. Conversely, the mediation through affective empathy showed a positive indirect effect, indicated by an effect of 0.126 (confidence interval: [0.047, 0.229]). This suggests that higher structural empowerment was associated with increased affective empathy, leading to higher levels of compassion fatigue.

CONCLUSION

The study illuminates the dual role of empathy within the framework of structural empowerment and its impact on compassion fatigue. Cognitive empathy serves as a protective factor, reducing susceptibility to compassion fatigue, while affective empathy appears to heighten vulnerability. These findings provide direct evidence supporting the dual processing pathways of empathy. It is recommended that healthcare policies integrate organizational support with targeted empathy training, such as cognitive reappraisal, emotion regulation, and peer support, to effectively counteract compassion fatigue among nurses. However, due to the cross-sectional nature and the single-hospital setting, the findings should be interpreted cautiously.

Research Review: Social cognition and everyday social skills in children and adolescents with attention-deficit/hyperactivity disorder: a meta-analysis of case-control studies

BACKGROUND

Previous studies that have assessed social cognition in Attention-Deficit/Hyperactivity Disorder (ADHD) have produced inconsistent findings. To summarize these data and shed light upon moderators that may explain observed inconsistencies, we conducted a systematic review and meta-analysis exploring social cognition (Theory of Mind (ToM), Empathy, Facial and Non-Facial Emotion Recognition) and Everyday Social Skills in children and adolescents with ADHD.

METHODS

The current meta-analysis involved 142 studies including 652 effect sizes. These studies compared children and adolescents with ADHD (n = 8,300) and with typical development (n = 7,983).

RESULTS

Participants with ADHD exhibited moderate to very large deficits in ToM (SMD = 0.84, 95% CI = 0.68-0.99), Facial Emotion Recognition (SMD = 0.63, 95% CI = 0.46-0.81), and Everyday Social Skills (SMD = 1.23, 95% CI = 1.08-1.37). The magnitude of these impairments was similar when considering effect sizes adjusted for some covariates and the methodological quality of the studies. Few studies have investigated Empathy and Non-Facial Emotion Recognition, which precludes definitive conclusions.

CONCLUSIONS

Children and adolescents with ADHD experience robust impairments in ToM, Facial Emotion Recognition and Everyday Social Skills. Future studies should explore whether these deficits are a consequence of difficulties in other areas of cognition (e.g., executive functioning). We have made all our raw data open access to facilitate the use of the present work by the community (e.g., clinicians looking for tools, assessing social impairments, or researchers designing new studies).

Associations between alcohol consumption and empathy in a non-clinical sample: drinking motives as a moderator

People consume alcohol for multiple reasons. Negative motives are often associated with alcohol-related problems. These problems might be explained by negative effects of high alcohol consumption on empathy. Past studies have associated alcohol use disorder (AUD) with reduced cognitive and affective empathy. Few studies have focused on non-clinical samples and considered behavioral empathy. We examined the links between alcohol consumption and multiple aspects of empathy, and if these links were moderated by negative drinking motives. We collected online data of 520 unselected individuals. All completed the AUD Identification Test (AUDIT) and a Drinking Motives Questionnaire. Affective and cognitive empathy were assessed using the Empathy Quotient. Behavioral empathy was assessed by asking participants how likely they would help the person in each of 24 scenarios involving pain. Helping others in pain was positively predicted by affective and cognitive empathy. Higher AUDIT scores were associated with helping others less, particularly among participants who scored higher on drinking to cope with negative affect. People who drink more and do so to cope with negative affect appear to have less behavioral empathy. This supports the view that negative drinking motives contribute to AUD risk.

The Influence of Affective Empathy on Online News Belief: The Moderated Mediation of State Empathy and News Type

The belief in online news has become a topical issue. Previous studies demonstrated the role emotion plays in fake news vulnerability. However, few studies have explored the effect of empathy on online news belief. This study investigated the relationship between trait empathy, state empathy, belief in online news, and the potential moderating effect of news type. One hundred and forty undergraduates evaluated 50 online news pieces (25 real, 25 fake) regarding their belief, state empathy, valence, arousal, and familiarity. Trait empathy data were collected using the Chinese version of the Interpersonal Reactivity Index. State empathy was positively correlated with affective empathy in trait empathy and believability, and affective empathy was positively correlated with believability. The influence of affective empathy on news belief was partially mediated by state empathy and regulated by news type (fake, real). We discuss the influence of empathy on online news belief and its internal processes. This study shares some unique insights for researchers, practitioners, social media users, and social media platform providers.

Schizotypy Moderates the Relationship Between Sleep Quality and Social Cognition

ABSTRACT

Poor sleep quality has been tied to worse social cognition. Social cognitive deficits have been noted in those with high schizotypy. Yet, no study has assessed whether schizotypy moderates the relationship between sleep quality and social cognition, which may be vital to our understanding of contributors to social functioning. We conducted a cross-sectional analysis of associations of sleep quality and social cognition, with potential moderation by schizotypy. Participants ( n = 906) completed self-report measures of schizotypy, sleep quality, and social cognition. Levels of schizotypy significantly moderated some of the relationships between sleep and social cognition. For participants low in total or interpersonal schizotypy, worse sleep quality was associated with worse theory of mind scores. For participants low in total, disorganized, or cognitive perceptual schizotypy, worse sleep quality was associated with worse self-reported cognitive empathy. For those high in these facets of schizotypy, worse sleep quality was associated with better self-reported cognitive empathy. These results suggest that the individual facets of schizotypy provide additional information and, therefore, are important to assess when examining social cognition and sleep.

Linking Blood Pressure-Associated Emotional Dampening to Trait Empathy

Gradual and sustained increases in resting blood pressure are accompanied by gradual and sustained reductions in the capacity to consciously experience several affective and somatosensory processes. Burgeoning theory suggests that this phenomenon, termed cardiovascular emotional dampening, contributes to heart disease risk by interfering with our ability to effectively respond to environmental demands. Interpersonal relationships are contexts in which this risk cascade likely occurs, but prior researchers have paid little attention to how emotional dampening might influence these relationships. As empathy is a construct used to describe facets of emotion-linked responding that facilitate interpersonal relationships, if emotional dampening influences interpersonal relationships, then we might expect resting blood pressure to covary with measures of empathy as it does with other previously studied aspects of affective responding. We recruited 175 healthy undergraduate college student participants (120 Women; M age = 19.17, SD age = 2.08) to complete a counterbalanced procedure in which we measured resting blood pressure and related it to participants' responses on the Toronto Alexithymia Scale, the Questionnaire of Cognitive and Affective Empathy, and a demographic survey. Bivariate comparisons revealed a significant inverse relationship between average resting systolic blood pressure (SBP) and cognitive empathy, as well as a significant inverse relationship between SBP and affective empathy. Multiple regression analyses revealed that SBP remained a significant predictor of cognitive empathy, but not affective empathy, after controlling for related covariates (i.e., sex, age, and alexithymia). SBP predicted cognitive empathy such that higher SBP was associated with lower cognitive empathy. Thus, people with higher resting blood pressures might experience increased interpersonal distress because of a reduced capacity for empathetic accuracy and perspective-taking. We discuss the implications and future directions of these findings.

Cognitive Empathy and the Dark Triad: A Literature Review

This literature review aims to analyze studies published by researchers on the topic of the relationship between the psychological constructs of the Dark Triad and Cognitive Empathy. This study hypothesizes how having good cognitive empathic skills could benefit people who demonstrate Dark Triad traits, as this could facilitate the implementation of manipulative strategies. Through the process of identifying studies via databases and registers, 23 studies were included in this literature review, and the results and theories brought forward by the researchers find more agreement regarding the individual components of the Dark Triad than the whole construct: narcissism seems to have, for the most part, relatively small and typical positive correlations (more than 50% of correlations), Machiavellianism has relatively small and typical negative relationships (about 80% of correlations), and psychopathy has relatively large negative relationships (about 90% of correlations). This study conveys that Machiavellians and psychopaths, having reduced empathic abilities, use manipulation techniques that do not have to do with empathy (for example seduction, intimidation etc.), while narcissists would be, among these three dimensions, those most likely to understand others' states of mind and thus be able to use this knowledge to their advantage-although there are doubts about the veracity of the statements and answers given by narcissists in the tests administered to them. This literature review could be a valid aid to professionals dealing with people who exhibit Dark Triad traits; understanding how those exhibiting Dark Triad traits manage their empathic abilities, the areas in which the various dimensions show deficits or not, and how they act to implement their manipulative and controlling tactics could aid in the development of more effective helping strategies to be utilized in therapy settings.

The influence of aggressive exercise on responses to self-perceived and others' pain

Previous studies have reported relationships between exercise and pain. However, little is known about how aggressive exercise modulates individuals' responses to their own and others' pain. This present study addresses this question by conducting 2 studies employing event-related potential (ERP). Study 1 included 38 participants whose self-perceived pain was assessed after intervention with aggressive or nonaggressive exercises. Study 2 recruited 36 participants whose responses to others' pain were assessed after intervention with aggressive or nonaggressive exercise. Study 1's results showed that P2 amplitudes were smaller, reaction times were longer, and participants' judgments were less accurate in response to self-perceived pain stimuli, especially to high-pain stimuli, after intervention with aggressive exercise compared to nonaggressive exercise. Results of study 2 showed that both P3 and LPP amplitudes to others' pain were larger after intervention with aggressive exercise than with nonaggressive exercise. These results suggest that aggressive exercise decreases individuals' self-perceived pain and increases their empathic responses to others' pain.

The role of empathy in trolley problems and variants: A systematic review and meta-analysis

The role of empathy in morality is a subject of ongoing scientific debate due to the lack of systematic reviews and meta-analyses on this topic. To address this gap, we conducted a PRISMA-based systematic quantitative review to investigate the role of empathy in moral judgements, decision-making, and inclinations using trolley problems and variants, which are popular types of moral dilemmas that explore utilitarianism and deontology. We searched for articles in four databases (PsycINFO, Pubmed, WorldWideScience, and Scopus) and performed citation searches. Out of 661 records, we selected 34 that studied the associations between empathy and moral judgements, moral decision-making, and/or moral inclinations. Six meta-analyses and systematic reviews of these records consistently showed small to moderate associations between affective empathy and these moral parameters, particularly in personal moral dilemmas involving intentional harm (although some approaches highlighted more complex associations between these parameters). Regarding other empathy domains, most studies found limited or insignificant links between cognitive empathy domains and moral judgements, decision-making, and inclinations. We discuss the nuances and implications of these results.

Longitudinal changes in attention bias to infant crying in primiparous mothers

Introduction

Infant stimuli attract caregiver attention and motivate parenting behavior. Studies have confirmed the existence of attentional bias toward infant face stimuli; however, relatively little is known about whether attentional bias exists for infant cry stimuli, which are as important as faces in child-rearing situations. Furthermore, scarce longitudinal evidence exists on how attentional bias toward infant crying changes through the postpartum period.

Methods

In the present study, we conducted an experiment to assess bias toward infant crying at two postpartum time points: at Time 1 (Mean = 75.24 days), 45 first-time mothers participated and at Time 2 (Mean = 274.33 days), 30 mothers participated. At both time points, the mothers participated in a Stroop task with infant crying and white noise as the stimuli. They were instructed to answer the color out loud as quickly and accurately as possible, while ignoring the sound. Four types of audio stimuli were used in this task (the cry of the mother's own infant, the cry of an unfamiliar infant, white noise matched to the cry of the mother's own infant, and white noise matched to the cry of an unfamiliar infant), one of which was presented randomly before each trial. Response time and the correct response rate for each condition were the dependent variables.

Results

For response time, the main effect of familiarity was significant, with longer response times when the participant's infant's cry was presented. In addition, response times were lower at Time 2 than at Time 1 in some conditions in which crying was presented.

Discussion

The results suggest that mothers may be less disturbed by infant crying as they gain more experience. Elucidating the characteristics of postpartum mothers' changes in cognitive performance related to infants' cries would be useful in fundamental and applied research to understand the process of parents' adaptation to parenting.

All it takes is empathy: how virtual reality perspective-taking influences intergroup attitudes and stereotypes

Research in the past decade has demonstrated the potential of virtual reality perspective-taking (VRPT) to reduce bias against salient outgroups. In the perspective-taking literature, both affective and cognitive mechanisms have been theorized and identified as plausible pathways to prejudice reduction. Few studies have systematically compared affective and cognitive mediators, especially in relation to virtual reality, a medium posited to produce visceral, affective experiences. The present study seeks to extend current research on VRPT's mechanisms by comparing empathy (affective) and situational attributions (cognitive) as dual mediators influencing intergroup attitudes (affective) and stereotypes (cognitive). In a between-subjects experiment, 84 participants were randomly assigned to embody a VR ingroup or outgroup waiting staff at a local food establishment, interacting with an impolite ingroup customer. Results indicated that participants in the outgroup VRPT condition reported significantly more positive attitudes and stereotypes towards outgroup members than those in the ingroup VRPT condition. For both attitudes and stereotypes, empathy significantly mediated the effect of VRPT, but situational attributions did not. Findings from this research provide support for affect as a key component of virtual experiences and how they shape intergroup perceptions. Implications and directions for further research are discussed.

Testing the social mindfulness paradigm: Longitudinal evidence of its unidimensionality, reliability, validity, and replicability in a sample of health care providers

OBJECTIVES

Social mindfulness is a relatively new concept in psychological research and is attracting increasing attention. Recent studies have provided evidence of its relevance with regard to prosocial behavior and empathy, but also concerning individual well-being and psychological health. In such studies, social mindfulness has been assessed using the social mindfulness paradigm by Van Doesum and colleagues, which is the standard measure of social mindfulness to date. However, evidence is scarce or lacking with regard to whether this measurement approach is unidimensional, whether it produces (test-retest) reliable and valid measurements, and whether its associations with personality and empathy are replicable.

METHODS

To test these assumptions, we assessed a sample of 265 participants currently working in health care professions on social mindfulness, several concepts of empathy, and the HEXACO personality dimensions longitudinally at two measurement occasions.

RESULTS

The results supported the assumption of unidimensionality of the measure. Partial support was found for its reliability, validity, and replicability. Test-retest reliability was acceptable, but the associations with personality and empathy turned out weaker than expected.

CONCLUSIONS

The social mindfulness paradigm is an interesting approach toward understanding social mindfulness, meaning mindfulness of other people's needs. Potential directions for the further development of the social mindfulness paradigm and its network of relations, especially to empathy, are discussed.

The intersection of empathy and addiction

Empathy, the ability to perceive the affective state of another, is a complex process that is integral to many of the prosocial behaviors expressed in humans and across the animal kingdom. Research into the behavioral and neurobiological underpinnings of empathic behaviors has increased in recent years. Growing evidence suggests changes in empathy may contribute to a myriad of psychiatric illnesses, including substance use disorder (SUD). Indeed, both clinical and preclinical research in SUD demonstrates a strong relationship between drug taking or relapse events and changes to empathic behavior. Further, there is significant overlap in the underlying neural substrates of these complex behaviors, including the insula, paraventricular nucleus of thalamus (PVT), and the paraventricular nucleus of the hypothalamus (PVN). In this review, we will discuss our current understanding of the interplay between empathic behaviors and SUD. We will also examine the underlying neurobiology that may regulate this interaction, focusing specifically on the insula, PVT, and PVN. Finally, we discuss the biologic and therapeutic importance of taking empathic processes into consideration when discussing SUD.

Understanding the neural mechanisms of empathy toward robots to shape future applications

This article provides an overview on how modern neuroscience evaluations link to robot empathy. It evaluates the brain correlates of empathy and caregiving, and how they may be related to the higher functions with an emphasis on women. We discuss that the understanding of the brain correlates can inform the development of social robots with enhanced empathy and caregiving abilities. We propose that the availability of these robots will benefit many aspects of the society including transition to parenthood and parenting, in which women are deeply involved in real life and scientific research. We conclude with some of the barriers for women in the field and how robotics and robot empathy research benefits from a broad representation of researchers.

Analyzing when parental warmth but without parental strictness leads to more adolescent empathy and self-concept: Evidence from Spanish homes

Introduction

Classical research mainly conducted with European-American families has identified the combination of warmth and strictness (authoritative style) as the parenting always associated with the highest scores on developmental outcomes. Additionally, despite the benefits of empathy for prosocial behaviors and protection against antisocial behaviors, most research has considered the contribution of specific practices (e.g., reasoning or power assertion), but not so much the parenting styles. Similarly, family studies tend to study the relationship between parenting and global self-perceptions (self-esteem), but not so much those of each dimension (self-concept).

Methods

In the present study, 600 Spanish adolescents from 12 to 17 years old (M = 15.25, SD = 2.01) were classified within one of the four household typologies (i.e., authoritative, indulgent, authoritarian, or neglectful). Adolescent developmental outcomes were cognitive empathy (adopting perspectives and emotional understanding), emotional empathy (empathic stress and empathic happiness), and self-concept (academic, social, emotional, family and physical).

Results

The results showed that the indulgent parenting (warmth but not strictness) was related to equal or even better empathy and self-concept than the authoritative style (warmth and strictness), whereas non-warm parenting (authoritarian and neglectful) was consistently associated with poor results.

Discussion

Overall, the present findings seriously question that parental strictness combined with parental warmth (authoritative style) is always the parenting style related to the greatest outcomes. By contrast, it seems that reasoning, warmth and involvement, without strictness (indulgent parenting) help adolescents to achieve a good orientation toward others in terms of cognitive and affective empathy and a good self-evaluation in terms of self-concept.

Psychopathic and autistic traits differentially influence the neural mechanisms of social cognition from communication signals

Psychopathy is associated with severe deviations in social behavior and cognition. While previous research described such cognitive and neural alterations in the processing of rather specific social information from human expressions, some open questions remain concerning central and differential neurocognitive deficits underlying psychopathic behavior. Here we investigated three rather unexplored factors to explain these deficits, first, by assessing psychopathy subtypes in social cognition, second, by investigating the discrimination of social communication sounds (speech, non-speech) from other non-social sounds, and third, by determining the neural overlap in social cognition impairments with autistic traits, given potential common deficits in the processing of communicative voice signals. The study was exploratory with a focus on how psychopathic and autistic traits differentially influence the function of social cognitive and affective brain networks in response to social voice stimuli. We used a parametric data analysis approach from a sample of 113 participants (47 male, 66 female) with ages ranging between 18 and 40 years (mean 25.59, SD 4.79). Our data revealed four important findings. First, we found a phenotypical overlap between secondary but not primary psychopathy with autistic traits. Second, primary psychopathy showed various neural deficits in neural voice processing nodes (speech, non-speech voices) and in brain systems for social cognition (mirroring, mentalizing, empathy, emotional contagion). Primary psychopathy also showed deficits in the basal ganglia (BG) system that seems specific to the social decoding of communicative voice signals. Third, neural deviations in secondary psychopathy were restricted to social mirroring and mentalizing impairments, but with additional and so far undescribed deficits at the level of auditory sensory processing, potentially concerning deficits in ventral auditory stream mechanisms (auditory object identification). Fourth, high autistic traits also revealed neural deviations in sensory cortices, but rather in the dorsal auditory processing streams (communicative context encoding). Taken together, social cognition of voice signals shows considerable deviations in psychopathy, with differential and newly described deficits in the BG system in primary psychopathy and at the neural level of sensory processing in secondary psychopathy. These deficits seem especially triggered during the social cognition from vocal communication signals.

White matter connectivity in brain networks supporting social and affective processing predicts real-world social network characteristics

Human behavior is embedded in social networks. Certain characteristics of the positions that people occupy within these networks appear to be stable within individuals. Such traits likely stem in part from individual differences in how people tend to think and behave, which may be driven by individual differences in the neuroanatomy supporting socio-affective processing. To investigate this possibility, we reconstructed the full social networks of three graduate student cohorts (N = 275; N = 279; N = 285), a subset of whom (N = 112) underwent diffusion magnetic resonance imaging. Although no single tract in isolation appears to be necessary or sufficient to predict social network characteristics, distributed patterns of white matter microstructural integrity in brain networks supporting social and affective processing predict eigenvector centrality (how well-connected someone is to well-connected others) and brokerage (how much one connects otherwise unconnected others). Thus, where individuals sit in their real-world social networks is reflected in their structural brain networks. More broadly, these results suggest that the application of data-driven methods to neuroimaging data can be a promising approach to investigate how brains shape and are shaped by individuals' positions in their real-world social networks.

Mirror neurons and empathy-related regions in psychopathy: systematic review, meta-analysis, and a working model

Mirror neurons have been associated with empathy. People with psychopathic traits present low levels of empathy. To analyze this, a systematic review of fMRI studies of people with psychopathic traits during an emotional facial expression processing task was performed. The regions of interest were structures associated with the mirror neuron system: ventromedial prefrontal cortex (vmPFC), inferior parietal lobe (IPL), inferior frontal gyrus and superior temporal sulcus. The analysis was also extended to structures related to affective empathy (insula, amygdala and anterior cingulate cortex) and to two more emotional processing areas (orbitofrontal cortex and fusiform gyrus). Hypoactivation was more frequently observed in regions of the mirror neuron system from people with high psychopathic traits, as well as in the emotional processing structures, and those associated with affective empathy, except for the insula, where it presented higher activity. Differences were observed for all types of emotions. The results suggest that the mirror neuron system is altered in psychopathy and their relationship with affective empathy deficits is discussed.

How cognitive and emotional empathy relate to rational thinking: empirical evidence and meta-analysis

Empathy is frequently described in opposition to rationality. Yet in two studies, we demonstrate that the relationship between rationality and empathy is nuanced and likely context dependent. Study 1 reports correlational data from two American samples and Study 2 presents a meta-analysis of existing literature (k = 22). We demonstrate that various types of cognitive empathy (perspective-taking, emotion recognition, and fantasy) are positively correlated with self-reported rationality, but unrelated to rational performance. In contrast, types of emotional empathy (empathic concern, personal distress, and emotion contagion) are generally negatively correlated with performance measures of rationality, but their relationships with self-reported rationality are divergent. Although these results do not settle the debate on empathy and rationality, they challenge the opposing domains hypothesis and provide tentative support for a dual-process model of empathy. Overall, these results indicate that the relationship between rationality and empathy differs depending upon how rationality and empathy are measured.

Cognitive and Affective Empathy Relate Differentially to Emotion Regulation

The constructs of empathy (i.e., understanding and/or sharing another's emotion) and emotion regulation (i.e., the processes by which one manages emotions) have largely been studied in relative isolation of one another. To better understand the interrelationships between their various component processes, this manuscript reports two studies that examined the relationship between empathy and emotion regulation using a combination of self-report and task measures. In study 1 (N = 137), trait cognitive empathy and affective empathy were found to share divergent relationships with self-reported emotion dysregulation. Trait emotion dysregulation was negatively related to cognitive empathy but did not show a significant relationship with affective empathy. In the second study (N = 92), the magnitude of emotion interference effects (i.e., the extent to which inhibitory control was impacted by emotional relative to neutral stimuli) in variants of a Go/NoGo and Stroop task were used as proxy measures of implicit emotion regulation abilities. Trait cognitive and affective empathy were differentially related to both task metrics. Higher affective empathy was associated with increased emotional interference in the Emotional Go/NoGo task; no such relationship was observed for trait cognitive empathy. In the Emotional Stroop task, higher cognitive empathy was associated with reduced emotional interference; no such relationship was observed for affective empathy. Together, these studies demonstrate that greater cognitive empathy was broadly associated with improved emotion regulation abilities, while greater affective empathy was typically associated with increased difficulties with emotion regulation. These findings point to the need for assessing the different components of empathy in psychopathological conditions marked by difficulties in emotion regulation.

Supplementary Information

The online version contains supplementary material available at 10.1007/s42761-021-00062-w.

Theory of Mind and Empathy in Adults With Epilepsy: A Meta-Analysis

Mounting evidence suggests that social cognitive abilities [including theory of mind (ToM) and empathy] are impaired in adult patients with epilepsy. Although the deficits in overall ToM in epilepsy have been documented well, the effects of epilepsy on empathic ability and specific subcomponents of ToM remain unclear. The primary aim of this study was to provide the first meta-analytic integration of ToM and empathy in adult patients with epilepsy, and to decompose these constructs to clearly differentiate their distinct (cognitive ToM and affective empathy) and overlapping (affective ToM/cognitive empathy) components. This meta-analysis included 28 studies. Adult patients with temporal lobe epilepsy (TLE) and frontal lobe epilepsy (FLE) showed impairments in cognitive ToM and affective ToM/cognitive empathy compared to the healthy controls (HCs); no group differences were identified for affective empathy. Besides, cognitive ToM was impaired in adult patients with idiopathic generalized epilepsy (IGE) and focal seizures (caused by epileptogenic foci) outside the temporal and frontal lobes (extra-TLE/FLE) and no group differences were evident for affective ToM/cognitive empathy compared to the HCs. Moreover, relative to the HCs, no group differences were identified for affective empathy in adult patients with IGE. Additionally, no (statistically) significant difference was observed between the magnitude of ToM/empathy impairment in adult patients who underwent and those who did not undergo epilepsy surgery. These quantitative findings suggest differential impairment of the core aspects of social cognitive processing in adult patients with epilepsy, which may contribute to the development of structured cognitive interventions (i.e., social cognitive training) for adult patients with epilepsy.

Experiences of Adults High in the Personality Trait Sensory Processing Sensitivity: A Qualitative Study

Sensory processing sensitivity (SPS) is a personality trait reflecting inter-individual differences in sensitivity to negative and positive environmental information. Being high in SPS is associated with increased stress-related problems if environments are unfavourable but also appears to enhance one’s ability to benefit from health-promoting environments. In understanding SPS, therefore, lies the potential for innovating the ways we use to promote mental health. However, as a young research field, the core characteristics of SPS are yet debated. Qualitative research interviewing highly sensitive adults is important to conduct ecologically valid research connected with the complex realities of people. This study was the first to systematically report the perceptions and experiences of SPS characteristics in adults high in this trait. Semi-structured interviews (n = 26) were analysed thematically and described following consolidated criteria for reporting qualitative research. Six themes emerged: (1) emotional responding; (2) relatedness to others; (3) thinking; (4) overstimulation; (5) perceiving details; and (6) global SPS characteristics. With regards to coping with negative consequences of high SPS, the main themes were: (1) reducing sensory input and (2) psychological strategies. We gained fine-grained information on experiences of adults high in SPS and derived new hypotheses regarding the fostering of well-being related to high SPS.

Social cognition and cortisol in the general population: A systematic review and meta-analysis

This systematic review examines the evidence on the association between social cognition and cortisol in the general population. Literature was searched in six databases. Of the 401 studies identified, meta-analyses were conducted on 46 effect sizes (Pearson's correlation coefficients) from 19 studies, supplemented by a narrative review. Pooled estimates suggest that better emotion control is associated with increased cortisol concentrations [r = 0.083, 95% CI (0.033, 0.132)]. Emotion recognition or empathy were not significantly associated with cortisol concentrations [r = 0.072, 95% CI (-0.020, 0.165) and r = 0.004, 95% CI (-0.061, 0.068) respectively]. Subgroup analyses showed that the association between emotion control and cortisol concentrations is significant in males, for morning cortisol, when the cortisol data are transformed to correct for skewed distributions, or when participants are instructed to avoid food and drink intake for at least one hour before sample collection. There was no evidence for an association between social cognition with diurnal cortisol slope or cortisol awakening response. More validation work with greater standardization of methodological procedures is required.

Age-related differences in negative cognitive empathy but similarities in positive affective empathy

Empathy, among other social-cognitive processes, changes across adulthood. More specifically, cognitive components of empathy (understanding another's perspective) appear to decline with age, while findings for affective empathy (sharing another's emotional state) are rather mixed. Structural and functional correlates underlying cognitive and affective empathy in aging and the extent to which valence affects empathic response in brain and behavior are not well understood yet. To fill these research gaps, younger and older adults completed a modified version of the Multifaceted Empathy Test, which measures both cognitive and affective empathy as well as empathic responding to both positive and negative stimuli (i.e., positive vs. negative empathy). Adopting a multimodal imaging approach and applying multivariate analysis, the study found that for cognitive empathy to negative emotions, regions of the salience network including the anterior insula and anterior cingulate were more involved in older than younger adults. For affective empathy to positive emotions, in contrast, younger and older adults recruited a similar brain network including main nodes of the default mode network. Additionally, increased structural microstructure (fractional anisotropy values) of the posterior cingulum bundle (right henisphere) was related to activation of default mode regions during affective empathy for positive emotions in both age groups. These findings provide novel insights into the functional networks subserving cognitive and affective empathy in younger and older adults and highlight the importance of considering valence in empathic response in aging research. Further this study, for the first time, underscores the role of the posterior cingulum bundle in higher-order social-cognitive processes such as empathy, specifically for positive emotions, in aging.

Current rodent models for the study of empathic processes

Empathy is a complex phenomenon critical for group survival and societal bonds. In addition, there is mounting evidence demonstrating empathic behaviors are dysregulated in a multitude of psychiatric disorders ranging from autism spectrum disorder, substance use disorders, and personality disorders. Therefore, understanding the underlying drive and neurobiology of empathy is paramount for improving the treatment outcomes and quality of life for individuals suffering from these psychiatric disorders. While there is a growing list of human studies, there is still much about empathy to understand, likely due to both its complexity and the inherent limitations of imaging modalities. It is therefore imperative to develop, validate, and utilize rodent models of empathic behaviors as translational tools to explore this complex topic in ways human research cannot. This review outlines some of the more prevailing theories of empathy, lists some of the psychiatric disorders with disrupted empathic processes, describes rat and mouse models of empathic behaviors currently used, and discusses ways in which these models have elucidated social, environmental, and neurobiological factors that may modulate empathy. The research tools afforded to rodent models will provide an increasingly clear translational understanding of empathic processes and consequently result in improvements in care for those diagnosed with any one of the many psychiatric disorders.

How stress can influence brain adaptations to motherhood

Research shows that a woman's brain and body undergo drastic changes to support her transition to parenthood during the perinatal period. The presence of this plasticity suggests that mothers' brains may be changed by their experiences. Exposure to severe stress may disrupt adaptive changes in the maternal brain and further impact the neural circuits of stress regulation and maternal motivation. Emerging literature of human mothers provides evidence that stressful experience, whether from the past or present environment, is associated with altered responses to infant cues in brain circuits that support maternal motivation, emotion regulation, and empathy. Interventions that reduce stress levels in mothers may reverse the negative impact of stress exposure on the maternal brain. Finally, outstanding questions regarding the timing, chronicity, types, and severity of stress exposure, as well as study design to identify the causal impact of stress, and the role of race/ethnicity are discussed.

RETRACTED: Epigenetic modification of the oxytocin gene is associated with gray matter volume and trait empathy in mothers

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). The Editor has concluded that the acceptance of this article was partly based upon the positive advice of an unreliable reviewer report. The report was provided to the journal by a reviewer suggested by the authors, and there were inappropriate communications between the authors and reviewer during the peer-review process. The Editor has therefore concluded that the review was not appropriate or independent. This manipulation of the peer-review process represents a clear violation of the fundamentals of peer review, our publishing policies, and publishing ethics standards. Apologies are offered to the readers of the journal that this deception was not detected during the submission process.

Empathy and Theory of Mind in Multiple Sclerosis: A Meta-Analysis

Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the central nervous system. Studies have shown that MS disrupts several social cognitive abilities [including empathy and theory of mind (ToM)]. Overall ToM deficits in MS are well documented, but how the specific ToM subcomponents and empathic capacity are affected remains unclear. For this meta-analysis, we searched PubMed, Web of Science, and Embase from inception to July 2020. Effect sizes were calculated using Hedges g with a random-effects model. Thirty-three studies were included. Relative to healthy controls (HCs), patients with MS were moderately impaired in overall empathy (g = -0.67), overall ToM (g = -74), cognitive ToM (g = -0.72), and the overlapping domains of cognitive empathy/affective ToM (g = -0.79); no group differences were identified for affective empathy (g = -0.19). Compared with HCs, patients with relapsing-remitting MS (RRMS) and progressive MS were impaired in overall empathy, overall ToM, cognitive ToM, and cognitive empathy/affective ToM, without significant RRMS-progressive MS differences in impairment degree. We conducted the first meta-analytic review investigating the empathy and ToM functioning patterns in patients with MS and examined the overlapping and distinct subcomponents of these constructs. The findings suggest differential impairment of the core aspects of social cognitive processing in patients with MS, which may importantly inform the development of structured social cognitive MS interventions.

Empathy and Theory of Mind in Alzheimer's Disease: A Meta-analysis

OBJECTIVE

A large literature now shows that Alzheimer's disease (AD) disrupts a number of social cognitive abilities, including social perceptual function and theory of mind (ToM). However, less well understood is how the specific subcomponents of ToM as well as both the broader and specific subcomponents of empathic processing are affected.

METHOD

The current study provides the first meta-analytic review of AD that focuses on both empathy and ToM as broad constructs, as well as their overlapping (cognitive empathy and affective ToM) and distinct (affective empathy and cognitive ToM) subcomponents.

RESULTS

Aggregated across 31 studies, the results revealed that, relative to controls, AD is associated with large-sized deficits in both cognitive ToM (g = 1.09) and affective ToM/cognitive empathy (g = 0.76). However, no statistical differences were found between the AD participants and controls on affective empathic abilities (g = 0.36).

CONCLUSIONS

These data point to a potentially important disconnect between core aspects of social cognitive processing in people with AD. The practical and theoretical implications of these findings are discussed.

Paracetamol alters empathy scores in healthy and headache subjects: Functional MRI correlates

INTRODUCTION

Although previous evidence suggest that paracetamol decreases psychological reactivity in healthy subjects, there is still no confirmed correlation between the empathy scores and brain activity in healthy and headache patients after paracetamol treatment.

MATERIAL AND METHODS

The study group included 16 patients with tension-type headache, and 12 healthy age-and sex-matched controls. After a detailed neurological examination Positive and Negative Affect Schedule (PANAS) and Empathy for Pain Scale (EPS) were applied to all subjects. Next, 1000 mg paracetamol tablet was administered orally, after administration of paracetamol, EPS were repeated, and fMRI was performed to all subjects.

RESULTS

We have revealed increased empathy scores in the headache group after the paracetamol treatment which were associated with significant alterations in brain regions which play a critical role in the processing of empathy.

DISCUSSION

The observed neuroimaging and clinical difference between healthy and headache subjects could be related to the fact that pain perception in healthy subjects might differ in some aspects from the mechanisms of empathy in headache-experienced patients.

CONCLUSION

To the best of our knowledge, this is the first study that evaluated the paracetamol treatment and neural networks' correlation with pain empathy in healthy and headache individuals.

Empathy Mediates the Relations between Working Memory and Perpetration of Intimate Partner Violence and Aggression

Deficits in executive functioning have been associated with aggressive and violent behavior toward intimate partners. However, it is unclear what specific mechanisms are being affected by cognitive deficits that increase an individual's tendency to become aggressive. The current study examined empathy as a mediating factor between deficits in working memory and perpetration of intimate partner aggression and violence. Men in heterosexual relationships (N = 49) were administered a measure of visual-spatial working memory, and questionnaire measures of head injury and empathy. During a second session, men participated in a conflict discussion with their female partner that was coded for aggressive behavior. Female partners also reported on men's physical and psychological abuse. Working memory was positively related to cognitive and affective empathy, and negatively related to men's physical abuse perpetration and observed aggression during the conflict discussion. The effects of working memory on observed aggression during the conflict were fully mediated by cognitive and affective empathy. Additionally, the effects of working memory on reported physical IPV frequency were fully mediated by affective empathy. Deficits in working memory may decrease men's ability to use empathetic processes, resulting in increased aggression and violence toward their intimate partners. Clinically, incorporating empathy training in battering intervention programs may be helpful, especially among men with deficits in cognitive functioning.