Alexithymia as a Mediator of the Relationship Between the Vulnerable Dark Triad and Empathy

The empathic abilities have never been examined in bipolar disorder patients, despite frequent observations of impaired social behavior. To examine the neuropsychological processes that underlie the affective and cognitive empathic ability in bipolar disorder, the authors compared affective and cognitive empathic abilities, as well as theory of mind and executive functions, of euthymic bipolar disorder patients and healthy comparison subjects. Significant deficits in cognitive empathy and theory of mind were observed, while affective empathy was elevated in bipolar disorder. Patients showed impaired cognitive flexibility (shifting and reversal learning) but intact planning behavior. Impaired cognitive empathy was related with performance in neurocognitive tasks of cognitive flexibility, suggesting that prefrontal cortical dysfunction may account for impaired cognitive empathy in bipolar disorder.

Harari, Shamay-Tsoory, Ravid, and Levkovitz (2010) demonstrated a "double dissociation" in empathy in borderline personality disorder (BPD), such that BPD patients had higher affective than cognitive empathy, whereas controls exhibited the opposite pattern. Two processes that may relate to this dissociation are emotion dysregulation (ER) and hypermentalization. However, these interrelated processes have not been studied concomitantly, and the dissociation of empathy types has not been examined in adolescents with BPD. This study examined the relations between ER, hypermentalization, and cognitive and affective empathy in 252 adolescent inpatients with and without BPD. Participants completed a computerized task of hypermentalization and measures of ER and empathy. Findings only partially replicated Harari et al.'s findings, with differential performance in cognitive and affective empathy demonstrated across groups. Multivariate analyses revealed that in both groups, ER related to increased affective empathy. Hypermentalizing related to decreased cognitive empathy in BPD patients, whereas hypermentalizing did not relate to either empathy type in non-BPD patients.

Borderline personality disorder (BPD) is characterized by severe interpersonal dysfunction with problems in social cognition, empathy and social approach. Although the neuropeptide oxytocin is known to regulate complex social cognition and behavior in healthy individuals and clinical populations, there is still a lack of evidence for a potential beneficial effect of oxytocin administration on social cognition and social approach in BPD. Fifty-one women with BPD and 51 matched healthy controls were randomized to a double-blind, placebo-controlled, between-subject experimental trial. We administered a single dose of 24 IU oxytocin or placebo intranasally prior to a standardized task measuring affective and cognitive empathy and approach motivation. All participants were free of hormonal contraception and tested in the mid-luteal phase of their menstrual cycle. In the placebo condition, patients with BPD showed reduced cognitive and affective empathy, and less approach behavior motivation than healthy controls. Intranasal oxytocin significantly increased affective empathy and approach motivation in both BPD patients and healthy controls compared to placebo. More importantly, oxytocin administration led to similar scores between BPD and healthy controls. These findings provide the first evidence for a beneficial effect of oxytocin on deficits in affective empathy and approach motivation of BPD. Our results indicate a beneficial effect of a single dose of oxytocin on affective empathy and approach motivation in women with BPD adapting their level of social functioning to healthy controls. Future clinical trials will need to investigate the long-term effects and effectiveness of oxytocin as an add-on treatment for social impairments in BPD.

ObjectivesThe current research has three primary hypotheses: (i) There is a positive relationship between the use of Facebook word messages and cognitive empathy in university students. (ii) There is a positive relationship between participating in the Facebook video and affective empathy in university students. (iii) Virtual affective and cognitive empathy cannot replicate real-world affective and cognitive empathy regarding a feeling of being emotionally supported in university students on Facebook but can replicate the feeling of being informationally supported in university students on Facebook.DesignThree different scales on a questionnaire have been used to investigate the usage of Facebook, empathy level and the degree of social support. A modified version of the Facebook usage scale (14 items) has been used to measure the usage of Facebook word messages and video. The Basic Empathy Scale has been used to measure both the cognitive (9 items) and affective empathy (11 items) levels of the respondents. A modified version of the basic empathy scale has been used to examine virtual empathy. The Medical Outcomes Study (MOS) social support scale has been used to study the degree of social support which is accessible to the participants when they need it. Four emotional and four informational support items (eight items in total) have been selected by the researchers from within the 18 support items.MethodsThe 204 participants are volunteer international and UK university students, randomly recruited from Facebook groups and from among the personal friends of the researcher. The participants were invited to complete questionnaires through a link to a third-part survey website, Qualtrics. A correlation and regression analysis from SPSS has been used to investigate the data.ResultsThere is a weak positive correlation between Facebook word messages and cognitive empathy. The correlation between Facebook word messages and cognitive empathy was significant. There is a weak negative correlation between Facebook video and affective empathy. The correlation between Facebook video and cognitive empathy was not significant. Virtual affective and cognitive empathy on Facebook cannot replicate real world affective and cognitive empathy with regard to the feeling of receiving emotional support and informational support.ConclusionsUniversity students who have a higher frequency of interacting with word messages on Facebook seem to be more skilful in understanding and identifying the emotions of others. Exposure to video on Facebook may not enhance university students’ affective empathy. Moreover, emotional and informational support online may only act as supplements rather than replacements for emotional and informational support in the real-world, although individuals can obtain a large amount of informational social support conveniently just by one click or post on social networking sites nowadays.

Objective:Previous research suggests that individuals with isolated Agenesis of the Corpus Callosum (AgCC) have cognitive and psychosocial deficiencies that include impaired recognition of the emotions of others (Symington et al., 2010) and a diminished ability to infer and describe the emotions of others (Paul et al., 2021; Turk et al., 2010). In addition, galvanic skin responses effectively discriminated between emotional images despite atypical emotion ratings (Paul et al, 2006), supporting a dissociation between cognitive and affective empathy in AgCC. Likewise, atypical patterns of visual attention to faces corresponded with impaired emotion recognition in AgCC (Bridgman et al, 2014), suggesting that atypical visual attention in AgCC negatively impacts the ability to identify others’ emotions. This study used the Multifaceted Empathy Test [MET] (Foell et al., 2018) to examine the impact of visual aesthetics (photo composition) on empathetic feelings (affective empathy) and situational emotion recognition (cognitive empathy) in persons with AgCC. Both cognitive and affective empathy scores are typically higher on MET stimuli composed according to the “Golden Spiral” (Callaway, 2022).Participants and Methods:Results from 50 control participants recruited from Cloud Research were compared to responses from 19 participants with AgCC and normal-range FSIQ (>80). Data was gathered through an online version of the MET, which uses a series of photographs of individuals displaying an emotion, half of which adhere to the compositional technique known as “The Golden Spiral.” To measure cognitive empathy, the participants are asked to pick the correct emotion being displayed with three distractors for each item. To measure affective empathy, they are then asked on a sliding scale, “how much do you empathize with the person shown” (1 = Not at all, 7 = Very much).Results:Repeated measures mixed ANOVAs revealed no difference between AgCC and control groups on affective empathy, and as expected on the MET, both groups had significantly higher ratings for photos composed according to the Golden Spiral (AgCC, np2 = .071; control, np2 = .136). In contrast, the AgCC group scored significantly lower than controls overall on cognitive empathy, np2 =.065. Exploratory post-hoc found a significant group difference in cognitive empathy only on photos composed according to the Golden Spiral, np2 = .090, with the scores in the AgCC group unimpacted by composition type while the control group exhibiting significantly higher scores Golden Spiral images, np2 = .254.Conclusions:Empathic deficits in AgCC were restricted to the cognitive component, while affective empathy was not impaired. Visual aesthetics of photo composition influenced affective empathy ratings in both AgCC and control groups. However, adults with AgCC had diminished ability to give cognitive labels to the emotional states of others, which was not enhanced by the formal aesthetics of stimuli. Thus the corpus callosum seems to facilitate the ability to cognitively label emotions by facilitating visual attention. It also suggests that the corpus callosum does not facilitate affective empathy, in part because it does not appear to determine whether formal aesthetics influences the processing of visual stimuli in AgCC or neurotypical controls.

Objective: This study aims to examine the relationship between the levels of social anxiety and social avoidance as an indicator of social functioning with positive and negative schizotypal symptoms in a nonclinical sample. In addition, the mediating effects of cognitive and affective empathy between these variables will also be examined. Methods: A sample of 133 men and 214 women participated in the study. Schizotypal symptoms were assessed with Schizotypal Personality Scale, social anxiety and social avoidance levels were assessed with Liebowitz Social Anxiety Scale, cognitive empathy was assessed with Reading Mind in The Eyes Test, and affective empathy was assessed with the Pictorial Empathy Test. Pearson correlation analysis was used for testing the significant correlations between the variables and the mediator effects were examined with PROCESS developed by Hayes. Results: Correlation analysis revealed that all variables were significantly correlated. While cognitive empathy has partial mediator effect between negative schizotypal symptoms and social anxiety and avoidance levels (95% CI = [0.01, 0.11]), affective empathy has full mediator effect on this relationship (95% CI = [0.18, 0.41]). Despite the presence of a predictive effect of positive schizotypal symptoms on social anxiety and avoidance levels, affective and cognitive empathy have no mediator effects between these variables. Conclusion: The findings suggest that the relationship between negative schizotypy and social anxiety and avoidance as indicators of social functioning is attributable to deficits in social cognitive functions. However, the lack of these mediator effects for positive schizotypy clearly demonstrates that individuals with different schizotypy traits show different profiles of social cognitive abilities and point out the importance of differentiating subtypes of schizotypy both in clinical and experimental settings. Cite this article as: Şandor S. Mediator effects of cognitive and affective empathy on the relationship between schizotypal symptoms and social anxiety/avoidance levels. Neuropsychiatr Invest. 2022;60(3):52-63.

Early adolescence is a period of development of emotional competence, but also of increasing vulnerability for the onset of depressive symptoms. While literature underscored that empathy promotes social relationships and psychological well-being over the life course, the possible role of high empathy levels as a risk factor for depression has been under investigated, especially among early adolescents. Moreover, although parenting practices are known to influence both empathy and depression in adolescence, few studies investigated if parenting moderates the relationship between empathy and depression. Therefore, the aims of the study were: (1) to investigate the relationships between affective and cognitive empathy and depression; (2) to investigate the moderating role of perceived paternal and maternal support on the associations between affective and cognitive empathy and depression; (3) to examine if the relationships among affective and cognitive empathy, maternal and paternal support and depression vary as a function of early adolescents’ gender. The study involved 386 Italian students aged between 12 and 14 (M age = 13, SD = 0.3, 47.9% girls) who completed an anonymous self-report questionnaire, including measures of cognitive and affective empathy, paternal and maternal support and depression. Results showed that with a mean level of affective and cognitive empathy, higher maternal support was related to lower depression for girls, whereas higher paternal support was related to lower depression for both boys and girls. Both maternal and paternal support moderated the relation between empathy and depression. In particular, maternal support moderated the non-linear relation between affective empathy and depression and the relation was further moderated by early adolescents’ gender: boys with low affective empathy reported lower depression in a context of high maternal support. Paternal support moderated the linear relation between cognitive empathy and depression, independently of early adolescents’ gender: boys and girls with high cognitive empathy reported higher depression in a context of low paternal support. The results of the study suggested that high empathy might be a risk factor for depression during early adolescence and mothers and fathers have a differential moderating role in relation to the affective and cognitive dimensions of empathy, also in relation to early adolescents’ gender.

Individual differences in local gray matter density are associated with differences in affective and cognitive empathy

Although there is evidence that testosterone has deteriorating effects on cognitive and affective empathy, whether testosterone administration influences both routes to understanding others has not yet been simultaneously investigated.We conducted a functional magnetic resonance imaging (fMRI) pharmacological study using a within-subjects, randomized, placebo-controlled, double-blind crossover design to examine the effects of 100 mg transdermal testosterone administration on brain activation during a task that examines affective and cognitive empathy simultaneously in a sample of 23 healthy right-handed adult men.Relative to placebo, testosterone did not alter affective or cognitive empathy functional brain networks. Instead, the task yielded activation in the canonical networks associated with both types of empathy. Affective empathy yielded activation in the inferior and middle frontal gyri, inferior temporal gyri, and the cingulate cortex. Cognitive empathy was associated with activation of the temporoparietal junction, medial prefrontal cortex, middle and inferior temporal gyri, and temporal pole. Behaviourally, testosterone administration decreased error rates and increased participants’ confidence in their responses regardless of response accuracy. Independent of testosterone administration, participants reported higher affective responses during emotionally negative scenarios.Even though our results provide further evidence that testosterone administration in healthy men does not alter brain activity underlying cognitive and affective empathy, testosterone administration does influence the empathic concern and hence socio-cognitive processes. The reproducibility and variability of the current and previous findings should nevertheless be addressed in upcoming studies.

The purpose of this study was to examine the differences in preschoolers’ cognitive and affective empathy based on socio-demographic variables and to explore the relationships among parents’ empathy, preschoolers’ empathy, caring behaviors, and happiness. Subjects for this study were 301 preschoolers and their parents. Parents’ e mpathy was assessed by the Korean Version of Questionnaire of Cognitive and Affective Empathy(K-QCAE). Preschoolers’ empathy was assessed by the Questionnaire of Cognitive and Affective Empathy(QCAE). Preschoolers’ caring behaviors were assessed by the caring behaviors scale(Kim, 2015), and happiness was assessed by the happiness scale(Lee, 2010). Data were analyzed using descriptive statistics, confirmatory factor analysis(CFA), and structural equation model(SEM) with the SPSS 25.0 and AMOS 23.0 program. <BR> The major results of this study were as follows. First, fathers’ empathy showed direct effects on preschoolers’ cognitive and affective empathy and happiness. And mothers’ empathy showed direct effects on preschoolers’ cognitive and affective empathy. Second, preschoolers’ cognitive empathy showed direct effects on preschoolers’ caring behaviors. And preschoolers’ caring behaviors showed direct effects on preschoolers’ happiness. Third, preschoolers’ cognitive empathy mediated the effects of parents’ empathy on preschoolers’ caring behaviors. And preschoolers’ caring behaviors mediated the effects of preschoolers’ cognitive empathy on preschoolers’ happiness. The findings of this study will contribute to designing intervention programs to improve preschoolers’ cognitive and affective empathy.

Affective and cognitive empathy and social quality of life in schizophrenia: A comparison between a parallel process model and an integrative meditation model

Impairments of interpersonal functioning are central to borderline personality disorder (BPD). Patients with BPD suffer from severe psychosocial dysfunction in general and - among others - disturbed romantic relationships. Compounding the problem, the diagnosis of BPD interferes with therapeutic relationships and results in pejorative and discriminatory clinical practices. Previously, interpersonal dysfunction has been related to emotional dysregulation, behavioral dyscontrol, and impaired social cognition. However, these features may be intertwined yet separate. In this review, we will focus on disturbed empathy and intimacy as they are referred to as two discrete impairments of interpersonal functioning in the new DSM-5 Section III. The aim of this review is to contribute to a comprehensive, integral understanding of interpersonal dysfunction in BPD based on the behavioral and neurobiological studies available up to now. Despite some inconsistencies, behavioral studies in BPD patients indicate impaired cognitive and affective empathy particularly in complex and ecologically valid measurements. These findings are reflected even more consistently in functional magnet resonance imaging studies. Low quality of intimate relationships in BPD may at least partially result from lower mentalizing abilities and cognitive empathy, higher personal distress and affective empathy in the social context. Finally, the evaluation of the severity and quality of impairment of interpersonal functioning may enable clinicians and researchers to describe and to understand the mechanisms of interpersonal dysfunction better, and to improve the effectiveness of the treatment of patients with BPD.

The effects of oxytocin on social cognition in borderline personality disorder

Experimental investigation of cognitive and affective empathy in borderline personality disorder: Effects of ambiguity in multimodal social information processing

Existing evidence about the way anxiety impacts empathy is mixed, highlighting the complexity of empathy as a construct. The impact of state anxiety on affective and cognitive empathy in women was tested. Seventy-five women underwent an anxiety or relaxation induction, prior to completing measures of affective and cognitive empathy, and trait anxiety. Robust positive correlations were found between trait cognitive and trait affective empathy, and trait and performance affective empathy. Induced anxiety impaired affective empathy performance when controlling for trait empathy, however, was not observed to impact cognitive empathy performance. Trait anxiety and empathy did not moderate the influence of induced anxiety on affective empathy performance. Irrespective of trait levels of anxiety and empathy, women are less affectively empathic when anxious, but do not vary in their cognitive empathy.