Empathy, Emotion Recognition, and Paranoia in the General Population.

Kendall Beals,Julia M Sheffield,Sarah H Sperry

doi:10.3389/fpsyg.2022.804178

Kendall Beals, Julia M Sheffield + Show 1 more

Open Access

https://doi.org/10.3389/fpsyg.2022.804178

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Abstract

BackgroundParanoia is associated with a multitude of social cognitive deficits, observed in both clinical and subclinical populations. Empathy is significantly and broadly impaired in schizophrenia, yet its relationship with subclinical paranoia is poorly understood. Furthermore, deficits in emotion recognition – a very early component of empathic processing – are present in both clinical and subclinical paranoia. Deficits in emotion recognition may therefore underlie relationships between paranoia and empathic processing. The current investigation aims to add to the literature on social cognition and paranoia by: (1) characterizing the relationship between paranoia and empathy, and (2) testing whether there is an indirect effect of emotion recognition on the relationship between empathy and paranoia.MethodsParanoia, empathy, and emotion recognition were assessed in a non-clinical sample of adults (n = 226) from the Nathan Kline Institute-Rockland (NKI-Rockland) dataset. Paranoia was measured using the Peters Delusions Inventory-21 (PDI-21). Empathy was measured using the Interpersonal Reactivity Index (IRI), a self-report instrument designed to assess empathy using four subscales: Personal Distress, Empathic Concern, Perspective Taking, and Fantasy. Emotion recognition was assessed using the Penn Emotion Recognition Test (ER-40). Structural equation modeling (SEM) was used to estimate relationships between paranoia, the four measures of empathy and emotion recognition.ResultsParanoia was associated with the Fantasy subscale of the IRI, such that higher Fantasy was associated with more severe paranoia (p < 0.001). No other empathy subscales were associated with paranoia. Fantasy was also associated with the emotion recognition of fear, such that higher Fantasy was correlated with better recognition of fear (p = 0.008). Paranoia and emotion recognition were not significantly associated. The Empathic Concern subscale was negatively associated with emotion recognition, with higher empathic concern related to worse overall emotion recognition (p = 0.002). All indirect paths through emotion recognition were non-significant.DiscussionThese results suggest that imaginative perspective-taking contributes to paranoia in the general population. These data do not, however, point to robust global relationships between empathy and paranoia or to emotion recognition as an underlying mechanism. Deficits in empathy and emotion recognition observed in schizophrenia may be associated with the broader pathology of schizophrenia, and therefore not detectable with subclinical populations.

Highlights

Paranoia is one of the most common psychotic experiences, occurring in over 70% of individuals presenting with their first episode of psychosis (Coid et al, 2013) and 10–15% of the general population (Freeman and Freeman, 2008)
This study investigated the relationship between empathy, emotion recognition, and paranoia in subclinical populations, TABLE 2 | Zero-order correlations
Fantasy Empathic concern total anger fear happy no emotion sad Perspective taking Fantasy Empathic concern Personal distress Paranoia ER total ER anger ER fear ER happy ER no emotion ER sad ER, emotion recognition. **Correlation is significant at the 0.01 level. *Correlation is significant at the 0.05 level

Summary

Introduction

Paranoia is one of the most common psychotic experiences, occurring in over 70% of individuals presenting with their first episode of psychosis (Coid et al, 2013) and 10–15% of the general population (Freeman and Freeman, 2008). Evidence suggests that theory of mind, attributional bias, emotion processing and social perception are all associated with paranoid thinking (McKay et al, 2005; Combs et al, 2006), and these relationships are observed across clinical and non-clinical populations (Martin and Penn, 2001; Freeman et al, 2002; Combs et al, 2013). Given that both paranoid thinking and social cognitive deficits contribute to functional impairment (Minkowski, 1953; Shamay-Tsoory et al, 2007; Sparks et al, 2010; Pinkham et al, 2016; Bonfils et al, 2017), fully elucidating how different facets of social cognition relate to paranoia is critical for advancing models of and treatments for paranoia. The current investigation aims to add to the literature on social cognition and paranoia by: (1) characterizing the relationship between paranoia and empathy, and (2) testing whether there is an indirect effect of emotion recognition on the relationship between empathy and paranoia

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Results

Conclusion