Empathy Deficits Research Articles

Impaired cognitive empathy in criminal psychopathy: Evidence from a laboratory measure of empathic accuracy.

Empathy deficits feature prominently in theoretical accounts of psychopathy, yet studies that have examined various aspects of emotional processing related to empathy have produced a mixed body of findings. We created a laboratory measure of cognitive empathy based on the empathic accuracy paradigm (i.e., the ability to accurately infer others' emotions in a simulated interpersonal interaction) and used it to examine relationships between psychopathy (assessed with the Psychopathy Checklist-Revised) and cognitive empathy in a sample of incarcerated male offenders. Psychopathy was inversely associated with empathic accuracy performance, as well as with the number of responses when rating the emotional states of others. Empathic accuracy performance was most strongly associated with the behavioral/antisocial and lifestyle features of psychopathy. When the emotional content of target vignettes was examined, psychopathy was associated with poorer empathic accuracy for negatively valenced emotions only (fear and sadness), although nonsignificant moderate effect sizes were also observed for joy. Whereas the interpersonal/affective factor of psychopathy was associated with poor empathic accuracy for joy, the behavioral/antisocial factor was associated with poor overall empathic accuracy for negatively valenced emotions. At the psychopathy facet level, the interpersonal and lifestyle features of psychopathy were associated with poor empathic accuracy for positively valenced emotions, whereas the affective and antisocial features of psychopathy were inversely associated with empathic accuracy for negatively valenced emotions. In contrast to its association with poor empathic accuracy performance, psychopathy was not associated with ratings of perceived task difficulty.

A neural model of mechanisms of empathy deficits in narcissism

From a multidimensional perspective, empathy is a process that includes affective sharing and imagining and understanding the emotions of others. The primary brain structures involved in mediating the components of empathy are the anterior insula (AI), the anterior cingulate cortex (ACC), and specific regions of the medial prefrontal cortex (MPFC). The AI and ACC are the main nodes in the salience network (SN), which selects and coordinates the information flow from the intero- and exteroreceptors. AI might play a role as a crucial hub – a dynamic switch between 2 separate networks of cognitive processing: the central executive network (CEN), which is concerned with effective task execution, and the default mode network (DMN), which is involved with self-reflective processes. Given various classifications, a deficit in empathy may be considered a central dysfunctional trait in narcissism. A recent fMRI study suggests that deficit in empathy is due to a dysfunction in the right AI. Based on the acquired data, we propose a theoretical model of imbalanced SN functioning in narcissism in which the dysfunctional AI hub is responsible for constant DMN activation, which, in turn, centers one’s attention on the self. This might hinder the ability to affectively share and understand the emotions of others. This review paper on neural mechanisms of empathy deficits in narcissism aims to inspire and direct future research in this area.

サイコパシー特性と多次元的共感性

One of the features in psychopathy is a deficit of empathy. Without empathy, psychopathy can not inhibit to harm others. However, previous studies revealed that offenders had more empathic traits than non-offenders. Empathy is defined as multidimensional components (e.g.; cognitive empathy and emotional empathy), but not as a unitary. Generally, psychopathy is consisted of two subcomponents: Primary Psychopathy (PP; features of callousness and lack of empathy) and Secondary Psychopathy (SP; features of impulsiveness and uncontrollability to own behaviours). Here, we hypothesized that psychopaths, particularly who are dominant in PP, have less empathic traits both in cognitive and emotional domains, on the other hand, SP is more linked with emotional empathic trait, but less linked with cognitive one. Furthermore, we investigated not only to relate psychopathic traits and multidimensional empathy, but also to validate a Japanese version of the Primary and Secondary Psychopathy Scales (PSPS), using both Machiavellianism (MACH) scale and Buss-Perry Aggression Questionnaire (BAQ). Results indicated that correlations between PP and MACH and between PP and BAQ subscales of physical aggression and verbal aggression were higher than correlations between SP and MACH and BAQ, while correlations between SP and BAQ subscales of anger and hostility were higher than correlations between PP and the BAQ subscales. About empathy, consistent with our hypothesis, PP was linked with less empathy both in cognitive and emotional domains, whereas SP was linked with more emotional empathy, but was linked with less cognitive empathy. This reveals that PSPS dissociated PP and SP well. Although there remain some problems, PSPS is a useful scale for measurement of psychopathic traits.

An fMRI study of affective perspective taking in individuals with psychopathy: imagining another in pain does not evoke empathy

While it is well established that individuals with psychopathy have a marked deficit in affective arousal, emotional empathy, and caring for the well-being of others, the extent to which perspective taking can elicit an emotional response has not yet been studied despite its potential application in rehabilitation. In healthy individuals, affective perspective taking has proven to be an effective means to elicit empathy and concern for others. To examine neural responses in individuals who vary in psychopathy during affective perspective taking, 121 incarcerated males, classified as high (n = 37; Hare psychopathy checklist-revised, PCL-R ≥ 30), intermediate (n = 44; PCL-R between 21 and 29), and low (n = 40; PCL-R ≤ 20) psychopaths, were scanned while viewing stimuli depicting bodily injuries and adopting an imagine-self and an imagine-other perspective. During the imagine-self perspective, participants with high psychopathy showed a typical response within the network involved in empathy for pain, including the anterior insula (aINS), anterior midcingulate cortex (aMCC), supplementary motor area (SMA), inferior frontal gyrus (IFG), somatosensory cortex, and right amygdala. Conversely, during the imagine-other perspective, psychopaths exhibited an atypical pattern of brain activation and effective connectivity seeded in the anterior insula and amygdala with the orbitofrontal cortex (OFC) and ventromedial prefrontal cortex (vmPFC). The response in the amygdala and insula was inversely correlated with PCL-R Factor 1 (interpersonal/affective) during the imagine-other perspective. In high psychopaths, scores on PCL-R Factor 1 predicted the neural response in ventral striatum when imagining others in pain. These patterns of brain activation and effective connectivity associated with differential perspective-taking provide a better understanding of empathy dysfunction in psychopathy, and have the potential to inform intervention programs for this complex clinical problem.

Social cognition in borderline personality disorder.

Many typical symptoms of borderline personality disorder (BPD) occur within interpersonal contexts, suggesting that BPD is characterized by aberrant social cognition. While research consistently shows that BPD patients have biases in mental state attribution (e.g., evaluate others as malevolent), the research focusing on accuracy in inferring mental states (i.e., cognitive empathy) is less consistent. For complex and ecologically valid tasks in particular, emerging evidence suggests that individuals with BPD have impairments in the attribution of emotions, thoughts, and intentions of others (e.g., Preißler et al., 2010). A history of childhood trauma and co-morbid PTSD seem to be strong additional predictors for cognitive empathy deficits. Together with reduced emotional empathy and aberrant sending of social signals (e.g., expression of mixed and hard-to-read emotions), the deficits in mental state attribution might contribute to behavioral problems in BPD. Given the importance of social cognition on the part of both the sender and the recipient in maintaining interpersonal relationships and therapeutic alliance, these impairments deserve more attention.

Selective cognitive empathy deficit in adolescents with restrictive anorexia nervosa

BackgroundA growing, but conflicting body of literature suggests altered empathic abilities in subjects with anorexia nervosa-restricting type (AN-R). This study aims to characterize the cognitive and affective empathic profiles of adolescents with purely AN-R.MethodsAs part of a standardized clinical and research protocol, the Interpersonal Reactivity Index (IRI), a valid and reliable self-reported instrument to measure empathy, was administered to 32 female adolescents with AN-R and in 41 healthy controls (HC) comparisons, matched for age and gender. Correlational analyses were performed to evaluate the links between empathy scores and psychopathological measures.ResultsPatients scored significantly lower than HC on cognitive empathy (CE), while they did not differ from controls on affective empathy (AE). The deficit in CE was not related to either disease severity nor was it related to associated psychopathology.ConclusionThese results, albeit preliminary, suggest that a dysfunctional pattern of CE capacity may be a stable trait of AN-R that should be taken into account not only for the clinical management, but also in preventive and therapeutic intervention.

Empathy deficits and sexual offending: A model of obstacles to empathy

Theoretical models of the role of empathy in sexual offending agree on five components relevant to the experience of empathy: a respectful and compassionate orientation to others, perspective taking, affective responding, the ability to manage personal distress, and situational factors. We identify overlap between these components of the empathic process and established risk factors for sexual offending and create a model detailing potential blocks to the empathic process during sexual offending. The model has external consistency and useful implications for interventions with sex offenders. Viewed in the light of this model, we argue that current sex offender treatment programs spend a disproportionate amount of time examining empathy for past victims. We recommend, instead, that treatment aims to enhance offenders' abilities in relation to the components of the empathic process more generally, using creative and engaging techniques akin to those used to develop “victim empathy”.

The neurobiological basis of empathy deficits in Autism Spectrum Conditions

The neurobiological basis of empathy deficits in Autism Spectrum Conditions

Empathy and emotion recognition in people with autism, first-degree relatives, and controls

Empathy is the lens through which we view others’ emotion expressions, and respond to them. In this study, empathy and facial emotion recognition were investigated in adults with autism spectrum conditions (ASC; N=314), parents of a child with ASC (N=297) and IQ-matched controls (N=184). Participants completed a self-report measure of empathy (the Empathy Quotient [EQ]) and a modified version of the Karolinska Directed Emotional Faces Task (KDEF) using an online test interface. Results showed that mean scores on the EQ were significantly lower in fathers (p<0.05) but not mothers (p>0.05) of children with ASC compared to controls, whilst both males and females with ASC obtained significantly lower EQ scores (p<0.001) than controls. On the KDEF, statistical analyses revealed poorer overall performance by adults with ASC (p<0.001) compared to the control group. When the 6 distinct basic emotions were analysed separately, the ASC group showed impaired performance across five out of six expressions (happy, sad, angry, afraid and disgusted). Parents of a child with ASC were not significantly worse than controls at recognising any of the basic emotions, after controlling for age and non-verbal IQ (all p>0.05). Finally, results indicated significant differences between males and females with ASC for emotion recognition performance (p<0.05) but not for self-reported empathy (p>0.05). These findings suggest that self-reported empathy deficits in fathers of autistic probands are part of the ‘broader autism phenotype’. This study also reports new findings of sex differences amongst people with ASC in emotion recognition, as well as replicating previous work demonstrating empathy difficulties in adults with ASC. The use of empathy measures as quantitative endophenotypes for ASC is discussed.

Elaborating on the Construct Validity of the Triarchic Psychopathy Measure in a Criminal Offender Sample

Patrick, Fowles, and Krueger (2009) developed the triarchic conceptualization of psychopathy in an effort to integrate historical theories and contemporary measurement models. The model proposes 3 phenotypic domains of boldness, meanness, and disinhibition. Patrick (2010) developed the Triarchic Psychopathy Measure (TriPM), a 58-item self-report measure, to index these 3 domains. This study examined the construct validity of the TriPM in a sample of incarcerated offenders (N = 141) and found evidence of good construct validity in that the scales were related to conceptually relevant normal-range and dysfunctional personality trait criteria, as well as narcissism and deficits in empathy.

Motor, Emotional, and Cognitive Empathy in Children and Adolescents with Autism Spectrum Disorder and Conduct Disorder

It is unclear which aspects of empathy are shared and which are uniquely affected in autism spectrum disorder (ASD) and conduct disorder (CD) as are the neurobiological correlates of these empathy impairments. The aim of this systematic review is to describe the overlap and specificity of motor, emotional, and cognitive aspects of empathy in children and adolescents with ASD or CD. Motor and cognitive empathy impairments are found in both ASD and CD, yet the specificity seems to differ. In ASD facial mimicry and emotion recognition may be impaired for all basic emotions, whereas in CD this is only the case for negative emotions. Emotional empathy and the role of attention to the eyes therein need further investigation. We hypothesize that impaired motor and cognitive empathy in both disorders are a consequence of lack of attention to the eyes. However, we hypothesize major differences in emotional empathy deficits between ASD and CD, probably due to emotional autonomic and amygdala hyper-responsivity in ASD versus hypo-responsivity in CD, both resulting in lack of attention to the eyes.

Amygdala volume predicts arousal and empathy deficits after severe traumatic brain injury

A dysfunction in working memory (WM) is a core cognitive impairment in schizophrenia that involves the cortical–subcortical–cerebellar network. We propose that in addition to other often-referred markers, the signal reduction in the network during verbal working memory (VWM) is a stable and intrinsic indicator of illness. We presented a Sternberg VWM task to 46 patients with schizophrenia and 46 healthy controls matched on performance accuracy during functional magnetic resonance imaging (fMRI). Reduced activation was demonstrated in the thalamus, cerebellar vermis, pons and the triangular part of the inferior frontal gyrus (IFG) in the patient group. We also found a “failure of deactivation” in the default mode network (DMN) in patients as represented by a low versus high load VWM. In addition, a reduced left lateralization in the triangular and opercular parts of the IFG was observed in the patient group replicating previous “failure of lateralization” findings in schizophrenia. A comparison of long (10 to 19 years) and short (3 to 9 years) durations of illness (DoIs) demonstrated that the DoI was only associated with the activation changes in the middle frontal gyrus and lateral temporal cortex but not with the IFG-subcortico-cerebellar regions observed. These alterations were consistent with the cognitive dysmetria described in the cortical–subcortical–cerebellar network in schizophrenia. In conclusion, the combination of reduced activation in the cortical–subcortical–cerebellar network during VWM in particular, reduced deactivation in the DMN and reduced lateralization in the IFG is thought to be stable neuroimaging signatures of schizophrenia.

Can deficits in empathy after head injury be improved by compassionate imagery?

Severe head injury (SHI) can result in problems in empathising, which in turn is associated with social difficulties. Compassionate imagery can increase compassion in non-brain injured people and can alter how they relate to themselves and others. This preliminary study investigates whether compassionate imagery can increase empathy in those with low empathy after SHI. A between-group repeated measures design was used wth 24 participants with severe SHI and low empathy, randomly allocated to a single treatment session of compassionate imagery or a control condition of relaxation. Empathy, self-compassion and relaxation were assessed pre- and post-intervention and fear of compassion pre-intervention as a potential covariate. A group effect of compassionate imagery on empathy was not found, F(1, 21) = 0.12, p = .73. A non-specific increase in self-compassion approached significance, T = 78.00, p = 0.07, r = –.26. Fear of compassion did not correlate significantly with changes in self-compassion or empathy. Demographic and injury factors associated with SHI that may impact on treatment effectiveness are discussed. Further research that takes these factors into account is warranted.

Sexual and violent offenders’ victim role assignments: a general model of offending style

Although distinct offence action patterns have been identified for different forms of sexual and violent crime, a generic psychological framework for this differentiation has yet to be advanced. An innovative framework derived from the emerging criminal narrative approach provides a significant contribution to the differentiation of offending styles. Canter (1994) argues that offenders’ empathy deficit leads them to assign a Victim, Object or Person role to their victims within their personal narratives. The evidence for this model is examined across 33 offence actions in 66 stranger rapes, 24 offence actions in 50 stalking offences and 39 offence actions in 50 serial murder offences. Hypothesised offence actions reflecting the Roles are found in distinct regions of Smallest Space Analysis (SSA-I) configurations for all three offence types. This evidence across diverse offence forms leads to the suggestion that the Roles assigned to victims within offenders’ narratives provide a generic framework for differentiating offending styles in all interpersonal crimes. The different Victim Roles articulate qualitatively different variants of the established control and empathy deficit components in sexual and violent offending, contributing to the debate about the operation of these components and having significant treatment implications.

Poster #23 NEURAL SUBSTRATES OF EMPATHIC ACCURACY IN PEOPLE WITH SCHIZOPHRENIA

Behavioural and neuroimaging data have recently pointed out that empathy (feeling into someone else) is associated with mental imagery and transformation related to one’s and other’s visuo-spatial perspectives. Impairments of both empathic and visuo-spatial abilities have been observed in patients with schizophrenia. Especially, it has been suggested that schizophrenics are altered in spontaneously simulating another individual’s first-person experience. However, there is so far only little evidence regarding the relationship between deficits in empathy and disturbances in spontaneous heterocentered coding in schizophrenia. In the present pilot-study, we tested with schizophrenic patients our behavioural paradigm that enables to measure from the bodily postures and movements whether individuals in ecologically more valid conditions are interacting with another individual by using egocentered – as in sympathy (feeling with someone else) – or heterocentered – as in empathy – visuo-spatial mechanisms. For that, ten patients and ten controls, standing and moving, interacted with a virtual tightrope walker, displayed life-sized, standing and moving as well. We show that patients with higher negative symptoms had, in most cases, deficits in spontaneously using heterocentered visuo-spatial mechanisms and employed preferentially an egocentered referencing to interact with the avatar. In contrast, preserved spontaneous heterocentered visuo-spatial strategies were not linked to a prevailing negative or positive symptomatology. Our data suggest that the severity of the negative symptoms in schizophrenia relates with disturbances of spontaneous (“on-line”) empathic processing in association with lower scoring self-reported trait cognitive empathy.

Affect Recognition, Empathy, and Dysosmia After Traumatic Brain Injury

Neumann D, Zupan B, Babbage DR, Radnovich AJ, Tomita M, Hammond F, Willer B. Affect recognition, empathy, and dysosmia after traumatic brain injury. ObjectiveTo investigate if olfaction is associated with affect recognition and empathy deficits after traumatic brain injury (TBI). Prior research has shown that TBI often leads to loss of smell. We hypothesized a relationship with emotion perception, because the neural substrates of the olfactory system overlap with the ventral circuitry of the orbital frontal cortex, which play a critical role in affective responses, such as empathy. DesignComparative study investigating differences between participants with TBI who had impaired olfaction (dysosmia) with those with normal olfaction (normosmia). SettingPostacute rehabilitation facilities in the United States, Canada, and New Zealand. ParticipantsParticipants (N=106) in the current study were a convenience sample of adults with moderate to severe TBI who were tested for olfactory function as part of a larger, related study on affect recognition. On average, participants were 11.5 years postinjury. InterventionsNot applicable. Main Outcome MeasuresOlfaction (Brief Smell Identification Test), facial affect recognition (Diagnostic Assessment of Nonverbal Affect 2–Adult Faces [DANVA2-AF]), vocal affect recognition (Diagnostic Assessment of Nonverbal Affect 2–Adult Paralanguage [DANVA2-AP]), emotional inference (Emotional Inference from Stories Test [EIST]), and empathy (Interpersonal Reactivity Index [IRI]). ResultsFifty-six percent of participants were dysosmic and only 36% of these participants were aware of their deficit. Participants with dysosmia performed significantly poorer on the DANVA2-AF (P=.003), DANVA2-AP (P=.007), EIST (P=.016), and IRI (P=.013). Medium effect sizes were found for all measures. Dysosmia had a sensitivity value of 86.4% for detecting facial affect recognition impairments and 67.8% for vocal affect recognition impairments. ConclusionsThis study shows that olfactory deficits may be indicative of affect recognition impairments and reduced empathy. Early knowledge of affect recognition and empathy deficits would be valuable so that treatment could be implemented predischarge.

Changes in emotional empathy, affective responsivity, and behavior following severe traumatic brain injury

This study was designed to examine the relationship between deficits in empathy, emotional responsivity, and social behavior in adults with severe traumatic brain injury (TBI). A total of 21 patients with severe TBI and 25 control participants viewed six film clips containing pleasant, unpleasant, and neutral content whilst facial muscle responses, skin conductance, and valence and arousal ratings were measured. Emotional empathy (the Balanced Emotional Empathy Scale, BEES: self-report) and changes in drive and control in social situations (The Current Behaviour Scale, CBS: relative report) were also assessed. In comparison to control participants, those in the TBI group reported less ability to empathize emotionally and had reduced facial responding to both pleasant and unpleasant films. They also exhibited lowered autonomic arousal, as well as abnormal ratings of valence and arousal, particularly to unpleasant films. Relative reported loss of emotional control was significantly associated with heightened empathy, while there was a trend to suggest that impaired drive (or motivation) may be related to lower levels of emotional empathy. The results represent the first to suggest that level of emotional empathy post traumatic brain injury may be associated with behavioral manifestations of disorders of drive and control.

Empathy in sexually sadistic offenders: An experimental comparison with non-sadistic sexual offenders

Previous studies suggest that severe sexual sadism and psychopathy are phenotypically different, although both are characterized by deficits in emotional processing. We assessed empathic capacity in a sample of 12 sexual sadists in comparison with 23 non-sadistic offenders using the Multifaceted Empathy Test (MET). All participants were forensic patients under mandatory treatment orders who had committed sexual offenses. The MET is a computerized rating task that differentiates and measures cognitive and emotional components of empathy, or perspective-taking versus compassionate components. To identify the effects of possible empathy deficits caused by psychopathic traits, we controlled both samples for psychopathy as a covariate, measured by the Psychopathy Checklist—Revised (PCL-R). According to our results, sexual sadists did not differ from non-sadistic sexual offenders with regard to emotional empathy for either positive or negative stimuli. The results suggest that severe sexual sadism is a distinct, pathological sexual arousal response, not a deficit in emotional processing.

Moving in and out of synchrony: A concept for a new intervention fostering empathy through interactional movement and dance

In this theoretical article, we link literature from different disciplines such as the neurosciences and psychology, dance/movement therapy, dance studies, and philosophy, in order to show that interactional, coordinated movement forms an important base for the development of empathy and prosocial behavior. The presented body of literature suggests that specific elements of joint movement and dance, namely imitation, synchronous movement and motoric cooperation, are suitable for fostering empathic abilities, especially in people with empathy deficits.In the second part of the article, we present a newly conceptualized dance and movement intervention for people with empathy dysfunction, tailored to its first application for people with autism spectrum disorders. Through enhancing and refining kinesthetic empathy skills, we hypothesize within an integrative concept of empathy, that both emotional and cognitive empathic processes such as empathic concern and perspective taking can be fostered. With a first treatment outcome study of the presented intervention that we will conduct in the near future with people on the autistic spectrum, we aim at evaluating the program and contributing to the understanding of dance and movement approaches for people with empathy deficits.

The impact of alcohol dependence on social brain function

The impact of alcoholism (ALC) or alcohol dependence on the neural mechanisms underlying cognitive and affective empathy (i.e. the different routes to understanding other people's minds) in schizophrenic patients and non-schizophrenic subjects is still poorly understood. We therefore aimed at determining the extent to which the ability to infer other people's mental states and underlying neural mechanisms were affected by ALC. We examined 48 men, who suffered either from ALC, schizophrenia, both disorders or none of these disorders, using functional magnetic resonance imaging while performing on a mind reading task that involves both cognitive and affective aspects of empathy. Using voxel-based morphometry, we additionally examined whether between-group differences in functional activity were associated with deficits in brain structural integrity. During mental state attribution, all clinical groups as compared with healthy controls exhibited poor performance as well as reduced right-hemispheric insular function with the highest error rate and insular dysfunction seen in the schizophrenic patients without ALC. Accordingly, both behavioral performance and insular functioning revealed schizophrenia × ALC interaction effects. In addition, schizophrenic patients relative to non-schizophrenic subjects (regardless of ALC) exhibited deficits in structural integrity and task-related recruitment of the left ventrolateral prefrontal cortex (vlPFC). Our data suggest that ALC-related impairment in the ability to infer other people's mental states is limited to insular dysfunction and thus deficits in affective empathy. By contrast, mentalizing in schizophrenia (regardless of ALC) may be associated with insular dysfunction as well as a combination of structural and functional deficits in the left vlPFC.