Empathy Questionnaire Research Articles

An Immersive Virtual Reality Simulation Scenario to Improve Empathy in Nursing Students.

Empathy is essential in nursing practice and can be taught throughout nursing curriculum using a variety of methods including clinical experiences, in-person simulation, virtual reality, and didactic lecture. Empathy can also change over time, often decreasing the longer nurses practice. A cohort of upper-level nursing students viewed a short immersive virtual reality simulation as part of routine curriculum and completed the Toronto Empathy Questionnaire before viewing (time 1), 2 weeks later (time 2), and, for a small cohort, several months later (time 3). The sample included 110 undergraduate nursing students. There were no improvements in Toronto Empathy Questionnaire scores from time 1 to time 2. There was no improvement from time 1 to time 3 for the cohort who completed the Toronto Empathy Questionnaire three times. There were no significant differences in Toronto Empathy Questionnaire scores between cohorts for any measurement times. Total mean empathy scores were comparatively high in this study and did not decline over time. Although this virtual reality simulation scenario appears to have protected against decline in empathy, it may have been insufficient to foster an increase in empathy scores. Empathic training needs to be immersed throughout their nursing education in both didactic and clinical settings.

Understanding empathy and theory of mind in Romanian dental students for improved educational strategies

Empathy and theory of mind (ToM) are critical components of social cognition that significantly impact patient care. This study evaluates the levels of empathy and ToM among dental students in Romania, examining demographic influences and predictors of high empathy. Utilizing the Toronto Empathy Questionnaire, the Reading the Mind in the Eyes Test and sociodemographic questions, the study involved 300 dental students, 78.3% females, with a median age of 22. Statistical analyses included the chi-square, Mann–Whitney and correlation tests. Logistic regression was used for the prediction of the highest tertile of empathy. The findings revealed that 73.3% of students had higher-than-average levels of empathy. High empathy is associated in a multivariate model with female gender (OR 2.032, 95% CI 1.041–3.963), excellent or very good perceived health status (OR 1.903, 95% CI 1.143–3.167), and theory of mind (OR 1.078, 95% CI 1.011–1.149). However, the year of study and perceived stress levels did not significantly influence empathy scores. A subset of students (25.6%) showing below-average ToM scores raises concerns, emphasizing the need for further investigation and screening of possible related conditions to enable early detection and intervention. These findings underscore the importance of incorporating empathy training and cognitive skill development into dental education to foster patient-centered care and address the emotional and cognitive needs of future practitioners.

The Comparison of the Effectiveness of Child-Centered Mindfulness Therapy and the Role of Acceptance and Commitment Therapy on Emotional-Cognitive Empathy of Students with Attention Deficit Hyperactivity Disorder Experiencing Bullying in Isfahan

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is considered a serious problem in educational environments and has significant negative impacts on the psychological well-being of students. The present study aimed to compare the effectiveness of child-centered mindfulness therapy and acceptance and commitment therapy on emotional-cognitive empathy of primary school students with ADHD experiencing bullying. Methods: This semi-experimental study was conducted in 2023 using a pre-test and post-test design with a control group and a two-month follow-up over a six-month period in Isfahan city. A purposive sampling method was employed, and 54 boy students aged 9-11 years meeting the inclusion criteria were randomly assigned to three groups of 18 participants including child-centered mindfulness therapy (N=18), acceptance and commitment therapy (N=18), and a control group (N=18). Data were collected using the child and adolescent empathy questionnaire. Participants in the first group received child-centered mindfulness therapy in 10 60-minute sessions, conducted twice a week, while participants in the second experimental group received acceptance and commitment therapy in 9 60-minute sessions, conducted twice a week. By the end of the study, 15 participants remained in each group. Data analysis was performed using repeated measures ANOVA and Bonferroni post-hoc tests, utilizing SPSS software version 26. Results: The results indicated that both child-centered mindfulness therapy and acceptance and commitment therapy were effective in enhancing emotional empathy (p<0/05) and cognitive empathy (p<0/05).This effectiveness was also maintained at the follow-up stage (p< 0/05). However, no significant differences were observed between the effectiveness of the interventions (p>0/05). Conclusion: The results of this study indicated that both child-centered mindfulness therapy and acceptance and commitment therapy significantly affected emotional and cognitive empathy in students with ADHD and can be utilized by therapists.

Psychometric Properties of the Polish Social Empathy Questionnaire: Reliability, Validity, and Gender and Age Equivalence

Introduction: Empathy is a dynamic developmental process, requiring flexible behaviour of the empathiser in the social context. Therefore, it is crucial to know and understand the social function of empathy and its dynamic nature in interpersonal relationships. Research Aim: The aim of the study was to evaluate the psychometric properties of the Polish version of the Social Empathy Questionnaire. Method: This instrument measures empathy levels in interpersonal relationships among adults. It is based on four dimensions of empathy, i.e. taking the perspective of others, emotional sensitivity and concern for others, interpersonal flexibility and openness to compromise, and altruism – deferring decisions for the benefit of others. It assesses levels of empathy in a social context, especially in situations of conflict. Two studies were conducted with 1,149 adults aged 18 to 74 years. Results: Study 1 confirmed the four-factor structure of the tool and assessed the reliability of the empathy dimensions. It also evaluated the measurement equivalence of the models for female and male gender and for age. Study 2 aimed to assess the convergent and discriminant validity. Conclusion: The results confirmed that the 33-item Polish version of the Social Empathy Questionnaire has good psychometric properties. It can be used in research and as a diagnostic tool to help diagnose people with difficulties in establishing social relationships or at risk of social maladjustment. It may also be useful in business, especially in the recruitment of employees for positions that require effective interpersonal communication that impacts work efficiency.

Does language experience and bilingualism shape empathy and emotional intelligence?

Aims and objectives: Previous research has reported that varied language experiences and language use can play a role in the development of empathy and emotional intelligence (EI). The present study aimed to investigate the association between language experience, bilingualism and personality. Methodology: One hundred and forty-two participants completed a language background questionnaire along with a series of measures to assess empathy and both trait and ability EI. Data and analysis: Measures included the Trait Emotional Intelligence Questionnaire short form (TEIQue), the Toronto Empathy Questionnaire (TEQ), and the Situational Test of Emotional Understanding Brief (STEU-B). Hierarchical regression models, analyses of variance (ANOVAs), and Structural Equation Modelling were used to examine the relationships between language experience, bilingualism, and measures of empathy and EI. Findings: Findings reveal that bilingualism and language experiences did not contribute to empathy and EI. These results question the role that linguistic experience has in shaping empathy and EI. However, a significant difference in empathy and EI scores emerged when comparing participants who processed information in their first (or native) language to those who did not, suggesting that empathy and EI are stronger when processed in the first language. Originality: This study provides a new understanding of the influence of language background on empathy and EI as well as the impact of processing information in a first language. Significance: This study highlights the importance of considering the role that language has in future cross-cultural and cross-linguistic studies. Implications for the use of culturally appropriate measures and future research are discussed.

In search of determinants of pro-social potential in a group of honorary blood donors – the importance of personality and health resources for interpersonal generosity

Worldwide reports attest to the burgeoning popularity of research in the group of honorary blood donors. It involves a wide range of variables related to both fear and anxiety associated with the blood donation process, as well as the search for traits and resources motivating people to donate blood and donating on a regular basis, and factors related to prosocial potential in this group. Accordingly, it was decided to explore the relationship between health behaviour, framed in terms of an individual’s health resources, empathy, self-construal, community and agency – understood as personal resources – and interpersonal generosity – understood as a determinant of the individual’s prosocial potential. The study sample included 580 individuals, 445 of whom (76.7%) were Honorary Blood Donors and 135 (23.3%) were non-donors. The following tools were used: the Health Behaviour Inventory (IZZ), the Self-Construal Scale (SKJ), the Cognitive and Affective Empathy Questionnaire (QCAE), Scales for Measuring Agency and Communion (30-item self-description questionnaire) and the Interpersonal Generosity Scale (IGS). The results of the correlation analyses showed associations between certain health behaviours, cognitive and affective empathy, self-construal, communion and agency and interpersonal generosity. The linear regression analysis found that preventive behaviours, positive psychological attitudes, cognitive and affective empathy, interdependent self and communality (in the total sample) were significant for interpersonal generosity. Comparison of results of the correlation and regression analyses showed differences in the strengths of the associations between the Blood Donor group and the control group, while analysis using the Mann-Whitney U test, despite showing statistically significant differences between the groups, did not show them to be large enough.

Relationship Between Empathy and Prosocial Behavior

This study focused on the relationship between empathy and prosocial behavior among individuals aged between 18 to 30 years old . The sample consisted of 90 individuals, including both students and working professionals. The study used the Toronto Empathy Questionnaire (TEQ) to assess empathy and the Prosocialness Scale for Adults (PSA) was used to measure behavior with the aim of establishing if there exists a notable correlation, between these distinct factors. The study found a significant positive correlation (r = 0.847, p<.001) between empathy and prosocial behavior, suggesting that individuals with higher empathy are more likely to engage in prosocial acts. These results offer supporting evidence for establishing theories like the Empathy-Altruism Hypothesis and the Emotional Contagion Theory, which propose that empathy plays a crucial role in motivating altruistic behavior. According to the study, developing empathy in young people may improve prosocial behavior, resulting in more compassionate and socially responsible communities.

Bridging the Gap: Virtual Reality as a Tool for De-Escalation Training in Disability Support Settings

Managing complex behaviors in disability support settings requires competent de-escalation skills. However, the current training methods often lack sufficient opportunities for realistic practice. This study details a three-stage development and evaluation of a virtual reality (VR) application for disability support staff to safely build de-escalation skills through simulated interactions. The first phase involved creating VR prototype scenarios depicting escalations with adolescent clients. Next, 12 disability support experts conducted content validation by refining the scenarios to confirm appropriateness and realism. Finally, a pilot study tested the tool’s usability and examined the initial construct validity in 20 participants. The prototype achieved high usability ratings (average 81.0 (SD 10.7) on the System Usability Scale). Additionally, a positive correlation between VR performance and empathy levels, as measured using the Toronto Empathy Questionnaire, was found (Pearson’s r = 0.487, p = 0.035). The promising results highlight the VR application’s potential as a transformative training tool. Future research should expand scenario diversity and compare VR with traditional methods to establish its efficacy in diverse settings and offer a path to enhance staff and student capabilities in challenging environments.

The Mediating Role of Social Interactions and Early Psychopathological Symptoms in the Relationship Between Empathy and Prosociality in Young Children with ASD and Neurotypical Peers.

This study examined the relationship between empathy, prosocial behaviour, social interactions and early psychopathological symptoms (internalising and externalising behaviours) in children with autism spectrum disorder (ASD) and typically developing (TD) children. A total of 506 parents of children aged 18-48 months participated in this study. The parents of 92 children with ASD and 414 neurotypical children completed the Empathy Questionnaire, the Child Prosocial Behaviour Questionnaire, and the Emotional and Social Development Questionnaire. The results confirmed the direct relationship between empathy and prosocial behaviour in both groups. However, the findings showed a different pattern of the indirect relationship between empathy and prosociality through the social dimensions in the children with ASD compared to their typically developing peers. In the children with ASD, there was only one significant indirect path from empathy to prosocial behaviour - through internalising behaviours (anxiety). Anxiety also played a moderating role in this relationship. The higher the anxiety, the stronger the relationship between empathy and prosociality. In the neurotypical group, social interactions were a significant mediator, strengthening the relationship between empathy and prosocial behaviour. Externalising behaviours weakened this relationship. Intergroup and gender differences were also examined. These findings may have practical implications for social skills training programmes based on behavioural interventions by highlighting the importance of prosocial behaviour for social interaction and protection against psychopathological problems in children with autism and typically developing children.

Children with facial differences experience deficits in emotion skills.

Children with facial differences, such as repaired cleft lip and palate (CLP), may present with reduced capacity for sensorimotor simulation, particularly in the form of facial mimicry. This study examined whether facial mimicry, emotion recognition, and empathy skills are reduced in children with CLP when compared with sex/age-matched controls. A case-control design was utilized. Forty-five children between the ages of 8 and 12 with CLP, and 45 age/sex-matched controls were recruited. Participants completed a facial mimicry task, and facial movements were tracked and quantified using OpenFace. Participants also completed picture and context-based emotion recognition tasks. Picture-based assessment involved identifying emotions from the Dynamic FACES database. Context-based assessment consisted of identifying how a child might feel in various situations. Finally, participants and their parents completed the Empathy Questionnaire for Children and Adolescents (EmQue-CA). Children with CLP presented with significantly reduced facial mimicry (p = .017), picture-based (p < .001), and context-based emotion recognition scores (p < .001) when compared with controls. Better facial mimicry was associated with better picture-based emotion recognition scores in the control group only (r = .22, p < .01). Children with CLP also had significantly lower child and parent-proxy EmQue-CA scores (p < .001). Greater facial mimicry significantly predicted better parent-proxy EmQue-CA scores (p = .016) but did not predict child scores. Children with CLP presented with reduced facial mimicry, poorer emotion recognition, and empathy skills. These findings have a broader relevance as they suggest children with facial differences may present with reduced facial mimicry and/or deficits in emotion recognition. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Evolutionary Role of the Female Orgasm: Insights into Mate Choice and Beyond.

The female orgasm remains a subject of extensive debate within evolutionary sciences, primarily due to the absence of a consensus regarding its adaptive function. Some hypotheses propose that it could function as a mechanism for mate selection, possibly linked to reproductive strategies. Studies have observed that lesbian women tend to experience orgasms more frequently than straight women, suggesting a potential link to advantageous partner characteristics. We explored the connection between the female orgasm and mate selection, aiming to ascertain its role as an adaptive tool for mate choice. A total of 939 sexually active Brazilian women (Mage = 28.3years) engaged in committed relationships participated by completing the Marital Empathy Questionnaire, the Female Sexual Function Index, and evaluations of their partners' attributes. Analysis using structural equation models revealed that higher orgasm scores were positively associated with perceptions of partner kindness, intelligence, good health, physical attractiveness, and empathy. However, the small effect sizes of these associations warrant caution in their interpretation, and no significant association was found for relationship duration, financial prospects, dominance, and masculinity/femininity. Additionally, no differences were found between women in same-sex and other-sex relationships regarding orgasm frequency and its association with partner traits. The findings partially support the mate-choice theory, encompassing both sire-choice and pair-bond hypotheses, suggesting that female orgasm is positively associated with some partner attributes related to genetic quality and the capability for emotional connection and resource investment. Therefore, female orgasm may offer information about the partner that might not be primarily accessed and contribute to relationship maintenance.

The interconnection between social media addiction, alexithymia and empathy in medical students.

This study explores whether high alexithymia values correlate with low levels of empathy, while also trying to identify potential connections with social media addiction. We hypothesized that alexithymia mediates the relationship between social media addiction and empathy levels in a sample of undergraduate students. The study population consisted of 649 medical students in the 4th/5th/6th University year, recruited between March and May 2021. For this assessment, we employed three psychometric instruments: the Toronto Empathy Questionnaire (TEQ), the Social Media Addiction Scale-Student Form (SMAS-SF), and the Toronto Alexithymia Scale (TAS-20). A pathway analysis investigated alexithymia as a mediator between social media addiction and the degree of empathy in medical undergraduates. Sobel's test and the Baron and Kenny approach were used for testing mediation. The TEQ total mean score was 48.76 ± 5.65, while the TAS-20 total mean score was 47.71 ± 11.49. Further analysis of the TAS-20 scale scores showed that 21.42% of students had possible alexithymia, while 14.02% had clear alexithymia. The SMAS-SF total mean score was 73.20 ± 14.59. None of the students reported levels consistent with major social media addiction. The mediated effect of the TAS-20 is about 1.3 times larger than the direct effect of the SMAS-SF on TEQ. We found a significant negative correlation between empathy and alexithymia in medical students. Alexithymia was a mediator between social media addiction and empathy. Therefore, we recommend further efforts to identify potential levels of alexithymia in medical students, in order to successfully develop tailored interventions aimed at increasing their emotional awareness.

Psychometric evaluation of the German version of the Questionnaire of Cognitive and Affective Empathy (QCAE)

Empathy as a central element of social cognition plays a decisive role in various psychosocial areas and interpersonal dynamics, especially within the context of psychotherapy. Despite the controversy surrounding a standardized definition, empathy is generally regarded as a multidimensional concept that encompasses both cognitive and affective dimensions. This differentiation between cognitive and affective facets is addressed by a widely used and internationally well-established self-report measure of empathy, the Questionnaire of Cognitive and Affective Empathy (QCAE). This study focuses on evaluating the psychometric properties of the German version of the QCAE. In a convenience sample (N=1300), the postulated confirmatory five-factor model showed an adequate fit to the underlying structure. The subscales of the QCAE exhibited satisfactory internal consistency and convergent validity with other instruments measuring empathy. Despite certain methodological limitations, our findings suggest that the German version of the QCAE is suitable as a reliable and valid instrument for measuring empathy. Further studies in population-representative samples and clinical populations are required before a clear recommendation regarding its utilization can be provided.

Empathy among autistic and non-autistic adolescents: The importance of informant effects.

Empathy is the ability to recognize the emotions of others (cognitive empathy) and to share in those emotions while maintaining a self-other distinction (emotional empathy). Previous research often, but not always, showed that autistic adults and children have lower levels of overall and cognitive empathy than non-autistic individuals. Yet how empathy manifests during adolescence, a developmental period marked by physiological, social, and cognitive change, is largely unclear. As well, we aimed to compare self versus parents' perceptions regarding adolescents' empathy. To do so, parents (N = 157) of 10-16-year-olds (N = 59 autistic) and their children (N = 133) completed empathy questionnaires. Adolescents also completed a measure of mental state recognition (Reading the Mind in the Eyes Test; RMET) and parents reported on their child's autistic traits. The tasks were completed twice ~six months apart. We found that autistic adolescents reported having lower empathic concern and higher personal distress than their non-autistic peers, whereas parents of autistic adolescents perceived them as having overall lower levels of empathy. Performance on the mental state recognition task of autistic and non-autistic adolescents' was comparable. The gap between self and parent reports regarding adolescents' empathy was explainable by parent-reported autistic traits, mainly communication difficulties. Empathy remains stable across the study's two time points. Thus, the findings do not support previous views of autistic people as having less empathy and these are possibly explainable by informant effects.

Effectiveness of forgiveness education with adolescents in Iran: Increasing the positive psychology of empathy, altruism, and willingness to forgive

ABSTRACT The aim of the current study was to investigate the effect of forgiveness education on positive psychology variables (empathy, altruism and willingness to forgive) in Iranian adolescents. Two hundred twenty-four (Persian, Azeri, and Kurdish) male and female students in eighth grade participated. Schools were randomly assigned to experimental (N=123) and control (N=101) groups. Measures include the Toronto Empathy Questionnaire, Altruistic Personality Scale, and Willingness to Forgive Scale, administered at pre-test, post-test, and follow-up. The experimental group was presented with 15 weekly sessions of teaching forgiveness programs by classroom teachers. The results showed that the experimental group improved more in degrees of empathy, altruism, and willingness to forgive compared to the control group, and also at follow-up. It seems that forgiveness education programs can contribute to human flourishing with the increase of positive psychology in students, particularly in empathy, altruism, and willingness to forgive.

Validation of the Chinese Empathy Questionnaire for Pre-School Children

ABSTRACT Research Findings: Empathy plays an important role in children’s early social-emotional development. However, there are not many instruments available for measuring the different aspects/levels of empathy in preschool children. Moreover, few studies examined the validity of the existing measures for empathy in Chinese children. The present study tested the Chinese version of the Empathy Questionnaire (EmQue) upon a group of Chinese preschool children (N = 182) aged from 2 to 6 years. The Chinese EmQue is a parent-report translated from Dutch that assesses the behavioral manifestations of three distinct levels of empathy: emotion contagion, attention to others’ feelings, and prosocial behaviors among preschool children. Confirmatory factor analysis showed satisfactory goodness-of-fit indexes for a three-level structure with 19 loading items. The results of concurrent validity showed that the three levels of empathy were functioning differently in the early social-emotional development. Practice or Policy: We could conclude that the 19-item Chinese EmQue is a valid, reliable instrument for measuring empathy in 2- to 6-year-old children in the Chinese context.

A cross-sectional analysis between physical activity levels, weight status and empathy-related behaviors in a sample of Tuscany primary school children.

The present study aimed to investigate the relationship between physical activity (PA) and the development of relational empathy skills in children, taking into account weight status. Parents/guardians of primary school children were involved in filling out a questionnaire: the Empathy Questionnaire (EmQue-I13) and children were asked to complete the Physical Activity Questionnaire for Children (PAQ-C) to investigate the self-reported PA levels. The weight status was assessed using a self-reported Body Mass Index (BMI). Three hundred seventy parents or guardians of students who attended primary school (8.53±1.61 yrs) were recruited. The total score was 2.41±0.89 for PAQ-C and 41.17±6.32 for EmQue-I13. The three domains of EmQue-I13 were: contagion (8.16±2.67), attention to others' feelings (19.40±2.99) and prosocial actions (13.62±3.01). Linear regression models showed that a higher PAQ-C score was positively associated with empathy-related total score P<0.000. Weight status, age and gender were not associated with EmQue-I13. Our results underline the positive association between physical activity and the development of relational empathic skills.

Effectiveness of immersive virtual reality in teaching empathy to medical students: a mixed methods study

Empathy in healthcare has been associated with positive outcomes such as increased patient satisfaction and reduced medical errors. However, research has indicated a decline in empathy among medical professionals. This study examined the effectiveness of Immersive Virtual Reality (IVR) for empathy training in medical education. A convergent mixed methods pretest posttest design was utilized. Participants were 1st-year medical students who engaged in an empathy training IVR educational intervention around a scenario depicting older adults struggling with social isolation. Jefferson Scale of Empathy (JSE) questionnaire was administered before and after the intervention to measure the change in empathy levels. Data were analyzed using a paired sample t-test on the pre-/post-test JSE empathy scores to assess the change in empathy scores. Nineteen qualitative semi structured interviews were conducted immediately after the IVR experience and follow-up interviews were conducted six months later. Qualitative data collected from the interviews’ transcripts were analyzed using a thematic and content analysis approach to capture individual experiences. Students (n = 19) scored 5.94 points higher on the posttest JSE questionnaire compared to pretest (p < 0.01) indicating an improvement in empathy levels. Qualitative analysis showed that the IVR training was well received by the students as a valuable empathy-teaching tool. Immersion, presence, and embodiment were identified as the main features of IVR technology that enhanced empathy and understanding of patients’ experiences. The debriefing sessions were identified as a key element of the training. IVR-based training could be an effective teaching tool for empathy training in medical education and one that is well received by learners. Results from the study offer preliminary evidence that using IVR to evoke empathy is achievable.

Особенности межличностного взаимодействия подростков, склонных к проявлению агрессии

&lt;p style="text-align: justify;"&gt;The article provides an analysis of the results of a study of the unique aspects of interpersonal interaction among adolescents prone to aggression. The theoretical basis for the purpose of the work was provided by modern research, showing the versatility of the process of interpersonal interaction between adolescents and manifestations of aggression. The respondents of the study were teenagers from educational schools in Moscow, numbering 68 people aged 15-16 years. The empirical study used the aggressiveness test by L.G. Pochebut, &amp;ldquo;Aggressive behavior&amp;rdquo; methodology by E.P. Ilyin and P.A. Kovalev, interpersonal relations questionnaire by A.A. Rukavishnikov, emotional empathy questionnaire by A. Mehrabian, N. Epstein. The results of the empirical study established significant differences in the interpersonal interaction of adolescents prone to aggression. They are characterized by a desire to dominate, a lack of willingness to control their behavior, low selectivity and criticality in choosing communication partners, as well as a low level of empathy development. The obtained results can be used in work with adolescents aimed at creating favorable interactions among adolescents and reducing aggression.&lt;/p&gt;

Sensitivity to moral and conventional rules in temporal lobe epilepsy

ObjectivesSensitivity to moral and conventional rules (SMCR) is supported by bilateral brain networks and psychosocial input both of which may be altered in temporal lobe epilepsy (TLE). This study evaluated the components of SMCR in patients with TLE, aiming to clarify their preservation and link to psychopathological and cognitive aspects. MethodsAdult patients with unilateral TLE and healthy controls were evaluated using neuropsychological tests for SMCR, memory, language, and executive functions, the Empathy Questionnaire (EQ), and the Symptom Checklist-90-R (SCL-90-R). ResultsThe SMCR test items showed good reliability and validity, yielding the Severity and Rules factors distinct from the Executive, Lexical and Memory factors. Patients with right TLE scored worse in moral rules recognition than controls, but this difference was nullified by a significant influence for age and sex. The Severity and Rules factors related to semantic fluency and age and, respectively, TLE side and psychoticism. However, these factors did predict TLE membership. ConclusionsIn adult patients with TLE, the SMCR test reflects a distinct cognitive domain. Conventional rules are well-retained, while moral reasoning may be only affected in right TLE if unfavorable demographics coexist. Although age, TLE side, semantic abilities, and psychoticism cooperate to determine SMCR, impairment of such domain is not a distinctive feature of TLE.