Empathy For Pain Research Articles

The effect of emotional information from eyes on empathy for pain: A subliminal ERP study.

Facial expressions are deeply tied to empathy, which plays an important role during social communication. The eye region is effective at conveying facial expressions, especially fear and sadness emotions. Further, it was proved that subliminal stimuli could impact human behavior. This research aimed to explore the effect of subliminal sad, fearful and neutral emotions conveyed by the eye region on a viewer's empathy for pain using event-related potentials (ERP). The experiment used an emotional priming paradigm of 3 (prime: subliminal neutral, sad, fear eye region information) × 2 (target: painful, nonpainful pictures) within-subject design. Participants were told to judge whether the targets were in pain or not. Results showed that the subliminal sad eye stimulus elicited a larger P2 amplitude than the subliminal fearful eye stimulus when assessing pain. For P3 and late positive component (LPC), the amplitude elicited by the painful pictures was larger than the amplitude elicited by the nonpainful pictures. The behavioral results demonstrated that people reacted to targets depicting pain more slowly after the sad emotion priming. Moreover, the subjective ratings of Personal Distress (PD) (one of the dimensions in Chinese version of Interpersonal Reactivity Index scale) predicted the pain effect in empathic neural responses in the N1 and N2 time window. The current study showed that subliminal eye emotion affected the viewer's empathy for pain. Compared with the subliminal fearful eye stimulus, the subliminal sad eye stimulus had a greater impact on empathy for pain. The perceptual level of pain was deeper in the late controlled processing stage.

Executive functions moderated the influence of physical cues on children’s empathy for pain: an eye tracking study

ABSTRACT Empathy for pain in daily life is more complex than in lab settings and involved higher cognitive abilities. In order to investigate the role of executive function in preschoolers’ empathy for pain, we investigated the role of three subcomponents of executive function (inhibitory control, working memory and cognitive flexibility) in children’s empathy for pain, and recorded the attentional process with eye tracking (N = 46). Results showed that inhibitory control (IC) and working memory (WM) were associated with preschool children’s empathy for pain and moderated the effect of physical cue on empathy for pain. With higher IC and WM, there was a higher difference in empathy caused by cue type. Eye-tracking results showed that attention partially mediated the roles of inhibitory control and working memory. These results suggested that both executive function and attention were important for children to make accurate empathic responses for pain.

Differences between empathy for face and body pain: Cognitive and neural responses

Empathy for pain is a hotspot in the field of empathy research because of its specific cognitive and neural mechanism. Currently, studies of empathy for pain can be classified into two categories based on the body regions receiving the painful stimulus, i.e., empathy for face pain and empathy for body pain, which conveys painful information based on individuals’ faces or body parts, respectively. Although the existing evidence revealed differences between these two kinds of pain empathy regarding the underlying cognitive and neural mechanisms, the current studies tend to confuse these findings. Therefore, we summarized the differences between empathy for face and body pain, mainly regarding the behavioral reactivity tendency, brain activations, and electrophysiological (EEG) signals. These differences probably stem from the fact that the human face contains more emotional information, while other body parts contain more perceptual information. Thus, future studies should identify the distinctions between empathy for face and body pain, to explore further how empathy for face pain is affected by the facial information of others and focus on empathy for face pain in individuals with psychopathological disorders. Furthermore, the specific reasons for these distinctions and their underlying neuromechanisms deserve to be further reviewed.

Linking brain structure and activation in anterior insula cortex to explain the trait empathy for pain.

The ability to perceive, understand, and react to the feelings of others' pain is referred to as empathy for pain which is composed of two components, affective‐perceptual empathy and cognitive‐evaluative empathy. Recent reviews on the neural mechanisms of empathetic pain showed the anterior insula (AI) cortex as a core circuit for empathy. However, little is known about the modulation of brain anatomy and empathic responses by trait measures of empathy (trait empathy). Thus, we investigated whether individual variation in the personality trait of empathy is associated with individual variation in the structure of specific brain regions using voxel‐based morphometry (VBM). We further investigated the relationship between the trait empathy and the activity of the same regions using state measures of empathy for pain in a trial‐by‐trial fashion in the given situation. VBM analysis indicated a small but significant negative relationship between trait empathy and gray matter volume in the bilateral AI. Functional MRI study further demonstrated that experimentally induced activity of the bilateral AI during state empathy for pain was also correlated with trait empathy. An asymmetry exists between the right and left AI between the affective and cognitive empathy. The right AI was found to be involved in the affective‐perceptual form of empathy and the left AI was active in cognitive‐evaluative forms of empathy. The interindividual differences in trait empathy may be reflected both in the state empathy and more stable brain structure difference.

Exploring the effects of visual perspective on the ERP components of empathy for pain

ABSTRACTPrevious neurophysiological research suggests that there are event-related potential (ERP) components associated with empathy for pain: an early affective component (N2) and two late cognitive components (P3/LPP). The current study investigated whether and how the visual perspective from which a painful event is observed affects these ERP components. Participants viewed images of hands in pain vs. not in pain from a first-person or third-person perspective. We found that visual perspective influences both the early and late components. In the early component (N2), there was a larger mean amplitude during observation of pain vs no-pain exclusively when images were shown from a first-person perspective. We suggest that this effect may be driven by misattributing the on-screen hand to oneself. For the late component (P3), we found a larger effect of pain on mean amplitudes in response to third-person relative to first-person images. We speculate that the P3 may reflect a later process that enables effective recognition of others’ pain in the absence of misattribution. We discuss our results in relation to self- vs other-related processing by questioning whether these ERP components are truly indexing empathy (an other-directed process) or a simple misattribution of another’s pain as one’s own (a self-directed process).

Role of Opioid System in Empathy-like Behaviours in Rats.

BackgroundEmpathy is defined as the ability to simulate the mental states of others. Recent studies have demonstrated empathy-like behaviors in other animals including rats and mice. The objective of the current study was to evaluate the effect of acute administration of morphine and naloxone on cognition and nociception changes following observing conspecifics undergoing nociceptive stimulus.MethodsAdult male Wistar rats were used (n = 8 for each group). One cagemate received formalin injection into the hindpaw five times within a nine-day period and the other cagemate observed the pain while being pretreated with saline, morphine, or naloxone [10 mg/kg, intraperitoneal (i.p.)]. Pain behaviors, anxiety-like behaviour, locomotion, balance and muscle strength were evaluated in the observer animals.FindingsObserving a cagemate in pain increased anxiety-like behavior and reduced thermal pain threshold in the observer animals. Administration of morphine reversed these effects and naloxone did not affect the responses.ConclusionResults of the current study reveal an important role for opioid receptors (ORs) in empathy for pain, so that activation of this system dampens the empathy-like responses.

The Role of Theory of Mind, Emotion Knowledge and Empathy in Preschoolers’ Disruptive Behavior

Research examining disruptive behaviors in clinical groups of preschool and school-aged children has consistently revealed significant difficulties in their emotion knowledge and empathy but intact performance in their theory-of-mind (ToM). However, it is largely not known if these difficulties in emotion knowledge and empathy as opposed to ToM are specific to extreme forms of disruption in clinical groups or rather represent broad deficiencies related to disruptive behaviors in general, including the milder levels exhibited by typically developing children. Milder disruptive behaviors (e.g., whining, arguing, rule-breaking and fighting) in peer contexts might relate to normative variations in socio-cognitive and emotional skills like ToM, emotion knowledge and empathy. To illuminate whether the same pattern of relations observed in clinical samples would arise in typical development, this study aims to examine the role of ToM, emotion knowledge and empathy in typically developing preschoolers’ disruptive behaviors. We used individual tasks to measure 116 typically developing Turkish preschoolers’ ToM, emotion knowledge (understanding anger and sadness) and empathy for pain, and received mothers’ reports about children’s levels of disruptive behavior in peer contexts. Path analysis showed that among these skills, it was only empathy which predicted disruptive behaviors significantly (β = −0.25, p 0.05, 90% CI = −0.106, 0.001). Overall, our results indicate that empathizing with others’ emotions is more important than understanding their mental states and emotions for lower disruptive behaviors.

A meta-analysis of neuroimaging studies on pain empathy: investigating the role of visual information and observers' perspective.

Empathy relies on brain systems that support the interaction between an observer’s mental state and cues about the others’ experience. Beyond the core brain areas typically activated in pain empathy studies (insular and anterior cingulate cortices), the diversity of paradigms used may reveal secondary networks that subserve other more specific processes. A coordinate-based meta-analysis of fMRI experiments on pain empathy was conducted to obtain activation likelihood estimates along three factors and seven conditions: visual cues (body parts, facial expressions), visuospatial (first-person, thirdperson), and cognitive (self-, stimuli-, other-oriented tasks) perspectives. The core network was found across cues and perspectives, and common activation was observed in higher-order visual areas. Body-parts distinctly activated areas related with sensorimotor processing (superior and inferior parietal lobules, anterior insula) while facial expression distinctly involved the inferior frontal gyrus. Self- compared to other-perspective produced distinct activations in the left insula while stimulus- versus other-perspective produced distinctive responses in the inferior frontal and parietal lobules, precentral gyrus, and cerebellum. Pain empathy relies on a core network which is modulated by several secondary networks. The involvement of the latter seems to depend on the visual cues available and the observer's mental state that can be influenced by specific instructions.

Sensory and Affective Dimensions of Pain and Anxiety Like Behaviors Are Altered in an Animal Model of Pain Empathy

Objective: Pain is a unique and subjective experience that has a prominent function in animals' survival. Observation of pain in others leads to alterations in pain sensation and affection, termed "Empathy for pain". The present study aimed to evaluate the effect of empathy on sensory and affective dimensions of pain and its effect on anxiety-like behaviors. Method : In this study, male Wistar rats were used. Two cage mates were selected, one of which underwent administration of a noxious stimuli for 10 days and the other observed the conspecific in pain. Hot plate, tail flick, and conditioned place aversion were used to evaluate sensory and affective dimensions of pain, respectively. Anxiety-like behavior was assayed using elevated plus maze paradigm and time spent in open and close arms and number of entrance into each arm was recorded as the anxiety indicator within a 5-minute framework. Results: Rats observing the cage mate in pain had a lower threshold to noxious stimuli in comparison to controls. They also had an increased aversion from painful stimuli, demonstrating heightened affective response to pain. Anxiety-like behavior was also enhanced in the observers. Conclusion: Results of this study demonstrate that both sensory and affective dimensions of pain are altered following observation of pain in a conspecific. Further studies evaluating the underlying mechanisms are encouraged to elucidate the role of different neurotransmitters in this phenomenon.

Alcohol, empathy, and morality: acute effects of alcohol consumption on affective empathy and moral decision-making

RationaleHypothetical moral dilemmas, pitting characteristically utilitarian and non-utilitarian outcomes against each other, have played a central role in investigations of moral decision-making. Preferences for utilitarian over non-utilitarian responses have been explained by two contrasting hypotheses; one implicating increased deliberative reasoning, and the other implicating diminished harm aversion. In recent field experiments, these hypotheses have been investigated using alcohol intoxication to impair both social and cognitive functioning. These studies have found increased utilitarian responding, arguably as a result of alcohol impairing affective empathy.ObjectivesThe present research expands existing investigations by examining the acute effects of alcohol on affective empathy and subsequent moral judgments in traditional vignettes and moral actions in virtual reality, as well as physiological responses in moral dilemmas.MethodsParticipants (N = 48) were administered either a placebo or alcohol in one of two dosages; low or moderate. Both pre- and post intervention, participants completed a moral action and moral judgment task alongside behavioural measures of affective empathy.ResultsHigher dosages of alcohol consumption resulted in inappropriate empathic responses to facial displays of emotion, mirroring responses of individuals high in trait psychopathy, but empathy for pain was unaffected. Whilst affective empathy was influenced by alcohol consumption in a facial responding task, both moral judgments and moral actions were unaffected.ConclusionsThese results suggest that facets, beyond or in addition to deficits in affective empathy, might influence the relationship between alcohol consumption and utilitarian endorsements.

Empathy in Females With Autism Spectrum Disorder.

Objective: Despite the fact that autism spectrum disorder (ASD) is a common psychiatric diagnosis, knowledge about the special behavioral and neurobiological female phenotype is still scarce. The present study aimed to investigate neural correlates of empathy for physical and social pain and to assess the impact of egocentric perspective taking on social pain empathy in complex social situations in women and girls with ASD. Methods: Nine female individuals with high functioning ASD were compared to nine matched peers without ASD during two functional magnetic resonance imaging (fMRI) experiments, examining empathy for physical and social pain using well-established paradigms. Participants viewed multiple pictorial stimuli depicting a social target in either physically painful or socially unpleasant situations. In the social situations, the participant either shared the social target’s knowledge about the inappropriateness of the situation (observed social target is aware about the embarrassment of the situation; e.g., tripping in public) or not (observed social target is unaware about the embarrassment of the situation; e.g., open zipper). Results: Females with ASD did not rate the physical pain stimuli differently from non-clinical controls. Social pain situations, however, posed a greater challenge to females with ASD: For non-shared knowledge situations, females with ASD rated the social target’s embarrassment as more intense. Thus, compared to non-clinical controls, females with ASD had a stronger egocentric perspective of the situation rather than sharing the social target’s perspective. On the neural systems level, both groups showed activation of areas of the so-called empathy network that was attenuated in females with ASD during empathy for physical and social pain with a particular reduction in insula activation. Conclusion: Females with high functioning ASD are able to share another person’s physical or social pain on the neural systems level. However, hypoactivation of the anterior insula in contrast to individuals without ASD suggests that they are less able to rely on their shared representations of emotions along with difficulties to take over a person’s perspective and to make a clear distinction between their own and someone else’s experience of embarrassment.

Increasing self-other bodily overlap increases sensorimotor resonance to others\u2019 pain

Empathy for another person’s pain and feeling pain oneself seem to be accompanied by similar or shared neural responses. Such shared responses could be achieved by mapping the bodily states of others onto our own bodily representations. We investigated whether sensorimotor neural responses to the pain of others are increased when experimentally reducing perceived bodily distinction between the self and the other. Healthy adult participants watched video clips of the hands of ethnic ingroup or outgroup members being painfully penetrated by a needle syringe or touched by a cotton swab. Manipulating the video presentation to create a visuospatial overlap between the observer’s and the target’s hand increased the perceived bodily self-attribution of the target’s hand. For both ingroup and outgroup targets, this resulted in increased neural responses to the painful injections (compared with nonpainful contacts), as indexed by desynchronizations of central mu and beta scalp rhythms recorded using electroencephalography. Furthermore, these empathy-related neural activations were stronger in participants who reported stronger bodily self-attribution of the other person’s hand. Our findings provide further evidence that empathy for pain engages sensorimotor resonance mechanisms. They also indicate that reducing bodily self-other distinction may increase such resonance for ingroup as well as outgroup targets.

How Do the Brains of Children, Teenagers, and Adults Respond to Others’ Pain?

Seeing someone in pain triggers a specific brain response, which is called “pain empathy.” In the present article, we examined this brain response in children, teenagers, and adults. We found that children’s brain response was of a certain type (called alpha power increase), whereas adults’ brain response was of a different type (called alpha power decrease). What we found particularly interesting was that teenagers’ brain responses included both types: alpha power increase and alpha power decrease. This suggests that the brain’s response to others’ pain changes in the course of human development. This study brings up two fascinating questions for future studies: (1) Why do the brains of children, teenagers, and adults respond in very different activation patterns to the pain of others? (2) What is the developmental purpose of the change we see as people get older?

Antidepressant treatment, not depression, leads to reductions in behavioral and neural responses to pain empathy

Major depressive disorder (MDD) has been hypothesized to lead to impairments in empathy. Previous cross-sectional studies did not disentangle effects of MDD itself and antidepressant treatment. In this first longitudinal neuroimaging study on empathy in depression, 29 patients with MDD participated in two functional magnetic resonance imaging (fMRI) sessions before and after 3 months of antidepressant therapy. We compared their responses to an empathy for pain task to a group of healthy controls (N = 35). All participants provided self-report ratings targeting cognitive (perspective taking) and affective (unpleasant affect) aspects of empathy. To control for general effects on processing of negative affective states, participants additionally underwent an electrical pain task. Before treatment, we found no differences in empathic responses between controls and patients with MDD. After treatment, patients showed significant decreases in both affective empathy and activity of three a priori selected brain regions associated with empathy for pain. Decreases in affective empathy were moreover correlated with symptom improvement. Moreover, functional connectivity during the empathy task between areas associated with affective (anterior insula) and cognitive (precuneus) empathy decreased between sessions in the MDD group. Neither cognitive empathy nor responses to painful electrical shocks were changed after treatment. These findings contradict previous cross-sectional reports of empathy deficits in acute MDD. Rather, they suggest that antidepressant treatment reduces the aversive responses triggered by exposure to the suffering of others. Importantly, this cannot be explained by a general blunting of negative affect, as treatment did not change self-experienced pain.

Affective and Cognitive Empathy in Pre-teachers With Strong or Weak Professional Identity: An ERP Study.

Pain empathy is influenced by a number of factors. However, few studies have examined the effects of strength of professional identity on pain empathy in pre-service teachers. This study used the event-related potential (ERP) technique, which offers a high temporal resolution, to investigate the neurocognitive mechanisms of pain empathy in pre-teachers with strong or weak professional identity. The N110 and P300 components have been shown to reflect an individual’s emotional sharing and cognitive evaluation in pain empathy, respectively. The results of the current study show that pre-teachers with strong professional identity showed a significant difference in N110 amplitudes evoked towards painful and non-painful stimuli; whereas pre-teachers with weak professional identity did not show a significant difference in the amplitudes evoked by the two stimulus types. For the P300 component, pre-teachers with weak professional identity showed a significant difference in the amplitudes evoked towards painful and non-painful stimuli; whereas pre-teachers with strong professional identity did not show a significant difference in the amplitudes evoked by the two stimulus types. Our results indicate that pre-teachers with strong professional identity show a higher level of pain empathy than those with weak professional identity.

Top-down Effects on Empathy for Pain in Adults with Autistic Traits

While empathic responses of individuals with autism-spectrum disorder have been reported to be modulated by top-down attention, it remains unclear whether empathy for pain in typically developing individuals with autistic traits also involves such top-down modulation mechanisms. This study employed the autism-spectrum quotient (AQ) to quantify autistic traits in a group of 1,231 healthy adults. Two subset groups (High-AQ and Low-AQ groups) were randomly selected from the highest and lowest 10% AQ scores respectively. We explored whether participants in both groups would differ in their response to others’ pain when their attention was directed toward (A-P tasks) or away (A-N tasks) from pain cues in auditory and visual experimental modalities. Compared to Low-AQ individuals, High-AQ individuals exhibited more suppressed N1 and P2 amplitudes in response to painful vocal cues in auditory A-N tasks. This suggests suppressed attentional and emotional processes of empathy for pain when High-AQ individuals have their attention directed away from others’ pain cues. No significant difference was found between both groups in the auditory A-P task, nor in the visual A-P and A-N tasks. These results suggest that top-down attention modulation of cortical empathic responses to others’ vocal pain is influenced by autistic traits.

Enhanced Processing of Painful Emotions in Patients With Borderline Personality Disorder: A Functional Magnetic Resonance Imaging Study.

Previous research has demonstrated that patients with borderline personality disorder (BPD) are more sensitive to negative emotions and often show poor cognitive empathy, yet preserved or even superior emotional empathy. However, little is known about the neural correlates of empathy. Here, we examined empathy for pain in 20 patients with BPD and 19 healthy controls (HC) in a functional magnetic resonance imaging (fMRI) study, which comprised an empathy for pain paradigm showing facial emotions prior to hands exposed to painful stimuli. We found a selectively enhanced activation of the right supramarginal gyrus for painful hand pictures following painful facial expressions in BPD patients, and lower activation to nonpainful pictures following angry expressions. Patients with BPD showed less activation in the left supramarginal gyrus when viewing angry facial expressions compared to HC, independent of the pain condition. Moreover, we found differential activation of the left anterior insula, depending on the preceding facial expression exclusively in patients. The findings suggest that empathy for pain becomes selectively enhanced, depending on the emotional context information in patients with BPD. Another preliminary finding was an attenuated response to emotions in patients receiving psychotropic medication compared to unmedicated patients. These effects need to be replicated in larger samples. Together, increased activation during the observation of painful facial expressions seems to reflect emotional hypersensitivity in BPD.

Empathy for others' pain is disrupted at the neurophysiological level in schizophrenia.

Previous research has shown that empathy for pain is disrupted at the neural level in people with schizophrenia. However, many of these studies have failed to assess key background contextual variables that have previously been linked to neurophysiological responding. Moreover, no study to date has examined the potential influence of schizotypal characteristics on neurophysiological responding in non-clinical individuals. People with schizophrenia (N=17) were compared to demographically matched controls (N=19) on an event-related potential (ERP) empathy for painparadigm. The control group also completed a measure of schizotypal personality traits. People with schizophrenia exhibited atypical neural responding at early, emotion-sharing (frontal N110), and late, cognitive (central late positive potential [LPP]) processing stages of pain empathy, relative to controls. In the control group, positive schizotypy traits were significantly negatively related to reduced ERP amplitude in the late, cognitive (central LPP) processing stage of empathy. These data cross-validate previous studies that have shown that schizophrenia is associated with atypicalities in bottom-up automatic resonance processes that likely contribute to empathic and socio-emotional processing deficits, and indicate that these findings cannot be easily attributed to background contextual differences between the two groups. The results also point to a potential relationship between positive schizotypal characteristics and neurophysiological responding. Implications for simulation theories of empathy and social functioning in schizophrenia are discussed. Empathic processing has been consistently linked to well-being and mental health in many groups, including people with schizophrenia. Previous research has shown that, relative to controls, people with schizophrenia exhibit abnormalities in their neurophysiological empathic response, but in these prior studies, the two groups also differed in a number of potentially important background contextual variables. The current study shows that, when closely matched on background contextual variables, abnormal neural responding is still evident. These data suggest that empathy for pain is disrupted at the neurophysiological level in schizophrenia.

The role of observer's fear of pain and health anxiety in empathy for pain: an experimental study.

Empathy for pain is influenced by several factors, including observer beliefs. This study aimed to test the associations between empathy for pain, fear of pain and health anxiety. A total of 182 participants rated their levels of empathy towards 16 images (8 female and 8 male) of individuals in pain and provided measures of fear of pain, health anxiety as well as age, sex and the presence of current pain. Both fear of pain and health anxiety were positively associated with empathy for pain, but in the regression model, only fear of pain was a significant positive predictor of overall empathy for pain and its three subscales: affective distress, vicarious pain and empathic concern. The presence of pain also predicted overall empathy for pain, affective distress and vicarious pain.Observer's sex and age were not significant. The pattern of results remained the same when we repeated the analysis separately for images with males and females. The results suggest that more fearful observers, and those in current pain themselves, have higher levels of empathy for pain. Future research should examine the mechanisms underlying this relationship and how fear of pain may influence empathic behaviours towards people in pain.

Hearing other’s pain is associated with sensitivity to physical pain: An ERP study

Numerous studies have demonstrated an overlap between the processing of self-pain and others’ pain, which suggests that psychological and neural representations are shared between the perception of physical pain and empathy for pain. As hearing emotional exclamations is a common way in which we regularly perceive and empathize with others’ pain, the present study aimed to investigate the link between sensitivity to physical pain and the sounds made by others in pain. We recorded event-related potential (ERP) responses to another person’s vocalizations (neutral or painful intonation) and identified electrophysiological responses associated with the processing of painful sounds. Additionally, individual pain sensitivity was characterized by a stimulus-response function that described the relationship between objective stimulus intensity and subjective pain intensity. Results showed that compared with hearing others’ neutral sounds, hearing others’ sounds of pain elicited more positive frontal-central N1 and N2 responses as well as more positive central-parietal P3 and late positive potential responses. These electrophysiological responses to hearing others’ pain replicated electrophysiological responses to observing pictures and video clips of people in pain. Importantly, the neural responses to hearing others in pain were associated with physical pain sensitivity that was indexed by stimulus-response characteristics. The identified link between perception of one’s own physical pain and the sounds of others in pain further supports the shared common psychological computations between processing one’s own pain and empathizing with others’ pain.