Investigating the functional anatomy of empathy and forgiveness

Neurobiological underpinnings of shame and guilt: a pilot fMRI study

In this study, a functional magnetic resonance imaging paradigm originally employed by Takahashi et al. was adapted to look for emotion-specific differences in functional brain activity within a healthy German sample (N = 14), using shame- and guilt-related stimuli and neutral stimuli. Activations were found for both of these emotions in the temporal lobe (shame condition: anterior cingulate cortex, parahippocampal gyrus; guilt condition: fusiform gyrus, middle temporal gyrus). Specific activations were found for shame in the frontal lobe (medial and inferior frontal gyrus), and for guilt in the amygdala and insula. This is consistent with Takahashi et al.'s results obtained for a Japanese sample (using Japanese stimuli), which showed activations in the fusiform gyrus, hippocampus, middle occipital gyrus and parahippocampal gyrus. During the imagination of shame, frontal and temporal areas (e.g. middle frontal gyrus and parahippocampal gyrus) were responsive regardless of gender. In the guilt condition, women only activate temporal regions, whereas men showed additional frontal and occipital activation as well as a responsive amygdala. The results suggest that shame and guilt share some neural networks, as well as having individual areas of activation. It can be concluded that frontal, temporal and limbic areas play a prominent role in the generation of moral feelings.

"I am worried, Doctor!" Emotions in the doctor-patient relationship

OBJECTIVE

To review research on emotional communication in medical interviews regarding predictors, physiological correlates and effects of clinicians' responses to patients' cues and concerns and individual differences among patients.

METHODS

A selective review of research literature on emotional communication in medical interviews was conducted.

RESULTS

Four questions regarding emotional communication were explored: What factors predict how clinicians respond to emotional cues and concerns? What happens in the brain and the body of both patients and clinicians during emotional talk? Are there individual differences in patients' responses to emotional talk in medical interviews? Do clinicians' responses to emotion affect health outcome?

CONCLUSION

Building on evidence reviewed, research on predictors of clinician responses, physiological correlates of behavior, individual differences and effects on outcome should be further pursued.

PRACTICE IMPLICATIONS

In communication skills training programs, better understanding of the phenomena described could have implications for training clinicians to handle emotions in clinical interviews.

Theory of mind performance in children correlates with functional specialization of a brain region for thinking about thoughts

Thinking about other people's thoughts recruits a specific group of brain regions, including the temporo-parietal junctions (TPJ), precuneus (PC), and medial prefrontal cortex (MPFC). The same brain regions were recruited when children (N=20, 5-11 years) and adults (N=8) listened to descriptions of characters' mental states, compared to descriptions of physical events. Between ages 5 and 11 years, responses in the bilateral TPJ became increasingly specific to stories describing mental states as opposed to people's appearance and social relationships. Functional activity in the right TPJ was related to children's performance on a high level theory of mind task. These findings provide insights into the origin of neural mechanisms of theory of mind, and how behavioral and neural changes can be related in development.

Neural network development in late adolescents during observation of risk-taking action

Emotional maturity and social awareness are important for adolescents, particularly college students beginning to face the challenges and risks of the adult world. However, there has been relatively little research into personality maturation and psychological development during late adolescence and the neural changes underlying this development. We investigated the correlation between psychological properties (neuroticism, extraversion, anxiety, and depression) and age among late adolescents (n = 25, from 18 years and 1 month to 22 years and 8 months). The results revealed that late adolescents became less neurotic, less anxious, less depressive and more extraverted as they aged. Participants then observed video clips depicting hand movements with and without a risk of harm (risk-taking or safe actions) during functional magnetic resonance imaging (fMRI). The results revealed that risk-taking actions elicited significantly stronger activation in the bilateral inferior parietal lobule, temporal visual regions (superior/middle temporal areas), and parieto-occipital visual areas (cuneus, middle occipital gyri, precuneus). We found positive correlations of age and extraversion with neural activation in the insula, middle temporal gyrus, lingual gyrus, and precuneus. We also found a negative correlation of age and anxiety with activation in the angular gyrus, precentral gyrus, and red nucleus/substantia nigra. Moreover, we found that insula activation mediated the relationship between age and extraversion. Overall, our results indicate that late adolescents become less anxious and more extraverted with age, a process involving functional neural changes in brain networks related to social cognition and emotional processing. The possible neural mechanisms of psychological and social maturation during late adolescence are discussed.

Regional brain responses in nulliparous women to emotional infant stimuli

Infant cries and facial expressions influence social interactions and elicit caretaking behaviors from adults. Recent neuroimaging studies suggest that neural responses to infant stimuli involve brain regions that process rewards. However, these studies have yet to investigate individual differences in tendencies to engage or withdraw from motivationally relevant stimuli. To investigate this, we used event-related fMRI to scan 17 nulliparous women. Participants were presented with novel infant cries of two distress levels (low and high) and unknown infant faces of varying affect (happy, sad, and neutral) in a randomized, counter-balanced order. Brain activation was subsequently correlated with scores on the Behavioral Inhibition System/Behavioral Activation System scale. Infant cries activated bilateral superior and middle temporal gyri (STG and MTG) and precentral and postcentral gyri. Activation was greater in bilateral temporal cortices for low- relative to high-distress cries. Happy relative to neutral faces activated the ventral striatum, caudate, ventromedial prefrontal, and orbitofrontal cortices. Sad versus neutral faces activated the precuneus, cuneus, and posterior cingulate cortex, and behavioral activation drive correlated with occipital cortical activations in this contrast. Behavioral inhibition correlated with activation in the right STG for high- and low-distress cries relative to pink noise. Behavioral drive correlated inversely with putamen, caudate, and thalamic activations for the comparison of high-distress cries to pink noise. Reward-responsiveness correlated with activation in the left precentral gyrus during the perception of low-distress cries relative to pink noise. Our findings indicate that infant cry stimuli elicit activations in areas implicated in auditory processing and social cognition. Happy infant faces may be encoded as rewarding, whereas sad faces activate regions associated with empathic processing. Differences in motivational tendencies may modulate neural responses to infant cues.

Neural circuits in the brain that are activated when mitigating criminal sentences

In sentencing guilty defendants, jurors and judges weigh 'mitigating circumstances', which create sympathy for a defendant. Here we use functional magnetic resonance imaging to measure neural activity in ordinary citizens who are potential jurors, as they decide on mitigation of punishment for murder. We found that sympathy activated regions associated with mentalising and moral conflict (dorsomedial prefrontal cortex, precuneus and temporo-parietal junction). Sentencing also activated precuneus and anterior cingulate cortex, suggesting that mitigation is based on negative affective responses to murder, sympathy for mitigating circumstances and cognitive control to choose numerical punishments. Individual differences on the inclination to mitigate, the sentence reduction per unit of judged sympathy, correlated with activity in the right middle insula, an area known to represent interoception of visceral states. These results could help the legal system understand how potential jurors actually decide, and contribute to growing knowledge about whether emotion and cognition are integrated sensibly in difficult judgments.

Jurors can be influenced by mitigating circumstances when deciding on sentences for committed crimes. Yamada et al. show that feelings of sympathy created by mitigating circumstances activate moral conflict regions of the brain that predict individual differences in the severity of the sentence.

Moral decision-making, ToM, empathy and the default mode network

Automatic intuitions and deliberate reasoning, sourcing internal representations of our personal norms and values, contribute to our beliefs of what is right and wrong. We used fMRI to directly compare moral (M) and non-moral (NM) decision-making processes using scenarios requiring conscious deliberation, whereby the main character declared an intention to take a course of action. Furthermore, we examined the relationship between BOLD signal, associated with M>NM decision-making, and moral judgment competence, psychopathy, and empathy. We observed greater activity in various parts of Theory of Mind, empathy and default mode networks during M>NM decision-making. There was a trend for high scores on primary psychopathy to correlate with decreased M>NM BOLD activation in an area extending from dorsolateral prefrontal cortex to medial prefrontal cortex. We suggest that moral decision-making entails a greater degree of internally directed processing, such as self-referential mental processing and the representation of intentions and feelings, than non-moral decision-making.

Neural correlates of dynamically evolving interpersonal ties predict prosocial behavior

There is a growing interest for the determinants of human choice behavior in social settings. Upon initial contact, investment choices in social settings can be inherently risky, as the degree to which the other person will reciprocate is unknown. Nevertheless, people have been shown to exhibit prosocial behavior even in one-shot laboratory settings where all interaction has been taken away. A logical step has been to link such behavior to trait empathy-related neurobiological networks. However, as a social interaction unfolds, the degree of uncertainty with respect to the expected payoff of choice behavior may change as a function of the interaction. Here we attempt to capture this factor. We show that the interpersonal tie one develops with another person during interaction – rather than trait empathy – motivates investment in a public good that is shared with an anonymous interaction partner. We examined how individual differences in trait empathy and interpersonal ties modulate neural responses to imposed monetary sharing. After, but not before interaction in a public good game, sharing prompted activation of neural systems associated with reward (striatum), empathy (anterior insular cortex and anterior cingulate cortex) as well as altruism, and social significance [posterior superior temporal sulcus (pSTS)]. Although these activations could be linked to both empathy and interpersonal ties, only tie-related pSTS activation predicted prosocial behavior during subsequent interaction, suggesting a neural substrate for keeping track of social relevance.

The Neural Correlates of Empathy: Experience, Automaticity, and Prosocial Behavior

Empathy is a critical aspect of human emotion that influences the behavior of individuals as well as the functioning of society. Although empathy is fundamentally a subjective experience, no studies have yet examined the neural correlates of the self-reported experience of empathy. Furthermore, although behavioral research has linked empathy to prosocial behavior, no work has yet connected empathy-related neural activity to everyday, real-world helping behavior. Lastly, the widespread assumption that empathy is an automatic experience remains largely untested. It is also unknown whether differences in trait empathy reflect either variability in the automaticity of empathic responses or the capacity to feel empathy. In this study, 32 participants completed a diary study of helping behavior followed by an fMRI session, assessing empathic responses to sad images under three conditions: watching naturally, under cognitive load, and while empathizing. Across conditions, higher levels of self-reported experienced empathy were associated with greater activity in medial PFC (MPFC). Activity in MPFC was also correlated with daily helping behavior. Self-report of empathic experience and activity in empathy-related areas, notably MPFC, were higher in the empathize condition than in the load condition, suggesting that empathy is not a fully automatic experience. Additionally, high trait empathy participants displayed greater experienced empathy and stronger MPFC responses than low trait empathy individuals under cognitive load, suggesting that empathy is more automatic for individuals high in trait empathy. These results underline the critical role that MPFC plays in the instantiation of empathic experience and consequent behavior.

Can we share the joy of others? Empathic neural responses to distress vs joy

The neural bases of empathy have been examined mainly in the context of reacting to others' distress, while almost no attention has been paid to the mechanisms by which we share others' joy. Using functional magnetic resonance imaging, we demonstrated that the same neural network mediates judgment of the emotional state of the other in response to both negative and positive events through empathy-related structures, such as the medial prefrontal cortex (MPFC), the insula, the superior temporal sulcus (STS) and the inferior frontal gyrus (IFG). However, the responses of the MPFC, bilateral insula and the right IFG to negative experiences occurring to the other (but not to the self) were found to be much more intense than the responses to positive experiences, indicating that humans have a remarkable ability to share the distress of others, but may react less to the joy of others.

Functional connectivity mapping of the human precuneus by resting state fMRI

Precuneus responds to a wide range of cognitive processes. Here, we examined how the patterns of resting state connectivity may define functional subregions in the precuneus. Using a K-means algorithm to cluster the whole-brain "correlograms" of the precuneus in 225 adult individuals, we corroborated the dorsal-anterior, dorsal-posterior, and ventral subregions, each involved in spatially guided behaviors, mental imagery, and episodic memory as well as self-related processing, with the ventral precuneus being part of the default mode network, as described extensively in earlier work. Furthermore, we showed that the lateral/medial volumes of dorsal anterior and dorsal posterior precuneus are each connected with areas of motor execution/attention and motor/visual imagery, respectively. Compared to the ventral precuneus, the dorsal precuneus showed greater connectivity with occipital and posterior parietal cortices, but less connectivity with the medial superior frontal and orbitofrontal gyri, anterior cingulate cortex as well as the parahippocampus. Compared to dorsal-posterior and ventral precuneus, the dorsal-anterior precuneus showed greater connectivity with the somatomotor cortex, as well as the insula, supramarginal, Heschl's, and superior temporal gyri, but less connectivity with the angular gyrus. Compared to ventral and dorsal-anterior precuneus, dorsal-posterior precuneus showed greater connectivity with the middle frontal gyrus. Notably, the precuneus as a whole has negative connectivity with the amygdala and the lateral and inferior orbital frontal gyri. Finally, men and women differed in the connectivity of precuneus. Men and women each showed greater connectivity with the dorsal precuneus in the cuneus and medial thalamus, respectively. Women also showed greater connectivity with ventral precuneus in the hippocampus/parahippocampus, middle/anterior cingulate gyrus, and middle occipital gyrus, compared to men. Taken together, these new findings may provide a useful platform upon which to further investigate sex-specific functional neuroanatomy of the precuneus and to elucidate the pathology of many neurological illnesses.

Altered empathic responding in major depressive disorder: relation to symptom severity, illness burden, and psychosocial outcome

Individuals with major depressive disorder (MDD) demonstrate deficits in multiple social cognitive domains; however, systematic investigations of empathic responding have not been performed. Twenty patients with MDD completed two measures of empathy, the Interpersonal Reactivity Index (IRI: Davis, 1980, 1983) and the Toronto Empathy Questionnaire (TEQ: Spreng et al., 2009). Relative to matched controls, patients with MDD reported significantly reduced levels of empathy measured broadly on the TEQ and specifically in cognitive ('Perspective Taking') and affective ('Empathic Concern') domains captured by the IRI. A higher illness burden (i.e., greater number of past depressive episodes) was associated with greater reductions in perspective taking ability. This study provides early evidence of impaired empathic abilities in patients with MDD that may worsen with illness progression. Alternatively, reductions in perspective taking ability may contribute to a more severe course of illness in this population. Further longitudinal work is needed to characterize the relation between social cognitive performance and social functioning in this population.

Forgiveness therapy: a clinical intervention for chronic disease

Every year, chronic illnesses result in significant costs, disability and deaths. Efforts to understand the causes, treatments and management possibilities for chronic illnesses are ongoing. Some chronic conditions, including addictions, obesity, mental health circumstances, COPD and cirrhosis, have been identified as health conditions with social and interpersonal etiologies. Recent research documents that these conditions are related to adverse early life experience; treatment and prevention of these chronic conditions remains challenging. Concurrent research investigating forgiveness interventions has been reported in the counseling therapy literature, which may have enormous personal and public health impact.

Deep hope: a song without words

Hope helps alleviate suffering. In the case of terminal illness, recent experience in palliative medicine has taught physicians that hope is durable and often thrives even in the face of imminent death. In this article, I examine the perspectives of philosophers, theologians, psychologists, clinicians, neuroscientists, and poets, and provide a series of observations, connections, and gestures about hope, particularly about what I call "deep hope." I end with some proposals about how such hope can be sustained and enhanced at the end of life. Studies of terminally ill patients have revealed clusters of personal and situational factors associated with enhancement or suppression of hope at the end of life. Interpersonal connectedness, attainable goals, spiritual beliefs and practices, personal attributes of determination, courage, and serenity, lightheartedness, uplifting memories, and affirmation of personal worth enhance hope, while uncontrollable pain and discomfort, abandonment and isolation, and devaluation of personhood suppress hope. I suggest that most of these factors can be modulated by good medical care, utilizing basic interpersonal techniques that demonstrate kindness, humanity, and respect.

Ventromedial prefrontal volume predicts understanding of others and social network size

Cognitive abilities such as Theory of Mind (ToM), and more generally mentalizing competences, are central to human sociality. Neuroimaging has associated these abilities with specific brain regions including temporo-parietal junction, superior temporal sulcus, frontal pole, and ventromedial prefrontal cortex. Previous studies have shown both that mentalizing competence, indexed as the ability to correctly understand others' belief states, is associated with social network size and that social group size is correlated with frontal lobe volume across primate species (the social brain hypothesis). Given this, we predicted that both mentalizing competences and the number of social relationships a person can maintain simultaneously will be a function of gray matter volume in these regions associated with conventional Theory of Mind. We used voxel-based morphometry of Magnetic Resonance Images (MRIs) to test this hypothesis in humans. Specifically, we regressed individuals' mentalizing competences and social network sizes against gray matter volume. This revealed that gray matter volume in bilateral posterior frontal pole and left temporoparietal junction and superior temporal sucus varies parametrically with mentalizing competence. Furthermore, gray matter volume in the medial orbitofrontal cortex and the ventral portion of medial frontal gyrus, varied parametrically with both mentalizing competence and social network size, demonstrating a shared neural basis for these very different facets of sociality. These findings provide the first fine-grained anatomical support for the social brain hypothesis. As such, they have important implications for our understanding of the constraints limiting social cognition and social network size in humans, as well as for our understanding of how such abilities evolved across primates.

Neural substrates of interpreting actions and emotions from body postures

Accurately reading the body language of others may be vital for navigating the social world, and this ability may be influenced by factors, such as our gender, personality characteristics and neurocognitive processes. This fMRI study examined the brain activation of 26 healthy individuals (14 women and 12 men) while they judged the action performed or the emotion felt by stick figure characters appearing in different postures. In both tasks, participants activated areas associated with visual representation of the body, motion processing and emotion recognition. Behaviorally, participants demonstrated greater ease in judging the physical actions of the characters compared to judging their emotional states, and participants showed more activation in areas associated with emotion processing in the emotion detection task, whereas they showed more activation in visual, spatial and action-related areas in the physical action task. Gender differences emerged in brain responses, such that men showed greater activation than women in the left dorsal premotor cortex in both tasks. Finally, participants higher in self-reported empathy demonstrated greater activation in areas associated with self-referential processing and emotion interpretation. These results suggest that empathy levels and sex of the participant may affect neural responses to emotional body language.

Brain activation during compassion meditation: a case study

OBJECTIVES

B.L. is a Tibetan Buddhist with many years of compassion meditation practice. During meditation B.L. uses a technique to generate a feeling of love and compassion while reciting a mantra. The aim of the present study was to investigate the neural correlates of compassion meditation in 1 experienced meditator.

METHODS

B.L. was examined by functional magnetic resonance imaging during compassion meditation, applying a paradigm with meditation and word repetition blocks.

RESULTS

The most significant finding was the activation in the left medial prefrontal cortex extending to the anterior cingulate gyrus. Other significant loci of activation were observed in the right caudate body extending to the right insula and in the left midbrain close to the hypothalamus.

CONCLUSIONS

The results in this study are in concordance with the hypothesis that compassion meditation is accompanied by activation in brain areas involved with empathy as well as with happy and pleasant feelings (i.e., the left medial prefrontal cortex and the anterior cingulate gyrus).

The involvement of emotion recognition in affective theory of mind

This study was conducted to explore the relationship between emotion recognition and affective Theory of Mind (ToM). Forty subjects performed a facial emotion recognition and an emotional intention recognition task (affective ToM) in an event-related fMRI study. Conjunction analysis revealed overlapping activation during both tasks. Activation in some of these conjunctly activated regions was even stronger during affective ToM than during emotion recognition, namely in the inferior frontal gyrus, the superior temporal sulcus, the temporal pole, and the amygdala. In contrast to previous studies investigating ToM, we found no activation in the anterior cingulate, commonly assumed as the key region for ToM. The results point to a close relationship of emotion recognition and affective ToM and can be interpreted as evidence for the assumption that at least basal forms of ToM occur by an embodied, non-cognitive process.

Gratitude and forgiveness: Convergence and divergence on self-report and informant ratings

Gratitude and forgiveness are theoretically linked character strengths that tend to be studied in isolation from other strengths. We examined gratitude and forgiveness in the same sample using self and confidant reports to better understand how strengths converge and diverge with personality factors, emotional vulnerabilities, and positive psychological processes. Data suggest that gratitude and forgiveness uniquely relate to personality factors, emotional vulnerabilities, and positive psychological processes with forgiveness evidencing stronger relations than gratitude. Forgiveness also appears to be more robust than gratitude due to the unique effects of forgiveness diminishing correlations between gratitude and other variables. Confidant data demonstrated that strengths were observable by others and related to observer perceptions of well-being. Results are discussed with an emphasis on the benefits of studying character strength profiles.

Dissociable brain mechanisms for processing social exclusion and rule violation

Social exclusion inherently involves an element of expectancy violation, in that we expect other people to follow the unwritten rule to include us in social interactions. In this functional magnetic resonance imaging (fMRI) study, we employed a unique modification of an interactive virtual ball-tossing game called "Cyberball" (Williams et al., 2000) and a novel paradigm called "Cybershape," in which rules are broken in the absence of social exclusion, to dissociate brain regions that process social exclusion from rule violations more generally. Our Cyberball game employed an alternating block design and removed evoked responses to events when the participant was throwing the ball in inclusion to make this condition comparable to exclusion, where participants did not throw. With these modifications, we replicated prior findings of ventral anterior cingulate cortex (vACC), insula, and posterior cingulate cortex activity evoked by social exclusion relative to inclusion. We also identified exclusion-evoked activity in the hippocampi, left ventrolateral prefrontal cortex, and left middle temporal gyrus. Comparing social exclusion and rule violation revealed a functional dissociation in the active neural systems as well as differential functional connectivity with vACC. Some overlap was observed in regions differentially modulated by social exclusion and rule violation, including the vACC and lateral parietal cortex. These overlapping brain regions showed different activation during social exclusion compared to rule violation, each relative to fair play. Comparing activation patterns to social exclusion and rule violation allowed for the dissociation of brain regions involved in the experience of exclusion versus expectancy violation.

Is there a core neural network in empathy? An fMRI based quantitative meta-analysis

Whilst recent neuroimaging studies have identified a series of different brain regions as being involved in empathy, it remains unclear concerning the activation consistence of these brain regions and their specific functional roles. Using MKDA, a whole-brain based quantitative meta-analysis of recent fMRI studies of empathy was performed. This analysis identified the dACC-aMCC-SMA and bilateral anterior insula as being consistently activated in empathy. Hypothesizing that what are here termed affective-perceptual and cognitive-evaluative forms of empathy might be characterized by different activity patterns, the neural activations in these forms of empathy were compared. The dorsal aMCC was demonstrated to be recruited more frequently in the cognitive-evaluative form of empathy, whilst the right anterior insula was found to be involved in the affective-perceptual form of empathy only. The left anterior insula was active in both forms of empathy. It was concluded that the dACC-aMCC-SMA and bilateral insula can be considered as forming a core network in empathy, and that cognitive-evaluative and affective-perceptual empathy can be distinguished at the level of regional activation.

Research on integrative healthcare: context and priorities

It is important that integrative healthcare research be conducted to optimize the effectiveness, safety, costs, and social and economic impact of prospective, personalized, patient-centered, comprehensive, and holistic healthcare that focuses on well-being as well as disease management, and that the research itself be well understood. The scope of this research extends beyond evaluation of specific therapies, to include evaluations of multimodality whole system intervention, practitioner-patient relationships, patient goals and priorities, promoting self-care and resilience, personalized diagnostic and therapeutic measures, practitioner well-being, the comparative effectiveness of different educational and outreach strategies in improving health and healthcare, and the environmental/social causes and consequence of health and healthcare. In this paper, we describe the state of the science of research on integrative healthcare, research needs, and opportunities offered by cutting-edge research tools. We propose a framework for setting priorities in integrative health research, list areas for discussion, and pose a few questions on a future research agenda.

Orbitofrontal volume reductions during emotion recognition in patients with major depression

BACKGROUND

Major depressive disorder is associated with both structural and functional alterations in the emotion regulation network of the central nervous system. The relation between structural and functional changes is largely unknown. Therefore, we sought to determine the relation between structural differences and functional alterations during the recognition of emotional facial expressions.

METHODS

We examined 13 medication-free patients with major depression and 15 healthy controls by use of structural T1-weighted high-resolution magnetic resonance imaging (MRI) and functional MRI during 1 session. We set the statistical threshold for the analysis of imaging data to p < 0.001 (uncorrected).

RESULTS

As shown by voxel-based morphometry, depressed patients had reductions in orbitofrontal cortex volume and increases in cerebellar volume. Additionally, depressed patients showed increased activity during emotion recognition in the middle frontal cortex, caudate nucleus, precuneus and lingual gyrus. Within this cerebral network, the orbitofrontal volumes were negatively correlated in depressed patients but not in healthy controls with changes in blood oxygen level-dependent signal in the middle frontal gyrus, caudate nucleus, precuneus and supplementary motor area.

LIMITATIONS

Our results are limited by the relatively small sample size.

CONCLUSIONS

This combined functional and structural MRI study provides evidence that the orbitofrontal cortex is a key area in major depression and that structural changes result in functional alterations within the emotional circuit. Whether these alterations in the orbitofrontal cortex are also related to persistent emotional dysfunction in remitted mental states and, therefore, are related to the risk of depression needs further exploration.

Facial emotion processing in schizophrenia: a meta-analysis of functional neuroimaging data

BACKGROUND

People with schizophrenia have difficulty with emotion perception. Functional imaging studies indicate regional brain activation abnormalities in patients with schizophrenia when processing facial emotion. However, findings have not been entirely consistent across different studies.

METHODS

Activation likelihood estimation (ALE) meta-analyses were conducted to examine brain activation during facial emotion processing in patients with schizophrenia, controls, and patients compared with controls. Secondary meta-analyses were performed to assess the contribution of task design and illness chronicity to the results reported.

RESULTS

When processing facial expressions of emotions, both patients with schizophrenia and healthy controls activated the bilateral amygdala and right fusiform gyri. However, the extent of activation in these regions was generally much more limited in the schizophrenia samples. When directly compared with controls, the extent of activation in bilateral amygdala, parahippocampal gyrus and fusiform gyrus, right superior frontal gyrus, and lentiform nucleus was significantly less in patients. Patients with schizophrenia, but not controls, activated the left insula. A relative failure to recruit the amygdala in patients occurred regardless of whether the task design was explicit or implicit, while differences in fusiform activation were evident in explicit, not implicit, tasks. Restricting the analysis to patients with chronic illness did not substantially change the results.

CONCLUSIONS

A marked underrecruitment of the amygdala, accompanied by a substantial limitation in activation throughout a ventral temporal-basal ganglia-prefrontal cortex "social brain" system may be central to the difficulties patients experience when processing facial emotion.

Altered self-report of empathic responding in patients with bipolar disorder

Despite evidence of impairments in social cognition in patients with bipolar disorder (BD), systematic investigations of empathic responding in this population have not been conducted. The objectives of the current study were to investigate empathic responding in patients with BD in varying states of illness and to determine whether course of illness variables and symptom severity predicted responding. Twenty well-characterized patients with BD and 20 matched healthy control subjects completed the Interpersonal Reactivity Index (IRI) and the Social Adjustment Scale Self-Report (SAS-SR), self-report measures of cognitive and emotional empathy and of psychosocial functioning, respectively. Patients with BD reported significantly reduced levels of cognitive empathy ('Perspective Taking') and higher levels of personal distress in response to others' negative experiences than did controls. Altered affective empathic abilities correlated significantly with reduced psychosocial functioning in family, social and occupational domains and with increased symptom severity. This study provides preliminary evidence of alterations in empathic responding in patients with BD. Alterations in the ability to adopt the perspective of others may contribute to the difficulties in social communication inherent in this patient population. Additional studies, involving larger samples, are required to determine the contribution of social cognitive performance to impaired social functioning in BD.

Attitudes towards the outgroup are predicted by activity in the precuneus in Arabs and Israelis

The modern socio-political climate is defined by conflict between ethnic, religious and political groups: Bosnians and Serbs, Tamils and Singhalese, Irish Catholics and Protestants, Israelis and Arabs. One impediment to the resolution of these conflicts is the psychological bias that members of each group harbor towards each other. These biases, and their neural bases, are likely different from the commonly studied biases towards racial outgroups. We presented Arab, Israeli and control individuals with statements about the Middle East from the perspective of the ingroup or the outgroup. Subjects rated how 'reasonable' each statement was, during fMRI imaging. Increased activation in the precuneus (PC) while reading pro-outgroup vs. pro-ingroup statements correlated strongly with both explicit and implicit measures of negative attitudes towards the outgroup; other brain regions that were involved in reasoning about emotionally-laden information did not show this pattern.

Gray matter loss in young relatives at risk for schizophrenia: relation with prodromal psychopathology

The maturation of neocortical regions mediating social cognition during adolescence and young adulthood in relatives of schizophrenia patients may be vulnerable to heritable alterations of neurodevelopment. Prodromal psychotic symptoms, commonly emerging during this period in relatives, have been hypothesized to result from alterations in brain regions mediating social cognition. We hypothesized these regions to show longitudinal alterations and these alterations to predict prodromal symptoms in adolescent and young adult relatives of schizophrenia patients. 27 Healthy controls and 23 relatives were assessed at baseline and one-year follow-up using scale of prodromal symptoms and gray matter volumes of hypothesized regions from T1-MRI images. Regional volumes showing deficits on ANCOVA and repeated-measures ANCOVAs (controlling intra cranial volume, age and gender) were correlated with prodromal symptoms. At baseline, bilateral amygdalae, bilateral pars triangulares, left lateral orbitofrontal, right frontal pole, angular and supramarginal gyrii were smaller in relatives compared to controls. Relatives declined but controls increased or remained stable on bilateral lateral orbitofrontal, left rostral anterior cingulate, left medial prefrontal, right inferior frontal gyrus and left temporal pole volumes at follow-up relative to baseline. Smaller volumes predicted greater severity of prodromal symptoms at both cross-sectional assessments. Longitudinally, smaller baseline volumes predicted greater prodromal symptoms at follow-up; greater longitudinal decreases in volumes predicted worsening (increase) of prodromal symptoms over time. These preliminary findings suggest that abnormal longitudinal gray matter loss may occur in regions mediating social cognition and may convey risk for prodromal symptoms during adolescence and early adulthood in individuals with a familial diathesis for schizophrenia.

Neural correlates of forgiveness for moral transgressions involving deception

We used positron emission tomography (PET) to investigate the neural mechanisms underlying the willingness to forgive another person's moral transgression involving deception. During scanning, 12 subjects were asked to judge the forgivability of a perpetrator's moral transgression. These transgressions were described by four kinds of scenarios composed of a combination of two factors: the attitude of the perpetrator (dishonest or honest) and the severity of the moral transgression (serious or minor). Behavioral data showed that both the perpetrator's dishonesty and the seriousness of the scenario decreased the subjects' willingness to forgive the moral transgression. Neuroimaging data revealed that, relative to honest responses, a perpetrator's dishonest responses were associated with right ventromedial prefrontal activity, which possibly reflects the subjects' identification of the perpetrator's deception. The opposite comparison did not show significant activation. Moreover, a comparison of serious scenarios with minor scenarios did not reveal significant activation. Instead, minor scenarios, relative to serious scenarios, evoked activity in the right middle frontal gyrus and the right caudate nucleus, possibly reflecting increased demand on frontal control system function. Further analysis revealed that the left ventromedial prefrontal cortex showed a significant interaction between the two factors, indicating that this region functions as a mediator of the two factors, modulating judgments regarding the forgivability of moral transgressions. Taken together, these findings suggest that the ventromedial prefrontal cortex plays a key role in the forgiveness of moral transgressions involving deception.

Temporal pole activity during understanding other persons' mental states correlates with neuroticism trait

Comprehension of other persons' mental states is one of the representative cognitive functions involved in social situations. It has been suggested that this function sometimes recruits emotional processes. The present fMRI study examined the neural mechanisms associated with understanding others' mental states, and the conditions that determine the recruitment of the emotional processes. The false belief paradigm, a traditional behavioral paradigm to investigate comprehension of others, was applied to an event-related fMRI analysis, allowing for the extraction of brain activity time-locked to successful understanding of others' mental states. Prominent brain activity was observed in multiple cortical regions including the medial prefrontal cortex, temporo-parietal junction, precuneus, and temporal pole. Then, correlational analyses were performed between the activations and individuals' scores of neuroticism, a personality trait that reflects emotional instability in daily life. It was revealed that the neuroticism scores were positively correlated with the activity in the temporal pole region, but not in the other regions. These results suggest that the emotional processes implemented in the temporal pole are recruited during successful understanding of other persons' mental states, and that the recruitment may be modulated by an emotional personality trait of individual subjects.

Alterations in cortical activity of male methamphetamine abusers performing an empathy task: fMRI study

OBJECTIVES

We investigate possible differences in neural correlates of empathy processing between abstinent methamphetamine (MA) abusers and healthy subjects using functional magnetic resonance imaging (fMRI).

METHODS

Nineteen abstinent MA abusers (mean age of 36.06 years, range 31-52 years) and 19 healthy subjects (mean age of 37.05 years, range 33-42 years) participated in this study. A visual fMRI activation paradigm was used, comprising a series of cartoons, each depicting a short story. There were two categories of stories: empathy (Empathy) and Physical causality (Physical). fMRI images were acquired using a 3.0 T whole-body scanner. All fMRI data were analyzed using MATLAB v. 7.2 and SPM5.

RESULTS

Both MA subjects and controls exhibited activation in the dorsomedial prefrontal cortex. Despite this similarity in activation patterns, we found that the two groups differed in the activation of several cortical regions associated with the processing of empathy information. Hypoactivations of the orbitofrontal cortex, temporal poles, and hippocampus in MA abusers relative to healthy subjects suggests that the ability of empathic response could be compromised in abstinent MA abusers (p < 0.05, corrected for a small volume).

CONCLUSIONS

Functional impairments in the empathic neural network caused by MA may contribute to the misunderstanding of others and to the erosion of social interactions in MA abusers.

Semantic, factual, and social language comprehension in adolescents with autism: an FMRI study

Language in high-functioning autism is characterized by pragmatic and semantic deficits, and people with autism have a reduced tendency to integrate information. Because the left and right inferior frontal (LIF and RIF) regions are implicated with integration of speaker information, world knowledge, and semantic knowledge, we hypothesized that abnormal functioning of the LIF and RIF regions might contribute to pragmatic and semantic language deficits in autism. Brain activation of sixteen 12- to 18-year-old, high-functioning autistic participants was measured with functional magnetic resonance imaging during sentence comprehension and compared with that of twenty-six matched controls. The content of the pragmatic sentence was congruent or incongruent with respect to the speaker characteristics (male/female, child/adult, and upper class/lower class). The semantic- and world-knowledge sentences were congruent or incongruent with respect to semantic expectancies and factual expectancies about the world, respectively. In the semantic-knowledge and world-knowledge condition, activation of the LIF region did not differ between groups. In sentences that required integration of speaker information, the autism group showed abnormally reduced activation of the LIF region. The results suggest that people with autism may recruit the LIF region in a different manner in tasks that demand integration of social information.

Forgiveness in health research and medical practice

With the rising popularity of positive psychology, research on forgiveness has flourished. Forgiveness has been found to have application to the field of medicine. We review definitions and describe potential physical and mental benefits of forgiveness. We (1) address potential mechanisms by which forgiveness might affect physical health, (2) evaluate the research on forgiveness and mental health, (3) summarize research on interventions to promote forgiveness, (4) examine issues specifically related to medicine in which forgiveness might play an important role, and (5) discuss forgiveness of self and others and seeking forgiveness in light of those applications. We emphasize the importance of one's motive in forgiving, noting that altruistic motives hold greater benefits than do self-interested motives.

The skin as a social organ

In general, social neuroscience research tends to focus on visual and auditory channels as routes for social information. However, because the skin is the site of events and processes crucial to the way we think about, feel about, and interact with one another, touch can mediate social perceptions in various ways. This review situates cutaneous perception within a social neuroscience framework by discussing evidence for considering touch (and to some extent pain) as a channel for social information. Social information conveys features of individuals or their interactions that have potential bearing on future interactions, and attendant mental and emotional states. Here, we discuss evidence for an affective dimension of touch and explore its wider implications for the exchange of social information. We consider three important roles for this affective dimension of the cutaneous senses in the transmission and processing of social information: first, through affiliative behavior and communication; second, via affective processing in skin-brain pathways; and third, as a basis for intersubjective representation.

SELF-RATED EXECUTIVE FUNCTION: DEVELOPMENT OF THE EXECUTIVE FUNCTION INDEX

There are several self-rating executive function (SREF) measures in existence that were developed solely in clinical populations or which sample a limited range of executive functions. The Executive Function Index (EFI) was developed here in a normal population with five subscales derived through factor analysis: Motivational Drive, Strategic Planning, Organization, Impulse Control, and Empathy. The content of three second order factors is consistent with the functions mediated by dorsolateral, orbitofrontal, and medial prefrontal circuits. Intrascale reliability and demographic relationships are reported as well as strong correlations with other SREF measures validated in clinical and neuroimaging studies. This brief measure provides a quick and efficient means of collecting data in large samples in order to test hypotheses regarding the role of prefrontal systems in various aspects of behavior and to corroborate findings of other methods, such as objective tests and functional neuroimaging.

Social cognition and the brain: a meta-analysis

This meta-analysis explores the location and function of brain areas involved in social cognition, or the capacity to understand people's behavioral intentions, social beliefs, and personality traits. On the basis of over 200 fMRI studies, it tests alternative theoretical proposals that attempt to explain how several brain areas process information relevant for social cognition. The results suggest that inferring temporary states such as goals, intentions, and desires of other people-even when they are false and unjust from our own perspective--strongly engages the temporo-parietal junction (TPJ). Inferring more enduring dispositions of others and the self, or interpersonal norms and scripts, engages the medial prefrontal cortex (mPFC), although temporal states can also activate the mPFC. Other candidate tasks reflecting general-purpose brain processes that may potentially subserve social cognition are briefly reviewed, such as sequence learning, causality detection, emotion processing, and executive functioning (action monitoring, attention, dual task monitoring, episodic memory retrieval), but none of them overlaps uniquely with the regions activated during social cognition. Hence, it appears that social cognition particularly engages the TPJ and mPFC regions. The available evidence is consistent with the role of a TPJ-related mirror system for inferring temporary goals and intentions at a relatively perceptual level of representation, and the mPFC as a module that integrates social information across time and allows reflection and representation of traits and norms, and presumably also of intentionality, at a more abstract cognitive level.

Neurobiology of wisdom: a literature overview

CONTEXT

Wisdom is a unique psychological trait noted since antiquity, long discussed in humanities disciplines, recently operationalized by psychology and sociology researchers, but largely unexamined in psychiatry or biology.

OBJECTIVE

To discuss recent neurobiological studies related to subcomponents of wisdom identified from several published definitions/descriptions of wisdom by clinical investigators in the field, ie, prosocial attitudes/behaviors, social decision making/pragmatic knowledge of life, emotional homeostasis, reflection/self-understanding, value relativism/tolerance, and acknowledgment of and dealing effectively with uncertainty.

DATA SOURCES

Literature focusing primarily on neuroimaging/brain localization and secondarily on neurotransmitters, including their genetic determinants.

STUDY SELECTION

Studies involving functional neuroimaging or neurotransmitter functioning, examining human (rather than animal) subjects, and identified via a PubMed search using keywords from any of the 6 proposed subcomponents of wisdom were included.

DATA EXTRACTION

Studies were reviewed by both of us, and data considered to be potentially relevant to the neurobiology of wisdom were extracted.

DATA SYNTHESIS

Functional neuroimaging permits exploration of neural correlates of complex psychological attributes such as those proposed to comprise wisdom. The prefrontal cortex figures prominently in several wisdom subcomponents (eg, emotional regulation, decision making, value relativism), primarily via top-down regulation of limbic and striatal regions. The lateral prefrontal cortex facilitates calculated, reason-based decision making, whereas the medial prefrontal cortex is implicated in emotional valence and prosocial attitudes/behaviors. Reward neurocircuitry (ventral striatum, nucleus accumbens) also appears important for promoting prosocial attitudes/behaviors. Monoaminergic activity (especially dopaminergic and serotonergic), influenced by several genetic polymorphisms, is critical to certain subcomponents of wisdom such as emotional regulation (including impulse control), decision making, and prosocial behaviors.

CONCLUSIONS

We have proposed a speculative model of the neurobiology of wisdom involving frontostriatal and frontolimbic circuits and monoaminergic pathways. Wisdom may involve optimal balance between functions of phylogenetically more primitive brain regions (limbic system) and newer ones (prefrontal cortex). Limitations of the putative model are stressed. It is hoped that this review will stimulate further research in characterization, assessment, neurobiology, and interventions related to wisdom.

The medical consultation viewed as a value chain: a neurobehavioral approach to emotion regulation in doctor-patient interaction

OBJECTIVE

To present a model of the medical consultation as a value chain, and to apply a neurobehavioral perspective to analyze each element in the chain with relevance for emotion regulation.

METHODS

Current knowledge on four elements in medical consultations and neuroscientific evidence on corresponding basic processes are selectively reviewed.

RESULTS

The four elements of communication behaviours presented as steps in a value chain model are: (1) establishing rapport, (2) patient disclosure of emotional cues and concerns, (3) the doctor's expression of empathy, and (4) positive reappraisal of concerns.

CONCLUSION

The metaphor of the value chain, with emphasis on goal orientation, helps to understand the impact of each communicative element on the outcome of the consultation. Added value at each step is proposed in terms of effects on outcome indicators; in this case patients affect regulation. Neurobehavioral mechanisms are suggested to explain the association between communication behaviour and affect regulation outcome.

PRACTICE IMPLICATIONS

The value chain metaphor and the emphasis on behaviour-outcome-mechanisms associations may be of interest as conceptualizations for communications skills training.

Neuroscience, moral reasoning, and the law

Modern advancements in functional magnetic resonance imaging (fMRI) technology have given neuroscientists the opportunity to more fully appreciate the brain's contribution to human behavior and decision making. Morality and moral reasoning are relative newcomers to the growing literature on decision neuroscience. With recent attention given to the salience of moral factors (e.g. moral emotions, moral reasoning) in the process of decision making, neuroscientists have begun to offer helpful frameworks for understanding the interplay between the brain, morality, and human decision making. These frameworks are relatively unfamiliar to the community of forensic psychologists, despite the fact that they offer an improved understanding of judicial decision making from a biological perspective. This article presents a framework reviewing how event-feature-emotion complexes (EFEC) are relevant to jurors and understanding complex criminal behavior. Future directions regarding converging fields of neuroscience and legal decision making are considered.

Processing of social emotion in patients with schizophrenia and substance use disorder: an fMRI study

The lifetime prevalence of substance use disorders among schizophrenia patients is close to 50%. The negative consequences of substance abuse in schizophrenia are well documented, but the aetiology of this comorbid condition remains unknown. Mounting evidence suggests that dual-diagnosis patients have fewer negative symptoms and better social skills, compared to non-abusing patients. We hypothesized that schizophrenia patients with substance use disorder (SCZ-SUD) would display increased cerebral activations in response to socioemotional stimuli, relative to patients with no SUD (SCZ). Schizophrenia patients (DSM-IV criteria) were divided into two groups: patients with (n=12) and without (n=11) substance use (alcohol and/or cannabis). Using functional magnetic resonance imaging (fMRI), patients were scanned during passive viewing of an emotional film excerpt with social content. Loci of activation were identified in the right mPFC (BA 10) and the right supramarginal gyrus (BA 40) in SCZ-SUD patients, and in the left pons in SCZ patients. Relative to SCZ patients, increased loci of activation were found in the right superior parietal cortex (BA 7) and the left medial prefrontal cortex (BA 10) in SCZ-SUD patients, who reported higher subjective emotional experience on a self-report scale. To our knowledge, this is the first fMRI study to assess social emotions in dual-diagnosis schizophrenia. Our results suggest that socioemotional processing may be less impaired in dual diagnosis, which recruited brain regions seemingly involved in "social cognition." Further studies on the topic are warranted.

A functional MRI study of Theory of Mind in euthymic bipolar disorder patients

OBJECTIVES

To determine the neural responses invoked in Theory of Mind (ToM) in euthymic bipolar patients as compared with healthy subjects.

METHODS

This study examined 20 euthymic bipolar patients (11 males and 9 females) and 20 suitably matched healthy subjects using functional magnetic resonance imaging (fMRI) while subjects were engaged in a ToM task. Within-scanner eye movements were monitored to ensure task engagement. The activation paradigm involved observing ToM and random-motion animated sequences in a block design. Both within group (ToM versus random motion) and random effects between group analyses were performed on fMRI data using the BrainVoyager software package. Demographic and clinical data, along with subject ratings of fMRI stimuli, were collated and analysed.

RESULTS

Patients were compromised in their ability to appropriately rate the ToM stimuli and assess them for intention as compared to healthy subjects. This was reflected in the fact that patients had few within-group significant activations in response to ToM animated sequences, namely, the left anterior cingulate, and precuneus and cuneus bilaterally. In contrast, robust activations in response to ToM animated sequences in healthy subjects were widespread and involved regions recognized for mental state reasoning, in particular the insula, inferior frontal, supramarginal and angular gyri, and temporal cortex. The between-group random effects analysis exclusively favoured the healthy subjects, with many activations occurring in regions overlapping with those found in the within-group analyses.

CONCLUSIONS

The findings of this novel neuroimaging study suggest that in a social context, euthymic bipolar patients, though seemingly well and capable of engaging aspects of ToM, are perhaps constrained in their ability to mentalize fully, and furthermore cannot reliably adopt an alternate cognitive perspective when appropriate. Impairment of this capacity, though subtle, may in effect compromise their ability to understand the emotions and intentions of others, and also may limit appreciation of their own illness and symptoms. Such a deficit in bipolar disorder perhaps impacts upon interpersonal relationships and adversely affects social cognition and clinical functioning. The potential implications of this putative mentalizing compromise in euthymic patients with bipolar disorder are substantial, both for the individual and for understanding the neural substrate of the illness, and therefore warrant further investigation.

Voxel-based morphometry study on brain structure in children with high-functioning autism

Earlier studies have suggested abnormal brain volumes in autism, but inconsistencies exist. Using voxel-based morphometry, we compared global and regional brain volumes in 17 high-functioning autistic children with 15 matched controls. We identified significant reduction in left white matter volume and white/gray matter ratio in autism. Regional brain volume reductions were detected for right anterior cingulate, left superior parietal lobule white matter volumes, and right parahippocampal gyrus gray matter volume, whereas enlargements in bilateral supramarginal gyrus, right postcentral gyrus, right medial frontal gyrus, and right posterior lobe of cerebellum gray matter in autism. Our findings showed global and regional brain volumes abnormality in high-functioning autism.

Brain anatomy of persistent violent offenders: more rather than less

Most violent crimes in Western societies are committed by a small group of men who display antisocial behavior from an early age that remains stable across the life-span. It is not known if these men display abnormal brain structure. We compared regional brain volumes of 26 persistently violent offenders with antisocial personality disorder and substance dependence and 25 healthy men using magnetic resonance imaging volumetry and voxel-based morphometry (VBM). The violent offenders, as compared with the healthy men, had markedly larger white matter volumes, bilaterally, in the occipital and parietal lobes, and in the left cerebellum, and larger grey matter volume in right cerebellum (effect sizes up to 1.24, P<0.001). Among the offenders, volumes of these areas were not associated with psychopathy scores, substance abuse, psychotropic medication, or global IQ scores. By contrast, VBM analyses of grey matter revealed focal, symmetrical, bilateral areas of atrophy in the postcentral gyri, frontopolar cortex, and orbitofrontal cortex among the offenders as compared with the healthy men (z-scores as high as 5.06). Offenders with psychopathy showed the smallest volumes in these areas. The larger volumes in posterior brain areas may reflect atypical neurodevelopmental processes that underlie early-onset persistent antisocial and aggressive behavior.

The role of social cognition in emotion

Although recent research has shown that social cognition and emotion engage overlapping regions of the brain, few accounts of this overlap have been offered. What systems might be commonly or distinctively involved in each? The close functional relationship between social cognition and emotion might be understood in terms of a central role for mental state attribution in the understanding, learning and regulation of emotion. In each of these cases, mental state attributions might be supported by either stimulus-driven or more reflective processes.

Ventral frontal cortex in children: morphology, social cognition and femininity/masculinity

The ventral frontal cortex (VFC) has been shown to differ morphologically between sexes. Social cognition, which many studies demonstrate involves the VFC, also differs between sexes, with females being more adept than males. In a previous study of subregions of the VFC in our lab, in an adult population, size of the straight gyrus (SG) but not the orbitofrontal cortex (OFC), differed between sexes and correlated with better performance on a test of social cognition and with greater identification with feminine characteristics. To investigate the relationship between VFC structure and social cognition in children, VFC gray matter volumes were measured on MRIs from 37 boys and 37 girls aged 7 to 17. The VFC was subdivided into the OFC and SG. Subjects were also administered a test of social perceptiveness and a rating scale of femininity/masculinity. In contrast to our findings in adults, the SG was slightly smaller in girls than boys. In girls, but not boys, smaller SG volumes significantly correlated with better social perception and higher identification with feminine traits. No volume differences by sex or significant correlations were found with the OFC. These data suggest a complex relationship between femininity, social cognition and SG morphology.

Your pain or mine? Common and distinct neural systems supporting the perception of pain in self and other

Humans possess a remarkable capacity to understand the suffering of others. Cognitive neuroscience theories of empathy suggest that this capacity is supported by 'shared representations' of self and other. Consistent with this notion, a number of studies have found that perceiving others in pain and experiencing pain oneself recruit overlapping neural systems. Perception of pain in each of these conditions, however, may also cause unique patterns of activation, that may reveal more about the processing steps involved in each type of pain. To address this issue, we examined neural activity while participants experienced heat pain and watched videos of other individuals experiencing injuries. Results demonstrated (i) that both tasks activated anterior cingulate cortex and anterior insula, consistent with prior work; (ii) whereas self-pain activated anterior and mid insula regions implicated in interoception and nociception, other pain activated frontal, premotor, parietal and amygdala regions implicated in emotional learning and processing social cues; and (iii) that levels of trait anxiety correlated with activity in rostral lateral prefrontal cortex during perception of other pain but not during self-pain. Taken together, these data support the hypothesis that perception of pain in self and other, while sharing some neural commonalities, differ in their recruitment of systems specifically associated with decoding and learning about internal or external cues.

Gender differences in empathy: the role of the right hemisphere

The relationship between activation of the right cerebral hemisphere (RH) and empathy was investigated. Twenty-two men and 73 women participated by completing a chimeric face task and empathy questionnaire. For the face task, participants were asked to pick which of the two chimeric faces looked happier. Both men and women were significantly more likely to say the chimera with the smile to their left was happier, suggesting activation of the RH. As expected, men scored significantly lower than women on the empathy questionnaire, p=.003. A correlation was found between RH activation on the face task and empathy for women only, p=.037, suggesting a possible neural basis for gender differences in empathy.