Associations between cognitive and affective empathy and internalizing symptoms in late childhood

Behavioral manifestations and neural mechanisms of empathic pain

Empathy is an important trait that allows individuals to comprehend and share the emotions and sentiments of others. It not only facilitates effective interpersonal communication, but also helps in establishing meaningful connections and fostering trust and understanding. Impaired empathy development can manifest as excessive self-centeredness, extreme egoism, and antisocial behaviors. Many psychiatric disorders, such as autism, narcissistic personality disorder, and schizophrenia, are often accompanied by empathy disorders. Pain empathy, which is a common behavioral paradigm of empathic behavior, is not only observed in humans but also in animals. By delving into the study of pain empathy, we can gain a deeper understanding of empathy itself. This understanding not only contributes to the advancement of scientific, clinical, and social fields, but also promotes the cultivation of emotional resonance and social harmony among humans, with profound significance and impact. This article provides a brief overview of the current understanding and mechanistic studies of pain empathy, as well as suggests future research directions.

The Dark and Light Sides of Empathy: The Clinical Relevance of the Assessment of Cognitive and Affective Empathy Across Negative and Positive Emotions

Is empathy a "double-edged sword"? This study aimed to contribute to a more nuanced understanding of the multidimensional empathy construct in the statistical prediction of negative and positive mental health outcomes. More specifically, this research intended to reveal whether, what, and how four individual empathy dimensions (i.e., cognitive empathy for negative emotions, cognitive empathy for positive emotions, affective empathy for negative emotions, and affective empathy for positive emotions) uniquely statistically predicted the levels of anxiety and depression symptoms, as well as well-being. A total of 786 Polish-speaking adults (452 females and 334 males) filled out a series of self-report questionnaires on empathy (the Perth Empathy Scale), anxiety, and depression symptoms, as well as well-being. Adjusting for demographic variables, the frequentist and Bayesian multiple regression analyses revealed that affective empathy dimensions (i.e., abilities to vicariously share others' emotions) significantly predicted psychopathology symptoms and well-being, whereas cognitive empathy dimensions (i.e., abilities to understand others' emotions) did not. In particular, higher affective empathy for negative emotions contributed to worse mental health outcomes, whereas higher affective empathy for positive emotions contributed to better mental outcomes. Overall, the results indicated that individual empathy dimensions demonstrated their specific dark and light sides in the statistical prediction of mental illness and well-being indicators, further supporting the clinical relevance of the multidimensional empathy construct.

The Dark Side of Empathy: The Role of Excessive Affective Empathy in Mental Health Disorders

Empathy, which is typically regarded as a positive attribute, is now being critically evaluated for its potential negative implications for mental health. A growing body of research indicates that excessive empathy, particularly a high level of affective empathy, can lead to overwhelming emotional states, thereby increasing susceptibility to psychological distress and psychiatric disorders. In this review, we aim to explore the negative effects of empathy on mental health. We review both human and animal studies concerning the relationship between empathy and psychological disorders, revealing that while empathy enhances social interactions and emotional understanding, it may also heighten empathic distress and potentially contribute to the development of pain, internalizing disorders, depression, anxiety, emotional overinvolvement, burnout, vicarious trauma, and posttraumatic stress disorder. This review contributes to the broader discourse on empathy by delineating its dual impacts, integrating insights from neurobiology, psychology, and behavioral studies. This review may enhance our understanding of empathy's complex role in mental health, offering a nuanced perspective that acknowledges both its beneficial and detrimental impacts.

The link between anxiety and theory of mind in children: A meta-analysis

BACKGROUND

The ability to reason about someone else's mental states, an ability known as theory of mind, is essential to help children navigate social life. However, not all children are socially skilled. Given socialisation is key for healthy development in children, finding what might exacerbate these difficulties is important. Emerging research suggests a potential link between anxiety and theory of mind abilities in children. This meta-analysis aims to characterise that link.

METHOD

Four electronic databases were systematically searched to identify relevant studies. Search terms included variations of terms for theory of mind, anxiety, and children. Studies were screened with inclusion and exclusion criteria for eligibility and identified papers were appraised on quality.

RESULTS

The search returned 3674 papers of which 20 were included in the analysis. These included a total of 3110 participants, aged 4-19. Overall, it was found that anxiety had a negative relationship with theory of mind and this appeared to be more pronounced in theory of mind processes related to affective states. There were no differences in the negative relationship between subtypes of anxiety or between studies with autistic and neurotypical children.

CONCLUSION

The findings suggest that anxious children may have difficulties using theory of mind abilities. Heterogeneity was substantial in the data, which limits the confidence in conclusions. Quality appraisal identified that the quality of theory of mind and anxiety measures varied between studies.

Are prosocial tendencies relevant for developmental psychopathology? The relations of prosocial behavior and empathy-related responding to externalizing problems, internalizing problems, and autism spectrum disorder

The field of developmental psychopathology tends to focus on the negative aspects of functioning. However, prosocial behavior and empathy-related responding - positive aspects of functioning- might relate to some aspects of psychopathology in meaningful ways. In this article, we review research on the relations of three types of developmental psychopathology- externalizing problems (EPs), internalizing problems (IPs), and Autism Spectrum Disorder (ASD) - to empathy-related responding (e.g., affective and cognitive empathy, sympathy, personal distress) and prosocial behavior. Empathy-related responding and prosocial behavior generally have been inversely related to EPs, although findings are sometimes reversed for young children and, for empathy, weak for reactive aggression. Some research indicates that children's empathy (often measured as emotional contagion) and personal distress are positively related to IPs, suggesting that strong sensitivity to others' emotions is harmful to some children. In contrast, prosocial behaviors are more consistently negatively related to IPs, although findings likely vary depending on the motivation for prosocial behavior and the recipient. Children with ASD are capable of prosocially and empathy-related responding, although parents report somewhat lower levels of these characteristics for ASD children compared to neurotypical peers. Issues in regard to measurement, motivation for prosociality, causal relations, and moderating and mediating factors are discussed.

Relationships between empathy, executive functions, and internalizing and externalizing symptoms in early adolescents

BACKGROUND

Previous studies have shown associations between internalizing and externalizing symptoms, executive functions, and empathy. However, the mechanisms that affect this relationship remain unclear. This study employed regression analysis to explore the relationships between empathy, executive functions, and internalizing and externalizing symptoms.

METHOD

Our study consisted of three consecutive stages. In the first stage, we assessed 2150 adolescents' parents aged 10-12 using the Strengths and Difficulties Questionnaire to determine which participants should be included in the subsequent stages. In the second stage, we conducted a pilot study with 50 participants to assess the validity of the assessment system and the six film scenes to be used in the following stage. Finally, in the third stage, we obtained 170 participants' state empathy, trait empathy, and executive functioning.

RESULTS

The regression analysis showed that working memory (β = 0.261) and externalizing symptoms (β = -0.157) predicted cognitive empathy, but only externalizing symptoms predicted affective empathy (β = -0.193). The regression analysis also showed that cognitive empathy (β = -0.513) and affective empathy (β = -0.535) predicted externalizing symptoms, but only inhibition predicted internalizing symptoms (β = 0.158).

CONCLUSION

This population-based study highlights the reciprocal effects of externalizing symptoms on cognitive and affective empathy. No significant relationship was found between internalizing symptoms and empathy. This study also highlights the effect of working memory on cognitive empathy. These findings may inform psychological interventions to improve empathic abilities in early adolescence.

Subthalamic Nucleus Stimulation Modulates Cognitive Theory of Mind in Parkinson's Disease

BACKGROUND

Theory of mind (ToM), the ability to infer others' mental state, is essential for social interaction among human beings. It has been widely reported that both cognitive (inference of knowledge) and affective (inference of emotion) components of ToM are disrupted in Parkinson's disease (PD). Previous studies usually focused on the involvement of the prefrontal cortex.

OBJECTIVE

This study investigated the causal role of the subthalamic nucleus (STN), a key hub of the fronto-basal ganglia loops, in ToM.

METHODS

Thirty-four patients with idiopathic PD (15 women, aged 62.2 ± 8.3 years) completed a Yoni task with deep brain stimulation (DBS) ON and OFF. The Yoni task was designed to separate the cognitive and affective components of ToM. Volumes of tissue activated (VTA) were computed for three subregions of the STN.

RESULTS

DBS showed insignificant effects on ToM inference costs at the group level, which may be due to the large interindividual variability. The associative VTA correlated with the cognitive inference cost change but not the affective inference cost change. Patients with greater associative STN stimulation infer more slowly on cognitive ToM. Stimulating associative STN can adversely affect cognitive ToM in PD patients, especially in patients with a wide range of stimulation (≥0.157) or cognitive decline (Montreal Cognitive Assessment < 26).

CONCLUSIONS

The associative STN plays a causal role in cognitive ToM in patients with PD. However, stimulating the associative STN likely impairs cognitive ToM and potentially leads to social interaction deficits in PD. © 2024 International Parkinson and Movement Disorder Society.

Empathy and psychopathology in children and adolescents: the role of parental mental illness and emotion regulation

Objective

Although empathy is known to be a strength, recent studies suggest that empathy can be a risk factor for psychopathology under certain conditions in children. This study examines parental mental illness as such a condition. Further, it aims to investigate whether maladaptive emotion regulation (ER) mediates the relationship between empathy and psychopathological symptoms of children.

Methods

Participants were 100 children of parents with a mental illness (55% female) and 87 children of parents without a mental illness (50% female) aged 6 - 16 years and their parents.

Results

Greater cognitive empathy was related to more psychopathological symptoms in COPMI, but not in COPWMI. In addition, in COPMI maladaptive ER mediated this relationship. In contrast, greater affective empathy was associated with more psychopathological symptoms regardless of whether parents had a mental illness.

Conclusion

Our findings highlight the importance of implementing preventive programs for COPMI that specifically target the reduction of maladaptive ER.

The effect of psilocybin on empathy and prosocial behavior: a proposed mechanism for enduring antidepressant effects

Psilocybin is a serotonergic psychedelic shown to have enduring antidepressant effects. Currently, the mechanism for its enduring effects is not well understood. Empathy and prosocial behavior may be important for understanding the therapeutic benefit of psilocybin. In this article we review the effect of psilocybin on empathy and prosocial behavior. Moreover, we propose that psilocybin may induce a positive feedback loop involving empathy and prosocial behavior which helps explain the observed, enduring antidepressant effects.

A meta-analytic review of the relations between anxiety and empathy

Although theory suggests that empathy may signal a risk for anxiety (Tone & Tully, 2014), the relation between these constructs remains unclear due to the lack of a quantitative synthesis of empirical findings. We addressed this question by conducting three meta-analyses assessing anxiety and general, cognitive, and affective empathy (k's = 70-102 samples; N's = 19,410-25,102 participants). Results suggest that anxiety has a small and significant association with general empathy (r = .08). The relation of clinical anxiety with cognitive empathy was significant but very weak (r = -.03), and small for affective empathy (r = .16). Geographic region and the type of cognitive (e.g., perspective taking, fantasy) and affective empathy (e.g., affective resonance, empathic concern) emerged as moderators. Results suggest that anxiety has a weaker association with general empathy but a stronger association with affective empathy in participants from predominantly collectivistic geographic regions. Further, greater anxiety was weakly associated with less perspective-taking and greater fantasy, and anxiety had a more modest association with empathic concern than other types of affective empathy. Targeting affective empathy (e.g., promoting coping strategies when faced with others' distress) in interventions for anxiety may be beneficial.

Online Moral Disengagement: An Examination of the Relationships Between Electronic Communication, Cognitive Empathy, and Antisocial Behavior on the Internet

A consequence of the proliferation of online communication is the concerning presence of antisocial behavior observed in virtual spaces. Research suggests the cognitive component of empathy is hindered by features of electronic communication which facilitates antisocial behaviors online. Investigations into how features of online communication inhibit cognitive empathy are lacking, and findings on moral disengagement and antisocial behavior have yet to be integrated with studies on cognitive empathy and electronic communication. The current study explores these relationships. One hundred and three undergraduate students completed several measures including the Online Moral Disengagement Scale, Questionnaire of Cognitive and Affective Empathy, and Online Prosocial and Antisocial Behavior Scale. Results showed a positive correlation between compulsive internet use and online moral disengagement, as well as a negative correlation between cognitive empathy and moral disengagement online. It was hypothesized that online moral disengagement would mediate the relation between cognitive empathy and antisocial behavior online but this mediation was not supported. However, a moderated relationship was revealed between cognitive empathy and moral justification, by liberalism. This moderation can be explored further and built upon by future research to deepen our understanding of how political ideology relates to virtual behavior. Furthermore, the findings concerning components of empathy and moral disengagement, and their role within the perpetration of antisocial conduct online, can inform future research as well as interventions focused on fostering prosocial behavior online and curbing cyberaggression.

The Origins of the Dark—Hyperactivity and Negative Peer Relationships, an Objectively Lower Sleep Efficiency, and a Longer Sleep Onset Latency at Age Five Were Associated with Callous-Unemotional Traits and Low Empathy at Age 14

Background: Within the spectrum of emotional competencies, callous-unemotional traits are socially discouraged, while empathy is considered a socially much more accepted emotional trait. This holds particularly true for adolescents, who are still building up their social and emotional competencies. The aims of the present study were two-fold: First, longitudinally, to identify traits of behavioral problems and objective sleep dimensions at the age of 5 years to predict callous-unemotional traits and empathy at the age of 14 years. Second, cross-sectionally, to associate callous-unemotional traits and empathy with current insomnia, stress, and mental toughness. Methods: Preschoolers at the age of 5 years were contacted nine years later at the age of 14 years. At 5 years, parents rated their children’s behavior (Strength and Difficulties Questionnaire, SDQ); in parallel, children underwent a one-night sleep-EEG assessment. At the age of 14 years, adolescents completed a series of questionnaires covering callous-unemotional traits, insomnia, empathy, stress, and mental toughness. Results: A total of 77 adolescents (38.1% females) took part in the present study. Longitudinally, higher scores for hyperactivity at age 5 significantly predicted higher callous-unemotional traits at age 14. A higher score for negative peer relationships at age 5 significantly predicted lower scores for cognitive empathy at age 14. Further, objective sleep-EEG measures showed that a higher sleep efficiency and a shorter sleep latency was associated with lower scores for callousness. Cross-sectionally, higher scores for callous-unemotional traits were associated with higher insomnia and stress, while lower insomnia was associated with higher empathy. Mental toughness was unrelated to callous-unemotional traits and empathy. Conclusions: It appears that hyperactivity traits and negative peer relationships and more unfavorable objective sleep patterns at 5 years predicted socially discouraged callous-unemotional traits and low empathy during adolescence. Further, cross-sectionally at the age of 14, callous-unemotional traits, subjective poor sleep, and higher stress were associated.

Individual differences in brain structure and self-reported empathy in children

Empathy refers to the understanding and sharing of others' emotions and comprises cognitive and affective components. Empathy is important for social functioning, and alterations in empathy have been demonstrated in many developmental or psychiatric disorders. While several studies have examined associations between empathy and brain structure in adults, few have investigated this relationship in children. Investigating associations between empathy and brain structure during childhood will help us to develop a deeper understanding of the neural correlates of empathy across the lifespan. A total of 125 children (66 females, mean age 10 years) underwent magnetic resonance imaging brain scans. Grey matter volume and cortical thickness from structural images were examined using the Computational Anatomy Toolbox (CAT12) within Statistical Parametric Mapping (SPM12) software. Children completed questionnaire measures of empathy (cognitive empathy, affective empathy: affective sharing, empathic concern, and empathic distress). In hypothesised region of interest analyses, individual differences in affective and cognitive empathy were related to grey matter volume in the insula and the precuneus. Although these relationships were of similar strength to those found in previous research, they did not survive correction for the total number of models computed. While no significant findings were detected between grey matter volume and empathy in exploratory whole-brain analysis, associations were found between cortical thickness and empathic concern in the right precentral gyrus. This study provides preliminary evidence that individual differences in self-reported empathy in children may be related to aspects of brain structure. Findings highlight the need for more research investigating the neurobiological correlates of empathy in children.

The Effects of the Creator’s Situation on Creativity Evaluation: The Rater’s Cognitive Empathy and Affective Empathy Matter in Rating Creative Works

Successful intelligence theory suggests that creativity is necessary for personal achievement outside of intelligence. Unlike intelligence, creativity can develop in a supportive environment. People should consider the situation of disadvantaged groups, which are characterized by low personal achievement and a bad growth environment in creativity evaluation from a caring perspective. This study focuses on the effect of the creator’s situation on creative evaluation and the role of the rater’s empathy (i.e., cognitive empathy and affective empathy) and sympathy in creative evaluation. Four pairs of creator’s situations (by age, physical state, family situation, and economic state) were designed to represent people with disadvantages or advantages. A between-subject design was used with 590 undergraduate students randomly assigned to eight sub-conditions. The participants were asked to assess three products in eight situations. The rater’s empathy and sympathy in creativity evaluation were explored in the overall disadvantage (N = 300) and advantage (N = 290) conditions. The results showed that the participants only provided significantly higher ratings to the creative product made by a child. Cognitive empathy only predicted a creative rating under disadvantaged conditions, and affective empathy negatively moderated this effect. Affective empathy only predicted a creative rating under advantage conditions, and cognitive empathy positively moderated this effect. Affective empathy only predicted a creative rating under advantage conditions, and cognitive empathy positively moderated this effect. The possible mechanisms of the effect and implications for the establishment of a supportive environment for creativity and creativity teaching practice were discussed.