Psychometric properties of the questionnaire of cognitive and affective empathy in a Portuguese sample

Childhood abuse and neglect are differentially related to perceived discrimination and structural change in empathy-related circuitry

Behavioral studies indicate that adverse childhood experiences (ACE) are associated with altered empathic responding, but the neural mechanisms underlying this relationship remain unclear. Given the significance of empathy in contexts marred by historical conflict and systemic inequality, work on these mechanisms is particularly important in such contexts. The current study extends previous work by (1) examining associations of different dimensions of ACE with volumetric change in empathy-related circuitry, (2) distinguishing between trait and state empathy, and (3) including perceived discrimination as an additional psychosocial stressor. Thirty-nine healthy South African adults from the general population (Mage = 40.6 years) underwent 3 T MRI. FreeSurfer v6.0 was used to extract predefined volumes subserving empathy. Results showed that childhood abuse and perceived discrimination were associated with reduced state empathic concern, whereas childhood neglect was associated with reduced trait cognitive empathy. Childhood abuse was furthermore associated with volumetric increases in frontolimbic (hippocampus, anterior cingulate cortex (ACC)) and neocortical (superior frontal and temporal) regions subserving affective and cognitive empathy, and uniquely mediated the relationship between ACC volume and perceived discrimination. The association of ACE with altered empathic responding may thus be underpinned by specific circuitry reflective of adversity type, with childhood abuse contributing to heightened responsivity to socioemotional cues.

Revisiting the Structure of the Chinese Version of the Questionnaire of Cognitive and Affective Empathy and Its Relationships with Schizotypy and Paranoia Using Network Approaches

Empathy is predominantly assessed with self-report questionnaires. However, their structural validities were not well-supported. This study aimed to re-explore and refine the factor structure of the Chinese version of the Questionnaire of Cognitive and Affective Empathy (QCAE) and investigate the pathways linked between dimensions of empathy and schizotypy. Data from a valid sample of 1,360 community-dwelling adults (aged 18-35) were subjected to the exploratory graph analysis (EGA) and bootstrap EGA for factor retention. A goodness-of-fit evaluation was conducted using confirmatory factor analysis (CFA). Lastly, a Gaussian graphical model with sum scores of the resultant empathy dimensions, positive, negative, and disorganized schizotypy, and paranoia as nodes was estimated. Results supported a three-factor structure for the revised 20-item QCAE, demonstrating a good model fit. The new Online simulation subscale was associated with reduced disorganized schizotypy, whereas the new Perspective-taking subscale was associated with decreased disorganized schizotypy and increased positive schizotypy. The composite Affective empathy subscale was associated with decreased negative schizotypy and increased positive and disorganized schizotypy and paranoia. Overall, the revised QCAE demonstrated good structural validity, measuring three separable and internally cohesive factors of empathy. Each factor possessed unique and differential relationships with schizotypy dimensions that merit research and clinical attention.

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

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

Measuring dispositional empathy in South African children

OBJECTIVE

Empathy is a key factor to examine in development, because of its predictive associations with both aggression and successful prosocial behaviour. However, established measures of empathy for Low-to-Middle Income Countries, including South Africa, are lacking. In children, parent-report measures are key. However, a local study examining empathy and aggression (Malcolm-Smith et al., 2015) found poor psychometric performance for a widely used parent-report measure of dispositional empathy, the Griffith Empathy Measure (GEM). We thus investigated which of two questionnaires measuring dispositional cognitive and affective empathy perform better in this context.

METHOD

We contrasted internal consistency reliability of a simplified version of the GEM (SGEM; n = 160) and a parent-report version of the Questionnaire of Cognitive and Affective Empathy (QCAE; n = 440) in a low-mid socio-economic status sample. Convergence between the measures and factor structure were also assessed.

RESULTS

The parent-report version of the QCAE performed well as a measure of child dispositional cognitive and affective empathy, with good reliability (overall α = 0.90 vs. SGEM α = .63), and confirmatory factor analysis supporting the two-factor structure. The SGEM's reliability and failure to correlate with QCAE indicated poor psychometric performance.

CONCLUSION

This is the first psychometric evaluation of the QCAE as a parent-report measure, and our results indicate that it should prove useful for future assessments of dispositional empathy in children across a variety of contexts.

Dissociating cognitive and affective empathy across psychopathy dimensions: The role of interoception and alexithymia

This study examined the associations between psychopathy dimensions (triarchic phenotypes and classical factors), empathy domains (cognitive and affective), and interoception (interoceptive attention and accuracy) while accounting for the putative role of alexithymia. A community sample (n = 515) completed an online survey encompassing: Triarchic Psychopathy Measure (boldness, meanness, disinhibition); Levenson Self-Report Psychopathy Scale (primary and secondary psychopathy); Body Perception Questionnaire (interoceptive attention); Interoceptive Accuracy Scale; Toronto Alexithymia Scale. Hierarchical linear regression models were implemented for hypothesis-driven analyses examining the associations between psychopathy, empathy, and interoception while controlling for sex, age, and alexithymia. Exploratory path models were employed to investigate alexithymia and/or cognitive empathy as mediators between interoception and psychopathy. Our results largely confirmed the postulated empathy profiles across psychopathy dimensions, as meanness and primary psychopathy displayed a broad empathy impairment, while disinhibition and secondary psychopathy were only associated with diminished cognitive empathy. Importantly, boldness displayed a unique pattern (enhanced cognitive empathy and reduced affective empathy), further reinforcing its importance within the constellation of psychopathy traits. Contrary to our hypotheses, self-perceived interoceptive attention and accuracy were not associated with either psychopathy dimension after controlling for alexithymia. However, interoceptive accuracy and alexithymia were associated with cognitive empathy, while alexithymia was also positively related to all psychopathy dimensions (as expected), despite the unexpected strong and negative association with boldness. Exploratory analyses suggested significant indirect effects (mediation) between interoceptive accuracy and psychopathy via alexithymia and/or cognitive empathy. These mediating effects must be interpreted with caution and future studies should be designed to formally test this model.

Theory of Mind in Offending: A Systematic Review

Theory of mind (ToM) impairment is associated with poor social functioning in some psychological disorders (e.g., autism and schizophrenia). ToM deficits have also been linked with offending behavior in the theoretical literature. However, no review has examined the empirical evidence for such a link. We carried out a systematic review to provide a critical overview of studies involving ToM ability in offenders. We included studies published in English that used an instrument to measure at least one aspect of ToM. Twenty-eight eligible studies were identified and coded. Our findings reveal a generally mixed literature. Taking study quality into account, our findings suggest that offenders and nonoffenders do not differ in their first-order ToM. For second-order ToM, findings are mixed, even when only the highest quality studies are examined. Studies exploring advanced ToM showed mixed results overall, though the highest quality research appeared to indicate that offenders have impairments in advanced ToM which means that they may have difficulty understanding various mental states such as pretense, white lies, irony, double bluffs, and sarcasm. We suggest that well-controlled future studies, which also measure other facets of ToM (e.g., distinguishing between cognitive and affective ToM or examining ToM content), are needed to fully understand the role of ToM in offending.

The psychological effects of imprisonment: The role of cognitive, psychopathic and affective traits

The present cross-sectional correlational study aimed to investigate a set of cognitive, affective, and personality traits impacting the psychological effects of imprisonment. Ninety-three male inmates filled out a battery including measures of intelligence, working memory, psychopathy, aggressiveness, anxious trait, emotionality, rumination styles, and empathy proneness. Inmates' psychological outcomes were conceptualized in terms of mood, anxiety, depression, and general health. Results showed that inmates with high cognitive abilities, psychopathic impulsivity, proactive aggression, personal distress and fantasy, anxious and negative emotionality are mainly prone to ill-being psychological outcomes. Contrariwise, the fearless dominance trait, positive emotionality and empathic concern ability seem to expose inmates to positive psychological outcomes. Reactive aggression and perspective taking seem to impact both positive and negative moods. Ruminative style was unrelated to psychological outcomes. These preliminary results provide an insight into which factors intervention programs should be based upon in order to enhance well-being and reduce distress among inmates.

Impact of a Virtual Reality-Based Simulation on Empathy and Attitudes Toward Schizophrenia

Virtual Reality (VR) has been identified as one of the most promising resources for developing empathy towards stigmatized groups as it allows individuals to experience a situation close to reality from another person’s perspective. This quasi-experimental study aimed to examine the impact on empathy, knowledge, and attitudes towards people with schizophrenia of a VR simulation that reproduces the experience of psychotic symptoms while performing a cognitive task compared with watching a 2D video and, thus, how these experiences could reduce stigma towards people diagnosed with schizophrenia. The sample comprised of 102 higher education health students, distributed by the experimental and control groups. The impact of the program was measured by completing multiple questionnaires on levels of empathy, attitudes, and mental health knowledge. Both methods (VR and 2D video) were, to a certain extent, effective. However, VR was more effective at eliciting attitudes and knowledge change compared to the control group. These findings suggest that not only VR but also 2D videos could be interesting strategies to enhance empathy and improve attitudes towards people with schizophrenia in higher education health students.

The Relative Role of Knowledge and Empathy in Predicting Pro-Environmental Attitudes and Behavior

Planet Earth is undergoing unprecedented levels of environmental degradation and destruction at a global scale. Incentivizing people to adopt behaviors that are compatible with a sustainable future will help address the current ecological crisis. However, it is first necessary to understand the psychological drivers of pro-environmental behavior. Here, we examined whether greater levels of environmental knowledge and empathy predicted higher levels of pro-environmental behavior in an Australian population sample. We aimed to advance our understanding of the psychological variables that motivate people to act in pro-environmental ways, while also advancing the ongoing debate amongst conservation scientists regarding the relative importance of fostering empathy. Correlational analyses revealed that objective, verifiable knowledge was a strong predictor of pro-environmental attitudes and behavior. Empathy also correlated positively with pro-environmental attitudes and behavior, but with a dissociation with respect to its cognitive and affective components. Multivariate analyses revealed that knowledge was a stronger predictor of both pro-environmental attitudes and behavior after controlling for individual variation in cognitive and affective empathy. This finding casts doubt on the claim by compassionate conservationists that fostering empathy is the key to solving the current environmental conservation crisis. Future research should aim to extend the present findings by testing whether a more exhaustive test of participants’ environmental knowledge and other measures of empathy, including empathic competencies and the recently developed Emotional and Cognitive Scale of the Human–Nature Relationship (ECS-HNR), yield the same dominance of knowledge over empathy.

Confirmatory factor analysis and exploratory structural equation modeling of the factor structure of the Questionnaire of Cognitive and Affective Empathy (QCAE)

The Questionnaire of Cognitive and Affective Empathy (QCAE) is a multiple dimensional measure of cognitive empathy [comprising primary factors for perspective taking (PT), online simulation (OS)], and affective empathy [comprising primary factors for emotion contagion (EC), proximal responsivity (PRO), and peripheral responsivity (PER)]. This study used independent clusters confirmatory factor analysis (ICM-CFA) and exploratory structural equation modeling (ESEM) to examine the scale's factor structure. A general community sample of 203 (men = 43, women = 160) between 17 and 63 years completed the QCAE. Although both the five-factor oblique and second order factor models showed good model fit, and clarity in the pattern of factor loadings, in the second-order factor model, none of the primary factors loaded significantly on their respective secondary factors, thereby favoring the five-factor oblique model. The factors in this model were supported in terms of external validity. Despite this, the factor for PRO in this model showed low reliability for meaning interpretation. A revised four-factor oblique model without the PRO factor showed good fit, clarity in the pattern of factor loadings, and reliability and validity for the factors in this model, thereby suggesting this to be the best model to represent ratings on the QCAE.

Empathy: Assessment Instruments and Psychometric Quality - A Systematic Literature Review With a Meta-Analysis of the Past Ten Years

Objective: To verify the psychometric qualities and adequacy of the instruments available in the literature from 2009 to 2019 to assess empathy in the general population. Methods: The following databases were searched: PubMed, PsycInfo, Web of Science, Scielo, and LILACS using the keywords "empathy" AND "valid∗" OR "reliability" OR "psychometr∗." A qualitative synthesis was performed with the findings, and meta-analytic measures were used for reliability and convergent validity. Results: Fifty studies were assessed, which comprised 23 assessment instruments. Of these, 13 proposed new instruments, 18 investigated the psychometric properties of instruments previously developed, and 19 reported cross-cultural adaptations. The Empathy Quotient, Interpersonal Reactivity Index, and Questionnaire of Cognitive and Affective Empathy were the instruments most frequently addressed. They presented good meta-analytic indicators of internal consistency [reliability, generalization meta-analyses (Cronbach's alpha): 0.61 to 0.86], but weak evidence of validity [weak structural validity; low to moderate convergent validity (0.27 to 0.45)]. Few studies analyzed standardization, prediction, or responsiveness for the new and old instruments. The new instruments proposed few innovations, and their psychometric properties did not improve. In general, cross-cultural studies reported adequate adaptation processes and equivalent psychometric indicators, though there was a lack of studies addressing cultural invariance. Conclusion: Despite the diversity of instruments assessing empathy and the many associated psychometric studies, there remain limitations, especially in terms of validity. Thus far, we cannot yet nominate a gold-standard instrument.

Psychometric Properties of Questionnaire of Cognitive and Affective Empathy (QCAE): Reliability and Factor Analysis Study in Turkish Sample

INTRODUCTION

The Questionnaire Cognitive and Affective Empathy (QCAE) scale is a tool that is widely used because of its multi-dimensional assessment of ability for empathy and is currently available in many languages. The aim of the current study was to examine the psychometric properties of the Turkish version of QCAE, which evaluates cognitive and emotional empathy with its multi-dimensional structure, and to bring it into the Turkish.

METHODS

The study was carried out in a Turkish population of 412 healthy volunteers. Internal consistency, confirmatory factor analyses and gender comparisons of the Turkish version of the scale were performed.

RESULTS

The Turkish version of QCAE had good construct validity and reliability for the five-correlated factors model (i. e., Emotion Contagion, Proximal Responsivity, Peripheral Responsivity, Perspective Taking and Online Simulation). Temporal reliability was high with a two week test-retest intra-correlation coefficient range of 0.69-0.79. A total of 3 models were tested with confirmatory factor analyses, including the models of the original investigation. Cognitive-Affective distinction was not supported by the pattern of correlations between the factors.

CONCLUSION

Our results support that it is appropriate to compute and interpret the 5 sub-dimensions of the Turkish version of QCAE separately and totally, but the limitations in its use in the Cognitive Empathy and Affective Empathy sub-dimensions should be heeded.

Measurement of empathy among health professionals during Syrian crisis using the Syrian empathy scale

BACKGROUND

Health professionals should have certain degree of empathy to eliminate the pain and suffering of their patients. There is a need to design a scale, which can assess empathy among health professionals and is relevant to community and culture. Therefore, this study was undertaken to measure the empathy among Syrian health professionals and students of health professions using a newly designed Syrian Empathy Scale that is relevant to community during Syrian crisis.

METHODS

A cross-sectional observational study was undertaken. A total of 214 participants (118 males and 96 females) responded to the Syrian Empathy Scale SES from Medical (n = 62), Dental (n = 152). They were 59 undergraduates, 116 postgraduates and 39 general practitioners. The SES was designed as a tool that includes 20 items in a 7-point Likert-type scale with overall score ranges from 20 to 140. Group comparisons of the empathy scores were conducted using t-test and analysis of variance (ANOVA). A factor analysis was performed. Bartlett's test of the sphericity and the KMO measure of sampling adequacy were also determined. Cronbach's alpha was calculated.

RESULTS

A significant difference was found between males and females in the SES mean score. The ANOVA analysis showed that the SES empathy scores of dentists were higher than the SES empathy scores in medical doctors with no significant difference. The SES empathy score of undergraduates was significantly higher than postgraduates and practitioners. Findings of KMO indicated sampling adequacy (KMO = 0.824 > 0.7) and the value of Bartlett's test of the sphericity (1255.65, df = 190, P-value< 0.001) proved that the factor analysis is meaningful and acceptable. The results of varimax rotation proved that five main factors were retained.

CONCLUSION

Findings of this study support the reliability of the newly designed Syrian Empathy Scale for measuring empathy in the field of health care. The SES can be suggested for assessing empathy in different health educational programs. However, future works are still essential to support the validity of the scale as well as to ascertain the role of empathy in improving health care.

Validation of the Questionnaire of Cognitive and Affective Empathy in patients with schizophrenia, major depressive disorder and bipolar disorder

INTRODUCTION

Alteration of empathy is common in patients with psychiatric disorders. Reliable and valid assessment tools for measuring empathy of clinical samples is needed. The Questionnaire of Cognitive and Affective Empathy (QCAE) is a newly-developed instrument to capture cognitive and affective components of empathy. This study aimed to validate the QCAE and compared self-reported empathy between clinical groups with varied psychiatric diagnoses and healthy sample.

METHODS

The present study performed factor analysis for the QCAE on clinical samples in the Chinese setting (n = 534), including patients with schizophrenia (n = 158), bipolar disorder (n = 213) and major depressive disorder (n = 163). Internal consistency, internal correlation and convergent validity was examined in the subsample (n = 361). Group comparison among patients with schizophrenia, bipolar disorder, major depressive disorder and healthy controls (n = 107) was conducted to assess the discriminant validity.

RESULTS

Our results indicated acceptable factor model, good reliability and validity of the QCAE. Impaired cognitive empathy was found in clinical samples, especially in patients with schizophrenia, while higher affective empathy was found in patients with bipolar disorder and major depressive disorder.

CONCLUSION

The QCAE is a useful tool in assessing empathy in patients with varied psychiatric diagnoses.

Higher trait mindfulness is associated with empathy but not with emotion recognition abilities

Mindfulness involves an intentional and non-judgemental attention or awareness of present-moment experiences. It can be cultivated by meditation practice or present as an inherent disposition or trait. Higher trait mindfulness has been associated with improved emotional skills, but evidence comes primarily from studies on emotion regulation. It remains unclear whether improvements extend to other aspects of emotional processing, namely the ability to recognize emotions in others. In the current study, 107 participants (M age = 25.48 years) completed a measure of trait mindfulness, the Five Facet Mindfulness Questionnaire, and two emotion recognition tasks. These tasks required participants to categorize emotions in facial expressions and in speech prosody (modulations of the tone of voice). They also completed an empathy questionnaire and attention tasks. We found that higher trait mindfulness was associated positively with cognitive empathy, but not with the ability to recognize emotions. In fact, Bayesian analyses provided substantial evidence for the null hypothesis, both for emotion recognition in faces and in speech. Moreover, no associations were observed between mindfulness and attention performance. These findings suggest that the positive effects of trait mindfulness on emotional processing do not extend to emotion recognition abilities.

Confirmation of a Two-Factor Solution to the Questionnaire of Cognitive and Affective Empathy in a French Population of Patients With Schizophrenia Spectrum Disorders

The Questionnaire of Cognitive and Affective Empathy (QCAE) is a tool for self-assessing the cognitive and emotional components of empathy. A study showed that a two-factor model fits the data of patients with schizophrenia, whereas other reports on healthy subjects have suggested a five-factor decomposition. We aimed to replicate the model of Horan et al. in a French population with schizophrenia spectrum disorders (i.e., schizophrenia and schizoaffective disorders) participating in the EVACO Study (NCT02901015). In total, 133 patients were assessed with the QCAE, the Positive and Negative Symptom Scale (PANSS), the Personal and Social Performance Scale (PSP), and the Self rating Quality of Life Scale (S-QoL). The two-factor model demonstrated an adequate fit with the data, comparable to that reported by Horan et al. Males scored higher on the Affective subscore than females. After correction for multiple tests, psychopathology (PANSS) and functioning (PSP) did not correlate significantly with the QCAE subscores. However, quality of life (S-QoL) correlated positively with the Emotional Contagion subscore. Thus, the variability of empathetic disposition in schizophrenia may be considered through the cognitive versus affective dichotomy and properly investigated with the QCAE. The results support further investigation of the relationship between QCAE scores and subjective outcome measurements, such as quality of life, and emphasize the importance of cross-cultural comparisons.

Psychometric Properties and Construct Validity of the Short Version of the Self-Report Psychopathy Scale in a Southern European Sample

The Self-Report Psychopathy Scale-Short Form (SRP-SF) is a brief measure of psychopathy, developed via model-based test theory. The SRP-SF has a 4-factor structure with items reflecting affective, interpersonal, lifestyle, and antisocial domains, in line with the Psychopathy Checklist-Revised (PCL-R), which can be aggregated to form the traditional F1 and F2 dimensions of psychopathy. Previous research indicates the SRP is a viable tool for examining the prevalence of psychopathic propensities and their correlates in nonoffender populations. Currently, a substantial amount of nonoffender research on psychopathy is conducted in North America. Here, we inspect the psychometric properties of the SRP-SF and probe its association with general personality and empathy in a large southern European (Portuguese) community sample. Consistent with previous studies, results indicated good fit for the 4-factor model, including for separate female and male subsamples, good internal consistency across its scales and subscales, and the predicted pattern of associations with the correlates of psychopathy. The results of this cross-cultural study provide further evidence of the validity of the SRP-SF in the assessment of psychopathy in community samples, and help to extend the nomological net on the larger construct to a southern European sample.

Validation and extension of the Questionnaire of Cognitive and Affective Empathy in the Chinese setting

The Questionnaire of Cognitive and Affective Empathy (QCAE) is a commonly used instrument in empathy research. However, this scale has not been validated in the Chinese context. We examined the psychometric properties and structure of the QCAE in a Chinese sample consisting of 1224 college students. The whole sample was split into two halves for exploratory factor analysis (EFA; n = 617) and confirmatory factor analysis (CFA; n = 607). A subsample (n = 351) completed the Chinese versions of the Interpersonal Reactivity Index (IRI) to examine convergent validity and the Revised Social Anhedonia Scale (RSAS) to examine the discriminate validity. Finally, 79 participants of the above subsample were retested after a 4-week interval. Results from EFA and CFA suggested a five-factor model, namely Perspective Taking, Online Simulation, Emotional Contagion, Proximal Responsivity, and Peripheral Responsivity. The internal consistency was .86 and test-retest reliability was .76. Scores on the QCAE positively correlated with scores on the IRI and negatively correlated with scores on the RSAS. The Chinese version of the QCAE exhibited good factor structure, reliability, and validity. Specific relationships between empathy and social anhedonia were also demonstrated.

Assessing self-reported empathy and altruism in patients suffering from enduring borderline personality disorder

Self-report studies on empathy in adults with borderline personality disorder (BPD) have based upon the Interpersonal Reactivity Index (IRI) and generally identified deficits in perspective taking abilities in this group, but indicated less coherent results regarding empathic concern. These two constructs are considered subcomponents of cognitive (CE) and affective empathy (AE), respectively. However, the IRI does not enable for valid investigation of overall levels of these empathy types. Surprisingly, although some findings from the general population suggest that empathy types may be positively related to altruism, neither this link nor general altruism have been examined in BPD. Additionally, these constructs have not been sufficiently studied in this group in the context of alexithymia or potential clinical confounders. Hence, women with BPD (N = 30) and healthy women (N = 38) completed, i.a., the Questionnaire of Cognitive and Affective Empathy, Self-Report Altruism Scale, TAS-20, STAI, and CESD-R. Patients with BPD reported significantly decreased overall CE (including worse online simulation abilities - conceptually similar to perspective taking from the IRI), but a similar level of overall AE. They also demonstrated lower altruism. Taken together, these results suggest that BPD patients have difficulties with imagining what emotions others are feeling and with altruistic responding to their needs.