Beyond physical sensations: investigating empathy and prosocial behavior in vicarious pain responders.

Empathy, the capacity to share others' emotional experiences, has been proposed as a key motivation for altruistic behavior in both humans and animals. Sharing another's emotional experience may generate a self-embodied simulation of their emotional state, fostering understanding and promoting prosocial behavior. Vicarious pain responders report sensing physical pain when observing others in pain. Whether this ability extends to emotional experiences remains unexplored. Using both questionnaires and ecologically valid behavioral tasks, we explored whether vicarious pain responders differ from nonresponders in empathic abilities and prosocial behavior. Participants watched video clips of people describing a negative emotional life event. We operationalized several empathic abilities and responses (empathic accuracy, affective synchrony, emotional reaction, and empathic motivation) based on participants' and targets' responses during and after watching the videos. Participants were also engaged in a donation task measuring tendency for prosocial behavior. Findings reveal that compared to nonresponders, vicarious pain responders exhibit enhanced empathic accuracy, intensified emotional reactions to others' emotional pain, and a greater motivation to communicate with the target. This study marks the first behavioral evidence showcasing vicarious pain responders' empathic abilities, reactions, and motivation in response to nonphysical pain of others, expanding our knowledge of this phenomenon and its association with broader empathic abilities.

Do you feel me? Autism, empathic accuracy and the double empathy problem.

LAY ABSTRACT: The assumption that autistic people lack empathy, particularly imagining how others feel, has been much debated and is now being challenged by an alternative view: the 'double empathy problem'. This suggests that non-autistic people may find it equally difficult to imagine how autistic people feel. Although this perspective is gaining popularity, research testing whether non-autistic people can accurately imagine and feel an autistic person's emotions is still limited. Our study used video clips of autistic and non-autistic people recounting emotional events to test if participants from the general population could: track the intensity of the narrators' emotions; name and feel the same emotion; match where the narrator felt the emotion and indicate how intensely they felt the emotion using a body map. Our results show that participants found it significantly harder to track autistic narrators' emotions compared to non-autistic narrator's emotions, especially when viewing clips of narrators feeling happy and sad. We also found that participants felt emotions more intensely in the body when viewing clips of autistic narrators compared to non-autistic narrators, especially when describing anger and fear. These findings support the double empathy problem and have strong implications for therapeutic and interpersonal relationships with autistic people.

I understand your pain but I do not feel it: lower affective empathy in response to others' social pain in narcissism.

Introduction: While the relationship between narcissism and empathy has been well-researched, studies have paid less attention to empathic accuracy, i.e., appreciating the precise strength of another person's emotions, and self-other distinction, in terms of the disparity between affective ratings for self and other in response to emotive stimuli. Furthermore, empathic responses may vary depending on whether the pain is physical or social. Methods: We investigated empathic accuracy, affective empathy, and the distinction between pain, emotion and intensity ratings for self and other, in high (n = 44) and low (n = 43) narcissism groups (HNG and LNG, respectively) selected from 611 students, in response to both types of pain. Participants watched six videos where targets expressed genuine experiences of physical and social pain, and rated the perceived affect and pain experienced by the person in the video and their own empathic emotional responses. Results and discussion: The HNG displayed lower affective empathy and empathic accuracy than the LNG for both pain types. Within the HNG there was higher empathic accuracy for social vs. physical pain, despite reduced affective empathy for social pain, in contrast to the LNG. In addition to this paradox, the HNG demonstrated greater differences between ratings for the self and for target others than the LNG, suggesting that narcissism is associated with higher self-other distinction in response to viewing other people describing social pain.

Empathic accuracy in individuals with schizotypal personality traits.

Empirical research using the Empathic Accuracy Task (EAT) has suggested that schizophrenia patients and people with schizotypal personality disorder exhibit lower empathic accuracy than healthy people. However, empathic accuracy in a subclinical sample with high levels of schizotypy has seldom been studied. Our study aimed to investigate empathy in a subclinical sample using the Chinese version of the EAT and a self-report empathy measure. Forty participants with high levels of schizotypy (HS participants) and 40 with low levels of schizotypy (LS participants), as measured by the Schizotypal Personality Questionnaire (SPQ), were recruited. All participants completed the Chinese version of the EAT and the self-report Questionnaire of Cognitive and Affective Empathy. Empathic accuracy (EA) scores and the intra-individual variability of EA scores were calculated. Independent samples t tests and Pearson correlation analyses were performed to examine group differences in empathy and the relationship between empathy and schizotypy respectively. HS participants exhibited reduced EA for both positive and negative videos, and larger intra-individual variability of EA for negative videos than LS participants. However, HS and LS participants did not differ in self-report cognitive empathy. Moreover, the interpersonal dimension of the SPQ was negatively correlated with EAT performance and self-report cognitive empathy in LS participants. Individuals with HS show poorer performance-based EA but relatively intact self-report cognitive empathy. This study provides empirical evidence for the ontogeny of empathy deficits in subclinical populations at risk of developing schizophrenia, supporting early interventions for social cognitive deficits.

Heterogeneity in functional connectivity: Dimensional predictors of individual variability during rest and task fMRI in psychosis.

BACKGROUND: Individuals with schizophrenia spectrum disorders (SSD) often demonstrate cognitive impairments, associated with poor functional outcomes. While neurobiological heterogeneity has posed challenges when examining social cognition in SSD, it provides a unique opportunity to explore brain-behavior relationships. The aim of this study was to investigate the relationship between individual variability in functional connectivity during resting state and the performance of a social task and social and non-social cognition in a large sample of controls and individuals diagnosed with SSD. METHODS: Neuroimaging and behavioral data were analyzed for 193 individuals with SSD and 155 controls (total n = 348). Individual variability was quantified through mean correlational distance (MCD) of functional connectivity between participants; MCD was defined as a global 'variability score'. Pairwise correlational distance was calculated as 1 - the correlation coefficient between a given pair of participants, and averaging distance from one participant to all other participants provided the mean correlational distance metric. Hierarchical regressions were performed on variability scores derived from resting state and Empathic Accuracy (EA) task functional connectivity data to determine potential predictors (e.g., age, sex, neurocognitive and social cognitive scores) of individual variability. RESULTS: Group comparison between SSD and controls showed greater SSD MCD during rest (p = 0.00038), while no diagnostic differences were observed during task (p = 0.063). Hierarchical regression analyses demonstrated the persistence of a significant diagnostic effect during rest (p = 0.008), contrasting with its non-significance during the task (p = 0.50), after social cognition was added to the model. Notably, social cognition exhibited significance in both resting state and task conditions (both p = 0.01). CONCLUSIONS: Diagnostic differences were more prevalent during unconstrained resting scans, whereas the task pushed participants into a more common pattern which better emphasized transdiagnostic differences in cognitive abilities. Focusing on variability may provide new opportunities for interventions targeting specific cognitive impairments to improve functional outcomes.

The Association Between Emotional Expressions and Empathic Accuracy.

Empathic accuracy, the ability to accurately represent and understand another's emotional state, is integral to socio-emotional functioning. It is also inherently an interpersonal process that requires active engagement of the emotional systems of both interaction partners. The emotional expressivity of the partner sharing their emotions restricts empathic accuracy and the perceiver's emotional expressivity might also affect empathic accuracy as they behaviorally simulate and thus share the emotions they see in the other's face. We explored a potential role of emotional expressivity in people's ability to understand another's emotions in a face-to-face dyadic interaction. Participants took turns sharing emotional experiences while their facial expressions were recorded. They then watched the recordings while continuously rating their own and their partner's affect at any given point during the recording. Empathic accuracy was indexed as the epoch by-epoch emotion change detection. We found that emotional expressivity of the listener, but not of the partner, was associated with increased empathic accuracy, even when controlling for partner's expressivity. Our findings highlight the active role the person empathizing takes in face-to-face emotional sharing.

Exploring Actual and Presumed Links between Accurately Inferring Contents of Other People's Minds and Prosocial Outcomes.

The term "empathic accuracy" has been applied to people's ability to infer the contents of other people's minds-that is, other people's varying feelings and/or thoughts over the course of a social interaction. However, despite the ease of intuitively linking this skill to competence in helping professions such as counseling, the "empathic" prefix in its name may have contributed to overestimating its association with prosocial traits and behaviors. Accuracy in reading others' thoughts and feelings, like many other skills, can be used toward prosocial-but also malevolent or morally neutral-ends. Prosocial intentions can direct attention towards other people's thoughts and feelings, which may, in turn, increase accuracy in inferring those thoughts and feelings, but attention to others' thoughts and feelings does not necessarily heighten prosocial intentions, let alone outcomes.

Empathic Accuracy Task: Indian Adaptation and Validation.

Background: The Empathic Accuracy Task (EAT) is an objective measure to assess empathic accuracy. Due to the variability in the number and linked emotions of the narrated events, we adapted EAT for the Indian sociocultural setting as Indian EAT (I-EAT). Methods: Eight videos were adapted in three languages (English, Hindi, and Kannada), narrating emotional events with a uniform representation of age groups, different emotions, and sex. The adapted I-EAT was then validated by cross-sectional comparison with different tests similar to EAT and those that assessed concepts different from or similar to empathy, in 29 healthy young adults, 23 healthy older adults (aged ≥60 years) along with clinical groups of 15 young people with depression, 15 older people with depression, and 15 young people with schizophrenia. Results: We selected eight videos with good content validity and internal consistency (Cronbach's alpha = 0.73. We obtained satisfactory concurrent validity of the EAT scores with the self-reported empathic assessments using the Questionnaire of Cognitive and Affective Empathy (Cognitive empathy score = 0.29, p = .034; Total score = 0.29, p = .035) and Interpersonal Reactivity Index (Empathic concern score = 0.45, p = .001). Good divergent validity was revealed in the high inverse correlation recorded with the Apathy Evaluation Scale ( = -0.67, p < .001). I-EAT did not correlate significantly with measures of social cognition. Known-groups validity was adequate in young adults with the significantly lower EAT scores (Cohen's d: 0.77 to 1.15) in the Schizophrenia group and higher EAT-N scores (Cohen's d: 0.51) in the Depression group, compared to the Healthy group. The Healthy group of the geriatric population also achieved significantly higher EAT scores (Cohen's d: 0.71 to 0.85) than the Depression group. Conclusion: With a good validity and internal consistency, I-EAT can be used in the Indian population to assess empathic accuracy without compromising performance of the original EAT.

Effects of social presence on behavioral, neural, and physiological aspects of empathy for pain.

In mediated interactions (e.g. video calls), less information is available about the other. To investigate how this affects our empathy for one another, we conducted an electroencephalogram study, in which 30 human participants observed 1 of 5 targets undergoing painful electric stimulation, once in a direct interaction and once in a live, video-mediated interaction. We found that observers were as accurate in judging others' pain and showed as much affective empathy via video as in a direct encounter. While mu suppression, a common neural marker of empathy, was not sensitive to others' pain, theta responses to others' pain as well as skin conductance coupling between participants were reduced in the video-mediated condition. We conclude that physical proximity with its rich social cues is important for nuanced physiological resonance with the other's experience. More studies are warranted to confirm these results and to understand their behavioral significance for remote social interactions.

Emotion recognition accuracy only weakly predicts empathic accuracy in a standard paradigm and in real life interactions.

The relationship between decoding ability (Emotion recognition accuracy, ERA) for negative and positive emotion expressions from only video, only audio and audio-video stimuli and the skill to understand peoples' unspoken thoughts and feelings (Empathic accuracy, EA) was tested. Participants (N = 101) from three groups (helping professionals with and without therapy training as well as non-helping professionals) saw or heard recordings of narrations of a negative event by four different persons. Based on either audio-video or audio-only recordings, the participants indicated for given time points what they thought the narrator was feeling and thinking while speaking about the event. A Bayesian regression model regressing group and ERA scores on EA scores was showing weak support only for the EA scores for ratings of unspoken feelings from audio only recordings. In a subsample, the quality of self-experienced social interactions in everyday life was assessed with a diary. The analysis of ERA and EA scores in relation to diary scores did not indicate much correspondence. The results are discussed in terms of relations between skills in decoding emotions using different test paradigms and contextual factors.

Dentist Empathic Accuracy Is Associated With Patient-Reported Reassurance.

OBJECTIVES: The aim of this work was to determine dentists' ability to accurately estimate patients' anxiety level during dental treatment (ie, "empathic accuracy") and to determine the strength of the association between empathic accuracy and patient-reported reassurance. METHODS: A cross-sectional study was conducted amongst 177 adult patients who underwent different invasive dental procedures (ie, extractions or procedures requiring injections and drilling) performed by 10 different dentists from 3 dental offices in the Netherlands. Patients reported their anxiety level during treatment and the extent to which they felt reassured by the dentist using a visual analogue scale (VAS). Simultaneously, the dentists estimated patients' anxiety level. Empathic accuracy was calculated as an absolute difference between patient-reported anxiety (100-point VAS) and dentist estimation of anxiety (100-point VAS). RESULTS: Agreement between dentists' assessment of patients' anxiety and patient-reported anxiety proved good, intraclass correlation coefficient (177) = 0.63; 95% confidence interval [CI], 0.53-0.71. A small to medium-sized positive correlation, r (177) = 0.15; 95% CI, 0.00-0.29, was found between dentists' empathic accuracy and patient-reported reassurance. A negative correlation was found between empathic accuracy and patients' anxiety scores, r (177) = -0.23; 95% CI, -0.38 to -0.09. CONCLUSIONS: Given that greater empathic accuracy was associated with higher patient-reported reassurance during treatment, training young dental professionals in empathic accuracy might help patients feel reassured. Importantly, our results also suggest that with elevated levels of patient anxiety it is increasingly challenging for dentists to recognise this emotion, and thus support the patient in anoptimal manner.

Motivation and empathic accuracy during conflict interactions in couples: it's complicated!

The aim of this study was to broadly investigate the role of relationship-, self-, and partner-serving motivation in empathic accuracy in couples' conflict interactions. To this end, a laboratory study was set up in which couples (n = 172) participated in a conflict interaction task, followed immediately by a video-review task during which they reported their own feelings and thoughts and inferred those of their partner to assess empathic accuracy. We used both trait and state measures of relationship-, self-, and partner-serving motivation, and we experimentally induced these three categories of motivation. Relationship-serving state motivation predicted greater empathic accuracy. In contrast, experimentally induced partner-serving motivation resulted in less empathic accuracy for men. Self-serving motivation was not found to be associated with empathic accuracy, nor were any of the trait measures. These findings underscore the complexity of the association between motivation and empathic accuracy in partners' conflict interactions. Supplementary Information: The online version contains supplementary material available at 10.1007/s11031-022-09982-x.

Challenges of measuring empathic accuracy: A mentalizing versus experience-sharing paradigm.

Empathic accuracy, the ability to accurately infer the mental states of others, is essential to successful interpersonal relationships. Perceivers can interpret targets' emotional experiences by decoding facial and voice cues (mentalizing) or by using their own feelings as referents (experience-sharing). We examined the relative efficacy of these processes via a replication and extension of Zhou et al. (Psychol Sci., 28, 2017, 482) who found experience-sharing to be more successful but undervalued. Participants estimated targets' emotional ratings in response to positive, neutral and negative images in mentalizing or experience-sharing conditions. Our analysis of absolute magnitudes of error showed similar levels of accuracy across process conditions (a non-replication of Zhou et al.); however, our exploratory analysis of directional variation across valence using raw scores revealed a pattern of conservative estimates for affective stimuli, which was accentuated in the mentalizing condition. Thus, our exploratory analysis lends conceptual support to Zhou et al.'s finding that experience-sharing represents the more successful process, and we replicated their finding that it was nevertheless undervalued. Extending Zhou et al., we also found that empathic accuracy was predicted by individual differences in fiction-exposure. Future research may further examine the impact of individual differences and stimulus properties in the employment of empathic inferencing strategies.

Stress and Stress-Induced Glucocorticoids Facilitate Empathic Accuracy in Men but Have No Effects for Women.

Empathy, the ability to understand the feelings of other people, is critical for navigating our social world and maintaining social connections. Given that acute stress, and resulting increased glucocorticoids, triggers a shift in two large-scale brain networks, prioritizing salience over executive control, we predicted that acute psychosocial stress would facilitate empathic accuracy. We also investigated the moderating role of gender, given that men typically show a more robust glucocorticoid response to acute stress than women. As predicted, results from two independent experiments (N = 267 college-age participants; 2,256 observations) showed that acute psychosocial stress facilitated empathic accuracy for men, an effect related to their glucocorticoid response in the stress condition. Conversely, psychosocial stress had no effect on empathic accuracy for women, who also showed a smaller cortisol response to stress than men. Exploratory analyses further revealed that women taking oral contraceptives performed worse on the empathic-accuracy task than regularly cycling women. This research highlights the important, but complex, role of stress in cognitive empathy.

Eyes on you: Ensuring empathic accuracy or signalling empathy?

The eye region is thought to play an important role in the ability to accurately infer others' feelings, or empathic accuracy (EA), which is an important skill for social interaction. However, most past studies used static pictures, including only visual information, and knowledge about the contribution of the eye region to EA when visual information is presented together with verbal content is lacking. We therefore examined whether eye gazing contributes to EA during videos of emotional autobiographical stories including both visual and verbal content. One hundred seven perceivers watched videos of targets talking about positive and negative life events and continuously rated the targets' feelings during the videos. Simultaneously, perceivers' eyes were tracked. After each video, perceivers reported on their feelings and the extent to which they empathized with and took the perspective of the targets. In contrast to studies using static pictures, we found that gazing to the eyes of targets during the videos did not significantly contribute to EA. At the same time, results on the association between the amount of gaze towards the eye region of targets and perceivers' state and trait empathy ratings suggest that eye gazing might signal empathy and social engagement to others.

Impaired empathic accuracy following damage to the left hemisphere.

Failing to understand others accurately can be extremely costly. Unfortunately, events such as strokes can lead to a decline in emotional understanding. Such impairments have been documented in stroke patients and are widely hypothesized to be related to right-hemisphere lesions, as well as to the amygdala, and are thought to be driven in part by attentional biases, for example, less fixation on the eyes. Notably, most of the previous research relied on measurements of emotional understanding from simplified cues, such as facial expressions or prosody. We hypothesize that chronic damage to the left hemisphere could hinder empathic accuracy and emotion recognition in naturalistic social settings that require complex language comprehension, even after a patient regains core language capacities. To assess this notion, we use an empathic accuracy task and eye-tracking measurements with chronic stroke patients with either right (N = 13) or left (N = 11) hemispheric damage-together with aged-matched controls (N = 15)-to explore the patients' understanding of others' affect inferred from stimuli that separates audio and visual cues. While we find that patients with right-hemisphere lesions showed visual attention bias compared to the other two groups, we uncover a disadvantage for patients with left-hemisphere lesions in empathic accuracy, especially when only auditory cues are present. These results suggest that patients with left-hemisphere damage have long-lasting difficulties comprehending real-world complex emotional situations.

Social anxiety and behavioral assessments of social cognition: A systematic review.

BACKGROUND: Social anxiety is highly prevalent and has increased in young adults during the COVID-19 pandemic. Since social anxiety negatively impacts interpersonal functioning, identifying aspects of social cognition that may be impaired can increase our understanding of the development and maintenance of social anxiety disorder. However, to date, studies examining associations between social anxiety and social cognition have resulted in mixed findings. METHODS: The aim of this systematic review was to summarize the literature on the association between social anxiety and social cognition, while also considering several potential moderators and covariates that may influence findings. RESULTS: A systematic search identified 52 studies. Results showed mixed evidence for the association between social anxiety and lower-level social cognitive processes (emotion recognition and affect sharing) and a trend for a negative association with higher-level social cognitive processes (theory of mind and empathic accuracy). Most studies examining valence-specific effects found a significant negative association for positive and neutral stimuli. LIMITATIONS: Not all aspects of social cognition were included (e.g., attributional bias) and we focused on adults and not children, limiting the scope of the review. CONCLUSIONS: Future studies would benefit from the inclusion of relevant moderators and covariates, multiple well-validated measures within the same domain of social cognition, and assessments of interpersonal functioning outside of the laboratory. Additional research examining the moderating role of attention or interpretation biases on social cognitive performance, and the potential benefit of social cognitive skills training for social anxiety, could inform and improve existing cognitive behavioral interventions.

Childhood emotional neglect predicts empathic accuracy in social inclusion and exclusion contexts.

Previous studies have shown that individuals with a history of childhood emotional neglect show impaired empathy. However, accurately identifying emotions in others is an essential aspect of empathic functioning. The current study aimed to investigate the influence of childhood emotional neglect on empathic accuracy. A total of 92 participants were recruited from a local university. Forty-six participants were randomly assigned to the social exclusion context (SE), and the other 46 were assigned to the social inclusion context (SI). The Childhood Trauma Questionnaire was used to measure childhood emotional neglect. Participants observed real interpersonal communications in which their in-group members were either socially included or excluded and evaluated the extent of the emotion they felt for their in-group members. Results found participants empathized with a high level of positive emotion in the SI context (t = 8.13, p < .001) and negative emotion in the SE context (t = 10.76, p < .001) in general. Moreover, childhood emotional neglect decreased the empathic accuracy in both contexts (SI context: ß = -0.42, SE = 0.04, p = .004; SE context: ß = -0.38, SE = 0.04, p = .009). These results contribute to the current understanding of social functioning of childhood emotional neglect in specific contexts.

Mu rhythm suppression over sensorimotor regions is associated with greater empathic accuracy.

When people encounter others' emotions, they engage multiple brain systems, including parts of the sensorimotor cortex associated with motor simulation. Simulation-related brain activity is commonly described as a 'low-level' component of empathy and social cognition. It remains unclear whether and how sensorimotor simulation contributes to complex empathic judgments. Here, we combine a naturalistic social paradigm with a reliable index of sensorimotor cortex-based simulation: electroencephalography suppression of oscillatory activity in the mu frequency band. We recruited participants to watch naturalistic video clips of people ('targets') describing emotional life events. In two experiments, participants viewed these clips (i) with video and sound, (ii) with only video or (iii) with only sound and provided continuous ratings of how they believed the target felt. We operationalized 'empathic accuracy' as the correlation between participants' inferences and targets' self-report. In Experiment 1 (US sample), across all conditions, right-lateralized mu suppression tracked empathic accuracy. In Experiment 2 (Israeli sample), this replicated only when using individualized frequency-bands and only for the visual stimuli. Our results provide novel evidence that sensorimotor representations-as measured through mu suppression-play a role not only in low-level motor simulation, but also in higher-level inferences about others' emotions, especially when visual cues are crucial for accuracy.

Parents' Empathic Accuracy: Associations With Type 1 Diabetes Management and Familism.

OBJECTIVE: To (1) test associations between parents' empathic accuracy for their adolescents' positive and negative emotions and adolescents' physical and mental health (HbA1c, diabetes self-care, and depressive symptoms) in a predominantly Latinx sample of adolescents with type 1 diabetes and their parents, and (2) explore how familism values were associated with parent empathic accuracy and adolescent physical and mental health in this population. METHODS: Parents and adolescents engaged in a discussion about a topic of frequent conflict related to the adolescents' diabetes management. Parents and adolescents subsequently completed a video recall task in which they rated their own and their partner's emotions once per minute; parents' empathic accuracy was calculated from an average discrepancy between parent and adolescent ratings of the adolescent's emotions. Adolescents reported on their depressive symptoms and both parents and adolescents reported on adolescents' diabetes self-care and their own familism values; HbA1c was obtained from medical records. RESULTS: Results from structural equation modeling revealed that parents' empathic accuracy for adolescents' negative (but not positive) emotions was uniquely associated with adolescents' HbA1c, self-care, and depressive symptoms. There was limited evidence that familism was related to parent empathic accuracy or adolescent physical and mental health. CONCLUSIONS: Promoting parents' empathic accuracy for adolescents' negative emotions in the context of type 1 diabetes management may have important implications for adolescents' mental and physical health.