Altered Cortico-Limbic Functional Connectivity During an Empathy Task in Subjects with Post-Traumatic Stress Disorder

Empathy is a multidimensional construct consisting of cognitive (inferring mental states) and emotional (empathic concern) components. Emotional empathy is severely impaired in individuals affected by Post-Traumatic Stress Disorder (PTSD). Here, we investigated the neural correlates of such an emotional empathy dysfunction to shed light on the neural circuitry responsible for the social and emotional dysfunction in PTSD. We asked a group of PTSD and a group of healthy controls to solve a Multifaceted Empathy Test, measuring both cognitive and emotional empathy, and investigated the functional connectivity of the cortical areas involved in solving the test. The results revealed that, in healthy individuals, increased neural activity in the frontal cortex modulates activity in the insula while subjects perform the emotional empathy task; whereas, in individuals affected by PTSD, increased activity in limbic regions such the insula and the amygdala modulates activity in the frontal cortex while performing the emotional empathy task. These findings suggest that the lack of cortical top-down control of the frontal cortex on the limbic system in PTSD during empathic processing may explain the emotional and social difficulties experienced by individuals suffering from PTSD.     

疼痛共情的神经机制

疼痛是一种多维度的体验。情感成分和感觉成分是疼痛体验的主要成分,二者有着不同的神经机制。疼痛共情是痛觉"共鸣"的情绪反应,其神经机制的研究也围绕疼痛的情感成分和感觉成分展开。疼痛共情的情感成分的相关脑区主要有前扣带皮层和脑岛等脑区,与自身疼痛时相比,它们的激活位点及所处的神经网络存在差异;疼痛共情的感觉成分主要与初级感觉皮层以及一些其它的躯体感觉皮层有关,对它们的激活情况的研究受技术手段和实验范式的影响较大。未来的研究应从技术手段、分析方法及实验操作上予以关注。     

Personal and parents’ life stories in patients with borderline personality disorder

Patients with borderline personality disorder (BPD) display disturbances in understanding self and others. We examined whether these disturbances extended to how patients described their personal and parents’ life stories and to measures of identity, alexithymia, empathy, and emotional intelligence. Thirty BPD patients and 30 matched control participants described personal and parents’ life stories and completed measures of identity disturbance, alexithymia, empathy, and emotional intelligence. Compared to the controls, patients with BPD described their personal and their parents’ life stories more negatively and with fewer themes of agency and communion fulfillment. Patients and controls showed equally complex reasoning about their personal life stories, but patients displayed less complexity and more self‐other confusion, when reasoning about their parents’ stories. Patients also differed from controls on identity disturbance, alexithymia, and empathy. The results suggest that patients’ storied understanding of themselves and others are disturbed and should be taken into account to better understand BPD.     

Hearing others’ pain: neural activity related to empathy

The human voice is one of the principal conveyers of social and affective communication. Recent neuroimaging studies have suggested that observing pain in others activates neural representations similar to those from the first-hand experience of pain; however, studies on pain expressions in the auditory channel are lacking. We conducted a functional magnetic resonance imaging study to examine brain responses to emotional exclamations of others’ pain. The control condition comprised positive (e.g., laughing) or negative (e.g., snoring) stimuli of the human voice that were not associated with pain and suffering. Compared to these control stimuli, pain-related exclamations elicited increased activation in the superior and middle temporal gyri, left insula, secondary somatosensory cortices, thalamus, and right cerebellum, as well as deactivation in the anterior cingulate cortex. The left anterior insular and thalamic activations correlated significantly with the Empathic Concern subscale of the Interpersonal Reactivity Index. Thus, the brain regions involved in hearing others’ pain are similar to those activated in the empathic processing of visual stimuli. Additionally, the findings emphasise the modulating role of interindividual differences in affective empathy.     

Empathie und Persönlichkeitsstörungen aus neurobiologischer Sicht

In contrast to the vague application of the term empathy in general usage, the neurobiological literature differentiates between cognitive empathy and emotional empathy. The former includes cognitive recognition of the mental state of someone else due to reflexive acquisition of perspectives and theory of mind functions, the latter includes the reflexive intuitive sympathy and sharing the emotions of others. Both independent from each other and interindividual differently expressed facets can be assigned to different brain networks which process these events. Early evolutionary processes of emotional empathy are already developed in infants by mirror image imitation of mimicry and gestures of the primary contact person. They involve premotor regions, areas of the sensomotor cortex, the inferior parietal lobule and the anterior insular regions. Phylogenetically younger processes of cognitive empathy are represented in particular in midline structures, such as the medial prefrontal cortex, superior temporal sulcus, posterior cingulum or precuneus as well as in the temporoparietal junction. They have their beginning in shared attention processes in early dyadic processes. Both facets of empathy are involved in moral decision-making processes. In this context, neurobiological studies show that psychopaths have undisturbed cognitive empathic capabilities and are principally able to recognize and apply moral values but confer little attentional importance to them when they compete with own targets. Individuals with borderline personality disorders in contrast to psychopaths show impairments in cognitive empathy. The deficits affect mentalization functions, which involve the understanding of the mental state of others and oneself and are also the starting point for many misunderstandings in an interpersonal context. Additionally, individuals with borderline personality disorder have a tendency to share emotions with other people. They therefore succeed in showing sympathy and compassion although associated with the danger of diffusion of self and third party borders.     

Social and emotional functioning following bilateral and unilateral neurosurgical prefrontal cortex lesions

Alterations in emotional and social functioning such as impaired ability to recognize emotions in others, a lack of empathy and poor insight have commonly been reported following prefrontal cortex damage. This study sought to investigate the subtleties of such difficulties in 34 individuals with discrete unilateral and bilateral neurosurgical lesions encroaching on the orbitofrontal, medial, and dorsolateral regions of the prefrontal cortex. A specifically devised self‐ and informant report measure, the social‐emotional questionnaire was used to examine five factors of functioning: emotion recognition; empathy; social conformity; antisocial behaviour; and sociability. There were some specific significant differences between the clinical and control groups' informant‐ratings in certain domains of social and emotional functioning. Individuals with damage involving the orbitofrontal region were reported to display elevated levels of antisocial behaviour. Individuals with bilateral orbitofrontal lesions were rated as showing significantly reduced social and emotional functioning in comparison with individuals with unilateral lesions and controls. In addition, individuals with bilateral lesions had significantly less insight overall regarding their social‐emotional abilities. The right unilateral lesion group showed significantly less insight into their abilities to recognize emotion in others in comparison with the left unilateral group. In conclusion, these results suggest that specific social‐emotional and insight deficits may form separate constellations of impairment. The findings also indicate that marked changes in social and emotional functioning are more likely following bilateral damage, and unilateral lesions do not inevitably lead to impairments.     

Effects of mineralocorticoid receptor blockade on empathy in patients with major depressive disorder

Background

The mineralocorticoid receptor (MR) is highly expressed in the hippocampus and prefrontal cortex and is involved in social cognition. We recently found that pharmacological stimulation of the MR enhances emotional empathy but does not affect cognitive empathy. In the current study, we examined whether blockade of the MR impairs empathy in patients with major depressive disorder (MDD) and healthy individuals.

Methods

In a placebo-controlled study, we randomized 28 patients with MDD without psychotropic medication and 43 healthy individuals to either placebo or 300 mg spironolactone, a MR antagonist. Subsequently, all participants underwent two tests of social cognition, the Multifaceted Empathy Test (MET) and the Movie for the Assessment of Social Cognition (MASC), measuring cognitive and emotional facets of empathy.

Results

In the MET, we found no significant main effect of treatment or main effect of group for cognitive empathy but a highly significant treatment by group interaction (p < 0.01). Patients had higher cognitive empathy scores compared to controls in the placebo condition but not after spironolactone. Furthermore, in the spironolactone condition reduced cognitive empathy was seen in MDD patients but not in controls. Emotional empathy was not affected by MR blockade. In the MASC, no effect of spironolactone could be revealed.

Conclusion

Depressed patients appear to exhibit greater cognitive empathy compared to healthy individuals. Blockade of MR reduced cognitive empathy in MDD patients to the level of healthy individuals. Future studies should further clarify the impact of MR functioning on different domains of social cognition in psychiatric patients.

     

Creation and Validation of an English-Language Version of the Multifaceted Empathy Test (MET)

The measurement of cognitive and emotional empathy, reflecting abilities to understand and to experience or ‘feel’ the emotional states of others, is important for many studies pertaining to clinical conditions as well as normative personality characteristics. The Multifaceted Empathy Test (MET) has been shown to be a useful and efficient instrument for indexing impaired empathy in different diagnostic groups, in particular due to its measurement of both cognitive and emotional components of empathy within the same task set. This makes the MET a valuable means for assessing empathy with implications for conditions such as autism and psychopathy. However, up to this point the MET has only been available in German, and has not been investigated in regard to specific facets of psychopathy. This report describes (a) the translation of the MET into English to allow its use in a wider range of populations, and (b) efforts undertaken to refine the measure itself and evaluate its relationship with distinct facets of psychopathy (i.e., boldness, meanness, disinhibition). As expected, MET emotional empathy showed its strongest association with the meanness component of psychopathy (r?=??.31, p?<?.01). The resulting instrument was then validated in a sample of 80 healthy control subjects, where it showed expected associations with other empathy measures and psychopathic tendencies. Findings also highlighted some issues pertaining to evaluation of scale reliability. Results from this study indicate that this translated version of the MET can serve as an effective tool for assessing emotional and cognitive empathy in English-speaking samples.     

记者痛感共情能力初步研究

本研究考察了记者人群与非记者人群对疼痛共情能力的差异,探讨职业训练对人类共情能力的影响。30名记者和30名非记者为本研究被试,分别给予疼痛图片或无疼痛图片后,要求被试对其进行疼痛评定。结果发现两组被试对无疼痛图片的痛感指数没有显著差异,但记者组的痛感指数明显高于非记者组,且疼感指数与记者的从业时间呈现显著的正相关性。这些结果表明记者人群在痛感共情能力上显著升高。进一步调查研究发现相对于非记者人群,记者在与人交往过程中更为在意他人,表明这可能是导致记者共情能力升高的原因之一。本研究运用实验研究的方法首次提供了记者共情能力升高的证据,并对影响因素进行了初步探讨,将有助于丰富本领域以及职业对人类共情能力影响机制的研究。     

Emotional processing in psychopathic personality

Emotional‐processing deficits may be one of the characteristic features of impaired affect in individuals with psychopathy. These include shallowness and profound lack of remorse or empathy. Performances on standardized emotion discrimination tasks and mood induction tasks were compared between 17 patients with antisocial personality disorder (DSM‐IV) and 17 nonpsychopaths. Subjects with psychopathic personality demonstrated poorer performance on emotion‐discrimination tasks compared with controls. However, higher scores on factor “emotional detachment” of the Psychopathy Checklist (PCL‐R) were associated with better discrimination ability. Subjective ratings were comparable between groups during mood induction. Although the findings support the hypothesis of a significant association between impaired emotional processing and psychopathy, they also suggest a relationship between emotional discrimination and the core personality features of psychopathy. Aggr. Behav. 28:394–400, 2002. © 2002 Wiley‐Liss, Inc.     

Cannot avert the eyes: reduced attentional blink toward others’ emotional expressions in empathic people

Empathy is one of the core components of social interaction. Although current models of empathy emphasize the role of attention, few studies have directly examined the relationship between attentional processes and individual differences in empathy. This study hypothesized that empathic people would process emotional expressions more efficiently and automatically compared to less empathic people. Crucially, such a processing advantage should be present only for faces of others compared to one’s own face. To test this hypothesis, 100 healthy participants varying in their self-reported empathy levels underwent an attentional blink task that tested preferential attentional processing. Results showed a diminished attentional blink effect for sad faces of others in the high-empathy group. Additionally, performance differences in the task were related to both trait empathy and daily prosocial behavior. Overall, our results show that emotional stimuli preferentially capture the attention of empathic people, leading to automatic processing.     

Cognitive empathy moderates the relationship between affective empathy and wellbeing in adolescents with autism spectrum disorder

Background: Individuals with autism spectrum disorder (ASD) reportedly have reduced cognitive empathy (CE), yet intact levels of affective empathy (AE) when compared to typically developing individuals. To date, no research has examined the implications of this empathic imbalance on personal wellbeing (PWB). Method: Twenty four high-functioning adolescents with ASD (M _age = 13.21, SD = 2.83, 14 males) and 24 non-clinical control adolescents (M _age = 13.10, SD = 2.73, 15 males) took part in the present study. CE and AE were measured using the interpersonal reactivity index, while PWB was assessed via the personal wellbeing index-school children. Results: Participants in the ASD group scored significantly lower than the control group on measures of CE and AE. Moderated regression analyses revealed that for the ASD group only, CE appeared to moderate the relationship between AE and PWB. Specifically, when CE was low, the relationship between AE and PWB was significant and negative. However, when CE was high, the relationship between AE and PWB was significant and positive. Conclusions: CE appears central to the PWB of those with ASD. Only when CE is high were participants able to experience the positive relationship between AE and PWB. Interventions that target the cognitive dimensions of empathy may improve PWB.     

Prior exposure to extreme pain alters neural response to pain in others

In the extant literature examining the brain mechanisms implicated in pain perception, researchers have theorized that the overlapping responses to pain in the self and in others mark the human capacity for empathy. Here we investigated how prior exposure to extreme pain affects pain perception, by assessing the dynamics of pain processing in veterans who were previously exposed to severe injury. Forty-three participants (28 pain-exposed and 15 controls) underwent whole-head magnetoencephalography (MEG) while viewing photographs of limbs in painful and nonpainful (neutral) conditions. Among controls, an early (0–220 ms) “pain effect” in the posterior cingulate and sensorimotor cortices, and a later (760–900 ms) “pain effect” in the posterior cingulate cortex, superior temporal gyrus/insula, and fusiform gyrus were found, indicated by enhanced alpha suppression to the pain versus nonpain conditions. Importantly, pain-exposed participants exhibited an atypical pain response in the posterior cingulate cortex, indicated by a normative response to pain, but no pain-to-no-pain differentiation. This may suggest that individuals exposed to extreme pain may perceive neutral stimuli as potentially threatening. Our findings demonstrate alterations in pain perception following extreme pain exposure, chart the sequence from automatic to evaluative pain processing, and emphasize the importance of considering past experiences in studying the neural response to others’ states.     

激活右腹外侧前额叶提高抑郁症患者对社会疼痛的情绪调节能力：一项TMS研究

负性人际交往经历和负性社会事件是抑郁症的重要诱导因素, 而社会功能受损是抑郁症患者的重要特征之一, 患者通常表现出对社会疼痛的情绪失调。为了提高抑郁症患者在负性社交情境中或面对负性社会事件时的情绪调节能力, 本研究采用经颅磁刺激技术(transcranial magnetic stimulation, TMS), 考察抑郁症患者在腹外侧前额叶(the ventrolateral prefrontal cortex, VLPFC)被激活后其情绪调节能力的改变。结果表明, 当右侧VLPFC被TMS激活且患者采用认知重评策略调节情绪时, 实验组患者(n = 64)比对照组患者(n = 63)在社会排斥情境下报告了更弱的负性情绪体验, 这说明激活右侧VLPFC可以有效提高患者对社会疼痛的外显性情绪调节能力。本研究是采用TMS提高抑郁症患者情绪调节能力的首次尝试, 实验发现不但支持了VLPFC与认知重评策略的因果关系, 还为临床改善抑郁症等社会功能障碍患者的情绪调节能力提供了明确的神经治疗靶点。后续研究还需探讨多疗程TMS刺激方案、改变社会疼痛的诱发方式、对比左右侧VLPFC的治疗效果、尝试使用其他的情绪调节策略, 进一步验证本研究的结论, 优化TMS治疗方案。     

Emotional Competence Disorders and Social Communication in Young Victims of Abuse

This research analyses the emotional competence difficulties (measured through emotional intelligence and empathy) and social communication disorders of young victims of abuse. These minors are in residential care centres with protective measures after suffering maltreatment and/or neglect. The relation between their emotional competence and social communication is analysed, as well as the contribution of empathy and emotional intelligence in predicting their social communication. The results indicate that a lack of emotional competence is related to and can predict their difficulties in social communication. The study manifests a scarcity of emotional intelligence, affecting attention, emotional repair and clarity of feelings, as well as a deterioration in affective and cognitive empathy. The minors’ scarce ability to put themselves in the place of others, to understand others’ intentions and emotional states, limits their use of language in social interactions. The research stresses the need to set up intervention programmes aimed at training in interpersonal and intrapersonal emotional competences which can encourage social communication.     

Frontal Lobe Function and Pain in the Elderly

We review the literature on pain and aging and conclude that evidence supports a hypothesis that right frontal cortex contributes to the mediation of the chronic pain experience in elderly persons with chronic pain syndromes. Evidence for the right frontal pain hypothesis comes from clinical, neurocognitive, and neuroimaging studies, which implicate right inferior and orbitofrontal cortex in (1) the persistent pain experience, (2) negative emotional states, (3) retrieval of negative emotional and autobiographical memories, (4) regulation of autonomic arousal, and (5) regulation of attentional and pain functions of the anterior cingulate region. Right frontal dysfunction is also implicated in the effects of cognitive aging. If right frontal neurocognitive systems are affected in cognitively impaired elderly, and if (by hypothesis) the right frontal cortex also plays a major role in the experience of chronic pain, then cognitively impaired elderly with right frontal dysfunction should be protected to some extent from persistent pain syndromes. Available evidence supports this proposition.     

睡眠不足对人际交互的影响及其认知神经机制

睡眠不足会对人的认知、情感和人际交互产生诸多影响。这种影响在社会情绪层面表现为个体情绪共情和认知共情的减少,易激惹性与愤怒情绪的增加;在社会行为层面则表现为亲社会行为的减少和攻击行为的增加。在睡眠不足状态下,情绪系统和认知系统功能连接的减弱可能是这些变化的潜在机制。未来应结合生态效度较高的睡眠操作手段,系统考察睡眠不足如何导致各种高级社会情绪的改变,以及这些社会情绪的变化如何导致社会行为的变化。     

The impact of empathy and reappraisal on emotional intensity recognition

Empathy represents a fundamental ability that allows for the creation and cultivation of social bonds. As part of the empathic process, individuals use their own emotional state to interpret the content and intensity of other people’s emotions. Therefore, the current study was designed to test two hypotheses: (1) empathy for the pain of another will result in biased emotional intensity judgment; and (2) changing one’s emotion via emotion regulation will modulate these biased judgments. To test these hypotheses, in experiment one we used a modified version of a well-known task that triggers an empathic reaction We found that empathy resulted in biased emotional intensity judgment. To the best of our knowledge, this is the first demonstration of a bias in the recognition of emotional facial expressions as a function of empathy for pain. In experiment two, we replicated these findings in an independent sample, and further found that this biased emotional intensity judgment can be moderated via reappraisal. Taken together, our findings suggest that the novel task used here can be employed to further explore the relation between emotion regulation and empathy.     

Does Empathy Have Any Place in Aquinas’s Account of Justice?

Recent developments in cognitive science have prompted philosophers to speculate about the importance of empathy, the ability to directly apprehend and take on the mental and emotional states of others, in understanding and being motivated by moral norms—particularly moral norms concerning other humans. In this paper, I investigate whether some kind of empathy is involved in Thomas Aquinas’s account of the virtue of justice, which he describes as essentially other-directed. I claim that a kind of empathy is involved in Aquinas’s notion of friendship and that this notion of friendship is related to justice as a virtue as its goal. Having the virtue of justice is geared towards establishing true friendship, at least in part. In so doing, it is directed towards establishing a sufficient groundwork for genuine empathy. Instances of genuine empathy, then, are approximations of this goal of the work of justice, even if they occur outside the context of a true friendship. Given this, I describe possible roles Aquinas might afford empathy and empathetic emotions in the context of cultivating the virtue of justice, including roles in motivation and knowledge.     

痛苦共情的功能性核磁共振成像研究述评

对他人痛苦的共情是指自动模拟受痛者的情感和运动状态,以及在自我-他人区分的基础上替代性地分享和理解他人由于受痛所引发的情绪状态.痛苦共情的fMRI研究常用图片诱导范式和线索诱导范式.痛苦共情的神经机制,包括(1)疼痛矩阵(该区域在个体自身受痛时也会激活)和(2)观点采择的相关脑区.痛苦共情的水平会受到实验范式和任务,以及共情者对于受痛者态度两方面因素的共同影响.加强应用研究和推出新型范式是痛苦共情研究的当务之急.