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PubMed2006

Empathy and judging other's pain: an fMRI study of alexithymia.

Because awareness of emotional states in the self is a prerequisite to recognizing such states in others, alexithymia (ALEX), difficulty in identifying and expressing one's own emotional states, should involve impairment in empathy. Using functional magnetic resonance imaging (fMRI), we compared an ALEX group (n = 16) and a non-alexithymia (non-ALEX) group (n = 14) for their regional hemodynamic responses to the visual perception of pictures depicting human hands and feet in painful situations. Subjective pain ratings of the pictures and empathy-related psychological scores were also compared between the 2 groups. The ALEX group showed less cerebral activation in the left dorsolateral prefrontal cortex (DLPFC), the dorsal pons, the cerebellum, and the left caudal anterior cingulate cortex (ACC) within the pain matrix. The ALEX group showed greater activation in the right insula and inferior frontal gyrus. Furthermore, alexithymic participants scored lower on the pain ratings and on the scores related to mature empathy. In conclusion, the hypofunction in the DLPFC, brain stem, cerebellum, and ACC and the lower pain-rating and empathy-related scores in ALEX are related to cognitive impairments, particularly executive and regulatory aspects, of emotional processing and support the importance of self-awareness in empathy.

Adult↗

PubMedDate not supplied

Empathy training as the major thrust of a staff development program.

The purpose of the study was to develop a human-relations-modeled staff development program and obtain an objective measure of the level of empathy of registered nurses who practiced in an acute- and chronic-care hospital. The short-term human-relations-modeled staff development program was designed specifically to assist nurses who scored low in empathy to increase their abilities to perceive and respond with greater empathy. The study indicated that all nurses tested possessed an extremely low level of empathy, that the staff development program significantly raised their levels of empathy, but that more training was needed to enable all or the majority of subjects to reach at least the minimal facilitative level necessary to help another person successfully.

Adult↗

PubMed2003

Empathy and response to distress in children with Down syndrome.

BACKGROUND: Most studies of empathy have focused on young children, and those who are typically developing. Thus, we know little about the emergence and manifestation of empathy in non-normally developing children. METHOD: Empathy and response to distress in others were examined in 30 children with Down syndrome, 22 children with nonspecific etiologies of mental retardation, and 22 typically developing children. RESULTS: Results indicated that compared to the other children, children with Down syndrome responded to distress in others by looking to them more, and offering more comfort in the form of prosocial responses. However, in a hypothetical empathy situation, children with Down syndrome were less likely to feel the same emotion as the protagonist than were the typical children. Children with Down syndrome differed from the children with nonspecific mental retardation only in their response to distress in others. The children with nonspecific mental retardation were more similar to than different from the MA-matched typical children. CONCLUSIONS: These results suggest some etiology-associated differences in empathy and response to distress in children with mental retardation.

Analysis of Variance↗

PubMed1995

Sibling empathy and behavioural adjustment of children with chronic illness.

This study investigated the relationship of healthy siblings' empathy to the psychosocial adjustment of children with a congenital heart disease (CHD) in 28 sibling dyads aged 3.5-11 years, as well as the perceived quality of sibling interactions, reported by mothers and children with illness. As in previous studies, children with CHD were reported to have more behaviour problems in the clinical range than either siblings or normative populations. On the basis of a task unconnected with illness issues, siblings were assigned to a high or low empathy group. Children with illness, but not their mothers, saw the siblings with high empathy more positively than those with low empathy. However, the adjustment of the children with illness did not differ between high and low empathy groups. Findings suggest the need to seek children's points of view when studying psychosocial effects of paediatric conditions.

Adaptation, Psychological↗

PubMed1996

A phenomenological study of the nature of empathy.

The purpose of this study was to gain an understanding of the nature of empathy, as perceived and experienced by registered nurses. A phenomenological approach was selected, with nine experienced staff nurses working in surgical settings being interviewed using an open, unstructured approach. Empathy was evidently felt to be beneficial, displayed both nonverbally and through the nurse's actions, and therefore the ability to empathize, and to feel empathy with the individual patient, needs supporting and promoting in nurses. The importance of learning from experience (both personal and professional), and the ability to communicate effectively, are both highlighted by this study. The nature of empathy is evidently multi-faceted, and the presence of empathy is influenced by a complex relationship between the individual nurse, patient and the environment. It should be recognized that environmental issues, such as high workload and stress, also affect ability to empathize.

Attitude of Health Personnel↗

PubMed1994

The influence of clients' perceptions of the helping relationship in the development of an empathy scale.

The paper includes a discussion about the origins of items on a measure of cognitive-behavioural empathy. This scale was originally produced by the author as a teaching tool for an empathy education programme (for RNs) and subsequently developed into a quantitative measure of empathy. The instrument is being used as part of a triangulated approach for data collection on research into the effectiveness of an educational programme about registered nurses' empathy. Antecedents of the initial item pool for the scale stem from theoretical views about empathy, the professional experience of others, and the researcher's experience with clients. While this scale has undergone some investigation for reliability and validity, this work will only be summarized briefly. The major focus for the paper is clients' reports of interpersonal conditions which they perceive as being helpful, or unhelpful, in respect of building therapeutic nurse-client relationships.

Attitude to Health↗

PubMed1987

Distress and empathy: two qualitatively distinct vicarious emotions with different motivational consequences.

The construct of empathy may be located conceptually at several different points in the network of interpersonal cognition and emotion. We discuss one specific form of emotional empathy--other-focused feelings evoked by perceiving another person in need. First, evidence is reviewed suggesting that there are at least two distinct types of congruent emotional responses to perceiving another in need: feelings of personal distress (e.g., alarmed, upset, worried, disturbed, distressed, troubled, etc.) and feelings of empathy (e.g., sympathetic, moved, compassionate, tender, warm, softhearted, etc.). Next, evidence is reviewed suggesting that these two emotional responses have different motivational consequences. Personal distress seems to evoke egoistic motivation to reduce one's own aversive arousal, as a traditional Hullian tension-reduction model would propose. Empathy does not. The motivation evoked by empathy may instead be altruistic, for the ultimate goal seems to be reduction of the other's need, not reduction of one's own aversive arousal. Overall, the recent empirical evidence appears to support the more differentiated view of emotion and motivation proposed long ago by McDougall, not the unitary view proposed by Hull and his followers.

Affective Symptoms↗

PubMed2005

Relationship between increased personal well-being and enhanced empathy among internal medicine residents.

BACKGROUND: While resident distress and its potential to negatively effect patient care have been well documented, little is known bout resident well-being or its potential to enhance care. OBJECTIVE: We measured resident well-being and explored its relationship with empathy. DESIGN: Anonymous, cross-sectional survey. PARTICIPANTS: Internal medicine residents at Mayo Clinic Rochester (n=165, summer 2003). MEASUREMENTS: Well-being was measured using the previously validated Medical Outcomes Study 8-item Short Form (SF-8). Empathy was measured using the previously validated Perspective Taking (PT) and Empathetic Concerns (EC) Sub-scales of the Interpersonal Reactivity Index (IRI). RESULTS: Eighty-three (50%) residents responded to the survey. Mean scores for well-being as measured by the SF-8 were comparable to the general population, and empathy scores on the IRI were similar to other resident samples. Resident empathy on both the cognitive (PT) and emotive (EC) sub-scales of the IRI was higher for residents with higher mental well-being on the SF-8; however, this difference was statistically significant only for the cognitive sub-scale. The importance of a number of personal wellness promotion strategies differed for residents with higher mental well-being on the SF-8. CONCLUSIONS: High mental well-being was associated with enhanced resident empathy in this cross-sectional survey. Future studies need to explore the potential for high resident well-being to enhance medical care and competency in addition to exploring the negative consequences of resident distress. Studies investigating how to promote resident well-being are needed.

Adult↗

PubMed2000

Empathy in families of women with borderline personality disorder, anorexia nervosa, and a control group.

This is a study of empathy in the families of 27 women with borderline personality disorder (BPD), 28 women with restricting anorexia nervosa (AN), and 27 women without a clinical diagnosis (NC). The daughters and both parents responded to the Interpersonal Reactivity Index (IRI), an instrument for assessing four dimensions of empathy. In addition, they were personally interviewed, with the Family Interview for Protectiveness and Empathy (FIPE), about the extent of empathy expressed by the parents to their daughter during her development. On the IRI, women with BPD scored highest on the immature and lowest on the mature aspects of empathy, whereas scores of AN and NC women were all within normal limits. Parents of BPDs had the lowest IRI scores, while parents of AN and NC groups were similar to each other and to criterion group scores. IRI scores of AN daughters were positively correlated with their parents' scores whereas BPDs' scores were negatively correlated with those of their parents. There were no correlations between the IRI scores of NC subjects and their parents. On the FIPE, borderline daughters and parents agreed about the relative absence of empathic parenting, whereas AN and NC daughters and parents agreed as to the presence of empathic parenting. The theoretical and clinical implications of these contrasting findings are discussed.

Adolescent↗

PubMed2002

Assessing victim empathy in sexual offenders using the victim letter task.

In attempting to enhance victim empathy, it is common to have sexual offenders write an apology letter to their victim. This task is thought to reveal the level of empathy that the sexual offender has for his victim. However, until now there has been no reliable method for judging the quality of empathy revealed in the victim letter. This paper reports the development and evaluation of 2 templates to score letters written to child victims and adult victims, respectively. An acceptable level of interrater reliability was obtained for the templates. Deficits revealed by the templates did not correlate with scores on a generic empathy measure but did correlate with scales measuring minimization and denial. The measures were also sensitive to change following empathy training.

Adult↗

PubMed2003

Trait empathy and criminal versatility in sexual offenders.

Associations between trait empathy and criminal versatility were examined in a sample of 88 incarcerated adult sexual offenders (29 extrafamilial child molesters, 26 intrafamilial child molesters, and 33 rapists). Considerable criminal versatility was observed, with 60% of the whole sample and 88% of recidivist offenders having previous convictions for nonsexual offenses. Regression analyses showed significant associations between trait empathy and nonsexual offense convictions, but not between trait empathy and sexual offense convictions. More specifically, greater involvement in violent offending (e.g., assault, robbery) was associated with lower levels of empathic concern and higher levels of fantasy. Greater involvement in miscellaneous (e.g., traffic, drug, public order) offending was associated with lower levels of empathic concern. We argue that insufficient theoretical and empirical attention has historically been given to criminal versatility among sexual offenders, especially among child molesters. In particular, we suggest that developments in empathy training for sexual offenders may benefit from distinguishing needs of criminally versatile and non-versatile sexual offenders. More knowledge about trait empathy in sexual offenders, and about situational factors that may override otherwise normal empathic responsiveness, is needed.

Adult↗

PubMed2004

The functional architecture of human empathy.

Empathy accounts for the naturally occurring subjective experience of similarity between the feelings expressed by self and others without loosing sight of whose feelings belong to whom. Empathy involves not only the affective experience of the other person's actual or inferred emotional state but also some minimal recognition and understanding of another's emotional state. In light of multiple levels of analysis ranging from developmental psychology, social psychology, cognitive neuroscience, and clinical neuropsychology, this article proposes a model of empathy that involves parallel and distributed processing in a number of dissociable computational mechanisms. Shared neural representations, self-awareness, mental flexibility, and emotion regulation constitute the basic macrocomponents of empathy, which are underpinned by specific neural systems. This functional model may be used to make specific predictions about the various empathy deficits that can be encountered in different forms of social and neurological disorders.

Adaptation, Psychological↗

PubMed2003

Enhancing victim empathy for sex offenders.

Victim empathy is a widely used component of sex offender treatment throughout North America and Great Britain. Yet, it has been controversial over the past few years. One of the complications involves giving empathy a solid definition. Empathy was defined as the capacity to express compassion for victims. A multi-level system was developed to help specify the definition. The second issue concerns which methods to use in enhancing victim empathy. A variety of techniques are provided as specific ways in which clinicians can help enhance an offender's empathy level.

Cognition↗

PubMed1991

Empathy, others-concept, and prosocial orientation.

The relationship between 56 nursing students' empathy and their others-concept was investigated to establish ties to a broader construct, prosocial orientation. The female Caucasian nursing students were rated for empathy by two clinical instructors. They were also given the Paired Hands Test to assess their others-concept. The students with the higher empathy ratings had more positive others-concepts. The responses of the low empathy group to the Paired Hands Test indicated a much stronger tendency to perceive and interpret social interactions negatively. Besides practical implications for nurses and other helping professionals, these findings have theoretical ramifications as well. Others-concept has been shown previously to be related to a cluster of variables such as positive social behavior and moral judgment. Evidence of the relationship to empathy helps to tie this cluster to the prosocial orientation construct as a base for further research.

Adult↗

PubMed1993

A study with a follow-up of the effects of music education on holistic development of empathy.

Half of the 32 children, aged 6 yr. old, took part in the 12-hr. holistic empathy education program with music exercises over three months. Others were controls. Children were tested at a pretest, 3 months later at the posttet after the training, and follow-up test, 9 months after posttest. The Feshbach and Roe Empathy Slide Test, the Weir and Duveen Prosociability Rating Scale, and the Kalliopuska Prosociability Rating Scale for Teachers were used. Empathy and prosociability increased significantly from pretest to posttest after empathy education. As hypothesized, comparison of pretest and follow-up test results showed a significant increase in empathy for the test group and a nonsignificant increase among controls.

Child↗

PubMed2000

Subtle sex bias in empathy and helping behavior.

The present study examined the influences on empathy and altruism of sex of participant, the affective demeanor (positive or negative) and cognitive processes (positive or negative) displayed by a female target in a video, and the perspective-taking focus of participants. The latter variable is related to the affective or cognitive response to the target's portrayal, or the response to technical aspects of the video (nonperspective-taking). Empathy was measured using Batson's Empathy Adjectives (1987) and altruism was measured by participants' written responses, which indicated how many hours they were willing to volunteer to help persons similar to the target. An ethnically diverse sample of working adults (M age = 31.6 yr., SD = 8.2) participated. Analysis yielded a subtle difference between groups. Men reported feeling more empathy for a confused, unfocused, illogical woman target, whereas women felt more empathy for a focused, clear, logical woman target. Moreover, there was a significant relationship between sex and helping--men offered more help than women.

Adult↗

PubMed2000

Physician expression of empathy and positiveness to Hispanic and non-Hispanic white patients during medical encounters.

BACKGROUND: This study examined the extent to which physicians expressed empathy and positiveness to Hispanic and non-Hispanic white patients during primary care visits. METHODS: Twenty-seven family practice and internal medicine resident physicians at the University of New Mexico Health Sciences Center were audiotaped in 1995 with 427 adult patients who were fluent in English or Spanish. The tapes were reviewed and organized to measure how frequently physicians expressed empathy and positiveness to patients. RESULTS: Physicians expressed empathy at equal rates to Hispanic and non-Hispanic white patients. When examining only Hispanic patients, physicians were significantly more likely to express empathy to patients who they knew better. Physicians expressed positiveness to non-Hispanic white patients more often than to Hispanic patients. When examining only Hispanic patients, physicians were more likely to express positiveness to patients who they knew better, who rated their health better, and who were more educated. When examining only non-Hispanic white patients, physicians were more likely to express positiveness to older and male patients than to younger and female patients. Also, female and younger physicians were significantly more likely to express positiveness to non-Hispanic white patients than male and older physicians were. CONCLUSIONS: Our findings illustrate that the resident physicians expressed empathy equally well to Hispanic and non-Hispanic white patients but that resident physicians need further training on how to express positiveness to patients from different ethnic backgrounds, especially Hispanic patients.

Adult↗

PubMed2001

[Studies on empathy in doctors and medical students].

Empathy is an expected attribute improving doctor-patient relationship. It also helps to understand psychological problems of patients. This paper describes a research study on empathy in physicians of different specializations. The study population included paediatricians, psychiatrists, oncologists, gynaecologists, internists, residents of family medicine and final-year-medical students. In order to evaluate empathic abilities in doctors and students two questionnaires were applied. Both estimate the level of emotional and cognitive empathy. Results indicated the highest empathic abilities in future family physicians, especially in its emotional aspect. Comparing them to internists and gynaecologists, the difference is of statistical significance. The highest level of cognitive empathy characterizes in order: paediatricians, psychiatrists and family doctors. Comparing to other specializations, internal medicine doctors and gynaecologists proved to be physicians of the lowest cognitive empathy.

Empathy↗