Costly altruism benefitting a stranger is a rare but evolutionarily conserved phenomenon. This behaviour may be supported by limbic and midbrain circuitry that supports mammalian caregiving. In rodents, reciprocal connections between the amygdala and the midbrain periaqueductal grey (PAG) are critical for generating protective responses toward vulnerable and distressed offspring. We used functional and structural magnetic resonance imaging to explore whether these regions play a role in supporting costly altruism in humans. We recruited a rare population of altruists, all of whom had donated a kidney to a stranger, and measured activity and functional connectivity of the amygdala and PAG as altruists and matched controls responded to care-eliciting scenarios. When these scenarios were coupled with pre-attentive distress cues, altruists' sympathy corresponded to greater activity in the left amygdala and PAG, and functional connectivity analyses revealed increased coupling between these regions in altruists during this epoch. We also found that altruists exhibited greater fractional anisotropy within the left amygdala-PAG white matter tract. These results, coupled with previous evidence of altruists' increased amygdala-linked sensitivity to distress, are consistent with costly altruism resulting from enhanced care-oriented responses to vulnerability and distress that are supported by recruitment of circuitry that supports mammalian parental care.

These results expand the literature on cognitive factors and glycemic control among patients with T1D. Factors like delay discounting represent potentially modifiable risk factors targetable through interventions.

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This multicomponent, web-delivered intervention provided unique benefits for improving SMBG and lowering HbA1c in teens with higher problems in emotional control.

The regulation of emotion evoked in response to another's distress may be important for biasing an individual toward a concerned response rather than personal distress. But, another threat to a prosocial response is regulation of empathic affect resulting in apathy. The role of empathic emotion regulation in promoting prosocial motivation and costly donation behavior was tested across two studies, first in a community sample and then in a sample of altruistic kidney donors and matched controls. Participants engaged in hopeful and distancing reappraisals while viewing photos of others in distress, then decided how much money to donate to help.While hope was expected to evoke an approach motivation indexed by increased donations, distance was expected to evoke an avoidance motivation indexed by decreased donations. It was hypothesized that varying effects of the two reappraisals on positive and negative affect would influence donation decisions. Across both studies, both reappraisals decreased negative affect and the hopeful reappraisal additionally increased positive affect. While instructed reappraisal was found to affect donation behavior in the community sample, in which a hopeful reappraisal resulted in higher donations than a distancing reappraisal, effects of reappraisal in altruists and controls were limited with regard to donation outcomes, suggesting that altruists and controls may instead differ in interacting effects of negative and positive affect on donation behavior across conditions. Keywords: empathy, altruism, emotion regulationPrior research has highlighted that emotional processes can be automatically evoked in response to distressed and vulnerable others, particularly in highly altruistic individuals (Marsh et al., 2014;Brethel-Haurwitz et al., 2017;Brethel-Haurwitz et al., 2018). As reviewed by Vaish (2016), it is thought that our concerned responses to others are a result of not only these seemingly bottom-up emotional responses, but also top-down cognitive processes that can modulate the behavioral effect of such emotional responses, resulting in a "multidetermined concern." The influence of modulatory processes on emotions evoked in response to another's distress, particularly emotion regulatory processes, may be important for biasing an individual toward a concerned and compassionate response rather than personal distress (Batson et al., 1983;Batson et al., 1987;Eisenberg et al., 1989;Klimecki et al., 2014). However, another threat to a concerned prosocial response is regulation of empathic affect resulting in apathy (Cameron and Payne, 2011). The current studies thus sought to examine the role of emotion regulatory appraisals in promoting prosocial helping behavior, first in a proof of concept test of an empathic emotion regulation task and then in an extension of this concept to extraordinary altruists.Emotion regulation is the set of processes by which we can change the occurrence, strength, and duration of negative or positive emotional reactions (Gross, 2015). Specifically, i...