Cognitive and emotional empathy in individuals at clinical high risk of psychosis

Abstract

and emotional empathy in individuals at clinical high risk of psychosis. Background: Impairments of social cognition are considered core features of schizophrenia and are established predictors of social functioning. However, affective aspects of social cognition including empathy have far less been studied than its cognitive dimensions. The role of empathy in the development of schizophrenia remains largely elusive. Methods: Emotional and cognitive empathy were investigated in large sample of 120 individuals at Clinical High Risk of Psychosis (CHR-P) and compared with 50 patients with schizophrenia and 50 healthy controls. A behavioral empathy assessment, the Multifaceted Empathy Test, was implemented, and associations of empathy with cognition, social functioning, and symptoms were determined. Results: Our findings demonstrated significant reductions of emotional empathy in individuals at CHR-P, while cognitive empathy appeared intact. Only individuals with schizophrenia showed significantly reduced scores of cognitive empathy compared to healthy controls and individuals at CHR-P. Individuals at CHR-P were characterized by significantly lower scores of emotional empathy and unspecific arousal for both positive and negative affective valences compared to matched healthy controls and patients with schizophrenia. Results also indicated a correlation of lower scores of emotional empathy and arousal with higher scores of prodromal symptoms. Conclusion: Findings suggest that the tendency to 'feel with' an interaction partner is reduced in individuals at CHR-P. Altered emotional reactivity may represent an additional, early vulnerability marker, even if cognitive mentalizing is grossly unimpaired in the prodromal stage. Different mechanisms might contribute to reductions of cognitive and emotional empathy in different stages of non-affective psychotic disorders and should be further explored.

Empathy and Theory of Mind in Ultra-High Risk for Psychosis: Relations With Schizotypy and Executive Function

“…The empathic concern subscale, but not the cognitive empathy subscale, of IRI was found to be compromised in UHR individuals. These results are consistent with the findings of a behaviorally-assessed empathy study which showed that, while emotional empathy in UHR individuals who later developed overt psychosis was poorer compared to HC, cognitive empathy was relatively preserved [ 18 ]. Regarding the emotional components of empathic tendency, the impairment of empathic concern in individuals at UHR for psychosis is consistent with our previous finding of reduced current pleasurable response to emotional stimuli in a laboratory setting in UHR individuals [ 50 ].…”

“…Our findings are consistent with a previous study on behaviorally assessed empathy of UHR individuals who later developed overt psychosis; in that study, it was shown that decreased emotional empathy was related to negative symptoms. 18 In addition, this finding is consistent with previous studies that showed a negative correlation between emotional empathy and negative schizotypy in schizophrenic patients 55 and non-clinical participants. 27,56,57 Since social anhedonia, which is a negative schizotypy, is defined as a decrease in pleasure derived from interpersonal sources, decreased empathic concern in UHR individuals may reflect indifference and lower emotional reactivity to other people's experiences.…”

“…These results are consistent with the findings of a behaviorally-assessed empathy study which showed that, while emotional empathy in UHR individuals who later developed overt psychosis was poorer compared to HC, cognitive empathy was relatively preserved. 18 Regarding the emotional components of empathic tendency, the impairment of empathic concern in individuals at UHR for psychosis is consistent with our previous finding of reduced current pleasurable response to emotional stimuli in a laboratory setting in UHR individuals. 50 The finding of reduced empathic concern without an increase in personal distress in UHR individuals is inconsistent with previous IRI findings in patients with first-episode schizophrenia that showed intact empathic concern and increased personal distress.…”

“…12 However, little is known about self-reported empathy in UHR individuals. One study 18 on behavioral assessments of empathic tendencies in individuals at UHR for psychosis showed that subjects who later developed overt psychosis were characterized by lower scores in emotional empathy but not in cognitive empathy.…”

Empathic Tendency and Theory of Mind Skills in Young Individuals with Schizophrenia: Its’ Associations with Self-Reported Schizotypy and Executive Function

“…더욱이 공감경향과 마음이론 결핍은 조현병의 일차 친족 12,13) 및 조현형인격장애(schizotypal personality disorder) 환자, 14,15) 그리고 정신증고위험군(ultra-high risk for psychosis) 12,16) 에서도 관찰되기에 사회인지 손상은 조현병의 내 적표현형(endophenotype)일 수 있으며, 17) 대인관계 등 사회기 능의 결정 인자로 제시된다. [18][19][20][21] 따라서 공감경향 및 마음이론 결핍은 조현병의 핵심 손상이다.…”