Empathy and Judging Other's Pain: An fMRI Study of Alexithymia

Abstract

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.

Recognition of Emotional Facial Expressions in Alexithymia

“…This pattern of results seems to confirm the existence of a difficulty in processing this type of emotions, in line with what has been previously demonstrated (Ihme et al, 2014;Parker et al, 1993;Parker et al, 2005;Prkachin et al, 2009). In this sense, Vanman, Dawson, and Brennan (1998) showed that the subjects with high levels of alexithymia valued negative images as less unpleasant than the subjects with low levels of alexithymia, or valued facial expressions of pain with lesser value than subjects with low levels of alexithymia (Moriguchi, Decety, Ohnishi, Maeda, Matsuda, & Komaki, 2007).…”

“…Our pattern of results represents a basis for explaining the difficulties of personal relationships for alexithymics, justified by the difficulty in perceiving negative emotions in others, leading to difficulties in handling these situations adaptively, and the consequences that may entail. These limited empathic skills with high levels of alexithymia have been highlighted in several studies (Bird, Silani, Brindley, White, Frith, & Singer, 2010;Grynberg, Luminet, Cornelius, Greg, & Berthoz, 2010;Moriguchi et al, 2007).…”

Autonomic and brain responses associated with empathy deficits in autism spectrum disorder

“…It is therefore not surprising that heightened SCR to others’ pain were accompanied by increased neural activations in the AIC in ASD in our study. Previous findings regarding AIC involvement in empathic processing in individuals with ASD and/or alexithymia (a condition characterized by deficits in emotional awareness that is highly comorbid with ASD) are scarce and mixed, with some demonstrating AIC hypoactivation (Fan, et al, 2014), while others demonstrate hyperactivation (Bird, et al, 2010; Moriguchi, et al, 2007). We suppose that the differences in findings are due to methodological (e.g.…”

“…Empathy, the ability to vicariously share feelings of others, is an important social-emotional faculty (Gu, et al, 2010; Moriguchi, et al, 2007) and is compromised in individuals with ASD (Baron-Cohen and Wheelwright, 2004). Empathy is considered a multi-facet construct, including at least emotional contagion and arousal and cognitive perspective-taking (de Waal, 2008).…”

High testosterone levels and sensitivity to acute stress in perpetrators of domestic violence with low cognitive flexibility and impairments in their emotional decoding process: A preliminary study

“…As shown in several neuropsychiatric disorders such as alexithymia, schizophrenia, and Asperger syndrome, deficits in cognitive empathy and/or ToM may be related to greater difficulties in dealing with emotional and negative interpersonal situations. For this reason, IPV perpetrators may experience higher levels of personal distress because they may misunderstand how they are evaluated by others (Moriguchi et al, 2007;Rogers, Dziobek, Hassenstab, Wolf, & Convit, 2007;Smith et al, 2012). Psychopathic traits are positively related to perspectivetaking or ToM; and inversely related to affective empathy (Mullins-Nelson, Salekin, & Leistico, 2006).…”