Empathy, compassion, and theory of mind in obsessive‐compulsive disorder

Abstract

Objectives. Individuals with obsessive-compulsive disorder (OCD) often suffer from impairments in social functioning. This study investigates differences in empathy, compassion, and Theory of Mind (ToM) in individuals with OCD as a possible cause for social functioning deficits.Design. Sixty-four individuals diagnosed with OCD and 62 healthy individuals completed a naturalistic behavioural task (EmpaToM) and a self-report measure (Interpersonal Reactivity Index, IRI). Methods. Three preregistered repeated measures analyses of variance (ANOVAs).Results. People with OCD exhibited higher empathy levelsnamely increased sharing of others' sufferingin the EmpaToM task and reported more distress (IRI) compared with healthy individuals. Furthermore, no differences in compassion (EmpaToM) between both groups emerged, although people with OCD reported more concern for others (IRI) compared with healthy individuals. Concerning the ToM, no group differences were detected, neither in the behavioural task, nor self-report. Conclusion.By investigating OCD with diverse scientific practices we shed light on the higher levels of empathy exhibited by individuals with OCD, which are relevant for clinical practice and our understanding of OCD symptomatology. Practitioner Points• People with obsessive-compulsive disorder show higher levels of empathy, that is the increased sharing of others' suffering, compared with healthy individuals in both a traditional self-report and a naturalistic task.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

A Meta-Analysis of the Relationship Between Emotion Regulation and Social Affect and Cognition

“…The lack of differences for the other facets of social affect and cognition might be a result of every disorder having its own specific social affect and cognition pattern. For example, aggressive offenders exhibit higher cognitive empathy and lower affective empathy (Winter et al, 2017), whereas people with depression or obsessive-compulsive disorder exhibit higher affective empathy (O’Connor et al, 2002; Salazar Kämpf et al, 2022) compared with nonclinical samples. Another suggestion by McRae and Gross (2020) is that people with mental disorders might use adaptive emotion regulation successfully when cued in the laboratory; however, they do not use it frequently in their everyday lives, which is in line with the idea that they might have difficulties fitting a strategy to a situation (Haines et al, 2016).…”

“…Furthermore, studies using the Coping Orientations to the Problems Experienced (COPE) Inventory (Carver, 1997) indicate that avoidant thought and action tendencies are associated with depression, anxiety, and stress (Mahmoud et al, 2012) as well as limited physical functioning in people with medical conditions (Eisenberg et al, 2012). Moreover, differences in social affect and cognition have been found in clinical samples, resulting in typical social affect and cognition patterns: For instance, impaired cognitive empathy has been identified as a key symptom in patients with eating disorders (Mansour et al, 2016), impaired (affective) empathy has been associated with obsessive-compulsive disorder ( Jansen et al, 2020;Salazar Kämpf et al, 2022) and schizophrenia (Bonfils et al, 2017;Green et al, 2015). Schreiter et al (2013) reported a positive association between empathic distress (i.e., shared pain) and depressive symptoms.…”

“…Moreover, differences in social affect and cognition have been found in clinical samples, resulting in typical social affect and cognition patterns: For instance, impaired cognitive empathy has been identified as a key symptom in patients with eating disorders (Mansour et al, 2016), impaired (affective) empathy has been associated with obsessive-compulsive disorder (Jansen et al, 2020; Salazar Kämpf et al, 2022) and schizophrenia (Bonfils et al, 2017; Green et al, 2015). Schreiter et al (2013) reported a positive association between empathic distress (i.e., shared pain) and depressive symptoms.…”

Theory of mind during pregnancy and postpartum: A systematic review

“…16 This discrepancy between self-reported and experimental measures of ToM has also been presented by other studies. 32 For instance, studies have shown very small positive correlations between the IRI and ToM experimental approaches [32][33][34] or differences between groups restricted to one dimension of the cognitive empathy subscale of the IRI and experimental ToM measures. 33,34 This is in line with results of a recent meta-analysis indicating that self-report scores for cognitive empathy account for approximately 1% of the variance in behavioral cognitive empathy assessment.…”

“…32 For instance, studies have shown very small positive correlations between the IRI and ToM experimental approaches [32][33][34] or differences between groups restricted to one dimension of the cognitive empathy subscale of the IRI and experimental ToM measures. 33,34 This is in line with results of a recent meta-analysis indicating that self-report scores for cognitive empathy account for approximately 1% of the variance in behavioral cognitive empathy assessment. 35 The findings in this systematic review point to an increased ability of ToM in the peripartum period that is only detected by means of experimental ToM tasks but is not perceived by parents themselves when assessed with selfreport measures.…”