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Empathy impairments are considered a key aspect of autism-spectrum disorders (ASD). Previous research consistently shows reduced cognitive empathy, but findings on affective empathy vary, possibly due to experimental design variations (e.g., stimulus modality, social distance) and individual psychological factors (e.g., perceptual abilities, emotional reactivity). This study aims to clarify deficits in affective and cognitive empathy in ASD by addressing these contributing factors. Empathy was examined in 34 autistic individuals and 33 typically developed controls (TDCs) through the Textual Empathy Test (TET). The TET was developed to assess emotional responses when imagining oneself (emotional reactivity) as compared to a target person (friend, stranger) in emotional situations presented via short verbal descriptions. Participants rated emotional states of the target person (cognitive empathy) as well as their own emotional responses when imagining the target person in that situation (affective empathy). Ratings were interpreted relative to normative mean values through standardized regression coefficients. Results showed that high-functioning autism was associated with lower cognitive and affective empathy irrespective of social distance as well as with decreased emotional reactivity compared to controls. Moreover, emotional reactivity mediated the impact of ASD on both empathic components. In summary, altered emotional reactivity may underlie impaired empathy in autistic individuals.

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BACKGROUND: Individuals with Borderline Personality Disorder (BPD) are theorized to experience lower cognitive empathy but heightened affective empathy. Despite meta-analyses addressing cognitive empathy, affective empathy remains unexplored. This pre-registered systematic review and meta-analysis investigated affective empathy in individuals with BPD or high BPD traits relative to healthy comparisons, using a multidimensional approach including, early affective empathy, emotion contagion, and empathic concern. METHODS: Systematic search of SCOPUS, PubMed, Medline COMPLETE, and PsycINFO (June 27, 2022, May 14, 2023, and July 1, 2024) was completed. Included studies compared affective empathy in those with BPD/high BPD traits with healthy comparisons, utilized experimental or self-report designs, and were peer-reviewed or PhD theses. Risk of bias was assessed using the Newcastle-Ottawa Scale. RESULTS: Among 22 eligible studies identified, results revealed individuals with BPD/high BPD traits showed significantly higher emotion contagion (Npooled = 1797, g = -1.10, 95 % CI [-1.57, -0.62]). No significant differences were found in empathic concern (Npooled = 1545, g = 0.06, 95 % CI [-0.10, 0.22]), or early affective empathy for anger (Npooled = 245, g = 0.28, 95 % CI [-0.0.53, 1.09]) and happiness, (Npooled = 189, g = 0.34, 95 % CI [-0.1.50, 2.18]). LIMITATIONS: Few included studies for early affective empathy, methodological shortcomings in the broader literature and study heterogeneity suggest caution when interpreting these effects, emphasizing the need for targeted research. CONCLUSIONS: While individuals with BPD/high BPD traits are more likely to subjectively experience others' distress through emotion contagion, no differences were found in early affective empathy or ability to direct sympathy and concern towards others.

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This review examines the complex interactions between estrogen receptors α and ß (ERα and ERß) and arginine vasopressin (AVP), delving into their significant roles in modulating empathy, a critical psychological component in human social dynamics. Empathy, integrating affective and cognitive elements, is anchored in neural regions like the amygdala and prefrontal cortex. ERα and ERß, pivotal in estrogen regulation, influence neurotransmitter dynamics and neural network activities, crucial for empathic development. AVP, key in regulating water balance, blood pressure, and social behaviors, interplays with these receptors, profoundly impacting empathic responses. The study highlights that ERα predominantly enhances empathy, especially affective empathy, by stimulating AVP synthesis and release. In contrast, ERß may diminish empathy in certain contexts by suppressing AVP expression and activity. The intricate interplay, homeostatic balance, and mutual conversion between ERα and ERß in AVP regulation are identified as challenging yet crucial areas for future research. These findings provide essential insights into the neurobiological underpinnings of empathy, offering new avenues for therapeutic interventions in social cognitive disorders and emotional dysregulation.

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OBJECTIVES: Patients commonly experience anxiety when visiting a medical provider. While regulating its level, the physician may adjust their own prosodic behavior to express different levels of affective empathy and shape the emotional outcome. The primary aim was to examine the impact of convergence and divergence with the patient's prosodic emotional cues on the patient-perceived physician's affective empathy and the emotion regulation process. METHODS: Analog patients (n = 132) made assessments after the exposure to an audio vignette of a physician - patient conversation in the prosodic convergence or divergence condition. RESULTS: Convergence with the prosodic cues of anxiety was associated with the physician experiencing the same as or a similar emotional state to the patient. The former type of emotional reaction was related to lower odds of anxiety alleviation. Prosodic convergence had a negative effect on anxiety alleviation through the mediation of experiencing the same emotional state as the patient. CONCLUSIONS: Divergence from the prosodic cues of anxiety and, therefore, a low patient-perceived level of this emotion may facilitate the anxiety regulation process. PRACTICE IMPLICATIONS: A careful use of convergence and divergence with prosodic emotional cues and adequate control of prosody in general are strongly recommended for practitioners.

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Autism spectrum disorder (ASD) is strongly associated with socio-cognitive impairments that may result in vulnerability to other mental health conditions, particularly anxiety disorders. This study examined the relationship between anxiety disorders and two key socio-cognitive impairments (cognitive empathy, affective empathy) in 60 adolescents (aged 11-18 years) with and without ASD. Adolescents with ASD showed cognitive empathy was negatively associated with separation anxiety disorder, whereas positive associations between affective empathy and generalized anxiety disorder, and positive marginal associations between affective empathy, social phobia, total anxiety, and separation anxiety disorder were observed. These findings suggest that cognitive and affective empathy show different patterns of associations with anxiety-related issues in ASD, and these differences should be considered for interventions and treatment programs.

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BACKGROUND: Empathy refers to the cognitive and emotional reactions of an individual to the experiences of another. Women with premenstrual dysphoric disorder (PMDD) report severe social difficulties during the luteal phase of their menstrual cycle. AIMS: This clinical and functional magnetic resonance imaging study aimed to explore affective and cognitive empathy in women with PMDD, during the highly symptomatic luteal phase. METHOD: Overall, 32 women with PMDD and 20 healthy controls participated in the study. The neuroimaging data were collected using a highly empathy-engaging movie. First, we characterised the synchrony of neural responses within PMDD and healthy groups, using the inter-individual correlation approach. Next, using network cohesion analysis, we compared connectivity within and between brain networks associated with affective and cognitive empathy between groups, and assessed the association of these network patterns with empathic measures. RESULTS: A consistent, although complex, picture of empathy abnormalities was found. Patients with PMDD showed decreased neural synchrony in parietal and frontal key nodes of cognitive empathy processing (theory-of-mind network), but higher neural synchrony in the anterior insula and anterior cingulate cortex, a part of the salience network, implicated in affective empathy. Positive correlations between cognitive perspective-taking scores and neural synchrony were found within the theory-of-mind network. Interestingly, during highly emotional moments, the PMDD group showed increased functional connectivity within this network. CONCLUSIONS: Similar to major depression, individuals with PMDD show enhanced affective empathy and reduced cognitive empathy. These findings echo clinical observations reported when women with PMDD have a dysregulated emotional response to negative stimuli.

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Empathy, crucial for social interaction, is impaired across various neuropsychiatric conditions. However, the genetic and neural underpinnings of empathy variability remain elusive. By combining forward genetic mapping with transcriptome analysis, we discover that aryl hydrocarbon receptor nuclear translocator 2 (ARNT2) is a key driver modulating observational fear, a basic form of affective empathy. Disrupted ARNT2 expression in the anterior cingulate cortex (ACC) reduces affect sharing in mice. Specifically, selective ARNT2 ablation in somatostatin (SST)-expressing interneurons leads to decreased pyramidal cell excitability, increased spontaneous firing, aberrant Ca2+ dynamics, and disrupted theta oscillations in the ACC, resulting in reduced vicarious freezing. We further demonstrate that ARNT2-expressing SST interneurons govern affective state discrimination, uncovering a potential mechanism by which ARNT2 polymorphisms associate with emotion recognition in humans. Our findings advance our understanding of the molecular mechanism controlling empathic capacity and highlight the neural substrates underlying social affective dysfunctions in psychiatric disorders.

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BACKGROUND: Do autistic people share the same moral foundations as typical people? Here we built on two prominent theories in psychology, moral foundations theory and the empathizing-systemizing (E-S) theory, to observe the nature of morality in autistic people and systemizers. METHODS: In dataset 1, we measured five foundations of moral judgements (Care, Fairness, Loyalty, Authority, and Sanctity) measured by the Moral Foundations Questionnaire (MFQ) in autistic (n = 307) and typical people (n = 415) along with their scores on the Empathy Quotient (EQ) and Systemizing Quotient (SQ). In dataset 2, we measured these same five foundations along with E-S cognitive types (previously referred to as "brain types") in a large sample of typical people (N = 7595). RESULTS: Autistic people scored the same on Care (i.e., concern for others) as typical people (h1). Their affective empathy (but not their cognitive empathy) scores were positively correlated with Care. Autistic people were more likely to endorse Fairness (i.e., giving people what they are owed, and treating them with justice) over Care (h2). Their systemizing scores were positively correlated with Fairness. Autistic people or those with a systemizing cognitive profile had lower scores on binding foundations: Loyalty, Authority, and Sanctity (h3). Systemizing in typical people was positively correlated with Liberty (i.e., hypervigilance against oppression), which is a sixth moral foundation (h4). Although the majority of people in all five E-S cognitive types self-identified as liberal, with a skew towards empathizing (h5), the percentage of libertarians was highest in systemizing cognitive types (h6). E-S cognitive types accounted for 2 to 3 times more variance for Care than did sex. LIMITATIONS: Our study is limited by its reliance on self-report measures and a focus on moral judgements rather than behavior or decision-making. Further, only dataset 2 measured political identification, therefore we were unable to assess politics in autistic people. CONCLUSIONS: We conclude that some moral foundations in autistic people are similar to those in typical people (despite the difficulties in social interaction that are part of autism), and some are subtly different. These subtle differences vary depending on empathizing and systemizing cognitive types.

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Affective empathy enables social mammals to learn and transfer emotion to conspecifics, but an understanding of the neural circuitry and genetics underlying affective empathy is still very limited. Here, using the naive observational fear between cagemates as a paradigm similar to human affective empathy and chemo/optogenetic neuroactivity manipulation in mouse brain, we investigate the roles of multiple brain regions in mouse affective empathy. Remarkably, two neural circuits originating from the ventral hippocampus, previously unknown to function in empathy, are revealed to regulate naive observational fear. One is from ventral hippocampal pyramidal neurons to lateral septum GABAergic neurons, and the other is from ventral hippocampus pyramidal neurons to nucleus accumbens dopamine-receptor-expressing neurons. Furthermore, we identify the naive observational-fear-encoding neurons in the ventral hippocampus. Our findings highlight the potentially diverse regulatory pathways of empathy in social animals, shedding light on the mechanisms underlying empathy circuity and its disorders.

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BACKGROUND: This article reports the Polish adaptation of the Questionnaire to Assess Affective and Cognitive Empathy (QAACE) by Zoll and Enz - a multidimensional self-report questionnaire used to measure empathy in children aged 8-14. The QAACE is based on a two-factor cognitive-emotional model of empathy. It has a number of international adaptations and offers a convenient Polish-language tool for use with young children and adolescents. PARTICIPANTS AND PROCEDURE: The sample consisted of 677 children aged 8-13. The survey was conducted on school premises, during classes, by an appropriately prepared researcher. RESULTS: Confirmatory factor analysis revealed a good fitting measurement model representing the original underlying factor structure of the QAACE among Polish children. The reliability of the questionnaire as measured by Cronbach's α and McDonald's ω was good. The reliability of the scale as assessed by the test-retest method (after four weeks) was .80. We assessed the validity of the tool by analyzing the correlation of empathy with love and sadism. General empathy, as well as cognitive and affective empathy, is positively related to love. The hypothesis that sadism is significantly related to empathy was also partially confirmed. General empathy and affective empathy are negatively correlated with sadism, while there was no relationship between sadism and cognitive empathy. CONCLUSIONS: The questionnaire is the first widely available tool of this type to examine empathy and its components appropriate for children and adolescents in Poland. The questionnaire can be a useful screening test for detecting children's level of empathy.

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People consume alcohol for multiple reasons. Negative motives are often associated with alcohol-related problems. These problems might be explained by negative effects of high alcohol consumption on empathy. Past studies have associated alcohol use disorder (AUD) with reduced cognitive and affective empathy. Few studies have focused on non-clinical samples and considered behavioral empathy. We examined the links between alcohol consumption and multiple aspects of empathy, and if these links were moderated by negative drinking motives. We collected online data of 520 unselected individuals. All completed the AUD Identification Test (AUDIT) and a Drinking Motives Questionnaire. Affective and cognitive empathy were assessed using the Empathy Quotient. Behavioral empathy was assessed by asking participants how likely they would help the person in each of 24 scenarios involving pain. Helping others in pain was positively predicted by affective and cognitive empathy. Higher AUDIT scores were associated with helping others less, particularly among participants who scored higher on drinking to cope with negative affect. People who drink more and do so to cope with negative affect appear to have less behavioral empathy. This supports the view that negative drinking motives contribute to AUD risk.

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Introduction: While the relationship between narcissism and empathy has been well-researched, studies have paid less attention to empathic accuracy, i.e., appreciating the precise strength of another person's emotions, and self-other distinction, in terms of the disparity between affective ratings for self and other in response to emotive stimuli. Furthermore, empathic responses may vary depending on whether the pain is physical or social. Methods: We investigated empathic accuracy, affective empathy, and the distinction between pain, emotion and intensity ratings for self and other, in high (n = 44) and low (n = 43) narcissism groups (HNG and LNG, respectively) selected from 611 students, in response to both types of pain. Participants watched six videos where targets expressed genuine experiences of physical and social pain, and rated the perceived affect and pain experienced by the person in the video and their own empathic emotional responses. Results and discussion: The HNG displayed lower affective empathy and empathic accuracy than the LNG for both pain types. Within the HNG there was higher empathic accuracy for social vs. physical pain, despite reduced affective empathy for social pain, in contrast to the LNG. In addition to this paradox, the HNG demonstrated greater differences between ratings for the self and for target others than the LNG, suggesting that narcissism is associated with higher self-other distinction in response to viewing other people describing social pain.

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OBJECTIVES: Two studies were conducted to better understand how children with intellectual disabilities (ID) empathize with the feelings of others during social interactions. The first study tested hypotheses of developmental delay or difference regarding empathy in 79 children with ID by comparing them with typically developing (TD) children, matched for developmental age or chronological age. The second study examined specific aspects of empathy in 23 children with Down syndrome (DS), compared with 23 nonspecific ID children, matched for developmental age, and TD children, matched for developmental age or chronological age. METHOD: An empathy task was administered to the children while their parents completed the French versions of the Empathy Questionnaire and the Griffith Empathy Measure. RESULTS: The first study showed that ID children showed delayed empathy development but were perceived by their parents as deficient in cognitive empathy. The second study showed that DS children were perceived as being more attentive to the feelings of others than TD children and non-specific ID children, matched for developmental age, and as having affective empathy that was similar to that of TD children matched for chronological age. CONCLUSION: These studies have drawn attention to delays or differences in different dimensions of empathy in children with ID and DS, which need to be taken into account in interventions.

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OBJECTIVE: Empathy is a key factor to examine in development, because of its predictive associations with both aggression and successful prosocial behaviour. However, established measures of empathy for Low-to-Middle Income Countries, including South Africa, are lacking. In children, parent-report measures are key. However, a local study examining empathy and aggression (Malcolm-Smith et al., 2015) found poor psychometric performance for a widely used parent-report measure of dispositional empathy, the Griffith Empathy Measure (GEM). We thus investigated which of two questionnaires measuring dispositional cognitive and affective empathy perform better in this context. METHOD: We contrasted internal consistency reliability of a simplified version of the GEM (SGEM; n = 160) and a parent-report version of the Questionnaire of Cognitive and Affective Empathy (QCAE; n = 440) in a low-mid socio-economic status sample. Convergence between the measures and factor structure were also assessed. RESULTS: The parent-report version of the QCAE performed well as a measure of child dispositional cognitive and affective empathy, with good reliability (overall α = 0.90 vs. SGEM α = .63), and confirmatory factor analysis supporting the two-factor structure. The SGEM's reliability and failure to correlate with QCAE indicated poor psychometric performance. CONCLUSION: This is the first psychometric evaluation of the QCAE as a parent-report measure, and our results indicate that it should prove useful for future assessments of dispositional empathy in children across a variety of contexts.

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The belief in online news has become a topical issue. Previous studies demonstrated the role emotion plays in fake news vulnerability. However, few studies have explored the effect of empathy on online news belief. This study investigated the relationship between trait empathy, state empathy, belief in online news, and the potential moderating effect of news type. One hundred and forty undergraduates evaluated 50 online news pieces (25 real, 25 fake) regarding their belief, state empathy, valence, arousal, and familiarity. Trait empathy data were collected using the Chinese version of the Interpersonal Reactivity Index. State empathy was positively correlated with affective empathy in trait empathy and believability, and affective empathy was positively correlated with believability. The influence of affective empathy on news belief was partially mediated by state empathy and regulated by news type (fake, real). We discuss the influence of empathy on online news belief and its internal processes. This study shares some unique insights for researchers, practitioners, social media users, and social media platform providers.

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Empathy can be divided into two core components, cognitive empathy (CE) and affective empathy (AE), mediated by distinct neural networks. Deficient empathy is a central feature of autism spectrum conditions (ASCs), but it is unclear if this deficit results from disruption solely within empathy networks or from disrupted functional integration between CE and AE networks. To address this issue, we measured functional connectivity (FC) patterns both within and between empathy networks in autistic children (4-8 years, n = 31) and matched typically developing (TD) children (n = 26) using near-infrared spectroscopy during the presentation of an animated story evoking CE and AE. Empathy and social communication ability were also assessed using the Empathy Quotient/Systemizing Quotient (EQ/SQ) and Social Responsiveness Scale, respectively. The results showed that the FC in the AE network of autistic children did not differ from the TD group across conditions; however, the ASC group showed weaker FC in the CE network under the CE condition and weaker FC between networks when processing AE information, the latter of which was negatively correlated with EQ scores in ASC. The empathy defect in ASC may involve abnormal integration of CE and AE network activities under AE conditions.

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Evidence suggests empathy deficits have a temporal relationship with substance use severity by late adolescence theorized to decrease use via recognition of social consequences. However, this has yet to be tested empirically along with differences in cognitive and affective empathy. Adolescents admitted to substance use treatment (n= 3,382) were followed through treatment and 12 months after treatment. Variable trajectories were fit using growth curve models; and cross-lagged effects of cognitive and affective empathy on response to social consequences of use were tested along with how response to social consequences affected the mean trajectory of substance use. Results indicate higher cognitive empathy predicted greater response to social consequences of use and response to these consequences at the end of treatment predicted a steeper decrease in substance use. This evidence highlights the importance of cognitive empathy for responding to social consequences of use for motivating less substance use in adolescents.

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Affect-sharing, the ability to vicariously feel another person's emotions, is the primary component of empathy that is typically thought to rely on the observer's capacity to feel the emotions of others. However, external signals, such as the target's physical characteristics, have been demonstrated to influence affect-sharing in the neuroscientific literature that speaks to the underappreciated role of external factors in eliciting affect-sharing. We consider factors that influence affect-sharing, including physical cues, emotional cues, situational factors, and observer-target relationships, as well as the neural circuits involved in these processes. Our review reveals that, while neural network activation is primarily responsible for processing affect-sharing, external factors also co-activate a top-down cognitive processing network to modulate the conscious process of affect-sharing. From this knowledge, an integrative framework of external factor interactions with affect-sharing are explained in detail. Finally, we identify critical areas for future research in social and affective neuroscience, including research gaps and incorporation of ecologically valid paradigms.

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OBJECTIVE: This study aimed to investigate social cognition and empathy properties in children among Disruptive Mood Dysregulation Disorder (DMDD) + Attention and Hyperactivity Disorder(ADHD); ADHD and healthy controls from Türkiye. METHODS: Twenty-two children with DMDD were compared to matched 30 children with ADHD and 60 healthy controls. We administered Affective Reactivity Index (ARI), KaSi Empathy Scale, Kiddie-SADS, and Reading Mind in the Eyes Test (RMET) to evaluate Theory of Mind skills to all study participants. RESULTS: DMDD + ADHD group had lower performance in ToM skills and empathy than in two groups. The ARI scores were found to be statistically significantly higher in the DMDD group than in two groups. It was also found that ARI, empathy, and ToM scores were significantly related in children with DMDD + ADHD. CONCLUSION: These results might be important to understand the difficulties in social functioning and interpersonal relationship in children with DMDD and ADHD. Children with DMDD may attend specific therapeutic programs which include specific techniques in social cognition, emotion regulation, and irritability.

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Empathic function, which is primarily manifested by facial imitation, is believed to play a pivotal role in interpersonal emotion regulation for mood reinstatement. To explore this association and its neural substrates, we performed a questionnaire survey (study l) to identify the relationship between empathy and interpersonal emotion regulation; and a task-mode fMRI study (study 2) to explore how facial imitation, as a fundamental component of empathic processes, promotes the interpersonal emotion regulation effect. Study 1 showed that affective empathy was positively correlated with interpersonal emotion regulation. Study 2 showed smaller negative emotions in facial imitation interpersonal emotion regulation (subjects imitated experimenter's smile while followed the interpersonal emotion regulation guidance) than in normal interpersonal emotion regulation (subjects followed the interpersonal emotion regulation guidance) and Watch conditions. Mirror neural system (e.g. inferior frontal gyrus and inferior parietal lobe) and empathy network exhibited greater activations in facial imitation interpersonal emotion regulation compared with normal interpersonal emotion regulation condition. Moreover, facial imitation interpersonal emotion regulation compared with normal interpersonal emotion regulation exhibited increased functional coupling from mirror neural system to empathic and affective networks during interpersonal emotion regulation. Furthermore, the connectivity of the right orbital inferior frontal gyrus-rolandic operculum lobe mediated the association between the accuracy of facial imitation and the interpersonal emotion regulation effect. These results show that the interpersonal emotion regulation effect can be enhanced by the target's facial imitation through increased functional coupling from mirror neural system to empathic and affective neural networks.

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