Empathy Flashcards
Definition of empathy
Vignemont and Singer (2006);
Empathy is the ability to share the feelings of another’s emotional or sensory state:
o one is in an affective state;
o this is congruent to another person’s affective state;
o this state is elicited by the observation or imagination of another person’s affective state;
o one knows that the other person is the source of one’s own affective state.
The Perception-Action Model of
empathy
Preston and de Waal (2002) formulated an influential theory of empathy:
“attended perception of the object’s state automatically activates the subjects’ representations of the state… and that activation of these representations automatically primes or generates the associated autonomic or somatic responses, unless inhibited”
“attended”: attention directed toward the object (other persons) state or response is needed to produce an empathic response
“automatically” : empathy occurs spontaneously without conscious effort
“representations” : predicts pain matrix activation during viewing someone else in pain
“somatic responses” : predicts involvement of action planning cortical structures (such as premotor cortex)
P-A-M example:
Vogt et al
guitarists and non-guitarists observed video clips of guitar chords being played, Viewing motor actions activates the motor mirror neuron system
Validation for PAM
Meta-analysis of brain activations related to pain empathy Lamm et al., 2011)
Anterior mid-cingulate cortex and bilateral anterior insula consistently activated in 9 pain empathy studies. Both ‘pain matrix’ regions. Other regions are likely but these are most consistent from evidence.
Pain empathy in mice (Langford et al., Science, 2006) –
Empathy was thought to be unique to higher primates, possibly humans alone.
Argument for automaticity of empathy: Mice tested given identical noxious stimulus in pairs displayed increased co-occurrence of pain behaviors
Viewing pain in cagemates produces more pain responses than viewing pain in strangers – modulation by familiarity.
Singer et al., Science (2004
Empathy for pain in others recruits the affective regions of the pain matrix
Insula and ACC activation correlated with empathy scores
Top-down control of pain empathy
Theoretical contribution (Singer and Lamm, 2009) suggested that brain imaging data about brain empathy differentiates Between distinct neural processes: • bottom-up processes : perception = representation of pain (automatic, mirror neurons?) • top-down processes: includes appraisal of context, attention, preparations for action etc.
Evidence of top down
Loggia (2008)
Participants received pain stimuli whilst observing the confederate in either compassionate (nice guy) or non-compassionate (nasty guy) conditions.
Compassion for the confederate led to increased perception of pain in the subject.Top-down influences on empathy are evident in levels of subjective pain perception.
Azevedo et al., 2012)
Anterior insulae showed increases during viewing pain in own race group compared to other race or violet-skin group. Insula activation during pain empathy for ones own group correlated with subjective measures of racial bias (implicit association task). In-group bias and pain empathy
(Singer et al., 2006)
Participants played a game wherein mutual beneficial or selfish behaviour could lead to a win-lose or win-win situation.
Watch video clips of that confederate receive painful stimulation. Preferential activation of the insula for the fair person. Females did have this effect, but there was some compassion for their pain. The activation in nucleus accumbens in males correlated with the desire for revenge.
Biological process in the insula is modulated by top down process, psychological effects. It can’t just be pure bottom-up process if we can effect it.
Decety et al., 2009
Intentionality (deliberate infliction of pain) affects empathy responses
Lamm 2007
Context modulation modulates empathic response.
Viewing pain in the numbed hand still activate pain brain regions suggesting some degree of automatic activation in accordance with Preston and de Waal (2002).
Empathy and disorders
Decety et al, 2013.
Eighty incarcerated males classified Psychopaths
fMRI responses to empathy-eliciting scenarios (pain scenes and facial expressions) were recorded.
Psychopaths exhibited significantly less activation in the ventromedial prefrontal cortex, lateral orbitofrontal cortex, and periaqueductal grey relative to controls, but showed greater activation in the insula -
Neural alterations for empathy - implications for society, e.g., crime?
Fan et al., 2014
Impaired empathy response for pain in autism spectrum disorder (ASD) patients.
Controls participants exhibited significant signal increase in regions implicated in both the affective and sensory discriminative components of pain processing, including aMCC, AIC, left precentral and SI/SII.
ASD showed activation in the SI/SII bilaterally - They could process the sensory aspect of pain but had impaired social understanding of pain (lack of normal differentiation for accidental and inflicted pain).
(Fallon et al, 2015)
We do see increased emotional processing in patients when they are viewing pain, however this also occurs in the non-pain conditions. They do score higher on the empthy task, but is this because they feel empathy or are Hypervigilance to pain?
Perception of pain in heath care
Professionals
Hodgkin et al. (1985)
Pain reports in 21 patients undergoing painful fluid aspiration procedure. Estimates were collected from their doctors as well. No significant difference in before or after pain ratings. Doctors and patients in agreement.
Forrest et al. 1989)
Asked 52 patients with abdominal pain and their 8 doctors to rate patient pain using visual analogue scales.
The median of pain ratings was significantly smaller in doctors (3.1) than in patients (6.1).
There was a positive correlations between the doctors’ and patients’ ratings ( r = 0.64, P < 0.05)
Need more research - only 8 doctors
Expertise modulates the empathic brain response
Cheng et al. 2007 analysed fMRI in control subjects and physicians applying acupuncture.
Physicians had a smaller empathic response than control subjects. Also, physicians attributed smaller pain to the scenes than control subjects. The reduction of empathy tends to happen over time with experience.
Effects of empathy on the couple interactions in chronic pain patients
Empathic behaviour in chronic pain couples correlates with marital satisfaction
Cano et al. (2008) analysed 91 couples in which one of the partners was a chronic pain patient.
Interactions between the partners during an interview about impacts of pain on their lives was recorded and analysed by experienced observers.
The empathic behaviour of the spouse correlated with greater marital satisfaction.
Non-empathic spouse’s behaviour correlated with punishing response.
