Article

Neural correlates of the core facets of empathy in schizophrenia. Schizophr Res

Institute for Clinical, Biological and Differential Psychology, University of Vienna, Vienna, Austria.
Schizophrenia Research (Impact Factor: 3.92). 04/2012; 136(1-3):70-81. DOI: 10.1016/j.schres.2011.12.018
Source: PubMed

ABSTRACT

Empathy is a multidimensional construct composed of several components such as emotion recognition, emotional perspective taking and affective responsiveness. Even though patients with schizophrenia demonstrate deficits in all core components of this basic social ability, the neural underpinnings of these dysfunctions are less clear. Using fMRI, we analyzed data from 15 patients meeting the DSM-IV criteria for schizophrenia and 15 matched healthy volunteers performing three separate paradigms tapping the core components of empathy, i.e. emotion recognition, perspective taking and affective responsiveness. Behavioral data analysis indicated a significant empathic deficit in patients, reflected in worse performance in all three domains. Analysis of functional data revealed hypoactivation in a fronto-temporo-parietal network including the amygdala in patients. Moreover, amygdala activation correlated negatively with severity of negative symptoms. The results suggest that schizophrenia patients not only suffer from a broad range of emotional deficits but also show cortical and subcortical abnormalities, extending previous findings on fronto-temporal cortical dysfunctions. Since empathy is related to psychosocial functioning and hence of high clinical relevance in schizophrenia, a more detailed understanding of the exact nature of these impairments is mandatory.

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    • "These sub-processes involve separate neural systems and adaptive empathic responding is believed to involve coordinated interaction between them (Zaki and Ochsner, 2011). Studies of empathy in schizophrenia have primarily examined cognitive empathy, reporting consistent evidence of diminished empathy across self-report, behavioral, and fMRI tasks (Benedetti et al., 2009;Derntl et al., 2012Derntl et al., , 2015Horan et al., 2015;Lee et al., 2010, Smith et al., 2015). The more limited research on affective empathy provides a less consistent pattern. "
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    ABSTRACT: Although it has been proposed that schizophrenia is characterized by impaired empathy, several recent studies found intact neural responses on tasks measuring the affective subdomain of empathy. This study further examined affective empathy in 21 schizophrenia outpatients and 21 healthy controls using a validated pain empathy paradigm with two components: (a) observing videos of people described as medical patients who were receiving a painful sound stimulation treatment; (b) listening to the painful sounds (to create Regions of Interest). The observing videos component incorporated experimental manipulations of perspective taking (instructions to imagine "Self" vs. "Other" experiencing pain) and cognitive appraisal (information about whether treatment was "Effective" vs. "Not Effective"). When considering activation across experimental conditions, both groups showed similar dorsal anterior cingulate cortex (dACC) and anterior insula (AI) activation while merely observing others in pain. However, there were group differences associated with perspective taking: controls showed relatively greater dACC and AI activation for the Self vs. Other contrast whereas patients showed relatively greater activation in these and additional regions for the Other vs. Self contrast. Although patients demonstrated grossly intact neural activity while observing others in pain, they showed more subtle abnormalities when required to toggle between imagining themselves versus others experiencing pain.
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    • "Performing the required processes that make social interaction successful is relatively effortless for most typically developing (TD) individuals, and the skill of emotion discrimination emerges as young as seven months of age in typical development (Caron, Caron, & Myers, 1982; Nelson & Dolgin, 1985). Impairments in understanding emotional expressions have been proposed to underlie the social difficulties in those with a variety of developmental and psychiatric disorders, and are thought to be particularly important in understanding the impairments and behaviors that are characteristic of individuals with Autism Spectrum Disorder (ASD), social phobia, conduct disorder, and schizophrenia ((Baron-Cohen, 1997, 2002; Brüne, 2005; Derntl et al., 2012; Happé & Frith, 1996; Rapee & Heimberg, 1997; Simonian, Beidel, Turner, Berkes, & Long, 2001). It is critically important, however, to understand the mechanisms and pathways by which impairments or atypicalities in face processing might impact upon social functioning, as well as how these mechanisms might be similar or different across different disorders. "
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    • "Further studies capitalizing the integration across the phenomenological and neurophysiological levels are hence necessary, in order to provide advances in the understanding of vulnerability markers in schizophrenia and enhance early identification and intervention approaches. The aim of this study is to explore whether a weak or high emotional motor resonance occurring in SzSp patients—considered a mirror mechanismproxy (Carr et al., 2003; Seitz et al., 2008; Derntl et al., 2012)—is related to patients' clinical features and to their anomalous subjective experiences as indexed by the Bonn Scale for the Assessment of Basic Symptoms (BSABS). "
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