Editorial: Empathy in a Broader Context: Development, Mechanisms, Remediation

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Editorial: Empathy in a Broader
Context: Development, Mechanisms,
Remediation
Simon Surguladze
1
*and Dessa Bergen-Cico
2
1
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom,
2
Public Health
Department, Syracuse University, Syracuse, NY, United States
Keywords: empathy, neurobiology of empathy, phenomenology of empathy, positive empathy, empathy and age
Editorial on the Research Topic
Empathy in a Broader Context: Development, Mechanisms, Remediation
Empathy has long been a subject of interest of social sciences, starting with the concept of
Einfühlung (“in-feeling”or “feeling into”) as the human capacity to feel the emotions that the artist
or writer had worked to represent (1).
Later on, Theodor Lipps transformed Einfühlung from a concept of aesthetics into a central
category of the philosophy of the social and human sciences and postulated that Einfühlung meant
the “experience of another human”underpinned by “inner imitation”or instinctive kinaesthetic
sensations in the observer as felt by the observed target (2). The word empathy was introduced to
English-speaking world by E.B. Titchener (3) who translated Einfühlung by using Greek em- (“in'”)
and pathos,(“feeling”,“suffering”,or“pity”). This heralded the beginning of new, psychological
research into the phenomenon, followed by operationalising the concepts of empathy thus firmly
rooting it in the fields of sociology and psychology.
The empathy is considered as a multifaceted construct encompassing (1) affective empathy, i.e.,
affective sharing, (2) empathic concern: motivation to caring for another's welfare, and (3)
perspective taking or cognitive empathy, the ability to consciously put oneself into the mind of
another and understand what that person is thinking or feeling (4). Through the recent advances in
neuroscience, researchers have begun to identify possible biological mechanisms of empathy (5) that
human beings may share with higher mammals (6).
The papers in this Research Topic present novel neuroscience research in addition to socially
diverse research examining skills, psychology, and interpersonal factors that modulate empathy in
specific contexts.
Despite more than a century of descriptive research into empathy, the definition, and
phenomenology of the empathy are still evolving and inquiry is broadening. One of the interesting
lines of inquiry centers on whether or not cognitive and affective empathy are part of the same concept.
This question is addressed in a paper in this Research Topic (Stietz et al.)wheretheauthorsarguethat
the aspects of perspective-taking and affective empathy should not be blended into unifying (“umbrella
term”) concept of empathy; but rather consider as distinct neurobiological and
phenomenological processes.
Sindermann et al.‘s study lends support to the above notion by demonstrating sexual
dimorphism between cognitive and affective empathy. The authors explored the relationship
Frontiers in Psychiatry | www.frontiersin.org June 2020 | Volume 11 | Article 5291
Edited and reviewed by:
Sören Krach,
University of Lübeck, Germany
*Correspondence:
Simon Surguladze
s.surguladze@gmail.com
Specialty section:
This article was submitted to
Social Cognition,
a section of the journal
Frontiers in Psychiatry
Received: 08 May 2020
Accepted: 22 May 2020
Published: 12 June 2020
Citation:
Surguladze S and Bergen-Cico D
(2020) Editorial: Empathy in a
Broader Context: Development,
Mechanisms, Remediation.
Front. Psychiatry 11:529.
doi: 10.3389/fpsyt.2020.00529
EDITORIAL
published: 12 June 2020
doi: 10.3389/fpsyt.2020.00529

between various self-report measures of empathy, e.g., Empathy
Quotient (EQ) (7), Interpersonal Reactivity Index (IRI) (8),
Autism Spectrum Quotient (AQ) (9), and Systemizing
Quotient-Revised (SQ-R) (10) in a large sample of healthy
adults. Apart from gender-neutral associations, the study
uncovered differential associations between the above measures
in females vs. males. In particular, both EQ and IRI measure of
Perspective-taking were negatively associated with Autism
Spectrum Quotient in female and male participants. However,
in females there was a negative correlation between the IRI scales
Perspective-Taking and Personal Distress which contrasted with
a weakly positive correlation in the male sample.
A hypothesis paper (Thiriou et al.) considers another aspect
of relationship between perspective-taking and empathy. The
authors present a bold idea of linking cognitive perspective-
taking with emotional/empathic understanding of others' point
of view. The authors postulate that this complex association may
underlie the insight in people with psychiatric disorders.
According to the proposal, affectively experiencing the position
of another person about oneself reinforces the insight, i.e., ability
to recognise the disorder. This new perspective would certainly
warrant an empirical validation.
The Perspective article by Light presents a re-
conceptualization of empathy concept by emphasizing a
possible change in emotional state of the observer that could
be of any, e.g., either negative or positive, or even contrasting
valence (contrasting empathy). This latter addition could be
considered as controversial by empathy researchers who
usually conceptualise empathy as an emergence of a matching,
rather than contrasting emotion as is the case of, e.g.,
Schadenfreude (which is not considered as empathetic
response). We are looking forward to any comments on this
topic by the research community. In the same paper, the author
provides their definition of slightly neglected part of empathy,
e.g., positive empathy. By positive empathy the author
understands our ability to respond to the negative and positive
emotion of others with appropriate positive affect. In line with
this proposal, another paper (Light et al.) presents a validation of
a brief self-report measure of “positive-valence empathy”. Apart
from excellent psychometric properties, this measure appears to
be a significantly better predictor of overall depressive
symptomatology than anhedonia.
The study of Heym et al. examined the relationship between
Dark Triad traits and distinct facets of empathy in a large sample
(301 participant) from two UK University participant pools and
via general online participation schemes. The authors addressed
two main issues: (1) whether impaired empathy represents a
common “dark core”binding Machiavellianism, narcissism, and
psychopathy, and (2) this core explains associations between the
dark traits and indirect relational aggression (IRA). The study
results did not support the notion that an unempathic core may
underpin all Dark Triade traits. The authors postulated that the
Dark Triade traits are best viewed as three independent
personality traits, rather than a joint (latent) dyad or triad
core, at least in the prediction of these specificempathic
deficits and indirect relational aggression.
Several papers in this Topic were focused on developmental
aspects of empathy.
The review paper by Beadle and de la Vega considered age-
related aspects of empathy. To summarize, across studies, there is
little evidence that emotional empathy is lower in older than
younger adults. However, older adults tend to show reduced
performance and report lower levels of cognitive empathy. The
authors also provide for a useful review of studies on neural bases
of empathy in aging that showed (counterintuitively) reduced
brain activation in older adults to tasks involving both cognitive
and affective empathy.
Shapira et al.'s study examined genetic and environmental
influences on children's emotion recognition, for the first time
adding vocal to facial cues of emotion. The authors report shared
environmental (rather than genetic) effect on emotion
recognition abilities in this cohort.
Kanie et al. report results of social cognition and interaction
training (SCIT) in a sample of patients with schizophrenia. SCIT
was developed by Penn and colleagues, as a program for social
cognitive rehabilitation in schizophrenia (11)Theauthors
reported that the training proved feasible and was well
tolerated by patients with schizophrenia in real-world
outpatient settings. Statistical analysis showed a significant
change in social cognitive outcome measure between the
baseline and 3-month interim assessments, and also between
the baseline and 6-month endpoint assessments, only in the
SCIT but not in treatment as usual (TAU) group. However, the
interaction between timepoint and group failed to reach
significance, which suggested that the effect of SCIT was no
different from that of TAU.
Sinval et al. present the results of a validation study of the
Portuguese version of the Oldenburg Burnout Inventory (12).
This version of OLBI is characterised by good internal validity
and sex-invariance, therefore providing researchers with a useful
free tool to measure burnout in Portuguese-speaking
populations. Although, not directly examining empathy, this
study gives a helpful reference for empathy researchers who
investigate potential associations between empathy and burnout.
This Research Topic includes substantive original research
that explores neural correlates of empathy among people with
autism spectrum disorder (ASD) borderline personality disorder
(BPD), conduct disorder (CD), eating disorders (ED), and
posttraumatic stress disorder (PTSD) and comparative
neurotypical control populations.
There are three studies that focus specifically on autism
spectrum disorder (ASD) examining cognitive empathy,
perspective taking, and interpersonal motivations. Findings
from Komeda et al. suggest that individuals with ASD
empathize with, and are more motivate to help, other people
with ASD than neurotypical people. Whereas a study by Neufeld
et al. found that, compared to neurotypical controls, the
association between reward and mimicry is reduced in people
with high autistic traits, and mimicry-related brain responses are
less modulated by learned reward value in individuals with
autism spectrum disorder. A third ASD study in this issue by
Stroth et al. examined females with high functioning ASD and
Surguladze and Bergen-Cico Editorial: Empathy in a Broader Context
Frontiers in Psychiatry | www.frontiersin.org June 2020 | Volume 11 | Article 5292

found they are able to share another person's physical or social
pain on the neural systems level. However, female participants
with ASD also have hypoactivation of the anterior insula when
compared to neurotypical female subjects. The measurement of
neural correlates provides objective measures and insight into
neuro-cognitive empathy among people with ASD.
AstudybyGaffney et al. which focused female participants
with anorexia nervosa (AN) drew some analogies with ASD. They
found lower cognitive empathy and intact affective empathy
profiles among female participants with AN that are similar to
that found in other psychiatric and neurodevelopmental
conditions, such as autism spectrum disorder (ASD). These
findings add to the literature characterizing the socio-emotional
phenotype in eating disorders.
There are two neuroimaging studies that focused on
borderline personality disorder (BPD). A study by Flasbeck
et al. found that people with BPD showed less activation in the
left supramarginal gyrus when viewing angry facial expressions
compared to healthy controls. Flasbeck et al. also found
differential activation of the left anterior insula among people
with BPD in response to the emotional context of facial
expressions. Thus, concluding that empathy for pain becomes
selectively enhanced among people with BPD. Ducque-Alarcon
et al. used fMRI to examine the influence of child abuse on the
etiology and neurobiological substrates of BPD. They found
hypoconnectivity between the structures responsible for
emotion regulation and social cognitive responses in the
frontolimbic circuitry (i.e., amygdala) among the BPD group.
They concluded that there were differential levels of neural
connectivity associated with the types and levels of abuse
people had experienced. Another interesting neuroimaging
study focused on neural basis of empathy in children and
adolescents with early onset conduct disorder (CD). von Polier
et al. studied the important role of the amygdala in empathy-
related emotional processing among boys with CD. They noted
that diminished amygdala responses and their association with
low empathy and high callous unemotional traits suggest a pivotal
influence of impaired amygdala processing in early-onset CD
with notable deficits in empathic behavior. Their study found
elevated response in the medial prefrontal cortex in boys with CD
which point towards increased demands on self-referential
processing to solve empathy tasks, and more cognitive biased
processing strategies required for boys with early-onset CD.
The study by Levy et al. is timely in its focus on mothers
exposed to wartime trauma who have posttraumatic stress
disorder (PTSD). They found that chronic stress takes a toll on
the mother's empathic ability and indirectly impacts the neural
basis of empathy by disrupting the coherence of both brain and
behavior. These findings have important implications for
interventions that may not only address PTSD among women
but may help address the long term or intergenerational impact
of wartime trauma.
In conclusion, we believe that this Research Topic provides
for an interesting collection of papers covering a wide variety of
emotional, cognitive, and neurobiological processes involved in
empathy. We hope this will give the readers useful guidance in
their research of this fascinating phenomenon.
AUTHOR CONTRIBUTIONS
SS conceived the idea of the Research Topic, was involved in
editing of submitted manuscripts and writing up the Editorial.
DB-C was involved in editing of submitted manuscripts and
writing up the Editorial.
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Conflict of Interest: The authors declare that the research was conducted in the
absence of any commercial or financial relationships that could be construed as a
potential conflict of interest.
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Surguladze and Bergen-Cico Editorial: Empathy in a Broader Context
Frontiers in Psychiatry | www.frontiersin.org June 2020 | Volume 11 | Article 5293