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Adolescent Substance Use Outcomes in Response to Social Consequences of Use: The Role of Empathy

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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 = 3382) 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 (interpersonal reactivity index) 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 adolescent substance use.
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The purpose of the present study was to examine the structure of empathy using a hierarchical approach, and to compare the dimensions of empathy with measures of social functioning, in order to contribute to the understanding of the nature of empathy. The dimensionality of the Interpersonal Reactivity Index, which comprises four subscales (empathic concern, perspective taking, fantasy and personal distress) was examined using confirmatory factor analysis. Relations with the Social Skills Inventory were also investigated. A sample of 127 applicants for places on nursing and social work undergraduate programs participated in the study. The study findings indicate that empathy is hierarchically organized, with one general dimension at the apex. The general factor is identical to empathic concern and this dimension overlaps to a great extent with perspective taking and fantasy. The findings also indicate that the general dimension constitutes an integrated entirety, with its main emphasis on emotional reactivity by also involving cognitive processes.
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Social neuro-science has recently started to investigate the neuronal mechanisms underlying our ability to understand the mental and emotional states of others. In this review, imaging research conducted on theory of mind (ToM or mentalizing) and empathy is selectively reviewed. It is proposed that even though these abilities are often used as synonyms in the literature these capacities represent different abilities that rely on different neuronal circuitry. ToM refers to our ability to understand mental states such as intentions, goals and beliefs, and relies on structures of the temporal lobe and the pre-frontal cortex. In contrast, empathy refers to our ability to share the feelings (emotions and sensations) of others and relies on sensorimotor cortices as well as limbic and para-limbic structures. It is further argued that the concept of empathy as used in lay terms refers to a multi-level construct extending from simple forms of emotion contagion to complex forms of cognitive perspective taking. Future research should investigate the relative contribution of empathizing and mentalizing abilities in the understanding of other people's states. Finally, it is suggested that the abilities to understand other people's thoughts and to share their affects display different ontogenetic trajectories reflecting the different developmental paths of their underlying neural structures. In particular, empathy develops much earlier than mentalizing abilities, because the former relys on limbic structures which develop early in ontogeny, whereas the latter rely on lateral temporal lobe and pre-frontal structures which are among the last to fully mature.