How Situational Context Impacts Empathic Responses and Brain Activation Patterns

NeuroImage, 2010

Watching or imagining other people experiencing pain activates the central nervous system's pain matrix in the observer. Without emotion regulation skills, repeated exposure to the suffering of others in healthcare professionals may be associated with the adverse consequences of personal distress, burnout and compassion fatigue, which are detrimental to their wellbeing. Here, we recorded event-related potentials (ERP) from physicians and matched controls as they were presented with visual stimuli depicting body parts pricked by a needle (pain) or touched by a Q-tip (no-pain). The results showed early N110 differentiation between pain and no-pain over the frontal area as well as late P3 over the centro-parietal regions were observed in the control participants. In contrast, no such early and late ERP responses were detected in the physicians. Our results indicate that emotion regulation in physicians has very early effects, inhibiting the bottom-up processing of the perception of pain in others. It is suggested that physicians' down-regulation of the pain response dampens their negative arousal in response to the pain of others and thus may have many beneficial consequences including freeing up cognitive resources necessary for being of assistance.

Translational psychiatry, 2014

Empathy cultivates deeper interpersonal relationships and is important for socialization. However, frequent exposure to emotionally-demanding situations may put people at risk for burnout. Burnout has become a pervasive problem among medical professionals because occupational burnout may be highly sensitive to empathy levels. To better understand empathy-induced burnout among medical professionals, exploring the relationship between burnout severity and strength of empathy-related brain activity may be key. However, to our knowledge, this relationship has not yet been explored. We studied the relationship between self-reported burnout severity scores and psychological measures of empathic disposition, emotional dissonance and alexithymia in medical professionals to test two contradictory hypotheses: Burnout is explained by (1) 'compassion fatigue'; that is, individuals become emotionally over involved; and (2) 'emotional dissonance'; that is, a gap between felt and e...

Healthcare

It is generally accepted that empathy should be the basis of patient care. However, this ideal may be unrealistic if healthcare professionals suffer adverse effects when engaging in empathy. The aim of this study is to explore the effect of inferring mental states and different components of empathy (perspective-taking; empathic concern; personal distress) in burnout dimensions (emotional exhaustion; depersonalization; personal accomplishment). A total of 184 healthcare professionals participated in the study (23% male, Mage = 44.60; SD = 10.46). We measured participants’ empathy, the inference of mental states of patients, and burnout. Correlation analyses showed that inferring mental states was positively associated with perspective-taking and with empathic concern, but uncorrelated with personal distress. Furthermore, emotional exhaustion was related to greater levels of personal distress and greater levels of inferences of mental states. Depersonalization was associated with gre...

Social Psychological and Personality Science, 2019

Empathy can be both beneficial and costly. This trade-off is pertinent for physicians who must care for patients while maintaining emotional distance to avoid burnout. Prior work using self-report and neurophysiological measures has found mixed evidence for differences in empathy between physicians and nonphysicians. We used implicit measurement and multinomial modeling to examine intentional empathy (IE) and unintentional empathy (UE) for pain among physicians and demographically matched nonphysicians. Relative to nonphysicians, physicians displayed greater ability to judge the painfulness of target experiences (i.e., IE). Contrary to some prior work, however, physicians and nonphysicians displayed comparable spontaneous resonance with dis-tracter experiences (i.e., UE). These findings suggest that physicians may be more likely than nonphysicians to empathize with others' pain when empathy aligns with their overt goals.

PLoS One, 2007

Background. Recent neuroscientific evidence suggests that empathy for pain activates similar neural representations as the first-hand experience of pain. However, empathy is not an all-or-none phenomenon but it is strongly malleable by interpersonal, intrapersonal and situational factors. This study investigated how two different top-down mechanisms – attention and cognitive appraisal - affect the perception of pain in others and its neural underpinnings. Methodology/ Principal Findings. We performed one behavioral (N = 23) and two functional magnetic resonance imaging (fMRI) experiments (N = 18). In the first fMRI experiment, participants watched photographs displaying painful needle injections, and were asked to evaluate either the sensory or the affective consequences of these injections. The role of cognitive appraisal was examined in a second fMRI experiment in which participants watched injections that only appeared to be painful as they were performed on an anesthetized hand. Perceiving pain in others activated the affective-motivational and sensory-discriminative aspects of the pain matrix. Activity in the somatosensory areas was specifically enhanced when participants evaluated the sensory consequences of pain. Perceiving non-painful injections into the anesthetized hand also led to signal increase in large parts of the pain matrix, suggesting an automatic affective response to the putatively harmful stimulus. This automatic response was modulated by areas involved in self/other distinction and valence attribution – including the temporo-parietal junction and medial orbitofrontal cortex. Conclusions/Significance. Our findings elucidate how top-down control mechanisms and automatic bottom-up processes interact to generate and modulate other-oriented responses. They stress the role of cognitive processing in empathy, and shed light on how emotional and bodily awareness enable us to evaluate the sensory and affective states of others.

2007

Abstract Whether observation of distress in others leads to empathic concern and altruistic motivation, or to personal distress and egoistic motivation, seems to depend upon the capacity for self-other differentiation and cognitive appraisal. In this experiment, behavioral measures and event-related functional magnetic resonance imaging were used to investigate the effects of perspective-taking and cognitive appraisal while participants observed the facial expression of pain resulting from medical treatment.

Neuropsychologia, 2006

Perspective-taking is a stepping stone to human empathy. When empathizing with another individual, one can imagine how the other perceives the situation and feels as a result. To what extent does imagining the other differs from imagining oneself in similar painful situations? In this functional magnetic resonance imaging experiment, participants were shown pictures of people with their hands or feet in painful or non-painful situations and instructed to imagine and rate the level of pain perceived from different perspectives. Both the Self's and the Other's perspectives were associated with activation in the neural network involved in pain processing, including the parietal operculum, anterior cingulate cortex (ACC; BA32) and anterior insula. However, the Self-perspective yielded higher pain ratings and involved the pain matrix more extensively in the secondary somatosensory cortex, the ACC (BA 24a /24b ), and the insula proper. Adopting the perspective of the Other was associated with specific increase in the posterior cingulate/precuneus and the right temporo-parietal junction. These results show the similarities between Self-and Other-pain representation, but most interestingly they also highlight some distinctiveness between these two representations, which is a crucial aspect of human empathy. It may be what allows us to distinguish empathic responses to others versus our own personal distress. These findings are consistent with the view that empathy does not involve a complete Self-Other merging. (J. Decety).

PLOS ONE, 2015

Neuroimaging studies have demonstrated that the actual experience of pain and the perception of another person in pain share common neural substrates, including the bilateral anterior insular cortex and the anterior midcingulate cortex. As many fMRI studies include the exposure of participants to repeated, similar stimuli, we examined whether empathic neural responses were affected by habituation and whether the participants' prior pain experience influenced these habituation effects.

Social Cognitive and Affective Neuroscience, 2020

Background Empathy for pain is a complex phenomenon incorporating sensory, cognitive and affective processes. Functional neuroimaging studies indicate a rich network of brain activations for empathic processing. However, previous research focused on core activations in bilateral anterior insula (AI) and anterior cingulate/anterior midcingulate cortex (ACC/aMCC) which are also typically present during nociceptive (pain) processing. Theoretical understanding of empathy would benefit from empirical investigation of shared and contrasting brain activations for empathic and nociceptive processing. Method Thirty-nine empathy for observed pain studies (1112 participants; 527 foci) were selected by systematic review. Coordinate based meta-analysis (activation likelihood estimation) was performed and novel contrast analyses compared neurobiological processing of empathy with a comprehensive meta-analysis of 180 studies of nociceptive processing (Tanasescu et al., 2016). Results Conjunction a...

Materia Socio Medica, 2015

Background: Nurse's empathy is one of the major parameters to improve the quality of provided health care known for the patient and it has a significant effect on reducing physical and psychological symptoms in patients. However, it has shown that over time and by increasing the background of nurses, their empathy is reducing. However, there is no research to investigate the Mu Suppression that is an indicator of the performance of mirror neurons that is a basis of empathy sense in the brain. So, the aim of this study is to investigate the difference between reported empathy and Mu suppression among nurses with three years of work background. Methods: So, a total of 39 male nurse were chosen by available sampling that 15 of them has about 3 years working experience more than other's 15 people, Data collection tool was empathy questionnaire of Jefferson's health professionals. Mirror neurons' activation was investigated by Mu suppression. So, EEG was recorded in three situations including: 1) watching a video of a motionless hand, 2) watching a video of a hand that is opening and closing and 3) moving their own hand. Results: The results of MANOVA analysis indicated that although Mu suppression among nurses with more background is less, but this difference is not significant. Also, there is no significant difference between the reported empathy scores by nurses among two groups Conclusions: These results indicate that three years of work experience don't have an effect on empathy reduction. Key word: Nurse, patient, physical and psychological.