Corbera S, Ikezawa S, Bell M D, Wexler B E
Connecticut Mental Health Center, Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06508, USA; Olin Neuropsychiatry Research Center, Institute of Living, Hartford Hospital, 200, Retreat Avenue, Hartford, CT 06106, USA.
Connecticut Mental Health Center, Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06508, USA; Division of Neuropsychiatry, Yowa Hospital, 3-5-1 Kamigoto, Yonago, Tottori 6830841, Japan.
Eur Psychiatry. 2014 Oct;29(8):463-72. doi: 10.1016/j.eurpsy.2014.01.005. Epub 2014 Mar 12.
Empathy is crucial for maintaining effective social interactions. Research has identified both an early-emotional sharing and a late-cognitive component of empathy. Although considered a functionally vital social cognition process, empathy has scarcely been studied in schizophrenia (SZ). We used event-related potentials (ERPs) to study the temporal dynamics of empathic response in 19 patients with SZ and 18 matched healthy controls (HC) using an empathy for physical pain paradigm. Participants responded to pictures of hands in neutral and painful situations in an active empathic condition and one manipulated by task demands. Additionally, subjective ratings of the stimuli and empathic self-reports were collected. People with SZ had (1) decreased early-emotional ERP responses to pictures of others in pain; (2) decreased modulation by attention of late-cognitive ERP responses; (3) lower ratings of perspective taking and higher ratings of personal distress which were both related to decreased modulation of late-cognitive empathic responses; (4) a significant relationship between high affective overlap between somebody else's pain and their own pain and decreased modulation of late-cognitive empathic responses; (5) a distinct relationship between regulatory deficits in late-cognitive empathy and functioning. Patients had present but reduced early and late empathy-related ERPs. Patients also reported increased personal distress when faced with distress in others. The late ERP responses are thought to be associated with self-regulation and response modulation. The magnitude of these late responses was inversely associated with reported levels of personal distress in both patients and controls. Additionally, regulatory deficits in cognitive empathy were highly related with deficits in functioning. Decreased ability to regulate one's own emotional engagement and response to emotions of others may be an important source of distress and dysfunction in social situations for patients with schizophrenia.
共情对于维持有效的社会互动至关重要。研究已经确定了共情的早期情感分享和晚期认知成分。尽管共情被认为是一个功能上至关重要的社会认知过程，但在精神分裂症（SZ）中几乎没有对其进行研究。我们使用事件相关电位（ERP），通过对身体疼痛的共情范式，研究了19名SZ患者和18名匹配的健康对照者（HC）的共情反应的时间动态。参与者在主动共情条件下和一个由任务需求操纵的条件下，对处于中性和疼痛情境的手部图片做出反应。此外，还收集了对刺激的主观评分和共情自我报告。SZ患者有：（1）对他人疼痛图片的早期情感ERP反应减少；（2）晚期认知ERP反应的注意力调节减少；（3）观点采择评分较低，个人痛苦评分较高，这两者都与晚期认知共情反应的调节减少有关；（4）他人疼痛与自身疼痛之间的高情感重叠与晚期认知共情反应的调节减少之间存在显著关系；（5）晚期认知共情中的调节缺陷与功能之间存在明显关系。患者存在但早期和晚期与共情相关的ERP减少。患者在面对他人的痛苦时也报告了个人痛苦增加。晚期ERP反应被认为与自我调节和反应调节有关。这些晚期反应的幅度与患者和对照者报告的个人痛苦水平呈负相关。此外，认知共情中的调节缺陷与功能缺陷高度相关。对于精神分裂症患者来说，调节自己情绪参与和对他人情绪反应的能力下降可能是社交情境中痛苦和功能障碍的一个重要来源。
