Valdespino Andrew, Antezana Ligia, Ghane Merage, Richey John A
Social Clinical Affective Neuroscience Laboratory, Department of Psychology, Virginia Tech, Blacksburg, VA, United States.
Front Psychol. 2017 Dec 21;8:2234. doi: 10.3389/fpsyg.2017.02234. eCollection 2017.
Distorted empathic processing has been observed across multiple psychiatric disorders. Simulation theory provides a theoretical framework that proposes a mechanism through which empathy difficulties may arise. Specifically, introspection-centric simulation theory (IST) predicts that an inability to accurately interpret and describe internal affective states may lead to empathy difficulties. The purpose of this review is to synthesize and summarize an empirical literature suggesting that simulation theory provides insights into a cognitive and neurobiological mechanism (i.e., alexithymia and insula pathology) that negatively impacts empathic processing, in addition to how disruptions in these processes manifest across psychiatric disorders. Specifically, we review an emerging non-clinical literature suggesting that consistent with IST, alexithymia and associated insula pathology leads to empathy deficits. Subsequently, we highlight clinical research suggesting that a large number of disorders characterized by empathy pathology also feature alexithymia. Collectively, these findings motivate the importance for future work to establish the role of alexithymia in contributing to empathy deficits across clinical symptoms and disorders. The current review suggests that simulation theory provides a tractable conceptual platform for identifying a potential common cognitive and neural marker that is associated with empathy deficits across a wide array of diagnostic classes.
在多种精神疾病中均观察到共情加工扭曲的现象。模拟理论提供了一个理论框架，提出了一种可能导致共情困难的机制。具体而言，以内省为中心的模拟理论（IST）预测，无法准确解释和描述内部情感状态可能会导致共情困难。本综述的目的是综合和总结实证文献，这些文献表明模拟理论为一种认知和神经生物学机制（即述情障碍和脑岛病变）提供了见解，这种机制会对共情加工产生负面影响，此外还涉及这些过程的中断在各种精神疾病中的表现方式。具体来说，我们回顾了新兴的非临床文献，这些文献表明与IST一致，述情障碍和相关的脑岛病变会导致共情缺陷。随后，我们强调临床研究表明，大量以共情病理为特征的疾病也具有述情障碍。总的来说，这些发现凸显了未来研究确定述情障碍在导致跨临床症状和疾病的共情缺陷中所起作用的重要性。当前的综述表明，模拟理论为识别一种潜在的共同认知和神经标志物提供了一个易于处理的概念平台，该标志物与广泛诊断类别中的共情缺陷相关。
