Department of Psychology, Carnegie Mellon University, Pittsburgh, PA.
Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, USA.
Addiction. 2022 Nov;117(11):2793-2804. doi: 10.1111/add.15941. Epub 2022 May 29.
To (1) measure the aggregated effect size of empathy deficits in individuals with alcohol use disorder (AUD) compared with healthy controls, (2) measure the aggregated effect sizes for associations between lower empathy and heavier alcohol consumption and more alcohol problems in non-clinical samples and (3) identify potential moderators on the variability of effect sizes across studies in these meta-analyses.
PsycINFO, PubMed and Google Scholar were searched following a pre-registered International Prospective Register of Systematic Reviews (PROSPERO) protocol (CRD42021225392) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. We meta-analyzed (using random-effects models) mean differences in empathy between individuals with AUD compared with healthy controls and associations between empathy and alcohol consumption and alcohol problems in non-clinical samples. A total of 714 participants were included in the meta-analysis on clinical samples; 3955 were included in the meta-analyses on non-clinical samples.
Individuals with AUD reported significantly lower empathy than healthy controls [Hedges' g = -0.53, 95% confidence interval (CI) = -0.91, -0.16, k = 9, P < 0.01, Q = 40.09, I = 80.04]. Study quality [Q = 1.88, degrees of freedom (d.f.) = 1, P = 0.17] and gender (β = -0.006, Z = -0.60, P = 0.55) were not moderators. Increases in age corresponded to an increase in effect size (β = 0.095, Z = 3.34, P < 0.001). Individuals with AUD (versus healthy controls) had significantly lower cognitive (Hedges' g = -0.44, CI = -0.79, -0.10, P < 0.05), but not affective empathy (Hedges' g = -0.19, CI = -0.51, 0.14, P = 0.27), and the difference between these was significant (Z = 2.34, k = 6, P < 0.01). In non-clinical samples, individuals with lower (versus higher) empathy reported heavier alcohol consumption (r = -0.12, CI = -0.15, -0.09, k = 11, P < 0.001, Q = 9.68, I = 0.00) and more alcohol problems (r = -0.08, CI = -0.14, -0.01, k = 7, P = 0.021, Q = 6.55, I = 8.34). There was no significant heterogeneity across studies.
Individuals with alcohol use disorder appear to show deficits in empathy compared with healthy controls. Deficits are particularly pronounced for older individuals and for cognitive (versus affective) empathy. In non-clinical samples, lower empathy appears to be associated with heavier alcohol consumption and more alcohol problems.
（1）测量与健康对照组相比，酒精使用障碍（AUD）个体的同理心缺陷的综合效应大小，（2）测量同理心较低与非临床样本中饮酒量增加和更多酒精问题之间的关联的综合效应大小，以及（3）在这些荟萃分析中确定研究之间效应大小变异性的潜在调节因素。
按照预先注册的国际前瞻性系统评价注册（PROSPERO）协议（CRD42021225392）和系统评价和荟萃分析的首选报告项目（PRISMA）方法，对 PsycINFO、PubMed 和 Google Scholar 进行了搜索。我们使用随机效应模型对 AUD 个体与健康对照组之间的同理心差异进行了荟萃分析，对非临床样本中同理心与饮酒量和酒精问题之间的关联进行了荟萃分析。共有 714 名临床样本参与者纳入了对临床样本的荟萃分析；3955 名非临床样本参与者纳入了荟萃分析。
与健康对照组相比，AUD 个体报告的同理心明显较低[Hedges' g = -0.53，95%置信区间（CI）=-0.91，-0.16，k = 9，P < 0.01，Q = 40.09，I = 80.04]。研究质量[Q = 1.88，自由度（d.f.）= 1，P = 0.17]和性别（β = -0.006，Z = -0.60，P = 0.55）不是调节因素。年龄的增加对应着效应大小的增加（β = 0.095，Z = 3.34，P < 0.001）。与健康对照组相比，AUD 个体（而不是健康对照组）的认知同理心（Hedges' g = -0.44，CI = -0.79，-0.10，P < 0.05）明显较低，但情感同理心（Hedges' g = -0.19，CI = -0.51，0.14，P = 0.27）却没有差异，并且这两种差异具有统计学意义（Z = 2.34，k = 6，P < 0.01）。在非临床样本中，同理心较低（与较高）的个体报告的饮酒量更重（r = -0.12，CI = -0.15，-0.09，k = 11，P < 0.001，Q = 9.68，I = 0.00），并且更多的酒精问题（r = -0.08，CI = -0.14，-0.01，k = 7，P = 0.021，Q = 6.55，I = 8.34）。各研究之间没有显著的异质性。
与健康对照组相比，酒精使用障碍患者似乎表现出同理心缺陷。缺陷在年龄较大的个体和认知（而非情感）同理心方面尤为明显。在非临床样本中，较低的同理心似乎与饮酒量增加和更多的酒精问题有关。
