School of Psychology, Cardiff University, Wales, UK.
Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, Netherlands.
Eur Child Adolesc Psychiatry. 2023 Oct;32(10):2077-2088. doi: 10.1007/s00787-022-02050-2. Epub 2022 Jul 21.
Many children with anxiety disorders exhibit significant and persistent impairments in their social and interpersonal functioning. Two components essential for successful social interaction are empathy and theory of mind (ToM). Both constructs develop rapidly in childhood, but no study has simultaneously examined these skills in young children with emerging mental health problems, including those with symptoms of anxiety. This study investigated empathy and ToM in children with anxiety symptomatology and examined their relationship with anxiety severity. A cross-sectional study was carried out with 174 children aged 4-8 years with emerging mental health difficulties who were referred by school teachers for an assessment because of emotional, cognitive, or behavioural problems at school. Participants completed empathy and ToM tasks. Parents were interviewed and rated children's emotional and behavioural problems. Correlational analyses indicated that elevated anxiety was associated with better cognitive ToM and worse affective empathy; there were no associations between anxiety and either cognitive empathy or affective ToM. Subsequent regression analyses demonstrated that whilst enhanced cognitive ToM was explained by age and verbal IQ, anxiety symptoms uniquely predicted impaired affective empathy. These results indicate that children with symptoms of anxiety have difficulty in sharing in other people's emotions. As a result, they may find it difficult to behave in socially adequate ways in interactions with others that involve affective sharing. These findings encourage the use of early and targeted interventions that improve affective empathy development in children with anxiety symptoms.
许多患有焦虑症的儿童在社交和人际交往方面存在显著且持续的障碍。成功社交互动的两个关键要素是同理心和心理理论（ToM）。这两个结构在儿童时期都迅速发展，但尚无研究同时检查患有新兴心理健康问题（包括焦虑症状）的幼儿的这些技能，包括焦虑症状。本研究调查了具有焦虑症状儿童的同理心和心理理论，并检查了它们与焦虑严重程度的关系。对 174 名年龄在 4-8 岁之间的儿童进行了横断面研究，这些儿童因在学校出现情绪、认知或行为问题而被学校老师推荐进行评估，这些儿童具有新兴的心理健康问题。参与者完成了同理心和心理理论任务。家长接受了访谈，并对孩子的情绪和行为问题进行了评分。相关分析表明，焦虑程度升高与更好的认知心理理论和更差的情感同理心有关；焦虑与认知同理心或情感同理心之间没有关联。随后的回归分析表明，虽然增强的认知心理理论可以通过年龄和语言智商来解释，但焦虑症状可以独特地预测情感同理心受损。这些结果表明，有焦虑症状的儿童在分享他人的情绪方面存在困难。因此，他们可能会发现，在与他人的情感分享互动中，很难表现出适当的社交行为。这些发现鼓励使用早期和针对性的干预措施，以改善具有焦虑症状的儿童的情感同理心发展。
