A Systematic Review and Meta-Analysis of Cognitive and Affective Empathy Ability in Adults With Chronic Pain Relative to Healthy Controls.

OBJECTIVE

Individuals with chronic pain (CP) often report difficulties with their social relationships. Empathic capacity is crucial for the development and maintenance of social relationships and deficits contribute to social difficulties. This review explored whether empathic capacity is disrupted in people with CP.

METHODS

A systematic review and meta-analysis was conducted following PRISMA guidelines. PsycINFO, CINAHL Complete, MEDLINE Complete, and Scopus were searched on May 14, 2023, for studies published in English in a peer-reviewed journal that assessed differences in cognitive or affective empathy in adults with CP and healthy controls (HC). The Appraisal Tool for Cross-Sectional Studies was used to evaluate study quality.

RESULTS

Eighteen studies were eligible ( Npooled = 1239) and two correlated effects robust variance estimation meta-analyses were conducted. Cognitive empathy (CE) was found to be poorer in people with CP relative to HC, but no significant difference was found between groups for affective empathy (AE). Subanalyses were conducted to explore the specific subconstructs of AE (affect sharing, empathic concern) and CE (affect attribution, mental state attribution), and how these are measured (self-report, performance).

CONCLUSIONS

Relative to HCs, people with CP exhibit moderate CE difficulties. Significant AE difficulties were not evident in the CP group, though since power was limited, and effect sizes of moderate to large magnitude were identified for some subcomponents of AE, caution is warranted interpreting these null findings. Overall, findings meaningfully extend current understanding of potential barriers to interpersonal function in people with CP and have implications for treatment and recovery approaches. Further research is needed to consider the potential moderators.