Clements Emily, Naragon-Gainey Kristin, Weinborn Michael, Pestell Carmela, Neumann Dawn, Preece David, Becerra Rodrigo
School of Psychological Science, The University of Western Australia, Perth, Australia.
Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
Neuropsychol Rev. 2025 Jun 18. doi: 10.1007/s11065-025-09667-5.
Empathy is the ability to recognise, share and understand others' emotional states. Increasing evidence suggests that empathy may be impacted by acquired brain injury (ABI), with consequences for social and emotional functioning. However, the literature has been characterised by inconsistent findings and small sample sizes. To address these limitations, we provide the first meta-analytic review of empathy in adults with ABI. Specifically, the review aimed to quantify the degree of impairment in adults with ABI across four empathy-related domains: cognitive, affective, empathic concern (e.g. sympathy) and personal distress. We also sought to estimate the prevalence of deficits in each area and explore whether demographic and injury factors moderate impairment. A systematic search yielded 29 studies measuring self-reported empathy in adults with ABI versus healthy, matched peers. A series of random-effects meta-analyses revealed moderate deficits in cognitive empathy (Hedges' g = - 0.68, 95% CI [- 0.87, - 0.50]) and affective empathy (Hedges' g = - 0.43, 95% CI [- 0.65, - 0.21]), as well as small-to-moderate deficits in empathic concern (Hedges' g = - 0.38, 95% CI [- 0.63, - 0.13]). No significant difference was found for personal distress. We estimated the proportion of ABI participants scoring equal to or more than 1 SD below the normative mean to be 15.3-35.0%, depending on the empathy subcomponent. Our results highlight that empathy deficits may play an important role in functional or emotional difficulties post-brain injury. This demonstrates the need for routine clinical assessment of empathy in survivors of brain injury and the need to develop interventions which target both cognitive and affective components.
同理心是识别、分享和理解他人情绪状态的能力。越来越多的证据表明，后天性脑损伤（ABI）可能会影响同理心，进而影响社交和情感功能。然而，相关文献的研究结果并不一致，且样本量较小。为解决这些局限性，我们首次对成年ABI患者的同理心进行了荟萃分析综述。具体而言，该综述旨在量化成年ABI患者在四个与同理心相关的领域中的受损程度：认知、情感、共情关注（如同情）和个人痛苦。我们还试图估计每个领域中缺陷的发生率，并探讨人口统计学和损伤因素是否会调节损伤程度。一项系统检索得出了29项研究，这些研究测量了成年ABI患者与健康的匹配同龄人自我报告的同理心。一系列随机效应荟萃分析显示，认知同理心存在中度缺陷（Hedges' g = -0.68，95% CI [-0.87, -0.50]），情感同理心存在中度缺陷（Hedges' g = -0.43，95% CI [-0.65, -0.21]），共情关注存在小到中度缺陷（Hedges' g = -0.38，95% CI [-0.63, -0.13]）。个人痛苦方面未发现显著差异。根据同理心子成分的不同，我们估计ABI参与者得分比正常均值低1个标准差及以上的比例为15.3%-35.0%。我们的研究结果强调，同理心缺陷可能在脑损伤后的功能或情感困难中起重要作用。这表明有必要对脑损伤幸存者进行常规的临床同理心评估，以及开发针对认知和情感成分的干预措施。
