Motivation and emotion/Book/2014/Empathy development

Overview
Empathy is a construct that bridges the gap between emotion and motivation. Empathy can elicit emotions that have a powerful motivating force towards pro-social behaviour. True empathy includes affective and cognitive components and combines emotion sharing with the ability to understand and identify the origins of empathically elicited emotions. Empathic mimicry is present in newborn infants, however, true empathy develops over childhood as individuals develop self-awareness and theory of mind. Autism spectrum disorder and a variety personality disorders may cause individuals to have diminished empathy and represent various forms of atypical empathic development. There are treatment options for these disorders, however, their capacity to enact therapeutic outcomes is limited. In non-pathological individuals, increased empathic ability can be cultivated through perspective-taking exercises and can result in positive outcomes including reduced punitive action and decreases in racial bias.

What is empathy?
Empathy is a complex psychological construct that includes cognitive and affective components of interpersonal interactions (Decety & Meyer, 2008). Simply put, empathy is the ability to identify with and experience the emotions of another individual (Vaughan & Hogg, 2010). Empathy allows individuals to assume emotional states that are relevant to another individual without having to directly experience their situation (Decety & Meyer, 2008). Empathy is fundamentally important for interpersonal communication as it facilitates perspective taking; the ability to consider things from another point of view (Decety & Meyer, 2008). Empathy also allows individuals to experience empathic concern (Decety & Meyer, 2008). Empathic concern causes an individual to experience feelings of kindness and compassion for individuals in need of assistance (Vaughan & Hogg, 2010). As empathy facilitates compassion it is also thought to be integral to the development of prosocial behaviour including altruism (Vaughan & Hogg, 2010).

The components of empathy
In its most basic form, empathy may cause an individual to reflexively assume the same emotional state as another person. This type of automatic response has been termed motor empathy or empathic mimicry (Decety & Meyer, 2008). An example of empathic mimicry is reflexive crying (Geangu, Benga, Stahl, & Striano, 2010). Reflexive crying is a phenomenon where infants begin crying when exposed to another crying infant (Geangu, et al., 2010). True empathy requires two complex cognitive faculties; self-awareness and theory of mind (Decety & Meyer, 2008). Self-awareness is a mental property that allows an individual to envision themselves as distinct from their environment and to distinguish between their actions and other changes in their surroundings (Decety & Meyer, 2008). Self-awareness also includes the ability to understand how the individual interacts with their environment and how their environment affects them (Decety & Meyer, 2008). The ability to understand that an individual’s actions interact with their environment is also known as a sense of agency (Decety & Meyer, 2008). Once an individual has developed self-awareness they may then develop theory of mind.

Theory of mind is the understanding that others also have feelings, thoughts and attitudes that are distinct from the individuals’ own (Apperly, Samson, Chiavarino, & Humphreys, 2004). A self-aware individual without theory of mind views the world as composed of two elements, themself and their environment. An individual with these mental properties would view the interactions of others as either having a cause within themselves or as arising due to the nature of their environment. However an individual with developed theory of mind is able to conceptualise the existence of other people, interacting with their environments in accordance with their own motivations (Apperly, et al., 2004). Theory of mind allows an individual to experience true empathy (Decety & Meyer, 2008). In contrast to the empathic mimicry, true empathy allows a person to experience and identify the emotions of another individual whilst understanding that the source of these emotions is external and is derived from another person’s experience rather than their own (Decety & Meyer, 2008). It is this distinction that allows empathy to facilitate prosocial behaviour via empathic concern while empathic mimicry would motivate concern for oneself.

The neuroscience of empathy
Empathic functioning is derived from multiple mechanisms in the brain. A type of neuron involved in the observational learning of motor activity called mirror neurons appear to also play a role in the recognition of emotions in facial expressions and in empathic mimicry (Decety & Meyer, 2008). The neurotransmitter oxytocin may also be involved in these processes (Melchers, Montag, Markett, & Reuter, 2013). The frontal lobe and the temporo-parietal lobe are believed to play an important role in the cognitive aspects of empathy by facilitating theory of mind (Apperly, et al., 2004).

Childhood development
Early research into the development of empathy suggested that young children were not capable of experiencing empathetic responses (Freud, 1958; Piaget, 1965). Further research has shown evidence that young children are able to display complex empathetic responses (Zahn-Waxler, Radke-Yarrow, Wagner, & Chapman, 1992a; Zahn-Waxler, Robinson, & Emde, 1992b). Measuring empathetic responses in young children does have issues due to restrictions in their verbal expressiveness. A typical way to measure empathy in young children is to examine their responses to others’ distress.

Reflexive crying
Reflexive crying, or emotional contagion refers to the phenomena in which newborns as early as 18 to 72 hours after birth show signs of distress when exposed to the sound of other infants crying (Martin & Clark, 1982) Newborns have been found to react more intensely to the crying of another infant than an assortment of control stimuli, including white noise, silence, non-human cries, synthetic cries and their own cry (Martin & Clark, 1982). This finding supports the idea that there is a biological predisposition to basic empathetic responses in newborn children.

Personal distress responses
Feelings of personal distress in response to the adverse emotional occurrences of others’ during infancy are considered to be the initial stages of empathetic concern responses (Zahn-Waxler & Radke-Yarrow, 1990). As young infants do not have an understanding of self-concept they cannot fully distinguish themselves from others and only have simple emotional regulations (Zahn-Waxler & Radke-Yarrow, 1990). Infants can become overwhelmed by others’ adverse emotional responses and may practice self-soothing behaviours to reduce their own distress Zahn-Waxler & Radke-Yarrow, 1990).

Empathetic responses in toddlers
Zahn-Waxler and colleagues (1992a) have carried out longitudinal studies that look at the development of empathy and related behaviours in two and three year old toddlers. These studies examined the responses of children aged 14 to 36 months, to simulated distress of a parent and of a stranger in their home and in a laboratory environment. Different empathic responses were measured including concern, hypothesis testing, prosocial behaviours and precursors to empathy including self-referential behaviors and personal distress. These behaviors were noted to advance significantly when the children reached two years of age and they increased their empathic concern, prosocial behaviours and hypothesis testing (Zahn-Waxler et al., 1992a). The quality of these prosocial behaviours also developed in the children’s second year. Additionally there was an increase in helping behaviors, including verbal comforting, sharing and trying to distract the distressed person (Zahn-Waxler et al., 1992a). By age three children and were capable of using a number of empathy related behaviours including verbal and facial concern, interest in the distress of another person and continued use of helping behaviours (Zahn-Waxler et al., 1992a).

Empathetic responses in early childhood
Cognitive empathic gains occur significantly as children enter their preschool and primary school years (Wellman, Cross & Watson, 2001). These developments occur in part as children have increased capabilities for language, which help to facilitate empathetic reflections and also assist the measurement of empathetic reflections (Wellman et al., 2001). Preschoolers, children at 4-5 years of age, are in general able to take on the perspectives of others in false belief tasks, which are commonly used to indicate the development of theory of mind (Wellman et al., 2001).

Wellman and colleagues (2001) used a false belief tasks to asses theory of mind in children (Wellman et al., 2001). In this task the children were presented with scenarios involving two individuals. One of the individuals lay down an item and left the room, after the first individual had left the room the second individual moved the item to a new location. When the first individual returned to the room the child was asked where the first individual would try and find the item. Children who had developed theory of mind stated that the individual would look in the original location, instead of where the second individual placed the object. This indicates that the child had a basic capacity to see the situation from the perspective of the first individual (Wellman et al., 2001).

Empathetic responses in adolescence
Adolescence is an important period for the development of empathy (Van der Graaff, Branje, De Wied, Hawk, Van Lier, & Meeus, 2014). Theorists have proposed that although empathic responses are seen in early childhood, perspective advances in adolescence can further enhance the ability to display empathic concern (Hoffman, 2000). Cross-sectional studies have shown no association between age and empathic concern in eighth and 11th grade students (Karinol, Gabay, Ochion, & Harari,1998). However, other studies have shown a positive association for girls with a sample of 13 to 16 year olds (Olweus & Endresen, 1998).

A recent report published by Van der Graaf and colleagues in 2014 has shown evidence that the development of empathic concern in adolescents may be affected by pubertal status. This study has revealed that gender differences in perspective taking and empathic concern emerged during adolescence. Girls were found to show higher levels of empathic concern than boys, and to have a steeper increase of perspective taking throughout adolescence. It was also shown that boys showed a decrease in empathic concern from early to the middle of their adolescence, and then returned to their original level of empathy. Girls’ levels of empathic concern remained stable throughout their adolescence. The study also suggested that boys who were more physically mature reported lower empathic concern. This suggests that there are gender differences in adolescents’ empathic concern and that boys who mature faster will have lower empathic concern than their peers (Van der Graaf et al., 2014).

Autism spectrum disorder
Autism spectrum disorder (ASD) is a psychological disorder characterised by a variety of deficiencies in social functioning (American Psychiatric Association, 2013). Individuals with (ASD) often present with atypical empathic ability (Decety & Meyer, 2008). Individuals with ASD display a reduced ability to identify emotions based on facial expressions (Clark, Winkielman, & McIntosh, 2008). Individuals affected by ASD may suffer impairment in their ability to perform the cognitive aspects of empathy. Research into ASD has shown that individuals with the disorder may struggle to differentiate between their actions and themselves and those of other people (Decety & Meyer, 2008) this is characteristic of deficiencies in self-awareness (Decety & Meyer, 2008). Individuals with ASD also display deficiencies in theory of mind (Lind, Williams, Raber, Peel, & Bowler, 2013). Self-awareness and theory of mind are essential to the development of cognitive empathy.

The empathy imbalance hypothesis states that individual with ASD are deficient in the cognitive aspects of empathy but possess an enhanced capacity to experience emotions displayed by others in their presence (Smith, 2009). Research into gender differences in empathy has found that women display a greater aptitude for empathy than males (Teatero, & Netley, 2013). Building on these findings, the extreme-male-brain hypothesis attempts to make sense of the atypical empathic abilities of individuals with ASD. The extreme-male-brain hypothesis states that the symptoms of ASD result from abnormal fetal testosterone exposure which causes the development of features similar to those found in a typical male brain, but differentiated to a much greater magnitude (Teatero, & Netley, 2013). Although research into this hypothesis is in the early stages, studies using brain imaging and biomarkers suggest that it may have merit (Teatero, & Netley, 2013).

Personality disorders
Personality disorders are pathological patterns of behaviour and experience that cause deviation from cultural norms and distress or impairment (American Psychiatric Association, 2013). These disorders develop in adolescence or early adult hood and are relatively stable throughout an individual’s lifetime (American Psychiatric Association, 2013). The behavioural and experiential effects of personality disorders are notable for being extremely inflexible and pervasive (American Psychiatric Association, 2013). In the past personality disorders have been viewed as unresponsive to treatment (Benjamin, & Karpiak, 2001). Contemporary research has indicated that it is possible to achieve positive outcomes for individuals with personality disorders through use of psychotherapy, although this treatment does provide diminishing returns over time (Benjamin, & Karpiak, 2001). Although the factors that contribute to the success of this treatment are unclear, a strong therapeutic relationship and a willingness to change on the part of the individual appear to be key (Benjamin, & Karpiak, 2001). The following sections will discuss personality disorders which effect empathic development.

Antisocial personality disorder
Antisocial personality disorder (APD) is a personality disorder characterised by a pattern of behaviour that results in the violation of others rights. Individuals with APD, which has also been called psychopathy or sociopathy, present with high levels of aggression and a lack of remorse (American Psychiatric Association, 2013). The absence of empathy is considered to be one of defining features of psychopathy (Hare, & Neumann, 2009) and has been traditionally been viewed as central to the disorder (American Psychiatric Association, 2013).

Borderline personality disorder
Individuals diagnosed with borderline personality disorder (BPD) display deficits in theory of mind and cognitive aspects of empathy including perspective taking (Harari, Shamay-Tsoory, Ravid, & Levkovitz, 2010). However individuals with BPD do not display deficits in their affective aspects of empathy and actually show an increased capacity to identify emotion through facial expressions (Harari, Shamay-Tsoory, Ravid, & Levkovitz, 2010). Individuals with borderline personality disorder display an unstable sense of self (American Psychiatric Association, 2013) which may be linked to their deficits in theory of mind.

Narcissistic personality disorder
The relationship between empathy and narcissistic personality disorder (NPD) is complex (Baskin-Sommers, Krusemark, & Ronningstam, 2014). There is some evidence that individuals with narcissistic personality disorder may be able to deactivate their empathic responses in order to avoid experiencing negative emotions (Baskin-Sommers, et al., 2014). Whilst some in individuals with NPD display highly functioninhg empathy others suffer from reduced ability to identify emotions in others (Baskin-Sommers, et al., 2014). Additionally, the personality features present in NPD, such as emotion intolerance and self-centeredness may be disruptive to empathic processes (Baskin-Sommers, et al, 2014)

Enhancing empathy
Recent findings by Goldstein and Winner (2012) have shown that acting can be used as a way to enhance empathy skills and theory of mind in adolescents. Two studies were conducted in which adolescents were taught a year of acting or other arts (music, visual art). Empathy and theory of mind were assessed before and after teaching. Both studies showed that adolescents who undertook acting lessons showed significant gains in empathy scores. The increases in empathy scores were hypothesized to result from an improvement in perspective taking ability.

Research into psychology in the criminal justice system has shown that perspective taking exercises can be used to elicit empathy and that this process can lead to a reduction in the severity of punitive action (Skorinko, Laurent, Bountress, Nyein, & Kuckuck, 2014). Perspective taking has also be shown to increase empathy for stigmatized racial groups (Shih, Stotzer, & Gutiérrez, 2013). This technique is effective in combating racial biases (Shih et al., 2013).

Conclusion
Empathy is an important ability that promotes pro-social behaviour and interpersonal communication. The fundamentals of empathy are present at birth, however development throughout childhood is essential for an individual to be able to achieve true empathy. Autism spectrum disorder and personality disorders represent atypical empathic development but may be able to be corrected through treatment. Healthy individuals can also improve their capacity for empathy through perspective taking exercises and doing so provides a range of benefits.


 * Complete this quiz to test your knowledge on the development of empathy
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{Empathic mimicry is usually - A learned skill. - A personality disorder symptom. + An ability infants have at birth.
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{Empathy has _______ & _______ components. + Affective and cognitive. - Affective and altruistic. - Personality and cognitive.
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{The empathy imbalance hypothesis states that individuals with ASD have - Too much empathy. - A deficit in affective empathy and increased capacity for cognitive empathy. + A deficit in cognitive empathy and increased capacity for affective empathy.
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{There is evidence that people with narcissistic personality disorder have - Personality features that disrupt their emphatic ability. - Varying emphatic capacity from individual to individual. - The ability to turn off their empathy. + All of the above.
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{The progression towards true empathy goes + Empathic mimicry, self-awareness, theory of mind. - Theory of mind, self awareness, empathic mimicry. - Self-awareness, empathic, mimicry.
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{Empathic ability can be enhanced by - Sleeping more + Perspective taking - Making new friends
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