Understanding empathy and its disorders through a focus on the neural mechanism.
Abstract
Empathy is a complex, multi-dimensional process. As such, it can be impaired at multiple stages, producing disorders of empathy with separable underlying causes. Studies often divide empathy into emotional and cognitive components to simplify the large space of empathic processes. This practice can be helpful, but also causes people to misunderstand their interdependence at the level of the mechanism and how they correspond to surveys and tasks. As a result, inferences made from experimental results are often incorrect and cannot be integrated across studies. We explain how emotional and cognitive empathy overlap through the proximate mechanism and clarify their operationalization in common surveys and tasks. A systematic review of three clinical disorders is used to highlight this issue and reinterpret and unite results according to the proximate framework--Borderline Personality Disorder (BPD), Narcissistic Personality Disorder (NPD), and Frontotemporal Dementia (FTD). Aligning constructs through the proximate mechanism allows us to understand both empathy and its disorders.
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Oliver, L. D., Mitchell, D. G. V., Dziobek, I., MacKinley, J. D., Coleman, K. K. L., Rankin, K. P., & Finger, E. C. (2014) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2014.11.022 · Cited by 64 · see citing works
Mohr, A. H., & Preston, S. D. (2011) · Cognition & Emotion · doi:10.1080/02699931.2011.559192 · Cited by 62 · see citing works
Self-citationVilladangos, M., Errasti, J. M., Vázquez, I. A., Jolliffe, D., & Garcı́a-Cueto, E. (2016) · Psicothema · doi:10.7334/psicothema2016.6 · Cited by 61 · see citing works
‘ Canis empathicus ’? A proposal on dogs' capacity to empathize with humans
Silva, K., & de Sousa, L. (2011) · Biology Letters · doi:10.1098/rsbl.2011.0083 · Cited by 57 · see citing works
Preston, S. D., & Stansfield, R. B. (2008) · Cognitive Affective & Behavioral Neuroscience · doi:10.3758/cabn.8.1.54 · Cited by 57 · see citing works
Self-citationLishner, D. A., Hong, P. Y., Jiang, L., Vitacco, M. J., & Neumann, C. S. (2015) · Personality and Individual Differences · doi:10.1016/j.paid.2015.05.036 · Cited by 43 · see citing works
Altered Empathy for Psychological and Physical Pain in Borderline Personality Disorder
Flasbeck, V., Enzi, B., & Brüne, M. (2017) · Journal of Personality Disorders · doi:10.1521/pedi_2017_31_276 · Cited by 40 · see citing works
Kalpakci, A. H., Vanwoerden, S., Elhai, J. D., & Sharp, C. (2015) · Journal of Personality Disorders · doi:10.1521/pedi_2015_29_192 · Cited by 35 · see citing works
Ritzl, A., Csukly, G., Balázs, K., & Égerházi, A. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.09.017 · Cited by 34 · see citing works
Zabihzadeh, A., Maleki, G., Richman, M. J., Hatami, A., Alimardani, Z., & Heidari, M. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.07.034 · Cited by 24 · see citing works
(2016) · North American journal of psychology · Cited by 22 · see citing works
Emotional caricatures in frontotemporal dementia
Clark, C. N., & Warren, J. D. (2015) · Cortex · doi:10.1016/j.cortex.2015.07.026 · Cited by 20 · see citing works
Clinical update on frontotemporal dementia: diagnosis and treatment
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Hsing, C. K., Mohr, A. H., Stansfield, R. B., & Preston, S. D. (2013) · International journal of psychological research · doi:10.21500/20112084.719 · Cited by 13 · see citing works
Self-citationMohr, A. H., Kross, E. F., & Preston, S. D. (2016) · Adaptive Human Behavior and Physiology · doi:10.1007/s40750-016-0044-x · Cited by 8 · see citing works
Self-citationAuthor reply: Understanding Empathy by Modeling Rather Than Organizing Its Contents
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Self-citationUnderstanding Empathy by Modeling Rather Than Organizing Its Contents
Preston, S. D., & Mohr, A. H. (2011) · Cited by 4 · see citing works
Self-citation
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The dark side of empathy in narcissistic personality disorder
di Giacomo, E., Andreini, E., Lorusso, O., & Clerici, M. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1074558 · Cited by 34 · see citing works
- Authors
- Preston, S. D., Ermler, M., Lei, Y., & Bickel, L.
- Affiliations
- University of Michigan (US)
- Scripps College (US)
- Corresponding author
- Preston, Stephanie D.
- Venue
- Cortex
- Publisher
- Elsevier BV
- Published
- 2020-06
- Volume
- 127
- Pages
- 347-370
- ISSN
- 0010-9452 (ISSN-L)
- OpenAlex
- W3011714118
- Cited by
- 23
- References
- 131
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 4 · 2023: 6 · 2022: 2 · 2021: 1 · 2020: 2
- FWCI
- 3.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cortex (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Scripps College Summer Internship Grant
- University of Michigan Rackham Graduate Program
- Templeton Foundation Positive Neuroscience Grant
- Topics
- Social Sciences › Psychology › Social Psychology › Action Observation and Synchronization
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- empathy, affective empathy, cognitive empathy, neural mechanisms of empathy, borderline personality disorder, narcissistic personality disorder, frontotemporal dementia, construct operationalization
- MeSH terms
- Borderline Personality Disorder, Emotions, Empathy, Humans, Personality Disorders, Frontotemporal Dementia
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