Empathy in Mental Illness

Author: Tom F. D. Farrow; Peter W. R. Woodruff  

Publisher: Cambridge University Press‎

Publication year: 2007

E-ISBN: 9780511276392

P-ISBN(Paperback): 9780521847346

Subject: R749.055 psychological therapy

Keyword: 神经病学与精神病学

Language: ENG

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Empathy in Mental Illness

Description

The lack of ability to emphathize is central to many psychiatric conditions. Empathy is affected by neurodevelopment, brain pathology and psychiatric illness. Empathy is both a state and a trait characteristic. Empathy is measurable by neuropsychological assessment and neuroimaging techniques. This book, first published in 2007, specifically focuses on the role of empathy in mental illness. It starts with the clinical psychiatric perspective and covers empathy in the context of mental illness, adult health, developmental course, and explanatory models. Psychiatrists, psychotherapists and mental heath professionals will find this a very useful reference for their work.

Chapter

2.6 Theoretical consideration

2.7 Future directions

2.8 Conclusion

References

3 Empathy, antisocial behaviour and personality pathology

3.1 Introduction

3.1.1 Definitions of empathy

3.1.2 Measures of empathy

Self-report questionnaires

Facial/gesture indexes of empathy

3.2 Empathy and offending

3.3 Empathy and aggression

3.4 Empathy, antisocial behaviour, and the antisocial personality disorders

3.5 Theory of Mind and the antisocial personality disorders

3.6 Emotional information processing in the antisocial personality disorders

3.7 Empathy and emotion recognition in sex offenders

3.8 Empathy and child abuse

3.9 Empathy and narcissism

3.10 Summary/Conclusions

References

4 Empathy and depression: the moral system on overdrive

4.1 Introduction

4.2 Depression: prevalence, costs and theories of aetiology

4.3 Empathy and developmental pathways to depression

4.4 Survivor guilt and depression

4.5 Programme of research: empathy, guilt and depression

4.6 Other empirical studies: empathy and depression

4.7 Evolutionary theories: empathy and depression

4.8 The evolution of altruism and evolved mechanisms at work in depression

4.9 Empathy, depression, and current neuroscience

4.10 Conclusions

Authors’ note

References

5 Empathy, social intelligence and aggression in adolescent boys and girls

5.1 Introduction

5.2 Sex differences in indirect aggression

5.3 Indirect aggression and social intelligence

5.4 Social intelligence and empathy

5.5 Relationships between social intelligence, empathy and conflict behaviour

5.6 Empathy training as an inhibitor of aggression

References

6 Impaired empathy following ventromedial prefrontal brain damage

6.1 Introduction

6.2 The anatomy of the ventromedial prefrontal cortex

6.3 The neuroanatomical basis of empathy: the role of the frontal lobes

6.3.1 What is the empathic ability comprised of?

6.3.2 Impaired empathic ability following prefrontal lesions

6.3.3 Impaired ‘mindreading’: the case of ToM

6.3.4 Further evidence for the role of the PFC in empathy: frontotemporal dementia studies

6.4 The role of the VM PFC in social cognition

6.5 A neural network for the organization of the empathic response: an integrative view

6.6 Summary

References

7 Non-autism childhood empathy disorders

7.1 Introduction

7.2 Empathy and ‘disorders of empathy’

7.3 Diagnostic conditions that contain an important subgroup with empathy disorder

7.4 Asperger’s syndrome and the inappropriate label of high-functioning autism

7.5 Attention-deficit/hyperactivity disorder (ADHD) with and without developmental coordination disorder (DCD)

7.6 Pervasive developmental disorders not otherwise specified

7.7 Tourette and other tic disorders

7.8 Obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD)

7.9 Other personality disorders

7.10 Eating disorders

7.11 Selective mutism

7.12 Childhood schizophrenia

7.13 Bipolar disorder

7.14 Conduct disorder and oppositional-defiant disorder (ODD)

7.15 Conclusions

References

8 Empathy and autism

8.1 Introduction

8.2 Early manifestations of autism

8.3 Research with older children and adolescents with autism

8.4 Developmental implications

8.5 Autism: a disorder of empathic relatedness?

References

Part II Empathy and related concepts in health

9 Neonatal antecedents for empathy

9.1 Introduction

9.2 Models for the development of empathy

9.2.1 Temperament/newborn arousal and regulation theories

9.2.2 Attunement among dyads

9.2.3 Stage theories

9.2.4 Learning and modelling theories

9.3 Overview of associations between newborn distress studies and empathy

9.4 Maternal psychological and physiological functioning predict the development of empathy in children

9.5 Dysfunctional socialization experiences influence the development of empathy by disrupting physiological and psychological regulation patterns

9.5.1 Maternal psychological neglect

9.5.2 Maternal abuse

9.6 A new definition and future directions for the study of newborn distress and empathy

9.7 Implications for practice when working with newborns and their mothers

9.8 Summary

References

10 The evolutionary neurobiology, emergence and facilitation of empathy

10.1 Introduction

10.2 Mutual aid

10.3 Neuroethology: the original of parental behaviours

10.3.1 Evolutionary origins of audiovocal communication: the isolation call

10.4 Neurophysiology: oxytocin and social behaviour

10.5 Evolution of the autonomic nervous system and social engagement

10.6 Mirror neurones

10.6.1 Role in understanding intentions

10.6.2 Role in understanding emotional states

10.7 Social bonding and attachment

10.8 Development of empathy in childhood

10.9 Summary

References

11 Naturally occurring variability in state empathy

11.1 Introduction

11.2 Issues in studying states

11.3 Daily variability in state empathy

11.4 Empathy in naturally occurring social interaction

11.5 Implications for mental health

References

12 Neuroimaging of empathy

12.1 Introduction

12.2 A neuroimaging primer

12.3 Component cognitive processes relevant to empathy

12.4 Neuroimaging studies of component parts of empathy

12.4.1 Socially relevant stimuli

12.4.2 Theory of Mind and social cognition

12.4.3 Self-awareness

12.4.4 Mirror neurones

12.4.5 General emotional processing

12.5 Studies of empathy itself

12.5.1 Emotional mimicry studies

12.5.2 Disgust

12.5.3 Pain

12.5.4 Empathy and sympathy

12.5.5 Empathy and forgiveness

12.6 Other relevant neuroimaging studies

12.7 Conclusions

References

13 The neurophysiology of empathy

13.1 Theories of empathy

13.1.1 Evolutionary theories of empathy

13.1.2 Somatic theories of empathy

13.1.3 Individual differences theories of empathy

13.2 EEG activity - a method of measuring brain-behaviour relations

13.3 Overview of associations between brain regions and empathy

13.3.1 The limbic circuitry

13.3.2 The temporal lobes

13.3.3 The frontal lobes

13.3.4 The autonomic nervous system

13.4 Empirical studies of the neurophysiological substrates of empathy

13.4.1 In development

13.4.2 Biobehavioural preparedness

13.4.3 Heritability

13.4.4 Individual contributions and temperament

13.4.5 In adults

13.5 Dysfunctional socialization experiences and changes in brain activation and empathic responding

13.6 Frontal lobe dysfunction and consequences for empathic responding

13.7 Summary

References

14 The cognitive neuropsychology of empathy

14.1 Introduction

14.2 Affective sharing between self and other

14.3 Beyond the perception-action coupling

14.4 Agency and self-awareness

14.5 Adopting the perspective of the other

14.6 Emotion regulation

14.7 Multiple facets of empathy disorders

14.8 From covert to overt representation of others’ mental states

References

15 The genetics of empathy and its disorders

15.1 Introduction

15.2 Deconstructing empathy

15.3 The component processes leading to empathy

15.4 Autism and empathy

15.5 Autism and personality

15.6 Empathy and personality

15.7 Empathy and psychiatric taxonomy

15.8 The genetics of empathy

15.8.1 Adoption, twin and extended family research

15.8.2 Association with specific genetic disorders

15.8.3 Linkage studies

15.8.4 Candidate gene research

15.9 Importance of gene-gene and gene-environment interactions for empathy

15.10 Implications for further research

References

16 Empathogenic agents: their use, abuse, mechanism of action and addiction potential

16.1 Introduction

16.2 The empathy concept

16.3 Raves and the pursuit of empathy

16.4 The concept of recreational use and addiction

16.5 Ordeal and near-death experience

16.6 The dopaminergic rewarding mechanism

16.7 Empathogenic substances

16.8 Designer drugs

16.9 Smart drugs

16.10 Ecstasy, an empathogenic and entactogenic molecule

16.10.1 History

16.10.2 Presentation

16.10.3 Effects

16.10.4 Testing

16.10.5 Neurobiochemical aspects

16.10.6 Ecstasy and the serotonergic system

16.10.7 The serotonergic deficiency syndrome

16.10.8 Neuroendocrine modifications

16.10.9 Empathy and imitation behaviours

16.11 Other empathogenic substances of the phenylethylamine type

16.11.1 MDA

16.11.2 MDEA

16.11.3 MBDB

16.11.4 2C-B

16.11.5 DOM or STP

16.12 Tryptamine-type empathogenic substances

16.12.1 DMT

16.13 Arylhexylamine-type empathogenic substances

16.13.1 PCP or phencyclidine

16.13.2 Ketamine: [2-(2-chlorophenyl)-2-methylamino-cyclohexan-1-one]

16.14 Other psychoactive substances

16.14.1 GHB: gamma-hydroxybutyric acid, Gamma-OHTM

16.14.2 LSD

16.15 Conclusions

References

17 Existential empathy: the intimacy of self and other

17.1 Imitation and empathy between self and other

17.2 Neural precursors of imitation and empathy

17.3 Human homologues of macaque mirror neurone areas

17.4 Imitation and empathy: the links between mirror neurones and the limbic system

17.5 The mirror neurone system and self-recognition

17.6 Existential empathy and existential neuroscience

17.7 Conclusion

References

18 Empathizing and systemizing in males, females and autism: a test of the neural competition theory

18.1 Empathizing and systemizing: sex differences

18.2 Autism

18.3 The empathy quotient (EQ) and the systemizing quotient (SQ)

18.4 Do the EQ and SQ ‘sex’ the brain? A re-analysis of the 2003 dataset

18.5 Interpretation

18.6 A taxonomy of brain types, based on the difference between empathy and systemizing

18.7 The brain basis of empathy: further distinctions?

18.8 Conclusions

Acknowledgments

References

19 Motivational-affective processing and the neural foundations of empathy

19.1 Introduction

19.2 Vicarious responding in a motivational-affective (M-A) framework

19.2.1 Studying vicarious responding

19.2.2 Domain-specific vicarious responses: pain and disgust

19.2.3 A motivational-affective framework

19.3 M-A systems in pain and disgust

19.3.1 Parsing pain

19.3.2 From motivation to movement

19.3.3 From learning to communication

19.3.4 Beyond vicarious responding

19.4 The analogy with mirror neurones

19.4.1 Comparison between M-A and action representation networks

19.4.2 Similarities

19.4.3 Differences: ‘hot’ versus ‘cold’ motor processing

19.4.4 Conclusions

Acknowledgements

References

20 Face processing and empathy

20.1 Introduction

20.2 How might perceptually mediated empathy enable emotion recognition?

20.3 Relationships between emotional state and emotion recognition performance

20.4 Emotion recognition via primitive emotional contagion

20.5 Emotion recognition via simulation

20.6 Concluding remarks

Acknowledgements

References

Part III Empathy models, regulation and measurement of empathy

21 Balancing the empathy expense account: strategies for regulating empathic response

21.1 Introduction

21.2 Defining empathy

21.3 Regulating emotional empathy

21.4 Regulating cognitive empathy

21.5 Shortcuts to cognitive empathy

21.6 The dark side of empathy… the costs of poor regulation

21.7 Undershooting emotional empathy

21.8 Overshooting emotional empathy

21.9 Undershooting cognitive empathy

21.10 Overshooting cognitive empathy

21.11 Closing thoughts

Acknowledgements

References

22 Empathic accuracy: measurement and potential clinical applications

22.1 Introduction

22.2 Assessment: the empathic accuracy paradigm

22.2.1 The unstructured dyadic interaction paradigm

22.2.2 The standard stimulus paradigm

22.2.3 Obtaining a measure of empathic accuracy

22.2.4 Reliability

22.2.5 Validity

22.3 Clinical implications of empathic accuracy research

22.3.1 Individual differences in empathic accuracy

Selecting for empathic accuracy

Training empathic accuracy

22.3.2 Empathic accuracy and couples’ therapy

Motivated inaccuracy

Motivated accuracy

Motivated attributional bias

22.3.3 Empathic accuracy and autism

22.3.4 Empathic accuracy and borderline personality disorder

22.4 Summary

References

23 A perception-action model for empathy

23.1 Introduction

23.2 Breaking down the PAM

23.2.1 Perception Action

23.2.2 Representations

23.2.3 Shared emotional experience and similar emotion

23.2.4 Automatically

23.2.5 Attention

23.3 Recent neuroscientific evidence

23.4 Disorders of empathy

23.4.1 Autism

23.4.2 Psychopathy

23.4.3 Frontal lobe damage

23.4.4 Depression

23.5 Summary

References

24 The Shared Manifold Hypothesis: embodied simulation and its role in empathy and social cognition

24.1 Introduction

24.2 Embodied simulation

24.3 Action understanding

24.3.1 The understanding of object-related actions

24.3.2 The understanding of intransitive actions

24.4 Experiencing the actions of others as embodied action simulation

24.5 The body of emotions

24.6 Being ‘in touch’

24.7 The shared manifold and empathy

24.8 Psychopathological implications of intentional attunement: schizophrenia

24.9 Psychopathological implications of intentional attunement: autism

24.10 Conclusions

Acknowledgments

References

25 Using literature and the arts to develop empathy in medical students

25.1 The problematic role of empathy in medicine

25.2 Theorizing a humanities-based approach to train empathy

25.3 A theoretical model

25.4 Translational applications

25.5 State of the research on the humanities and empathy

25.6 Mental illness as an exemplar of ‘otherness’

25.7 Mental illness as a curricular challenge

25.8 Literature relevant to specific psychiatric diagnoses

25.9 Limitations, possibilities and conclusions

References

Index

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