Definition/Introduction
The term "empathy" (translated from the German word Einfuhlung, which means feeling into) started over 100 years ago and was introduced by psychologist Edward Titchener.[1]
Empathy is a complex, psychological-influencing social interaction; it plays a role in understanding others' feelings, suffering, and behavior with a significant link to compassion. It is a motivated phenomenon that allows people to connect emotionally by sharing experiences and feelings.[2][3][4] Not limited to the comprehension of feelings, empathy is directly linked to the fundamentals of morality and plays an important role in many social relations.[5]
The start of an empathic process is triggered by many agents such as vocalization (screaming or laughing), a body posture or facial expression, and verbal descriptions; however, it is not limited to any expression and environmental interaction that may target another person and trigger the empathic process.[5]
Neuroanatomical Structures
Empathy is linked to neuroanatomical structures such as the amygdala, anterior cingulate cortex, and anterior insular cortex. Furthermore, a multidimensional empathy approach classifies it as cognitive, affective, or behavioral empathy.[6]
- The amygdala, located in the anterior medial part of each temporal lobe, consists of a diverse group of nuclei with distinct structures and functions. It serves as a recipient for sensory input from various cortical regions, including visual, auditory, somatosensory, and olfactory systems, as well as polysensory areas like the perirhinal cortex and the parahippocampal gyrus. Anatomically, the lateral nucleus segregates sensory modalities, but due to internal connections, the amygdala integrates multimodal information in regions such as the lateral, basal, and accessory basal nuclei. The amygdala's output extends to numerous target structures, encompassing the prefrontal cortex, striatum, sensory cortices (including primary sensory cortices unique to primates), hippocampus, perirhinal cortex, entorhinal cortex, basal forebrain, and subcortical structures responsible for physiological responses associated with emotions, such as autonomic and hormonal responses, as well as startle reflex. Notably, the central nucleus generates subcortical projections, while the basal, accessory basal, and sometimes lateral nuclei give rise to connections with the cortex and striatum.[7]
- The anterior cingulate cortex (ACC) is a key brain region involved in various important functions such as emotion, action, and memory. It receives input from the orbitofrontal cortex, providing information about rewards and non-rewards. This enables the ACC to connect actions and outcomes through action-outcome learning. Additionally, the ACC's involvement in emotional processes arises from its role in connecting rewards to actions. On the other hand, the ACC also interacts with the posterior cingulate cortex, which allows for transmitting spatial and action-related information from parietal cortical areas. Moreover, the ACC's outputs to the hippocampal system contribute to memory functions. This intricate network of connectivity and its positioning within the proisocortical limbic region highlight the multifaceted nature of the ACC in the brain.[8]
- The anterior insular cortex (AIC) is associated with a wide range of phenomena and actions, from the perception of bodily sensations like bowel distension and pleasure during orgasm to intense desires for cigarettes and maternal affection to cognitive processes such as decision-making and sudden moments of understanding. Its role in the reinterpretation of internal bodily signals provides a potential foundation for its involvement in the entirety of subjective emotions and experiences.[9]
Measuring Empathy
To measure empathy, several scales have been designed that help identify an individual's capacity to be more empathic or less empathic. As empathy involves many psychological concepts, many scales are currently used to identify empathy. These include the Empathic Accuracy Task (EAT), Empathy Components Questionnaire, and the dated Interpersonal Reactivity Index (IRI).[10][11][12]
- Empathic Accuracy Task (EAT): The EAT is an assessment tool used to measure cognitive empathy. It involves participants watching videos where a target individual shares a personal story, and their task is to continuously rate the valence (positive or negative) of these videos using a turning device. The EAT calculates empathic accuracy by comparing the participants' ratings with the target individual's own ratings. This correlation-based index indicates how accurately the participants can perceive and understand the emotional experiences of the target individual.[13]
- Empathy Components Questionnaire (ECQ): The ECQ is a standardized assessment tool used to measure different components of empathy. It aims to capture empathy's cognitive and affective aspects by examining multiple dimensions. The questionnaire typically includes items that assess perspective-taking, which refers to the ability to understand and adopt the viewpoint of others, as well as empathic concern, which involves feeling compassion and concern for others' well-being. Additionally, the ECQ may include items related to personal distress, which measures the tendency to feel uncomfortable or distressed when witnessing others' negative emotions. By evaluating these various dimensions, the ECQ provides a comprehensive understanding of an individual's empathic abilities and helps researchers and practitioners gain insights into empathy-related traits and behaviors.[11]
- Interpersonal Reactivity Index (IRI): The IRI is a widely used self-report questionnaire to measure empathy and related constructs. The IRI consists of four subscales that capture different aspects of empathy. The perspective-taking subscale assesses the ability to adopt the point of view of others and understand their feelings and thoughts. The fantasy subscale measures the tendency to imaginatively identify with fictional characters in books, movies, or other media. The empathic concern subscale evaluates feelings of compassion, warmth, and concern for others' well-being. Lastly, the personal distress subscale examines the propensity to experience discomfort and distress when witnessing others' suffering. The IRI provides a comprehensive assessment of individual differences in empathy, allowing researchers and clinicians to better understand empathic tendencies and their implications in various social and interpersonal contexts.[14]