Self-reported empathy deficits are uniquely associated with poor functioning in schizophrenia.
BACKGROUND
Social cognitive deficits have been proposed to be among the causes of poor functional outcome in schizophrenia. Empathy, or sharing and understanding the unique emotions and experiences of other people, is one of the key elements of social cognition, and prior studies suggest that empathic processes are impaired in schizophrenia. The current study examined whether impairments in self-reported empathy were associated with poor functioning, above and beyond the influences of neurocognitive deficits and psychopathology.


METHODS
Individuals with schizophrenia (n=46) and healthy controls (n=37) completed the Interpersonal Reactivity Index (IRI), a measure of emotional and cognitive empathy. Participants also completed a neuropsychological test battery, clinical ratings of psychopathology, and functional outcome measures assessing both functional capacity and community functioning. After testing for between-group differences, we assessed the relationships between self-reported empathy and the measures of functioning, neurocognition, and psychopathology. Regression analyses examined whether empathic variables predicted functional outcomes.


RESULTS
Individuals with schizophrenia reported lower IRI scores for perspective-taking and empathic concern, and higher IRI scores for personal distress than controls. Among individuals with schizophrenia, lower perspective-taking, greater disorganized symptoms, and deficits in working memory and episodic memory were correlated with poorer functional capacity and community functioning. Lower scores for perspective-taking explained significant incremental variance in both functional capacity (ΔR(2)=.09, p<.05) and community functioning (ΔR(2)=.152, p<.01) after accounting for relevant neurocognitive and psychopathological variables.


CONCLUSIONS
Impaired perspective-taking, a component of cognitive empathy, is associated with poor functioning even after taking into account the influences of neurocognitive deficits and psychopathology. These findings support further efforts to clarify the underlying causes of empathic disturbances and suggest that treatments for these disturbances may help functional recovery in schizophrenia.
Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. matthewsmith@northwestern.edu
Matthew J
MJ
Smith
William P
WP
Horan
Tatiana M
TM
Karpouzian
Samantha V
SV
Abram
Derin J
DJ
Cobia
John G
JG
Csernansky
D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D004645:Empathy / Q000502:physiology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis / Q000209:etiology*; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012559:Schizophrenia / Q000150:complications*; D012565:Schizophrenic Psychology; D057566:Self Report; D055815:Young Adult