title: Performance-based empathy mediates the influence of working memory on social competence in schizophrenia.
abstract: Empathic deficits have been linked to poor functioning in schizophrenia, but this work is mostly limited to self-report data. This study examined whether performance-based empathy measures account for incremental variance in social competence and social attainment above and beyond self-reported empathy, neurocognition, and clinical symptoms. Given the importance of working memory in theoretical models of empathy and in the prediction of functioning in schizophrenia, we also examined whether empathy mediates the relationship between working memory and functioning. Sixty outpatients and 45 healthy controls were compared on performance-based measures of 3 key components of empathic responding, including facial affect perception, emotional empathy (affective responsiveness), and cognitive empathy (emotional perspective-taking). Participants also completed measures of self-reported empathy, neurocognition, clinical symptoms, and social competence and attainment. Patients demonstrated lower accuracy than controls across the 3 performance-based empathy measures. Among patients, these measures showed minimal relations to self-reported empathy but significantly correlated with working memory and other neurocognitive functions as well as symptom levels. Furthermore, cognitive empathy explained significant incremental variance in social competence (∆R (2) = .07, P < .05) and was found to mediate the relation between working memory and social competence. Performance-based measures of empathy were sensitive to functionally relevant disturbances in schizophrenia. Working memory deficits appear to have an important effect on these disruptions in empathy. Empathy is emerging as a promising new area for social cognitive research and for novel recovery-oriented treatment development.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; matthewsmith@northwestern.edu.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Smith
authors.affiliation: Department of Psychaitry & Biobehavioral Sciences, Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA; VA Greater Los Angeles Healthcare System, VISN22 MIRECC, Los Angeles, CA;
authors.forename: William P
authors.initials: WP
authors.lastname: Horan
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL;
authors.forename: Derin J
authors.initials: DJ
authors.lastname: Cobia
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL;
authors.forename: Tatiana M
authors.initials: TM
authors.lastname: Karpouzian
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL;
authors.forename: Jaclyn M
authors.initials: JM
authors.lastname: Fox
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL;
authors.forename: James L
authors.initials: JL
authors.lastname: Reilly
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; Warren Wright Adolescent Center, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Hans C
authors.initials: HC
authors.lastname: Breiter
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000523:psychology*; D004644:Emotions; D004645:Empathy; D005149:Facial Expression; D005260:Female; D006801:Humans; D008297:Male; D008570:Memory, Short-Term; D008875:Middle Aged; D010364:Pattern Recognition, Visual; D012559:Schizophrenia; D012565:Schizophrenic Psychology; D012938:Social Perception; D066107:Social Skills
keywords: empathy; functional outcomes; social cognition; working memory