title: Cognitive empathy contributes to poor social functioning in schizophrenia: Evidence from a new self-report measure of cognitive and affective empathy.
abstract: Cognitive empathy impairments have been linked to poor social functioning in schizophrenia. However, prior studies primarily used self-reported empathy measures developed decades ago that are not well-aligned with contemporary models of empathy. We evaluated empathy and its relationship to social functioning in schizophrenia using the recently developed Questionnaire of Cognitive and Affective Empathy (QCAE). Schizophrenia (n=52) and healthy comparison (n=37) subjects completed the QCAE, Interpersonal Reactivity Index (IRI), and measures of neurocognition, symptoms, and social functioning. Between-group differences on the QCAE, and relationships between QCAE and IRI subscales, neurocognition, symptoms, and social functioning were examined. The schizophrenia group reported significantly lower cognitive empathy than comparison subjects, which was driven by low online simulation scores. Cognitive empathy explained significant variance in social functioning after accounting for neurocognition and symptoms. Group differences for affective empathy were variable; the schizophrenia group reported similar proximal responsivity, but elevated emotion contagion relative to comparison subjects. These findings bolster support for the presence and functional significance of impaired cognitive empathy in schizophrenia using a contemporary measure of empathy. Emerging evidence that some aspects of affective empathy may be unimpaired or hyper-responsive in schizophrenia and implications for the assessment and treatment of empathy in schizophrenia are discussed.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Tania M
authors.initials: TM
authors.lastname: Michaels
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at University of California at Los Angeles, USA; VA Greater Los Angeles Healthcare System, VISN22 MIRECC, USA.
authors.forename: William P
authors.initials: WP
authors.lastname: Horan
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Ginger
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Martinovich
authors.affiliation: School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Pinkham
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Warren Wright Adolescent Center, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: matthewsmith@northwestern.edu.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Smith
keywords: Empathy; QCAE; Schizophrenia; Social cognition; Social functioning