title: Empathy in depression: Egocentric and altercentric biases and the role of alexithymia.
abstract: Major depressive disorder (MDD) has been associated with empathy deficits. The exact nature of these deficits and their relation to concurrent alexithymia remain unknown. Here we tested under which conditions MDD patients with high and low alexithymia show deficient empathy, particularly investigating empathic abilities when inhibition of self-related emotional states is needed and when it is not.
  
  
  
  Healthy controls (low: n=28, high: n=14) and currently depressed MDD patients (low: n=11, high: n=18) with low or high alexithymia performed an emotional egocentricity paradigm based on tactile stimulation. This task measures empathic judgements, when emotional states of self and other differ and inhibition of self-related emotional states is needed, and when they do not and thus empathic judgments can be based on simple projection mechanisms.
  
  
  
  Only alexithymia but not depression decreased empathy, in situations when simple projection sufficed. However, when inhibition of self-related emotional states was needed, MDD patients showed an egocentric bias during empathic judgments and an altercentric bias during self emotion judgments, the latter suggesting heightened emotional contagion, both independent of alexithymia. Across the entire sample, alexithymia decreased the size of the egocentric bias.
  
  
  
  This study was based on a relatively sample size.
  
  
  
  These results suggest that MDD patients show intact empathic judgments, when simple projection is required and no concurrent alexithymia is present. In situations when incongruent emotional states of self and other have to be resolved, MDD patients are prone to egocentric and altercentric biases.
authors.affiliation: Department of Social Neuroscience, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany. Electronic address: hoffmann@cbs.mpg.de.
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Hoffmann
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Universitätsmedizin Berlin, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Banzhaf
authors.affiliation: Department of Social Neuroscience, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Kanske
authors.affiliation: Department of Psychiatry, Charité Benjamin Franklin, Universitätsmedizin Berlin, Germany.
authors.forename: Matti
authors.initials: M
authors.lastname: Gärtner
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Universitätsmedizin Berlin, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Bermpohl
authors.affiliation: Department of Social Neuroscience, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
authors.forename: Tania
authors.initials: T
authors.lastname: Singer
mesh_terms: D000328:Adult; D000339:Affect; D000342:Affective Symptoms / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D004644:Emotions / Q000502:physiology; D004645:Empathy; D005260:Female; D006801:Humans; D007600:Judgment; D008297:Male; D008875:Middle Aged; D009014:Morals; D012938:Social Perception
keywords: Alexithymia; Depression; Egocentric bias; Empathy