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Heart rate variability (HRV) has been linked to resilience and emotion regulation (ER). How HRV and brain processing interact during ER, however, has remained elusive. Sixty-two subjects completed the acquisition of resting HRV and task HRV while performing an ER functional Magnetic Resonance Imaging (fMRI) paradigm, which included the differential strategies of ER reappraisal and acceptance in the context of viewing aversive pictures. We found high correlations of resting and task HRV across all emotion regulation strategies. Furthermore, individuals with high levels of resting, but not task, HRV showed numerically lower distress during ER with acceptance. Whole-brain fMRI parametrical modulation analyses revealed that higher task HRV covaried with dorso-medial prefrontal activation for reappraisal, and dorso-medial prefrontal, anterior cingulate and temporo-parietal junction activation for acceptance. Subjects with high resting HRV, compared to subjects with low resting HRV, showed higher activation in the pre-supplementary motor area during ER using a region of interest approach. This study demonstrates that while resting and task HRV exhibit a positive correlation, resting HRV seems to be a better predictor of ER capacity. Resting and task HRV were associated with ER brain activation in mid-line frontal cortex (i.e. DMPFC).
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Encéfalo , Regulação Emocional , Emoções , Frequência Cardíaca , Imageamento por Ressonância Magnética , Humanos , Frequência Cardíaca/fisiologia , Masculino , Feminino , Adulto , Encéfalo/fisiologia , Encéfalo/diagnóstico por imagem , Adulto Jovem , Emoções/fisiologia , Regulação Emocional/fisiologia , Mapeamento Encefálico , Descanso/fisiologiaRESUMO
Although mindreading is an important prerequisite for successful social interactions, the underlying mechanisms are still matter of debate. It is unclear, for example, if inferring others' and own mental states are distinct processes or are based on a common mechanism. Using an affect-induction experimental set-up with an acoustic heart rate feedback that addresses affective mindreading in self and others, we investigated if non-autistic study participants relied on similar information for self- and other-directed mindreading. We assumed that due to altered mindreading capacities in autism, mainly individuals with low autistic traits would focus on additional sensory cues, such as heart rate, to infer their own and their gambling partner's affective states. Our analyses showed that the interpretation of a heart rate signal differed in self- and other-directed mindreading trials. This effect was modulated by autistic traits suggesting that individuals with higher autistic traits might not have interpreted the heart rate feedback for gambling partner ratings and differentiated less between self- and other-directed mindreading trials. We discuss these results in the context of a common mechanism underlying self- and other-directed mindreading and hypothesize that the weighting of internal and external sensory information might contribute to how we make sense of our and others' mental states.
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Transtorno Autístico , Frequência Cardíaca , Humanos , Frequência Cardíaca/fisiologia , Masculino , Feminino , Transtorno Autístico/psicologia , Transtorno Autístico/fisiopatologia , Adulto , Adulto Jovem , Afeto/fisiologia , Teoria da Mente/fisiologiaRESUMO
BACKGROUND: Patient and public involvement (PPI) describes the participation of patients and relatives, i.e., experts by experience (EE), in the research process. The PPI has not been widely adopted in the fields of medicine and clinical psychology in Germany and there is a notable absence of institutional support. The German Center for Mental Health (DZPG), which has been under construction since May 2023, aims to achieve nationwide and cross-center implementation of PPI, constituting one of its primary objectives. Participation of EE is to be implemented in the DZPG at all levels of decision-making. OBJECTIVES: The article describes the origins, development and challenges associated with the implementation of participation structures and projects in the DZPG. The central political PPI committee in the DZPG, the Trilogue Center Council (TZR), developed a comprehensive PPI strategy for the DZPG in almost 3 years of work, before the beginning of the financial support of the DZPG. Among various measures, the strategy entails establishing a far-reaching representation for EE in all decision-making bodies of the DZPG, to involve EE as reviewers in evaluating research proposals, to integrate participatory elements into all studies of the DZGG and to foster user-initiated research endeavors. The implementation of the strategy is ensured by a cross-center PPI infrastructure, the Center for PPI, and scientific PPI consultants. The Center for PPI's tasks include supporting the voice of the EE and developing instruments and guidelines for participatory research, bringing together EE and researchers for joint DZPG projects as well as the documentation and quality assurance for participatory research. One of the particular challenges for the successful implementation of the PPI strategy is the limited experience with PPI in Germany in the field of mental health research and the widespread lack of structural implementation. Currently developed solution strategies include training for researchers and EE to communicate the benefits and pathways in the realization of PPI and thus enable shared decision-making and research. In addition, extensive access to knowledge and resources for EE will be created and uniform remuneration regulations for EE will be developed. CONCLUSION: A PPI strategy at the DZPG has been successfully developed and is currently being implemented by the cross-center infrastructure Center for PPI.
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Participação do Paciente , Alemanha , Humanos , Participação da Comunidade , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administraçãoRESUMO
BACKGROUND: The research landscape examining social cognition (SC) impairment in patients with major depressive disorders (MDD) and bipolar disorders (BD) is notably scarce. Presently, assessments predominantly rely on static stimuli and self-reported measures, which may not capture the dynamic dimensions of social cognition. OBJECTIVES: This study aimed to validate the Chinese version of Movie Assessment of Social Cognition (MASC-CH) and to investigate whether MDD and BD exhibit distinct patterns of SC impairments, shedding light on potential differences between these two mood disorders. METHODS: The study encompassed 197 participants, aged 18-65, distributed as follows: 21 BD, 20 MDD, and 156 healthy controls (HC). We focused on examining "cognitive" and "emotional" SC scores and "undermentalizing" and "overmentalizing" error patterns, with nonsocial inference as a control. Additional assessments included the Reading Mind in the Eyes Test (RMET) and the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). We also explored the association between depression severity (measured by the Hamilton Depressive Rating Scale, HDRS) and distinct SC dimensions between MDD and BD. RESULTS: The MASC-CH exhibited strong validity and reliability for SC assessment. In group comparisons, BD participants scored significantly lower on MASC-CH, while the MDD group scores were not significantly different from HC. Specifically, BD individuals had notably lower cognitive SC scores and made more undermentalizing and absence of mentalizing errors than MDD and HC. Additionally, a negative correlation between HDRS score and overmentalizing was observed in BD, not in the MDD. CONCLUSIONS: The findings indicate that depression severity scores in BD were inversely related to MASC-CH scores. In contrast, this relationship was not observed in the MDD group. These results underscore the importance of SC impairments as distinguishing characteristics of both BD and MDD. It provides valuable insights into the distinct social-cognitive profiles of both mood disorders.
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Transtorno Bipolar , Transtorno Depressivo Maior , Humanos , Transtorno Bipolar/psicologia , Cognição Social , Reprodutibilidade dos Testes , Emoções , CogniçãoRESUMO
INTRODUCTION: The alternative model for personality disorders (AMPD) of the Diagnostic and Statistical Manual of Mental Disorders - 5th edition (DSM-5) considers impairments in empathy a basic feature of personality disorders (PDs). In contrast, the AMPD pathological personality trait model and the categorical DSM-5 Section II PD model associate deficits in empathy to specific forms of personality pathology. The present study investigated to what extent impairments in cognitive and emotional empathy are markers of general versus specific personality pathology. METHODS: In a clinical sample (n = 119), the Multifaceted Empathy Test was used to assess cognitive empathy, emotional empathy for positive emotions, and emotional empathy for negative emotions. Personality functioning, pathological personality traits, and DSM-5 Section II PDs were assessed via interviews and self-reports. Confirmatory factor analyses were applied to associate the three empathy facets with the three personality pathology approaches, each modeled with general personality pathology (common factor) and specific personality pathology (residuals of indicators). RESULTS: Impairments in cognitive empathy and emotional empathy for positive emotions were significantly correlated with general personality pathology. All three empathy facets were also correlated to specific personality pathology when controlling for general personality pathology, respectively. Impairments in cognitive empathy were incrementally associated with identity and empathy (personality functioning), psychoticism (pathological personality traits), and paranoid and dependent PD (DSM-5 Section II PDs). Deficits in emotional empathy for positive emotions were incrementally associated with self-direction and intimacy (personality functioning) and detachment (pathological personality traits). Impairments in emotional empathy for negative emotions were incrementally associated with antagonism (pathological personality traits) and antisocial PD (DSM-5 Section II PDs). CONCLUSION: The results suggest that impairments in cognitive empathy and emotional empathy for positive emotions, but not for negative emotions, are markers of general personality pathology, while deficits in the three empathy facets are also markers for specific personality pathology.
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Empatia , Transtornos da Personalidade , Humanos , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia , Personalidade , Emoções , Manual Diagnóstico e Estatístico de Transtornos Mentais , Cognição , Inventário de PersonalidadeRESUMO
BACKGROUND: The present study evaluated the psychometrics properties of a sensitive video-based test used in the evaluation of mentalizing skills, that is, the Movie for the Assessment of Social Cognition-Taiwanese version (MASC-TW). METHODS: We recruited two independent samples of nonclinical participants (N = 167) and adult patients with schizophrenia (N = 41). The MASC-TW and two other social cognition measures, namely the Chinese version of Theory of Mind task (ToM) and the Taiwanese version of the Diagnostic Analysis of Nonverbal Accuracy-2 (DANAV-TW-2), and an executive function measure of the Wisconsin Card Sorting Test (WCST), were administered to both groups. RESULTS: The MASC proved to be a reliable measure of mentalizing capacity, high Cronbach's α value of 0.87. The intraclass correlation coefficient for the MASC-TW total correct scores was 0.85 across three waves of data collection. Across the entire sample, the scores on the MASC-TW were significantly correlated with verbal and nonverbal scores for the ToM task and recognition of facial and prosodic emotion on the DANAV-TW-2. Both executive function and emotion recognition emerged as noteworthy predictors of mentalizing, indicating that these two variables might play crucial roles in the development of mentalizing capacities. Finally, a receiver operating characteristic analysis revealed that in patients with schizophrenia, the MASC was the most accurate discriminator of diagnostic groups, highlighting the validity of the MASC. CONCLUSIONS: Overall, the MASC-TW is an ecologically valid and useful tool for assessing mentalizing abilities in a Taiwanese population.
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Mentalização , Adulto , Humanos , Filmes Cinematográficos , Cognição Social , Povo Asiático , Coleta de DadosRESUMO
Introduction: Discrimination toward ethnic minorities is a persistent societal problem. One reason behind this is a bias in trust: people tend to trust their ingroup and comparatively distrust outgroups. Methods: In this study, we investigated whether and how people change their explicit trust bias with respect to ethnicity based on behavioral interactions with in- and outgroup members in a modified Trust Game. Results: Subjects' initial explicit trust bias disappeared after the game. The change was largest for ingroup members who behaved unfairly, and the reduction of trust bias generalized to a small sample of new in- and outgroup members. Reinforcement learning models showed subjects' learning was best explained by a model with only one learning rate, indicating that subjects learned from trial outcomes and partner types equally during investment. Discussion: We conclude that subjects can reduce bias through simple learning, in particular by learning that ingroup members can behave unfairly.
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Autism has been linked to atypicalities in reward processing, especially in the social domain. However, results are heterogeneous, and their interpretation is hindered by the use of personally non-relevant social rewards. In this study we investigated behavioural (reaction times), neuronal (event-related potentials), and autonomic (pupil sizes) responses to personally relevant social rewards, money, and neutral outcomes in 26 autistic and 53 non-autistic subjects varying in levels of autistic traits. As hypothesised and preregistered, autism and autistic traits did not differently influence responses to social, monetary, or neutral outcomes on either response level. While groups did not differ in behaviour (reaction times), autism was linked to generally enhanced brain responses in early anticipation and larger pupil constrictions in reward reception. Together, these results suggest that when using personally relevant stimuli, autism is linked to generally preserved, although less neuronally efficient processing of rewards. Considering the role of social relevance in reward processing, we propose an interpretation of contradictory evidence from clinical practice and empirical research.
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Transtorno Autístico , Humanos , Motivação , Encéfalo , Potenciais Evocados/fisiologia , RecompensaRESUMO
In this randomized controlled trial (RCT), the digital socio-emotional competence training Zirkus Empathico was tested in 74 Central European children (5.1 (0.9) years; 34 females) within a longitudinal design (three time points: T1 = pre-training; T2 = immediately following 6-week training, T3 = 3-month follow-up). The pre-registered primary outcome was empathy, secondary outcomes included emotion recognition, prosocial behavior, and behavioral problem reduction; furthermore, children's neural sensitivity to facial expressions quantified with event-related potentials. Compared to controls (N = 38), Zirkus Empathico participants (N = 36) showed increases in empathy (d = 0.28 [-0.17, 0.76]), emotion recognition (d = 0.57 [0.01, 1.06]), prosocial behavior (d = 0.51 [0.05, 0.99]) and reduced behavioral problems (d = 0.54 [0.08, 1.03]). They also showed larger P3 amplitudes to happy vs. angry and neutral facial expressions post-training. Thus, Zirkus Empathico may be a promising digital training for social competence in preschoolers.
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BACKGROUND: We propose and evaluate a contribution to the conceptualization and assessment of personality functioning based on social domains and mentalizing hypotheses. Social domains are distinct social contexts, such as with acquaintances and friends, with differentiated expectations regarding participants' behaviours and social attributions. The capacity to organize social participation according to these expectations requires the ability, we suggest, to modulate mentalizing processes domain by domain. Drawing on evidence that social domain organization is impaired in borderline personality disorder (BPD) and that hypermentalizing, a heightened interpretation of others' motives, thoughts or emotions, is elevated in adolescent BPD, we hypothesized that hypermentalizing levels in adolescents will vary by social domain and that elevated BPD features will be associated with impairment of this domain organization of hypermentalizing. METHODS: Measures including the borderline personality features scale for children (BPFSC) and the movie for the assessment of social cognition (MASC) were administered to 171 adolescents aged 12-17 recruited from public schools and community organizations in a large metropolitan area in southwestern United States. Mean hypermentalizing scores were computed for adolescent interpretations of sequences in the MASC focusing on the social domains of acquaintance, friends and romantic interactions. RESULTS: There was a progressive increase in hypermentalizing scores across the acquaintance, friends and romantic interactions (repeated measures ANOVA, p < .001, all pairwise comparisons, p ≤ .02), which was markedly reduced in the presence of elevated BPD features (interaction term, p = .007). CONCLUSIONS: Hypermentalizing is organized according to social domain and this organization is impaired in the presence of elevated BPD features. The findings are consistent with the proposal that personality functioning entails a social domains organization of hypermentalizing, which is impaired in personality dysfunction. Identifying mentalizing processes domain by domain has the potential to create a personalized focus for the treatment of adolescents with personality difficulties.
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Transtorno da Personalidade Borderline , Mentalização , Criança , Humanos , Adolescente , Formação de Conceito , Transtornos da Personalidade , Personalidade , Transtorno da Personalidade Borderline/psicologiaRESUMO
The faces of our friends and loved ones are among the most pervasive and important social stimuli we encounter in our everyday lives. We employed electroencephalography to investigate the time line of personally relevant face processing and potential interactions with emotional facial expressions by presenting female participants with photographs of their romantic partner, a close friend and a stranger, displaying fearful, happy and neutral facial expressions. Our results revealed elevated activity to the partner's face from 100 ms after stimulus onset as evident in increased amplitudes of P1, early posterior negativity, P3 and late positive component, while there were no effects of emotional expressions and no interactions. Our findings indicate the prominent role of personal relevance in face processing; the time course of effects further suggests that it might not rely solely on the core face processing network but might start even before the stage of structural face encoding. Our results suggest a new direction of research in which face processing models should be expanded to adequately capture the dynamics of the processing of real-life, personally relevant faces.
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Potenciais Evocados , Reconhecimento Facial , Humanos , Feminino , Emoções , Eletroencefalografia/métodos , Medo , Expressão FacialRESUMO
Autism spectrum disorder (ASD) is characterized by impaired social interaction and communication skills, repetitive behaviors, restricted interests, and specific sensory processing. Particularly, adults with high-functioning ASD often remain unrecognized, presumably due to their high compensatory skills, but at the cost of high stress, which is often linked to anxiety and depression. This may further explain the significantly high suicide rates and reduced life expectancy among individuals with ASD. Thus, providing support to high-functioning autistic adults in managing core symptoms, as well as co-occurring anxiety and depression, appears essential. To date, only a limited number of evidence-based psychosocial therapeutic options are available, and very few of them have undergone rigorous evaluation in a clinical context. To obtain a comprehensive understanding, a systematic literature search was conducted according to the PRISMA checklist, and only studies demonstrating robust methodological quality were included and discussed in this review article. Although promising initial key factors and methods have been identified, additional evidence-based studies are imperative to ascertain the optimal treatment and evaluate the long-term outcomes for adults with high-functioning ASD.
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Academia has been facing a mental health crisis particularly affecting early career researchers (ECRs). Moreover, the COVID-19 pandemic posed an unprecedented burden on the mental health of many individuals. Therefore, we cross-sectionally investigated how doctoral researchers (N = 222) evaluate their mental health status and satisfaction with their PhD training before and during the pandemic. As compared to self-reported, retrospective evaluations about the pre-pandemic state, we found decreased satisfaction with PhD training and overall well-being. The whole sample exhibited high levels of personal and work-related burnout, a fifth indicated clinically meaningful levels of depressive symptoms and almost 25% experienced severe loneliness. When exploring predictors of depression, anxiety, and burnout, we identified low satisfaction with PhD training as the most prominent predictor for poor mental health, suggesting a link between the doctoral work and their mental health status. Females vs. males and doctoral researchers in individual doctorate vs. structured PhD programs reported higher symptoms of burnout. Our study replicates previous findings of poor mental health in doctoral researchers and indicates further decreases of mental wellbeing under the influence of the pandemic. Systematic adjustments in academia are required to improve the mental health of ECRs.
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Esgotamento Profissional , COVID-19 , Masculino , Feminino , Humanos , COVID-19/epidemiologia , Saúde Mental , Pandemias , Estudos Retrospectivos , Controle de Doenças Transmissíveis , Esgotamento Profissional/epidemiologia , Satisfação Pessoal , Depressão/epidemiologia , Depressão/psicologiaRESUMO
Intellectual disability is a neurodevelopmental disorder with a related co-occurrence of mental health issues and challenging behaviors. In addition to purely cognitive functions, socio-emotional competencies may also be affected. In this paper, the lens of developmental social neuroscience is used to better understand the origins of mental disorders and challenging behaviors in people with an intellectual disability. The current concept of intelligence is broadened by socio-emotional brain functions. The emergence of these socio-emotional brain functions is linked to the formation of the respective neuronal networks located within the different parts of the limbic system. Thus, high order networks build on circuits that process more basic information. The socio-emotional skills can be assessed and complement the results of a standardized IQ-test. Disturbances of the brain cytoarchitecture and function that occur at a certain developmental period may increase the susceptibility to certain mental disorders. Insights into the current mental and socio-emotional functioning of a person may support clinicians in the calibration of treatment and support. Acknowledging the trajectories of the socio-emotional brain development may result in a more comprehensive understanding of behaviors and mental health in people with developmental delays and thus underpin supports for promotion of good mental health in this highly vulnerable population.
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Deficiência Intelectual , Transtornos do Neurodesenvolvimento , Humanos , Deficiência Intelectual/epidemiologia , Deficiência Intelectual/psicologia , Emoções , Saúde Mental , EncéfaloRESUMO
Parenting requires mothers to read social cues and understand their children. It is particularly important that they recognise their child's emotions to react appropriately, for example, with compassion to sadness or compersion to happiness. Despite this importance, it is unclear how motherhood affects women's ability to recognise emotions associated with facial expressions in children. Using videos of an emotionally neutral face continually and gradually taking on a facial expression associated with an emotion, we quantified the amount of information needed to match the emotion with the facial expression. Mothers needed more information than non-mothers to match the emotions with the facial expressions. Both mothers and non-mothers performed equally on a control task identifying animals instead of emotions, and both groups needed less information when recognising the emotions associated with facial expressions in adolescents than pre-schoolers. These results indicate that mothers need more information for to correctly recognise typically associated emotions in child facial expressions but not for similar tasks not involving emotions. A possible explanation is that child facial expressions associated with emotions may have a greater emotional impact on mothers than non-mothers leading to task interference but possibly also to increased compassion and compersion.
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Expressão Facial , Reconhecimento Facial , Humanos , Feminino , Criança , Emoções , Felicidade , Tristeza , Sinais (Psicologia)RESUMO
Patients suffering from social anxiety disorder (SAD) fear social interaction and evaluation, which severely undermines their everyday life. There is evidence of increased prosocial behavior after acute social stress exposure in healthy individuals, which may be interpreted as stress-regulating "tend-and-befriend" behavior. In a randomized controlled trial, we measured empathic abilities in a first diagnostic session. In the following experimental session, we investigated how patients with SAD (n = 60) and healthy control participants (HC) (n = 52) respond to an acute social stressor (Trier Social Stress Test for groups) or a non-stressful control condition, and whether empathic abilities and acute social stress interact to modulate anxious appearance and social behavior in a social conversation test. Salivary cortisol, heart rate, and subjective stress response were repeatedly measured. The anxious appearance and social behavior of participants were rated by the conversation partner. SAD patients demonstrated stronger subjective stress responses while the biological responses did not differ from HC. Moreover, patients performed worse overall in the conversation task, which stress additionally undermined. Finally, we found that both emotional and cognitive empathy buffered the negative effects of acute stress on social behavior in SAD, but not in HC. Our data highlight the importance of empathic abilities for SAD during stressful situations and call for multimodal clinical diagnostics. This may help to differentiate clinical subtypes and offer better-tailored treatment for patients. General Scientific Summary: This study shows that high levels of cognitive and emotional empathy can buffer the negative effects of acute stress on social behavior in social anxiety disorder (SAD). Empathic abilities may be included as an additional diagnostic resource marker for SAD.
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This study aimed to discover predictors of subjective and objective difficulty in emotion perception from dynamic facial expressions. We used a multidimensional emotion perception framework, in which observers rated the perceived emotion along a number of dimensions instead of choosing from traditionally-used discrete categories of emotions. Data were collected online from 441 participants who rated facial expression stimuli in a novel paradigm designed to separately measure subjective (self-reported) and objective (deviation from the population consensus) difficulty. We targeted person-specific (sex and age of observers and actors) and stimulus-specific (valence and arousal values) predictors of those difficulty scores. Our findings suggest that increasing age of actors makes emotion perception more difficult for observers, and that perception difficulty is underestimated by men in comparison to women, and by younger and older adults in comparison to middle-aged adults. The results also yielded an increase in the objective difficulty measure for female observers and female actors. Stimulus-specific factors-valence and arousal-exhibited quadratic relationships with subjective and objective difficulties: Very positive and very negative stimuli were linked to reduced subjective and objective difficulty, whereas stimuli of very low and high arousal were linked to decreased subjective but increased objective difficulty. Exploratory analyses revealed low relevance of person-specific variables for the prediction of difficulty but highlighted the importance of valence in emotion perception, in line with functional accounts of emotions. Our findings highlight the need to complement traditional emotion recognition paradigms with novel designs, like the one presented here, to grasp the "big picture" of human emotion perception.
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Emoções , Expressão Facial , Idoso , Nível de Alerta , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Percepção , AutorrelatoRESUMO
The study examined processing differences for facial expressions (happy, angry, or neutral) and their repetition with early (P1, N170) and late (P3) event-related potentials (ERPs) in young children (N = 33). EEG was recorded while children observed sequentially presented pairs of facial expressions, which were either the same (repeated trials) or differed in their emotion (novel trials). We also correlated ERP amplitude differences with parental and child measures of socio-emotional competence (emotion recognition, empathy). P1 amplitudes were increased for angry and happy as compared to neutral expressions. We also detected larger P3 amplitudes for angry expressions as compared to happy or neutral expressions. Repetition effects were evident at early and late processing stages marked by reduced P1 amplitudes for repeated vs. novel happy expressions, but enhanced P3 amplitudes for repeated vs. novel facial expressions. N170 amplitudes were neither modulated by facial expressions nor their repetition. None of the repetition effects were associated with measures of socio-emotional competence. Taken together, negative facial expressions led to increased neural activations in early and later processing stages, indicative of enhanced saliency to potential threating stimuli in young children. Processing of repeated facial expression seem to be differential for early and late neural stages: Reduced activation was detected at early neural processing stages particularly for happy faces, indicative of effective processing for an emotion, which is most familiar within this age range. Contrary to our hypothesis, enhanced activity for repeated vs. novel expression independent of a particular emotion were detected at later processing stages, which may be linked to the creation of new memory traces. Early and late repetition effects are discussed in light of developmental and perceptual differences as well as task-specific load.
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OBJECTIVE: Serious games are a promising means of fostering socio-emotional skills in children on the autism spectrum (AS). However, empathy and related constructs have not yet been addressed comprehensively and together with emotion recognition, and there is a lack of randomized controlled trials (RCT) to investigate skill maintenance and the transfer to functional behavior. METHOD: The manualized, parent-assisted serious game Zirkus Empathico (ZE) was tested against an active control group, in a six-week multicenter RCT. Eighty-two children aged 5-10 years on the AS were assessed at baseline, post-treatment, and three-month follow-up. Empathy and emotion recognition skills were defined as the primary outcomes. The secondary outcomes included measures of emotional awareness, emotion regulation, autism social symptomatology (Social Responsiveness Scale), and subjective therapy goals. RESULTS: Training effects were observed after the intervention for empathy (d = 0.71) and emotion recognition (d = 0.50), but not at follow-up. Moderate effects on emotional awareness, emotion regulation, and autism social symptomatology were indicated by the short and mid-term assessments. Parents reported treatment goal attainment and positive training transfer. CONCLUSION: While a six-week training with ZE failed to induce lasting changes in empathy and emotion recognition, it may be effective for improving emotional awareness and emotion regulation, and mitigate general autism symptomatology. CLINICAL TRIAL REGISTRATION INFORMATION: Zirkus Empathico - Promoting socioemotional competencies in 5- to 10-year-old children with autism spectrum conditions using a computer-based training program; https://www.drks.de/; DRKS-ID: DRKS00009337; Universal Trial Number (UTN): U1111-1175-5451.
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Transtorno do Espectro Autista , Transtorno Autístico , Regulação Emocional , Transtorno do Espectro Autista/psicologia , Transtorno do Espectro Autista/terapia , Transtorno Autístico/psicologia , Criança , Pré-Escolar , Emoções , Humanos , PaisRESUMO
BACKGROUND: While witnessing the suffering of other people results in personal distress, it is not clear whether regulating others' emotions in such situations also comes at an emotional cost for the observer. METHODS: This study included 62 subjects and used a newly developed functional Magnetic Resonance Imaging (fMRI) paradigm to investigate mechanisms of self and other emotion regulation via reappraisal while the subject and an interaction partner outside the scanner were facing the same distressing situation simultaneously. The relationship between distress levels and individual differences in emotional and cognitive empathy were also assessed. RESULTS: We found that individuals exhibited especially high levels of personal distress when relating with a partner while both being exposed to aversive photographs and that especially highly empathetic individuals were prone to such personal distress. Moreover, when engaging in social emotion regulation, personal distress was reduced in the observer at a similar rate as in self emotion regulation. FMRI analyses revealed increased activation for other vs. self emotion regulation in the precuneus and the left temporo-parietal junction, which are commonly engaged in social cognition. Furthermore, this activation was associated with lower self-reported stress and decreased sympathetic autonomic activity. While regulating others, precuneus activation exhibited a distinctive functional connectivity profile with parietal emotion regulation regions. CONCLUSIONS: This study demonstrates benefits of actively regulating another person's emotions for reducing one's own distress and identifies the precuneus as an important node for social emotion regulation. Given the novelty of the study design, the results are of exploratory and preliminary nature.