The relationship between personality and bullying among primary school children: the mediation role of trait emotion intelligence and empathy

Background/Objectives: Several studies have shown that personality traits are a benchmark in research field of bullying prevention, while others have highlighted that the socio-emotional skills are important to prevent a wide range of maladjusted behaviors, suggesting that the investment in their developing may mediate the effects of personality dispositions. The present study aims to clarify if socio-emotional attitudes can mediate the relationships between personality traits and bullying. Methods: Five sequential mediation models are tested using the Big Five personality traits as focal predictors, bullying as the outcome, and trait emotional intelligence and empathy as causally chained mediators, involving 199 primary school children (8-10 years) through the Bullying Prevalence Questionnaire, the Big Five Questionnaire for children, the Emotional Intelligence Index and the Empathy-Teen Conflict Survey. Results: Data showed that openness, conscientiousness, and agreeableness were inversely related to bullying, and that the causal chain of TEI-empathy negatively and completely mediated the relationship between emotional instability and bullying and negatively and partially mediated the relationship between openness and bullying. Conclusions: These results suggest that TEI and empathy mediate the relationship between personality traits and bullying, reducing the risk of being involved in bullying perpetration. (AU)

Preparing for the End of Life: Medical Students Completing Their Own Advance Directives Described Increased Empathy for Patients.

BACKGROUND AND OBJECTIVES: Family medicine offers the opportunity to integrate advance care planning into routine primary care, connecting relationship-centered orientation with thoughtful action before a terminal diagnosis. However, physicians are undertrained in end-of-life counseling and care. To address this educational gap, we had clerkship students complete their own advance directives and submit a written reflection about the experience. The aim of this study was to learn about how students report on the value of completing their own advance directives, according to their written reflections. We hypothesized that self-described empathy, previously defined as understanding patients' emotions and communicating that understanding back to patients, would increase, as reported by students in their reflections. METHODS: We analyzed 548 written reflections over 3 academic years using a qualitative content analysis approach. An iterative process included open coding, building of themes, and verification with the text by four professionally diverse researchers. RESULTS: After completing their own advance directives, students reported increased empathy for patients facing end-of-life decisions and discussed the intention to change their future clinical practice regarding helping patients plan for the end of life. CONCLUSIONS: Using experiential empathy, an approach to teaching and cultivating empathy in which the participants experience the topic first-hand, we directed medical students to consider their own end-of-life wishes. Upon reflection, many noted this process changed their attitudes and clinical approaches to patients' death. This learning experience could be one meaningful component of a longitudinal and comprehensive curriculum to prepare medical school graduates to help patients plan for and face the end of life.

An effective emotion tendency perception model in empathic dialogue.

The effectiveness of open-domain dialogue systems depends heavily on emotion. In dialogue systems, previous models primarily detected emotions by looking for emotional words embedded in sentences. However, they did not precisely quantify the association of all words with emotions, which has led to a certain bias. To overcome this issue, we propose an emotion tendency perception model. The model uses an emotion encoder to accurately quantify the emotional tendencies of all words. Meanwhile, it uses a shared fusion decoder to equip the decoder with the sentiment and semantic capabilities of the encoder. We conducted extensive evaluations on Empathetic Dialogue. Experimental results demonstrate its efficacy. Compared with the state of the art, our approach has distinctive advantages.

Increased empathic distress in adults is associated with higher levels of childhood maltreatment.

While many studies investigated basic facets of empathy, less is known about the association with early life adversity (ELA). To investigate a possible association of empathy with ELA, we assessed self-reported ELA, using the Childhood Trauma Questionnaire (CTQ), the Parental Bonding Instrument (PBI) for mother and father, and empathy, using the Interpersonal Reactivity Index (IRI), in a sample of N = 228 (83% female, agemean = 30.51 ± 9.88 years, agerange = 18-60). Further, we measured willingness to donate a certain percentage of study compensation to a charity as an index of prosocial behavior. In line with our hypotheses that stated a positive association of empathy with ELA, increased levels of emotional, physical, and sexual abuse, and emotional and physical neglect were positively correlated with personal distress in response to others' suffering. Likewise, higher parental overprotection and lower parental care were related to higher personal distress. Furthermore, while participants with higher levels of ELA tended to donate more money on a merely descriptive level, only higher levels of sexual abuse were significantly related to larger donations after correction for multiple statistical tests. Other facets of the IRI (empathic concern, perspective taking and fantasy) were not related to any other ELA measure. This suggests ELA only affects levels of personal distress.

Only empathy-related traits, not being mimicked or endorphin release, influence social closeness and prosocial behavior.

Seminal studies suggest that being mimicked increases experienced social closeness and prosocial behavior to a mimicking confederate (i.e., interaction partner). Here we reexamine these results by considering the role of empathy-related traits, an indirect proxy for endorphin uptake, and their combined effects as an explanation for these results. 180 female participants were mimicked or anti-mimicked in an interaction with a confederate. The effects of being mimicked versus anti-mimicked in relation to empathy-related traits and endorphin release (assessed indirectly via pain tolerance) on experienced closeness and prosocial behavior were assessed using Bayesian analyses. Our results suggest that high individual empathy-related traits increase social closeness to the anti-mimicking and mimicking confederate and to one's romantic partner, as compared to mimicry alone. Results furthermore strongly suggest that high individual empathy-related traits increase prosocial behavior (donations and willingness to help) as compared to mimicry alone. These findings extend previous work by highlighting that empathy-related traits are more influential in creating positive effects on social closeness and prosocial behavior than a one-shot mimicking encounter.

Mindfulness may be associated with less prosocial engagement among high intelligence individuals.

This study examined the role of dispositional mindfulness in the association between intelligence and prosocial behavior. A total of 759 college students (mean age is 22.03; 477 females) participated in exchange for extra credit in psychology course. The results confirmed a positive relationship between intelligence and prosocial behavior as revealed by many studies, with empathy serving as a potential mediator. Mindfulness negatively moderated all the hypothesized pathways between research variables. Specifically, with the increase of the levels of dispositional mindfulness, (1) the intelligence-prosociality association changed from positive to negative, (2) the intelligence-empathy association changed from positively significant to insignificant, (3) the empathy-prosociality association changed from stronger to weaker. These findings may suggest some limitations of mindfulness. That is, present moment awareness and acceptance of the status quo may result in reduced arousal when witnessing others suffering, thereby preventing high intelligence individuals from helping the sufferers to get rid of trouble.

Physician empathy in Korean clinical contexts: developing a conceptual framework and exploring influencing factors.

PURPOSE: Despite its well-known clinical importance, physician empathy (PE) has been variably defined and its concepts among cultures are yet to be studied. This study aimed to develop a conceptual framework of PE and explore influencing factors on physicians' empathetic behavior in the Korean clinical context. METHODS: Forty-two faculty members and 67 residents participated in the two-round Delphi survey to arrive at a consensus regarding the conceptual framework of PE in 2019. To explore individual and external factors affecting physicians' empathetic behavior, a Likert scale questionnaire based on an initial free-text response was administered to the same participants. RESULTS: The conceptual framework of PE among Korean doctors consisted of basic communication skills and attitudes, cognitively understanding of patients' thoughts and emotions, and communicating the doctors' understandings to patients. Individual attributes and system- and patient-factors were revealed as influencing factors for PE in real practice. The former included communication ability, self-awareness and management, humanism, clinical competence, and good personality traits. Excessive workload, time constraints, aggressive attitudes, and negative preconceptions towards doctors were perceived as inhibiting or hindering empathy in patient care. CONCLUSION: PE in the Korean clinical context comprised behavioral and cognitive components. Individual attributes, as well as external factors including system- and patient-factors were identified to affect PE in clinical settings. Further studies are needed to enhance the conceptual clarity of PE and identify how to promote doctors' empathetic practice even in less favorable healthcare environments.

Too strong to care? Investigating the links between formidability, worldviews, and views on climate and disaster.

People vary in climate change skepticism and in their views on disaster cause and prevention. For example, the United States boasts higher rates of climate skepticism than other countries, especially among Republicans. Research into the individual differences that shape variation in climate-related beliefs represents an important opportunity for those seeking ways to mitigate climate change and climate-related disasters (e.g., floods). In this registered report, we proposed a study examining how individual difference in physical formidability, worldview, and affect relate to attitudes about disaster and climate change. We predicted that highly formidable men would tend to endorse social inequality, hold status quo defensive worldviews, report lower levels of empathy, and report attitudes that promote disaster risk accumulation via lesser support for social intervention. The results of an online study (Study 1) support the notion that men's self-perceived formidability is related to disaster and climate change beliefs in the predicted direction and that this relationship is mediated by hierarchical worldview and status quo defense but not empathy. An analysis of a preliminary sample for the in-lab study (Study 2) suggests that self-perceived formidability relates to disaster views, climate views, and status quo maintaining worldviews.

Exposure to hate speech deteriorates neurocognitive mechanisms of the ability to understand others' pain.

The widespread ubiquity of hate speech affects people's attitudes and behavior. Exposure to hate speech can lead to prejudice, dehumanization, and lack of empathy towards members of outgroups. However, the impact of exposure to hate speech on empathy and propensity to attribute mental states to others has never been directly tested empirically. In this fMRI study, we examine the effects of exposure to hate speech on neural mechanisms of empathy towards ingroup (Poles) versus outgroup members (Arabs). Thirty healthy young adults were randomly assigned to 2 groups: hateful and neutral. During the fMRI study, they were initially exposed to hateful or neutral comments and subsequently to narratives depicting Poles and Arabs in pain. Using whole-brain and region of interest analysis, we showed that exposure to derogatory language about migrants attenuates the brain response to someone else's pain in the right temporal parietal junction (rTPJ), irrespective of group membership (Poles or Arabs). Given that rTPJ is associated with processes relevant to perspective-taking, its reduced activity might be related to a decreased propensity to take the psychological perspective of others. This finding suggests that hate speech affects human functioning beyond intergroup relations.

When the Psychiatrist Morally Disapproves.

The understanding of concepts like moral distress and countertransference in mental health settings has advanced over time. While organizational constraints and the clinician's moral values are conventionally thought to play a part in evoking such responses, certain behavioral transgressions might be universally deemed as morally unacceptable. The authors present case scenarios that took place during forensic assessments and routine clinical care. Clinical interactions evoked a diverse range of negative emotional reactions, including anger, disgust, and frustration. The clinicians struggled with moral distress and negative countertransference, which resulted in difficulty mobilizing empathy. Such responses could affect a clinician's ability to best work with the individual and could even affect the clinician's well-being adversely. The authors put forth several suggestions on how to manage one's own negative emotional reactions in similar settings.

The Therapeutic Relationship: Intrapsychic and Behavioral Changes in Both Patient and Analyst.

This article explores how the therapeutic relationship facilitates intrapsychic and behavioral changes in both the patient and the analyst. Key elements of the therapeutic relationship are reviewed, including transference, countertransference, introjective and projective identification, as well as the "real relationship." Special attention is paid to the "transformative relationship," which is a special kind of bond that develops between analyst and patient that is unique and transformative. It consists of mutual respect, emotional intimacy, trust, understanding, and affection. Empathic attunement is a key element in the evolution of a transformative relationship. This attunement optimally promotes intrapsychic and behavioral changes in both the patient and the analyst. This process is illustrated by a case presentation.

Associations of observed callous-unemotional behaviors in early childhood with conduct problems and substance use over 14 years.

Callous-unemotional (CU) behaviors (i.e., low concern and active disregard for others) uniquely predict severe conduct problems and substance use when present by late childhood. Less is known about the predictive utility of CU behaviors displayed in early childhood, when morality is developing and interventions may be more effective. Children aged 4-7 years (N = 246; 47.6% girls) completed an observational task wherein they were encouraged to tear an experimenter's valued photograph, and blind raters coded children's displayed CU behaviors. During the next 14 years, children's conduct problems (i.e., oppositional defiant and conduct symptoms) and age of onset of substance use were assessed. Compared to children displaying fewer CU behaviors, children displaying greater CU behaviors were 7.61 times more likely to meet criteria for a conduct disorder (n = 52) into early adulthood (95% CI, 2.96-19.59; p = <.0001), and their conduct problems were significantly more severe. Greater CU behaviors were associated with earlier onset of substance use (B = -.69, SE = .32, t = -2.14, p = .036). An ecologically valid observed indicator of early CU behavior was associated with substantially heightened risk for conduct problems and earlier onset substance use into adulthood. Early CU behavior is a powerful risk marker identifiable using a simple behavioral task which could be used to target children for early intervention.

A physiological cause to empathy deficits in a mouse model of FTD.

Loss of empathy is a core behavioral symptom of frontotemporal dementia (FTD). In this issue of Neuron, a study by Phillips et al.1 reveals that hypoactivity of dorsomedial prefrontal cortex is causally linked to empathy deficits in a mouse model of FTD.

A bioelectronic route to compassion: Rationale and study protocol for combining transcutaneous vagus nerve stimulation (tVNS) with compassionate mental imagery.

BACKGROUND: The vagus nerve (VN) is a neural nexus between the brain and body, enabling bidirectional regulation of mental functioning and peripheral physiology. Some limited correlational findings suggest an association between VN activation and a particular form of self-regulation: compassionate responding. Interventions that are geared towards strengthening self-compassion in particular, can serve as an antidote to toxic shame and self-criticism and improve psychological health. OBJECTIVE: We describe a protocol for examining the role of VN activation on 'state' self-compassion, self-criticism, and related outcomes. By combining transcutaneous vagus nerve stimulation (tVNS) with a brief imagery-based self-compassion intervention, we aim to preliminarily test additivity versus synergy between these distinct bottom-up and top-down methods for putatively regulating vagal activity. We also test whether the effects of VN stimulation accumulate with daily stimulation and daily compassionate imagery practice. METHODS: Using a randomized 2 x 2 factorial (stimulation x imagery condition) design, healthy volunteers (n = 120) receive active (tragus) or sham (earlobe) tVNS plus standardized (audio-recorded) self-compassionate or sham mental imagery instructions. These interventions are delivered in a university-based psychological laboratory in two sessions, one week apart, as well as being self-administered between sessions by participants at home. Pre-stimulation, peri-stimulation and post-imagery measures of state self-compassion, self-criticism and related self-report outcomes are assessed in two lab sessions, separated by a week (Days 1 and 8). Heart rate variability is used as a physiological metric of vagal activity and an eye-tracking task assesses attentional bias to compassionate faces during the two lab sessions. On Days 2-7, participants continue their randomly assigned stimulation and imagery tasks at home, and complete state measures at the end of each remote session. DISCUSSION: Demonstrating modulation of compassionate responding using tVNS would support a causal link between VN activation and compassion. This would provide a basis for future studies of bioelectronic approaches to augmenting therapeutic contemplative techniques. CLINICAL TRIALS REGISTRATION: ClinicalTrials.gov, Identifier: NCT05441774 (Date: July 1st 2022). OSF REGISTRATION: https://osf.io/4t9ha.

The relationship between autistic traits and empathy in adolescents: An ERP study.

Based on the mind-blindness hypothesis, a large number of studies have shown that individuals with autism-spectrum disorder (ASD) and autistic traits have empathy deficits. However, the recent double empathy theory contradicts the mind-blindness hypothesis and suggests that individuals with ASD and autistic traits do not necessarily lack empathy. Thus, the presence of empathy deficits in individuals with ASD and autistic traits is still controversial. We recruited 56 adolescents (28 high autistic traits, 28 low autistic traits, 14-17 years old) in this study to explore the relationship between empathy and autistic traits. The study participants were required to undertake the pain empathy task, during which the electroencephalograph (EEG) activities were recorded. Our results show that empathy was negatively associated with autistic traits at the questionnaire, behavioral, and EEG levels. Our results also suggested that empathy deficits in adolescents with autistic traits may be manifested mainly in the late stages of cognitive control processing.

Evolutionarily conserved role of oxytocin in social fear contagion in zebrafish.

Emotional contagion is the most ancestral form of empathy. We tested to what extent the proximate mechanisms of emotional contagion are evolutionarily conserved by assessing the role of oxytocin, known to regulate empathic behaviors in mammals, in social fear contagion in zebrafish. Using oxytocin and oxytocin receptor mutants, we show that oxytocin is both necessary and sufficient for observer zebrafish to imitate the distressed behavior of conspecific demonstrators. The brain regions associated with emotional contagion in zebrafish are homologous to those involved in the same process in rodents (e.g., striatum, lateral septum), receiving direct projections from oxytocinergic neurons located in the pre-optic area. Together, our results support an evolutionary conserved role for oxytocin as a key regulator of basic empathic behaviors across vertebrates.

Drivers and drainers of compassion in intensive care medicine: An empirical study using video vignettes.

BACKGROUND: The aim was to determine what factors drive and enhance compassionate care behaviors in the ICU setting and which factors drain and negate such caring attitudes and behaviors. METHODS: Qualitative, focus group discussions using video vignettes. 20 participants agreed to be part of 3 separate focus groups facilitated by the authors. RESULTS: Thematic analysis revealed emphasis on behavior and nonverbal cues, clinical decision making, communication and sensitivity, and building humane relations. The results show that physicians feel driven by the humanity and sensitivity felt in ICU work, however, there exists structural incompetence, as well as the stress and personal -systemic imbalances of ICU work, which leads to burnout and erosion of such motivations, draining compassion. CONCLUSIONS: Regulatory and scheduling practices must be examined to foster the growth of compassionate behaviors and attitudes in healthcare, and these should be treated as essential patient centered metrics.

Moving beyond inquiry: a secondary qualitative analysis on promoting racial justice in clinical care.

BACKGROUND: Anti-Black racism is prevalent in medicine, and anti-racism training is needed in medical education. One such training is the Presence 5 for Racial Justice (P5RJ) Curriculum which covers evidence-based anti-racism communication strategies that promote health equity for Black patients. The P5RJ Curriculum was developed using feedback from clinicians and trainees with diversity, equity, and inclusion (DEI) experience. In this study, we identify themes in recommended anti-racism language and phrases that surveyed clinicians and trainees use to promote racial justice and health equity in clinical care for Black patients. METHODS: Secondary analysis of survey responses to identify themes in qualitative data. DATASET: Survey responses of specific phrases for anti-racism communication based on P5RJ Curriculum feedback. POPULATION STUDIED: N = 50 respondents (27 clinicians, 17 medical trainees, 6 unreported) recruited through convenience sampling and listservs of clinicians with DEI experience. An inductive qualitative analysis was performed on survey responses to identify emerging themes. RESULTS: Emerging themes from survey responses reflected four communication practices: "Inquiry" was the predominant practice (59%), followed by "Empathy" (25%), "Statements of Allyship" (9%), and "Self-Accountability" (8%). CONCLUSION: Inquiry and empathy may be predominant communication practices when addressing anti-Black racism in medicine. There is an opportunity to expand anti-racism communication tools with statements of self-accountability and allyship. Future research is necessary to analyze the patient voice on clinician communication practices that promote anti-racism in clinical care.

GREEK MILITARY NURSING OFFICERS' COMPASSION COMPETENCE AND COMPASSION LEVEL AT WORK AND THEIR PROFESSIONAL QUALITY OF LIFE.

OBJECTIVE: Aim: Of this study was to investigate the level of Military Nursing Officers'(MNOS) compassion competence and their personal level of compassion at work and their correlation with the professional quality of life. PATIENTS AND METHODS: Materials and methods This is a cross-sectional study carried out from December 2019 to May 2020 using the method of convenience sampling. The study involved 235 MNOs serving in Greek Military Hospitals. A single questionnaire containing Compassion at Work index, Compassion competence scale and ProQOL 5 was used for data collection. A total of 400 questionnaires were distributed with a response rate of 58.75%. Data analysis was performed using the statistical package SPSS 22.0. RESULTS: Results: The research showed that there was a significant positive correlation of the Compassion Satisfaction score with the com¬passion at work and compassion competence scales. So, the more compassion participants had, the more satisfaction they received from the care they put into their work. Conversely, the more compassion participants had, the less burnout they felt. Regarding secondary traumatic stress, it was found that the higher the participants' score on the dimensions of compassion in the dimension "Being non-judgmental", "Being tolerant to personal distress" and "Being empathic", the lower the secondary traumatic stress they felt. The position at hospital, the score on the compassion dimension in the dimension "Experiencing the suffering of others" were found to be independently related to the Compassion Satisfaction score. Specifically, Head Nurses had a 3.86 points lower score compared to Nurse managers. Higher values in the "Experiencing the suffering of others" dimension were related to a higher Compassion Satisfaction score. Nursing Officers who scored higher in compassion dimensions such as "Being non-judgmental", "Being tolerant to personal distress" and "Being empathic", they felt lower secondary traumatic stress. CONCLUSION: Conclusions: It is really important for Military nursing Officers to be compassionate in order to get more satisfaction from caring about their work and feel less burnout.

Scarcity mindset reduces empathic responses to others' pain: the behavioral and neural evidence.

Resource scarcity pervades our life. A scarcity mindset triggered by perceiving insufficient resources has been proven to influence our cognition and behaviors, yet it remains unknown whether this mindset specifically influences empathy. The present study induced feelings of scarcity or abundance in separate groups of participants through experimental manipulation and examined the effects of both mindsets on the behavioral and neural responses to others' pain. Behaviorally, pain intensity ratings of others' pain were lower in the scarcity group than in the abundance group. The analysis of event-related potentials revealed that N1 amplitudes for painful and nonpainful stimuli were comparable in the scarcity group but differed significantly in the abundance group. Additionally, while both groups showed larger late positive potential amplitudes for painful stimuli than for nonpainful stimuli, this amplitude differential was significantly smaller in the scarcity group than in the abundance group. Thus, behavioral and neural evidence suggests that inducing a scarcity mindset significantly dampens the ability to empathize with others' pain during both the early and late stages of empathic processing. These findings shed light on our understanding of how a scarcity mindset may influence social emotions and behaviors.