Empathy for others' pain is disrupted at the neurophysiological level in schizophrenia.

ABSTRACT

OBJECTIVE: Previous research has shown that empathy for pain is disrupted at the neural level in people with schizophrenia. However, many of these studies have failed to assess key background contextual variables that have previously been linked to neurophysiological responding. Moreover, no study to date has examined the potential influence of schizotypal characteristics on neurophysiological responding in non-clinical individuals. METHODS: People with schizophrenia (N = 17) were compared to demographically matched controls (N = 19) on an event-related potential (ERP) empathy for pain paradigm. The control group also completed a measure of schizotypal personality traits. RESULTS: People with schizophrenia exhibited atypical neural responding at early, emotion-sharing (frontal N110), and late, cognitive (central late positive potential [LPP]) processing stages of pain empathy, relative to controls. In the control group, positive schizotypy traits were significantly negatively related to reduced ERP amplitude in the late, cognitive (central LPP) processing stage of empathy. CONCLUSIONS: These data cross-validate previous studies that have shown that schizophrenia is associated with atypicalities in bottom-up automatic resonance processes that likely contribute to empathic and socio-emotional processing deficits, and indicate that these findings cannot be easily attributed to background contextual differences between the two groups. The results also point to a potential relationship between positive schizotypal characteristics and neurophysiological responding. Implications for simulation theories of empathy and social functioning in schizophrenia are discussed. PRACTITIONER POINTS Empathic processing has been consistently linked to well-being and mental health in many groups, including people with schizophrenia. Previous research has shown that, relative to controls, people with schizophrenia exhibit abnormalities in their neurophysiological empathic response, but in these prior studies, the two groups also differed in a number of potentially important background contextual variables. The current study shows that, when closely matched on background contextual variables, abnormal neural responding is still evident. These data suggest that empathy for pain is disrupted at the neurophysiological level in schizophrenia.