共情能力的作用及其培养

本文通过文献研究,国内外研究的现状,认识共情的概念,共情在医学领域的重要性,分析总结国内外共情能力提高的培训方式,将共情能力的改变融入医学教育中,为改善医护人员和培养医学生的共情能力打下良好基础。共情作为重要的心理特质,对缓解当前紧张的医患关系有着重要的作用。     

社会阶层共情差异的理论与实证探析

社会阶层指个体在社会层级结构中所处的地位以及对自身所处地位的主观感知。关于不同社会阶层在共情上差异的问题,学界在实证研究和理论解释上都没能得到一致的结果。本文梳理并比较了此领域内的各种理论,并从共情的各维度和成分出发,综述了高低社会阶层在特质和状态共情,情绪和认知共情,神经机制上的异同,分析了差异形成的可能原因。最后,从概念界定、假设提出、研究范式几个方面为未来研究的开展提出了几点建议。     

精神障碍患者疼痛共情的功能影像学研究进展

临床研究发现共情缺陷与精神障碍有着密切关系。本文将对精神分裂症、破坏性行为、孤独症等精神障碍疼痛共情的脑功能成像研究进行回顾和分析,以了解本领域的研究现状以及探讨不同精神障碍是否存在特征性共情神经机制异常,并对未来研究可能的发展方向进行展望。     

拟人化、自然共情与亲环境行为

拟人化是指给非人类个体赋予人类特征,使其被看作是有感觉和思想的人。自然共情则被定义为理解并共享一个自然个体的情绪体验。以往研究关注拟人化、自然共情和亲环境行为的概念、理论解释并证明了前两者对亲环境行为的促进作用。探讨提升亲环境行为的有效策略、完善自然共情理论,以及关注拟人化、自然共情与亲环境行为之间的复杂关系,是未来的研究方向。     

Empathy:本源,内涵与译名

Empathy 在国内,在发展心理学和美学领域,常常被翻译为移情,而在临床心理学领域常常被翻译为共情、神入、通情、同感、移情、同理心、设身处地的着想等.本文从以下角度讨论empathy的翻译.     

团体咨询成员相互共情的影响因素——基于社会关系模型

目的:采用社会关系模型探究团体咨询过程中成员相互共情的变异来源及影响因素。方法:共收集53名成员,10个团体的数据,考察共情能力、共情动机、情绪表达性、自我表露、相似性与相互共情的关系。结果:(1)共情水平和被共情水平的变异主要来源于知觉者变量;(2)共情水平与观点采择、共情动机、相似性显著正相关;相似性更能够预测共情水平;(3)被共情水平与相似性显著正相关。结论:成员的共情水平及被共情水平受自身因素影响。相似性是相互共情中重要的有利影响因素。     

感同身受不如善解人“情”？情绪共情和认知共情与情绪加工的关系

目的:分别探讨情绪共情和认知共情与情绪加工之间的关系。方法:采用共情量表、情绪加工量表和同情量表对307名大学生展开调查,并使用结构方程模型进行潜变量建模。结果:(1)情绪共情正向影响情绪失调、情绪加工不足、体验枯竭及情绪回避;(2)认知共情负向影响情绪失调、情绪加工不足、体验枯竭、情绪回避及情绪压抑;(3)当合并两种共情成分时,共情对情绪失调和情绪加工不足的影响不显著,对体验枯竭、情绪回避和情绪压抑有负向影响,情绪共情的作用被掩盖。结论:情绪共情是情绪加工问题的风险因子,而认知共情则是情绪加工的保护因子。     

青少年共情能力现状及相关因素

目的:了解青少年共情能力发展的现状,并探讨青少年共情能力的相关影响因素。方法:选取淮南市、温州市的部分中学和中职学校,共发放问卷1460份,回收有效问卷1159份(男613例,女546例)。采用中文版人际反应指标(IRI-C)、家庭功能评定量表(FAD)、《我的班级》问卷分别评估青少年的共情能力、家庭功能以及班级环境。结果:女生的IRI-C情绪共情、认知共情以及总共情[(55±12)vs.(51±11)]得分均高于男生[(50±11)vs.(54±11),(50±11)vs.(54±11),(均P0.05)]。中职生的IRI-C情绪共情、认知共情以及总共情得分均低于初中生和高中生(均P0.05)。《我的班级》问卷的竞争得分、同学关系得分与IRI-C的情绪共情得分正向关联(β=0.11、0.13,均P0.001);FAD的角色得分与IRI-C的情绪共情得分正向关联(β=0.14,P0.001);FAD的问题解决得分与认知共情得分、总共情得分负向关联(β=-0.22、-5.20,均P0.001)。《我的班级》问卷的同学关系得分与认知共情得分、总共情得分正向关联(β=0.18、5.76,均P0.001)。结论:女生的共情能力发展可能优于男生;与初中生、高中生相比,中职生的共情能力发展可能较差;良好的同学关系、有效的问题解决、适度的竞争可能是青少年共情发展的有利因素。     

家庭环境与大学生亲社会行为:有调节的中介作用

目的:探究家庭环境、共情和性别对大学生亲社会行为的影响机制。方法:采取随机抽样选取1350名大学生,完成家庭环境量表、基本共情量表、亲社会行为倾向量表。使用Process验证中介模型和调节中介模型。结果:(1)在男生群体中,家庭环境、共情和亲社会行为相关显著,但女生群体中家庭环境和共情的相关不显著。(2)共情在家庭环境和亲社会行为间具有中介作用。(3)性别在家庭环境通过共情影响亲社会行为的作用中具有调节作用。结论:家庭环境以共情为中介影响大学生亲社会行为,性别在家庭环境通过共情影响亲社会行为的作用中具有调节作用,在男生群体中家庭环境通过共情为中介对亲社会行为的效应比在女生群体中效应更大。     

医务人员的共情能力与医患关系认知的关系

目的:了解医务人员的共情能力和医患关系认知评价的特点,并探讨两者之间的关联,为改善医患关系提供依据。方法:以贵州省某两家医院200名医务人员为研究对象,采用人际反应指针量表(测量共情能力)和医患关系感知量表进行问卷调查。结果:医务人员的共情能力总分为(44.28±13.30),医患关系总分为(25.45±6.90);医务人员的共情能力和医患关系认知总分存在显著的正相关(r=0.488,P0.01);共情中的观点采择、想象力、个人痛苦对医患关系总分具有正向预测作用;共情高分组的医患关系总分、患者客观行为、主观与客观结合得分显著高于共情低分组(t=7.176,6.394,6.874;P0.001)。结论:医务人员的共情能力与医患关系存在密切关联,共情能力有助于医患关系的改善。     

Empirical research on empathy in medicine—A critical review

Objective

There is a growing amount of empirical research on empathy in medicine. This critical review assesses methodological limitations in this body of research that have not received adequate attention.

Methods

Scientific publications presenting empirical research on medical students’ or physicians’ empathy were systematically searched for.

Results

206 publications were identified and critically reviewed. Multiple empirical approaches have been used. However, there are some remarkable tendencies given the complexity of the study object: empathy is often not defined. Qualitative approaches are rarely used and the predominant quantitative instruments have a relatively narrow or peripheral scope. For example, the concrete experiences, feelings, and interpretations of the physician and the patient, and empathy in clinical practice, are often neglected. Furthermore, possible influences of medical training and working conditions on empathy have not been adequately explored.

Conclusion

The empirical studies of empathy in medicine tend to separate empathy from main parts of clinical perception, judgment, and communication. Thus, important aspects and influences of empathy have been relatively neglected.

Practice implications

Future studies should include transparent concepts, more than one method and perspective, qualitative approaches, the physician's and the patient's concrete experiences and interpretations, and the context in which empathy is developed and practiced.     

Toward a consensus on the nature of empathy: A review of reviews

ObjectiveThe objective was to provide a synthesis of already synthesized literature on empathy in order to identify similarities and differences among conceptualizations.MethodsA review of reviews was conducted to locate synthesized literature published between January 1980 and December 2019. Two authors screened and extracted data, and quality-appraised the sources. A total of 52 articles deemed relevant to this overview were synthesized using thematic analysis.ResultsThe analysis resulted in four themes found in most empathy conceptualizations. In empathy, the empathizer (1) understands, (2) feels, and (3) shares another person’s world (4) with self-other differentiation.ConclusionsMost writings about empathy begin by claiming that there is far from a consensus on how empathy should be defined. This article shows a developing consensus among neuroscientists, psychologists, medical scientists, nursing scientists, philosophers, and others that empathy involves understanding, feeling, sharing, and self-other differentiation.Practice implicationsA clarification of the content of empathy may assist practitioners and researchers in avoiding confusion regarding the meaning of the concept, as well as in developing and measuring the relevant aspects of the concept.     

A prospective study of the relationship between medical knowledge and professionalism among internal medicine residents.

PURPOSE: To explore residents' competency in medical knowledge and in empathy, one element of professionalism, and to evaluate the relationship between competencies in these domains. METHOD: In 2003-2004 and 2004-2005, first-year internal medicine residents at the Mayo Clinic College of Medicine in Rochester, Minnesota were invited to participate in a prospective, longitudinal study of resident competency. Participating residents completed the annual Internal Medicine In-Training Examination (ITE) each October and the Interpersonal Reactivity Index (IRI), a standardized tool to measure empathy administered at multiple time points during training. Changes in medical knowledge and empathy between the fall of postgraduate years one and two were evaluated, and associations between medical knowledge and empathy were explored. RESULTS: Residents' medical knowledge as measured by the ITE increased over the first year of training (mean increase 8.7 points, P < .0001), whereas empathy as measured by the empathic concern subscale of the IRI decreased over this same time period (mean decrease 1.6 points, P = .0003). No significant correlation was found between medical knowledge and empathy or between changes in these domains of competency over time. CONCLUSIONS: Resident competency in the domains of medical knowledge and empathy seems to be influenced by separate and independent aspects of training. Training environments may promote competency in one domain while simultaneously eroding competency in another. Residency programs should devise specific curricula to promote each domain of physician competency.     

Structural group auditing of a UMLS semantic type's extent

Each UMLS concept is assigned one or more of the semantic types (STs) from the Semantic Network. Due to the size and complexity of the UMLS, errors are unavoidable. We present two auditing methodologies for groups of semantically similar concepts. The straightforward procedure starts with the extent of an ST, which is the group of all concepts assigned this ST. We divide the extent into groups of concepts that have been assigned exactly the same set of STs. An algorithm finds subgroups of suspicious concepts. The human auditor is presented with these subgroups, which purportedly exhibit the same semantics, and thus she will notice different concepts with wrong or missing ST assignments. The dynamic procedure detects concepts which become suspicious in the course of the auditing process. Both procedures are applied to two semantic types. The results are compared with a comprehensive manual audit and show a very high error recall with a much higher precision.     

Brief report: empathy and psychological adjustment in siblings of children with cancer

OBJECTIVE: To examine relationships between empathy, illness concepts, sibling relationship variables, and psychological adjustment among siblings of children with cancer. METHODS: Participants were 29 siblings and 14 children diagnosed with acute lymphoblastic leukemia, acute myelocytic leukemia, or non-Hodgkin's lymphoma. Data included self- and parent-report questionnaires completed during active treatment. RESULTS: Siblings did not exhibit increased rates of behavior problems, but did display more social and academic difficulties. Empathy was a significant predictor of externalizing and total problems. Cancer knowledge was not related to adjustment, but was associated with empathy. Birth order of the child with cancer and closeness within the sibling relationship were associated with less positive adjustment. CONCLUSIONS: Empathy may play an important role in sibling adjustment following the diagnosis of cancer. Specific sibling relationship and family variables may be helpful in identifying siblings who are at greater need for psychosocial intervention.     

The effects of sleep deprivation on emotional empathy

Previous studies have shown that sleep loss has a detrimental effect on the ability of the individuals to process emotional information. In this study, we tested the hypothesis that this negative effect extends to the ability of experiencing emotions while observing other individuals, i.e. emotional empathy. To test this hypothesis, we assessed emotional empathy in 37 healthy volunteers who were assigned randomly to one of three experimental groups: one group was tested before and after a night of total sleep deprivation (sleep deprivation group), a second group was tested before and after a usual night of sleep spent at home (sleep group) and the third group was tested twice during the same day (day group). Emotional empathy was assessed by using two parallel versions of a computerized test measuring direct (i.e. explicit evaluation of empathic concern) and indirect (i.e. the observer's reported physiological arousal) emotional empathy. The results revealed that the post measurements of both direct and indirect emotional empathy of participants in the sleep deprivation group were significantly lower than those of the sleep and day groups; post measurement scores of participants in the day and sleep groups did not differ significantly for either direct or indirect emotional empathy. These data are consistent with previous studies showing the negative effect of sleep deprivation on the processing of emotional information, and extend these effects to emotional empathy. The findings reported in our study are relevant to healthy individuals with poor sleep habits, as well as clinical populations suffering from sleep disturbances.     

A review of metaphor research

The study of the metaphor is interdisciplinary and focuses mostly on three points in cognitive psychology: (a) the cognition of metaphoricity, (b) metaphor comprehension processes, and (c) the reason why one concept is represented by another concept as a metaphor. This article reviews the history of research on the metaphor from these three perspectives. Most recent studies support the following viewpoints. Metaphor comprehension is as quick and automatic as literal comprehension. Metaphor comprehension entails the processes of comparison and abstraction. The reason why one concept is compared with another concept is strongly related with the motivation process of combination between different concepts such as embodied cognition.     

The role of sleep in aesthetic perception and empathy: A mediation analysis

The ability to experience aesthetics plays a fundamental role in human social interactions, as well as the capacity to feel empathy. Some studies have shown that beauty perception shares part of the neural network underlying emotional and empathic abilities, which are also known to affect sleep quality and duration. In this study, we evaluated for the first time the effects of sleep on the relation between aesthetic perception and empathic abilities in healthy subjects using a mediation analysis approach. One‐hundred and twenty‐six subjects participated in this study. One‐hundred and one subjects slept at home (Sleep Group). The remaining 25 subjects were tested as controls after 1 night of sleep deprivation to assess the effects of lack of sleep on aesthetic perception and empathy (Sleep‐Deprived Group). All participants underwent one testing session in which they performed a battery of empathy tests and an aesthetic perception task (Golden Beauty). The results showed that sleep duration mediates the relationship between empathy and aesthetic perception in the sleep group. The mediation effect of sleep was more evident on the emotional empathy measures. Conversely, in the sleep deprivation group the lack of correlations among empathy, aesthetic perception and sleep variables did not allow to perform the mediation analysis. These results suggest that adequate sleep duration may play a significant role in improving cognitive and emotional empathic abilities as well as the capability to give accurate aesthetic judgements.     

The association between oxytocin receptor gene polymorphism (OXTR) and trait empathy

BackgroundOxytocin exerts well accepted effects on one of the key social processes: empathy. Previous researches have demonstrated that oxytocin promotes emotional and cognitive aspects of empathy, by exogenous administration as well as on gene level. However, the effect of diverse gene locus haplotypes of oxytocin receptor gene (OXTR) on trait empathy lacks reliable evidence.MethodsParticipants consisted of 101 genetically unrelated, non-clinical Chinese subjects (46 males and 55 females). Interpersonal Reactivity Index (IRI) was applied to measure the trait empathy from four dimensions: empathy concern, personal distress, perspective taking and fantasy. Fantasy and perspective taking measured cognitive aspect of empathy, while empathy concern and personal distress measured emotional aspect of empathy. Ten single tagging SNPs on OXTR rs2268491, rs1042778, rs53576, rs7632287, rs2254298, rs13316193, rs237897, rs237887, rs4686302, and rs2268493 were tested.ResultsGenotype difference in emotional empathy was found on rs237887 and rs4686302 whereas cognitive empathy varied on SNPs rs2268491 and rs2254298 between homozygous and variant carriers. For IRI score, there is a genotype and gender interaction on rs4686302 and rs13316193.LimitationThe sample sizes from the current study were not so optimal that these results should have to be interpreted with caution when amplified into a larger population.ConclusionThe findings demonstrate that natural variants of OXTR associated with trait empathy; specifically, individuals with certain OXTR genotype did perform better on trait empathy, while others did not. Our findings also provide genetic evidence for gender-related difference on empathy, indicating the popular fact that females who displayed more empathy than males could be likely to trace back to the genetic variants.