Birgit Derntl

Multidimensional assessment of empathic abilities: neural correlates and gender differences.

Empathy is a multidimensional construct and comprises the ability to perceive, understand and feel the emotional states of others. Gender differences have been reported for various aspects of emotional and cognitive behaviors including theory of mind. However, although empathy is not a single ability but a complex behavioral competency including different components, most studies relied on single aspects of empathy, such as perspective taking or emotion perception. To extend those findings we developed three paradigms to assess all three core components of empathy (emotion recognition, perspective taking and affective responsiveness) and clarify to which extent gender affects the neural correlates of empathic abilities. A functional MRI study was performed with 12 females (6 during their follicular phase, 6 during their luteal phase) and 12 males, measuring these tasks as well as self-report empathy questionnaires. Data analyses revealed no significant gender differences in behavioral performance, but females rated themselves as more empathic than males in the self-report questionnaires. Analyses of functional data revealed distinct neural networks in females and males, and females showed stronger neural activation across all three empathy tasks in emotion-related areas, including the amygdala. Exploratory analysis of possible hormonal effects indicated stronger amygdala activation in females during their follicular phase supporting previous data suggesting higher social sensitivity and thus facilitated socio-emotional behavior. Hence, our data support the assumption that females and males rely on divergent processing strategies when solving emotional tasks: while females seem to recruit more emotion and self-related regions, males activate more cortical, rather cognitive-related areas.

Generalized deficit in all core components of empathy in schizophrenia.

Empathy is a multidimensional construct composed of several components such as emotion recognition, emotional perspective taking and affective responsiveness. Patients with schizophrenia demonstrate deficits in several domains of emotion processing and perspective taking, thus suggesting a dysfunctional emotional competence. We assessed empathic abilities via three paradigms measuring emotion recognition, perspective taking and affective responsiveness as well as self-report empathy questionnaires in 24 (12 females, 12 males) schizophrenia patients meeting the DSM-IV criteria for schizophrenia and 24 matched healthy volunteers. Patients were recruited from the Department of Psychiatry and Psychotherapy, RWTH Aachen University and healthy volunteers were recruited via advertisement. Groups were matched for age, gender and parental education. Data analysis indicates a significant empathic deficit in patients, reflected in worse performance in all three domains. This deficit was only partly reflected in the self-report empathy questionnaires. Comparing the different tasks, emotional perspective taking was the most difficult task for all subjects and symptomatology worsened affective responsiveness. Schizophrenia patients not only struggle to correctly identify emotions, but also have difficulties in spontaneously simulating another persons subjective world (perspective taking) and might not be able to respond adequately in terms of their own emotional experience (affective responsiveness), which are not caused by emotion perception deficits. The results suggest that all domains of empathy are affected in schizophrenia and have to be addressed independently in behavioral therapies, thereby offering a possibility to improve socio-occupational life.

Amygdala activation and facial expressions: explicit emotion discrimination versus implicit emotion processing.

Emotion recognition is essential for social interaction and communication and is a capacity in which the amygdala plays a central role. So far, neuroimaging results have been inconsistent as to whether the amygdala is more active during explicit or incidental facial emotion processing. In consideration of its functionality in fast automatic evaluation of stimuli and involvement in higher-order conscious processing, we hypothesize a similar response to the emotional faces presented regardless of attentional focus. Using high field functional magnetic resonance imaging (fMRI) specifically optimized for ventral brain regions we show strong and robust amygdala activation for explicit and implicit processing of emotional facial expressions in 29 healthy subjects. Bilateral amygdala activation was, however, significantly greater when subjects were asked to recognize the emotion (explicit condition) than when required to discern the age (implicit condition). A significant correlation between amygdala activation and emotion recognition, but not age discrimination performance, emphasizes the amygdalas enhanced role during conscious emotion processing.

Amygdala activity to fear and anger in healthy young males is associated with testosterone

Neuroimaging studies have documented modulation of the activity of the amygdala - a key node in the neural network underlying emotion perception and processing, and one that has also been associated with regulating aggression - by exogenous testosterone. However, results on the impact of normal range testosterone levels on explicit emotion recognition as a prerequisite for social interaction and amygdala activation in healthy young males are missing. Hence, we performed functional MRI at 3T in a group of 21 healthy males during explicit emotion recognition with a protocol specifically optimized to reliably detect amygdala activation. We observed similar amygdala activation to all emotions presented without any effect of gender of poser or laterality. Reaction times to fearful male faces were found negatively correlated to testosterone concentration, while no significant effects emerged for other emotions and neutral expressions. Correlation analyses revealed a significant positive association between testosterone levels and amygdala response to fearful and angry facial expressions, but not to other expressions. Hence, our results demonstrate that testosterone levels affect amygdala activation and also behavioral responses particularly to threat-related emotions in healthy young males. We conclude that these findings add to our understanding of emotion processing and its modulation by neuroendocrine factors.

Emotion recognition accuracy in healthy young females is associated with cycle phase

Several studies reported a significant influence of ovarian hormone status on cognition and person perception. In particular, it has been stated that female mating preferences are shifted during the menstrual cycle. It remains, however, unclear if facial emotion recognition, a prerequisite for successful social interaction, is also influenced by estradiol and progesterone levels. Hence, we investigated 32 healthy right-handed females, 15 during their follicular phase and 17 during their luteal phase and compared their recognition accuracy. Hormone levels were correlated with several neuropsychological parameters. Subjects were matched for age and education and did not differ in any neuropsychological function. Analysis of emotion recognition performance (ANOVA) revealed a significant effect of phase, showing higher accuracy in the follicular group. Furthermore, a significant negative correlation between progesterone level and emotion recognition performance emerged, indicating higher accuracy with lower progesterone levels, hence supporting the group differences. Our results indicate a significant association of menstrual cycle phase and thus ovarian hormone concentration on facial emotion recognition, with progesterone exerting a special influence on this social-emotional ability.

Facial emotion recognition and amygdala activation are associated with menstrual cycle phase

Converging evidence has accumulated that menstrual cycle and thus hormonal levels can affect emotional behavior, in particular facial emotion recognition. Here we explored the association of ovarian hormone levels and amygdala activation during an explicit emotion recognition task in two groups of healthy young females: one group was measured while in their follicular phase (n=11) and the other during their luteal phase (n=11). Using a 3T scanner in combination with a protocol specifically optimized to reliably detect amygdala activation we found significantly stronger amygdala activation in females during their follicular phase. Also, emotion recognition performance was significantly better in the follicular phase. We observed significant negative correlations between progesterone levels and amygdala response to fearful, sad and neutral faces, further supporting a significant modulation of behavior and neural response by hormonal changes during the menstrual cycle. From an evolutionary point of view this significant influence of ovarian hormone level on emotion processing and an important neural correlate, the amygdala, may enable a higher social sensitivity in females during their follicular phase, thus facilitating socio-emotional behavior (and social interaction) which may possibly facilitate mating behavior as well.

Amygdala activation at 3T in response to human and avatar facial expressions of emotions.

Facial expressions of emotions are important in nonverbal communication. Although numerous neural structures have been identified to be involved in emotional face processing, the amygdala is thought to be a core moderator. While previous studies have relied on facial images of humans, the present study is concerned with the effect of computer-generated (avatar) emotional faces on amygdala activation. Moreover, elicited activation patterns in response to viewing avatar faces are compared with the neuronal responses to human facial expressions of emotions. Twelve healthy subjects (five females) performed facial emotion recognition tasks with optimized 3T event-related fMRI. Robust amygdala activation was apparent in response to both human and avatar emotional faces, but the response was significantly stronger to human faces in face-sensitive structures, i.e. fusiform gyri. We suggest that avatars could be a useful tool in neuroimaging studies of facial expression processing because they elicit amygdala activation similarly to human faces, yet have the advantage of being highly manipulable and fully controllable. However, the finding of differences between human and avatar faces in face-sensitive regions indicates the presence of mechanisms by which human brains can differentiate between them. This mechanism merits further investigation.

Facial emotion recognition in patients with bipolar I and bipolar II disorder.

OBJECTIVESnThe ability to recognize facial emotional expressions is a fundamental skill that is necessary for successful social interaction. Previous studies examining this competency in patients with bipolar disorder have generated mixed results. Since bipolar patients show multiple psychosocial difficulties even after remission, this study was aimed at further elucidating emotion recognition deficits in bipolar patients.nnnMETHODS AND DESIGNnSixty-two stable bipolar out-patients (37 females; 25 males) and 62 matched healthy controls participated in the study. Explicit facial emotion recognition accuracy was measured with a computerized task.nnnRESULTSnAnalysis of emotion recognition performance revealed no gender effect but a significant group effect, indicating significantly worse accuracy in patients with bipolar I. Patients with bipolar II disorder did not differ significantly from healthy controls. These results were not correlated with either residual symptoms or intellectual impairments.nnnCONCLUSIONSnBased on our results, patients with bipolar disorder vary not only in diagnosis, but also in social cognitive functions, all of which should be addressed in clinical treatment. Future studies should clarify whether emotion recognition deficits are involved in the development and maintenance of bipolar disorder.

General and specific responsiveness of the amygdala during explicit emotion recognition in females and males

BackgroundThe ability to recognize emotions in facial expressions relies on an extensive neural network with the amygdala as the key node as has typically been demonstrated for the processing of fearful stimuli. A sufficient characterization of the factors influencing and modulating amygdala function, however, has not been reached now. Due to lacking or diverging results on its involvement in recognizing all or only certain negative emotions, the influence of gender or ethnicity is still under debate.This high-resolution fMRI study addresses some of the relevant parameters, such as emotional valence, gender and poser ethnicity on amygdala activation during facial emotion recognition in 50 Caucasian subjects. Stimuli were color photographs of emotional Caucasian and African American faces.ResultsBilateral amygdala activation was obtained to all emotional expressions (anger, disgust, fear, happy, and sad) and neutral faces across all subjects. However, only in males a significant correlation of amygdala activation and behavioral response to fearful stimuli was observed, indicating higher amygdala responses with better fear recognition, thus pointing to subtle gender differences. No significant influence of poser ethnicity on amygdala activation occurred, but analysis of recognition accuracy revealed a significant impact of poser ethnicity that was emotion-dependent.ConclusionApplying high-resolution fMRI while subjects were performing an explicit emotion recognition task revealed bilateral amygdala activation to all emotions presented and neutral expressions. This mechanism seems to operate similarly in healthy females and males and for both in-group and out-group ethnicities. Our results support the assumption that an intact amygdala response is fundamental in the processing of these salient stimuli due to its relevance detecting function.

How specific are emotional deficits? A comparison of empathic abilities in schizophrenia, bipolar and depressed patients

Empathy is a rather elaborated human ability and several recent studies highlight significant impairments in patients suffering from psychiatric disorders, such as schizophrenia, bipolar disorder or major depression. Therefore, the present study aimed at comparing behavioral empathy performance in schizophrenia, bipolar and depressed patients with healthy controls. All subjects performed three tasks tapping the core components of empathy: emotion recognition, emotional perspective taking and affective responsiveness. Groups were matched for age, gender, and verbal intelligence. Data analysis revealed three main findings: First, schizophrenia patients showed the strongest impairment in empathic performance followed by bipolar patients while depressed patients performed similar to controls in most tasks, except for affective responsiveness. Second, a significant association between clinical characteristics and empathy performance was only apparent in depression, indicating worse affective responsiveness with stronger symptom severity and longer duration of illness. Third, self-report data indicate that particularly bipolar patients describe themselves as less empathic, reporting less empathic concern and less perspective taking. Taken together, this study constitutes the first approach to directly compare specificity of empathic deficits in severe psychiatric disorders. Our results suggest disorder-specific impairments in emotional competencies that enable better characterization of the patient groups investigated and indicate different psychotherapeutic interventions.