Dawn Baker

Empathy and enduring depersonalization: The role of self-related processes

Abstract Empathy has two key components: affective and cognitive. It relies on “embodied” processes such as the generation, representation and perception of feeling states. People diagnosed with Depersonalization Disorder (DPD) report disturbances in affective experience, such as emotional numbing, alongside aberrations in “body image” such as increased self-focus and feelings of “disembodiment”. DPD therefore provides a test bed for the role of such self-related processes in empathy. We tested 16 participants diagnosed with DPD and 48 control volunteers on measures of cognitive and affective empathy. We used self-report measures (EQ; Baron-Cohen & Wheelwright, 2004), an objective measure of cognitive empathy—the “Eyes” task (Baron-Cohen, Wheelwright, Hill, Raste, & Plumb, 2001), and a novel task tapping affective empathy, utilizing speech rate as an implicit measure of physiological arousal. We also measured participants’ tendency to use mental representations that relate to the self during the affective empathy task. The DPD group showed intact performance on the cognitive empathy task. However, there was a disruption in the physiological component of affective empathy alongside a more pronounced reliance on mental representations of the self. These findings suggest affective empathy to be reliant on intact emotional experience in the observer. In addition, excessive self-focus may be detrimental to an empathic response.

Emotional memory and perception of emotional faces in patients suffering from depersonalization disorder.

Previous work has shown that patients with depersonalization disorder (DPD) have reduced physiological responses to emotional stimuli, which may be related to subjective emotional numbing. This study investigated two aspects of affective processing in 13 patients with DPD according to the DSM-IV criteria and healthy controls: the perception of emotional facial expressions (anger, disgust, fear, happiness, sadness, and surprise) and memory for emotional stimuli. Results revealed a specific lack of sensitivity to facial expression of anger in patients, but normal enhancement of memory for peripheral aspects of arousing emotional material. The results are consistent with altered processing of threat-related stimuli but intact consolidation processes, at least when the stimuli involved are potently arousing.

Injection Phobia: A Systematic Review of Psychological Treatments

Injectable medications are commonplace but injection phobia can have a detri-mental impact on the utilization of health care by patients with subsequent adverse clinical outcomes. This systematic review aimed to identify the various psychological treatments for injection phobia and to assess their effectiveness. A systematic literature search was conducted using Cochrane, PsycINFO, EMBASE, MEDLINE, and AMED databases. Studies with five or more cases that investigated psychological treatment outcomes were selected and assessed in terms of methodological quality, type of intervention and outcomes. Eighty-four publications were identified by the search. Only three studies fulfilled the selection criteria and all used cognitive-behavioural techniques, including exposure to the feared object through a traditional graded hierarchy. Methodology differed but all had optimistic outcomes. Psychological treatments for injection fear or phobia exist, but the overall quality of evidence for treatment effectiveness is poor and outcome measures need consensus and further development.