Dissociation Between Affective and Cognitive Empathy in Alcoholism: A Specific Deficit for the Emotional Dimension

Abstract

At the theoretical level, this first observation of a specific deficit for emotional empathy in alcoholism, combined with the exact inverse pattern observed in other psychiatric populations, leads to a double-dissociation, which supports the notion that emotional and cognitive empathy are 2 distinct abilities. At the clinical level, this deficit calls for considering emotional empathy rehabilitation as a crucial concern in psychotherapy. Background: Emotional impairments constitute a crucial and widely described dimension of alcoholism, but several affective abilities are still to be thoroughly explored among alcohol-dependent patients. This is particularly true for empathy, which constitutes an essential emotional competence for interpersonal relations and has been shown to be highly impaired in various psychiatric states. The present study aimed at exploring empathic abilities in alcoholism, and notably the hypothesis of a differential deficit between emotional and cognitive empathy.Methods: Empathy abilities were evaluated among 30 recently detoxified inpatients diagnosed with alcohol dependence and 30 paired healthy controls, using highly validated questionnaires (Interpersonal Reactivity Index [J Pers Soc Psychol 44:113] and Empathy Quotient [J Autism Dev Disord 34:163]). Correlational analyses were performed to evaluate the links between empathy scores and psychopathological measures (i.e., depression, anxiety, interpersonal problems, and alexithymia).Results: When psychiatric comorbities are controlled for, alcoholism is not associated with a general empathy deficit, but rather with a dissociated pattern combining impaired emotional empathy and preserved cognitive one. Moreover, this emotional empathy deficit is not associated with depression or anxiety scores, but is negatively correlated with alexithymia and the severity of interpersonal problems. Conclusions: At the theoretical level, this first observation of a specific deficit for emotional empathy in alcoholism, combined with the exact inverse pattern observed in other psychiatric populations, leads to a double-dissociation, which supports the notion that emotional and cognitive empathy are 2 distinct abilities. At the clinical level, this deficit calls for considering emotional empathy rehabilitation as a crucial concern in psychotherapy.

The Independent Contributions of Emotion Dysregulation and Hypermentalization to the “Double Dissociation” of Affective and Cognitive Empathy in Female Adolescent Inpatients With BPD

“…Therefore, it is possible that the dissociation of empathy types is a feature of empathic processing in adolescents with psychiatric disorders in general, rather than those with BPD specifically. This possibility is bolstered by findings of discrepancies across affective and cognitive empathy in other psychiatric disorders (Dziobek et al, 2011;Maurage et al, 2011;Shamay-Tsoory et al, 2007) and evidence of the existence of two neurobiological systems for empathy: a basic emotional contagion system, and a more advanced cognitive perspective-taking system (Shamay-Tsoory et al, 2009).…”

Profiles of impaired, spared, and recovered neuropsychologic processes in alcoholism

“…The alcoholics also had lower emotional intelligence scores, suggesting that these factors contributed to impaired interpersonal functioning. Further, higher levels of alexithymia, characterized by difficulties identifying, differentiating, and expressing feelings, have been reported in alcoholism (Maurage et al, 2011; Stasiewicz et al, 2012), and positive correlations between alexithymia measures and severity of alcohol use have been reported (Thorberg et al, 2011). …”

Below and beyond the recognition of emotional facial expressions in alcohol dependence: from basic perception to social cognition

“…This confirmed that the affective deficit extends beyond basic emotional states. Other studies have described, on the basis of questionnaires or experimental tasks, deficits in a wide range of emotional abilities such as empathy,30,31 alexithymia,32 or irony detection,33 leading to the proposal of a wide affective processing deficit in ADI.…”