Abstract
Adverse childhood experiences (ACEs) have been proven to affect overall well-being, impacting physiological, psychological, and interpersonal functioning. Empathy is often regarded as cooperative behavior, but empathy is not always adaptive. Empathy becomes maladaptive when one disregards personal needs to care for another individual. Pathological concern, a compulsive need to care for another person, seems conceptually related to maladaptive empathy. The current study intended to assess the ability to predict pathological concern based on adverse childhood experiences (ACEs) and empathy. Participants (N = 171) completed a sequence of self-report questionnaires to assess ACEs, empathy, and pathological concern. Multiple regression analyses confirmed ACEs and empathy simultaneously predict pathological concern. The unique role of maladaptive empathy was revealed through exploratory analyses. Clinical and empirical implications are discussed, and future research directions are suggested to help understand this predictive relationship.
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The data that support the findings of this study are openly available in “The contribution of empathy to the relationship between adverse childhood experiences and pathological concern” at https://www.openicpsr.org/openicpsr/workspace?goToPath=/openicpsr/175002&goToLevel=project.
References
Afifi, T. O., Enns, M. W., Cox, B. J., Asmundson, G. J., Stein, M. B., & Sareen, J. (2008). Population attributable fractions of psychiatric disorders and suicide ideation and attempts associated with adverse childhood experiences. American Journal of public health, 98(5), 946–952. https://doi.org/10.2105/AJPH.2007.120253.
Batson, C. D., Duncan, B. D., Ackerman, P., Buckley, T., & Birch, K. (1981). Is empathic emotion a source of altruistic motivation? Journal of Personality and Social Psychology, 40(2), 290–302. https://doi.org/10.1037/0022-3514.40.2.290.
Bowlby, J. (1979). The making and breaking of affectional bonds. London, England: Tavistock.
Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. Basic Books.
Boyda, D., McFeeters, D., & Shevlin, M. (2015). Intimate partner violence, sexual abuse, and the mediating role of loneliness on psychosis. Psychosis: Psychological Social and Integrative Approaches, 7(1), 1–13. https://doi.org/10.1080/17522439.2014.917433.
Bush, N. R., Lane, R. D., & McLaughlin, K. A. (2016). Mechanisms underlying the Association between Early-Life Adversity and Physical Health: Charting a course for the future. Psychosomatic Medicine, 78(9), 1114–1119. https://doi.org/10.1097/PSY.0000000000000421.
Cameron, C. D., Hutcherson, C. A., Ferguson, A. M., Scheffer, J. A., Hadjiandreou, E., & Inzlicht, M. (2019). Empathy is hard work: People choose to avoid empathy because of its cognitive costs. Journal of Experimental Psychology: General, 148(6), 962–976. https://doi.org/10.1037/xge0000595.
Davis, M. H. (1980). A multidimensional approach to individual differences in empathy. JSAS Catalog of Selected Documents in Psychology, 10, 85.
Davis, M. H. (1983). Measuring individual differences in empathy: Evidence for a multidimensional approach. Journal of Personality and Social Psychology, 44(1), 113–126. https://doi.org/10.1037/0022-3514.44.1.113.
Davis, M. H. (1996). Empathy: A Social Psychological Approach. Boulder: Westview Press.
Eisenberg, N., & Fabes, R. A. (1990). Empathy: Conceptualization, measurement, and relation to prosocial behavior. Motivation and Emotion, 14(2), 131–149. https://doi.org/10.1007/BF00991640.
Eklund, J., Andersson-Stråberg, T., & Hansen, E. M. (2009). I’ve also experienced loss and fear”: Effects of prior similar experience on empathy. Scandinavian Journal Of Psychology, 50, 65–69. https://doi.org/10.1111/j.1467-9450.2008.00673.x.
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245–258.
Ferguson, C. J. (2011). Video games and youth violence: A prospective analysis in adolescents. Journal of Youth and adolescence, 40(4), 377–391. https://doi.org/10.1007/s10964-010-9610-x.
Finkelhor, D., Shattuck, A., Turner, H., & Hamby, S. (2015). A revised inventory of adverse childhood experiences. Child abuse & neglect, 48, 13–21. https://doi.org/10.1016/j.chiabu.2015.07.011.
Gerber, Z., Tolmacz, R., & Doron, Y. (2015). Self-compassion and forms of concern for others. Personality and Individual Differences, 86, 394–400. https://doi.org/10.1016/j.paid.2015.06.052.
Greenberg, D. M., Baron-Cohen, S., Rosenberg, N., Fonagy, P., & Rentfrow, P. J. (2018). Elevated empathy in adults following childhood trauma. PloS one, 13(10), e0203886. https://doi.org/10.1371/journal.pone.0203886.
Herzog, J. I., & Schmahl, C. (2018). Adverse childhood experiences and the Consequences on Neurobiological, Psychosocial, and somatic conditions across the Lifespan. Frontiers in psychiatry, 9, 420. https://doi.org/10.3389/fpsyt.2018.00420.
Hesse, E., & Main, M. (2000). Disorganized infant, child, and adult attachment: Collapse in behavioral and attentional strategies. Journal of the American Psychoanalytic Association, 48(4), 1097–1187. https://doi.org/10.1177/00030651000480041101.
Israelashvili, J., Sauter, D. A., & Fischer, A. H. (2020). Different faces of empathy: Feelings of similarity disrupt recognition of negative emotions. Journal of Experimental Social Psychology, 87, 103912. https://doi.org/10.1016/j.jesp.2019.103912.
Kamas, L., & Preston, A. (2021). “Empathy, gender, and prosocial behavior,“ Journal of Behavioral and Experimental Economics. Elsevier, 92(C). https://doi.org/10.1016/j.socec.2020.101654.
Karatekin, C., Mason, S. M., Riegelman, A., Bakker, C., Hunt, S., Gresham, B., Corcoran, F., & Barnes, A. (2022). Adverse childhood experiences: A scoping review of measures and methods. Children and Youth Services Review, 36, 106425. https://doi.org/10.1016/j.childyouth.2022.106425.
Klimecki, O., & Singer, T. (2012). Empathic distress fatigue rather than compassion fatigue? Integrating findings from empathy research in psychology and social neuroscience. In B. Oakley, A. Knafo, G. Madhavan, & D. Wilson (Eds.), Pathological altruism (pp. 368–383). New York: Oxford University Press.
Lim, D., & DeSteno, D. (2016). Suffering and compassion: The links among adverse life experiences, empathy, compassion, and prosocial behavior. Emotion (Washington D C), 16(2), 175–182. https://doi.org/10.1037/emo0000144.
Linley, P. A., & Joseph, S. (2004). Positive change following trauma and adversity: A review. Journal of traumatic stress, 17(1), 11–21. https://doi.org/10.1023/B:JOTS.0000014671.27856.7e.
Löckenhoff, C. E., Terracciano, A., Patriciu, N. S., Eaton, W. W., & Costa, P. T. Jr. (2009). Self-reported extremely adverse life events and longitudinal changes in five-factor model personality traits in an urban sample. Journal of Traumatic Stress, 22(1), 53–59. https://doi.org/10.1002/jts.20385.
Lovis-Schmidt, A., Schilling, J., Pudschun, C., & Rindermann, H. (2022). Adverse childhood experiences and physical diseases in adulthood: A summary of meta-analyses. Traumatology Advance online publicationhttps://doi.org/10.1037/trm0000412.
Maguire-Jack, K., Lanier, P., & Lombardi, B. (2020). Investigating racial differences in clusters of adverse childhood experiences. American Journal of Orthopsychiatry, 90, 106–114. https://doi.org/10.1037/ort0000405.
McLaughlin, K. A., Green, J. G., Gruber, M. J., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2010). Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication II: Associations with persistence of DSM-IV disorders. Archives of general psychiatry, 67(2), 124–132. https://doi.org/10.1001/archgenpsychiatry.2009.187.
Merrick, M. T., Ford, D. C., Ports, K. A., & Guinn, A. S. (2018). Prevalence of adverse childhood experiences from the 2011–2014 behavioral risk factor Surveillance System in 23 States. JAMA pediatrics, 172(11), 1038–1044. https://doi.org/10.1001/jamapediatrics.2018.2537.
Mooradian, T. A., Davis, M., & Matzler, K. (2011). Dispositional empathy and the hierarchical structure of personality. American Journal of Psychology, 124, 99–109.
Nurius, P. S., Green, S., Logan-Greene, P., & Borja, S. (2015). Life course pathways of adverse childhood experiences toward adult psychological well-being: A stress process analysis. Child abuse & neglect, 45, 143–153. https://doi.org/10.1016/j.chiabu.2015.03.008.
O’Connor, L. E., Berry, J. W., Weiss, J., & Gilbert, P. (2002). Guilt, fear, submission, and empathy in depression. Journal of affective disorders, 71(1–3), 19–27. https://doi.org/10.1016/s0165-0327(01)00408-6.
O’Connor, D. B., O’Connor, R. C., & Marshall, R. (2007). Perfectionism and psychological distress: Evidence of the mediating effects of rumination. European Journal Of Personality, 21, 429–452. https://doi.org/10.1002/per.616.
O’Connor, L. E., Berry, J. W., Lewis, T. B., & Stiver, D. J. (2012). Empathy-based pathogenic guilt, pathological altruism, and psychopathology. In B. Oakley, A. Knafo, G. Madhavan, & D. Wilson (Eds.), Pathological altruism (pp. 10–30). New York: Oxford University Press.
Poole, J. C., Dobson, K. S., & Pusch, D. (2018). Do adverse childhood experiences predict adult interpersonal difficulties? The role of emotion dysregulation. Child abuse & neglect, 80, 123–133. https://doi.org/10.1016/j.chiabu.2018.03.006.
Robinson, J. L., Zahn-Waxler, C., & Emde, R. N. (1994). Patterns of development in early empathic behavior: Environmental and child constitutional influences. Social Development, 3, 125–145.
Seery, M. D., Holman, E. A., & Silver, R. C. (2010). Whatever does not kill us: Cumulative lifetime adversity, vulnerability, and resilience. Journal of personality and social psychology, 99(6), 1025–1041. https://doi.org/10.1037/a0021344.
Selya, A. S., Rose, J. S., Dierker, L. C., Hedeker, D., & Mermelstein, R. J. (2012). A practical guide to calculating Cohen’s f 2, a measure of local effect size, from PROC MIXED. Frontiers in psychology, 3, article 111. https://doi.org/10.3389/FPSYG.2012.00111.
Sened, H., Lavidor, M., Lazarus, G., Bar-Kalifa, E., Rafaeli, E., & Ickes, W. (2017). Empathic accuracy and relationship satisfaction: A meta-analytic review. Journal of Family Psychology, 31(6), 742–752. https://doi.org/10.1037/fam0000320.
Shavit, Y., & Tolmacz, R. (2014). Pathological concern: Scale construction, construct validity, and associations with attachment, self-cohesion, and relational entitlement. Psychoanalytic Psychology, 31(3), 343–356. https://doi.org/10.1037/a0036560.
Thomson, P., & Jaque, S. V. (2017). Adverse childhood experiences (ACE) and adult attachment interview (AAI) in a non-clinical population. Child abuse & neglect, 70, 255–263. https://doi.org/10.1016/j.chiabu.2017.06.001.
Tone, E. B., & Tully, E. C. (2014). Empathy as a “risky strength”: A multilevel examination of empathy and risk for internalizing disorders. Development and Psychopathology, 26(4), 1547–1565. https://doi.org/10.1017/S0954579414001199.
Tost, H., Champagne, F. A., & Meyer-Lindenberg, A. (2015). Environmental influence in the brain, human welfare and mental health. Nature neuroscience, 18(10), 1421–1431. https://doi.org/10.1038/nn.4108.
Zahn-Waxler, C., & Van Hulle, C. (2012). Empathy, guilt, and depression: When caring for others becomes costly to children. In B. Oakley, A. Knafo, G. Madhavan, & D. S. Wilson (Eds.), Pathological altruism (pp. 321–344). Oxford University Press.
Zaki, J. (2014). Empathy: A motivated account. Psychological Bulletin, 140(6), 1608–1647. https://doi.org/10.1037/a0037679.
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Katherine J. Siegler and Andrew F. Luchner. The first draft of the manuscript was written by Katherine J. Siegler, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Siegler, K.J., Luchner, A.F. The role of early adverse experience and empathy in the prediction of pathological concern. Curr Psychol 43, 7952–7958 (2024). https://doi.org/10.1007/s12144-023-04983-6
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DOI: https://doi.org/10.1007/s12144-023-04983-6