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Article

Cross-Cultural Perspectives on the Role of Empathy during COVID-19’s First Wave

by
Marina L. Butovskaya
1,2,3,*,
Valentina N. Burkova
1,2,
Ashley K. Randall
4,
Silvia Donato
5,
Julija N. Fedenok
1,
Lauren Hocker
4,
Kai M. Kline
4,
Khodabakhsh Ahmadi
6,
Ahmad M. Alghraibeh
7,
Fathil Bakir Mutsher Allami
8,
Fadime Suata Alpaslan
9,
Mohammad Ahmad Abdelaziz Al-Zu’bi
10,
Derya Fatma Biçer
11,
Hakan Cetinkaya
12,
Oana Alexandra David
13,
Seda Dural
14,
Paige Erickson
15,
Alexey M. Ermakov
16,
Berna Ertuğrul
9,
Emmanuel Abiodun Fayankinnu
17,
Maryanne L. Fisher
18,
Ivana Hromatko
19,
Elena Kasparova
20,
Alexander Kavina
21,
Hareesol Khun-Inkeeree
22,
Fırat Koç
23,
Vladimir Kolodkin
24,
Melanie MacEacheron
25,
Irma Rachmawati Maruf
26,
Norbert Meskó
27,
Ruzan Mkrtchyan
28,
Poppy Setiawati Nurisnaeny
29,
Oluyinka Ojedokun
30,
Damilola Adebayo
30,
Mohd S. B. Omar-Fauzee
31,
Barış Özener
9,
Edna Lúcia Tinoco Ponciano
32,33,
Igor V. Popov
16,
Muhammad Rizwan
34,
Agnieszka Sabiniewicz
35,
Victoriya I. Spodina
36,
Stanislava Stoyanova
37,
Nachiketa Tripathi
38,
Satwik Upadhyay
38,
Carol Weisfeld
15,
Mohd Faiz Mohd Yaakob
31,
Mat Rahimi Yusof
31 and
Raushaniia I. Zinurova
39
add Show full author list remove Hide full author list
1
Center of Cross-Cultural Psychology and Human Ethology, Institute of Ethnology and Anthropology, Russian Academy of Sciences, 119991 Moscow, Russia
2
International Center of Anthropology, National Research University Higher School of Economics, 101000 Moscow, Russia
3
Study and Science Center of Cultural Antropology, Russian State University for the Humanities, 125993 Moscow, Russia
4
Counseling and Counseling Psychology, Arizona State University, Tempe, AZ 85287-0811, USA
5
Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy
6
Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran 19395-5478, Iran
7
Department of Psychology, King Saud University, Riyadh 2458, Saudi Arabia
8
Physical Education and Sport Sciences, University of Misan, Amarah 62001, Maysan, Iraq
9
Department of Anthropology, İstanbul University, İstanbul 34452, Turkey
10
Department of Early Childhood, Faculty of Educational Sciences, Zarqa University, Zarqa City 5468, Jordan
11
Department of Business Administration, Sivas Cumhuriyet University, Sivas 58140, Turkey
12
Department of Psychology, Ankara University, Ankara 06100, Turkey
13
Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University Cluj-Napoca, 400015 Cluj-Napoca, Romania
14
Department of Psychology, Izmir University of Economics, İzmir 35330, Turkey
15
Department of Psychology, University of Detroit Mercy, Detroit, MI 48221-3038, USA
16
Faculty of Bioengineering and Veterinary Medicine, Don State Technical University, 344000 Rostov-on-Don, Russia
17
Department of Sociology, Adekunle Ajasin University, Akungba Akoko 001, Nigeria
18
Department of Psychology, Saint Mary’s University, Halifax, NS B3H 3C3, Canada
19
Department of Psychology, Faculty of Humanities and Social Sciences, 10000 Zagreb, Croatia
20
Department of Pedagogy and Problems of Education Development, Belarusian State University, 220030 Minsk, Belarus
21
Department of History, St John’s University of Tanzania, Dodoma P.O. Box 47, Tanzania
22
School of Languages and General Education, Walailak University, Thasala District, Nakhon si Thammarat 80160, Thailand
23
Department of Anthropology, Hitit University, Çorum 19030, Turkey
24
Faculty of Media Communications and Multimedia Technology, Don State Technical University, 344000 Rostov-on-Don, Russia
25
School of Social & Behavioral Sciences, Arizona State University, Tempe, AZ 85287-0811, USA
26
Post Graduate Notary Law Program, Pasundan University, Bandung 40113, West Java, Indonesia
27
Department for General and Evolutionary Psychology, Institute of Psychology, University of Pécs, 7624 Pécs, Hungary
28
Department of Cultural Studies, Faculty of History, Yerevan State University, Yerevan 0025, Armenia
29
State Intelligence College, Bogor 16001, Indonesia
30
Department of Pure & Applied Psychology, Adekunle Ajasin University, Akungba Akoko 001, Nigeria
31
School of Education, Universiti Utara Malaysia, UUM Sintok, Kedah 06010, Malaysia
32
Institute of Psychology and Center of Social Studies, University of the State of Rio de Janeiro, Rio de Janeiro 20943-000, Brazil
33
Institute of Psychology and Center of Social Studies, University of Coimbra, 3004 Coimbra, Portugal
34
Department of Psychology, University of Haripur, Khyber Pakhtunkhwa 22620, Pakistan
35
Department of Otorhinolaryngology, Smell and Taste Clinic TU Dresden, 01069 Dresden, Germany
36
Department of History and Ethnology, Ob-Ugric Institute of Applied Researches and Development, 628011 Khanty-Mansiysk, Russia
37
Department of Psychology, South-West University “Neofit Rilski”, 2700 Blagoevgrad, Bulgaria
38
Department of Humanities & Social Sciences, Indian Institute of Technology Guwahati, Guwahati 781 039, Assam, India
39
Institute of Innovation Management, Kazan National Research Technological University, 420015 Kazan, Russia
*
Author to whom correspondence should be addressed.
Sustainability 2021, 13(13), 7431; https://doi.org/10.3390/su13137431
Submission received: 7 May 2021 / Revised: 23 June 2021 / Accepted: 28 June 2021 / Published: 2 July 2021
(This article belongs to the Special Issue Evolutionary Perspectives on Human Behavior in Pandemics)

Abstract

:
The COVID-19 pandemic has spread throughout the world, and concerns about psychological, social, and economic consequences are growing rapidly. Individuals’ empathy-based reactions towards others may be an important resilience factor in the face of COVID-19. Self-report data from 15,375 participants across 23 countries were collected from May to August 2020 during the early phases of the COVID-19 pandemic. In particular, this study examined different facets of empathy—Perspective-Taking, Empathic Concern, and Personal Distress, and their association with cross-cultural ratings on Individualism, Power Distance, The Human Development Index, Social Support Ranking, and the Infectious Disease Vulnerability Index, as well as the currently confirmed number of cases of COVID-19 at the time of data collection. The highest ratings on Perspective-Taking were obtained for USA, Brazil, Italy, Croatia, and Armenia (from maximum to minimum); on Empathetic Concern, for the USA, Brazil, Hungary, Italy, and Indonesia; and on Personal Distress, from Brazil, Turkey, Italy, Armenia, Indonesia. Results also present associations between demographic factors and empathy across countries. Limitations and future directions are presented.

1. Introduction

Since the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic in March 2020, concerns about psychological, social, and economic consequences have grown rapidly. Indeed, news reports and social media postings have been abuzz with how things have changed for the entire world, including psychological, economic, social, and health consequences [1,2,3,4,5,6,7]. Empathy is a key component of social interactions as it promotes prosocial behavior and discourages aggressive behavior towards others [8,9]. Empathy is defined as the capacity to imagine, experience, and understand what the other person is feeling, and consists of affective and cognitive aspects (e.g., [10,11]). Given the importance of empathy in the time of global stress and insecurity feelings, the purpose of this study was to examine how the level of empathy during the first wave of COVID-19 varies cross-culturally, and how this relates to the infection rates and familiarity of people with pandemics.
Studies examining levels of Empathic Concern in crisis situations are not numerous and primarily deal with general philosophic discussions on global civilization crises [12,13,14], while those discussing the COVID-19 pandemic are scarce [15]. Past research conducted with adult and child samples has conclusively demonstrated the beneficial effects of both cognitive (accepting the point of view of others) and affective (caring and understanding for others) empathy on the well-being of others. In particular, cognitive empathy has been associated with a decrease in intergroup conflict and prejudice, and affective empathy has been shown to promote altruism and caring [3,16,17]. Currently, studies have demonstrated that social support has been one of the important predictors of resilience during a global pandemic [1,18]; however, the links between social support and empathy remain unclear.
Undoubtedly, the COVID-19 pandemic and its associated restrictions have impacted our interpersonal relationships [4,19]. The new demands on the organization of interpersonal relations, in turn, have affected the concept of empathy itself, producing new positive perspectives in the study of the phenomenon according to sociological and neurological point of view [2]. Reports of those helping others (relatives, friends, neighbors, etc.) are frequent in the media, wherein people are helping those who are more vulnerable by delivering food or medicine for people who cannot leave their home. In one such study, conducted in Western populations (Germany, UK, USA), empathy was found to be positively associated with the motivation to adhere to physical distancing and wearing face masks. Furthermore, the authors concluded that inducing empathy towards people most vulnerable to the virus promoted the motivation to adhere to these measures (whereas merely providing information about the importance of the measures did not) [3]. Conversely, some people are experiencing a feeling of “forced sympathy”, which can cause people to distance themselves from others, increasing social phobias [2]. Studies conducted before and during the pandemic have demonstrated that empathy also generates vulnerability for stress-related symptoms, such as compassion fatigue and burnout, especially in medical professionals under extreme conditions, such as the current COVID-19 pandemic [20,21,22].
Importantly, the associations between empathy and motivations depend on context and settings [23]. According to Davis [24], core components of empathy are perspective-taking and empathetic concern. Perspective-Taking consists of adopting the point of view of another person and attempting to understand things from their perspective. Empathic Concern is conceptually closer to sympathy and is the emotional reaction of an individual who is attentive to others’ experiences [25]. Perspective-taking and Empathic Concern have been associated with differential outcomes. For example, healthcare professionals in Argentina viewed Perspective-Taking as helpful in caring for patients; however, high levels of Empathic Concern interfered with objectivity in diagnosis and treatment due to its emotional component [21]. Importantly, a recent study on the role of empathy during the COVID-19 pandemic in China demonstrated empathetic concern, and Personal Distress may be risk factors for depression and anxiety in extreme conditions including COVID-19 [26,27,28,29].
Empathy is an important aspect to consider when examining individuals’ reactions to the pandemic; however, little is known about empathetic behavior of humans during the pandemic. For example, a diary study conducted with adolescents during the COVID-19 pandemic showed there was decreased empathic anxiety, opportunities for prosocial action, and tension and stable levels of social value orientation, altruism, and terrifying prosociality [30]. In the economic game, the dictator, in new conditions of pandemic, adolescents showed a higher level of commitment to a friend (familiar to another, about 51% of the total share), a doctor in a hospital (deserves a goal, 78%), and people with COVID-19 or weak immune systems (goals in need, 69% and 63%, respectively) compared with an unfamiliar peer (39%). This suggests that during the pandemic, need and deservedness have had a greater impact on a teen’s performance than familiarity. Oosterhoff et al. (2020) reported that the greatest motivators for adolescents in the United States to follow social distancing rules were prosocial motivations, including social responsibility and not wanting others to get sick, being in a city/state of lockdown, and parental rules [31]. Another study conducted in the Canadian population during COVID-19 isolation showed that people with higher empathy scores, as measured with the Interpersonal Reactivity Index, reported higher scores on anxiety and depression [32]. While increased anxiety and trauma seem to be detrimental to emotional well-being, it is reasonable to assume that people who are more concerned about themselves and the well-being of others will also have more empathy for others. Currently, available data suggest that the dissemination of COVID-19 related information (i.e., number of infections and deaths), some of which can be incorrect, can cause an over-empathic response and worsen panic and depression among people [33].
Demographic factors associated with empathy (sex, age, and culture). Previous studies have highlighted sex differences in empathy, with females usually reporting higher scores compared to males [10,34,35,36,37,38,39]. However, how these sex differences manifest during isolation in response to the pandemic is still unclear. In a study of sleep quality, empathy, and mood during the isolation period of the COVID-19 pandemic in the Canadian population, females reported higher scores on the all IRI empathy scale [32]. Interestingly, there were no changes associated with increased length of the isolation period in the IRI subscales for males or females [32]. However, to date, no study has examined potential sex differences in empathy during the COVID-19 context.
Prior research has demonstrated associations between age and empathy. Results of previous research showed that scores on Perspective-Taking and Empathetic Concern were increased with age, whereas scores on the Personal DistressDistress subscale were decreased with age [37,40,41,42]. Older adults have weaker cognitive empathy than younger adults, but their emotional empathy does not differ by age [43,44,45]. In a study of associations of aging, empathy, and prosociality, results demonstrated that older adults showed greater prosocial behavior than younger adults in response to an empathy induction [43]. Based on this research, it is hypothesized that age will be positively associated with empathy scores.
Cultural norms and institutions, specifically sizes of relative’s networks and obligations between friends, can be an important factor in influencing the level of empathy during COVID-19, especially given its global impact. While no study to date has examined such associations, prior research conducted outside the COVID-19 context has found Spanish people (i.e., those living in Spain) to have the highest scores on Empathic Concern and Perspective-Taking and USA for Personal Distress; lower scores in empathy were demonstrated in East Asian (i.e., Chinese) samples [46].
Prior research conducted by the authors has shown the important role of the cultural dimension of Individualism–Collectivism in anxiety (see this issue [7]). For example, collectivistic values were associated with higher empathy. The study of the role of Individualism–Collectivism in empathy showed that collectivism was correlated positively with dispositional intellectual empathy and empathic emotion, collectivism predicted experienced empathic emotion, and individualism predicted intellectual empathy [47]. In another study, Asian students from another research study from collectivistic countries showed more empathy [48]. Recent work done during the pandemic on a diverse sample (n = 967 total from Canada, Sweden, the United Kingdom, and the United States) showed that levels of Empathic Concern and Perspective-Taking were positively correlated with social distancing, but not with Personal Distress [49]. Authors suggest that these results depend on cultural level analogs (i.e., Individualism–Collectivism), and this association influences social distancing. These results show that empathy plays an important role in motivating people to social distance (and other preventive measures) and should be emphasized in times of crisis.
Taken together, the goal of the current paper was three-fold: first, to examine the associations between the level of empathy during the first wave of the COVID-19 pandemic across 23 countries and quarantine restrictions in a global cross-cultural perspective; second, to test sex and age differences of empathy these countries; and third, to test for associations between the level of empathy and a number of global cultural indices to gain a better understanding of empathetic motivations during lockdown and social distancing.

2. Materials and Methods

2.1. Participants

Participants were recruited from various university listservs and social networking sites. Participants were of 18 years of age and older, with a mean age of 29 years (median 24 years). The majority of the sample was female (1:179 in favor of women). See Table 1, Figure 1. Individuals who reported having a chronic disease and/or predisposition for depression and received treatment were excluded from the current analysis.
Self-reported data from 15,375 respondents were collected (see Table 1 for details). The sample was comprised of people from 23 countries (seven from Europe: Belarus, Bulgaria, Croatia, Hungary, Italy, Romania, Russia; eleven from South, Southeast, and Western Asia: Armenia, India, Indonesia, Iran, Iraq, Jordan, Malaysia, Pakistan, Saudi Arabia, Thailand, Turkey; two African: Nigeria and Tanzania; and three from North, Central, and South America: Brazil, Canada, USA).
Local versions (Canada, USA) included a few additional demographic variables that were not included in our analyses.

2.2. Procedure

All coauthors collected data in their home countries for this study. The questionnaire was generated on the Google Forms service hosted by the principal investigator. The original questionnaire was developed in Russian and English. In all non-English speaking countries (except Russia), colleagues translated the measures into their native languages using a back-translation procedure [50,51].
The survey was conducted during the first wave, and slightly after the introduction of quarantine (lockdown), of the COVID-19 pandemic from May to August 2020 (Median 5 June 2020) (see more details in [7], this issue).
All participants provided informed consent. If eligible, participants were directed to complete the self-report survey on Google forms to provide informed consent and were asked to take the survey, described below, which took approximately 20 min to complete. Participants were not compensated for their participation.

2.3. Measures

Participants responded to standard demographic questions, and the measures listed below. Specifically, participants reported the country of living, age, sex (coded as 1 = male; 2 = female), marital status (coded as 1 = single; 2 = relationship 3 = married; 4 = divorced; 5 = widowed; 6 = other), religion (coded as 0 = agnostic; 1 = Hindu; 2 = Buddhist; 3 = Judaist; 4 = Christian; 5 = Islamic; 6 = follower of tradition local religion), educational level, etc.
Related to the COVID-19 pandemic, participants were asked about their personal experiences with COVID-19, attitudes towards the current situation, family income, living conditions (0 = live with others; 1 = live alone), situation with lockdown status (0 = no, 1 = yes), involvement in voluntary activity (0 = no; 1 = yes).

Empathy

To measure empathy, the Interpersonal Reactivity Index (IRI) [10] was utilized. The IRI contains 28 items using 5-point Likert scales, ranging from 1 = “Does not describe me well” to 5 = “Describes me very well”. It is represented by four subscales, each made up of seven different items. These subscales are 1. Perspective-Taking—the tendency to spontaneously adopt the psychological point of view of others; 2. Empathic Concern—“other-oriented” feelings of sympathy and concern for unfortunate others; 3. Personal Distress—“self-oriented” feelings of personal anxiety and unease in tense interpersonal setting; 4. Fantasy—respondents’ tendencies to transpose themselves imaginatively into the feelings and actions of fictitious characters in books, movies, and plays. For the purpose of this study, we analyzed data from the first three subscales (Perspective-Taking, Empathetic Concern, and Personal Distress) (Table 2). The Fantasy subscale was not used, due to the cross-cultural nature of our study, to avoid any subjectivity, which is highly probable in the case of the fantasy-taps subscale.
Demographic information across countries for the IRI is presented in Table 3. The IRI has been validated in different languages [10,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69]. The ratings on each IRI subscale were tested for reliability, and Cronbach alphas were calculated for each country, as well as for the whole sample (Table 3).

2.4. Global Indices Used in This Study

Individualism and collectivism. To measure individualism and collectivism, we used two dimensions of national cultures from Hofstede model: (1) Individualism versus Collectivism scale, related to the integration of individuals into primary groups, and (2) the Power Distance scale, related to the different solutions to the basic problem of human inequality [69]. Each country has been positioned relative to other countries through a score on each dimension. “Individualism stands for a society in which the ties between individuals are loose: Everyone is expected to look after her/his immediate family only. Collectivism stands for a society in which people from birth onwards are integrated into strong, cohesive in-groups, which throughout people’s lifetime continue to protect them in exchange for unquestioning loyalty” [70] (p. 225). “Power Distance has been defined as the extent to which the less powerful members of organizations and institutions (like the family) accept and expect that power is distributed unequally. This represents inequality (more versus less), but defined from below, not from above. It suggests that a society’s level of inequality is endorsed by the followers as much as by the leaders” [70] (p. 9). Each country’s information on these two dimensions was obtained from https://www.hofstede-insights.com. (accessed 5 June 2020). For more detailed information on these indices, please refer to [7].
Vulnerability to disease. To measure vulnerability to disease, the Infectious Disease Vulnerability Index (IDVI) was utilized. The IDVI is a country-level index of vulnerability that reflects a more comprehensive evidence base, a more robust set of factors potentially contributing to outbreak vulnerability and associated proxy measures, the use of adjustable weights for these parameters, and an examination of all countries world-wide. Information about this indicator in each country was obtained from https://www.rand.org/pubs/research_reports/RR1605.html (accessed on 5 June 2020). For more detailed information on these indices, please refer to [7].
Human development. Human Development Index (HDI; 2020) is a summary measure of average achievement in key dimensions of human development: (1) a long and healthy life, (2) being knowledgeable, and (3) having a decent standard of living. The HDI is the geometric mean of normalized indices for each of the three dimensions and was taken from http://hdr.undp.org/en/content/latest-human-development-index-ranking (accessed on 5 June 2020).
Social support. Social support was measured using the 2016–2018 grouping from the Social Support Ranking Scale of World Happiness Rankings, where countries ranged from 0 to 10 scores (with the worst possible life as a 0 and the best possible life as a 10). Social support is the national average of the binary responses (either 0 or 1) to the Gallup World Poll (GWP) question “If you were in trouble, do you have relatives or friends you can count on to help you whenever you need them, or not?”. Information about this indicator in each country was obtained from https://worldhappiness.report/ed/2019/changing-world-happiness/ (accessed on 5 June 2020).
Epidemic experience. Data on the epidemic experience of each country were obtained from World Health Organization (WHO; accessed 5 June 2020). We checked, according to the WHO, whether there were any epidemics recorded in each country and assigned a rank of 0, provided that the country did not have such an experience, and a rank of 1, if there was such an experience. For example, in Brazil, according to WHO, there was an epidemic of Zika virus in 2015–2016, Yellow fever 2019, and in Canada, there was an epidemic of Measles in 2015 and human infection with avian influenza A (H7N9) 2014–2015.
Confirmed cases of COVID-19. Data on confirmed cases of COVID-19 were obtained from the everyday situation report from WHO (Coronavirus disease (COVID-19) Weekly Epidemiological Update and Weekly Operational Update) https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/ (accessed on 10 Fabruary 2021).

2.5. Data Analysis

Descriptive statistics, including the mean, median, and standard deviations (SD) were calculated for continuous variables to describe the sample’s characteristics. A t-test was used to estimate the sex differences in ratings on each of the three subscales of IRI. Linear regression was used to test the effects of the global indexes on these subscales. GLM MANCOVAs were used for the analysis of IRI subscales as outcome variables to estimate the effects of social indices, sex, religion, living conditions, volunteering, country, and other variables. Tukey’s post hoc test was used for multiple comparisons. SPSS (Version 27.0) was employed for data evaluation.

2.6. Ethics Statement

The study was conducted according to the principles expressed in the Declaration of Helsinki. The Scientific Council of the Institute of Ethnology and Anthropology of the Russian Academy of Sciences (protocol No 01, dated 9 April 2020) approved the protocols used in recruiting participants and data collection. All participants provided informed consent via the Google form before completing the survey, as noted above.

3. Results

3.1. Variations on IRI Scores across Total Sample and within Countries

Data on descriptive statistics on the three IRI subscales are presented in Table 2.
Table 2. Descriptive statistics on IRI subscales for the total sample.
Table 2. Descriptive statistics on IRI subscales for the total sample.
Perspective-TakingEmpathic ConcernPersonal Distress
N15,29415,29415,289
Mean16.8717.2613.69
Std. Deviation4.755.274.83
Minimum0.001.000.00
Maximum28.0028.0028.00
Approximately 25% (3824 individuals) of the sample scored lower than 14 on Perspective-Taking (PT), which is reflective of low Perspective-Taking. Twenty-six percent (4028 individuals) of the total sample scored lower than 13 on Empathic Concern (EC) and were estimated to be low-empathy individuals. Thirty-two percent (n = 4983) of the total sample scored 11 and lower on Personal Distress (PD) and were estimated to be individuals with low PD. Twenty-five percent (n = 3824) of the total sample scored higher than 20 on PT and higher than 21 on EC, respectively. Twenty-eight percent (n = 6761) of the total sample scored 17 and higher on PD and were estimated to be individuals with high PD.
As shown in Figure 2a–c, individual ratings on the subscales of empathy varied substantially across countries. In the case of each subscale, we selected five countries with the highest ratings. Countries that scored highest on Perspective-Taking were the USA, Brazil, Italy, Croatia, and Armenia (Figure 2a). The countries with the highest ratings on Empathetic Concern were the USA, Brazil, Hungary, Italy, and Indonesia (Figure 2b). The countries with the highest ratings on Personal Distress were Brazil, Turkey, Italy, Armenia, and Indonesia (Figure 2c). Although Armenia was among the counties with the highest ratings on Perspective-Taking and Personal Distress, this information should be interpreted with caution given the small sample size.

3.2. Sex and Country Differences on Empathy Scores

Potential between-country sex differences in empathy were examined, and results are presented separately for each country (Table 3, Figure 2a–c). Cronbach’s alpha of empathy scales varied between countries (Table 3). Across the total sample, sex differences were demonstrated for all scales, although with small effect sizes. Generally, results showed that females reported higher empathy compared to males during the first wave of the pandemic (see Table 3).
Interesting sex differences between countries emerged. Specifically, sex differences on Perspective-Taking were obtained for Armenia, Bulgaria, Canada, Hungary, India, Indonesia, Malaysia, Pakistan, Russia, Tanzania, and Turkey (Table 3, Figure 3a); on Empathetic Concern for Belarus, Brazil, Bulgaria, Canada, Croatia, Hungary, Indonesia, Iran, Italy, Malaysia, Pakistan, Romania, Russia, Saudi Arabia, Tanzania, Turkey, and USA (Table 3, Figure 3b); and on Personal Distress for Belarus, Brazil, Bulgaria, Canada, Croatia, Hungary, India, Indonesia, Malaysia, Nigeria, Pakistan, Romania, Russia, Saudi Arabia, Tanzania, and Turkey (Table 3, Figure 3c). Effect sizes for these subscales within countries vary substantially, ranging from small to high. In most cases, female ratings on all scales were higher or equal to those of men (e.g., in Jordan), with the exception of those who participated from Armenia, which may be attributed to the small sample size.
Table 3. Sex differences on empathy scores, as measured by the IRI [12] across the countries and in the total sample.
Table 3. Sex differences on empathy scores, as measured by the IRI [12] across the countries and in the total sample.
CountryIRI Subscales.NSexMeanSDtdfp95% CIHedges’ g *Cronbach’s Alpha
LowerUpper
ARMENIAPerspective-Taking27
6
men
women
19.26
13.50
4.97
5.05
2.563310.0151.17610.3431.1280.577
Empathic Concern27
6
men
women
17.74
15.33
4.40
2.80
1.275310.212−1.4436.2580.5610.307
Personal Distress27
6
men
women
13.07
12.33
6.36
3.50
0.274310.786−4.7756.2570.1210.705
BELARUSPerspective-Taking143
195
men
women
16.45
17.36
4.92
4.44
−1.7903360.074−1.9240.090−0.1970.661
Empathic Concern143
195
men
women
15.74
18.02
4.46
4.54
−4.585336<0.001−3.250−1.299−0.5040.622
Personal Distress143
195
men
women
10.37
14.01
4.73
4.62
−7.081336<0.001−4.651−2.629−0.7780.712
BRAZILPerspective-Taking82
430
men
women
19.40
19.41
4.66
4.71
−0.0205100.984−1.1251.102−0.0020.669
Empathic Concern82
430
men
women
20.63
22.30
4.44
4.36
−3.1675100.002−2.703−0.633−0.3810.607
Personal Distress82
430
men
women
12.76
15.92
5.63
5.62
−4.668510<0.001−4.497−1.833−0.5620.743
BULGARIAPerspective-Taking129
193
men
women
16.91
18.63
4.80
4.16
−3.317247<0.001−2.737−0.698−0.3870.688
Empathic Concern129
193
men
women
17.27
19.54
3.78
4.02
−5.079320<0.001−3.146−1.389−0.5760.621
Personal Distress129
193
men
women
12.78
14.86
4.50
5.05
−3.791320<0.001−3.167−1.003−0.4300.753
CANADAPerspective-Taking383
227
men
women
16.27
17.82
3.85
4.31
−4.491433<0.001−2.239−0.876−0.3870.629
Empathic Concern383
227
men
women
15.95
17.67
3.93
5.21
−4.298379<0.001−2.507−0.933−0.3860.686
Personal Distress383
227
men
women
13.28
14.41
4.11
4.46
−3.1836050.002−1.831−0.434−0.2670.639
CROATIAPerspective-Taking71
204
men
women
18.59
19.33
4.73
4.27
−1.2272730.221−1.9320.449−0.1690.737
Empathic Concern71
204
men
women
16.82
20.77
4.28
4.36
−6.622273<0.001−5.134−2.781−0.9100.758
Personal Distress71
204
men
women
11.21
13.97
4.11
3.75
−5.197273<0.001−3.798−1.711−0.7140.624
HUNGARYPerspective-Taking35
198
men
women
15.86
18.98
5.30
4.59
−3.625231<0.001−4.828−1.428−0.6620.696
Empathic Concern35
198
men
women
17.09
21.35
4.25
4.61
−5.097231<0.001−5.911−2.615−0.9320.714
Personal Distress35
198
men
women
9.49
11.63
5.41
5.52
−2.126231<0.001−4.134−0.157−0.3890.771
INDIAPerspective-Taking213
170
men
women
16.42
16.70
4.95
5.29
−0.537381<0.001−1.3150.750−0.0550.653
Empathic Concern213
170
men
women
17.66
18.36
4.64
5.55
−1.3233290.187−1.7480.342−0.1390.679
Personal Distress213
170
men
women
11.95
13.72
4.73
4.53
−3.705381<0.001−2.708−0.830−0.3800.574
INDONESIAPerspective-Taking504
424
men
women
16.71
18.77
4.49
3.85
−7.540926<0.001−2.602−1.527−0.4900.540
Empathic Concern504
424
men
women
18.96
20.99
4.65
4.40
−6.782926<0.001−2.615−1.441−0.4470.596
Personal Distress504
424
men
women
12.76
16.24
4.09
4.62
−12.026852<0.001−4.044−2.909−0.8000.569
IRANPerspective-Taking88
217
men
women
15.81
16.43
4.32
4.74
−1.0733030.284−1.7750.523−0.1350.635
Empathic Concern88
217
men
women
16.84
18.32
4.81
4.10
−2.5391410.012−2.635−0.328−0.3420.532
Personal Distress88
217
men
women
13.01
13.47
3.69
4.24
−0.8793030.380−1.4710.563−0.1110.444
IRAQPerspective-Taking88
85
men
women
14.94
15.11
4.74
4.72
−0.2261710.821−1.5821.256−0.0340.497
Empathic Concern88
85
men
women
16.15
17.12
4.04
4.52
−1.4891710.138−2.2560.316−0.2250.331
Personal Distress88
85
men
women
12.02
13.18
3.92
4.19
−1.8701710.063−2.3720.064−0.2830.360
ITALYPerspective-Taking44
208
men
women
18.16
19.50
4.50
4.22
−1.8982500.059−2.7420.051−0.3140.676
Empathic Concern44
208
men
women
19.57
21.14
4.96
3.95
−2.2882500.023−2.924−0.219−0.3790.560
Personal Distress44
208
men
women
12.73
14.15
5.53
4.84
−1.7262500.086−3.0440.201−0.2860.722
JORDANPerspective-Taking121
328
men
women
14.36
14.55
3.45
3.57
−0.5084470.612−.9320.549−0.0540.489
Empathic Concern121
328
men
women
15.41
15.72
4.22
3.95
−0.7084470.479−1.1450.539−0.0750.519
Personal Distress121
328
men
women
13.09
13.69
2.85
3.18
−1.8064470.072−1.2430.053−0.1920.456
MALAYSIAPerspective-Taking478
609
men
women
12.31
13.09
4.37
4.60
−2.82310460.005−1.308−0.235−0.1710.441
Empathic Concern478
609
men
women
10.92
12.13
4.54
4.36
−4.4771085<0.001−1.746−0.682−0.2730.469
Personal Distress478
609
men
women
11.88
12.86
3.65
4.11
−4.1131069<0.001−1.434−0.508−0.2480.390
NIGERIAPerspective-Taking214
102
men
women
17.38
17.38
5.97
5.70
0.0012070.999−1.3721.3740.0000.674
Empathic Concern214
102
men
women
18.93
19.93
5.62
5.51
−1.4903140.137−2.3240.321−0.1790.663
Personal Distress214
102
men
women
11.80
13.54
4.33
4.74
−3.2363140.001−2.798−0.682−0.3880.468
PAKISTANPerspective-Taking212
272
men
women
14.42
16.00
5.04
5.09
−3.4024820.001−2.491−0.667−0.3110.557
Empathic Concern212
272
men
women
15.58
17.59
4.38
5.13
−4.659478<0.001−2.867−1.166−0.4180.510
Personal Distress212
272
men
women
12.31
13.83
4.27
4.51
−3.763482<0.001−2.313−0.726−0.3440.406
ROMANIAPerspective-Taking42
226
men
women
17.05
18.85
6.01
4.78
−1.843510.071−3.7740.161−0.3610.764
Empathic Concern42
226
men
women
17.57
19.58
4.48
4.29
−2.7662660.006−3.438−0.579−0.4630.622
Personal Distress42
226
men
women
8.93
10.87
5.50
5.12
−2.2312660.027−3.658−0.229−0.3740.751
RUSSIAPerspective-Taking486
1417
men
women
16.22
16.84
5.27
5.09
−2.28619010.022−1.147−0.088−0.1200.651
Empathic Concern486
1417
men
women
16.06
17.44
4.36
4.52
−5.8741901<0.001−1.845−0.921−0.3090.524
Personal Distress486
1417
men
women
10.43
13.28
4.97
4.81
−11.1621901<0.001−3.349−2.348−0.5870.636
SAUDI ARABIAPerspective-Taking98
316
men
women
15.18
15.79
3.63
3.97
−1.3424120.180−1.4890.281−0.1550.554
Empathic Concern98
316
men
women
16.45
17.64
4.16
4.65
−2.4031780.017−2.168−0.213−0.2620.636
Personal Distress98
316
men
women
13.97
14.81
3.51
3.45
−2.1014120.036−1.627−0.054−0.2430.418
TANZANIAPerspective-Taking185
156
men
women
13.96
15.40
4.47
4.72
−2.8803390.004−2.416−0.455−0.3120.358
Empathic Concern185
156
men
women
14.01
15.31
3.91
4.75
−2.7313000.007−2.241−0.364−0.3010.435
Personal Distress185
156
men
women
12.62
14.27
3.91
4.20
−3.759339<0.001−2.518−0.788−0.4080.353
TURKEYPerspective-Taking1609
3093
men
women
16.79
17.65
4.06
3.96
−7.0404700<0.001−1.105−0.623−0.2160.546
Empathic Concern1609
3093
men
women
15.10
17.24
4.52
5.18
−14.6223669<0.001−2.423−1.850−0.4300.627
Personal Distress1609
3093
men
women
14.14
15.85
4.59
4.44
−12.2313162<0.001−1.981−1.433−0.3800.557
THAILANDPerspective-Taking49
250
men
women
15.45
16.03
2.34
3.54
−1.441970.153−1.3770.219−0.1710.524
Empathic Concern49
250
men
women
16.45
17.20
2.72
3.55
−1.4002970.162−1.8070.304−0.2180.506
Personal Distress49
250
men
women
12.71
13.27
2.75
3.14
−1.1592970.247−1.5050.389−0.1810.485
USAPerspective-Taking181
460
men
women
19.28
20.04
4.94
4.52
−1.8596390.063−1.5570.043−0.1630.780
Empathic Concern181
460
men
women
20.70
22.68
5.15
4.32
−4.576285<0.001−2.833−1.129−0.4330.795
Personal Distress181
460
men
women
9.85
10.25
5.50
5.87
−0.8016370.423−1.4000.589−0.0700.830
TOTALPerspective-Taking5482
9786
men
women
16.14
17.28
4.78
4.69
−14.13111168<0.001−1.289−0.975−0.2400.603
Empathic Concern5482
9786
men
women
15.99
17.97
5.02
5.27
−22.89811824<0.001−2.143−1.804−0.3810.661
Personal Distress5479
9784
men
women
12.62
14.29
4.63
4.85
−21.02011788<0.001−1.825−1.514−0.3500.584
N—number of cases, t—t-test criteria, df—degrees of freedom, p—statistical significance, NS—not significant, CI—Confidence Interval of the Difference. * Hedges’ g, which provides a measure of effect size weighted according to the relative size of each sample, is an alternative where there is a different sample size.

3.2.1. Empathy Ratings Depending on Culture, Religion, Living Conditions, Involvement in Voluntary Activity, and Fear of COVID-19

To examine possible associations between demographic factors and empathy, we conducted a GLM MANCOVA. The following variables were included in the model as independent variables: sex, country, religion, living conditions (0 = live with others; 1 = live alone), involvement in voluntary activity lockdown presence, and belief that “COVID-19 is a threat to relatives” (0 = no, 1 = yes); see Table 4.
Out of the 14,766 people included in these analyses, 91.34% reported living in households with other people (relatives, partners, or friends) and 8.66% reported living alone. Of our respondents, 83.4% believed that COVID-19 caused a real threat for their relatives and were worried about them. These independent variables explained 13.5% of the variance in Perspective-Taking scores, 23.6% in Empathetic Concern, and 12.3% in Personal Distress scores. The effect sizes for country were medium for PT and PD and large for EC (Table 4).
Tukey’s Post Hoc tests indicated significant differences in ratings on IRI subscales in pairs of some countries and similarities between other pairs of countries (Supplementary Table S1). For example, Bulgaria was different on Perspective-Taking, compared to Brazil, India, Iran, Iraq, Jordan, Malaysia, Pakistan, Russia, Saudi Arabia, Tanzania, Thailand, and the USA. The remaining variables showed either small effect sizes (religion and sex) or no effects (living alone, voluntary activity, COVID-19 is a threat to relatives). However, Post Hoc Tests on religion suggested significant differences in IRI subscales, related to religious background of individuals (Supplementary Table S2). For example, agnostic individuals were different on Perspective-Taking ratings compared to Hindu, Buddhist, and Islamic individuals, along with adherents of traditional local religions.
A t-test was conducted to estimate the differences in ratings on IRI scales between people living alone and those who share a home with others. Our data did not indicate any differences in ratings on the first two subscales—Perspective-Taking (t = 1.740, df = 15,292, p = 0.082) and Empathic Concern (t = 1.670, df = 15,292, p = 0.095)—but co-habiting respondents demonstrated significantly higher scores on Personal Distress (t = 7.183, df = 15,287, p = 7.14 × 10−13).

3.2.2. Association between Age, Sex, and Empathy

The associations between age, sex, and empathy showed small effects (Table 5, Figure 4a–c). Self-ratings for both Perspective-Taking and Empathetic Concern subscales were significantly higher for older individuals for both men and women. Ratings for the Personal Distress subscale were higher in younger age for both men and women (Figure 4c).

3.2.3. Association between Global Indices and Empathy

A GLM MANCOVA was conducted to examine the association between empathy and global indices (Table 6). These variables explained 69.1% of the variance in the case of Perspective-Taking, 60.5% for Empathic Concern, and 45.6% for Personal Distress. Previous epidemic experience in the country was negatively associated with median ratings on Perspective-Taking and Empathic Concern subscales with high effect sizes. Power Distance country index was a negative predictor of ratings on Empathic Concern, with a high effect size (Table 6). Total cases confirmed was a negative predictor of Personal Distress.

3.2.4. Association between Individualism/Collectivism and Empathy

Three linear regression analyses were used to estimate the association between individualism and collectivism and three empathy scores (Table 7). Countries with high scores on Individualism (Italy, USA, and Hungary, from maximum to minimum) rated higher on Perspective-Taking and Empathic Concern compared to less individualistic countries (Iraq, Malaysia, Tanzania, Jordan, and Brazil) (Figure 5a,b). Notably, Turkey was rated highest on Personal Distress (Figure 5c).

3.2.5. Association between Power Distance and Empathy

Three linear regression analyses were conducted to estimate the associations between Power Distance and each of the empathy subscales. As shown in Table 8, no significant associations were found. However, some interesting patterns emerged. Specifically, countries with high ratings on Power Distance (Saudi Arabia, Iraq, Russia, Belarus) rated lower on Perspective-Taking and Empathic Concern compared to less Power Distance countries (Canada, USA, Hungary, Italy) (Figure 6a,b). Turkey was rated highest on Personal Distress (Figure 6c).

3.2.6. Association between COVID-19 Cases and Empathy

Next, we conducted three linear regression analyses to estimate the effect of total confirmed cases on 01 July 2020 on Perspective-Taking, Empathic Concern, and Personal Distress subscales (Table 9, Figure 7a–c). The effect of the number of COVID-19 cases in the country was significantly positive in the case of Empathic Concern and negative in the case of Personal Distress subscale. Perspective-Taking was not influenced by the degree of distribution of pandemics on the cross-cultural level.

3.2.7. Association between Epidemic Experience and Empathy

Linear regression analyses demonstrated a significant association between epidemic experience, as defined by the World Health Organization, and Perspective-Taking and Empathic Concern subscales (see Table 10). Countries with epidemic experience had lower scores of Perspective-Taking and Empathic Concern (Figure 8a,b). No associations between Personal Distress and epidemic experience and empathy were found (Table 10, Figure 8c). In countries previously familiar with infections and epidemics, ratings on Perspective-Taking and Empathic Concern were significantly lower in the current COVID-19 pandemic than in countries with no previous epidemic experience.

4. Discussion

Given the uncertainty that has accompanied the COVID-19 pandemic, it is important that researchers work to identify aspects of resilience. Results from thes multi-nation data collected from over 15,000 participants during the early phases of the COVID-19 pandemic revealed substantial variations in empathy ratings, as measured by the IRI [10], on the culture-specific level. Interestingly, our results showed that individuals from Malaysia had the highest percentage of low scores on Perspective-Taking and Empathic Concern compared to individuals from the USA who had the highest percentage of low scores on Personal Distress.
While we do not have data on empathy ratings prior to the start of COVID-19, we compared the data on IRI ratings, obtained earlier for other respondents from countries for which similar data were available [10,15,32,46,55,56,61,67,68,71,72,73] (see Table 11). Accordingly, these comparisons suggest that scores on Perspective-Taking and Empathic Concern were higher than those reported in the general populations in Bulgaria, Romania, Russia, and the USA before the pandemic, but lower in Belarus, Brazil, Pakistan, and Turkey. Scores on Personal Distress were higher in Bulgaria, remained unchanged in Russia and USA, and were lower in Belarus, Brazil, Pakistan, and Turkey. Notably, these results should be interpreted with caution, given that many respondents in previous samples were medical or psychological students, compared to the general public (see Table 11).
In order to demonstrate the effect of the COVID-19 pandemic and social distancing restrictions on empathy, we compared our data with other studies conducted in 2020, particularly data from Canada, Iran, Italy, and Malaysia on empathy ratings. Based on prior research, respondents from Iran were more empathetic and less distressed than clinical students from Iran [71]. Possible explanations for these differences may be due to burnout of medical students [74,75]. Scores of empathy scales from another study in Italy [15] did not differ from our data; whereas the scores from Malaysia in our sample were lower than for medical students [56]. It is worth noting that respondents from the Malaysian sample in our study had the lowest scores for empathy compared to other countries (see Figure 3a,b); however, the reasons for this remain unclear. Data from a Canadian population collected during the isolation period of COVID-19 show slightly lower scores compared with the present study [32]. This could be because our data were collected later and the level of empathy could have increased even more; however, given that this study does not indicate the dates of the study, we cannot test this assumption.
According to recent research conducted by other authors during the current COVID-19 pandemic, the rates of Perspective-Taking, a key element in empathy, have increased, compared to the rates of Empathic Concerns, which have decreased compared to pre-pandemic levels [30]. Van de Groep and colleagues (2020) attributed the latter reduction to a possible increase in emotional self-focusing [30]. Unfortunately, our data do not allow us to draw any conclusions on this point. This is a notable area for future research.
While beyond the scope of the current study to examine associations between empathy and interpersonal behavior, research on empathy during the pandemic is also important because of its association with aggression. Each country’s COVID-19 restrictions and lockdowns have forced many people to stay in unavoidable long-time proximity with family members, which has been associated with increased reports of domestic violence [4,76]. Prior research suggests that those with a high score of empathy may use hostile behavior as a dysfunctional coping strategy to break out of this unpleasant state and/or self-regulate emotions [77].
Sex differences. Our data revealed significant sex differences in empathy, which is generally in line with initial data measured by IRI [10]. Additionally, these are not specific for pandemic conditions, as they were reported earlier by other authors [10,34,35,36,37,38]. Across all three subscales, females rated higher compared to males, which supports prior research [10,34]. However, it is important to note that the effect sizes for the empathy subscales were small, which limits the generalizability of these results. Interestingly, effect sizes for IRI subscales were highly variable cross-culturally, especially evident for Empathic Concern (with high effect sizes for Croatia, Hungary, and medium effect sizes for Belarus), and Personal Distress (high effect size for Indonesia, and medium effect sizes for Belarus, Brazil, Croatia and Russia).
Age. Self-ratings on Perspective-Taking and Empathic Concern were positively associated with age, whereas scores on the Personal Distress subscale were negatively associated with age, consistent with previous research [38,40,41,42]. We are unable to say whether some age cohorts reacted disproportionally more empathetically under lockdown and social distancing conditions than others, given that we did not collect longitudinal data.
Relation to other people. In our study most respondents (91.34%) were living with others during the COVID-19 pandemic, limiting generalizability to those who were living alone. However, even with this limitation in mind, our data did not show any differences in Perspective-Taking and Empathic Concern ratings between those who lived with others versus those who lived alone; however, those living with others did report high scores on Personal Distress. We suggest that single respondents were less stressed by the constant presence of other people and lack of privacy, as well as constant wariness about the health of their co-habitants.
In the context of the COVID-19 pandemic, the positive and negative effects and consequences have been discussed in a vast number of studies (e.g., [5,6,43]). Certain positive consequences of pandemics, such as strengthening family and friend relationships, have been mentioned as well [5,6]. Of our respondents, 83.4% believed that COVID-19 caused a real threat for their relatives, and they were worried about them. Moreover, in another study, based on Russian data [78], we have demonstrated that married men expressed their responsibility for the safety of their families during pandemics and preferred to take the greatest risks with respect to coming out of the home in cases of emergency. Early COVID-19 restrictions, such as shelter-in-place orders, created a unique opportunity for many families to spend more time together, enhancing emotional closeness and warmth, as well as leading to an awareness of the value of family ties [79,80].
Country-level differences. Our results showed that a person’s country of residence was the only reliable predictor (according to the effect size data) of self-ratings on IRI subscales, with a large effect size for Empathic Concern and medium effect sizes for the other two subscales. Although not measured in the current study, we suggest that cultural beliefs about empathy and support towards others shape individual attitudes (both emotional and rational) and prescriptions, approved or disproved by the social network of each and other individuals. These beliefs may become important in stressful situations, such as COVID-19 lockdowns and social distancing mandates. Specifically, countries with previous epidemic experience scored significantly lower on Perspective-Taking and Empathic Concern (Malaysia, Tanzania, Jordan, Saudi Arabia, etc.). These findings may suggest that this is either due to mechanisms similar to burnout, which is often experienced by medical specialists [74,75], or that people are less stressed because the pandemic situation is not novel to them, and they already know how to functionally cope with it. Over time, growing accustomed to the pandemic, its associated restrictions, and developments related to immunity may produce less uncertainty and thus lower levels of empathy and concern for the wellbeing of others. In general, countries that have previously experienced similar epidemics have developed certain schemes for eliminating and preventing the spread of viral respiratory infections, and the authorities are taking much stricter forms of control over social distancing of the population. Thus, people are better informed about preventive measures and better cope with stress [7,81]. In our study, the same countries that were most vulnerable in terms of infectious diseases (e.g., Nigeria, Tanzania, Pakistan) who were also were experienced with such diseases reported lower levels of anxiety compared to countries less experienced with severe infections ([7] this issue). Uncertainty and poor understanding of the general situation in turn can lead to multiple detrimental consequences for well-being [82]; however, given that people are unable to reliably predict the effect of the ongoing pandemic [83], they may react to restriction less seriously [82].
It is worth noting that all countries with previous epidemic experience (were more likely to be categorized as collectivistic (with the exception of Canada). Our results showed that countries with low ratings on Individualism (i.e., Iraq, Malaysia, Tanzania, Jordan, and Brazil) also rated lower on Perspective-Taking and Empathic Concern compared to more individualistic countries (Italy, USA, Hungary). Specifically, countries with high ratings on Power Distance (i.e., Saudi Arabia, Iraq, Russia, Belarus) rated lower on Perspective-Taking and Empathic Concern compared to lower Power Distance countries (Canada, USA, Hungary, Italy). Using the same sample, it was previously shown that more collectivistic countries scored lower on anxiety than individualistic countries ([7], this issue). Participants from countries with the highest ratings of anxiety (Canada and Italy) were also highest on individualism, whereas the least anxious countries were those with the lowest levels of individualism (Thailand, Indonesia, Malaysia, Nigeria). Higher anxiety ratings were registered for nations with low Power Distance (Canada, Italy) [7].
No associations between the Human Development Index, Infectious Disease Vulnerability Index, and Social Support Ranking Scale of World Happiness Ranking were demonstrated.
Religion. Individual’s religious backgrounds were differentially associated with empathy scores. For example, agnostic individuals were different on Perspective-Taking ratings compared to Hindu, Buddhist, and Islamic individuals, along with adherents of traditional local religions. However, it is difficult to interpret these results within the framework of this article, given that previous research findings of the association between religion and empathy were mixed [84]. Studies based on self-report data usually find that religious people tend to be prosocial and helpful [85,86]. More recent studies that investigated this association within the context of intergroup relations concluded that intrinsically religious people (i.e., religious fundamentalists and even people high in quest religiosity) are not willing to act prosocially and help outgroup members; rather, they are the target of discrimination [86]. The mixed findings related to religion and empathy call for additional research on this topic.

5. Limitations and Future Directions

As with any study, our study has a number of limitations. First, with respect to measurement, the IRI has been previously mainly applied to the study of medical personnel, which limits the reliability for use with a general population. Second, a majority of participants in the present study were female, which is consistent with other sample demographics [30,87,88,89]. Relatedly, it is important to acknowledge that participants were asked their sex and not their gender identity, which limits the generalizability of the study’s findings to individuals who may identify with anything apart from their sex assigned at birth. Additionally, this study included a majority of participants who were living with others at the time of data collection, which limits the generalizability to those who are currently living in isolation. Additionally, it is important to mention that while the overall sample included over 15,000 participants, the representation in some countries (i.e., Armenia, Iraq) was quite low, and data collection was limited to those with a stable internet connection (to complete the questionnaire), which precluded participation from those without this access. A special concern is the lack of participation of people of lower socioeconomic status in some of the countries, given the internet accessibility challenges.
While the study’s measures were translated and back-translated using appropriate procedures, some of the measures reflect low alpha levels. For example, in the case of Iraq, the identical Arabic version has been used in other Arabic countries, and the Cronbach alphas obtained there were much higher. Low values of alpha may be due to small sample sizes, as for example in the case of Armenia. While the sample size in the case of Armenia was small, it was quite representative in the case of Iraq. Hence, the possible explanation may be that these discrepancies may be associated with chronic stress associated with war and civil insecurity in both countries. In the cases of Malaysia and Tanzania, the low alphas may be due to specific cultural norms), along with high variations in individuals’ reactions towards the pandemic situation in their countries. In sum, more representative samples that reflect within-country variability should be collected.
Importantly, we need to be cautious with cross-cultural data, as numerous factors were not included in the present study that could have affected the results. These include but are not limited to cultural differences in social and personal distance and variations in topography and intensity of tactile behavior. At the moment, this pandemic is far from over; therefore, more data are needed on the next-coming waves of COVID-19.

6. Conclusions

The COVID-19 pandemic continues to be a great threat to the world, yet at the same time it presents a unique test for humanness, prosociality, and empathy towards others who are living in a similar situation. Data from this multi-nation study collected during the early phases of the COVID-19 pandemic contribute to the understanding of how empathy, especially that towards close others, may be a factor of resilience during these uncertain times. Social distancing and associated measures have been associated with increased reports of distress, given the “sense of community and the ties that bind us together as human beings” [22]. Presently, the international community has begun mass vaccinations against COVID-19, which have not been without its challenges, including dealing with differing personal attitudes about being vaccinated. According to Pfattheicher and colleagues [3], the motivation to get vaccinated was promoted by information about needs for group immunity, as well as by general empathy feelings. Cross-cultural differences in these respects may be of special interest to researchers and policy makers alike.

Supplementary Materials

The following are available online at https://www.mdpi.com/article/10.3390/su13137431/s1, Table S1: Results of Tukey’s post hoc tests analyses with IRI subscales as outcome variables, and country. Table S2: Results of Tukey’s post hoc tests analyses with IRI subscales as outcome variables, and religion.

Author Contributions

Conceptualization, M.L.B., V.N.B.; Methodology, M.L.B., V.N.B., A.K.R.; Data analysis, M.L.B., V.N.B.; Data collections, all authors; Resources, all authors; Data curation, V.N.B.; Writing—original draft preparation, M.L.B., V.N.B., A.K.R., L.H., K.M.K.; Visualization, M.L.B., V.N.B.; Project administration, M.L.B., V.N.B. All authors have read and agreed to the published version of the manuscript.

Funding

This research was supported by a grant from the Russian Science Foundation (grant No 18-18-00075) (Marina L. Butovskaya, Valentina N. Burkova). The authors extend their appreciation to the Deanship of Scientific Research at King Saud University for funding this work through Support to Ahmad M. Alghraibeh (Saudi Arabia). This research was supported by the Russian Foundation for Basic Research (project № 20-04-60263 (Alexey M. Ermakov, Igor V. Popov). Data collection in Hungary was supported by the Hungarian Scientific Research Fund (OTKA) awarded to N. Meskó (K125437).

Institutional Review Board Statement

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee of the Institute of Ethnology and Anthropology of the Russian Academy of Sciences (protocol No 01, dated 9 April 2020).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

Data produced and processed in this study are included in the published article. The datasets can be acquired from the corresponding author for appropriate purposes.

Conflicts of Interest

The authors declare no conflict of interest.

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Figure 1. Countries represented in data collection.
Figure 1. Countries represented in data collection.
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Figure 2. Distribution of individuals with low, middle, and high levels on IRI subscales (medians) across 23 countries: (a) Perspective-Taking, (b) Empathetic Concern, (c) Personal Distress.
Figure 2. Distribution of individuals with low, middle, and high levels on IRI subscales (medians) across 23 countries: (a) Perspective-Taking, (b) Empathetic Concern, (c) Personal Distress.
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Figure 3. Sex differences on median IRI subscales scores across 23 countries: (a) Perspective-Taking, (b) Empathetic Concern, and (c) Personal Distress.
Figure 3. Sex differences on median IRI subscales scores across 23 countries: (a) Perspective-Taking, (b) Empathetic Concern, and (c) Personal Distress.
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Figure 4. Association between age and IRI subscales in the total sample: (a) Perspective-Taking, (b) Empathetic Concern, and (c) Personal Distress.
Figure 4. Association between age and IRI subscales in the total sample: (a) Perspective-Taking, (b) Empathetic Concern, and (c) Personal Distress.
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Figure 5. Association between Individualism and IRI subscales in total sample: (a) Perspective-Taking, (b) Empathetic Concern, and (c) Personal Distress.
Figure 5. Association between Individualism and IRI subscales in total sample: (a) Perspective-Taking, (b) Empathetic Concern, and (c) Personal Distress.
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Figure 6. Association between Power Distance and IRI subscales in total sample: (a) Perspective-Taking, (b) Empathetic Concern, and (c) Personal Distress.
Figure 6. Association between Power Distance and IRI subscales in total sample: (a) Perspective-Taking, (b) Empathetic Concern, and (c) Personal Distress.
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Figure 7. Association between total confirmed cases on 01 July 2020 and IRI subscales in total sample: (a) Perspective-Taking, (b) Empathetic Concern, and (c) Personal Distress.
Figure 7. Association between total confirmed cases on 01 July 2020 and IRI subscales in total sample: (a) Perspective-Taking, (b) Empathetic Concern, and (c) Personal Distress.
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Figure 8. Association between epidemic experience and IRI subscales in total sample: (a) Perspective-Taking, (b) Empathetic Concern and (c) Personal Distress.
Figure 8. Association between epidemic experience and IRI subscales in total sample: (a) Perspective-Taking, (b) Empathetic Concern and (c) Personal Distress.
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Table 1. Distribution of sample by country, sex 1, and age.
Table 1. Distribution of sample by country, sex 1, and age.
CountrySurvey LanguageTotal NSexMean Age
Men (n)Women (n)(±SD)
ARMENIAArmenian3327620.45 (±2.37)
BELARUSRussian33814319519.20 (±2.85)
BRAZILPortuguese5158243038.80 (±13.78)
BULGARIABulgarian32212919328.34 (±8.75)
CANADAEnglish69244624630.33 (±8.74)
CROATIAEnglish2757120424.10 (±8.40)
HUNGARYHungarian2353519831.95 (±11.84)
INDIAEnglish38321317029.95 (±9.85)
INDONESIAIndonesian93050442432.05 (±12.09)
IRANPersian3068821733.68 (±7.34)
IRAQArabic173888535.03 (±10.63)
ITALYItalian2534420823.50 (±4.15)
JORDANArabic44912132833.68 (±10.52)
MALAYSIAMalay108747860933.19 (±11.12)
NIGERIAEnglish31621410234.09 (±11.24)
PAKISTANEnglish48421227227.06 (±11.11)
ROMANIARomanian2694222636.22 (±10.94)
RUSSIARussian1903486141720.99 (±4.72)
SAUDI ARABIAArabic4149831626.76 (±9.72)
TANZANIAEnglish34118515623.95 (±4.25)
TURKEYTurkish47171609309327.57 (±10.84)
THAILANDThai3004925032.82 (±13.00)
USAEnglish66618947745.16 (±17.15)
TOTAL 15,3755553982229.15 (±11.80)
1 Data on biological sex of respondents are presented based on respondent’s answers.
Table 4. GLM MANCOVA analysis with IRI subscales as outcome variables, and country, religion, sex, living condition, lockdown presence, and voluntary activity as independent variables (total sample).
Table 4. GLM MANCOVA analysis with IRI subscales as outcome variables, and country, religion, sex, living condition, lockdown presence, and voluntary activity as independent variables (total sample).
Independent
Variables
Dependent
Variables
dfFpη2
SexPerspective-Taking1150.027<0.0010.010
Empathic Concern1449.535<0.0010.030
Personal Distress1471.898<0.0010.031
COUNTRYPerspective-Taking2272.617<0.0010.098
Empathic Concern22143.856<0.0010.177
Personal Distress2250.210<0.0010.070
ReligionPerspective-Taking62.3830.0270.001
Empathic Concern66.156<0.0010.003
Personal Distress63.4160.0020.001
COVID-19 is a threat to relativesPerspective-Taking125.593<0.0010.002
Empathic Concern121.440<0.0010.001
Personal Distress114.447<0.0010.001
Living conditionsPerspective-Taking17.2210.0070.000
Empathic Concern19.3830.0020.001
Personal Distress114.234<0.0010.001
Involvement in voluntary activityPerspective-Taking15.1490.0230.000
Empathic Concern1.3340.5630.000
Personal Distress18.7960.0030.001
R2 (Perspective-Taking) = 0.135; R2 (Empathic Concern) = 0.236. R2 (Personal Distress) = 0.122. R2–R Squared, df—degrees of freedom, F—F test statistics, p—statistical significance, η2—Partial Eta Squared effect size.
Table 5. GLM MANCOVA analysis with IRI subscales as outcome variables, and age and sex as independent variables (total sample).
Table 5. GLM MANCOVA analysis with IRI subscales as outcome variables, and age and sex as independent variables (total sample).
Independent
Variables
Dependent
Variables
dfFpη2
SexPerspective-Taking1219.083<0.0010.014
Empathic Concern1545.523<0.0010.035
Personal Distress1376.272<0.0010.024
AgePerspective-Taking143.536<0.0010.003
Empathic Concern181.672<0.0010.005
Personal Distress1167.227<0.0010.011
R2 (Perspective-Taking) = 0.016; R2 (Empathic Concern) = 0.037. R2 (Personal Distress) = 0.038. R2–R Squared, df—degrees of freedom, F—F test statistics, p—statistical significance, η2—Partial Eta Squared effect size.
Table 6. The GLM MANCOVA with empathy subscales (Perspective-Taking, Empathic Concern, Personal Distress (median for each country)) as outcome variables, and epidemic experience, IDVI, HDI, total confirmed cases of COVID-19 per country, Individualism, Power Distance, and Social support scale as independent variables.
Table 6. The GLM MANCOVA with empathy subscales (Perspective-Taking, Empathic Concern, Personal Distress (median for each country)) as outcome variables, and epidemic experience, IDVI, HDI, total confirmed cases of COVID-19 per country, Individualism, Power Distance, and Social support scale as independent variables.
Independent
Variables
Dependent VariablesDfFpη2
Epidemic experiencePerspective-Taking114.8890.0020.498
Empathic Concern19.9280.0070.398
Personal Distress11.5800.2280.095
IDVIPerspective-Taking10.7830.3900.050
Empathic Concern11.7400.2070.104
Personal Distress10.1150.7400.008
HDIPerspective-Taking10.2450.6280.016
Empathic Concern11.4930.2410.091
Personal Distress10.0030.9550.000
Social SupportPerspective-Taking10.1400.7140.009
Empathic Concern10.5070.4870.033
Personal Distress10.3820.5460.025
Power DistancePerspective-Taking13.2870.0900.180
Empathic Concern15.6010.0320.272
Personal Distress10.1920.6680.013
IndividualismPerspective-Taking10.3280.5750.021
Empathic Concern10.3840.5450.025
Personal Distress10.4910.4940.032
Total confirmed cases of COVID-19 per countryPerspective-Taking10.0220.8840.001
Empathic Concern10.3330.5730.022
Personal Distress 19.7210.0070.393
R2 (Perspective-Taking) = 0.691; R2 (Empathic Concern) = 0.605. R2 (Personal Distress) = 0.456. R2–R Squared, df—degrees of freedom, F—F test statistics, p—statistical significance, η2—Partial Eta Squared effect size. IDVI—Infectious Disease Vulnerability Index, HDI—Human Development Index, Social Support—Social Support Ranking Scale of World Happiness Ranking.
Table 7. Regression analysis with individualism as the predictor and each of the three IRI subscales as the dependent variable.
Table 7. Regression analysis with individualism as the predictor and each of the three IRI subscales as the dependent variable.
PredictorDependent VariableR2BSEBetatp
IndividualismPerspective-Taking0.0250.0410.0020.15819.826<0.001
Empathic Concern0.0290.0490.0020.16921.206<0.001
Personal Distress0.009−0.0260.002−0.097−12.045<0.001
R2—R Squared, SE–standard error, p—statistical significance.
Table 8. Regression analyses with Power Distance as predictor and each of the three IRI subscales as dependent variables.
Table 8. Regression analyses with Power Distance as predictor and each of the three IRI subscales as dependent variables.
PredictorDependent VariableR2BSEBetatp
Power
Distance
Perspective-Taking0.141−0.0450.024−0.375−1.8530.078
Empathic Concern0.135−0.0560.031−0.388−1.8110.084
Personal Distress0.005−0.0050.016−0.070−0.3220.751
R2—R Squared, SE—standard error, p—statistical significance.
Table 9. Regression analyses with Total confirmed cases as predictor and each of the three IRI subscales as dependent variables.
Table 9. Regression analyses with Total confirmed cases as predictor and each of the three IRI subscales as dependent variables.
PredictorDependent VariableR2BSEBetatp
Total confirmed cases on 1 July 2020Perspective-Taking0.0699.844 ×10−70.0000.2631.2470.226
Empathic Concern0.0571.119 ×10−60.0000.2381.1250.023
Personal Distress0.267−1.158 ×10−60.000−0.517−2.7650.012
R2—R Squared, SE—standard error, p—statistical significance.
Table 10. Regression analyses with epidemic experience as predictor and each of the three IRI subscales as dependent variables.
Table 10. Regression analyses with epidemic experience as predictor and each of the three IRI subscales as dependent variables.
PredictorDependent VariableR2BSEBetatp
Epidemic experiencePerspective-Taking0.537−3.2380.655−0.733−4.94000006
Empathic Concern0.405−3.5160.931−0.636−3.7780.001
Personal Distress0.0490.5830.5620.2211.0370.311
R2—R Squared, SE—standard error, p—statistical significance.
Table 11. The data of studies of empathy ratings before and during the first wave of the pandemic of COVID-19.
Table 11. The data of studies of empathy ratings before and during the first wave of the pandemic of COVID-19.
CountryYearSampleN *PTECPDPresent StudyReferences
PTECPD
BELARUS201119—22 yy.
helper students
116m
92w
21.69
23.74
21.72
24.59
19.38
22.20
16.45
17.36
15.74
18.02
10.37
14.01
[72]
BRAZIL2011SD = 20.8 yy.25026.15
27.57
26.14
29.09
20.69
23.66
19.40
19.41
20.63
22.30
12.76
15.92
[55]
BULGARIA201519—25 yy.
teacher students
5414.7514.257.7516.91
18.63
17.27
19.54
12.78
14.86
[61]
CANADA202025.9 ± 10.5 yy.112m
459w
14.6
16.1
17.3
20.8
11.0
8.8
16.27
17.82
15.95
17.67
13.28
14.41
[31]
IRAN2020clinical students8513.5215.8614.6815.81
16.43
16.84
18.32
13.01
13.47
[71]
ITALY2020SD = 42 yy.326m
827w
18.2320.39-18.16
19.50
19.57
21.14
12.73
14.15
[15]
MALAYSIA2020medical students1172728.522.412.31
13.09
10.92
12.13
11.88
12.86
[56]
PAKISTAN2013medical students132m
299w
15.3
16.2
19.2
20.2
13.5
15.4
14.42
16.00
15.58
17.59
12.31
13.83
[69]
ROMANIA2017Students43m
173w
15.86
17.38
16.84
20.71
-17.05
18.85
17.57
19.58
8.93
10.87
[67]
RUSSIA201317—25 yy. psystudents101m
217w
15.41
16.44
15.77
17.48
10.48
13.28
16.22
16.84
16.06
17.44
10.43
13.28
[53]
TURKEY201017—21 yy.
traniee students
13224.1723.4018.6716.79
17.65
15.10
17.24
14.14
15.85
[73]
USA1980psystudents579m
582w
16.78
17.96
19.04
21.67
9.46
12.28
19.28
20.04
20.70
22.68
9.85
10.25
[10]
2016students 19.58 yy.9217.4619.1112.74[46]
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Butovskaya, M.L.; Burkova, V.N.; Randall, A.K.; Donato, S.; Fedenok, J.N.; Hocker, L.; Kline, K.M.; Ahmadi, K.; Alghraibeh, A.M.; Allami, F.B.M.; et al. Cross-Cultural Perspectives on the Role of Empathy during COVID-19’s First Wave. Sustainability 2021, 13, 7431. https://doi.org/10.3390/su13137431

AMA Style

Butovskaya ML, Burkova VN, Randall AK, Donato S, Fedenok JN, Hocker L, Kline KM, Ahmadi K, Alghraibeh AM, Allami FBM, et al. Cross-Cultural Perspectives on the Role of Empathy during COVID-19’s First Wave. Sustainability. 2021; 13(13):7431. https://doi.org/10.3390/su13137431

Chicago/Turabian Style

Butovskaya, Marina L., Valentina N. Burkova, Ashley K. Randall, Silvia Donato, Julija N. Fedenok, Lauren Hocker, Kai M. Kline, Khodabakhsh Ahmadi, Ahmad M. Alghraibeh, Fathil Bakir Mutsher Allami, and et al. 2021. "Cross-Cultural Perspectives on the Role of Empathy during COVID-19’s First Wave" Sustainability 13, no. 13: 7431. https://doi.org/10.3390/su13137431

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