The Dark and Light Sides of Empathy: The Clinical Relevance of the Assessment of Cognitive and Affective Empathy Across Negative and Positive Emotions
Abstract
:1. Introduction
1.1. The Empathy Construct and Its Definition
1.2. The Clinical Relevance of Distinguishing Between Cognitive and Affective Empathy
1.3. The Role of Emotional Valence: The Distinction Between Cognitive and Affective Empathy Across Negative and Positive Emotions
1.4. The Perth Empathy Scale: A New Multidimensional Empathy Measure and Its Clinical Utility
1.5. The Current Study
2. Materials and Methods
2.1. Procedure
2.2. Participants
2.3. Measures
2.3.1. The Sociodemographic Form
2.3.2. The Perth Empathy Scale (PES)
2.3.3. The Patient Health Questionnaire-4 (PHQ-4)
2.3.4. The WHO-Five Well-Being Index (WHO-5)
2.4. Analytic Strategy
3. Results
4. Discussion
4.1. Negative and Positive Affective Empathy as Strong Predictors of Illness and Well-Being
4.2. The Practical and Theoretical Value of the Study
4.3. Strengths and Limitations of the Study
4.4. Future Directions
5. Conclusions
Supplementary Materials
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Demographic Categories | n | % |
---|---|---|---|
Age | M = 28.63, SD = 12.58, median = 23.00, min. = 18, max. = 76 | 786 | 100 |
Gender | Females | 452 | 57.51 |
Males | 334 | 42.49 | |
Education | Primary | 52 | 6.62 |
Vocational | 48 | 6.11 | |
Secondary | 438 | 55.73 | |
Higher | 248 | 31.55 | |
Relationship status | Single | 376 | 47.84 |
In a relationship | 410 | 52.16 |
Variables | McDonald’s Omega with 95% Credible Interval | Cronbach’s Alpha with 95% Credible Interval | M | SD | Skewness | Kurtosis | Minimum | Maximum |
---|---|---|---|---|---|---|---|---|
PES Negative Cognitive Empathy | 0.88 (0.86; 0.89) | 0.88 (0.86; 0.89) | 19 | 4.36 | −0.68 | 0.36 | 5 | 25 |
PES Positive Cognitive Empathy | 0.86 (0.84; 0.87) | 0.86 (0.84; 0.87) | 19.18 | 4.19 | −0.66 | 0.36 | 5 | 25 |
PES Negative Affective Empathy | 0.78 (0.75; 0.80) | 0.78 (0.75; 0.80) | 12.5 | 4.13 | 0.3 | −0.2 | 5 | 25 |
PES Positive Affective Empathy | 0.82 (0.80; 0.84) | 0.82 (0.80; 0.84) | 14.62 | 4.46 | −0.06 | −0.29 | 5 | 25 |
PES General Cognitive Empathy | 0.92 (0.92; 0.93) | 0.92 (0.92; 0.93) | 38.18 | 8.16 | −0.68 | 0.49 | 10 | 50 |
PES General Affective Empathy | 0.85 (0.83; 0.86) | 0.85 (0.83; 0.86) | 27.11 | 7.47 | 0.02 | 0.14 | 10 | 50 |
PES General Empathy (Total Score) | 0.89 (0.88; 0.90) | 0.90 (0.89; 0.91) | 65.3 | 13.09 | −0.47 | 0.75 | 20 | 100 |
PHQ-4 Anxiety | 0.77 (0.74; 0.80) | 0.77 (0.73; 0.80) | 3.52 | 1.9 | −0.1 | −1.26 | 0 | 6 |
PHQ-4 Depression | 0.81 (0.79; 0.84) | 0.81 (0.79; 0.84) | 3.41 | 2.02 | −0.1 | −1.29 | 0 | 6 |
PHQ-4 Total Score | 0.86 (0.84; 0.87) | 0.86 (0.84; 0.87) | 6.93 | 3.61 | −0.1 | −1.2 | 0 | 12 |
WHO-5 Well-Being | 0.86 (0.84; 0.88) | 0.86 (0.85; 0.88) | 8 | 4.94 | 0.77 | 0.3 | 0 | 25 |
Models | Predictors | Anxiety Symptoms Prediction (PHQ-4 Anxiety Scores as the Dependent Variable) | Depression Symptoms Prediction (PHQ-4 Depression Scores as the Dependent Variable) | Well-Being Prediction (WHO-5 Scores as the Dependent Variable) | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Beta | t | p | Beta | t | p | Beta | t | p | ||
Step 1 | Sex | −0.13 | −3.88 | <0.001 | −0.02 | −0.48 | 0.629 | 0.08 | 2.36 | 0.019 |
Age | −0.25 | −6.36 | <0.001 | −0.21 | −5.44 | <0.001 | 0.15 | 3.75 | <0.001 | |
Education | 0.01 | 0.26 | 0.791 | 0 | −0.11 | 0.914 | 0.04 | 1 | 0.317 | |
Relationship status | 0.03 | 0.8 | 0.424 | −0.06 | −1.57 | 0.117 | −0.01 | −0.22 | 0.822 | |
Step 2 | Sex | −0.09 | −2.75 | 0.006 | −0.001 | −0.15 | 0.879 | 0.1 | 2.9 | 0.004 |
Age | −0.21 | −5.76 | <0.001 | −0.19 | −5.01 | <0.001 | 0.13 | 3.56 | <0.001 | |
Education | −0.03 | −0.82 | 0.415 | −0.03 | −0.77 | 0.442 | 0.04 | 1.23 | 0.219 | |
Relationship status | 0.03 | 0.9 | 0.367 | −0.05 | −1.44 | 0.149 | −0.02 | −0.73 | 0.465 | |
PES Negative Cognitive Empathy | 0.08 | 1.34 | 0.179 | 0.01 | 0.17 | 0.862 | −0.02 | −0.29 | 0.774 | |
PES Positive Cognitive Empathy | −0.04 | −0.66 | 0.512 | 0 | 0.01 | 0.993 | 0.11 | 1.59 | 0.112 | |
PES Negative Affective Empathy | 0.36 | 9.06 | <0.001 | 0.3 | 7.42 | <0.001 | −0.22 | −5.35 | <0.001 | |
PES Positive Affective Empathy | −0.24 | −5.52 | <0.001 | −0.34 | −7.56 | <0.001 | 0.37 | 8.3 | <0.001 | |
Model parameters for Step 1 | F(4,781) = 16.78, p < 0.001, adj. R2 = 7.44% | F(4,781) = 11.50, p < 0.001, adj. R2 = 5.08% | F(4,781) = 7.38, p < 0.001, adj. R2 = 3.15% | |||||||
Model parameters for Step 2 | F(8,777) = 22.33, p < 0.001, adj. R2 = 17.86% | F(8,777) = 17.98, p < 0.001, adj. R2 = 14.75% | F(8,777) = 20.16, p < 0.001, adj. R2 = 16.34% | |||||||
Δ adj. R2 between Steps 2 and 1 | 10.42% | 9.67% | 13.19% |
Coefficient | P(incl) | P(excl) | P(incl|data) | P(excl|data) | BFinclusion | M | SD | 95% Credible Interval | |
---|---|---|---|---|---|---|---|---|---|
Lower | Upper | ||||||||
Intercept | 1 | 0 | 1 | 0 | 1 | 3.52 | 0.06 | 3.4 | 3.63 |
Sex | 0.5 | 0.5 | 0.94 | 0.06 | 15.46 | −0.35 | 0.15 | −0.59 | 0 |
Age | 0.5 | 0.5 | 1 | 9.41 × 10−8 | 1.06 × 10+7 | −0.03 | 5.13 × 10−3 | −0.04 | −0.02 |
Education | 0.5 | 0.5 | 0.29 | 0.71 | 0.41 | −0.02 | 0.05 | −0.17 | 0.05 |
Relationship status | 0.5 | 0.5 | 0.31 | 0.69 | 0.45 | 0.04 | 0.09 | −0.05 | 0.32 |
Negative Cognitive Empathy | 0.5 | 0.5 | 0.41 | 0.59 | 0.7 | 0.01 | 0.02 | −72.6 | 0.06 |
Positive Cognitive Empathy | 0.5 | 0.5 | 0.29 | 0.71 | 0.41 | −14.9 | 0.02 | −0.05 | 0.03 |
Negative Affective Empathy | 0.5 | 0.5 | 1 | 5.55 × 10−16 | 2.73 × 10+16 | 0.17 | 0.02 | 0.13 | 0.2 |
Positive Affective Empathy | 0.5 | 0.5 | 1 | 1.86 × 10−7 | 5.38 × 10+6 | −0.1 | 0.02 | −0.14 | −0.08 |
Coefficient | P(incl) | P(excl) | P(incl|data) | P(excl|data) | BFinclusion | M | SD | 95% Credible Interval | |
---|---|---|---|---|---|---|---|---|---|
Lower | Upper | ||||||||
Intercept | 1 | 0 | 1 | 0 | 1 | 3.41 | 0.07 | 3.27 | 3.52 |
Sex | 0.5 | 0.5 | 0.14 | 0.86 | 0.17 | −19.6 | 0.05 | −0.15 | 0.1 |
Age | 0.5 | 0.5 | 1 | 1.69 × 10−6 | 593,161.38 | −0.03 | 5.54 × 10−3 | −0.04 | −0.02 |
Education | 0.5 | 0.5 | 0.18 | 0.82 | 0.21 | −0.01 | 0.05 | −0.13 | 0.06 |
Relationship status | 0.5 | 0.5 | 0.28 | 0.72 | 0.4 | −0.06 | 0.11 | −0.36 | 4.72 × 10−3 |
Negative Cognitive Empathy | 0.5 | 0.5 | 0.15 | 0.85 | 0.17 | 6.39 × 10−4 | 7.80 × 10−3 | −0.01 | 0.02 |
Positive Cognitive Empathy | 0.5 | 0.5 | 0.14 | 0.86 | 0.17 | 3.51 × 10−4 | 8.57 × 10−3 | −0.02 | 0.01 |
Negative Affective Empathy | 0.5 | 0.5 | 1 | 3.68 × 10−12 | 2.72 × 10+11 | 0.14 | 0.02 | 0.11 | 0.18 |
Positive Affective Empathy | 0.5 | 0.5 | 1 | 2.91 × 10−13 | 3.43 × 10+12 | −0.15 | 0.02 | −0.19 | −0.12 |
Coefficient | P(incl) | P(excl) | P(incl|data) | P(excl|data) | BFinclusion | M | SD | 95% Credible Interval | |
---|---|---|---|---|---|---|---|---|---|
Lower | Upper | ||||||||
Intercept | 1 | 0 | 1 | 0 | 1 | 8 | 0.16 | 7.66 | 8.27 |
Sex | 0.5 | 0.5 | 0.96 | 0.04 | 26.14 | 0.96 | 0.38 | 0 | 1.5 |
Age | 0.5 | 0.5 | 1 | 2.92 × 10−3 | 341.08 | 0.05 | 0.01 | 0.03 | 0.08 |
Education | 0.5 | 0.5 | 0.47 | 0.53 | 0.89 | 0.13 | 0.2 | −0.04 | 0.63 |
Relationship status | 0.5 | 0.5 | 0.37 | 0.63 | 0.6 | −0.09 | 0.23 | −0.68 | 0.3 |
Negative Cognitive Empathy | 0.5 | 0.5 | 0.42 | 0.58 | 0.72 | 5.39 × 10−3 | 0.05 | −0.1 | 0.12 |
Positive Cognitive Empathy | 0.5 | 0.5 | 0.74 | 0.26 | 2.84 | 0.08 | 0.07 | −43.1 | 0.22 |
Negative Affective Empathy | 0.5 | 0.5 | 1 | 1.36 × 10−6 | 735,130.1 | −0.26 | 0.05 | −0.35 | −0.17 |
Positive Affective Empathy | 0.5 | 0.5 | 1 | 2.33 × 10−14 | 4.19 × 10+13 | 0.41 | 0.05 | 0.31 | 0.5 |
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Larionow, P. The Dark and Light Sides of Empathy: The Clinical Relevance of the Assessment of Cognitive and Affective Empathy Across Negative and Positive Emotions. Eur. J. Investig. Health Psychol. Educ. 2025, 15, 38. https://doi.org/10.3390/ejihpe15030038
Larionow P. The Dark and Light Sides of Empathy: The Clinical Relevance of the Assessment of Cognitive and Affective Empathy Across Negative and Positive Emotions. European Journal of Investigation in Health, Psychology and Education. 2025; 15(3):38. https://doi.org/10.3390/ejihpe15030038
Chicago/Turabian StyleLarionow, Paweł. 2025. "The Dark and Light Sides of Empathy: The Clinical Relevance of the Assessment of Cognitive and Affective Empathy Across Negative and Positive Emotions" European Journal of Investigation in Health, Psychology and Education 15, no. 3: 38. https://doi.org/10.3390/ejihpe15030038
APA StyleLarionow, P. (2025). The Dark and Light Sides of Empathy: The Clinical Relevance of the Assessment of Cognitive and Affective Empathy Across Negative and Positive Emotions. European Journal of Investigation in Health, Psychology and Education, 15(3), 38. https://doi.org/10.3390/ejihpe15030038