Empathy In Adolescent With Schizophrenia

Objective: Schizophrenia is a common,chronic,agnogenic severe mental illness.Empathy is psychological process to distinguish,understand,speculate and experience others' emotions,emotional state and behavior.There is a large number of studies have shown that schizophrenia in adults have serious damage in empathy ability,lack of empathy is the one of the important factors that led to the decrease of the social function of patients with schizophrenia,and it also influence the patient's social life and relationships.Adolescence is a important period to develop empathy,but at present,domestic and foreign studies of empathy in adolescent schizophrenia is relatively scarce,this study selected Chinese version of interpersonal reactivity index(IRI-C),faux pas recognition and pain empathy paradigm,explore the empathy ability of adolescent schizophrenia in behavioral and neuro-physiological levels,the purpose of the study is to provide the theory and practice basis to early recognition and intervention the social function injury of adolescent patients with schizophrenia clinically.Methods:(1)Subjects: 54 adolescent patients with schizophrenia conforms to the diagnostic criteria for schizophrenia in fifth edition of diagnostic and statistical manual of mental disorders(DSM-V),in the disease stabilization,and 42 healthy adolescents to eliminate suffering from mental illness,and mental illness in first-degree relatives,and the age,gender,years of education,cognitive function match the patient group.All participants to exclude nervous system diseases,serious body disease,mental activity substance abusers,vision and hearing defects and can't test independently.(2)Research tool: Chinese version of interpersonal reactivity index(IRI-C)was used to assess all the subjects' ability of empathy.It includes four factors: perspective taking(PT),fantasy(FS),empathy concern(EC)and personal distress(PD).Faux pas recognition was used to test subjects' understanding and empathy ability of gaffes(due the speaker don't know to misunderstand,said that let the listener bitter,unhappy or inappropriate words)and psychological state.In the pain empathy paradigm,we use the judgment task's accuracy,reaction time and the pain rating scores as the behavioral indicators to estimate pain empathy ability.And EEG data were recorded in the meanwhile of judgment task,and we use early N1's and late P3's average amplitudes as the neuro-physiological indicators to compare the two groups' pain empathy ability..Results:(1)IRI-C Patients showed lower scores in empathy concern subscale than the control group,the difference is statistically significant(P<0.05).(2)Faux pas recognition Patients showed lower scores in identifying lapses,understanding gaffes and the problems related to gaffes than the control group,the differences were statistically significant(P<0.05);the score in control problems was no statistical significance between the two groups(P>0.05).(3)Pain empathy paradigm Behavioral results showed that all of the subjects' accuracy of the pain stimulus is lower than neutral stimulus(P<0.05),the accuracy of the pain judgment task is lower than the laterality judgment task(P<0.001),the reaction time of the pain judgment task is longer than the laterality judgment task(P<0.001),the score of rating pain pictures is higher than rating neutral images(P<0.001);In two stimuluses of the pain judgment task and the laterality judgment task,the accuracy of patients is lower than the control group(P<0.001),the reaction time of patients is longer than the control group(P<0.01);The score of patients in rating pain pictures is lower than the control group(P<0.05),the difference between the two groups of rating neutral images is not significant(P>0.05).ERP results showed that,early N1 amplitudes is highest in FZ(P<0.001),the amplitudes induced by patients were lower than those by controls(P<0.05),and the stimulus main effect and task main effect were not significant(P>0.05).Late P3 amplitudes is highest in CPZ(P<0.001),the amplitudes induced by pain judgment task is higher than those by laterality judgment task(P<0.001),amplitudes induced by pain stimulus is higher than those by neutral stimulus(P<0.001),the stimulus main effect is significant in pain judgment task(P<0.001),and the difference was not found in laterality judgment task(P>0.05).(4)Patients' IRI-C,faux pas recognition and the pain empathy paradigm's correlation with the clinical symptom score and the duration of disease Each factor of IRI-C,faux pas recognition and the pain empathy paradigm have no statistical correlation with PANSS subscales and scale's total score(P>0.05);Factors of empathy concern and personal distress in IRI-C was negatively correlated with duration of disease in patients(P<0.05),other factors in IRI-C,faux pas recognition and the pain empathy paradigm have no statistical correlation with duration of disease(P>0.05).Conclusion: The capability of empathy was impaired in adolescent schizophrenia,Empathy ability reduce may be trait damage of adolescent schizophrenia.