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The lack of ability to emphathize is central to many psychiatric conditions. Empathy is affected by neurodevelopment, brain pathology and psychiatric illness. Empathy is both a state and a trait characteristic. Empathy is measurable by neuropsychological assessment and neuroimaging techniques. This book, first published in 2007, specifically focuses on the role of empathy in mental illness. It starts with the clinical psychiatric perspective and covers empathy in the context of mental illness, adult health, developmental course, and explanatory models. Psychiatrists, psychotherapists and mental heath professionals will find this a very useful reference for their work.
Empathy, the ability or process ‘to identify with and understand another's situation, feelings and motives’ would initially appear an unlikely candidate for neuroimaging research. Being aware of, and interpreting, other's behaviour on an emotional level is likely to be recently evolved and hence a ‘high-level’ cognitive process. Such complex brain processes are generally considered as unlikely to have a dedicated brain region serving them, or to be easy to isolate for examination.
This chapter will describe how empathy has been dissected into a set of component cognitive processes, how brain imaging researchers have designed experiments to examine various combinations of these components, and what these finding may tell us about empathy's neurophysiological basis.
A neuroimaging primer
It may be useful to begin by summarizing the field of neuroimaging, and highlighting which aspects may be of relevance. Structural neuroimaging concerns the physical size and integrity of brain tissue, and in as much as there may be a relationship between size and function, if we could identify brain regions which were part of an empathy system or circuit, then investigating their size or integrity may be informative (presuming that we can objectively measure subjects’ behavioural empathic levels). Functional neuroimaging utilizes surrogate markers (normally regional blood flow) to infer which parts of the brain are ‘active’ whilst a specific task or mental process is undertaken.
Avolition affects quality of life in chronic schizophrenia. We investigated
the effect of modafinil upon unconstrained motor activity in 18 male
patients. In a randomised crossover design study wrist-worn actigraphic
monitors were used to objectively record motor activity over a 20 h period.
Patients' total activity was significantly greater when given the drug.
These data suggest that modafinil increases quantifiable motor behaviour in
schizophrenia and may have an impact on avolition.
Avolition affects quality of life in chronic schizophrenia. We investigated the relationship between unconstrained motor activity and the volume of key executive brain regions in 16 male patients with schizophrenia. Wrist-worn actigraphy monitors were used to record motor activity over a 20 h period. Structural magnetic resonance imaging brain scans were parcellated and individual volumes for anterior cingulate cortex and dorsolateral prefrontal cortex extracted. Patients' total activity was positively correlated with volume of left anterior cingulate cortex. These data suggest that the volume of specific executive structures may affect (quantifiable) motor behaviours, having further implications for models of the ‘will’ and avolition.
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