Empathy and Emotion Processing in Mild Head Injury and Sub-clinical Psychopathy

The current study sought to investigate the nature of empathic responding and emotion processing in persons who have experienced Mild Head Injury (MHI) and how this relationship between empathetic responding and head injury status may differ in those with higher psychopathic characteristics (i.e., subclinical psychopathy). One-hundred university students (36% reporting having a previous MHI) completed an Emotional Processing Task (EPT) using images of neutral and negative valence (IAPS, 2008) designed to evoke empathy; physiological responses were recorded. Additionally, participants completed measures of cognitive competence and various individual differences (empathy - QCAE; Reniers, 2011; Psychopathy - SRP-III, Williams, Paulhus & Hare, 2007) and demographics questionnaires. MHI was found to be associated with lower affective empathy and physiological reactivity (pulse rate) while viewing images irrespective of valence, reflecting a pattern of generalized underarousal. The empathic deficits observed correlated with the individual’s severity of injury such that the greater number of injury characteristics and symptoms endorsed by a subject, the more dampened the affective and cognitive empathy reactions to stimuli and the lower his/her physiological reactivity. Importantly, psychopathy interacted with head injury status such that the effects of psychopathy were significant only for individuals indicating a MHI. This group, i.e., MHI subjects who scored higher on psychopathy, displayed the greatest compromise in empathic responding. Interestingly, the Callous Affect component of psychopathy was found to account for the empathic and emotion processing deficits observed for individuals who report a MHI; in contrast, the Interpersonal Manipulation component emerged as a better predictor of empathic and emotion deficits observed in the No MHI group. These different patterns may indicate the involvement of different underlying processes in the manifestation of empathic deficits associated with head injury or subclinical psychopathy. It also highlights the importance of assessing for prior head injury in populations with higher psychopathic characteristics due to the possible combined/enhanced influences. The results of this study have important social implications for persons who have experienced a concussion or limited neural trauma since even subtle injury to the head may be sufficient to produce dampened emotion processing, thereby impacting one’s social interactions and engagement (i.e., at risk for social isolation or altered interpersonal success). Individuals who experience MHI in conjunction with certain personality profiles (e.g., higher psychopathic characteristics) may be particularly at risk for being less capable of empathic compassion and socially-acceptable pragmatics and, as a result, may not be responsive to another person’s emotional well-being.