Empathic communication in dignity therapy: Feasibility of measurement and descriptive findings

Objective Dignity therapy (DT) is a guided process conducted by a health professional for reviewing one's life to promote dignity through the illness process. Empathic communication has been shown to be important in clinical interactions but has yet to be examined in the DT interview session. The Empathic Communication Coding System (ECCS) is a validated, reliable coding system used in clinical interactions. The aims of this study were (1) to assess the feasibility of the ECCS in DT sessions and (2) to describe the process of empathic communication during DT sessions. Methods We conducted a secondary analysis of 25 transcripts of DT sessions with older cancer patients. These DT sessions were collected as part of larger randomized controlled trial. We revised the ECCS and then coded the transcripts using the new ECCS-DT. Two coders achieved inter-rater reliability (κ = 0.84) on 20% of the transcripts and then independently coded the remaining transcripts. Results Participants were individuals with cancer between the ages of 55 and 75. We developed the ECCS-DT with four empathic response categories: acknowledgment, reflection, validation, and shared experience. We found that of the 235 idea units, 198 had at least one of the four empathic responses present. Of the total 25 DT sessions, 17 had at least one empathic response present in all idea units. Significance of results This feasibility study is an essential first step in our larger program of research to understand how empathic communication may play a role in DT outcomes. We aim to replicate findings in a larger sample and also investigate the linkage empathic communication may have in the DT session to positive patient outcomes. These findings, in turn, may lead to further refinement of training for dignity therapists, development of research into empathy as a mediator of outcomes, and generation of new interventions.

The Most Important Shot in Popular Cinema

In this chapter, evidence is presented that the most important shot in cinema is the reaction shot—a shot of an unspeaking character reacting to an event. In particular, those at the end of a conversation have increased dramatically during the past 70 years. Much discussion of the reaction shot has focused on the Kuleshov effect, the empathic response of viewers to the mere juxtaposition of a character’s emotionless face with content. There seems to be little experimental support for this effect in isolation. The chapter then explores the nature of reaction-shot facial expressions in movies during the past 70 years. Results show a distinctly non-Kuleshovian bent. Instead of characters being expressionless, they show mild arousal and mild displeasure. This is consistent with the notion that viewers need hints to employ theory-of-mind considerations in evaluating these shots.

Citizens of the world: National stereotypes do not affect empathic response in the presence of individuating information

Stereotyping is defined as generalising an attribute to a whole group and overlooking individual differences. In this study, we investigated whether Iranians' stereotypes of nations affected their empathy for the citizens of those nations. First, in a pilot study we explored common national stereotypes by using the stereotype content model (SCM) based on which six countries with different perceived warmth and competence scores were selected as nationalities of the protagonists of the vignettes in our experiment. In the next phase, 21 participants were asked to rate the degree of sadness associated with each vignette in an fMRI scanner. The results showed no significant differences in brain activity while participants were exposed to scenarios in which negative events befell people from different nations. This may be due to the individuation of victims by providing personal information about them.

The role of moral disengagement and animal empathy in the meat paradox

Current levels of meat consumption are environmentally unsustainable and cause suffering to billions of animals each year. Researchers have sought to understand the psychological mechanisms driving people’s meat consumption. Research suggests that having empathy towards animals may reduce a person’s meat consumption, however, an empathic response does not always result in action (the “meat paradox”). It may be that some people ‘disengage’ from their animal related morality when consuming meat. The current study aimed to test whether moral disengagement mediated the relationship between animal empathy and meat consumption. A total of 302 participants (18 to 70 years, 55.3% female) completed the Animal Empathy Scale, Moral Disengagement in Meat Questionnaire, and the Meat Consumption Scale. Results supported the mediation model, whereby high empathy for animals appeared to reduce one’s capacity to disengage with their morality, resulting in lower meat consumption. This study was the first to investigate the dual role of animal empathy and moral disengagement in meat consumption. We conclude that moral disengagement is a possible explanation for the meat paradox.

Natural human postural oscillations enhance the empathic response to a facial pain expression in a virtual character

Virtual reality platforms producing interactive and highly realistic characters are being used more and more as a research tool in social and affective neuroscience to better capture both the dynamics of emotion communication and the unintentional and automatic nature of emotional processes. While idle motion (i.e., non-communicative movements) is commonly used to create behavioural realism, its use to enhance the perception of emotion expressed by a virtual character is critically lacking. This study examined the influence of naturalistic (i.e., based on human motion capture) idle motion on two aspects (the perception of other’s pain and affective reaction) of an empathic response towards pain expressed by a virtual character. In two experiments, 32 and 34 healthy young adults were presented video clips of a virtual character displaying a facial expression of pain while its body was either static (still condition) or animated with natural postural oscillations (idle condition). The participants in Experiment 1 rated the facial pain expression of the virtual human as more intense, and those in Experiment 2 reported being more touched by its pain expression in the idle condition compared to the still condition, indicating a greater empathic response towards the virtual human’s pain in the presence of natural postural oscillations. These findings are discussed in relation to the models of empathy and biological motion processing. Future investigations will help determine to what extent such naturalistic idle motion could be a key ingredient in enhancing the anthropomorphism of a virtual human and making its emotion appear more genuine.

Patient Expectations on How Doctors Deliver Bad News (Case Study of Cancer Patients in Jambi City)

Research related to patient expectations has existed, but not specifically in Indonesia, especially in Jambi. For this reason, this study is aimed, firstly, to find out the patient's opinion on how doctors deliver bad news according to the SPIKES stage. The second objective was to explore patients' opinions regarding their expectations about the way doctors communicate bad news, namely cancer diagnosis and prognosis in breast cancer patients, taking into account the SPIKES protocol. This case study research uses a qualitative approach. Research in the city of Jambi in January - November 2019, used interviews with eight informants, namely female patients who saw an oncologist (cancer). Interviews were conducted with each informant and also to the group. Doctors only use some stages, namely stages, interview, giving knowledge, strategy, and summary. The patients studied think that the doctor passes through stages, perception, and invitation. There was a large tendency in the Emotions with the empathic response stage, patients who felt that they were given attention to the patient's emotional condition with an empathetic response, only a small proportion did not feel the doctor's empathic response. Expectations of patients, doctors pay attention to the stages of SPIKES as well as the dimensions of content and dimensions of relationships in delivering bad news about a diagnosis of the disease.

Age-related differences in negative cognitive empathy but similarities in positive affective empathy

Empathy, among other social-cognitive processes, changes across adulthood. More specifically, cognitive components of empathy (understanding another’s perspective) appear to decline with age, while findings for affective empathy (sharing another’s emotional state) are rather mixed. Structural and functional correlates underlying cognitive and affective empathy in aging and the extent to which valence affects empathic response in brain and behavior are not well understood yet. To fill these research gaps, younger and older adults completed a modified version of the Multifaceted Empathy Test, which measures both cognitive and affective empathy as well as empathic responding to both positive and negative stimuli (i.e., positive vs. negative empathy). Adopting a multimodal imaging approach and applying multivariate analysis, the study found that for cognitive empathy to negative emotions, regions of the salience network including the anterior insula and anterior cingulate were more involved in older than younger adults. For affective empathy to positive emotions, in contrast, younger and older adults recruited a similar brain network including main nodes of the default mode network. Additionally, increased structural microstructure (fractional anisotropy values) of the posterior cingulum bundle (right henisphere) was related to activation of default mode regions during affective empathy for positive emotions in both age groups. These findings provide novel insights into the functional networks subserving cognitive and affective empathy in younger and older adults and highlight the importance of considering valence in empathic response in aging research. Further this study, for the first time, underscores the role of the posterior cingulum bundle in higher-order social-cognitive processes such as empathy, specifically for positive emotions, in aging.