Empathy in multiple sclerosis--Correlates with cognitive, psychological and occupational functioning

K van der Hiele; E E A van Egmond; P J Jongen; J J L van der Klink; E A C Beenakker; J J J van Eijk; S T F M Frequin; E Hoitsma; J P Mostert; W I M Verhagen; D A M van Gorp; H A M Middelkoop; L H Visser

doi:10.1016/j.msard.2020.102036

Empathy in multiple sclerosis--Correlates with cognitive, psychological and occupational functioning

Mult Scler Relat Disord. 2020 Jun:41:102036. doi: 10.1016/j.msard.2020.102036. Epub 2020 Mar 2.

Authors

Affiliations

¹ Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, PO Box 9555, 2300 RB, Leiden, the Netherlands; National Multiple Sclerosis Foundation, Industrieweg 130C, 3044 AT, Rotterdam, the Netherlands; Department of Neurology, Elisabeth-TweeSteden Hospital, PO Box 90151, 5000 LC, Tilburg, the Netherlands. Electronic address: hiele@fsw.leidenuniv.nl.
² Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, PO Box 9555, 2300 RB, Leiden, the Netherlands; National Multiple Sclerosis Foundation, Industrieweg 130C, 3044 AT, Rotterdam, the Netherlands; Department of Neurology, Elisabeth-TweeSteden Hospital, PO Box 90151, 5000 LC, Tilburg, the Netherlands; Department of Care Ethics, University of Humanistic Studies, PO Box 797, 3500 AT, Utrecht, the Netherlands. Electronic address: elianne@nationaalmsfonds.nl.
³ MS4 Research Institute, Ubbergseweg 34, 6522 KJ, Nijmegen, the Netherlands; Department of Community & Occupational Medicine, University of Groningen, University Medical Centre Groningen, PO Box 30001, 9700 RB, Groningen, the Netherlands. Electronic address: ms4ri@kpnmail.nl.
⁴ Tilburg School of Social and Behavioural Sciences, Tranzo Scientific Centre for Care and Welfare, Tilburg University, PO Box 90153, 5000 LE, Tilburg, the Netherlands; Optentia, North West University of South Africa, PO Box 1174, Vanderbijlpark, South-Africa. Electronic address: j.j.l.vdrKlink@uvt.nl.
⁵ Department of Neurology, Medical Centre Leeuwarden, PO Box 888, 8901 BR, Leeuwarden, the Netherlands. Electronic address: martijn.beenakker@znb.nl.
⁶ Department of Neurology, Jeroen Bosch Hospital, PO Box 90153, 2000 ME, 's-Hertogenbosch, the Netherlands. Electronic address: j.eijkvan@jbz.nl.
⁷ Department of Neurology, St. Antonius Hospital, PO Box 2500, 3430 EM, Nieuwegein, the Netherlands. Electronic address: s.frequin@antoniusziekenhuis.nl.
⁸ Department of Neurology, Alrijne Hospital Leiden, PO Box 9650, 2300 RD, Leiden, the Netherlands. Electronic address: ehoitsma@alrijne.nl.
⁹ Department of Neurology, Rijnstate Hospital, PO Box 9555, 6800 TA, Arnhem, the Netherlands. Electronic address: jmostert@rijnstate.nl.
¹⁰ Department of Neurology, Canisius-Wilhelmina Hospital, PO Box 9015, 6500 GS, Nijmegen, the Netherlands. Electronic address: w.verhagen@cwz.nl.
¹¹ Department of Care Ethics, University of Humanistic Studies, PO Box 797, 3500 AT, Utrecht, the Netherlands. Electronic address: dennis.vangorp@phd.uvh.nl.
¹² Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, PO Box 9555, 2300 RB, Leiden, the Netherlands; Department of Neurology, Leiden University Medical Centre, PO Box 9600, 2300 RD, Leiden, the Netherlands. Electronic address: h.a.m.middelkoop@lumc.nl.
¹³ Department of Neurology, Elisabeth-TweeSteden Hospital, PO Box 90151, 5000 LC, Tilburg, the Netherlands; Department of Care Ethics, University of Humanistic Studies, PO Box 797, 3500 AT, Utrecht, the Netherlands. Electronic address: lh.visser@etz.nl.

PMID: 32169828
DOI: 10.1016/j.msard.2020.102036

Abstract

Background: Recent studies report deficits in social cognition in individuals with multiple sclerosis (MS). Social cognitive skills such as empathy are important for adequate social and occupational functioning. Our objectives are: (1) to examine whether empathy differs between individuals with MS and healthy controls, (2) to examine relations between empathy and cognitive, psychological and occupational functioning.

Methods: 278 individuals with MS (relapsing-remitting subtype) and 128 healthy controls from the MS@Work study participated in this investigation. The participants completed questionnaires about demographics, cognitive, psychological and occupational functioning, and underwent neurological and neuropsychological examinations. Mann-Whitney U-tests were used to examine group differences in empathy. Pearson and Spearman rank correlation analyses were used to examine relations between empathy and the other measures.

Results: Empathy did not differ between individuals with MS and healthy controls. In individuals with MS, higher empathy was correlated with a higher educational level (X²(df) = 13.2(2), p = 0.001), better verbal learning (r = 0.20, p = 0.001), less symptoms of depression (r=-0.21, p = 0.001), higher extraversion (r = 0.25, p ≤ 0.001), agreeableness (r = 0.55, p ≤ 0.001) and conscientiousness (r = 0.27, p ≤ 0.001) and better occupational functioning in terms of work scheduling and output demands (r = 0.23, p = 0.002) and less cognitive/psychological work barriers (r = -0.21, p = 0.001). In healthy controls, higher empathy was correlated with less symptoms of depression (r = -0.34, p ≤ 0.001), less fatigue (r = -0.37, p ≤ 0.001), higher agreeableness (r = 0.59, p ≤ 0.001) and better occupational functioning in terms of work ability as compared to lifetime best (r = 0.28, p = 0.001) and less cognitive/psychological work barriers (r = -0.34, p ≤ 0.001). Empathy did not differ between unemployed and employed individuals with MS or healthy controls.

Conclusion: Empathy did not differ between individuals with MS and healthy controls. Within both investigated groups, higher empathy was weakly to moderately correlated with less symptoms of depression, higher agreeableness and better occupational functioning. We also found unique correlations for empathy within the investigated groups. Longitudinal studies are needed to further examine social cognition in relation to cognitive, psychological and occupational functioning in both individuals with MS and healthy controls. It would be particularly interesting to concurrently examine changes in the brain network involved with social cognition.

Keywords: Empathy; Multiple sclerosis; Neuropsychological functioning; Occupational functioning; Social cognition.

MeSH terms

Adult
Cognitive Dysfunction / etiology
Cognitive Dysfunction / physiopathology*
Depression / etiology
Depression / physiopathology*
Educational Status
Efficiency / physiology*
Empathy / physiology*
Employment* / psychology
Female
Humans
Male
Middle Aged
Multiple Sclerosis, Relapsing-Remitting / complications
Multiple Sclerosis, Relapsing-Remitting / physiopathology*
Multiple Sclerosis, Relapsing-Remitting / psychology*
Neuropsychological Tests
Personality / physiology*
Social Cognition*