Empathy deficit in male patients with schizophrenia and its relationships with impulsivity and premeditated violence

Muxin Gong; Lei Yao; Xiaodan Ge; Zhenru Liu; Caiyi Zhang; Yujing Yang; Nousayhah Amdanee; Chengdong Wang; Xiangrong Zhang

doi:10.3389/fpsyt.2023.1160357

Empathy deficit in male patients with schizophrenia and its relationships with impulsivity and premeditated violence

Front Psychiatry. 2023 Jun 15:14:1160357. doi: 10.3389/fpsyt.2023.1160357. eCollection 2023.

Authors

Muxin Gong^{1

2}, Lei Yao¹, Xiaodan Ge¹, Zhenru Liu², Caiyi Zhang¹, Yujing Yang¹, Nousayhah Amdanee³, Chengdong Wang¹, Xiangrong Zhang^{1

2

3}

Affiliations

¹ Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
² Department of Psychiatry, Xuzhou Medical University, Xuzhou, China.
³ Department of Geriatric Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.

Abstract

Objective: To explore the pattern of empathy characteristics in male patients with schizophrenia (SCH) and to examine whether empathy deficit is associated with impulsivity and premeditated violence.

Methods: One hundred and fourteen male SCH patients were enrolled in this study. The demographic data of all patients were collected and the subjects were divided into two groups, namely, the violent group, including 60 cases, and the non-violent group, comprising 54 cases, according to the Modified Overt Aggression Scale (MOAS). The Chinese version of the Interpersonal Reactivity Index-C (IRI-C) was used to evaluate empathy and the Impulsive/Predicted Aggression Scales (IPAS) was employed to assess the characteristics of aggression.

Results: Among the 60 patients in the violent group, 44 patients had impulsive aggression (IA) and 16 patients had premeditated aggression (PM) according to the IPAS scale. In the violent group, the scores of the four subfactors of the IRI-C, i.e., perspective taking (PT), fantasy (FS), personal distress (PD), and empathy concern (EC), were significantly lower than in the non-violent group. Stepwise logistic regression showed that PM was independent influencing factor for violent behaviors in SCH patients. Correlation analysis revealed that EC of affective empathy was positively correlated with PM but not with IA.

Conclusion: SCH patients with violent behavior had more extensive empathy deficits compared with non-violent SCH patients. EC, IA and PM are independent risk factors of violence in SCH patients. Empathy concern is an important index to predict PM in male patients with SCH.

Keywords: aggressiveness; empathy; neuropsychology; schizophrenic patients; violence.