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. Author manuscript; available in PMC: 2023 Feb 1.
Published in final edited form as: Pers Individ Dif. 2021 Sep 17;185:111238. doi: 10.1016/j.paid.2021.111238

The Cognitive, Affective and Somatic Empathy Scales for Adults.

Adrian Raine 1, Frances R Chen 2, Rebecca Waller 3
PMCID: PMC8880876  NIHMSID: NIHMS1737704  PMID: 35221409

Abstract

The Cognitive, Affective and Somatic Empathy Scales (CASES) assess three forms of empathy, each with subscales for positive and negative empathy. The present study extends this child instrument to adults and examines its factor structure and construct validity. A secondary aim is to investigate the under-researched area of positive empathy. Community samples totaling 2,604 adults completed the CASES for adults, together with scales assessing construct validity. Confirmatory factor analysis supported the three-factor cognitive-affective-somatic model and a two-factor positive-negative empathy model. Findings were replicated in a second independent sample. Internal reliabilities ranged from .80 to .92. Individuals with higher psychopathy and stimulation-seeking scores were less impaired in their empathic reactions to positive relative to negative valence events, suggesting that they are relatively capable of responding emotionally to rewarding events. Somatic empathy was most strongly associated with pleasure in affective touch and with female > male gender differences. While proactive aggression was associated with reduced cognitive and affective empathy, reactive aggression was associated with increased empathy. Findings provide initial support for the utility of CASES for assessing different forms of empathy and suggest that the balance between positive and negative empathy could provide new insights into psychological traits.

Keywords: Empathy, cognitive, affective, somatic, motor, positive empathy, psychopathy, reactive aggression

1. Introduction.

Despite instrumentation advances, there are at least two aspects of empathy which are less researched in the field - somatic (or motor) empathy, and positive empathy. To address these gaps, we previously developed a brief self-report empathy measure for children and adolescents – the Cognitive, Affective, and Somatic Empathy Scales (CASES - Raine & Chen, 2018). This scale comprises three main factors of empathy – cognitive, affective, and somatic. Each of these can be sub-divided into positive empathy and negative empathy. A unique aspect of the test construction for CASES was wording of all items to be appropriate for adults as well as children. The overarching goals of the current study are to confirm the factor structure of this child instrument on adults, provide initial construct validity, and develop further the relatively under-researched area of positive empathy.

The empathy literature deals overwhelmingly with empathic concern in the context of emotionally negative encounters. The relatively new concept of positive empathy in contrast has been defined as understanding and vicariously sharing other’s positive emotions (Morelli, Lieberman, & Zaki, 2015). There is surprisingly little research on empathic reactions in positive and rewarding social contexts. Whereas negative empathy may be adaptive in motivating oneself to both help those who are suffering and also to learn from and to avoid experiencing negative affect in the future, positive empathy could serve to promote and maintain a pleasant emotional state in both self and others (Telle & Pfister, 2016). An empathy measure which yields an assessment of positive empathy alongside negative empathy holds the promise of contributing to the relatively new field of positive psychology (Seligman & Csikszentmihalyi, 2000) and providing a new vista on well-being.

In this context we made several predictions. Because positive empathy has been viewed as important for the development of relationships (Andreychik & Lewis, 2017), we predicted that positive empathy in this study would be associated with more socially connected relationships, including need to belong and having close relationships. It has been argued that positive empathy functions to drive generosity (Morelli, Sacchet, & Zaki, 2015), and as such it was anticipated to be associated with giving more to charity. While higher empathy has been quite consistently associated with emotional intelligence, no study to date has reported on positive empathy. Less clear is the relationship between empathy and self-control. While empathy has been broadly associated with a wide range of prosocial behaviors (Telle & Pfister, 2016), links with selfcontrol are less clear, and at least one study has observed a negative association with negative empathy (Fernandez-Abascal & Martin-Diaz, 2019). Yet again, there is a research gap on selfcontrol and positive empathy. The relationship between positive empathy and the experience of pleasure is unknown, but given that one recent study has shown that laboratory measures of empathic cheerfulness (positive empathy) are selectively associated with increased activity in the striatum (a key component of the reward circuit) (Mirabito, Taiwo, Bezdek, & Light, 2019), we anticipated experience of pleasure to be especially related to positive empathy. Better quality of sleep has been associated with increased empathy (Guadagni, Burles, Ferrara, & Iaria, 2018), although its link to positive empathy is unexplored. Finally, while positive empathy is anticipated to be broadly associated with positive psychological traits (Andreychik & Lewis, 2017; Telle & Pfister, 2016), they are anticipated to be negatively associated with negative psychological traits such as psychopathy, callous-unemotional traits, crime, and impulsive stimulation-seeking.

Somatic or motor empathy is even less studied that positive empathy. Unlike cognitive and affective empathy which are predominantly covert processes, somatic empathy is behavioral and overt (e.g. “When I see children smiling, I smile too”). Motor empathy is thought by some to have its foundation in part in the mirror neuron system, an automatic mechanism that mirrors what is occurring in the brains of other people (Shamay-Tsoory, 2011). Some suggest that the mirror neuron system upon which somatic empathy is predicated is argued to be a central and fundamental neural basis for the capacity to empathize (Iacoboni, 2009). Similarly, somatic empathy has been viewed as necessary for affective empathy which then gives rise to cognitive empathy (Van der Graaff et al., 2016). Others suggest that focusing on the affective components of empathy is simply not sufficient for understanding the neurophysiology of empathy, and that motor functions play an important role in both the initiation and modulation of empathy (Lamm & Majdandzic, 2015). At the same time, research on somatic empathy has been extremely limited, and confined to laboratory measures that include facial EMG, somatosensory eventrelated potentials, and transcranial magnetic stimulation-induced motor evoked potentials. To our knowledge, CASES is the only instrument to allow self-reporting of motor empathy (Raine & Chen, 2018). In the current study we included a somatic measure (pleasure in affective touch) to evaluate its relationship with somatic empathy.

Beyond the primary goal of confirming the factor structure of CASES in adults and the secondary goal of investigating positive and somatic empathy, we also sought to extend prior investigations of more substantive issues in empathy research. Foremost amongst these is the ambiguous relationship between empathy and aggression. One meta-analysis documented only a weak negative effect size between these two traits (d = −.11), arguing for the “non-relation” between empathy and aggression (Vachon, Lynam, & Johnson, 2014). One issue in this field that has been overlooked is the distinction between reactive (impulsive, “hot-blooded”) and proactive (planned, “cold-blooded”) aggression. Few studies on empathy have distinguished between proactive and reactive aggression. It is conceivable that while low empathy may be associated with proactive aggression, reactively aggressive individuals may have increased emotional sensitivity. When these two forms are combined together, they may result in a “non-relation” between empathy and aggression measures. Reduced empathy might be more expected in more psychopathic-like, “cold-blooded” proactive aggression, whereas reactive aggression may be characterized by an excess of emotion and paradoxically intact or even increased empathy. This possibility is suggested by findings from Hong Kong schoolchildren where reactive aggression loaded positively (.37) on a canonical function in which empathy also loaded positively (.41), whereas proactive aggression loaded negatively (−.75) on this function (Fung, Gerstein, Chan, & Engebretson, 2015). We therefore evaluated in the current study whether differential relationships could be obtained between empathy and these different manifestations of aggression.

In this study, our primary goal of confirming in adults the factor structure of CASES found in children was tested in two studies (Sample 1 and Sample 2) from the community. Both of these samples also included measures to assess construct validity, another element of our primary goal. We hypothesized that confirmatory factor analyses of CASES would provide support for a three-factor structure (cognitive, affective, somatic), a two-factor structure (positive and negative), and a six-factor structure (cognitive-positive, cognitive-negative, affective-positive, affective-negative, somatic-positive, somatic-negative). We tested replicability of findings using a second independent sample. Regarding our secondary goals, we hypothesized that positive empathy would be associated with positive psychology and well-being constructs (e.g. sociability, emotional intelligence, better sleep quality), whereas negative empathy would be more associated with negative empathy constructs (e.g. psychopathy, selfishness). It was further anticipated that somatic empathy would be particularly associated with pleasure in affective touch. It was also hypothesized that while higher proactive aggression scores would be associated with lower empathy, reactive aggression would be associated with positive empathy.

2. Materials and Methods

2.1. Participants

Three independent samples of community participants (total N=2,604; 51.5% female) were recruited through Amazon’s Mechanical Turk (MTurk). Participants had a mean age of 36.95 years (SD = 11.54), with ethnicity as follows: White (63.1%), Asian (17.2%), Black (11.1%), Hispanic (6.8%), Other (1.8%). Ethical approval was obtained from the IRB board of the University of Pennsylvania.

The first sample (Sample 1: N=1,215) provided data on both CASES for confirmatory factor analysis (CFA) and also construct validity measures (positive and negative psychological traits). The second sample (Sample 2: N = 521) also yielded data on CASES and construct validity measures (callous-unemotional traits, touch experiences, need to belong, and emotion recognition - see below). The third sample (N = 868) only provided data on CASES for CFA. A combined total of 2,604 provided the basis for confirmatory factor analysis of CASES, with these participants randomly assigned to two separate samples (N = 1,302 in each) to assess replicability of findings.

In Sample 1, participants had to have an approval rating of 98% or more to participate. To maximize data fidelity, the three validity check items from the NEO PI-R (Costa & Mccrae, 1992) were also administered at the end of the study to assess honesty and carelessness, with participants excluded if one or more responses flagged dishonesty/carelessness. In Samples 2 and 3 participants had to have a HIT rate of > 97% and to live in the USA to participate, and were excluded if they completed <10% of the survey questions, if they completed the survey in an impossibly short period of time, or if they had a variance of 0 across survey items.

2.2. Cognitive, Affective, and Somatic Empathy Scales (CASES) (Samples 1, 2 and 3)

Full details of the original scale construction are provided in Raine and Chen (2018). Briefly, this 30-item scale was specifically designed to be applicable for use with both children and adults, with items and wording being identical for these two populations. Attempts were made to sample across multiple social situations, make the social context applicable to adults as well as children, keep grammar simple and sentence length short, and sample across a range of emotions. Items were represented evenly across the six domains of Cognitive (Positive – Negative), Affective (Positive-Negative) and Somatic (Positive – Negative) empathy. Response frequency options were 0 (rarely), 1 (sometimes), or 2 (often). The three main domains (cognitive, affective, somatic) were each represented by 10 items, while each of the six subdomains were represented by five items. The complete instrument and scoring guidelines are available upon request.

Cognitive items reflect predominantly theory-of-mind ability (e.g. “I know when someone is unhappy even before they say why”). Affective items reflect experiencing the emotion of another’s emotion (e.g. “Seeing people sad at a funeral would make me feel sad too”). Somatic items reflect a motor mimicry of the emotion in question (e.g. “Seeing others laugh makes me laugh too”), or a somatic response to an emotional event (e.g. “I cringe when I see someone cut or bleeding”). Positive affect items reflect empathy in the context of a positive emotional context (e.g. “Seeing people looking cheerful makes me grin” – somatic positive empathy), while negative affect items reflect empathy in the context of a negative emotional context (e.g. “When someone is disappointed, I can tell by how they look” – cognitive negative empathy).

CASES allows for computation of a total of 12 scores: total, cognitive, affective, somatic, positive empathy, negative empathy, cognitive-positive, cognitive-negative, affective-positive, affective-negative, somatic-positive, and somatic-negative. The first six are viewed as primary scales while the second set allow for more fine-grained analyses. For the purposes of further evaluating positive versus negative empathy, four further sub-scale scores were computed to evaluate the relative balance of positive versus negative empathy. These were computed as positive empathy minus negative empathy, with higher scores reflect a bias towards more positive relative to negative empathy.

2.3. Demographic Variables (Sample 1)

These included age, gender, ethnicity (White, Black, Asian, Hispanic/Latino Other), family income ($ per year), education (coded less than seventh grade, junior high [9th grade], partial high school [10th or 11th grade], high school graduate, partial college [one year] or specialized training, college / university graduate, graduate school), relationship status (single, casual relationship, serious relationship, co-habiting, married), and number of children.

2.4. Negative Psychology Measures (Sample 1)

2.4.1. Psychopathy

was assessed using the Triarchic Personality Measure (TriPM), which consists of three phenotypic components: boldness, meanness, and disinhibition (Patrick, 2010)). This brief self-report measure yields good evidence for construct validity (Hall et al., 2014; Sellbom & Phillips, 2013).

2.4.2. Selfishness

was assessed using the Selfishness Questionnaire (SQ) which consisted of 24 items assessing egocentric, adaptive, and pathological forms of selfishness (Raine & Uh, 2019). Good internal reliability, test-retest reliability, convergent validity, discriminant validity, factorial validity, incremental validity, and criterion validity have been documented (Raine & Uh, 2019).

2.4.3. Reactive-Proactive Aggression

was assessed using the 23-item Reactive-Proactive Aggression Questionnaire (RPQ) which yields scales of reactive, proactive, and total aggression (Raine et al., 2006). Reliability and validity have been extensively documented (Cima & Raine, 2009; Cima, Raine, Meesters, & Popma, 2013; Raine et al., 2006).

2.4.4. Schizotypal Personality Questionnaire (SPQ-B).

The Schizotypal Personality Questionnaire-Brief (SPQ-B) is a two-minute, 22-item self-report assessment covering DSM 5 features of Schizotypal Personality Disorder (Raine & Benishay, 1995). Reliability and construct validity have been documented (Fonseca-Pedrero, Paino, Lemos-Giraldez, Sierra-Baigrie, & Muniz, 2011; Raine & Benishay, 1995).

2.4.5. Impulsive sensation-seeking

was assessed using the impulsive sensation-seeking subscale of the Zuckerman-Kuhlman Personality Questionnaire (ZKPQ; Zuckerman, Kuhlman, Joireman, Teta, & Kraft, 1993). This 19-item instrument assesses a lack of planning, impulsive behavior, and the tendency to take risks in the pursuit of excitement or novelty, and has acceptable reliability and validity (Zuckerman & Kuhlman, 2000; Zuckerman et al., 1993).

2.4.6. Alcohol Problems.

This was assessed using the 10-item Alcohol Use Disorders Identification Test (AUDIT) which constitutes a brief screening scale for alcohol problems (Barbor, Higgins-Biddle, Saunders, & Montero, 2001). Good reliability and extensive validity has been documented (Reinert & Allen, 2007).

2.4.7. Crime.

Criminal / antisocial behavior was assessed based on 9 items covering unlawful behavior as follows: shoplifting, illegal street drugs, lying on legal documents, fake identity, deception to doctor to obtain drugs, conning a person for financial gain, unruly in public, assault, and threat to injure / kill. Frequency of offending for each item was coded 0 (never), 1 (1–2 occasions), or 2 (3 or more) to yield one overall score of criminal behavior. Internal reliability (Chronbach’s alpha) for this scale in this study was .79.

2.5. Positive Psychology Measures. (Sample 1)

2.5.1. Emotional Intelligence

was assessed using the 30-item Trait Emotional Intelligence Questionnaire – Short Form (TEIQ-SF - Petrides (2009) which provides a total score in addition to four EQ sub-scales: well-being, self-control, emotionality and sociability. Adequate reliability and validity for this short form has been documented (Laborde, Allen, & Guillen, 2016; Petrides, 2009).

2.5.2. Self-control

was evaluated using the frequently-used 13-item Brief Self-Control Scale (Tangney, Baumeister, & Boone, 2004). Acceptable reliability and validity have been reported (Harty, Forkner, Thompson, Stuewig, & Tangney, 2010; Pechorro, DeLisi, Goncalves, Quintas, & Hugo Palma; Tangney et al., 2004).

2.5.3. Sleep quality

was measured using the eight-item Epworth Sleepiness Scale (Johns, 1991) which has been very extensively used in the sleep literature (Lapin, Bena, Walia, & Moul, 2018). Higher scores on this scale reflected increased daytime alertness and higher sleep quality.

2.5.4. Altruism

was assessed by asking participants how much they give to charities per year. Due to significant skew and kurtosis on this variable, five groups were created as follows: 1 = $0 2 = $1-$25, 3 = $26-$100, 4 = $101-$250, 5 = >$250.

2.6. Measures Employed in Sample 2.

The second sample provided both data on CASES for confirmatory factor analysis, and also additional variables to further explore construct validity. These latter variables were as follows:

2.6.1. Psychopathic Traits

were assessed by two different instruments not used in Sample 1. The first consisted of the 28-item Self-Report of Psychopathy-Short Form (SRP-SFIV; Paulhus, Neumann, Hare, Williams, & Hemphill, 2016). Psychometric studies support the reliability and validity of this scale (Dotterer et al., 2017; Neumann & Pardini, 2014). The second measure consisted of the 26-item Primary and Secondary Psychopathy Scale (Levenson, Kiehl, & Fitzpatrick, 1995) which has received relatively extensive support for reliability and validity (Salekin, Chen, Sellbom, Lester, & MacDougall, 2014; Sellbom, 2011).

2.6.2. Callous-Unemotional Traits

were assessed using the Inventory of Callous-Unemotional Traits (ICU), a 24-item instrument to assess callousness, uncaring, and lack of sensitivity to the emotional cues of others (Frick, 2004). Acceptable evidence for the reliability, validity and use in adults of the total scale has been documented (Byrd, Kahn, & Pardini, 2013; Gao & Zhang, 2016; Ray & Frick, 2018).

2.6.3. Pleasure in Affective Touch

was assessed using the 10-item Pleasure in Affective Touch Scale (PATS - Waller et al. in press) which assesses sensitivity to pleasurable touch from loved ones, friends, and other physical touch sensations. Initial findings support adequate reliability and validity (Waller et al., in press).

2.6.4. Need to Belong

was assessed using the 10-item Need to Belong scale which reflects the need to interact and affiliate with others. Support has been documented for the reliability of this scale together with nine studies supporting construct validity (Leary, Kelly, Cottrell, & Schreindorfer, 2013).

2.6.5. Emotion recognition

was assessed using the Reading the Mind in the Eyes task (Baron-Cohen, Wheelwright, Hill, Raste, & Plumb, 2001). In this task, participants are presented with 36 photographs of the eye region of the face and are asked to choose which word best describes the person in emotional terms. Reliability and construct validity has been documented for this extensively-used laboratory task (Vellante et al., 2013).

2.6.6. Experience of Pleasure

was assessed using the Temporal Experience of Pleasure Scale, an 18 item instrument with two subscales measuring both anticipatory and consummatory experiences of pleasure (Gard, Gard, Kring, & John, 2006). Reliability and validity are reasonably well-established for this scale (Gard et al., 2006; Simon et al., 2018).

2.7. Statistical analysis

All analyses to confirm the hypothesized factor structure of CASES were conducted in Mplus 8.3 (Muthén & Muthén, 2019) using WLSMV as the robust weighted least squares estimator using a diagonal weight matrix. For the factor structure hypotheses, a series of five confirmative factor analyses (CFA) were conducted to both test and compare different models using model fit indices. We first compared one-factor (overall empathy – Model 1), two-factor (dual positive / negative valence – Model 2), and three-factor (cognitive, affective, somatic – Model 3) models. All models were evaluated with the χ2 test, the Comparative Fit Index (CFI), the Root Mean Square Error of Approximation (RMSEA), and Root Mean Square Residual (RMSR) (Hu & Bentler, 1998). A model is believed to fit the data well when the CFI has a value above .90, and when the RMSEA and SRMR have a value below .05 (Hu & Bentler, 1998). An RMSEA value range from 0.05 to 0.08 would suggest a fair fit (Browne & Cudeck, 1993).

We then tested whether each facet of empathy could be reliably decomposed into positive and negative valence by comparing two nested second-order factor models. The first second-order model (Model 4) had three first-order factors (cognitive, affective, somatic) and one second-order factor (a general empathy factor). The second second-order model (Model 5) was nested in the first model, and consisted of six first-order factors (cognitive, affective, somatic – each with positive and negative valences) and one second-order factor (general empathy factor). We excluded 2.1% of data due to missing values and we report on all measures and manipulations in this study.

For hypotheses on construct validity, empathy scores, correlations and t-tests were computed. Because a moderately high correlation between reactive and proactive aggression was observed in this study (r = .61), partial correlations were computed in which proactive-empathy correlations were controlled for reactive aggression, and vice-versa. Data are available to researchers upon reasonable request for the purpose of cross-checking findings.

3. Results

This section reports on the main subscales of CASES – total score, cognitive, affective, somatic, positive, negative, and positive / negative balance. Results for other subsidiary subscales may be found in the online supplement.

3.1. Comparisons between one-factor, two-factor and three-factor model

Model fit indices and comparisons for one, two, and three-factor models and the two second-order factor models are outlined in Table 1 for the two replication samples, while factor loadings are outlined in the Supplement (Table S1). In the first replication sample, support was provided for both a two-factor structure (positive-negative empathy, Model 2) and a three-factor structure (cognitive-affective-somatic empathy, Model 3). These two models fit the data adequately, with high CFI values of .97 and RMSR below .046, but a more marginal fit for RMSEA (.08-.09). In addition, the two-factor model had a significantly better fit to the data over the one-factor model based on the chi-square difference test (Δχ2 = 139.14, df = l, p < 0.001), as did the three-factor model (Δχ2 = 427.54, df = 3, p < .001).

Table 1.

Model Fit Indices for the Two Random Samples, and Comparisons for One, Two, and Three-factor Models and the Two Second-Order Factor Models.

Model χ2 df CFI RMSEA (95% CI) RMSR Model comparison Δdf Δχ2
Random Sample 1
1 One empathy factor model 5033.76 405 .96 .094 (0.091, 0.096) 0.046
2 Two-factor model 4815.51 404 .97 .092 (0.089, 0.094) 0.045 1 vs. 2 1 139.14
3 Three-factor model 3798.61 402 .97 .081 (0.078, 0.083) 0.038 1 vs. 3 3 427.54
4 Three 1st order factors a 3782.31 403 .97 .080 (0.078, 0.083) 0.038 1 vs. 4 2 374.21
5 Six 1st order factors b 3930.83 400 .97 .082 (0.080, 0.085) 0.039 1 vs. 5 5 721.50
Random Sample 2
6 One empathy factor model 4177.97 405 .97 .085 (0.082, 0.087) 0.040
7 Two-factor model 4018.50 404 .98 .083 (0.081, 0.085) 0.040 6 vs. 7 1 110.25
8 Three-factor model 3184.85 402 .98 .073 (0.071, 0.075) 0.033 6 vs. 8 3 391.71
9 Three 1st order factors a 3156.26 403 .98 .072 (0.070, 0.075) 0.033 6 vs. 9 2 353.87
10 Six 1st order factors b 3309.34 400 .98 .075 (0.072, 0.077) 0.035 6 vs. 10 5 563.54
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a.

Due to a Haywood Case where the residual variance of affective empathy was negative, the residual variance of affective empathy was set to 0.

b.

Due to a Haywood Case where the residual variance of affective positive empathy was negative, the residual variance of affective positive empathy was set to 0.

As indicated in Table 1, findings for the second (replication) Sample 2 provided support for replicability of these CFA findings. In all cases, CFIs were at least .97 and above, RMSEA values for all models were slightly lower (indicating better fits) than for replication Sample 1, ranging from .075 to .085. RMSR values indicated a good fit, ranging from .033 to .04. RMSR values indicated a good fit, ranging from .033 to .04. Incrementally better fits were again shown for two- and three-factor models.

3.2. Internal Reliability and Scale Intercorrelations.

Full details are provided in the Supplement following Table S8. Briefly, internal reliabilities (ω) for main scales were good and replicated well, ranging from .82 to .92. Intercorrelations between main scales ranged from .56 to 72.

3.3. Comparison between second-order factor models

In order to test whether cognitive, affective and somatic empathy could be modeled with positive and negative valences, we compared two second-order factor models each containing a general second-order empathy factor. These two models differed in their first order factors, one with only the three facets of empathy as the first-order factor and the other breaking the three facets into positive and negative emotion to yield six first-order factors. Fit indices for these models are given in Tables 1. The six first-order factor model (Model 5) had a significantly better fit than the three-first-order factor model (Model 4 - Δχ2 = 721.50 in replication sample 1 and 563.54 in replication sample 2, df = 3, p < .001). This indicates that cognitive, affective and somatic empathy can be further differentiated into positive and negative valence.

3.4. Negative psychology scales.

Results of associations between CASES scales and negative psychology traits are shown in Table 2 and S8. Lower scores on all key empathy scales (total, three main domains, and positive / negative empathy) were almost without exception associated with higher scores on psychopathy, aggression, selfishness, schizotypy, alcohol problems, crime, and impulsive stimulation-seeking. The salient exception was that while higher proactive aggression was associated with reduced empathy, higher reactive aggression was associated with increased empathy.

Table 2.

Relationships between empathy scales and negative psychological traits. N = 1,142 to 1,159.

Total TPM Bold TPM Meanness TPM Disinhibition TPM Reactive Aggression Proactive Aggression Selfishness Schizotypy Alcohol Problems Crime Impulsive Stim-Seek
CASES Scales
Total −.40*** .01 −.51*** −.29*** .14*** −.28*** −.31*** −.20*** −.16*** −.17*** −.19***
Cognitive −.31*** −.14*** −.42*** −.29*** .14*** −.27*** −.24*** −.20*** −.14*** −.14*** −.16***
Affective −.49*** .01 −.58*** −.39*** .17*** −.38*** −.34*** −.27*** −.20*** −.19*** −.26***
Somatic −.28*** −.09** −.36*** −.12*** .05 −.11*** −.24*** −.09*** −.11*** −.14*** −.11***
 
Positive −.32*** .13*** −.46*** −.28*** .08** −.21*** −.28*** −.23*** −.15*** −.15*** −.18***
Negative −.45*** −.09** −.51*** −.29*** .18*** −.32*** −.31*** −.17*** −.16*** −.18*** −.27***
 
Total +/− Balance .20*** .33*** .09** .02 −.16*** .16*** .05 −.10*** .02 .05 .22***
 
 
 
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Note.

***

p < .001

**

p < .01

*

p < .05. TPM = Tridimensional Personality Measure.

Total psychopathy (as measured by the TPM) was associated with reduced empathy, although one of the three factors (boldness) showed a null relationship (r = .01). While both positive and negative empathy were largely negatively associated with these negative traits, the balance of positive-to-negative empathy showed differential effects. In particular, individuals high on boldness (r = .33), proactive aggression (r = .16) and impulsive stimulation-seeking (r = .22) had levels of positive empathy that were more intact relative to negative empathy. Reactive aggression and schizotypy showed the reverse pattern, with relatively greater deficits in positive than negative empathy.

3.5. Positive Psychology Scales

Correlations between CASES scales and positive psychology traits are shown in Table 3. In almost all cases, higher levels of positive empathy were associated with higher levels of emotional intelligence, self-control, sleep quality, and charity donations. Positive empathy was generally more associated with these positive traits than negative empathy. The balance of positive-to-negative empathy further confirmed that these positive psychology traits were characterized by more positive empathy than negative empathy, and this was particularly true for the positive/negative balance of somatic empathy (see Supplement, Table S3).

Table 3.

Relationships between empathy scales and positive psychology / well-being traits. N = 1,097 to 1,158.

EQ Total EQ Well-Being EQ Self-Control EQ Emotion EQ Sociability Self- Control Sleep Quality Charity Donations
CASES Scales
Total .37*** .39*** .19*** .45*** .19*** .24*** .06* .15***
 
Cognitive .45*** .38*** .30*** .50*** .30*** .29*** .05 .10***
Affective .39*** .40*** .22*** .45*** .19*** .29*** .06* .18***
Somatic .18*** .26*** .01 .27*** .04 .09*** .06* .13***
 
Positive .43*** .45*** .23*** .47*** .26*** .26*** .12*** .18***
Negative .29*** .29*** .14** .40*** .11*** .22*** .00 .11***
 
Total +/− Balance 22*** .24*** .14*** .10** .24*** .07* .18*** .10***
Cognitive +/− Balance 12*** .16*** .07* .14* .03 .08** .11*** .09**
Affective +/− Balance .07* .10*** .01 −.05 .15*** −.04 .13*** .05
Somatic +/− Balance .25*** .22*** .19*** .14*** .28*** .11*** .12*** .07*
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Note.

***

p < .001

**

p < .01

*

p < .05. EQ = emotional intelligence.

3.6. Construct Validity Measures From Sample 2

Associations between CASES scales and psychopathy, callous-unemotional traits, pleasure in affective touch, need to belong, and theory-of-mind measures derived from Sample 2 are shown in Table 4. Negative psychology traits (two psychopathy measures and callousunemotional traits) were associated with lower empathy, while positive traits (pleasure in affective touch, need to belong, and emotion recognition) were all associated with higher empathy.

Table 4.

Relationships between empathy and psychopathy, positive touch, need to belong, and theory-of-mind measures (N = 472).

Self-Report Psychopathy ICU Total Psychopathy (LSRP) Primary Psychopathy (LSRP) Secondary Psychopathy (LSRP) Experiencing Pleasure (TEPS) Pleasure In Affective Touch Need To Belong Emotion Recognition
CASES Scales
Total −.35*** −.60*** −.45*** −.43*** −.42*** .50*** .43*** .19*** .30***
 
Cognitive −.28*** −.56*** −.39*** −.36*** −.38*** .42*** .34*** .01 .33***
Affective −.42*** −.60*** −.51*** −.48*** −.47*** .45*** .35*** .18*** .36***
Somatic −.21*** −.41*** −.29*** −.28*** −.25*** .42*** .43*** .29*** .11*
 
Positive −.28*** −.56*** −.39*** −.36*** −.39*** .52*** .43*** .17*** .22***
Negative −.38*** −.58*** −.44*** −.44*** −.39*** .42*** .38*** .20*** .36***
 
Total +/− Balance .13** −.04 .10* .14*** .00 .19*** .12** −.03* −.19***
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Note.

***

p < .001

**

p < .01,

*

p < .05.

ICU = Inventory of Callous-Unemotional Traits. ICU = Inventory of Callous-Unemotional Traits. LPSP = Levenson’s Primary and Secondary Psychopathy Scale. TEMPS = Temporal Experience of Pleasure Scale

Positive psychology measures were uniformly associated with higher levels of empathy. Within the three main domains of empathy, somatic empathy was most strongly associated with pleasure in affective touch and need to belong.

Regarding the balance of positive-negative empathy, negative psychology measures were positively associated with positive/negative balance, with higher scores associated with a balance favoring more positive relative to negative empathy. While this was also true of pleasure in affective touch, emotion recognition was associated with a bias toward more negative (relative to positive) empathy.

3.7. Gender differences

Results for gender differences together with effects sizes in the two adult samples are shown in Table 5. Robust gender differences were observed on all but one empathy scale, with females having higher empathy than males. Effects sizes for the three main empathy factors were relatively strong and replicable, ranging from d = .45 to .70 for Sample 1 and .43 to .65 for Sample 2. These effects were weakest for cognitive empathy and strongest for somatic empathy. Table 5 also provides effect sizes from the original child sample which also produced the same gender differences (Raine & Chen, 2018). Although effect sizes on total empathy for the adult sample were almost twice the size of those in children, indicating that this gender difference increases with age.

Table 5.

Sex differences in empathy. Child d values are from the original CASES manuscript on 11–12-year-old children.

CASES Scales Females (N = 582) Males (N = 572) F p Child d Adult d Sample 1 Adult d Sample 2
Total 45.09 (10.37) 38.01 (11.19) 124.00 .001 0.33 .66 .62
Cognitive 14.25 (3.84) 12.45 (4.21) 57.32 .001 0.34 .45 .43
Affective 15.93 (3.43) 13.87 (4.17) 82.87 .001 0.35 .54 .51
Somatic 13.56 (4.14) 10.64 (4.12) 143.17 .001 0.35 .70 .65
Positive 21.42 (5.41) 18.76 (5.90) 63.97 .003 0.30 .47 .51
Negative 22.32 (5.20) 18.23 (5.90) 165.46 .001 0.33 .76 .68
Total + / − Balance −0.90 (3.61) 0.53 (3.77) 43.20 .001 0.19 .39 .17
Cognitive + / − Balance 0.22 (1.59) 0.37 (1.71) 2.29 .13 0.21 .09 .10
Affective + / − Balance −1.25 (1.89) −0.63 (2.05) 28.06 .001 0.29 .43 .21
Somatic + / − Balance 0.13 (1.89) 0.80 (2.09) 32.30 .001 0.31 .33 .17
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3.8. Demographics

The most salient relationships between empathy and demographic factors were found for age and social relationships (see Table 6). Empathy increased with age, more stable interpersonal relationships, and with increasing number of children. Regarding positive / negative balance, with increasing age, negative empathy predominated. In contrast, with increasing educational status and more stable relationships, positive empathy predominated.

Table 6.

Relationships between empathy scales and demographic factors. N = 1,142 to 1,158.

Age Income Education Relationship Status Number Children
CASES Scales
Total .22*** .08** −.02 .18*** .21***
 
Cognitive .17*** .10*** −.01 .13*** .16***
Affective .28*** .08** −.02 .18*** .23***
Somatic .15*** .03 −.01 .16*** .18***
 
Positive .18*** .08** .04 .21*** .21***
Negative .25*** .03 −.07* .13*** .20***
 
Total +/− Balance −.11*** .03 .16*** .13*** .02
Cognitive +/− Balance .00 .00 .05 .10*** .05
Affective +/− Balance −.17*** .01 .19*** .09** .00
Somatic +/− Balance −.04 .04 .07* .07* .00
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Note.

***

p < .001

**

p < .01

*

p < .05.

4. Discussion

This study aimed to establish the psychometric properties of CASES for an adult population and to investigate more substantive issues in the field of empathy. Confirmatory factors analysis supported the three-factor cognitive-affective-somatic model, together with a two-factor positive-negative empathy model, and a broader 6-factor model. These findings replicated closely from one sample to another. Internal reliability was good, ranging from .82 to .93, findings which also replicated. Construct validity was supported by expected relations with both negative and positive psychological traits, as well as robust gender differences. Somatic empathy was more strongly associated with pleasure in affective touch and gender differences. While proactive aggression was associated with reduced empathy, reactive aggression was associated with increased empathy, potentially reflecting heightened emotionality in reactively aggressive individuals. Individuals with higher psychopathy and stimulation-seeking scores were less impaired in their empathic reactions to positive valence events compared to negative events, suggesting that such individuals are relatively capable of responding to rewarding events. Taken together, findings support the utility of this brief five-minute instrument for the assessment of different forms of empathy in adults, adolescents, and children, and encourage further evaluation of the balance between positive and negative empathy.

4.1. Factor Structure of CASES

A goal of this study was to confirm the factor structure of CASES in adults and to investigate its construct validity. Regarding factor structure, confirmatory factor analyses established better model fit for both the three-factor model (cognitive, affective, somatic) and also the two-factor model (positive – negative) over the one-factor model. We achieved two levels of replication of the factor structure for CASES. First, the factor structure from our adult community Sample 1 was closely replicated in our adult community Sample 2. Second, findings in both these adult samples replicated findings from the original child sample (Raine & Chen, 2018). This two-level replication across developmental stages provides psychometric validation for what has been assumed but not demonstrated in the prior literature – that there are three meaningful and different forms of empathy (Blair, 2005). In addition, we found support for a more complex six-factor model that differentiated the three main factors in terms of positive and negative empathy, providing a significantly better fit than other models. Findings further document that differentiating between positive and negative empathy is a meaningful distinction (Van der Graaff et al., 2016). Although we recommend that initial use of CASES could focus on the three main factors and the positive / negative distinction, further investigation of all six factors would seem warranted.

4.2. Positive empathy

A secondary goal of this study concerned the relatively new and under-researched area of positive empathy. It had been hypothesized that positive empathy would be associated with positive psychology and well-being constructs, whereas negative empathy would be more associated with negative psychology constructs. This hypothesis was broadly supported. Negative empathy was most strongly associated with higher scores on psychopathy, callous-unemotional traits, reactive and proactive aggression, selfishness, schizotypy, alcohol use problems, crime, and impulsive stimulation-seeking. Positive empathy on the other hand was positively associated with positive traits. Specifically, a balance favoring more positive relative to negative empathy was significantly associated with emotional intelligence, sociability, selfcontrol, better sleep quality, more charitable donations, need to belong, close relationship status, higher level of education, pleasure in affective touch, and experiencing pleasure. As such, while both forms of empathy were associated with these variables, positive empathy showed stronger associations, providing support for the construct validity of positive empathy.

One striking finding on positive empathy is that while total TPM psychopathy and impulsive stimulation-seeking were negatively associated with both positive and negative empathy, these empathy impairments were significantly less evidenced for positive empathy. This was documented by significant positive associations between these traits and the balance of positive to negative empathy. This was particularly true for psychopathic traits of boldness (TPM) and primary psychopathy (Levenson psychopathy scale), though not for secondary psychopathy and callous-unemotional traits. This finding appears to be new in the literature and suggests that psychopathic individuals, while impaired in connecting with another person’s negative experiences, are in relative terms more capable of identifying with another person’s positive experiences. While research in this area is very scarce, one study employing laboratory measures of motor empathy found that higher psychopathy scores are associated with impairments in motor empathy to negative emotions, but not to positive emotions (Khvatskaya & Lenzenweger, 2016), suggesting some convergence with the current findings. One theoretical perspective pertinent to the current findings is the reward dominance theory of psychopathy. This perspective argues that psychopathic individuals are more drawn to rewarding contexts and situations, with rewards dominating over punishment in terms of influence (O’Brien, Frick, & Lyman, 1994; Scerbo et al., 1990). Psychopaths have been found to show increased dopamine release in the striatum in anticipation of rewards compared to controls (Buckholtz et al., 2010) as well as a volume increase in the striatum (Glenn, Raine, Yaralian, & Yang, 2010), a pivotal brain region subserving reward. The fact that a higher positive to negative empathy balance was also associated with increased stimulation-seeking gives further credence to this perspective. In this context, positive empathy has been associated with encouraging others to try out new positive experiences (Andreychik & Lewis, 2017), which would again converge with the current findings. Furthermore, the fact that a higher dominance of positive over negative empathy was particularly associated with the anticipation of pleasure (see supplemental Table S7) which itself is associated with reward responsiveness (Gard et al., 2006) also gives broad support to this reward dominance hypothesis of the positive empathy- psychopathy findings.

4.3. Somatic Empathy

Another secondary goal of this study consisted of the similarly under-researched area of somatic (motor) empathy. As anticipated, somatic empathy was found to be particularly associated with pleasure in affective touch, providing some construct validity to this form of empathy. Similarly a marked relationship was obtained between somatic empathy and need to belong which could be understood from the standpoint that need to belong has been associated with somatosensory pain (Chester, DeWall, & Pond, 2016), and as such could have in part a somatosensory basis.

Construct validity for somatic empathy was further documented with respect to gender differences. Perhaps the most striking difference concerned effects for males having lower empathy than females, with somatic empathy in Sample 1 showing the strongest effect size (d = .70) compared to cognitive empathy (d = .45) and affective empathy (d = .54), a finding replicated in Sample 2.

The primacy of somatic empathy in understanding gender differences may in part be understood within the context of evolutionary theory. Empathy has been viewed as having its roots in evolutionary processes (de Waal, 2008), and is argued to be predicated on basic neurophysiological processes (Decety, 2011). One such process, oxytocin, enhances empathy (Hurlemann et al., 2010), and it has been argued that differential evolution of brain mechanisms subserving the oxytocin system has shaped sex differences in social behavior (Caldwell, 2018). These basic neurophysiological processes may be particularly pertinent to physiological, somatic empathy which is viewed as a basic, primitive form of empathy (Blair, 2005), with motor mimicry of facial emotions in place by 3 weeks of age, a process not explained by early conditioning and appearing to be largely genetic in origin (Meltzoff & Moore, 1977). Empathy has a strong (albeit not total) genetic basis, and one large (N = 1,700) twin study has documented significantly stronger heritability for empathy in females (53%) compared to males (4%), a finding interpreted from a phylogenetic, evolutionary perspective (Toccaceli et al., 2018). The strong gender difference in somatic empathy with its basis in physiological reactivity may therefore reflects a more hard-wired, evolutionary female-male differences, although social interpretations should not be discounted.

4.4. Proactive-Reactive Aggression and Empathy

The final secondary goal of this study was to test the differential hypothesis that while higher proactive aggression scores would be associated with lower total empathy scores, reactive aggression would be associated with higher empathy. Support was obtained for this hypothesis, with proactive aggression being negatively associated with total empathy while reactive aggression was positively associated with total empathy, with effects sizes being higher for proactive (d = .58) than reactive (d = .28) aggression. These findings replicate similar findings obtained in Hong Kong schoolchildren (Fung, Gerstein, Chan, & Engebretson, 2015). Furthermore, the same findings were obtained in the original study of CASES with US schoolchildren, with reactive aggression positively associated (d=.35) and proactive aggression negative related (d= −.28) to total empathy. A third study obtained the same results in a large (N = 4,411) sample of schoolchildren (Chen, Fung, & Raine, 2021). As such, the current findings appear to be robust as these are the only four studies to date to have examined any measure of empathy in relation to reactive and proactive aggression, with all reporting significant effects in the same direction.

In the current study, findings were strongest for affective empathy (Table 2) and especially affective negative empathy (see Supplemental Table S2), suggesting that overall findings may be predominantly driven by emotional processes rather than cognitive or somatic processes. In this context, while proactive aggression has been characterized by reduced emotionality, emotion regulation, and being “cold-tempered” (Scarpa, Haden, & Tanaka, 2010), reviews of reactive aggression have emphasized emotional reactivity, poor emotion regulation, and heightened irritability (Lickley & Sebastian, 2018). These fundamental differences in emotion processing documented in prior studies of reactive and proactive aggression could be intrinsically related to differences in affective empathy. That is, reduced emotion processing in proactively aggressive individuals may result in reduced empathy, while enhanced emotionality in reactively aggressive individuals may paradoxically allow for some degree of emotional connectedness with others.

A related finding on the proactive-reactive aggression distinction consisted of a balance favoring positive empathy in proactive aggression, in stark contrast to a balance favoring negative empathy in reactive aggression. As before, these findings were more in evidence for the affective measure of positive / negative balance (see online supplement, Table S2). Proactive aggression has been more associated with psychopathy (Cima et al., 2013), while in contrast links between reactive aggression and psychopathy have been disputed (Reidy, ShelleyTremblay, & Lilienfeld, 2011). The proactive aggression – psychopathy relationship may in part have its foundation in such individuals being more attracted to positive, rewarding situations, a bias reflected in a balance favoring positive relative to negative empathy.

4.5. Limitations, Contributions, and Conclusions

Limitations of the study should be recognized. First participants were MTurk samples who tend to be more highly educated, liberal, single, and without children relative to the general US population (Casey, Chandler, Levine, Proctor, & Strolovitch, 2017). Although such samples are also argued to be more representative than face-to-face studies and to bring a reasonable degree of socio-economic and ethnic diversity (Casler, Bickel, & Hackett, 2013), future research on in-person samples could further assess generalizability of findings.. Second, we do not have longitudinal data to assess the long-term stability of CASES. Third, all findings are correlational; as such, causality cannot be inferred and any causal hypotheses (e.g. effect of better sleep quality on positive empathy) remain to be tested using experimental studies. Fourth, while we included a laboratory task (Reading the Mind in the Eyes Task), other laboratory measures of empathy would be advantageous. These limitations should be set against strengths of the study which include replication of factor structure and reliability, reasonable sample sizes, and a multidimensional assessment of empathy for all ages that includes new constructs of positive and somatic empathy.

Contributions of the current study can be viewed at a number of levels. First and foremost, they document psychometric support, in terms of factor structure and construct validity, for the use of CASES in adults. These findings provide some support for the original goal of developing one instrument that can be used with children, adolescents, and adults (Raine & Chen, 2018). The CASES instrument fills a relative void in the field as it is one of the few instruments to cover the child-to-adult age-range, and could have particular utility in family studies examining the intergenerational transmission of empathy, or longitudinal studies following children into adulthood.

A second contribution lies in a measure that not only assesses cognitive and affective empathy across ages, but also evaluates two under-researched areas – positive and somatic empathy. For example, CASES could have utility in functional brain imaging research on positive empathy. There has been considerable growth in this research over the past two decades, with one meta-analysis documenting that vicarious rewards, as compared to non-empathic personal rewards, preferentially activate the dorsomedial prefrontal cortex and the posterior superior temporal sulcus which are both involved in mentalizing and mirroring (Morelli, Sacchet, et al., 2015). This body of research however has generally not made use of trait measures of positive and negative empathy. Future research could utilize such measures to delineate further the functional neuroanatomy of trait expressions for positive empathy alongside structural correlates, which may include the dorsomedial prefrontal cortex and posterior superior temporal sulcus, together with the ventromedial prefrontal cortex, amygdala and striatum which have also been implicated in vicarious reward (Mirabito et al., 2019; Morelli, Sacchet, et al., 2015).

Third, the finding that the link between empathy and aggression differs markedly as a function of whether the aggression in question is reactive or proactive helps to clarify why prior findings on aggression-empathy associations have been so mixed (Vachon, Lynam, & Johnson, 2014). It also provides a new avenue for this area of research to explore, given that adaptive and functional characteristics of proactively aggressive individuals are very much the exception rather than the rule. Similarly, findings provide a novel perspective on other negative psychological traits (psychopathy, crime, reactive aggression, impulsive stimulation-seeking), highlighting that they are characterized more by an inability to empathize in negative contexts than in positive contexts. This knowledge in turn could have possible intervention implications for these negative traits by potentially focusing on enhancing that aspect of empathy (positive) that is least impaired. Our current knowledge on how positive empathy can be enhanced is extremely limited, although the fact that we found enhanced sleep quality to be associated with a balance favoring positive over negative empathy (see Table 3) suggests one health intervention that could be pursued.

In conclusion, this study documents the utility of the same 30-item instrument to assess empathy in adults that can be also used for children and adolescents, covering not just cognitive and affective empathy, but also positive, negative, and somatic empathy, and the balance between positive and negative empathy. Prior work on empathy has been strongly focused on negative affective empathy. It is hoped that CASES will facilitate the broadening of past important prior research on affective and cognitive empathy into the less-developed arenas of positive and somatic empathy. The ultimate promise of positive empathy is that it can serve to enhance positive emotions and feelings in oneself and others, promoting a contagion of positive mood and well-being, and potentially be of value in promoting positive mental health.

Supplementary Material

mmc1

Highlights.

  • Positive and somatic empathy are under-researched

  • CASES assesses cognitive, affective, somatic, positive and negative empathy

  • Psychopathic and stimulation-seeking individuals are less impaired in positive empathy

  • Gender differences are strongest for somatic empathy

  • Construct validity is documented for this adult measure of empathy

Footnotes

Declaration of Interest: None

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Contributor Information

Adrian Raine, University of Pennsylvania.

Frances R. Chen, Georgia State University

Rebecca Waller, University of Pennsylvania.

References

  1. Andreychik MR, & Lewis E. (2017). Will you help me to suffer less? How about to feel more joy? Positive and negative empathy are associated with different other-oriented motivations. Personality and Individual Differences, 105, 139–149. [Google Scholar]
  2. Barbor T, Higgins-Biddle J, Saunders J, & Montero M. (2001). AUDIT-the alcohol use disorders identification test. Guidelines for Use in Primary Care. Second Edition, WHO. [Google Scholar]
  3. Baron-Cohen S, Wheelwright S, Hill J, Raste Y, & Plumb I. (2001). The “Reading the Mind in the Eyes” test revised version: A study with normal adults, and adults with Asperger syndrome or high-functioning autism. Journal of Child Psychology and Psychiatry and Allied Disciplines, 42(2), 241–251. [PubMed] [Google Scholar]
  4. Blair RJR (2005). Responding to the emotions of others: Dissociating forms of empathy through the study of typical and psychiatric populations. Consciousness and Cognition, 14(4), 698–718. [DOI] [PubMed] [Google Scholar]
  5. Browne MW, & Cudeck R. (1993). Alternative ways of assessing model fit. In Bollen KA & Long JS (Eds.), Testing structural equation models (pp. 136–162). Newbury Park, CA: Sage. [Google Scholar]
  6. Buckholtz JW, Treadway MT, Cowan RL, Woodward ND, Benning SD, Li R, . . . Zald DH. (2010). Mesolimbic dopamine reward system hypersensitivity in individuals with psychopathic traits. Nature Neuroscience, 13(4), 419–421. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Byrd AL, Kahn RE, & Pardini DA (2013). A validation of the Inventory of Callous-Unemotional Traits in a community sample of young adult males. Journal of psychopathology and behavioral assessment, 35(1), 20–34. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Caldwell HK (2018). Oxytocin and sex differences in behavior. Current Opinion in Behavioral Sciences, 23, 13–20. doi: 10.1016/j.cobeha.2018.02.002 [DOI] [Google Scholar]
  9. Casey LS, Chandler J, Levine AS, Proctor A, & Strolovitch DZ (2017). Intertemporal differences among MTurk workers: Time-based sample variations and implications for online data collection. SAGE Open, 7(2), 2158244017712774. [Google Scholar]
  10. Casler K, Bickel L, & Hackett E. (2013). Separate but equal? A comparison of participants and data gathered via Amazon’s MTurk, social media, and face-to-face behavioral testing. Computers in Human Behavior, 29(6), 2156–2160. [Google Scholar]
  11. Chen FR, Fung ALC, & Raine A. (2021). The cognitive, affective, and somatic empathy scales (CASES): Cross-cultural replication and specificity to different forms of aggression and victimization. Journal of Personality Assessment, 103, 80–91. doi: 10.1080/00223891.2019.1677246 [DOI] [PubMed] [Google Scholar]
  12. Chester DS, DeWall CN, & Pond RS (2016). The push of social pain: Does rejection’s sting motivate subsequent social reconnection? Cognitive Affective & Behavioral Neuroscience, 16(3), 541–550. doi: 10.3758/s13415-016-0412-9 [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Cima M, & Raine A. (2009). Distinct characteristics of psychopathy relate to different subtypes of aggression. Personality and Individual Differences, 47(8), 835–840. [Google Scholar]
  14. Cima M, Raine A, Meesters C, & Popma A. (2013). Validation of the Dutch Reactive Proactive Questionnaire (RPQ): Differential Correlates of Reactive and Proactive Aggression From Childhood to Adulthood. Aggressive Behavior, 39(2), 99–113. [DOI] [PubMed] [Google Scholar]
  15. Costa PT, & Mccrae RR (1992). Revised NEO Personality Inventory (NEO-PI-R) and NEO Five-Factor Inventory (NEO-FFI) Professional Manual. Retrieved from Odessa, FL: [Google Scholar]
  16. de Waal FBM (2008). Putting the altruism back into altruism: The evolution of empathy. Annual Review of Psychology, 59, 279–300. doi: 10.1146/annurev.psych.59.103006.093625 [DOI] [PubMed] [Google Scholar]
  17. Decety J. (2011). Dissecting the Neural Mechanisms Mediating Empathy. Emotion Review, 3(1), 92–108. [Google Scholar]
  18. Dotterer HL, Waller R, Neumann CS, Shaw DS, Forbes EE, Hariri AR, & Hyde LW (2017). Examining the Factor Structure of the Self-Report of Psychopathy Short-Form Across Four Young Adult Samples. Assessment, 24(8), 1062–1079. doi: 10.1177/1073191116640355 [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Fernandez-Abascal EG, & Martin-Diaz MD (2019). Relations Between Dimensions of Emotional Intelligence, Specific Aspects of Empathy, and Non-verbal Sensitivity. Frontiers in Psychology, 10. doi: 10.3389/fpsyg.2019.01066 [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Fonseca-Pedrero E, Paino M, Lemos-Giraldez S, Sierra-Baigrie S, & Muniz J. (2011). Measurement invariance of the Schizotypal Personality Questionnaire-Brief across gender and age. Psychiatry Research, 190(2–3), 309–315. [DOI] [PubMed] [Google Scholar]
  21. Frick PJ (2004). Inventory of callous-unemotional traits. Unpublished Manuscript, University of New Orleans. [Google Scholar]
  22. Gao Y, & Zhang W. (2016). Confirmatory Factor Analyses of Self- and Parent- Report Inventory of Callous-Unemotional Traits in 8-to 10-Year-Olds. Journal of Psychopathology and Behavioral Assessment, 38(3), 331–340. doi: 10.1007/s10862-015-9527-5 [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Gard DE, Gard MG, Kring AM, & John OP (2006). Anticipatory and consummatory components of the experience of pleasure: A scale development study. Journal of Research in Personality, 40(6), 1086–1102. [Google Scholar]
  24. Glenn AL, Raine A, Yaralian PS, & Yang YL (2010). Increased Volume of the Striatum in Psychopathic Individuals. Biological Psychiatry, 67(1), 52–58. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Guadagni V, Burles F, Ferrara M, & Iaria G. (2018). Sleep quality and its association with the insular cortex in emotional empathy. European Journal of Neuroscience, 48(6), 2288–2300. doi: 10.1111/ejn.14124 [DOI] [PubMed] [Google Scholar]
  26. Hall JR, Drislane LE, Patrick CJ, Morano M, Lilienfeld SO, & Poythress NG (2014). Development and Validation of Triarchic Construct Scales From the Psychopathic Personality Inventory. Psychological Assessment, 26(2), 447–461. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Harty L, Forkner RD, Thompson A, Stuewig J, & Tangney JP (2010). Are inmates’ subjective sleep problems associated with borderline personality, psychopathy, and antisocial personality independent of depression and substance dependence? Journal of Forensic Psychiatry & Psychology, 21(1), 23–38. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Hu L, & Bentler PM (1998). Fit indices in covariance structure modeling: Sensitivity to under-parametized model mis-specification. Psychological Methods, 3, 424–453. [Google Scholar]
  29. Hurlemann R, Patin A, Onur OA, Cohen MX, Baumgartner T, Metzler S, . . . Kendrick KM. (2010). Oxytocin Enhances Amygdala-Dependent, Socially Reinforced Learning and Emotional Empathy in Humans. Journal of Neuroscience, 30(14), 4999–5007. doi: 10.1523/jneurosci.5538-09.2010 [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Johns MW (1991). A new measure for measuring daytime sleepiness - The Epworth Sleepiness Scale. Sleep, 14(6), 540–545. doi: 10.1093/sleep/14.6.540 [DOI] [PubMed] [Google Scholar]
  31. Khvatskaya Y, & Lenzenweger MF (2016). Motor Empathy in Individuals with Psychopathic Traits: A Preliminary Study. Journal of Personality Disorders, 30(5), 613–632. [DOI] [PubMed] [Google Scholar]
  32. Laborde S, Allen MS, & Guillen F. (2016). Construct and concurrent validity of the short- and long-form versions of the trait emotional intelligence questionnaire. Personality and Individual Differences, 101, 232–235. doi: 10.1016/j.paid.2016.06.009 [DOI] [Google Scholar]
  33. Lamm C, & Majdandzic J. (2015). The role of shared neural activations, mirror neurons, and morality in empathy - A critical comment. Neuroscience Research, 90, 15–24. doi: 10.1016/j.neures.2014.10.008 [DOI] [PubMed] [Google Scholar]
  34. Lapin BR, Bena JF, Walia HK, & Moul DE (2018). The Epworth Sleepiness Scale: Validation of One-Dimensional Factor Structure in a Large Clinical Sample. Journal of Clinical Sleep Medicine, 14(8), 1293–1301. doi: 10.5664/jcsm.7258 [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Leary MR, Kelly KM, Cottrell CA, & Schreindorfer LS (2013). Construct Validity of the Need to Belong Scale: Mapping the Nomological Network. Journal of Personality Assessment, 95(6), 610–624. [DOI] [PubMed] [Google Scholar]
  36. Levenson MR, Kiehl KA, & Fitzpatrick CM (1995). Assessing psychopathic attributes in a noninstitutionalized population. Journal of Personality and Social Psychology, 68(1), 151–158. doi: 10.1037/0022-3514.68.1.151 [DOI] [PubMed] [Google Scholar]
  37. Lickley RA, & Sebastian CL (2018). The neural basis of reactive aggression and its development in adolescence. Psychology Crime & Law, 24(3), 313–333. [Google Scholar]
  38. Meltzoff AN, & Moore MK (1977). Imitation of facial and manual gestures by human neonates. Science, 198(4312), 75–78. doi: 10.1126/science.198.4312.75 [DOI] [PubMed] [Google Scholar]
  39. Mirabito G, Taiwo Z, Bezdek M, & Light SN (2019). Fronto-striatal activity predicts anhedonia and positive empathy subtypes. Brain Imaging and Behavior, 13(6), 1554–1565. [DOI] [PubMed] [Google Scholar]
  40. Morelli SA, Lieberman MD, & Zaki J. (2015). The Emerging Study of Positive Empathy. Social and Personality Psychology Compass, 9(2), 57–68. [Google Scholar]
  41. Morelli SA, Sacchet MD, & Zaki J. (2015). Common and distinct neural correlates of personal and vicarious reward: A quantitative meta-analysis. Neuroimage, 112, 244–253. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Muthén LK, & Muthén BO (2019). Mplus User’s Guide (8th Ed.). Los Angeles, CA: Muthén & Muthén. [Google Scholar]
  43. Neumann CS, & Pardini D. (2014). Factor strucure and construct validity of the Self-Report Psychopathy (SRP) scale and the Youth Psychopathic Traits Inventory in young men. Journal of Personality Disorders, 28(3), 419–433. doi: 10.1521/pedi_2012_26_063 [DOI] [PubMed] [Google Scholar]
  44. O’Brien BS, Frick PJ, & Lyman RD (1994). Reward dominance among children with disruptive behavior disorders. Journal of Psychopathology and Behavioral Assessment, 16(2), 131–145. doi: 10.1007/bf02232724 [DOI] [Google Scholar]
  45. Patrick CJ (2010). Operationalizing the Triarchic conceptualization of psychopathy: Preliminary description of brief scales for assessment of boldness, meanness, and disinhibition. Retrieved from Tallahassee, FL: [Google Scholar]
  46. Paulhus DL, Neumann CS, Hare RD, Williams K, & Hemphill J. (2016). Self-Report Psychopathy Scale 4th edition-technical manual. Toronto, Canada: Multi-Health Systems. [Google Scholar]
  47. Pechorro P, DeLisi M, Goncalves RA, Quintas J, & Hugo Palma V. The Brief Self-Control Scale and Its Refined Version among Incarcerated and Community Youths: Psychometrics and Measurement Invariance. Deviant Behavior. doi: 10.1080/01639625.2019.1684942 [DOI] [Google Scholar]
  48. Petrides KV (2009). Psychometric properties of the trait emotional intelligence questionnaire (TEIQue). In Stough C. (Ed.), Assessing emotional intelligence (pp. 85–101). New York: Springer. [Google Scholar]
  49. Raine A, & Benishay D. (1995). The SBQ-B: A brief screening instrument for schizotypal personality disorder. Journal of Personality Disorders, 9(4), 346–355. doi: 10.1521/pedi.1995.9.4.346 [DOI] [Google Scholar]
  50. Raine A, & Chen FR (2018). The Cognitive, Affective, and Somatic Empathy Scales (CASES) for Children. Journal of Clinical Child and Adolescent Psychology, 47(1), 24–37. [DOI] [PubMed] [Google Scholar]
  51. Raine A, Dodge K, Loeber R, Gatzke-Kopp L, Lynam D, Reynolds C, . . . Liu JH. (2006). The reactive-proactive aggression questionnaire: Differential correlates of reactive and proactive aggression in adolescent boys. Aggressive Behavior, 32(2), 159–171. [DOI] [PMC free article] [PubMed] [Google Scholar]
  52. Raine A, & Uh S. (2019). The Selfishness Questionnaire: Egocentric, Adaptive, and Pathological Forms of Selfishness. Journal of Personality Assessment, 101(5), 503–514. doi: 10.1080/00223891.2018.1455692 [DOI] [PubMed] [Google Scholar]
  53. Ray JV, & Frick PJ (2018). Assessing callous-unemotional traits using the total score from the inventory of callous-unemotional traits: A meta-analysis. Journal of Clinical Child & Adolescent Psychology, 1–10. [DOI] [PubMed] [Google Scholar]
  54. Reidy DE, Shelley-Tremblay JF, & Lilienfeld SO (2011). Psychopathy, reactive aggression, and precarious proclamations: A review of behavioral, cognitive, and biological research. Aggression and Violent Behavior, 16(6), 512–524. doi: 10.1016/j.avb.2011.06.002 [DOI] [Google Scholar]
  55. Reinert DF, & Allen JP (2007). The Alcohol Use Disorders Identification Test: An update of research findings. Alcoholism-Clinical and Experimental Research, 31(2), 185–199. doi: 10.1111/j.1530-0277.2006.00295.x [DOI] [PubMed] [Google Scholar]
  56. Salekin RT, Chen DR, Sellbom M, Lester WS, & MacDougall E. (2014). Examining the Factor Structure and Convergent and Discriminant Validity of the Levenson Self-Report Psychopathy Scale: Is the Two-Factor Model the Best Fitting Model? Personality Disorders-Theory Research and Treatment, 5(3), 289–304. doi: 10.1037/per0000073 [DOI] [PubMed] [Google Scholar]
  57. Scarpa A, Haden SC, & Tanaka A. (2010). Being hot-tempered: Autonomic, emotional, and behavioral distinctions between childhood reactive and proactive aggression. Biological Psychology, 84(3), 488–496. [DOI] [PubMed] [Google Scholar]
  58. Scerbo A, Raine A, O’Brien M, Chan CJ, Rhee C, & Smiley N. (1990). Reward dominance and passive avoidance learning in adolescent psychopaths. Journal of Abnormal Child Psychology, 18(4), 451–463. [DOI] [PubMed] [Google Scholar]
  59. Seligman MEP, & Csikszentmihalyi M. (2000). Positive psychology - An introduction. American Psychologist, 55(1), 5–14. doi: 10.1037/0003-066x.56.1.89 [DOI] [PubMed] [Google Scholar]
  60. Sellbom M. (2011). Elaborating on the Construct Validity of the Levenson Self-Report Psychopathy Scale in Incarcerated and Non-Incarcerated Samples. Law and Human Behavior, 35(6), 440–451. doi: 10.1007/s10979-010-9249-x [DOI] [PubMed] [Google Scholar]
  61. Sellbom M, & Phillips TT (2013). An examination of the triarchic conceptualization of psychopathy in incarcerated and nonincarcerated samples. Journal of Abnormal Psychology, 122, 208–214. [DOI] [PubMed] [Google Scholar]
  62. Shamay-Tsoory SG (2011). The Neural Bases for Empathy. Neuroscientist, 17(1), 18–24. doi: 10.1177/1073858410379268 [DOI] [PubMed] [Google Scholar]
  63. Simon JJ, Zimmermann J, Cordeiro SA, Maree I, Gard DE, Friederich HC, . . . Kaiser S. (2018). Psychometric evaluation of the Temporal Experience of Pleasure Scale (TEPS) in a German sample. Psychiatry Research, 260, 138–143. doi: 10.1016/j.psychres.2017.11.060 [DOI] [PubMed] [Google Scholar]
  64. Tangney JP, Baumeister RF, & Boone AL (2004). High self-control predicts good adjustment, less pathology, better grades, and interpersonal success. Journal of Personality, 72(2), 271–324. [DOI] [PubMed] [Google Scholar]
  65. Telle NT, & Pfister HR (2016). Positive Empathy and Prosocial Behavior: A Neglected Link. Emotion Review, 8(2), 154–163. [Google Scholar]
  66. Toccaceli V, Fagnani C, Eisenberg N, Alessandri G, Vitale A, & Stazi MA (2018). Adult Empathy: Possible Gender Differences in Gene-Environment Architecture for Cognitive and Emotional Components in a Large Italian Twin Sample. Twin Research and Human Genetics, 21(3), 214–226. doi: 10.1017/thg.2018.19 [DOI] [PubMed] [Google Scholar]
  67. Vellante M, Baron-Cohen S, Melis M, Marrone M, Petretto DR, Masala C, & Preti A. (2013). The “Reading the Mind in the Eyes” test: Systematic review of psychometric properties and a validation study in Italy. Cognitive Neuropsychiatry, 18(4), 326–354. doi: 10.1080/13546805.2012.721728 [DOI] [PMC free article] [PubMed] [Google Scholar]
  68. Waller R, Corbett N, Raine A, Wagner NJ, Broussard A, Edmonds D, . . . Neumann CS. (in press). Reduced sensitivity to affiliation and psychopathic traits. Personality Disorders: Theory, Research, and Treatment. [DOI] [PubMed] [Google Scholar]
  69. Zuckerman M, & Kuhlman DM (2000). Personality and risk-taking: Common biosocial factors. Journal of Personality, 68(6), 999–1029. doi: 10.1111/1467-6494.00124 [DOI] [PubMed] [Google Scholar]
  70. Zuckerman M, Kuhlman DM, Joireman J, Teta P, & Kraft M. (1993). A comparison of three structural models for personality: The big three, the big five, and the alternative five. Journal of Personality and Social Psychology, 65, 757–768. [Google Scholar]

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