COMPRENDERE L'EMPATIA NELLE DIMENSIONI INTRAPERSONALE E INTERPERSONALE DA UNA PROSPETTIVA INCARNATA: UNA RACCOLTA DI STUDI

The present doctoral project aims, across five empirical studies, two systematic reviews, and one theoretical and methodological proposal, at deepening the intraindividual and interindividual dimensions of empathy within the construct of embodiment. Intraindividual empathy has been studied, in the first empirical study, from the perspective of one of its hormonal correlates, i.e., testosterone, in 18 patients affected by Kennedy’s disease. In such an EEG study, results revealed a significant increase in neural reactivity (pcorr = 0.019) in terms of experience sharing (construct close to affective empathy) 0–350 ms post-stimulus, with respect to 18 non-clinical male healthy subjects. The first PRISMA systematic review, on the main neurodegenerative diseases (of 528 screened studies, 39 fulfilled inclusion and exclusion criteria), confirmed that each facet of empathy probably has a morpho-functional peculiar layout thus confirming the somatic perspective as a potentially unifying framework to outline the plethora of constructs that are comprehended under the term “empathy.” In the second empirical study, empathy, in its self- and other-oriented components, has been studied in a psychiatric sample of 59 consecutively recruited inpatients. Comparison of multinomial models revealed how self-oriented empathy was the best predictor of the levels of personality organization, as evaluated by the PDM-2, explaining data 25 times better than the null model. Contrary to the hypothesis, no association with somatizations aspects has been found. The other five investigations were devoted to the interpersonal perspective of empathy. Specifically, the second PRISMA systematic review aimed at identifying the constructs and the definition of such perspective on empathy and its associations with somatic components. From a total of 127 screened articles, the 17 included reports allowed us to infer that the best term to use, and that has been used throughout my thesis, is the one of “interpersonal empathy.” Unfortunately, none of the screened records investigated its somatic counterparts. 2 Therefore, in the third empirical study, we started validating a self-report questionnaire measuring interpersonal empathy based on the three empathy components by Zaki and Ochsner (2012): the affective, cognitive, and prosocial ones. Ninety-two interacting dyads participated, and their interactions were audio and video recorded. The questionnaire, in its state and trait versions, seems to have good psychometric proprieties although its validation isn’t concluded yet. We then conducted three more empirical studies, (Study 6A, 6B, and 7) in which 17 sessions of different therapies and a whole therapy of 16 sessions have been video registered and both members of the therapeutic dyad had their physiological signals acquired. In these studies, we hypothesised higher dyadic physiological synchronization (PS) would correspond to moment of high interpersonal affective empathy. Physiological acquisition was done through BIOPAC wireless acquisition device; therapist’s interventions were categorized with the Psychodynamic Intervention Rating Scale (PIRS; Cooper et al., 2002) and patient’s responses with the Therapeutic Collaboration Coding System (TCCS; E. Ribeiro et al., 2013). Briefly, results have essentially confirmed our hypothesis by indicating higher levels of PS when therapists’ interventions were of Reflections or Associations PIRS categories, and when patient’s responses were of Safety TCCS category. PS has therefore been confirmed as a possible somatic marker of interpersonal affective empathy and, for the first time in literature, also through the use of coding systems on the verbatim transcripts of therapeutic sessions. Finally, in a proposal, we outlined a neural model engaging both the central and the peripheral nervous system, by considering mirror mechanisms and assigning a crucial role to oxytocin.