Empathy has been conceptualized as comprising a cognitive and an emotional component, the latter being further\ndivided into direct and indirect aspects, which refer, respectively, to the explicit evaluation of the observerâ??s feelings while\nattending someone in an emotional situation and to the physiological response of the observer. Empathy has been previously\ninvestigated in several neurological disorders. Objective. This study is aimed at investigating empathy in patients with spinal\ncord injury (SCI). We hypothesize that, due to deafferentation following their injury, SCI patients will display difficulty in the\nprocessing of emotional stimuli and blunted empathic responses as compared to healthy controls. Materials and Methods. 20\npatients with spinal cord injury (SCI) (12 males and 8 females, mean age = 50 9, standard deviation SD = 16 1 years; mean educati 9, SD = 4 1 years) were included in the study and compared to 20 matched healthy subjects. Participants were\ninvestigated using the State-Trait Anxiety Inventory (Form Y) (STAI-Y), the Beck Depression Scale, and the Toronto\nAlexithymia Scale. Moreover, participants were further evaluated by means of the Interpersonal Reactivity Index (IRI), which\nexplores both cognitive and emotional aspects of empathy, and through an experimental protocol based on the use of a\nmodified version of the computerized Multifaceted Empathy Test (MET) to evaluate emotional (direct and indirect) empathy\nand the ability to judge the valence of complex emotional scenes. Results. As compared to healthy controls, SCI patients\nreported higher scores on the Perspective-Taking subscale of the IRI, while, on the modified MET, they were less accurate in\nidentifying the valence of neutral scenes, notwithstanding their spared direct and indirect emotional empathy ability.\nFurthermore, we found a significant negative correlation between the time interval since injury and the direct emotional\nempathy scores on the positive images, as well as a negative correlation with the indirect emotional empathy scores on both\npositive and neutral images, indicating a blunting of the empathic responses as time elapses. Conclusion. Results suggest that\nSCI patients, when analyzing the meaning of emotional stimuli, tend to rely on a cognitive empathy strategy rather than on\nemotion simulation.
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