Empathy in Schizotypy: Exploring Differential Deficits in Cognitive and Affective Empathy, Potential Mechanisms, and Impacts on Social Connectedness

Higher empathy is associated with better interpersonal and social functioning; areas in which we often observe deficits in individuals with schizophrenia spectrum disorders or elevated schizotypal traits. Unfortunately, there is limited research on empathy in these populations. What does exist often utilizes problematic measures and conceptualizations of empathy. Further, empirical literature often fails to acknowledge the heterogeneity of schizophrenia and schizotypy, and thus differential impacts across subtypes. This study sought to examine differential deficits in cognitive empathy, emotion contagion, and emotional responsiveness to others, among individuals with high positive, negative, and disorganized schizotypy. Alexithymia and distress tolerance were explored as potential mediators of these relationships. Downstream effects on social connectedness were also examined. A sample of 824 college students completed a series of self-report questionnaires on schizotypy, empathy, alexithymia, distress tolerance, and social connectedness. Results of a mediation model revealed that elevations in positive schizotypy did not uniquely predict deficits in empathy or social connectedness. Negative and disorganized schizotypy both uniquely predicted lower cognitive empathy, which was mediated by greater alexithymia. Negative schizotypy contributed to lower emotion contagion, which was mediated by pathways involving alexithymia and cognitive empathy. Significant decreases in distress tolerance among those with high disorganized schizotypy ultimately contributed to a net increase in emotion contagion. This same pattern of results was revealed with responsiveness to others. Cognitive empathy was the only facet of empathy that uniquely contributed to decreased social connectedness in those with high negative and disorganized schizotypy. A secondary analysis utilizing multiple regression revealed that individuals who may be at elevated risk for later development of a schizophrenia spectrum diagnosis (the top 10% of schizotypy scorers), generally had the same predictors of empathy and social connectedness as the middle 60% of the sample. Clinical implications and future research directions are discussed