This article reviews concepts of, as well as neurocognitive and genetic studies on, empathy. Whereas cognitive empathy can be equated with affective theory of mind, that is, with mentalizing the emotions of others, affective empathy is about sharing emotions with others. The neural circuits underlying different forms of empathy do overlap but also involve rather specific brain areas for cognitive (ventromedial prefrontal cortex) and affective (anterior insula, midcingulate cortex, and possibly inferior frontal gyrus) empathy. Furthermore, behavioral and imaging genetic studies (...) provide evidence for a genetic basis for empathy, indicating a possible role for oxytocin and dopamine as well as for a genetic risk variant for schizophrenia near the gene ZNF804A. (shrink)
Walter applies the methodology of neurophilosophy to one of philosophy's centralchallenges, the notion of free will. Neurophilosophical conclusions are based on, and consistentwith, scientific knowledge about the brain and its functioning.
Decisions about brain surgery pose existential challenges because they are often decisions about life or death, and sometimes about possible personality changes. Therefore they require rigorous neuroethical consideration. However, we doubt whether metaphysical interpretations of ambiguous statements of patients are useful for deriving ethical and legal conclusions. Particularly, we question the application of psychological theories of personal identity on neuroethical issues for several reasons. First, even the putative “standard view” on personal identity is contentious. Second, diverse accounts of personal identity (...) have been introduced into the neuroethical debate, which are incompatible. Third, the criteria for “diagnosing” the supposed changes in “identity” are ambiguous and indeterminate. Fourth, the metaphysical theories of personal identity imply highly questionable ethical and legal revisions, namely the denial of advance directives, particularly of Ulysses contracts, and, for patients with brain cancer, even therapeutic nihilism.We discuss three examples in which ideas from the personal identity debate in metaphysics are straightforwardly applied to discuss ethical issues of neurosurgery. We discuss revisions of the current medico-legal practice that have been proposed on grounds of psychological theories of personal identity. We argue that the established status quo in law and clinical practice is beneficial to the patients concerned. Furthermore, it is metaphysically neutral, which is an important principle of liberal, democratic, pluralistic societies.We recommend a pragmatic approach: empirical research on personality changes arising from brain disorders or interventions, comprehensive information about risks of personality changes, and advance directives, particularly Ulysses contracts. (shrink)
Beauchamp and Childress have performed a great service by strengthening the principle of respect for the patient's autonomy against the paternalism that dominated medicine until at least the 1970s. Nevertheless, we think that the concept of autonomy should be elaborated further. We suggest such an elaboration built on recent developments within the neurosciences and the free will debate. The reason for this suggestion is at least twofold: First, Beauchamp and Childress neglect some important elements of autonomy. Second, neuroscience itself needs (...) a conceptual apparatus to deal with the neural basis of autonomy for diagnostic purposes. This desideratum is actually increasing because modern therapy options can considerably influence the neural basis of autonomy itself.Sabine MNeuroScienceAndNorms: Ethical and Legal Aspects of Norms in Neuroimaging at Bonn University Hospital, Germany. Her main research interests are in neuroethics. She is coauthor of three German books about neuroethics and bioethics.Henrik Walter, M.D., Ph.D., is Full Professor of Medical Psychology at the University of Bonn, Germany, and vice-director of the Department of Psychiatry and Psychotherapy at the University Clinic of Bonn. He is author of Neurophilosophy of Free Will and editor of the book From Neuroethics to Neurolaw?. His research fields are biological psychiatry, cognitive neuroscience, neuroimaging, neurophilosophy, and neuroethics. (shrink)
Neuroscientific research on empathy has made much progress recently. How far can we get and how should we do it? Two different routes have been suggested by Dziobek and Jacobs in their commentaries. The first is becoming ecologically more valid by using real-life settings as stimuli. The second is becoming more quantitative by specifying a neurocognitive model, allowing more precise quantitative predictions. Although neither approaches are mutually exclusive, I suggest that these two routes are in a certain tension to each (...) other. I suggest an additional third, more indirect way, namely studying modulating factors of empathy like emotion regulation which have until now been largely neglected in empathy research. (shrink)
In his article, "Delusion, Reality, and Inter-subjectivity," Thomas Fuchs gives an "enactivist" account of how primary delusions in early schizophrenia evolve. First, subjects experience the "loss of familiar, commonsensical meanings"—known as delusional mood. Consecutively they experience new "revelatory significances," in perception as well as in social interaction, with all experiences becoming radically "subjectivized." Out of these "uncanny, spurious and made" experiences delusions develop. Suddenly the formerly uncanny experiences make sense. This new subjective reality, however, is "rigid." Subjects are no longer (...) able to take on different perspectives. The usually present, shared reality we live by is lost.... (shrink)
Attachment is the way we relate to others. The way we attach to others is developed early in childhood, can be impaired by early traumatic life events, and is disturbed in many psychiatric disorders. Here we give a short overview about attachment patterns in psychiatric disorders with a focus on depression, and discuss two recent empirical studies of our own that have investigated attachment related brain activation using fMRI. In the first study with patients with borderline personality disorder we used (...) a paradigm in which patients produced narratives in response to attachment pictures and measured brain activity while participants were talking. Our results are consistent with the view that BPD pathology might be correlated with traumatic attachment fear related to autobiographic abuse and loss experiences. In the second study we investigated patients with major depression undergoing therapy in a longitudinal design. In this study we used a design with individualized stimuli that were extracted from narratives produced outside of the scanner. We found that patients, as compared to healthy controls, showed differences in a pre-post comparison. The significant correlation of changes in the subgenual cingulate and medial prefrontal cortex with symptom improvement provides evidence that these regions are involved in mediating therapy related effects. (shrink)
Extensive research has demonstrated that rs1360780, a common single nucleotide polymorphism within the FKBP5 gene, interacts with early-life stress in predicting psychopathology. Previous results suggest that carriers of the TT genotype of rs1360780 who were exposed to child abuse show differences in structure and functional activation of emotion-processing brain areas belonging to the salience network. Extending these findings on intermediate phenotypes of psychopathology, we examined if the interaction between rs1360780 and child abuse predicts resting-state functional connectivity between the amygdala and (...) other areas of the salience network. We analyzed data of young European adults from the general population who took part in the IMAGEN study. In the absence of main effects of genotype and abuse, a significant interaction effect was observed for rsFC between the right centromedial amygdala and right posterior insula, which was driven by stronger rsFC in TT allele carriers with a history of abuse. Our results suggest that the TT genotype of rs1360780 may render individuals with a history of abuse more vulnerable to functional changes in communication between brain areas processing emotions and bodily sensations, which could underlie or increase the risk for psychopathology. (shrink)