Abstract

Empathy is associated with a reduced antisocial and increasing prosocial behavior. In this study empathy and prosocial behavior are investigated in response to sadness and distress in ODD / CD and ADHD. Six and seven year olds with ODD / CD (with / without ADHD) and with ADHD alone were compared with normally developing (NO) children. Parents and teachers indicated the degree of affective empathy of children in response to sadness and distress on a scale. Children indicated this on the basis of sad story vignettes. Compared to children with NO, children with ODD / CD and ADHD scored less highly in terms of empathy by teachers, but not by parents. Children with ODD / CD showed less prosocial behavior in response to sadness and distress compared to NO children. Children with ADHD alone did not differ from NO children. When all children with a disorder were compared with the NO children, it was found that the difference in prosocial behavior continued to exist when the ADHD symptoms were checked, but not when the ODD / CD symptoms were checked. The reduced empathy-driven prosocial behavior in response to sadness and distress in young children with ODD / CD shows that interventions should focus on increasing prosocial behavior in these children.

Introduction

Empathy is described as the ability to understand and share emotions of others with people with whom we interact. This consists of an emotional and cognitive component. Empathically related reactions are often associated with prosocial behavior and contribute to the inhibition of antisocial and aggressive behavior. The explanation for this is often sought in the central role in showing sadness and distress in the inhibition of aggressive behavior. Prosocial behavior has no direct material benefits for the person who positions himself like that. For example, when children hurt each other and see sadness and distress in the other, they also get into the same state and stop unwanted behavior to restore their own personal state.

In children and adolescents, deficiencies in empathy are known by ODD / CD. Disorders related to oppositional, distant, and antisocial behaviors. Cognitive empathy often seemed intact. It seems that a reduction in sharing feelings of sadness and distress in others is related to disruptive and aggressive behavior in children and adolescents. However, a number of things still need to be clarified:

• The study of affective empathy response patterns in response to signs of sadness and distress in others

• Research into prosocial behavior in a clinical sample of children with ODD / CD diagnoses

• Research into the influence of ADHD on emotional perception and processing in children with ODD / CS

• The investigation into whether empathy deficiencies are already visible at a younger age than school-going children and adolescents

The current study examines:

• Comparison between parent and teacher reports of affective empathy

• Measuring affective empathy in response to sad vignettes in children

• Determining empathy-induced prosocial behavior by means of a computer task with sample NO children in comparison with ODD / CD (with / without ADHD) and ADHD

It is expected that 6/7 year olds with a diagnosis score less highly on the empathy indicated by parents and teachers, show less affective empathy with the vignettes and show less prosocial behavior in comparison with NO children. In addition, the clinical group is expected to show less empathy and prosocial behavior that this difference persisted even after controlling ADHD symptoms, but not when checking for ODD / CD symptoms.

Method

Attendees

37 NO children were compared with 93 children between 6 and 7 years old with a clinical diagnosis of ODD / CD and / or ADHD.

Procedure

The interview with parents was conducted at home, as well as the CBCL. Teachers completed the TRF and the GEM. The data of the children was obtained in a quiet room with the children at school.

Measuring instruments

DISC: parent version to separate clinical group (ie: ADHD only, ODD / CD only or comorbid). GEM: both parents and teacher data. A questionnaire to clarify the empathy of children. Story Task: 8 short stories with different emotions (angry, happy, sadness or fear), each emotion has 2 stories. 2 sad stories were used here. The story was followed by an interview with the child to see if the emotion was recognized and shared. IRT: computer task that registers prosocial behavior within a social context. This was a ball throw game.

Results

Children in the clinical group were more often young and had lower SES than NO children. Teachers score children with ODD / CD and / or ADHD with less empathy in response to sadness compared to NO children. A significant negative relationship was also found between TRF aggression and affective empathy indicated by teachers. Parents did not indicate this. A significant effect of prosocial behavior was found in children's tasks. Children with ODD / CD (with / without ADHD) scored lower than NO children. Children with ADHD alone did not differ from the NO children. This difference persisted when checking for attention scores, but not for aggression scores.

Discussion

The current study differs from other studies, because attention has also been paid to empathy-induced prosocial behavior. Teachers reported deficiencies in affective empathy in response to sadness and distress in 6 and 7 year old children with ODD / CD (with / without ADHD) and in children with ADHD alone. Children with ODD / CD (with / without ADHD) failed in observed empathy-induced prosocial behavior in response to sadness and distress. Children with ADHD alone did not differ from NO children.

It seems that younger children with ADHD, the empathic response to sadness and distress of peers, is reduced, regardless of the presence of behavioral problems. This is only visible in socially challenging situations, such as school. It is therefore clear that children with disruptive and aggressive behavior genuinely have problems in sharing sadness and distress at school. The difference with the parents shows that children exhibit different behavior in different places. Perhaps a school setting is more socially challenging and there are clearer and easier shortcomings of empathy there than at home. In addition, a negative correlation was found between SES and parent-reported empathy: parents with a higher SES scored higher on their children with regard to empathy than parents with a lower SES. It seems unlikely that SES had any influence on the results of this study. For interventions it is important to pay attention to the role of empathy within the generation of prosocial behavior, not just an emphasis on reducing aggressive behavior.

Shortcomings:

• Most children with ODD / CD also had other disorders, not just ODD / CD

• There was (too) little difference between groups found in the story task, perhaps the task was not suitable for this age group

• In addition to empathy, the outcomes of the IRT can probably also be related to other relevant processes (such as monetary versus social reward)

Conclusion

Shortcomings in young children with ODD / CD regarding empathy-induced prosocial behavior have been demonstrated. As interventions have shown, empathy can be used to provoke prosocial behavior in normally developing children. This should serve as a guideline to adjust current treatments for children with ODD / CD, as they can benefit from increasing empathy-induced prosocial behavior.