Empathic behavioral and physiological responses to dynamic stimuli in depression Daniel Schneider a,b,n , Christina Regenbogen a,b , Thilo Kellermann a,b , Andreas Finkelmeyer c , Nils Kohn a,b , Birgit Derntl a,d , Frank Schneider a,b,e , Ute Habel a,b a Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Germany b JARA Translational Brain Medicine, J¨ ulich, Germany c Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, England, UK d Institute of Clinical, Biological and Differential Psychology, University of Vienna, Austria e School of Medicine, University of Pennsylvania, Philadelphia article info Article history: Received 7 December 2011 Received in revised form 26 March 2012 Accepted 30 March 2012 Keywords: Depression Emotion processing Dynamic stimulus material Verbal information Emotional context insensitivity Galvanic skin conductance abstract Major depressive disorder (MDD) is strongly linked to social withdrawal and interpersonal problems which characterize the disorder and further aggravate symptoms. Investigating the nature of impaired emotional-social functioning as a basis of interpersonal functioning in MDD has been widely restricted to static stimuli and behavioral emotion recognition accuracy. The present study aimed at examining higher order emotional processes, namely empathic responses and its components, emotion recogni- tion accuracy and affective responses in 28 MDD patients and 28 healthy control participants. The dynamic stimulus material included 96 short video clips depicting actors expressing basic emotions by face, voice prosody, and sentence content. Galvanic skin conductance measurements revealed implicit processes in the multimethod assessment of empathy. Overall, patients displayed lower empathy, emotion accuracy, and affective response rates than controls. Autonomous arousal was higher in patients. A generalized emotion processing deficit is in line with the ‘‘emotional context insensitivity’’ (ECI) theory which proposes decreased overall responsive- ness to emotional stimuli. The dissociation between hypo-reactivity in explicit and hyper-reactivity in implicit measures of emotion processing can be related to the ‘‘limbic-cortical dysregulation’’ model of depression. Our findings support the dissociation of autonomic and subjective emotional responses which may account for interpersonal as well as emotional deficits in depression. & 2012 Elsevier Ireland Ltd. All rights reserved. 1. Introduction Empathy, the ability to recognize, understand, and share the emotions of others conveys a feeling of social coherence and constitutes a central part of human social interactions which are essential for our adaptive functioning (Ekman, 1982; Plutchik, 1982; Plutchik and Kellermann, 1989; Ekman, 2003; Lewis et al., 2008). Although a variety of different definitions contribute to the complex and multidimensional construct of empathy (Derntl et al., 2009, 2010) most theoretical models include three core components: emotion recognition, affective response, and per- spective taking (Preston and de Waal, 2002; Decety and Jackson, 2004; Leiberg and Anders, 2006; Singer, 2006; Batson, 2009; Singer and Lamm, 2009) while implying the distinction into ‘‘self’’ and ‘‘other’’ (de Vignemont and Singer, 2006). The ability to empathize is suggested to be affected in unipolar major depressive disorder due to the central defining clinical fea- tures: depressed mood and anhedonia which often lead to a limited affective range and subsequent social malfunctioning (Wells et al., 1989; Beck et al., 1996). Empirically, deficits have been characterized by an impaired ability to identify and discriminate emotions con- veyed via facial expressions (Lepp¨ anen et al., 2004; Lepp ¨ anen, 2006; Surguladze et al., 2004, 2005; Suslow et al., 2004; Bourke et al., 2010), as well as distorted emotion self-regulation capacities (Beauregard et al., 2006; Diener et al., 2009). These findings are further supported by self-reports following mood induction procedures conveying a blunted affect in depressed patients (Goodwin and Williams, 1982; Nelson and Stern, 1988; Falkenberg et al., 2012). The latter is one facet of emotion reactivity, which we see as the response aspect of emotion processing (e.g. subjective, behavioral, physiological, as well as cerebral, Keltner and Gross, 1999). Contents lists available at SciVerse ScienceDirect journal homepage: www.elsevier.com/locate/psychres Psychiatry Research 0165-1781/$ - see front matter & 2012 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.psychres.2012.03.054 n Corresponding author at: Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical School, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany. Tel.: þ49 241 80 89693; fax: þ49 241 8082 401. E-mail address: dschneider@ukaachen.de (D. Schneider). Psychiatry Research 200 (2012) 294–305