Individuals with High Social Anhedonia but not Schizophrenia Exhibited Altered Empathy in Daily Life.

Background and hypothesis: Despite empathic abnormalities exhibited in both clinical and subclinical samples of schizophrenia (SCZ) in the laboratory, understanding of their empathy in the real world remains limited. This study applied the experience sampling method (ESM) to investigate empathy in people with SCZ and high social anhedonia (SocAnh), as well as its associations with social pleasure and emotional states in daily life.

Study design: Thirty-one participants with SCZ, 31 individuals with high SocAnh, and 32 healthy controls completed a 7-day ESM survey (10 surveys per day) to assess empathy, social pleasure, and emotional states in daily life. The empathic accuracy task was used to measure empathy accuracy (EA) in the laboratory. Multilevel regression models were estimated to examine group differences of the ESM variables and their associations.

Study results: Compared to controls, people with SCZ showed lower EA but comparable cognitive and affective empathy in daily life, whereas Individuals with high SocAnh exhibited similar EA but lower affective empathy in daily life. Positive association between social pleasure and empathy was found across 3 groups. Empathy for positive emotions predicted increased positive emotional states in individuals with high SocAnh and controls, but not in people with SCZ. Positive emotional states predicted greater empathy in individuals with high SocAnh, which was not observed in the other 2 groups.

Conclusions: Our findings revealed altered empathy in daily life among people at-risk for SCZ but not in clinical patients, shedding light on a better understanding of social cognitive changes in SCZ spectrum.