儿童期创伤与共情的关系：一项三水平元分析

doi:10.3724/SP.J.1041.2023.01285

摘要/Abstract

摘要：

本研究运用三水平元分析技术系统探讨儿童期创伤与共情的关系及其调节因素。通过文献检索与筛选, 获得46项研究和352个效应量, 共包含23039名被试。元分析结果发现, 儿童期创伤与共情存在显著负相关(r = −0.076)。儿童期创伤类型存在调节作用, 躯体忽视(r = −0.095)与情感忽视(r = −0.128)均与共情显著负相关, 而躯体虐待(r = 0.005)、情感虐待(r = −0.051)和性虐待(r = −0.058)均与共情相关不显著。共情成分存在调节作用, 在认知共情中, 儿童期创伤与观点采择(r = −0.127)显著负相关, 而与幻想(r = −0.044)相关不显著; 在情感共情中, 儿童期创伤与共情关注(r = −0.148)显著负相关, 而与个人痛苦(r = 0.153)显著正相关。本研究首次系统比较了不同类型儿童期创伤与共情的关系以及儿童期创伤在共情各成分上的效应, 并提出了培养共情的建议。

关键词: 儿童期创伤, 共情, 观点采择, 个人痛苦, 元分析

Abstract:

A considerable number of studies have discussed the association between childhood maltreatment and empathy, but the results have been mixed. Theoretically, there are four main arguments regarding the association between childhood maltreatment and empathy. Attachment theory suggests that childhood maltreatment predisposes individuals to an insecure attachment style that is detrimental to empathy development. The facial feedback hypothesis and “like-me” hypothesis suggest that neglected children have fewer opportunities to imitate others’ facial expressions, and show deficits in empathy. However, the perception-action model argues that individuals with childhood maltreatment are more likely to empathize with others who have traumatic experiences, while the Russian doll model implies that the association between childhood maltreatment and empathy may not be linear. Empirically, current research has reported an inconsistent correlation between childhood maltreatment and empathy, with r values ranging from −0.451 to 0.86. Therefore, the present meta-analysis aimed to estimate the extent to which childhood maltreatment is associated with empathy and whether these associations vary depending on the study or sample characteristics such as the type of childhood maltreatment, gender, and age.

A systematic literature review was conducted using Web of Science, ScienceDirect, PubMed, PsycARTICLES, CNKI (China National Knowledge Infrastructure), CSTJD (China Science and Technology Journal Database) and WFD (Wan Fang Data). Three-level meta-analyses were performed using R to synthesize the effect sizes and conduct moderator analyses. Publication bias was assessed using funnel plots and Egger's regression tests. No significant publication bias was observed in any of the studies.

A total of 46 studies (N = 23039 participants) producing 352 effect sizes were included. The results showed that the correlation between childhood maltreatment and empathy was significantly negative but only to a small extent (r = −0.076, 95% CI [−0.117, −0.035]). Moderator analysis revealed that the association between childhood maltreatment and empathy was moderated by the type of childhood maltreatment. The association between childhood maltreatment and empathy was stronger for physical neglect (r = −0.095) and emotional neglect (r = −0.128) than for physical abuse (r = 0.005). Furthermore, the association between childhood maltreatment and empathy was moderated by the dimensions of empathy. Specifically, the association between childhood maltreatment and empathy was negative for perspective-taking (r = −0.127), fantasy (r = −0.044), and empathic concern (r = −0.148), but positive for personal distress (r = 0.153). In addition, the mean age of the participants moderated the association between childhood maltreatment and empathy, with the mean age predicting a reduced negative association between childhood maltreatment and empathy (β = 0.004). However, the percentage of females did not moderate the observed association, which may indicate consistency in the association between childhood maltreatment and empathy across genders.

The results supported the attachment theory, the facial feedback hypothesis, the "like-me" hypothesis, the perception-action model, and the Russian doll model, suggesting that the association between childhood maltreatment and empathy was complicated. These findings not only deepen our understanding of the association between childhood maltreatment and empathy but also produce meaningful practical implications for future research and intervention program design regarding how to promote the development of empathy.

Key words: childhood maltreatment, empathy, perspective taking, personal distress, meta-analysis

中图分类号:

B844
C912.6

孟现鑫, 俞德霖, 陈怡静, 张玲, 傅小兰. (2023). 儿童期创伤与共情的关系：一项三水平元分析. 心理学报, 55(8), 1285-1300.

MENG Xianxin, YU Delin, CHEN Yijing, ZHANG Lin, FU Xiaolan. (2023). Association between childhood maltreatment and empathy: A three-level meta-analytic review. Acta Psychologica Sinica, 55(8), 1285-1300.

图/表 5

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第一作者	发表年份	研究设计	样本类型	平均年龄	女性比	国家	CM测量	EM测量	文献类型	文献质量
Simons	2002	横断研究	非临床	39	0%	美国	PSIR	CET, EWT	SSCI	5
Lucas	2009	横断研究	非临床	未报告	未报告	美国	CTS	BSES	学位论文	6
徐凯文	2010	横断研究	临床	36.6	10%	中国	CTQ	IRI	普通期刊	7
Locher	2014	横断研究	非临床	未报告	67%	南非	CTQ	SRES	SSCI	5
Maneta	2015	横断研究	非临床	37.2	50%	美国	CTQ	UDIP	SSCI	7
Mielke	2016	横断研究	非临床	39.96	100%	德国	CECA	IRI	SSCI	7
陈领	2016	横断研究	临床、非临床	29.34	54.08%	中国	CTQ	IRI	普通期刊	7
李和孺	2016	横断研究	非临床	13.2	48.90%	中国	CTQ	BES	学位论文	6
李婷	2016	横断研究	非临床	11.65	52.43%	中国	CTQ	IRI	学位论文	6
Flasbeck	2017	横断研究	临床、非临床	27.54	100%	德国	CTQ	IRI	SSCI	7
Ceroni	2018	横断研究	非临床	未报告	未报告	美国	CTQ	MDEES	学位论文	6
Flasbeck	2018	横断研究	临床、非临床	未报告	100%	德国	CTQ	IRI	SSCI	7
Greenberg	2018	横断研究	非临床	34.84	65.86%	英国	CTES	EQ	SCI	6
Miano	2018	横断研究	非临床	29.13	50%	德国	CTQ	UDIP	SSCI	7
任怡臻	2018	横断研究	非临床	33.98	35.89%	中国	CTQ	EQ	中文核心	6
Boccadoro	2019	横断研究	非临床	36.28	100%	英国	SLESQ	IRI	SSCI	6
Bujalski	2019	横断研究	非临床	未报告	73.80%	美国	CCMS	IRI	SSCI	6
Flasbeck	2019	横断研究	临床、非临床	27.46	100%	德国	CTQ	IRI	SCI	7
Milone	2019	横断研究	临床	13.27	0%	意大利	MCS	IRI	SCI	7
韩凤师	2019	横断研究	非临床	未报告	57.30%	中国	CTQ	BES	普通期刊	6
Fang	2020	横断研究	非临床	19.96	69.70%	中国	CPMS	BES	SSCI	6
Metcalf	2020	横断研究	非临床	14.84	61.70%	美国	MCS	BES	SSCI	5
Sun	2020	横断研究	非临床	20.39	41.40%	中国	CPMS	BES	SCI	6
杨娟	2020	横断研究	非临床	20.18	51.20%	中国	CTQ	IRI	普通期刊	6
Yu	2020	横断研究	非临床	15.41	54.20%	中国	CTQ	BES	SSCI	8
Antunes	2021	横断研究	非临床	41.91	73.10%	葡萄牙	ACE	IRI	会议论文	6
Flasbeck	2021	横断研究	临床、非临床	未报告	100%	德国	CTQ	IRI	SCI	7
Guarda	2021	横断研究	非临床	37.96	0%	葡萄牙	CTQ	IRI	会议论文	6
Wang	2021	横断研究	非临床	33.41	0%	中国	CTQ	QCAE	SSCI	7
侯小花	2021	横断研究	非临床	未报告	58.24%	中国	CTQ	IRI	普通期刊	6
黄广乔	2021	横断研究	非临床	13.57	56%	中国	CPMS	BES	学位论文	7
乔介石	2021	横断研究	非临床	13.46	48%	中国	CPMS	BES	学位论文	6
尹天子	2021	横断研究	非临床	16.27	60%	中国	CPMS	IRI	中文核心	7
Berzenski	2022	纵向研究	非临床	8.13	50%	美国	ETI, CTS, MNBS	GEM	SSCI	11
Brassard	2022	横断研究	非临床	34.18	0%	加拿大	DQ	IRI	SSCI	7
Petruccelli	2022	横断研究	临床、非临床	46.72	0%	意大利	SSI	BES	普通期刊	5
Sesar	2022	横断研究	非临床	23.17	100%	波黑、克罗地亚	CCMS	IRI	普通期刊	7
Zhang, Q.	2022	横断研究	非临床	19.07	64%	中国	CTQ	IRI	SCI	6
Zhang, X.	2022	横断研究	非临床	19.83	56.52%	中国	CTQ	SOR	SSCI	7
Zheng	2022	横断研究	非临床	未报告	57.24%	中国	CTQ	JSPE	SCI	7
陈程	2022	横断研究	非临床	18.51	70.91%	中国	CTQ	IRI	中文核心	7
董锦锦	2022	横断研究	非临床	12.01	46.17%	中国	CNS	IRI	学位论文	7
王丽萍	2022	横断研究	非临床	未报告	58.30%	中国	CTQ	IRI	普通期刊	6
王茜鑫	2022	横断研究	临床	15.23	75.21%	中国	CTQ	IRI	学位论文	7
张洁	2022	横断研究	非临床	16.58	53.86%	中国	CTQ	BES	学位论文	7
张梦宁	2022	横断研究	非临床	19.86	50.19%	中国	CTQ	SRES	学位论文	8

第一作者	发表年份	研究设计	样本类型	平均年龄	女性比	国家	CM测量	EM测量	文献类型	文献质量
Simons	2002	横断研究	非临床	39	0%	美国	PSIR	CET, EWT	SSCI	5
Lucas	2009	横断研究	非临床	未报告	未报告	美国	CTS	BSES	学位论文	6
徐凯文	2010	横断研究	临床	36.6	10%	中国	CTQ	IRI	普通期刊	7
Locher	2014	横断研究	非临床	未报告	67%	南非	CTQ	SRES	SSCI	5
Maneta	2015	横断研究	非临床	37.2	50%	美国	CTQ	UDIP	SSCI	7
Mielke	2016	横断研究	非临床	39.96	100%	德国	CECA	IRI	SSCI	7
陈领	2016	横断研究	临床、非临床	29.34	54.08%	中国	CTQ	IRI	普通期刊	7
李和孺	2016	横断研究	非临床	13.2	48.90%	中国	CTQ	BES	学位论文	6
李婷	2016	横断研究	非临床	11.65	52.43%	中国	CTQ	IRI	学位论文	6
Flasbeck	2017	横断研究	临床、非临床	27.54	100%	德国	CTQ	IRI	SSCI	7
Ceroni	2018	横断研究	非临床	未报告	未报告	美国	CTQ	MDEES	学位论文	6
Flasbeck	2018	横断研究	临床、非临床	未报告	100%	德国	CTQ	IRI	SSCI	7
Greenberg	2018	横断研究	非临床	34.84	65.86%	英国	CTES	EQ	SCI	6
Miano	2018	横断研究	非临床	29.13	50%	德国	CTQ	UDIP	SSCI	7
任怡臻	2018	横断研究	非临床	33.98	35.89%	中国	CTQ	EQ	中文核心	6
Boccadoro	2019	横断研究	非临床	36.28	100%	英国	SLESQ	IRI	SSCI	6
Bujalski	2019	横断研究	非临床	未报告	73.80%	美国	CCMS	IRI	SSCI	6
Flasbeck	2019	横断研究	临床、非临床	27.46	100%	德国	CTQ	IRI	SCI	7
Milone	2019	横断研究	临床	13.27	0%	意大利	MCS	IRI	SCI	7
韩凤师	2019	横断研究	非临床	未报告	57.30%	中国	CTQ	BES	普通期刊	6
Fang	2020	横断研究	非临床	19.96	69.70%	中国	CPMS	BES	SSCI	6
Metcalf	2020	横断研究	非临床	14.84	61.70%	美国	MCS	BES	SSCI	5
Sun	2020	横断研究	非临床	20.39	41.40%	中国	CPMS	BES	SCI	6
杨娟	2020	横断研究	非临床	20.18	51.20%	中国	CTQ	IRI	普通期刊	6
Yu	2020	横断研究	非临床	15.41	54.20%	中国	CTQ	BES	SSCI	8
Antunes	2021	横断研究	非临床	41.91	73.10%	葡萄牙	ACE	IRI	会议论文	6
Flasbeck	2021	横断研究	临床、非临床	未报告	100%	德国	CTQ	IRI	SCI	7
Guarda	2021	横断研究	非临床	37.96	0%	葡萄牙	CTQ	IRI	会议论文	6
Wang	2021	横断研究	非临床	33.41	0%	中国	CTQ	QCAE	SSCI	7
侯小花	2021	横断研究	非临床	未报告	58.24%	中国	CTQ	IRI	普通期刊	6
黄广乔	2021	横断研究	非临床	13.57	56%	中国	CPMS	BES	学位论文	7
乔介石	2021	横断研究	非临床	13.46	48%	中国	CPMS	BES	学位论文	6
尹天子	2021	横断研究	非临床	16.27	60%	中国	CPMS	IRI	中文核心	7
Berzenski	2022	纵向研究	非临床	8.13	50%	美国	ETI, CTS, MNBS	GEM	SSCI	11
Brassard	2022	横断研究	非临床	34.18	0%	加拿大	DQ	IRI	SSCI	7
Petruccelli	2022	横断研究	临床、非临床	46.72	0%	意大利	SSI	BES	普通期刊	5
Sesar	2022	横断研究	非临床	23.17	100%	波黑、克罗地亚	CCMS	IRI	普通期刊	7
Zhang, Q.	2022	横断研究	非临床	19.07	64%	中国	CTQ	IRI	SCI	6
Zhang, X.	2022	横断研究	非临床	19.83	56.52%	中国	CTQ	SOR	SSCI	7
Zheng	2022	横断研究	非临床	未报告	57.24%	中国	CTQ	JSPE	SCI	7
陈程	2022	横断研究	非临床	18.51	70.91%	中国	CTQ	IRI	中文核心	7
董锦锦	2022	横断研究	非临床	12.01	46.17%	中国	CNS	IRI	学位论文	7
王丽萍	2022	横断研究	非临床	未报告	58.30%	中国	CTQ	IRI	普通期刊	6
王茜鑫	2022	横断研究	临床	15.23	75.21%	中国	CTQ	IRI	学位论文	7
张洁	2022	横断研究	非临床	16.58	53.86%	中国	CTQ	BES	学位论文	7
张梦宁	2022	横断研究	非临床	19.86	50.19%	中国	CTQ	SRES	学位论文	8

调节变量	k	Intercept/mean z (95% CI)	β (95% CI)	Mean r	F	p	水平2方差	水平3方差
人口统计学特征
女性比例	350	−0.121 (−0.209, −0.033)^**	0.001 (−0.001, 0.002)	−	1.298	0.255	0.028^***	0.010^***
平均年龄	261	−0.079 (−0.120, −0.038)^***	0.004 (0.000, 0.008)^*	−	4.415	0.037	0.016^***	0.009^***
儿童期创伤的类型
躯体虐待	66	0.005 (−0.056, 0.065)		0.005	4.056	0.003	0.026^***	0.008^***
情感虐待	57	−0.051 (−0.115, 0.013)	−0.055 (−0.124, 0.013)	−0.051
性虐待	58	−0.058 (−0.121, 0.005)	−0.063 (−0.130, 0.004)	−0.058
躯体忽视	54	−0.095 (−0.161, −0.030)^**	−0.100 (−0.171, −0.030)^**	−0.095
情感忽视	66	−0.129 (−0.189, −0.068)^***	−0.133 (−0.202, −0.065)^***	−0.128
共情的成分
观点采择	67	−0.128 (−0.193, −0.062)^***		−0.127	83.051	<.001	0.007^***	0.015^***
幻想	63	−0.044 (−0.111, 0.023)	0.083 (0.041, 0.126)^***	−0.044
共情关注	65	−0.149 (−0.216, −0.083)^***	−0.022 (−0.064, 0.020)	−0.148
个人痛苦	67	0.154 (0.089, 0.220)^***	0.282 (0.240, 0.324)^***	0.153
共情的测量
IRI	277	−0.038 (−0.089, 0.012)		−0.038	0.562	0.690	0.027^***	0.009^***
BES	40	−0.109 (−0.200, −0.018)^*	−0.071 (−0.175, 0.033)	−0.109
EQ	5	−0.022 (−0.219, 0.176)	0.017 (−0.181, 0.214)	−0.022
GEM	6	−0.089 (−0.327, 0.148)	−0.051 (−0.293, 0.192)	−0.089
UDIP	8	−0.113 (−0.310, 0.084)	−0.075 (−0.278, 0.129)	−0.113
儿童期创伤的测量
CTQ	271	−0.088 (−0.140, −0.036)^***		−0.088	1.164	0.327	0.028^***	0.010^***
CCMS	18	−0.022 (−0.201, 0.157)	0.066 (−0.121, 0.253)	−0.022
CPMS	7	−0.151 (−0.309, 0.007)	−0.063 (−0.230, 0.103)	−0.150
CTES	12	0.135 (−0.095, 0.366)	0.223 (−0.013, 0.460)	0.134
CNS	16	−0.084 (−0.302, 0.134)	0.004 (−0.220, 0.228)	−0.084
样本类型
非临床样本	327	−0.084 (−0.129, −0.038)^***		−0.084	1.039	0.309	0.024^***	0.012^***
临床样本	92	−0.119 (−0.191, −0.047)^**	−0.035 (−0.103, 0.033)	−0.118

调节变量	k	Intercept/mean z (95% CI)	β (95% CI)	Mean r	F	p	水平2方差	水平3方差
人口统计学特征
女性比例	350	−0.121 (−0.209, −0.033)^**	0.001 (−0.001, 0.002)	−	1.298	0.255	0.028^***	0.010^***
平均年龄	261	−0.079 (−0.120, −0.038)^***	0.004 (0.000, 0.008)^*	−	4.415	0.037	0.016^***	0.009^***
儿童期创伤的类型
躯体虐待	66	0.005 (−0.056, 0.065)		0.005	4.056	0.003	0.026^***	0.008^***
情感虐待	57	−0.051 (−0.115, 0.013)	−0.055 (−0.124, 0.013)	−0.051
性虐待	58	−0.058 (−0.121, 0.005)	−0.063 (−0.130, 0.004)	−0.058
躯体忽视	54	−0.095 (−0.161, −0.030)^**	−0.100 (−0.171, −0.030)^**	−0.095
情感忽视	66	−0.129 (−0.189, −0.068)^***	−0.133 (−0.202, −0.065)^***	−0.128
共情的成分
观点采择	67	−0.128 (−0.193, −0.062)^***		−0.127	83.051	<.001	0.007^***	0.015^***
幻想	63	−0.044 (−0.111, 0.023)	0.083 (0.041, 0.126)^***	−0.044
共情关注	65	−0.149 (−0.216, −0.083)^***	−0.022 (−0.064, 0.020)	−0.148
个人痛苦	67	0.154 (0.089, 0.220)^***	0.282 (0.240, 0.324)^***	0.153
共情的测量
IRI	277	−0.038 (−0.089, 0.012)		−0.038	0.562	0.690	0.027^***	0.009^***
BES	40	−0.109 (−0.200, −0.018)^*	−0.071 (−0.175, 0.033)	−0.109
EQ	5	−0.022 (−0.219, 0.176)	0.017 (−0.181, 0.214)	−0.022
GEM	6	−0.089 (−0.327, 0.148)	−0.051 (−0.293, 0.192)	−0.089
UDIP	8	−0.113 (−0.310, 0.084)	−0.075 (−0.278, 0.129)	−0.113
儿童期创伤的测量
CTQ	271	−0.088 (−0.140, −0.036)^***		−0.088	1.164	0.327	0.028^***	0.010^***
CCMS	18	−0.022 (−0.201, 0.157)	0.066 (−0.121, 0.253)	−0.022
CPMS	7	−0.151 (−0.309, 0.007)	−0.063 (−0.230, 0.103)	−0.150
CTES	12	0.135 (−0.095, 0.366)	0.223 (−0.013, 0.460)	0.134
CNS	16	−0.084 (−0.302, 0.134)	0.004 (−0.220, 0.228)	−0.084
样本类型
非临床样本	327	−0.084 (−0.129, −0.038)^***		−0.084	1.039	0.309	0.024^***	0.012^***
临床样本	92	−0.119 (−0.191, −0.047)^**	−0.035 (−0.103, 0.033)	−0.118