自闭特质对疼痛共情的影响：疼痛负性情绪和认知的中介作用

doi:10.3724/SP.J.1041.2023.01501

摘要/Abstract

摘要：

已有研究提示自闭症个体的疼痛共情缺陷可能源于自身疼痛的异常。鉴于高自闭特质与自闭症的相似性, 本研究分别通过实验范式和问卷调查评估了状态和特质共情, 旨在刻画自闭特质、自身疼痛与共情之间的联系。在假双人疼痛共情范式中, 高自闭特质个体在目睹他人接受疼痛时P2响应更强, 不愉悦度评分更高, 且部分源于对疼痛的高恐惧水平。问卷调查结果发现, 自闭特质水平越高, 在共情特质量表的观点采择维度得分越低, 而个人痛苦维度得分越高, 其中疼痛恐惧和灾难化中介了自闭特质与个人痛苦之间的联系。因此, 高自闭特质个体表现出高水平的状态和特质情绪共情, 且部分源于对疼痛存在更为负面的情绪和认知。这支持从自身疼痛异常的角度去理解高自闭特质和自闭症群体的共情等社会功能障碍, 为临床治疗和干预提供了潜在的靶点。

关键词: 自闭特质, 疼痛共情, 疼痛恐惧, 疼痛灾难化, 事件相关电位

Abstract:

Individuals with autism spectrum disorders (ASD) are typically characterized by impaired social interactions that are thought to be related to deficits in empathy. While cognitive empathy deficit in ASD is widely recognized, it remains controversial whether individuals with ASD have a deficiency in emotional empathy. According to the shared representation theory, psychological and neuronal mechanisms involved in the personal experience of an emotional or somatosensory state are also engaged while empathizing with other individuals in those states. It suggests that the deficits of empathy seen in the ASD population could arise from the atypical experience of first-hand pain. Mild, subclinical forms of the characteristics associated with ASD are referred to as autistic traits. Individuals with high autistic traits exhibit sensory, emotional, and social behaviors similar to those with ASD. Given the relationship between pain empathy and first-hand pain as well as the similarity between autistic traits and ASD, the present study tested the hypothesis that autistic traits in the general population would influence pain empathic responses, which could be contributed by first-hand pain-related profiles.

In Experiment 1, we adopted an ecological pain empathy paradigm and compared behavioral and neural activity between individuals with high scores on the Autism-Spectrum Quotient Test (HAQ, with high autistic traits) and those with low scores (LAQ, with low autistic traits). During the pain empathy paradigm, the participants either perceived the painful electrical stimuli themselves or witnessed the delivery of painful electrical stimuli to their partners in certain and uncertain contexts. When perceiving pain themselves, behavioral and brain responses were comparable between HAQ and LAQ groups. When witnessing others in pain, participants in the HAQ group had greater amplitudes of the P2 component on the event-related potentials and reported higher ratings of unpleasantness than those in the LAQ group. The between-group differences in the behavioral and neural responses related to pain empathy were not moderated by certainty of the context (certain or uncertain). Mediation analysis further revealed that the between-group differences in the unpleasantness elicited by witnessing others’ pain could be contributed by the greater fear of pain while anticipating the upcoming painful stimuli.

In Experiment 2, the relationship among autistic traits, pain-related profiles, and trait empathy was assessed in randomly recruited participants. We found that autistic trait levels were negatively correlated with scores on the perspective-taking subscale of the Interpersonal Reactivity Index and positively correlated with the personal distress subscale. Importantly, pain-related fear and pain catastrophizing mediated the link between autistic traits and personal distress.

Data from Experiments 1 and 2 demonstrated that autistic traits heighten emotional empathy, which can be explained by the negative emotion and cognition toward pain. Given the similarities between individuals with high autistic traits and ASD, this finding may help to expand the biological mechanisms underlying ASD, such as explaining empathy deficits or other social difficulties seen in the ASD from the perspective of atypical pain-related profiles. Future studies should combine multiple modalities of painful stimulations and multidimensional pain assessments to comprehensively characterize pain-related profiles among individuals with high autistic traits or ASD, and establish linkage between pain-related profiles and empathy or social deficits. This understanding has the potential to provide targets for clinical interventions and treatments of ASD.

Key words: autistic traits, pain empathy, pain-related fear, pain catastrophizing, event-related potentials

中图分类号:

R395

张文芸, 卓诗维, 郑倩倩, 关颖琳, 彭微微. (2023). 自闭特质对疼痛共情的影响：疼痛负性情绪和认知的中介作用. 心理学报, 55(9), 1501-1517.

ZHANG Wenyun, ZHUO Shiwei, ZHENG Qianqian, GUAN Yinglin, PENG Weiwei. (2023). Autistic traits influence pain empathy: The mediation role of pain-related negative emotion and cognition. Acta Psychologica Sinica, 55(9), 1501-1517.

图/表 8

图1 假双人疼痛共情范式流程图

表1 LAQ组和HAQ组被试的人口学变量和量表统计结果(M ± SE)

变量	LAQ组 (n = 30)	HAQ组 (n = 30)	统计指标
变量	LAQ组 (n = 30)	HAQ组 (n = 30)	t₅₈ / χ²	p
性别(男/女)	16/14	15/15	0.07	0.796
年龄	20.77 ± 0.34	21.30 ± 0.31	-1.16	0.458
自闭特质	10.73 ± 0.35	30.53 ± 0.54	-30.81	<0.001
电刺激强度(mA)	4.34 ± 0.37	4.18 ± 0.30	0.34	0.812
疼痛敏感性	5.45 ± 0.23	5.73 ± 0.23	-0.86	0.618
疼痛恐惧	80.13 ± 2.46	82.53 ± 2.82	-0.64	0.721
疼痛灾难化	24.83 ± 1.48	32.87 ± 1.85	-3.39	<0.001
人际反应指针量表
观点采择	13.47 ± 0.48	11.87 ± 0.49	2.35	0.060
个人痛苦	8.57 ± 0.62	13.67 ± 0.73	-5.33	<0.001
同情关心	12.77 ± 0.41	13.57 ± 0.40	-1.41	0.361
想象	12.57 ± 0.41	12.93 ± 0.58	-0.52	0.744

图2 假双人疼痛共情任务中的行为学结果注：LAQ：低自闭特质; HAQ：高自闭特质; * p < 0.05, ** p < 0.01, *** p < 0.001。

图3 自闭特质对情绪共情的影响：疼痛恐惧的中介作用注：LAQ：低自闭特质; HAQ：高自闭特质; 图中路径系数均为标准化回归系数; *: p < 0.05, **: p < 0.01。

图4 自身接受疼痛和目睹他人接受疼痛诱发的ERP波形图、地形图和平均波幅注：在波形图中, 红色虚线代表HAQ组在确定的情境(HAQ-Cer), 红色实线代表HAQ组在不确定的情境(HAQ-Uncer), 黑色虚线代表LAQ组在确定的情境(LAQ-Cer), 黑色实线代表低LAQ组不确定的情境(LAQ-Uncer); 白色突出显示的电极点为该成分纳入分析的电极点。平均波幅差异性检验结果如柱形图所示, 用M ± SE表示柱形图中的数据。Cer：确定; Uncer：不确定; *: p < 0.05; ***: p < 0.001。

图5 目睹他人疼痛诱发P2波幅与不愉悦度评分的相关散点图注：LAQ：低自闭特质; HAQ：高自闭特质。* p < 0.05。

表2 各研究变量的描述统计结果及相关矩阵

变量	M	SE	1	2	3	4	5	6	7
1. AQ	19.65	0.29	-
2. PSQ	4.53	0.07	-0.02	-
3. PCS	20.63	0.53	0.19***	0.19***	-
4. FPQ	69.29	0.82	0.04	0.53***	0.39***	-
5. IRI-PT	13.18	0.17	-0.19***	0.02	0.06	0.02	-
6. IRI-PD	10.36	0.20	0.27***	0.16**	0.47***	0.25***	-0.01	-
7. IRI-EC	15.91	0.19	-0.10	-0.01	0.01	0.05	0.28***	0.08	-
8. IRI-FS	15.86	0.21	-0.07	-0.08	0.15**	0.04	0.36***	0.19***	0.29***

图6 自闭特质对情绪共情的影响：疼痛负性情绪和认知的中介作用注：图中路径系数均为标准化回归系数; ** p < 0.01; *** p < 0.001。

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