Relationships between empathy, symptoms, and functioning in first episode psychosis

Social cognitive difficulties among those with schizophrenia and first episode psychosis (FEP) are well-documented, but less research has investigated the social cognitive construct of empathy. Empathy has been linked in schizophrenia samples to symptoms and functioning, but minimal work has examined empathy among those with FEP. This study examined associations between empathy, symptoms, and functioning in FEP participants, as well as whether empathy accounts for unique variance in these constructs over and above other social cognitive measures. Participants were 100 people with FEP who were taking part in a larger randomized controlled trial. Two empathy measures, the Interpersonal Reactivity Index (IRI) and Questionnaire of Cognitive and Affective Empathy (QCAE), were administered at baseline, along with measures of symptoms, functioning, and other social cognitive constructs. Results revealed that greater empathy, measured by the IRI, was linked to less severe negative symptoms across multiple domains, while fewer associations were evident for positive symptoms and functioning. Across tested domains, empathy significantly predicted clinical outcomes over and above other social cognitive constructs. However, both empathy measures displayed low internal consistency. Taken together, results suggest that empathy may be important to consider in FEP populations, particularly as it relates to negative symptoms, and empathy predicts unique variance in multiple clinical characteristics. Future work should focus on improving empathy measurement approaches and examining empathy in tandem with broader social cognitive batteries among FEP samples.