Effects of Personal Unfairness Recollections and Trait Empathy on Empathic Responses Toward Others' Pain

BACKGROUND: Situational stressors influence pain empathy levels, but little is known about how interactions of such stressors interact with baseline trait empathy (TE) to influence empathic processing. Toward elucidating this issue, we investigated the effects of a cognitively loading stressor-personal unfairness recollections-on pain empathy levels in high versus low TE groups. METHODS: Undergraduate participants (N = 121) were divided into high versus low TE groups using median Interpersonal Reactivity Index scores. Participants were randomly assigned to recall personal experiences of unfairness (unfairness prime) or boring daily routines (boredom prime) and then evaluate injury images (Task 1) and facial expression images (Task 2), rating pain/joy intensity to index cognitive empathy and unpleasantness/pleasantness to index affective empathy. RESULTS: Cognitive empathy levels remained stable across priming conditions. However, affective empathy was modulated by both priming conditions and TE levels. Within the boredom priming control condition, high TE group members reported significantly more unpleasantness toward injury images and painful facial expressions, and more pleasantness toward joyful facial expressions than low TE group members did. Paradoxically, unfairness priming resulted in reduced affective empathy toward painful and joyful facial expressions in the high TE group and enhanced affective empathy to injury images in the low TE group. CONCLUSIONS: This experiment indicated cognitive empathy ratings remain stable while affective empathy ratings are susceptible to interactions between trait empathy levels and negatively-valenced recollections. Specifically, personal unfairness experiences may diminish effects of baseline empathic sensitivity on pain empathy among high-TE people and magnify affective empathy among those with low TE. SIGNIFICANCE STATEMENT: This experiment demonstrates effects of personal experiences of perceived unfairness (versus boredom) differentially bias affective pain empathy based on individuals' baseline trait empathy levels. By revealing the unique impact of affectively valenced stressors on affective empathy, main findings underscore potential mechanisms by which healthcare providers' occupational stressors may compromise objective pain assessment.