Instruments currently being used to measure empathy do not reflect the recent neuroscientific scholarship on mirror neurons and the importance of self-awareness and emotion regulation in experiencing the fullest extent of empathy. The authors describe a theoretical framework for the initial development and pilot application of an empathy self-report instrument, the Empathy Assessment Index (EAI). The EAI is based on a comprehensive definition of empathy that is rooted in social cognitive neuroscience, developmental psychology, and social work's commitment to social justice. The authors present reliability, concurrent validity, and data reduction and refinement results from the first administration of the index. Four of the five EAI subscales had excellent internal consistency and test-retest reliability. Three subscales were tested for concurrent validity. The exploratory factor analysis identified six factors that explained over 43% of the variance.
KEY WORDS: affective response; emotion regulation; empathic attitudes; empathy; self-awareness
Recent breakthroughs in neuroscience, particularly social cognitive neuroscience, have given social scientists unprecedented opportunities to observe and attempt to measure various aspects of human thought, feeling, and behavior (Doidge, 2007). Among these psychological phenomena is empathy. The importance of empathy for effective social work practice is commonly accepted within the profession (Hepworth, Rooney, Rooney, Strom-Gottfried, & Larsen, 2006; Shulman, 2009) .Twenty-first century technology has allowed neuroscientists to demonstrate that empathy can be empirically observed and quantified (Jackson, Brunet, Meltzoff, & Decety, 2006; Lamm, Batson, & Decety, 2007; Schulte-Ruther, Markowitsch, Shah, Fink, & Piefke, 2008).
Zaki, Weber, Bolger, and Ochsner (2009) conducted one of the first studies to cross-check and validate the correlation between three different empathy-related phenomena: (1) the subjective experience of people telling an emotional autobiographical story, (2) the empathic response of people watching the storytellers, and (3) the brain activity of the story viewers. This study suggests that brain activity can be used as an empirical measure of affective sharing and cognitive processing and that "accurate" empathy may be physically differentiated from projection or other emotional reactions.
Such research can enrich our ability to cultivate greater empathy in social workers and their clients. As all the social sciences reorient themselves to accommodate the mounting empirical evidence of the brain's neuroplasticity (Rakio, 2002) and the interpersonal neurobiology of empathy, we would like to help open social work research to a richer, more multifaceted examination of empathy. Most social workers do not have access to technologies like functional magnetic resonance imaging (fMRI) machines, nor do they have sufficient funds for expensive and labor-intensive neurological workups of themselves or their clients. In an ideal world, social workers would have a reasonably accurate, affordable, and user-friendly way of quantifying empathy that incorporates new findings from social cognitive neuroscience.
We believe the best initial approach is the development of a self-report index that can be tested and validated by ongoing correlation of phenomenological observation, self-report responses, and specific brain activity. The findings reported in this article represent a first step toward that end. We describe a theoretical framework for the initial development and pilot application of an empathy self-report instrument, the Empathy Assessment Index (EAI). The EAI is based on a comprehensive definition of empathy that is rooted in social cognitive neuroscience, developmental psychology, and social work's commitment to social justice. Finally, we present reliability, concurrent validity, and data reduction and refinement results from the first administration of the index.
DEFINING EMPATHY: PAST, PRESENT, AND FUTURE
Before we discuss the theoretical framework for and development of our assessment index, we briefly review the history of how empathy has been conceptualized and measured in the literature. Surprisingly, there is a relative paucity of empirical research on empathy in the social work literature. Perhaps the scarcity of research can be explained, in part, by the lack of a clear and comprehensive definition of empathy. Even a cursory review of recent empathy research in social work and related fields--such as Berg, Raminani, Greer, Harwood, and Safren (2008); Busby and Gardner (2008); Forrester, Kershaw, Moss, and Hughes (2007); Green and Christensen (2006); Sale, Bellamy, Springer, and Wang (2008); and Waldinger, Schultz, Hauser, Allen, and Cromwell (2004)--reveals that definitions of empathy are not always consistent across studies. As a result of this semantic fuzziness, conceptualizations and measurement techniques for empathy vary--so much so that it has been difficult to engage in meaningful comparison or to reach significant conclusions about how we define and measure empathy and how to effectively cultivate it in social workers and clients (Pedersen, 2009; Preston & de Waal, 2002).
The Past: 20th Century Conceptualizations of Empathy
The earliest conceptualization of empathy dates back to German and American psychologists Theodor Lipps (1903/1979) and Edward Tichener (1909). Intrigued by the psychological phenomenon of imitation, they coined the word Einfuhlung, literally "in-feeling," which is Latinized as "empathy." Their articulation of empathy was indicative of people's tendency to imitate when observing another person, commonly referred to as the "other" (Davis, 1996). Empathy was conceived as both a passive reflection of the other and as an active effort to get inside the other.
The early 20th century view of empathy eventually led to the identification of two different components of empathy: (1) affect(ive) sharing or emotional empathy (Batson, 1987, 1991) and (2) perspective taking or cognitive empathy (Hoffman, 1981, 2000). Twentieth century researchers alternately used one or the other or both elements of empathy to develop instruments (Hojat et al., 2002). For example, the Hogan Empathy Scale (Hogan, 1969) focuses on cognitive empathy, the Questionnaire Measure of Emotional Empathy (Mehrabian & Epstein, 1972) emphasizes the affective component of empathy; and the Interpersonal Reactivity Index (IRI) (Davis, 1980, 1983) attempts to measure both cognitive and emotional elements of empathy. All of these measures are self-report instruments using Likert-type scales and have demonstrated some ability to generate reliable and valid data. However, over the past 10 years, a new conceptualization of empathy has emerged from the field of social cognitive neuroscience (Decety & Jackson, 2004), one that is richer and more actionable. In spite of the innovative 21st century conceptualization of empathy, more recent self-report measures of empathy, including the Toronto Empathy Scale (Spreng, McKinnon, Mar, & Levine, 2009) and the Basic Empathy Scale (Jolliffe & Farringon, 2006), have not incorporated recent findings. Our goal was to pilot an instrument that quantified and operationalized empathy in the context of the latest scientific findings.
The Present: Mirror Neurons and 21st Century Definition of Empathy
Recent research combining neuroscientific brain imagining (Gazzola, Aziz-Zadeh, & Keysers, 2006) with social cognitive neuroscience (Kaplan & Iacoboni, 2006; Lamm et al., 2007) has led to the identification of additional components of empathy and a clearer articulation of the affective and cognitive elements of empathy (Decety &Jackson, 2004; Decety & Lamm, 2006; Decety & Moriguchi, 2007). Using fMRI equipment, neuroscientists confirmed that when we see another person's actions, our bodies unconsciously and automatically respond as if we were the "actor" and not just an observer (Jackson et al., 2006). This phenomenon is called mirroring, and the circuitry of the brain responsible for this is referred to as the mirror neuron system (MNS) (Iacoboni, 2008).
When we hear people speak or watch their posture, gestures, and facial expressions, the neural networks in our brains are stimulated by a "shared representation." The result is an inner reflection or simulation of the experiences of those whom we are observing. Mirroring appears to be innate and part of human hardwiring (Iacoboni, 2008). The affective automatic and involuntary responses triggered by the MNS are only one part of empathy. Neuroscientists recognize that there are cognitive components as well.
Combining social science research on empathy with the new findings in social cognitive neuroscience, Decety and Jackson (2004), Decety and Lamm (2006), and Decety and Moriguchi (2007) developed a conceptualization of empathy based on the interaction of four "neural networks": affective sharing, self-awareness, perspective taking, and emotion regulation. These networks are empirically observable brain phenomena (Decety & Moriguchi, 2007). They are defined later, in the Conceptualizations of the Five EAI Constructs section.
These networks include both involuntary affective responses to another and voluntary cognitive aspects of processing the experience. The inclusion of self-awareness and emotion regulation as necessary components of empathy is critical. For example, observation of another person's emotional state can lead to distress rather than empathic concern if the observer has not developed the capacities for self-other differentiation and emotion regulation (Lamm et al., 2007).
Whether 20th- or 21st-century, the conceptualizations of empathy we have discussed typically end after describing what an individual needs to "feel" and "think" to experience empathy for another person. External actions by the observer or social changes as a result of people's empathy...