Psychological Medicine

Original Articles

Schizophrenia patients are impaired in empathic accuracy

J. Leea1a2 c1, J. Zakia3, P.-O. Harveya1a2, K. Ochsnera3 and M. F. Greena1a2

a1 Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA

a2 VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA

a3 Department of Psychology, Columbia University, New York, NY, USA


Background Empathy is crucial for successful social relationships. Despite its importance for social interactions, little is known about empathy in schizophrenia. This study investigated the degree to which schizophrenia patients can accurately infer the affective state of another person (i.e. empathic accuracy).

Method A group of 30 schizophrenia patients and 22 healthy controls performed an empathic accuracy task on which they continuously rated the affective state of another person shown in a video (referred to as the ‘target’). These ratings were compared with the target's own continuous self-rating of affective state; empathic accuracy was defined as the correlation between participants' ratings and the targets' self-ratings. A separate line-tracking task was administered to measure motoric/attentional factors that could account for group differences in performance. Participants' self-rated empathy was measured using the Interpersonal Reactivity Index, and targets' self-rated emotional expressivity was measured using the Berkeley Expressivity Questionnaire.

Results Compared with controls, schizophrenia patients showed lower empathic accuracy although they performed the motoric tracking task at high accuracy. There was a significant group×target expressivity interaction such that patients showed a smaller increase in empathic accuracy with higher levels of emotional expressivity by the target, compared with controls. Patients' empathic accuracy was uncorrelated with self-reported empathy or clinical symptoms.

Conclusions Schizophrenia patients showed lower empathic accuracy than controls, and their empathic accuracy was less influenced by the emotional expressivity of the target. These findings suggest that schizophrenia patients benefit less from social cues of another person when making an empathic judgement.

(Received November 18 2010)

(Revised March 14 2011)

(Accepted March 24 2011)

(Online publication April 28 2011)


c1 Address for correspondence: J. Lee, Ph.D., 300 Medical Plaza Room 2261, Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA 90095-6968, USA. (Email: