The role of executive functions in the development of empathy and its association with externalizing behaviors in children with neurodevelopmental disorders and other psychiatric comorbidities: Brain Sciences

C. Cristofani, G. Sesso, P. Cristofani, P. Fantozzi, E. Inguaggiato, P. Muratori, A. Narzisi, C. Pfanner, S. Pisano, L. Polidori, L. Ruglioni, E. Valente, G. Masi, A. Milone

Research output: Contribution to journalArticlepeer-review

Abstract

Executive functions have been previously shown to correlate with empathic attitudes and prosocial behaviors. People with higher levels of executive functions, as a whole, may better regulate their emotions and reduce perceived distress during the empathetic processes. Our goal was to explore the relationship between empathy and executive functioning in a sample of children and adolescents diagnosed with Attention Deficit and Hyperactivity Disorder alone or associated with comorbid Disruptive Behavior Disorders and/or Autism Spectrum Disorder. We also aimed to examine the role of empathic dimensions and executive skills in regulating externalizing behaviors. The 151 participants with ADHD were assigned to four groups according to their psychiatric comorbidity (either “pure” or with ASD and/or ODD/CD) and assessed by means of either parent-or self-reported questionnaires, namely the BRIEF−2, the BES, and the IRI. No questionnaire was found to discriminate between the four groups. Affective Empathy was found to positively correlate with Emotional and Behavioral Regulation competences. Furthermore, Aggressiveness and Oppositional Defiant Problems were positively associated with Executive Emotional and Behavioral Regulation competences. On the other hand, Rule-Breaking Behaviors and Conduct Problems were negatively associated with Affective Empathy and with Behavioral skills. Our study provides an additional contribution for a better understanding of the complex relationship between empathic competence and executive functions, showing that executive functioning and empathic attitudes interact with each other to regulate aggressive behaviors. This study further corroborates developmental models of empathy and their clinical implications, for which externalizing behaviors could be attenuated by enhancing executive functioning skills. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
Original languageEnglish
Pages (from-to)1-16
Number of pages16
JournalBrain Sci.
Volume10
Issue number8
DOIs
Publication statusPublished - 2020

Keywords

  • Attention deficit and hyperactivity disorder
  • Autism spectrum disorder
  • Disruptive behavior disorders
  • Empathy
  • Executive functions
  • adolescent
  • adult
  • Article
  • attention deficit disorder
  • autism
  • behavior rating inventory of executive function
  • behavior therapy
  • Behavioral Regulation Index
  • child
  • Child Behavior Checklist
  • cognitive behavioral therapy
  • Cognitive Regulation Index
  • comorbidity
  • DSM-5
  • emotion
  • Emotional Regulation Index
  • empathy
  • executive function
  • female
  • Global Executive Composite score
  • human
  • major clinical study
  • male
  • mental disease
  • mental disease assessment
  • psychotherapy
  • questionnaire
  • self report
  • social cognition
  • structured interview

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