Aberrant cognitive empathy in individuals with elevated social anxiety and regulation with emotional working memory training

Figures & data

Table 1. Descriptive statistics for Study 1 participants.

Variable	Normative social anxiety (n = 15)	Elevated social anxiety (n = 15)
Age in years, M (SD)	26.00 (7.92)	26.47 (8.33)
Gender (female), n (%)	12 (80%)	12 (80%)
Country of birth (Australia), n (%)	10 (67%)	12 (80%)
Highest education level (completed post-school qualification), n (%)	7 (47%)	7 (47%)
Employment (employed), n (%)	9 (60%)	6 (40%)
SIAS-6, M, (SD)	1.07 (0.88)	8.73 (4.82)
SPS-6, M, (SD)	0.53 (0.52)	10.33 (5.61)
DASS-D, M, (SD)	4.13 (4.98)	12.93 (7.55)
Empathic accuracy task
Cognitive empathic accuracy for negative emotions, M, (SD)	0.79 (0.45)	1.14 (0.16)
Cognitive empathic accuracy for positive emotions, M, (SD)	0.95 (0.43)	1.24 (0.28)
Affective empathic accuracy for negative emotions, M, (SD)	0.40 (0.34)	0.62 (0.30)
Affective empathic accuracy for positive emotions, M, (SD)	0.76 (0.40)	0.81 (0.37)

Note: The four variables derived from the empathic accuracy task are averaged transformed Pearson correlations reflecting an overall estimate of empathic accuracy for the four empathy domains (higher scores indicate greater empathic accuracy). SIAS-6 = Social Interaction Anxiety Scale 6-item version; SPS-6 = Social Phobia Scale 6-item version; DASS-D = Depression; Anxiety Stress Scales – Depression subscale.

Table 2. Descriptive statistics for Study 2 participants in the eWMT and CT conditions.

Variable	Time	eWMT (n = 21)	CT (n = 19)
		M (SD)	M (SD)
Age in years, M (SD)	Pre-training	22.57 (6.32)	23.37 (8.17)
Gender (female), n (%)	Pre-training	17 (81.0%)	18 (94.7%)
Country of birth (Australia), n (%)	Pre-training	16 (76.2%)	16 (84.2%)
Highest qualification (completed secondary school), n (%)	Pre-training	13 (61.9%)	12 (63.2%)
Employment (employed), n (%)	Pre-training	14 (66.7%)	16 (84.2%)
SIAS-6, M, (SD)	Pre-training	10.71 (5.31)	9.32 (5.57)
SPS-6, M, (SD)	Pre-training	11.52 (6.36)	10.05 (5.40)
DASS-D, M, (SD)	Pre-training	18.67 (11.09)	12.74 (9.53)
DSBT, M, (SD)	Pre-training	4.91 (1.58)	4.72 (1.15)
Empathic accuracy task
Cognitive empathic accuracy for negative emotions, M, (SD)	Pre-training	1.15 (0.30)	1.01 (0.30)
	Post-training	1.06 (0.24)	1.05 (0.33)
Cognitive empathic accuracy for positive emotions, M, (SD)	Pre-training	1.23 (0.26)	1.19 (0.40)
	Post-training	1.33 (0.20)	1.27 (0.35)
Affective empathic accuracy for negative emotions, M, (SD)	Pre-training	0.48 (0.26)	0.56 (0.36)
	Post-training	0.60 (0.28)	0.61 (0.31)
Affective empathic accuracy for positive emotions, M, (SD)	Pre-training	0.83 (0.37)	1.03 (0.23)
	Post-training	0.90 (0.29)	1.08 (0.18)

Note: The four variables derived from the empathic accuracy task are averaged transformed Pearson correlations reflecting an overall estimate of empathic accuracy for the four empathy domains (higher scores indicate greater empathic accuracy). eWMT = Emotional working memory training; CT = Control training; SIAS-6 = Social Interaction Anxiety Scale 6-item version; SPS-6 = Social Phobia Scale 6-item version; DASS-D = Depression Anxiety Stress Scales – Depression subscale; DSBT = Digit Span Backwards Task.

Figure 1. CONSORT flow diagram. eWMT = Emotional working memory training; CT = Control training.

Figure 2. Panel A (top panel): Training performance changes for the dual n-back task during emotional working memory training (eWMT). Panel B (bottom panel): Training performance changes for the feature match task during control training (CT). Error bars represent standard errors.

Table 3. Effects of eWMT and CT on cognitive empathic accuracy for negative and positive emotions of targets in Study 2.

Variable	Training effect		Training effect, with covariates		Training effect, with pre-training working memory as moderator		Training effect, with pre-training working memory as moderator and covariates
	B [95% CI]	p	B [95% CI]	p	B [95% CI]	p	B [95% CI]	p
Negative emotions
Intercept	1.01 [0.88, 1.14]	<.001	0.93 [0.75, 1.10]	<.001	1.14 [0.59, 1.69]	<.001	1.17 [0.62, 1.72]	<.001
SIAS-6	–	–	0.02 [0.00, 0.04]	.030	–	–	0.02 [0.01, 0.04]	.025
SPS-6	–	–	0.01 [−0.01, 0.02]	.492	–	–	0.01 [−0.01, 0.02]	.386
DASS-D	–	–	−0.01 [−0.02, 0.00]	.007	–	–	−0.01 [−0.02, 0.00]	.004
DSBT	–	–	–	–	−0.03 [−0.14, 0.09]	.634	−0.05 [−0.16, 0.06]	.339
Time	0.05 [−0.11, 0.20]	.537	0.04 [−0.12, 0.20]	.597	−0.47 [−1.11, 0.18]	.150	−0.47 [−1.11, 0.17]	.144
Condition	0.13 [−0.04, 0.31]	.139	0.17 [−0.01, 0.34]	.051	−0.25 [−0.93, 0.43]	.471	−0.46 [−1.10, 0.18]	.157
Time x Condition	−0.13 [−0.35, 0.08]	.221	−0.14 [−0.35, 0.08]	.211	0.83 [0.05, 1.61]	.038	0.84 [0.06, 1.62]	.036
Time x DSBT	–	–	–	–	0.11 [−0.02, 0.24]	.104	0.11 [−0.02, 0.24]	.103
Condition x DSBT	–	–	–	–	0.08 [−0.06, 0.22]	.256	0.13 [0.00, 0.26]	.051
Time x Condition x DSBT	–	–	–	–	−0.20 [−0.36, −0.04]	.014	−0.20 [−0.36, −0.04]	.013
Positive emotions
Intercept	1.19 [1.05, 1.33]	<.001	1.16 [0.96, 1.36]	<.001	1.46 [0.87, 2.05]	<.001	1.62 [0.98, 2.40]	<.001
SIAS-6	–	–	0.02 [0.00, 0.04]	.100	–	–	0.02 [0.00, 0.04]	.054
SPS-6	–	–	0.00 [−0.02, 0.02]	.813	–	–	0.00 [−0.01, 0.02]	.590
DASS-D	–	–	−0.01 [−0.02, 0.00]	.023	–	–	−0.02 [−0.03, −0.01]	.002
DSBT	–	–	–	–	−0.06 [−0.18, 0.06]	.345	−0.10 [−0.21, 0.02]	.190
Time	0.08 [−0.06, 0.21]	.262	0.07 [−0.06, 0.21]	.275	−0.40 [−0.97, 0.18]	.169	−0.38 [−0.96, 0.20]	.027
Condition	0.04 [−0.15, 0.23]	.653	0.09 [−0.10, 0.27]	.359	−0.50 [−1.23, 0.23]	.179	−0.78 [−1.47, −0.09]	.100
Time x Condition	0.03 [−0.16, 0.21]	.774	0.02 [−0.16, 0.21]	.816	0.58 [−0.12, 1.28]	.103	0.56 [−0.14, 1.26]	.113
Time x DSBT	–	–	–	–	0.10 [−0.02, 0.22]	.095	0.09 [−0.02, 0.21]	.109
Condition x DSBT	–	–	–	–	0.11 [−0.04, 0.26]	.134	0.18 [0.04, 0.33]	.012
Time x Condition x DSBT	–	–	–	–	−0.11 [−0.26, 0.03]	.109	−0.11 [−0.25, 0.03]	.115

Note: eWMT = Emotional working memory training; CT = Control training; SIAS-6 = Social Interaction Anxiety Scale 6-item version; SPS-6 = Social Phobia Scale 6-item version; DASS-D = Depression Anxiety Stress Scales – Depression subscale; DSBT = Digit Span Backwards Task.

Table 4. Effects of eWMT and CT on affective empathic accuracy for negative and positive emotions of targets in Study 2.

Variable	Training effect		Training effect, with covariates		Training effect, with pre-training working memory as moderator		Training effect, with pre-training working memory as moderator and covariates
	B [95% CI]	p	B [95% CI]	p	B [95% CI]	p	B [95% CI]	p
Negative emotions
Intercept	0.56 [0.42, 0.69]	<.001	0.53 [0.33, 0.74]	<.001	0.67 [0.09, 1.26]	.025	0.71 [0.07, 1.34]	.029
SIAS-6	–	–	0.01 [−0.01, 0.04]	.165	–	–	0.02 [−0.01, 0.04]	.147
SPS-6	–	–	−0.01 [−0.03, 0.01]	.298	–	–	−0.01 [−0.03, 0.01]	.201
DASS-D	–	–	0.00 [−0.01, 0.01]	.839	–	–	0.00 [−0.01, 0.01]	.976
DSBT	–	–	–	–	−0.02 [−0.15, 0.10]	.687	−0.04 [−0.16, 0.09]	.559
Time	0.07 [−0.07, 0.21]	.291	0.07 [−0.07, 0.21]	.315	−0.02 [−0.65, 0.60]	.937	−0.03 [−0.66, 0.59]	.919
Condition	−0.07 [−0.26, 0.11]	.436	−0.07 [−0.26, 0.12]	.440	−0.06 [−0.79, 0.66]	.865	−0.09 [−0.82, 0.64]	.810
Time x Condition	0.05 [−0.14, 0.24]	.618	0.05 [−0.14, 0.24]	.608	0.16 [−0.60, 0.92]	.676	0.17 [−0.59, 0.93]	.656
Time x DSBT	–	–	–	–	0.02 [−0.11, 0.15]	.744	0.02 [−0.11, 0.15]	.735
Condition x DSBT	–	–	–	–	0.00 [−0.15, 0.15]	.985	0.00 [−0.15, 0.16]	.959
Time x Condition x DSBT	–	–	–	–	−0.02 [−0.18, 0.13]	.759	−0.03 [−0.18, 0.13]	.738
Positive emotions
Intercept	1.03 [0.90, 1.15]	<.001	1.05 [0.86, 1.24]	<.001	0.85 [0.30, 1.40]	.003	0.87 [0.28, 1.47]	.005
SIAS-6	–	–	0.01 [−0.01, 0.03]	.316	–	–	0.01 [−0.01, 0.03]	.409
SPS-6	–	–	−0.01 [−0.03, 0.00]	.104	–	–	−0.01 [−0.03, 0.00]	.128
DASS-D	–	–	0.00 [−0.01, 0.01]	.588	–	–	0.00 [−0.01, 0.01]	.404
DSBT	–	–	–	–	0.04 [−0.08, 0.15]	.515	0.03 [−0.08, 0.15]	.550
Time	0.04 [−0.10, 0.18]	.584	0.04 [−0.10, 0.17]	.605	−0.14 [−0.75, 0.47]	.643	−0.14 [−0.75, 0.46]	.634
Condition	−0.20 [−0.38, −0.02]	.027	−0.21 [−0.38, −0.03]	.022	−0.01 [−0.69, 0.67]	.982	0.04 [−0.65, 0.72]	.914
Time x Condition	0.05 [−0.13, 0.24]	.561	0.06 [−0.13, 0.25]	.556	0.16 [−0.58, 0.90]	.673	0.16 [−0.58, 0.90]	.656
Time x DSBT	–	–	–	–	0.04 [−0.09, 0.16]	.553	0.04 [−0.09, 0.16]	.548
Condition x DSBT	–	–	–	–	−0.04 [−0.18, 0.10]	.557	−0.05 [−0.20, 0.09]	.459
Time x Condition x DSBT	–	–	–	–	−0.02 [−0.17, 0.13]	.784	−0.02 [−0.17, 0.13]	.765

Note: eWMT = Emotional working memory training; CT = Control training; SIAS-6 = Social Interaction Anxiety Scale 6-item version; SPS-6 = Social Phobia Scale 6-item version; DASS-D = Depression Anxiety Stress Scales – Depression subscale; DSBT = Digit Span Backwards Task.

Data availability statement

The datasets generated and analysed during the current study are available from the corresponding author on reasonable request.