The role of empathy and perceived stress in the association between dispositional awe and prosocial behavior in medical students: a moderated mediation model

References

• Aknin, L. B., Van de Vondervoort, J. W., & Hamlin, J. K. (2018). Positive feelings reward and promote prosocial behavior. Current Opinion in Psychology, 20, 55–59. https://doi.org/10.1016/j.copsyc.2017.08.017
   PubMed Web of Science ®Google Scholar
• Bai, Y., Maruskin, L. A., Chen, S., Gordon, A. M., Stellar, J. E., McNeil, G. D., Peng, K., & Keltner, D. (2017). Awe, the diminished self, and collective engagement: Universals and cultural variations in the small self. Journal of Personality and Social Psychology, 113(2), 185–209. https://doi.org/10.1037/pspa0000087
   PubMed Web of Science ®Google Scholar
• Berry, D. R., Cairo, A. H., Goodman, R. J., Quaglia, J. T., Green, J. D., & Brown, K. W. (2018). Mindfulness increases prosocial responses toward ostracized strangers through empathic concern. Journal of Experimental Psychology. General, 147(1), 93–112. https://doi.org/10.1037/xge0000392
   PubMed Web of Science ®Google Scholar
• Boer, D., & Fischer, R. (2013). How and when do personal values guide our attitudes and sociality? Explaining cross-cultural variability in attitude-value linkages. Psychological Bulletin, 139(5), 1113–1147. https://doi.org/10.1037/a0031347
   PubMed Web of Science ®Google Scholar
• Bombeke, K., Symons, L., Debaene, L., De Winter, B., Schol, S., & Van Royen, P. (2010). Help, I’m losing patient-centredness! Experiences of medical students and their teachers. Medical Education, 44(7), 662–673. https://doi.org/10.1111/j.1365-2923.2010.03627.x
   PubMed Web of Science ®Google Scholar
• Brock, J. M., Lange, A., & Leonard, K. L. (2016). Generosity and prosocial behavior in healthcare provision: Evidence from the laboratory and field. Journal of Human Resources, 51(1), 133–162. https://doi.org/10.3368/jhr.51.1.133
   Web of Science ®Google Scholar
• Buck, E., Holden, M., & Szauter, K. (2015). A methodological review of the assessment of humanism in medical students. Academic Medicine: journal of the Association of American Medical Colleges, 90(11 Suppl), S14–S23. https://doi.org/10.1097/acm.0000000000000910
   PubMed Web of Science ®Google Scholar
• Burks, D. J., & Kobus, A. M. (2012). The legacy of altruism in health care: The promotion of empathy, prosociality and humanism. Medical Education, 46(3), 317–325. https://doi.org/10.1111/j.1365-2923.2011.04159.x
   PubMed Web of Science ®Google Scholar
• Carlo, G., Crockett, L. J., Randall, B. A., & Roesch, S. C. (2007). A latent growth curve analysis of prosocial behavior among rural adolescents. Journal of Research on Adolescence, 17(2), 301–324. https://doi.org/10.1111/j.1532-7795.2007.00524.x
   Web of Science ®Google Scholar
• Carlo, G., & Randall, B. A. (2002). The development of a measure of prosocial behaviors for late adolescents. Journal of Youth and Adolescence, 31(1), 31–44. https://doi.org/10.1023/A:1014033032440
   Web of Science ®Google Scholar
• Carlo, G., White, R. M. B., Streit, C., Knight, G. P., & Zeiders, K. H. (2018). Longitudinal relations among parenting styles, prosocial behaviors, and academic outcomes in U.S. Mexican adolescents. Child Development, 89(2), 577–592. https://doi.org/10.1111/cdev.12761
   PubMed Web of Science ®Google Scholar
• Chen, L., Zhang, J., Zhu, Y., Shan, J., & Zeng, L. (2023). Exploration and practice of humanistic education for medical students based on volunteerism. Medical Education Online, 28(1), 2182691. https://doi.org/10.1080/10872981.2023.2182691
   PubMed Web of Science ®Google Scholar
• Cohen, S. (1988). Perceived stress in a probability sample of the United States. In S. Spacapan & S. Oskamp (Eds.), The social psychology of health (pp. 31–67). Sage Publications, Inc.
   Google Scholar
• Decety, J. (2015). The neural pathways, development and functions of empathy. Current Opinion in Behavioral Sciences, 3, 1–6. https://doi.org/10.1016/j.cobeha.2014.12.001
   Web of Science ®Google Scholar
• Decety, J., & Jackson, P. L. (2004). The functional architecture of human empathy. Behavioral and Cognitive Neuroscience Reviews, 3(2), 71–100. https://doi.org/10.1177/1534582304267187
   PubMedGoogle Scholar
• Decety, J., & Michalska, K. J. (2010). Neurodevelopmental changes in the circuits underlying empathy and sympathy from childhood to adulthood. Developmental Science, 13(6), 886–899. https://doi.org/10.1111/j.1467-7687.2009.00940.x
   PubMed Web of Science ®Google Scholar
• Dehaene, S., Artiges, E., Naccache, L., Martelli, C., Viard, A., Schürhoff, F., Recasens, C., Martinot, M. L., Leboyer, M., & Martinot, J. L. (2003). Conscious and subliminal conflicts in normal subjects and patients with schizophrenia: The role of the anterior cingulate. Proceedings of the National Academy of Sciences of the United States of America, 100(23), 13722–13727. https://doi.org/10.1073/pnas.2235214100
   PubMed Web of Science ®Google Scholar
• Dong, R., Peng, K., & Yu, F. (2013). Positive emotion: Awe]. Advances in Psychological Science, 21(11), 1996–2005. 积极情绪之敬畏 [ https://doi.org/10.3724/SP.J.1042.2013.01996
   Google Scholar
• Eisenberg, N., Eggum, N. D., & Di Giunta, L. (2010). Empathy-related responding: Associations with prosocial behavior, aggression, and intergroup relations. Social Issues and Policy Review, 4(1), 143–180. https://doi.org/10.1111/j.1751-2409.2010.01020.x
   PubMed Web of Science ®Google Scholar
• Eisenberg, N., & Miller, P. A. (1987). The relation of empathy to prosocial and related behaviors. Psychological Bulletin, 101(1), 91–119. https://doi.org/10.1037/0033-2909.101.1.91
   PubMed Web of Science ®Google Scholar
• Fredrickson, B. L. (1998). What good are positive emotions? Review of General Psychology: journal of Division 1, of the American Psychological Association, 2(3), 300–319. https://doi.org/10.1037/1089-2680.2.3.300
   PubMedGoogle Scholar
• Fredrickson, B. L. (2001). The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. The American Psychologist, 56(3), 218–226. https://doi.org/10.1037//0003-066x.56.3.218
   PubMed Web of Science ®Google Scholar
• Gao, X. Y., Mi, B. B., Wu, W. T., Wu, C. L., Li, M. M., Liu, Y. Z., Jiang, H., Wang, P. B., Zeng, L. X., Dang, S. N., & Yan, H. (2020). 电子数据采集系统REDCap在大型自然人群队列研究中的应用[Application of electronic data acquisition system REDCap in large natural population-based cohort studies]. Zhonghua Yu Fang Yi Xue Za Zhi, 41(9), 1542–1549.
   Google Scholar
• Greener, S., & Crick, N. R. (2001). Normative beliefs about prosocial behavior in middle childhood: What does it mean to be nice? Social Development, 8(3), 349–363. https://doi.org/10.1111/1467-9507.00100
   Web of Science ®Google Scholar
• Guan, F., Chen, J., Chen, O. T., Liu, L. H., & Zha, Y. Z. (2019). Awe and prosocial tendency. Current Psychology, 38(4), 1033–1041. https://doi.org/10.1007/s12144-019-00244-7
   Web of Science ®Google Scholar
• Guan, F., Xiang, Y., Chen, O., Wang, W., & Chen, J. (2018). Neural basis of dispositional awe. Frontiers in Behavioral Neuroscience, 12, 209. https://doi.org/10.3389/fnbeh.2018.00209
   PubMed Web of Science ®Google Scholar
• Hall, J. A. (2011). Clinicians’ accuracy in perceiving patients: Its relevance for clinical practice and a narrative review of methods and correlates. Patient Education and Counseling, 84(3), 319–324. https://doi.org/10.1016/j.pec.2011.03.006
   PubMed Web of Science ®Google Scholar
• Harris, P. A., Taylor, R., Minor, B. L., Elliott, V., Fernandez, M., O’Neal, L., McLeod, L., Delacqua, G., Delacqua, F., Kirby, J., & Duda, S. N, REDCap Consortium. (2019). The REDCap consortium: Building an international community of software platform partners. Journal of Biomedical Informatics, 95, 103208. https://doi.org/10.1016/j.jbi.2019.103208
   PubMed Web of Science ®Google Scholar
• Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Journal of Educational Measurement, 51(3), 335–337.
   Web of Science ®Google Scholar
• Heinen, I., Bullinger, M., & Kocalevent, R. D. (2017). Perceived stress in first year medical students - associations with personal resources and emotional distress. BMC Medical Education, 17(1), 4. https://doi.org/10.1186/s12909-016-0841-8
   PubMed Web of Science ®Google Scholar
• Holden, M., Buck, E., Clark, M., Szauter, K., & Trumble, J. (2012). Professional identity formation in medical education: The convergence of multiple domains. HEC Forum: An Interdisciplinary Journal on Hospitals’ Ethical and Legal Issues, 24(4), 245–255. https://doi.org/10.1007/s10730-012-9197-6
   PubMedGoogle Scholar
• Holmes, C. L., Miller, H., & Regehr, G. (2017). (Almost) forgetting to care: An unanticipated source of empathy loss in clerkship. Medical Education, 51(7), 732–739. https://doi.org/10.1111/medu.13344
   PubMed Web of Science ®Google Scholar
• Huang, F., Wang, H., Wang, Z., Zhang, J., Du, W., Su, C., Jia, X., Ouyang, Y., Wang, Y., Li, L., Jiang, H., & Zhang, B. (2020). Psychometric properties of the perceived stress scale in a community sample of Chinese. BMC Psychiatry, 20(1), 130. https://doi.org/10.1186/s12888-020-02520-4
   PubMed Web of Science ®Google Scholar
• Jiang, S., Dong, L., & Jiang, C. X. (2020). Examining the link between economic strain and adolescent social behavior: Roles of social bonds and empathy. Journal of Adolescence, 84(1), 1–10. https://doi.org/10.1016/j.adolescence.2020.07.015
   PubMedGoogle Scholar
• Jing, D., Jin, Y., & Liu, J. (2019). The impact of monetary incentives on physician prosocial behavior in online medical consulting platforms: Evidence from China. Journal of Medical Internet Research, 21(7), e14685. https://doi.org/10.2196/14685
   PubMed Web of Science ®Google Scholar
• Kauten, R., Barry, C. T., & Leachman, L. (2013). Do perceived social stress and resilience influence the effects of psychopathy-linked narcissism and CU traits on adolescent aggression? Aggressive Behavior, 39(5), 381–390. https://doi.org/10.1002/ab.21483
   PubMed Web of Science ®Google Scholar
• Keltner, D., & Haidt, J. (2003). Approaching awe, a moral, spiritual, and aesthetic emotion. Cognition & Emotion, 17(2), 297–314. https://doi.org/10.1080/02699930302297
   PubMed Web of Science ®Google Scholar
• Kou, Y., Hong, H., Tan, C., & Li, L. (2007). 青少年亲社会倾向量表的修订[Revisioning prosocial tendencies measure for adolescents]. Psychological Development and, Education(01), 112–117.
   Google Scholar
• Lagarde, M., & Blaauw, D. (2017). Physicians’ responses to financial and social incentives: A medically framed real effort experiment. Social Science & Medicine (1982), 179, 147–159. https://doi.org/10.1016/j.socscimed.2017.03.002
   PubMed Web of Science ®Google Scholar
• Lardier, D. T., Lee, C. Y. S., Rodas, J. M., Garcia-Reid, P., & Reid, R. J. (2020). The effect of perceived college-related stress on depression, life satisfaction, and school satisfaction: The coping strategies of hispanic college students from a hispanic serving institution. Education and Urban Society, 52(8), 1204–1222. https://doi.org/10.1177/0013124519896845
   Web of Science ®Google Scholar
• Li, J. J., Dou, K., Wang, Y. J., & Nie, Y. G. (2019). Why awe promotes prosocial behaviors? The mediating effects of future time perspective and self-transcendence meaning of life. Frontiers in Psychology, 10, 1140. https://doi.org/10.3389/fpsyg.2019.01140
   PubMed Web of Science ®Google Scholar
• Lin, X. J., Zhang, C. Y., Yang, S., Hsu, M. L., Cheng, H., Chen, J., & Yu, H. (2020). Stress and its association with academic performance among dental undergraduate students in Fujian, China: A cross-sectional online questionnaire survey. BMC Medical Education, 20(1), 181. https://doi.org/10.1186/s12909-020-02095-4
   PubMed Web of Science ®Google Scholar
• Liu, Y., Jiang, N., & Sun, H. (2021). 医学生亲社会行为与生命道德感的关系:生命意义感和共情的多重中介效应 [The relationship between moral sense of life and prosocial behavior among medical students: The multiple mediating effects of meaning in life and empathy]. Chinese Journal of Behavioral Medicine and Brain Science, 30(10), 944–948.
   Google Scholar
• Liu, Z., Liu, R., Zhang, Y., Zhang, R., Liang, L., Wang, Y., Wei, Y., Zhu, R., & Wang, F. (2021). Association between perceived stress and depression among medical students during the outbreak of COVID-19: The mediating role of insomnia. Journal of Affective Disorders, 292, 89–94. https://doi.org/10.1016/j.jad.2021.05.028
   PubMed Web of Science ®Google Scholar
• Maxwell, S. E., & Cole, D. A. (2007). Bias in cross-sectional analyses of longitudinal mediation. Psychological Methods, 12(1), 23–44. https://doi.org/10.1037/1082-989x.12.1.23
   PubMed Web of Science ®Google Scholar
• McKerrow, I., Carney, P. A., Caretta-Weyer, H., Furnari, M., & Miller Juve, A. (2020). Trends in medical students’ stress, physical, and emotional health throughout training. Medical Education Online, 25(1), 1709278. https://doi.org/10.1080/10872981.2019.1709278
   PubMed Web of Science ®Google Scholar
• Ngai, S. S. Y., & Xie, L. L. (2018). Toward a validation of the prosocial tendencies measure among Chinese adolescents in Hong Kong. Child Indicators Research, 11(4), 1281–1299. https://doi.org/10.1007/s12187-017-9475-6
   Web of Science ®Google Scholar
• Piff, P. K., Dietze, P., Feinberg, M., Stancato, D. M., & Keltner, D. (2015). Awe, the small self, and prosocial behavior. Journal of Personality and Social Psychology, 108(6), 883–899. https://doi.org/10.1037/pspi0000018
   PubMed Web of Science ®Google Scholar
• Prade, C., & Saroglou, V. (2016). Awe’s effects on generosity and helping. The Journal of Positive Psychology, 11(5), 522–530. https://doi.org/10.1080/17439760.2015.1127992
   Web of Science ®Google Scholar
• Rackoff, G. N., & Newman, M. G. (2020). Reduced positive affect on days with stress exposure predicts depression, anxiety disorders, and low trait positive affect 7 years later. Journal of Abnormal Psychology, 129(8), 799–809. https://doi.org/10.1037/abn0000639
   PubMed Web of Science ®Google Scholar
• Rudd, M., Vohs, K. D., & Aaker, J. (2012). Awe expands people’s perception of time, alters decision making, and enhances well-being. Psychological Science, 23(10), 1130–1136. https://doi.org/10.1177/0956797612438731
   PubMed Web of Science ®Google Scholar
• Shiota, M. N., Keltner, D., & John, O. P. (2006). Positive emotion dispositions differentially associated with Big Five personality and attachment style. The Journal of Positive Psychology, 1(2), 61–71. https://doi.org/10.1080/17439760500510833
   Google Scholar
• Shiota, M. N., Keltner, D., & Mossman, A. (2007). The nature of awe: Elicitors, appraisals, and effects on self-concept. Cognition and Emotion, 21(5), 944–963. https://doi.org/10.1080/02699930600923668
   Web of Science ®Google Scholar
• Smith, K. E., Norman, G. J., & Decety, J. (2017). The complexity of empathy during medical school training: Evidence for positive changes. Medical Education, 51(11), 1146–1159. https://doi.org/10.1111/medu.13398
   PubMed Web of Science ®Google Scholar
• Smith, K. E., Norman, G. J., & Decety, J. (2020). Medical students’ empathy positively predicts charitable donation behavior. The Journal of Positive Psychology, 15(6), 734–742. https://doi.org/10.1080/17439760.2019.1651889
   PubMed Web of Science ®Google Scholar
• Stellar, J. E., Anderson, C. L., & Gatchpazian, A. (2020). Profiles in empathy: Different empathic responses to emotional and physical suffering. Journal of Experimental Psychology. General, 149(7), 1398–1416. https://doi.org/10.1037/xge0000718
   PubMed Web of Science ®Google Scholar
• Sun, J. J., Liu, J. S., Liu, M. W., Feng, Y. M., & Li, Y. (2023). Maternal warmth and prosocial behaviors among Chinese preschool children: The roles of social competence sibling presence. Early Education and Development, 35(4), 691–703. https://doi.org/10.1080/10409289.2023.2200338
   Web of Science ®Google Scholar
• Tett, R. P., & Burnett, D. D. (2003). A personality trait-based interactionist model of job performance. The Journal of Applied Psychology, 88(3), 500–517. https://doi.org/10.1037/0021-9010.88.3.500
   PubMed Web of Science ®Google Scholar
• Tomova, L., Majdandžic, J., Hummer, A., Windischberger, C., Heinrichs, M., & Lamm, C. (2017). Increased neural responses to empathy for pain might explain how acute stress increases prosociality. Social Cognitive and Affective Neuroscience, 12(3), 401–408. https://doi.org/10.1093/scan/nsw146
   PubMed Web of Science ®Google Scholar
• Tusche, A., Böckler, A., Kanske, P., Trautwein, F. M., & Singer, T. (2016). Decoding the charitable brain: Empathy, perspective taking, and attention shifts differentially predict altruistic giving. The Journal of Neuroscience: The Official Journal of the Society for Neuroscience, 36(17), 4719–4732. https://doi.org/10.1523/jneurosci.3392-15.2016
   PubMed Web of Science ®Google Scholar
• Van der Graaff, J., Carlo, G., Crocetti, E., Koot, H. M., & Branje, S. (2018). Prosocial behavior in adolescence: Gender differences in development and links with empathy. Journal of Youth and Adolescence, 47(5), 1086–1099. https://doi.org/10.1007/s10964-017-0786-1
   PubMed Web of Science ®Google Scholar
• van Mulukom, V., Patterson, R. E., & van Elk, M. (2020). Broadening your mind to include others: The relationship between serotonergic psychedelic experiences and maladaptive narcissism. Psychopharmacology, 237(9), 2725–2737. https://doi.org/10.1007/s00213-020-05568-y
   PubMed Web of Science ®Google Scholar
• Vossen, H. G. M., Piotrowski, J. T., & Valkenburg, P. M. (2015). Development of the adolescent measure of empathy and sympathy (AMES). Personality and Individual Differences, 74, 66–71. https://doi.org/10.1016/j.paid.2014.09.040
   Web of Science ®Google Scholar
• Wang, J. J., Liu, H. Y., Cui, X. C., Ye, J., & Chen, H. Z. (2023). Impact of a physician’s prosocial behavior on the patient’s choice: An empirical investigation in online health community. Information Technology & People, 36(4), 1703–1725. https://doi.org/10.1108/ITP-12-2020-0878
   Web of Science ®Google Scholar
• Wang, Y., Wang, C., Wen, Z., & Xiao, W. (2017). 共情和同情量表在中国幼儿教师样本中的效度和信度 [Validity and reliability of the measure of empathy and sympathy in Chinese preschool teachers]. Chinese Journal of Clinical Psychology, 25(6), 1027–1030.
   Google Scholar
• Weiskopf, N., Veit, R., Erb, M., Mathiak, K., Grodd, W., Goebel, R., & Birbaumer, N. (2003). Physiological self-regulation of regional brain activity using real-time functional magnetic resonance imaging (fMRI): Methodology and exemplary data. NeuroImage, 19(3), 577–586. https://doi.org/10.1016/s1053-8119(03)00145-9
   PubMed Web of Science ®Google Scholar
• Yang, Y., Yang, Z. Y., Bao, T. X., Liu, Y. Z., & Passmore, H. A. (2016). Elicited awe decreases aggression. Journal of Pacific Rim Psychology, 10, e11. https://doi.org/10.1017/prp.2016.8
   Web of Science ®Google Scholar
• Yaraghi, N., Wang, W., Gao, G. G., & Agarwal, R. (2018). How online quality ratings influence patients’ choice of medical providers: Controlled experimental survey study. Journal of Medical Internet Research, 20(3), e99. https://doi.org/10.2196/jmir.8986
   PubMed Web of Science ®Google Scholar
• Zaki, J. (2014). Empathy: A motivated account. Psychological Bulletin, 140(6), 1608–1647. https://doi.org/10.1037/a0037679
   PubMed Web of Science ®Google Scholar
• Zhao, J., Li, Q., Wang, L., Lin, L., & Zhang, W. (2019). Latent profile analysis of left-behind adolescents’ psychosocial adaptation in rural China. Journal of Youth and Adolescence, 48(6), 1146–1160. https://doi.org/10.1007/s10964-019-00989-1
   PubMed Web of Science ®Google Scholar