Empathy and childhood maltreatment: A mixed-methods investigation

BACKGROUND: Impaired empathy is regarded as a psychological consequence of childhood maltreatment, yet few studies have explored this relationship empirically. We investigated whether empathy differed in healthy and maltreated individuals by examining their emotional responses to people in distress. METHODS: Forty-nine individuals (age 20 to 60) viewed short film clips from the South African Truth and Reconciliation Commission testimonies depicting dialogues between victims and perpetrators of gross human rights violations. Participants were divided into 3 groups based on their scores on the Childhood Trauma Questionnaire: control (n = 18), moderate maltreatment (n =. 21), and severe maltreatment (n = 10). We employed a mixed-methods design to explore empathic responses to film clips both quantitatively and qualitatively. RESULTS: Quantitative results indicated that self-reported empathy was lower in the moderate maltreatment group compared to the control group, but of similar strengths in the severe maltreatment and control groups. However, qualitative thematic analysis indicated that both maltreatment groups displayed themes of impaired empathy. CONCLUSIONS: Our results support the notion that childhood maltreatment is associated with impaired empathy, and suggest that such impairment may differ depending on the level of maltreatment: moderate maltreatment was associated with emotional blunting and impaired cognitive empathy, whereas severe maltreatment was associated with emotional over-arousal and diminished cognitive insight.