Impaired Cognitive Empathy in Outpatients with Chronic Musculoskeletal Pain: A Cross-Sectional Study

Abstract

Background. In recent years, a growing number of researchers showed significant interest in psychological and social interventions to manage chronic musculoskeletal (MSK) pain. Cognitive and emotional empathy is an attractive and valuable sociopsychological factor that may provide protection and resilience against chronic MSK pain. However, its effect on outpatients remains underexplored. Objective. To compare the empathy ability between chronic MSK pain outpatients and healthy controls and explore the relationship between cognitive/emotional empathy and chronic pain. Methods. Patients with chronic MSK pain ( $n=22$ ) and healthy controls ( $n=26$ ) completed the pain assessment and empathy ability task, utilizing a multidimensional empathy assessment tool with satisfactory reliability and validity (i.e., the Chinese version of the Multifaceted Empathy Test (MET-C)). Results. The data indicated that the chronic MSK pain outpatients had impaired cognitive empathy (i.e., lower squared cognitive empathy accuracy: Student’s $t=-2.119$ , $P=0.040$ , and longer task completion time: Student’s $t=3.382$ , $P=0.002$ ) compared to healthy controls, and cognitive empathy was negatively correlated with pain intensity ( $r=-0.614$ , $P=0.002$ ). Further, the impaired cognitive empathy was present in identifying positive, but not negative emotions. Conclusion. These results indicate that chronic MSK pain is associated with impaired empathy ability. Our studies contribute to offering a potential direction for developing psychosocial interventions to treat chronic MSK pain.