Gender differences in understanding the meanings of affect cues, often labeled emotion recognition, have been studied for over a century. Past reviews of the literature have concluded that girls and women score higher than boys and men on tests of accuracy in decoding affect cues, which are most often tested in the cue modalities of face, body, and content-free voice. The present meta-analysis updates knowledge on this topic by including many more studies (1188 effect sizes in 1011 studies; total N = 837,637) and examining a wide range of moderators such as health status of sample, international location, cue channels of the test, and other sample and test characteristics. Indeed, the gender difference favoring girls and women still exists, and evidence for publication bias was weak. The difference is not large (r = 0.12, d = 0.24), but it is extremely consistent across many moderators, which, even when significant, show minor differences. Health status was the only moderator to produce groups without a significant gender difference.

INTRODUCTION:Everyday experience as well as the research literature on trait attributions suggest that people use nonverbal cues when judging the personality of a person. However, little research has reported on people's explicitly held beliefs about these associations. METHODS:Two hundred forty-five participants recruited through Amazon's Mechanical Turk rated how strongly they thought 20 nonverbal cues are related to each of the Big Five traits. Their beliefs were then compared to a previous meta-analysis to see how explicit beliefs compare to implicit beliefs measured in lens models (cue utilizations) and to actual links between the Big Five and nonverbal cues (cue validities). RESULTS:Participants' explicit beliefs formed coherent constellations for each trait. The explicit beliefs corresponded generally well with implicit beliefs as well as with cue validities. CONCLUSION:The results support the validity of explicit beliefs about nonverbal cues and the Big Five, offering new opportunities for researchers interested in how beliefs affect interpersonal interactions.

BACKGROUND:To train and encourage providers to be more empathic, it is crucial to first understand what behaviors providers consider acts of empathy in clinical practice. Research has asked this important question of patients and certain physician specialties, but has left out a unique physician population-anesthesiologists. Given the link between patients' preoperative anxiety and poorer postoperative outcomes, anesthesiologists' ability to address patients' needs effectively, particularly during shorter interactions with new patients, may impact patient outcomes. The purpose of the current research was to investigate what anesthesiologists consider to be empathic behaviors and to compare these results with past investigations of other physician specialties.METHODS:Practicing anesthesiologists (N = 99) were recruited online to rate 49 physician behaviors on a 0 to 10 scale for the degree to which each behavior was aligned with their own conceptualization of clinical empathy.RESULTS:Three components of empathic behaviors emerged: Conscientious and Reassuring, Relationship Oriented, and Emotionally Involved. In line with past work with other physician specialties, anesthesiologists rated Relationship-Oriented behaviors as those most closely related and Conscientious and Reassuring behaviors as least closely related to what they viewed as empathy. Although not statistically significantly, men anesthesiologists were more likely to view Conscientious and Reassuring behaviors as aligned with their conceptualizations of empathy than women anesthesiologists, and women anesthesiologists were significantly more likely to view Emotionally Involved behaviors as aligned with their conceptualizations of empathy than men anesthesiologists, with medium effect sizes.CONCLUSIONS:Although anesthesiologists interact with patients during some of the most emotionally charged and vulnerable situations when evaluating, monitoring, and supervising patient care, beginning preoperatively and continuing through their postoperative care, they do not view empathy behaviors fundamentally differently than other physician specialties. We discuss how these results can inform medical education communication and relational approaches by capitalizing on the understanding of anesthesiologists' conceptualizations of empathy.

People often want to know what their interaction partners are thinking. How accurate are they, what information do they use, what predicts how accurate they will be, and does accuracy matter? We organize our review of thought-feeling accuracy, defined as the accuracy of individuals’ judgments about the content of another person's thoughts and feelings in live interaction, around these questions. At the same time, we argue that often people are especially interested in what others are thinking about them, such that research on the accuracy of individuals’ metaperceptions regarding others’ views of them is highly relevant to understanding thought-feeling accuracy more broadly construed. In particular, we maintain that systematic biases characterizing individuals’ spontaneous metaperceptions are an important source of preventable and harmful forms of thought-feeling inaccuracy. We advocate for integration across the thought-feeling accuracy and meta-accuracy literatures so as to generate new insights that can move them both forward.

Social perception accuracy includes stereotype accuracy, defined as holding correct beliefs about social groups. The present article examines this type of accuracy in relation to gender stereotypes, defined by beliefs about differences between women and men. After locating all studies yielding comparisons between judges' stereotypes and relevant criterion data, we extracted their results and/or conducted original analyses of the raw data reported in the studies. Comparisons of judges' estimates to the criteria yielded high accuracy about the female versus male direction of differences, with 85% of 673 estimates of gender differences aligning with criteria. Consensual sensitivity correlations that assessed judges' collective awareness of the relative size and direction of the criterion differences also favored accuracy with a mean correlation of .77. Analysis of bias in these beliefs revealed both under- and overestimation of the differences, depending on the type of criterion. This review's finding of good evidence for gender stereotype accuracy is consistent with the extensive exposure men and women have to other men and women in daily life.

Despite the ubiquity of thin-slice coding for behavioral measurement, there exists relatively little systematic research into the convergent validity of thin-slice coding metrics for nonverbal behaviors when using human coders. This study utilized five previous datasets to measure four commonly-measured nonverbal behaviors (gaze, gestures, nods, smiles) using three different coding metrics (duration, frequency, rating) coded in 2 or 3 min slices. Convergent validity was measured by comparing a given behavior coded with at least two different metrics. Meta-analytic assessments across studies, behaviors, and metrics indicated strong convergent validity for various metrics for each behavior. Results provide confidence to researchers on the validity of using these thin-slice coding metrics for nonverbal behaviors.

Artificial intelligence (AI) chatbots may be an asset to patient-provider communication, but not enough is known about how patients respond and how chatbots answer patients’ questions. How perceptions of empathy, quality, trust, liking, and goodness vary by both the actual and perceived source of responses to patient questions (chatbot vs. actual physician). We also coded and compared key verbal elements in chatbot and physician responses. This cross-sectional experimental study used chatbot and physician responses from Ayers et al. (2023) in a 2 (actual source: chatbot vs. physician) × 2 (perceived source: chatbot vs. physician) factorial design. U.S.-based, English-speaking participants were recruited online (N = 1454). Participants rated responses on empathy, quality, trust, liking, and goodness. Verbal content of the chatbot and physician responses was independently coded by trained research assistants to identify elements contributing to higher empathy ratings by participants. Replicating Ayers et al. (2023), participants rated chatbot responses as more empathic than physician responses (Cohen’s d = 0.56, p < 0.001). Chatbot responses received higher empathy ratings than physician responses regardless of what participants were told about authorship (ηp2 = 0.60, p < 0.001). Empathy ratings were higher when participants thought the response was physician-authored, whether it was or not (ηp2 = 0.17, p < 0.001). Participant ratings of quality, trust, liking, and goodness followed the same pattern as empathy. Chatbot responses contained more coder-rated validation, reassurance, and non-judgmental language and were less rushed and more structured than physician responses (Cohen’s d = 0.32 to 1.82, p’s < 0.01). AI-generated responses, with human oversight, could enhance computer-mediated clinical communication, although patient awareness of AI contributions may reduce perceptions of empathy. Identification of the specific verbal elements in AI-generated responses could augment communication and increase perceptions of empathic care.

The term empathy has become a buzzword in recent decades, and the concept has received both scholarly attention and has also been the focus of public interest, professional trainings, and policy initiatives. However, misconceptions about its nature persist. Our aim is to rectify these misunderstandings by highlighting claims about empathy that have been empirically refuted. We address seven myths about empathy: #1 People mean the same thing when they say "empathy," #2 Empathy increases burnout, #3 Empathy cannot be measured, #4 Empathy comes effortlessly, #5 Empathy cannot be learned, #6 More recent generations lack empathy, #7 Women are naturally more empathic. These myths, selected due to their considerable implications, often contain a grain of truth but are usually exaggerated or misapplied, typically by generalizing findings from one narrow empathy definition to all empathy constructs. The term "empathy" is an umbrella term encompassing lower-order constructs like compassion, personal distress, emotional congruence, perspective taking, and accurate interpersonal perception. We specify for which lower-order empathy constructs each myth holds, for which constructs it is debunked (based on empirical evidence), and for which lower-order constructs sufficient or consistent evidence exists to offer a conclusive verdict. We illuminate the complexities involved in discussing and studying empathy while debunking these prevalent misunderstandings. Our goal extends beyond merely refuting these myths; we strive to avert their potentially harmful impact on policies and society.

Critical reviews of a test's measurement validity are valuable scientific contributions, yet even strong reviews can be undermined by subtle problems in how evidence is compiled and presented to readers. First, if discussions of poor reporting practices by a test's users are interwoven with discussions about validity support for the test itself, readers can be inadvertently misled into impressions of the latter which are improperly conflated with the former. Second, test reviewers should give at least as much careful attention to a test's external validity as to its structural validity; test reviewers who prioritize factor analysis and internal consistency at the expense of discriminant and convergent validity can inadvertently mislead readers into perceptions of a test which are more negative or more positive than is warranted by the evidence overall. In this commentary, we aim to help test evaluators in crafting critical investigations of measurement validity. We use Higgins et al.'s (2024) review of the Reading the Mind in the Eyes Test (RMET; Baron-Cohen et al., 2001) as a basis for discussion. We argue that their otherwise impressive review went astray in the two ways described above. After considering both the psychometric evidence that Higgins et al. (2024) provided and the external validity evidence that they did not provide, we conclude that their recommendations that the RMET should be abandoned, and that most prior research findings based on it should be reassessed or disregarded, are unwarranted.

Although the empathy concept is relevant across all domains of human relations, it is often used in a vague and poorly defined way that limits its utility both in science and in real-world applications. Research indeed suggests that behaviors considered “empathic” vary across individuals and according to context. This research looked at the organizational context, by (a) in two studies, asking employees in many different work settings to rate a diverse list of workplace behaviors for how much each is empathic to them, and (b) in a third study, analyzing employees’ messages describing instances of fellow employees’ empathic behavior posted to their companies’ rewards platform. In Study 1 (N = 318), employees in different companies responded to a list of 44 discrete behaviors, and in Study 2 (N = 234), employees responded to the same behaviors as well as 25 more. In both studies, two conceptually different, but empirically related, types of empathy emerged, which we labeled Emotional Sensitivity and Professionalism. In Study 3, we coded for these two dimensions in 1,497 messages sent by employees on a company rewards platform where they described “empathic” workplace behaviors by co-workers. Results of all three studies suggest that in the workplace, behavioral manifestations of “empathy” extend beyond conventional notions of personal responsiveness to include task functions, thus demonstrating that “empathy” in the real world covers surprisingly wide territory. The research shows that context matters in discussions of empathy and provides a concrete vocabulary for scholars and organizations to use in research on workplace culture.

Self-report measures of empathy capture several distinct facets of the empathy concept. What does this mean for how different “empathies” are correlated with personality? To find out, we measured six empirically derived facets of self-reported empathy in a data-driven approach, plus self-reported global empathy, along with 25 personality variables (N = 351). Analysis consisted of first correlating each of these seven empathy facets with all of the personality variables, yielding a vector of personality correlates for each empathy facet. Next, we created profile correlations by correlating these vectors of correlates between the empathy facets to show similarities and differences in terms of their pattern of personality correlates. Some of the empathy facets had extremely similar profiles of personality correlates, while others stood apart. These findings indicate that the personality profile of an empathic person depends on the specific facet of empathy that is employed.

The term “empathic accuracy” has been applied to people’s ability to infer the contents of other people’s minds—that is, other people’s varying feelings and/or thoughts over the course of a social interaction. However, despite the ease of intuitively linking this skill to competence in helping professions such as counseling, the “empathic” prefix in its name may have contributed to overestimating its association with prosocial traits and behaviors. Accuracy in reading others’ thoughts and feelings, like many other skills, can be used toward prosocial—but also malevolent or morally neutral—ends. Prosocial intentions can direct attention towards other people’s thoughts and feelings, which may, in turn, increase accuracy in inferring those thoughts and feelings, but attention to others’ thoughts and feelings does not necessarily heighten prosocial intentions, let alone outcomes.

Abstract: Self-report measures of empathy capture several distinct facets of the empathy concept. What does this mean for how different “empathies” are correlated with personality? To find out, we measured six empirically derived facets of self-reported empathy in a data-driven approach, plus self-reported global empathy, along with 25 personality variables ( N = 351). The analysis consisted of first correlating each of these seven empathy facets with all of the personality variables, yielding a vector of personality correlates for each empathy facet. Next, we created profile correlations by correlating these vectors of correlates between the empathy facets to show similarities and differences in terms of their pattern of personality correlates. Some of the empathy facets had extremely similar profiles of personality correlates, while others stood apart. These findings indicate that the personality profile of an empathic person depends on the specific facet of empathy that is employed.

Objective: To offer a critique of empathy concept usage in healthcare and medical education research. Methods: Analysis of current usage and suggestions for authors and researchers. Results: Empathy is often undefined or inconsistently defined, and "empathy" as represented in research covers an unmanageably wide and varied range of intentions, attitudes, emotions, and behaviors. The ubiquitous use of "empathy" as a vague and often undefined umbrella term hinders comprehension and, therefore, scientific progress. Patients are rarely asked directly about empathy; instead, measures of so-called perceived empathy contain descriptive items that could as well be called quality of care, patient-centeredness, or patient satisfaction. Conclusions: Although "empathy" in medical care is widely valued by researchers, educators, and practitioners, the empathy concept as used in the published literature is overused and unclear, and potentially damaging to scholarship, medical education, and ultimately healthcare. The vague term empathy should be replaced as much as possible with concrete descriptions of what is actually measured, experimentally manipulated, or taught. Practice implications: Identifying patients' own empathy definitions will improve medical education and medical care through clarifying what clinical behaviors will best fulfill patients' needs and desires. This approach allows for greater specificity and personalized care delivery.

Objectives: Training in emotion management is not a standard part of medical education. This study's objective was to understand physicians' challenges navigating emotion (their own and their patients') and identify areas for intervention to support physician wellness and enhance patient care.Methods: In 2019, we surveyed 103 physicians in emergency medicine, internal medicine, family medicine, and neurology. Participants quantitatively reported emotion training, emotions that were challenging, and barriers to addressing emotion. They provided qualitative examples of emotion challenges and successes that we analyzed using an inductive thematic analysis.Results: There were no significant differences in responses by specialty. Only 10% reported receiving emotion management training, with no evidence that more recently trained physicians received more. Those who had received training on emotion reported greater comfort in dealing with patients' emotions and were more likely to engage in teaching on emotion. There were gender and career stage differences regarding which emotions physicians found most challenging. The authors identified central themes of emotion-related challenges and successes.Conclusions: Targeted educational initiatives are needed to advance physicians' ability to navigate emotion in clinical encounters. Practice implications: Developing strategies for managing patients' emotions may better prepare physicians for navigating the emotional demands of practicing medicine.

Sillitoe's metaphor of individual sacrifice, singular focus and hard work applies in equal measure to traditional thinking about how to achieve success in a research career. Planning for the Relationship-Centered Care Initiative began in the spring of 2001 with the two co-principal investigators who conceived of a project that would involve two arms: applying Relationship-Centered Care principles to changing the culture of a large medical school and creating a relationship centered care research network. By design, the research network included individuals with different professional and methodological orientations. Logistic support and day-to-day management of the project fell to the project manager, Dave Mossbarger. While the effects of physical environment have been studied in many settings such as classroom design, instrumentation in aviation, and hospital design for patients with dementia, scant attention has been paid to the effect(s) of physical context on developing and sustaining research and research relationships.

The concept of empathy as it is used in scholarly discourse has been challenged for over 50 years, yet the same ambiguities and controversies associated with the concept persist and, indeed, have accelerated with the accumulation of definitions, subconstructs that are included under the empathy umbrella, and measuring instruments. In this article we address the following interrelated problems: many definitions, authors not offering definitions, authors using instruments that do not match their definitions, authors not specifying definitions and measurements in cited studies, the jingle-jangle problem, and the persistent need for more construct validity research. In this Special Issue on empathy and its problems, authors bring new theoretical insights, creative research designs, and a critical focus on the empathy concept itself.