# Reduced categorical congruence of cognitive and affective empathy in persons with psychotic disorders

## TL;DR

People with psychotic disorders show less alignment between their understanding of others' emotions and their own emotional responses, but their motivation to help remains intact.

## Contribution

This study reveals reduced categorical congruence in cognitive and affective empathy among individuals with psychotic disorders.

## Key findings

- Patients with psychotic disorders showed reduced categorical agreement between cognitive and affective empathy.
- Compassionate empathy aspects remained unaffected in these patients.
- Emotional categorical congruence was examined using self-reported emotional states in response to scenarios.

## Abstract

Empathy encompasses the ability to recognize the emotional states of others (cognitive empathy), adjust one’s own feelings accordingly (affective empathy), and develop the motivation to provide support (compassionate empathy). Emotional categorical congruence describes the similarity between the emotions we attribute to another person or experience ourselves in response to their situation and that person’s original emotional state. Some authors argue that categorical congruence is an essential feature of empathy, while others emphasize that similarity regarding the hedonic quality of the respective emotional states is sufficient. Several studies have reported empathic deficits in patients with psychotic disorders. Here, the categorical congruence of empathic responses was examined in 21 individuals with psychotic disorders and 21 healthy controls. After reading brief descriptions of emotional situations, participants categorized both the emotional state of the person described in the scenario and their own emotional state, as the other person experiences the situation, using five positive and five negative emotion categories. Additionally, participants rated their motivation and ability to support the other person in the given situation. Patients with psychotic disorders showed reduced categorical agreement between cognitive and affective empathy, while both aspects of compassionate empathy remained unaffected.

The online version contains supplementary material available at 10.1038/s41598-025-34560-9.