The Toronto Empathy Questionnaire
The Toronto Empathy Questionnaire
The Toronto Empathy Questionnaire
The Toronto Empathy Questionnaire: Scale Development and Initial Validation of a Factor-Analytic Solution to Multiple Empathy Measures
R. NATHAN SPRENG,1, MARGARET C. MCKINNON,2,3, RAYMOND A. MAR,4 AND BRIAN LEVINE1,5,6
Rotman Research Institute at Baycrest Centre, Toronto, Ontario, Canada Mood Disorders Program, St. Josephs Healthcare, Hamilton, Ontario, Canada 3 Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada 4 Department of Psychology, York University, Toronto, Ontario, Canada 5 Department of Psychology, University of Toronto, Toronto, Ontario, Canada 6 Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
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To formulate a parsimonious tool to assess empathy, we used factor analysis on a combination of self-report measures to examine consensus and developed a brief self-report measure of this common factor. The Toronto Empathy Questionnaire (TEQ) represents empathy as a primarily emotional process. In 3 studies, the TEQ demonstrated strong convergent validity, correlating positively with behavioral measures of social decoding, self-report measures of empathy, and negatively with a measure of Autism symptomatology. Moreover, it exhibited good internal consistency and high testretest reliability. The TEQ is a brief, reliable, and valid instrument for the assessment of empathy.
Empathy is an important component of social cognition that contributes to ones ability to understand and respond adaptively to others emotions, succeed in emotional communication, and promote prosocial behavior. The term empathy is derived from Titcheners (1909; Wisp , 1986) translation of the German word e Einf hlung, meaning feeling into (Wisp , 1987). Generally u e speaking, it refers to the consequences of perceiving the feeling state of another as well as the capacity to do so accurately. Despite the prominence of the empathy construct in developmental research (Sagi & Hoffman, 1976; Ungerer, 1990; Zahn-Waxler, Friedman, & Cummings, 1983) and cross-species investigations of empathic capabilities (Masserman, Wechkin, & Terris, 1964; Rice & Gainer, 1962), a clear, consensual denition of the construct of empathy remains elusive. Recent research into empathy has emphasized the distinction between cognitive and emotional components of the construct (Preston & de Waal, 2002). These components assume various denitions. Put simply, however, emotional empathy is commonly thought of as an emotional reaction (e.g., compassion) to anothers emotional response (e.g., sadness). This reaction is not dependent on a cognitive understanding of why a person is suffering (Rankin, Kramer, & Miller, 2005), although it may facilitate understanding and action. By contrast, cognitive empathy involves an intellectual or imaginative apprehension of anothers emotional state, often described as overlapping with the construct of theory of mind (understanding the thoughts and feelings of others) and used interchangeably by some authors (Lawrence, Shaw, Baker, Baron-Cohen, & David, 2004). Numerous authors have focused on distinguishing empathy from
Received March 13, 2008; Revised June 30, 2008. Both authors contributed equally. Address correspondence to R. Nathan Spreng, Rotman Research Institute at Baycrest Centre, 3560 Bathurst Street, Toronto, Ontario, M6A 2E1 Canada; Email: [email protected]
the related concepts of emotional contagion, sympathy, and perspective taking surveyed in some self-report measures of empathy (Omdahl, 1995; Wisp , 1986, 1987). Whereas emotional e contagion (also referred to as personal distress) involves the perceiver assuming the emotional state of the target, sympathy is thought to reect a state of feeling sorry for the target with or without an associated behavioral response (Preston & de Waal, 2002). Perspective taking, in contrast, involves the apprehension of anothers thought and feeling states through the assessment of visual, auditory, or situational cues (Rankin et al., 2005), without any personal emotional response. Agreement among researchers and theoreticians on the interrelated processes contributing to empathy has been elusive. Although the processes described previously (perspective taking, sympathy, personal distress, emotional contagion, theory of mind) are referred to as empathic, there is little agreement in the literature as to whether they are distinct from empathy as an accurate affective insight into the feelings of another or are facets of a central process required for empathic responding. Indeed, the current corpus of self-report measures of empathy reects these differing constructs, resulting in signicant heterogeneity among measures (Ickes, 1997). In the face of such heterogeneity, one useful approach may be to ask what is common among these different conceptions, allowing one to examine the consensus, or core, opinion on this important process. It is important to note that a multifaceted measure may be preferable in some situations. We are not proposing that multifactorial approaches be replaced with a unidimensional measure or that empathy itself be viewed as a single, homogenous construct. Rather, the eld of empathy measurement lacks a sufcient tool for examining this construct at the broadest level, and it is this gap that we endeavor to remedy. A useful parallel may be drawn with early intelligence research, which has suffered a similar period of confusion populated by multiple conceptions. When a single underlying factor was extracted from the multiple
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Other self-report measures of empathy have been developed to target specic populations. These include the Scale of Ethnocultural Empathy (Wang et al., 2003), the Jefferson Scale of Physician Empathy (Hojat et al., 2001), the Nursing Empathy Scale (Reynolds, 2000), the Autism Quotient (BaronCohen, Wheelwright, Skinner, Martin, & Clubley, 2001) and the Japanese Adolescent Empathy Scale (Hashimoto & Shiomi, 2002). Although these instruments were designed for use with specic groups, aspects of these scales may be suitable for assessing a general capacity for empathic responding. That is, all of these diverse scales touch on an aspect of empathy, broadly speaking. The Autism Quotient (Baron-Cohen, Wheelwright, Skinner, et al., 2001) was developed to measure Autism spectrum disorder symptoms. Baron-Cohen, Wheelwright, Skinner, et al. viewed a decit in theory of mind as the characteristic symptom of this disease (Baron-Cohen, 1995) and a number of items from this measure relate to broad decits in social processing (e.g., I nd it difcult to work out peoples intentions.). Thus, any measure of empathy should exhibit a negative correlation with this measure. The magnitude of this relation, however, will necessarily be attenuated by the other aspects of the Autism Quotient, which measure unrelated constructs (e.g., attentional focus and local processing biases). Additional self-report measures of social interchange appearing in the neuropsychological literature contain items tapping empathic responding including the Dysexecutive Questionnaire (Burgess, Alderman, Evans, Wilson, & Emslie, 1996) and a measure of emotion comprehension developed by Hornak, Rolls, and Wade (1996). These scales focus on the respondents ability to identify the emotional states expressed by another (e.g., I recognize when others are feeling sad.). Current theoretical notions of empathy emphasize the requirement for understanding of anothers emotions to form an empathic response (Bernieri, 2001). Only a small number of items on current measures of empathy, however, assess this ability. In this study, we attempted to formulate a consensus among the many scales in use to gauge the empathy construct. Using exploratory factor analysis (EFA), we forced the items to load onto a single factor, thereby assembling a group of highly related items from across many measures of empathic responding, bringing about a unidimensional factor of empathy. Our aim was to identify what is common among different conceptions of empathy as operationalized by published measures of this construct. In a series of three studies, we constructed the Toronto Empathy Questionnaire (TEQ) and demonstrated the TEQs construct validity through associations with behavioral and self-report measures of interpersonal sensitivity as well as its internal consistency and testretest reliability.
CURRENT SELF-REPORT MEASURES OF EMPATHY The Empathy Scale (Hogan, 1969), one of the rst measures to achieve widespread use, contains four separate dimensions: social self-condence, even-temperedness, sensitivity, and nonconformity. A psychometric analysis of the scale, however, indicates questionable testretest reliability and low internal consistency along with poor replication of its previously hypothesized factor structure (Froman & Peloquin, 2001). Indeed, several authors have suggested that the four factors measured by this scale are better suited to the measurement of social skills, broadly speaking, than a central tendency toward empathic behavior (Baron-Cohen & Wheelwright, 2004; Davis, 1983). Hogans (1969) Empathy Scale has been widely employed as a measure of cognitive empathy (e.g., Eslinger, 1998) but has recently been supplanted in popularity by the Interpersonal Reactivity Index (IRI; Davis, 1983), discussed following. The Questionnaire Measure of Emotional Empathy (QMEE; Mehrabian & Epstein, 1972) reemphasizes the original denition of the empathy construct (Titchener, 1909; Wisp , 1986). e The scale contains seven subscales that together show high split-half reliability, indicating the presence of a single underlying factor thought to reect affective or emotional empathy. Mehrabian, Young, and Sato (1988) suggested more recently, however, that rather than measuring empathy per se, the scale more accurately reects general emotional arousability. In response, an unpublished, revised version of the measure, the Balanced Emotional Empathy Scale (Mehrabian, 2000) taps respondents reactions to others mental states (cf. Lawrence et al., 2004). The IRI (Davis, 1983) contains four subscales: Perspective Taking and Fantasy in addition to Empathic Concern and Personal Distresseach pair purported to tap cognitive and affective components of empathy, respectively. As pointed out by Baron-Cohen and Wheelwright (2004), however, the Fantasy and Personal Distress subscales of this measure contain items that may more properly assess imagination (e.g., I daydream and fantasize with some regularity about things that might happen to me) and emotional self-control (e.g., In emergency situations I feel apprehensive and ill at ease), respectively, than theoretically derived notions of empathy. Indeed, the Personal Distress subscale appears to assess feelings of anxiety, discomfort, and a loss of control in negative environments. Factor analytic and validity studies have suggested that the Personal Distress subscale may not assess a central component of empathy (Cliffordson, 2001). Instead, Personal Distress may be more related to the personality trait of neuroticism, whereas the most robust components of empathy appear to be represented in the Empathic Concern and Perspective Taking subscales (Alterman, McDermott, Cacciola, & Rutherford, 2003).
STUDY 1 We began by submitting responses to every self-report measure of empathy we were able to identify to an EFA, determining what were common across these previously published measures. Items were forced to load on to a single factor, forming the basis of our questionnaire that was then examined for factorial integrity, internal consistency, and reliability.
64 Methods Participants. A total of 200 University of Toronto undergraduates (100 female), mean age 18.8 years (SD = 1.2), participated for course credit in a psychology course, satisfying general recommendations for sample size in factor analysis aimed at determining the stability of component patterns (Guilford, 1954; Russell, 2002). We carefully observed a balance of genders for initial scale development. Materials. We conducted a review of the literature with the aim of collecting all available measures related, even tangentially, to the self-report of empathic processes or the assessment of decits in empathic ability. Questions were selected from several published self-report empathy measures including the IRI (28 items; Davis, 1983), Hogans Empathy Scale (15 items; Hogan, 1969), the QMEE (nine items; Mehrabian & Epstein, 1972), a reworded Balanced Emotional Empathy Scale (12 items; Mehrabian, 2000), the Scale of Ethnocultural Empathy (four items; Wang et al., 2003), Jefferson Scale of Physician Empathy (six items; Hojat et al., 2001), Nursing Empathy Scale (eight items; Reynolds, 2000), Japanese Adolescent Empathy Scale (10 items; Hashimoto & Shiomi, 2002), and the Measure of Emotional Intelligence (three items; Schutte et al., 1998), for a total of 95 items after redundant questions were removed. An additional 36 questions were composed based on the literature concerning individuals with altered empathic responding due to neurological or psychiatric disease, with the addition of modied items from the Dysexecutive Questionnaire (four items; Burgess et al., 1996) and a measure of emotion comprehension developed by Hornak et al. (seven items; 1996). Factor analysis with 200 participants and 142 items yielded an independent observation-to-item ratio of 1.4:1 that exceeds the minimum 1.2:1 ratio capable of recovering a population factor structure (Barrett & Kline, 1981; see MacCallum, Widaman, Zhang, & Hong, 1999). To ensure consistency across sampled items, we reworded questions to assess frequency of behavior rather than to pose general statements or tendencies. Responses were given using a 5-point Likert scale corresponding to various levels of frequency (i.e., never, rarely, sometimes, often, always) as opposed to agreement with individual statements, a method used in several of the scales described previously. Two additional self-report measures were administered in their entirety to establish convergent and discriminant validity: the IRI, comprising four subscales of seven items each (Davis, 1983) and the 50-item Autism Quotient (Baron-Cohen, Wheelwright, Skinner, et al., 2001). We expected the subscales of the IRI to be positively related to the TEQ, given that these subscales reect the content of the majority of empathy measures. Within this measure, we predicted that the Empathic Concern subscale would show the strongest association with the TEQ followed by the Perspective Taking subscale, as these subscales are thought to map closely onto emotional and cognitive constructs of empathy. We did not expect the Fantasy and Personal Distress subscales of this measure to show a strong association with the TEQ given their close relation to imagination and emotional self-control (Baron-Cohen & Wheelwright, 2004). Finally, we predicted that the Autism Quotient would be negatively related to the TEQ, as it measures a degree of decit in social processing. We expected this relation to be moderated,
Statistical analysis. We determined a consensus account of empathy using an EFA examining the structure of intercorrelations among items. We conducted an iterated principal-axis factor analysis with squared multiple correlations of each item with all other items as the initial communality estimates on responses for each item. We forced items from this EFA to load onto a single factor. To devise a unidimensional empathy questionnaire that maximized item-remainder coefcients and factor loadings, we eliminated items that had low itemremainder coefcients (below .30), those that failed to improve internal consistency, and items possessing factor loadings lower than .40. We then conducted a second EFA with the 16 retained items to more completely document the factor structure of the questionnaire. We then assessed convergent and discriminant validity of the newly devised 16-item TEQ by calculating Pearson correlations with the IRI and the Autism Quotient. We assessed gender differences in the TEQ by an independent samples t test and by calculating the effect size with Cohens d. We also determined correlations between the IRI subscales and the Autism Quotient. Results and Discussion Initial eigenvalues greater than 1 and their variance explained are provided in Table 1. A total of 41 factors with an eigenvalue greater than 1 suggested a multiplicity of factors in the self-report of empathy and related constructs (according to the Kaiser criteria). Conducting an EFA with a forced single factor yielded 55 items with loadings above .40, drawing on items from each scale. When more than 10 items load at .40 or above, a single component can be considered a stable representation of the population parameter with this sample size (Guadagnoli & Velicer, 1988; Stevens, 2002). To form a brief scale, we then culled these 55 items with loadings above .40 to maximize internal consistency and item-remainder coefcients. This process led to the formation of the 16-item TEQ (see Appendix). The TEQ contains an equal number of positively and negatively worded/scored items from a number of different scales as well as newly composed items (Table 2). Unidimensional factor loadings ranged from .41 to .65 (M = .51, SD = .07; Table 2). Item-remainder coefcients were sound, ranging from .36 to .59 (Table 2); internal consistency was also good: Cronbachs = .85. In a second EFA of the 16-item TEQ, the rst 5 eigenvalues were 5.23, 1.43, 1.13, 1.06, and 0.93. There is a discontinuity between the rst and second factor consistent with a unidimensional structure. Factor coefcients are reported in Table 2 in which the items were forced to load on a single factor, ranging from .42 to .65 (M = .53, SD = .08). This analysis yielded four items with loadings above .60, an indication that the factor is reliable regardless of sample size (Guadagnoli & Velicer, 1988; Stevens, 2002). We further explored the factor structure of the newly formed TEQ in an independent sample in Study 2. Participants total scores on TEQ items positively correlated with the IRI subscale Empathic Concern, r = .74, p < .001. Four items within the TEQ were reworded Empathic Concern subscale items. When these items were removed from the TEQ
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TABLE 2.Toronto Empathy Questionnaire sources and psychometric attributes. Factor Loadings Item Remainder Study 1 Study 1 Study Study Study 142161 2 3 Item EFA Item EFA .41 .54 .54 .47 .52 .43 .43 .36 .40 .42 .48 .58 .59 .50 .40 .47 .38 .43 .47 .56 .54 .59 .40 .37 .39 .47 .51 .59 .71 .46 .39 .43 .40 .66 .70 .54 .63 .64 .47 .34 .37 .36 .43 .51 .71 .53 .38 .35 .46 .56 .60 .50 .57 .47 .47 .41 .44 .45 .51 .62 .66 .55 .44 .53 .48 .59 .64 .47 .61 .50 .50 .44 .48 .47 .44 .65 .62 .58 .42 .53
Item Source 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Hashimoto & Shiomi, 2002; Mehrabian, 2000 Davis, 1983 Mehrabian, 2000 Hornak, Rolls, & Wade, 1996; Mehrabian, 2000 Hogan, 1969 Davis, 1983 Mehrabian & Epstein, 1972 Hornak, Rolls, & Wade, 1996 Hogan, 1969 Mehrabian, 2000 New item New item Hogan, 1969; Mehrabian, 2000 Davis, 1983 Mehrabian & Epstein, 1972 Davis, 1983
Note. EFA = exploratory factor analysis. All items from the Interpersonal Reactivity Index (Davis, 1983) were derived from the Empathic Concern subscale.
total score, the correlation remained high, r = .71, p < .001, suggesting that TEQ items used to measure empathy tap a construct similar to that measured by the Empathic Concern subscale of the IRI. The TEQ had a lower, but still positive, correlation with the IRI subscale of Perspective Taking despite containing no items from this scale, r = .35, p < .001. Thus, our measure of the broadest level of empathy, although clearly closer to an emotional measure of empathy, still captured variance associated with a more cognitive measure of empathy. The TEQ scores exhibited a negative correlation with the Autism Quotient, as hypothesized, r = .30, p < .001. Individuals scoring highly on our measure tended to report less social processing and communication difculties as assessed by the Autism Quotient. As predicted, the magnitude of this association was not as great as that for the IRI in which the Autism Quotient measures other symptoms of this disorder not specifically related to social functioning and thus not expected to relate systematically to our measure of empathy. Relations to the Autism Quotient are intended only to demonstrate divergence with related, although conceptually quite different, measures. Means and standard deviations of all measures can be found in Table 3.
We observed no effect of gender in this sample of the TEQ (Table 4), suggesting that men and women provided equivalent responses on our measure. The IRI subscales also demonstrated signicant associations with the Autism Quotient. Consistent with the theory of mind decits associated with Autism spectrum disorder, the IRI subscale Perspective Taking was negatively associated with the Autism Quotient, r = .23, p < .01. A positive association, however, was observed between the IRI subscale Personal
TABLE 3.Means and standard deviations of self-report and behavioral measures for all studies. Study 1 Measure M SD Study 2 M SD Study 3 M SD 7.47
Toronto Empathy Questionnaire 44.54 7.70 47.27 Interpersonal Responsivity Index Empathic Concern 3.81 0.63 3.89 Personal Distress 2.62 0.77 2.65 Perspective Taking 3.48 0.71 3.45 Fantasy 3.49 0.82 3.69 Autism Quotient 18.28 5.24 Reading the Mind in the Eyes Task 27.24 Interpersonal Perception Task 9.81 Empathy Quotient
4.42
40.69 10.36
Note. All means and standard deviations are within the normal ranges of healthy adults previously reported (cf. Davis, 1980; Baron-Cohen, Wheelwright, Hill, Raste, & Plumb, 2001; Baron-Cohen, Wheelwright, Skinner, Martin, & Clubley, 2001; Costanzo & Archer, 1994; Baron-Cohen & Wheelwright, 2004). Interpersonal Responsivity Index subscale means are reported as the mean Likert (15) score.
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Distress and the Autism Quotient, r = .36, p < .01. This association suggests that individuals reporting greater emotional arousability report greater difculties with social processing and communication and may not represent a core component of empathy. Additionally, there was a slight negative or no relationship with the other subscales: Empathic Concern, r = .10, p > .10; and Fantasy, r = .02, p > .75. The low association between the Autism Quotient and Empathic Concern suggests that the subscales construct of empathy is unrelated to self-reported prociency in social processing and communication. We examined the relationship between self-reported empathy and social processing more explicitly in Study 2.
STUDY 2 From the current corpus of heterogeneous self-report measures of empathy, we identied items that together assess a common construct of empathy. This led to the creation of a unidimensional empathy questionnaire, the TEQ, which possesses high internal consistency and demonstrated convergent and discriminant validity. In a second study, we aimed to further demonstrate the TEQs factorial integrity, internal consistency, and expand on its construct validity. In processing interpersonal information, an empathic individual must discriminate and interpret stimuli relevant to the goals of social processing. This interpersonal information must subsequently be interpreted accurately to facilitate the task of responding in an empathic fashion (Bernieri, 2001). We assessed the relation of the TEQ to two behavioral measures that also require the processing of complex interpersonal stimuli: The Reading the Mind in the Eyes TestRevised (MIE; BaronCohen, Wheelwright, Hill, Raste, & Plumb, 2001) and the Interpersonal Perception Task15 (IPT15; Costanzo & Archer, 1994). Together, these measures assess processes that are described commonly in the theoretical literature surrounding empathic accuracy (e.g., emotion comprehension, perspective taking; Sagi & Hoffman, 1976; Ungerer, 1990; Zahn-Waxler et al., 1983). The utility of any self-report measure is improved greatly if associations can be found with task-based measures (which in this case are presumably less inuenced by factors such as socially desirable responding). Indeed, scores on a valid scale of empathy should be systemically related to the correct identication and comprehension of social stimuli as assessed by these measures. However, most self-report measures of empathy are not systematically associated with performance on interpersonal sensitivity tasks (e.g., Ickes, 1997) except in rare instances when other factors, such as the targets trait expressivity, is taken into account (Zaki, Bolger, & Ochsner, 2008). Here, we predicted that in assessing the broadest level of empathy, the TEQ would have more success in predicting empathic performance than did these measures. Method Participants. A total of 79 University of Toronto students (55 female) aged, on average, 18.9 years (SD = 3.0) participated for course credit in psychology. Materials. In addition to the newly formed TEQ, this new sample of participants completed the IRI (Davis, 1983), the MIE (Baron-Cohen, Wheelwright, Hill, et al., 2001) and the IPT15 (Costanzo & Archer, 1994).
Analysis. We examined the validity of the TEQ by correlating total scores with the IRI subscales, MIE, and IPT15. We assessed gender differences by an independent samples t test, and the effect size was determined by calculating Cohens d. As a secondary goal, we again examined the structure of this measure by calculating item-remainder coefcients and Cronbachs alpha. We then employed two tests to reexamine the structural validity of the TEQ. Parallel analysis and Velicers minimum average partial test (B. P. OConnor, 2000; Steger, 2006; Velicer, 1976) are statistical methods that enable one to objectively determine the number of factors in a data set. Parallel analysis provides the eigenvalues from a factor analysis of a randomly permuted data set. Here, we performed random permutations of raw TEQ data (matching for sample size, number of items, and scoring range). We then plotted and compared the eigenvalues of the random permutations from the 95th percentile with the real data. The number of factors present in the data was observed at the point of intersection on the scree plot. Next, we performed Velicers minimum average partial test to determine the number of factors (or components) in the TEQ. In the minimum average partial test, a complete principal components analysis is performed, after which the rst principal component is partialled out of the correlations among the variables, and the average squared partial correlation is noted. This procedure was repeated using the rst 2 principal components, then the rst 3, an so forth. The number of components whose partialling out resulted in the minimum average partial is the number of components related to systematic, rather than unsystematic, variance in the original correlation matrix. Results and Discussion The TEQ correlated positively with the IRI subscales of Empathic Concern, r = .74, p < .001; Perspective Taking, r = .29, p < .01; and unlike in Study 1, Fantasy, r = .52, p <
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44.45 8.19 44.62 7.22 0.16 198 0.87 43.46 7.79 48.93 6.77 3.16 77 <.05 43.63 7.93 48.33 6.90 2.39 63 <.01
Note. TEQ = Toronto Empathy Questionnaire.
.001. Scores on the TEQ also correlated with the behavioral measures of social comprehension: MIE, r = .35, p < .01; IPT15, r = .23, p < .05. This was true even though these two measures themselves were uncorrelated, r = .08, p > .45. The lack of correlation between the MIE and IPT15 illustrates the problematic heterogeneity that is commonly observed with regard to empathy measurement (Ickes, 1997) and emphasizes the need for a measure that represents core empathy or what is common among these diverse measures. Furthermore, these associations with behavioral measures of interpersonal sensitivity demonstrate validity extending beyond agreement with other self-report measures. Importantly, the magnitude of these associations is not trivial. The association with the MIE falls within the top third of all effect sizes observed in psychology for measures that do not share method variance, and the correlation with the IPT15 lies within the middle third (Hemphill, 2003). Unlike the TEQ, the IRI subscales demonstrated a slight negative or no relationship with the MIE: Empathic Concern, r = .15, p < .05; Perspective Taking, r = .16, p < .01; Personal Distress, r = .14, p < .05; and Fantasy, r = .06, p > .30. Additionally, the IRI exhibited statistically nonsignicant relationships with the IPT15, which were weaker but similar in value to the TEQ: Empathic Concern, r = .17, p > .10; Perspective Taking, r = .20, p > .05; Personal Distress, r = .11, p > .30; and Fantasy, r = .10, p > .40. Thus, although the TEQ was highly related to the Empathic Concern subscale of the IRI (Study 1), it performed better than the IRI when predicting actual social cognitive performance on measures related to empathic accuracy. Unlike Study 1, gender differences were observed in this sample (Table 4). Consistent with previous self-report measures of empathy (e.g., Davis, 1983), a moderate effect was observed: Women scored higher than men. Item-remainder coefcients for the TEQ were sound, ensuring that all the items assess the same construct, and ranged from .37 to .71; and internal consistency was good, Cronbachs = .85. An examination of the scree plot of the real and permuted data (Figure 1) indicated that the number of factors in the data set was one. Velicers minimum average partial test found systematic variance in the TEQ related to a single component, with the smallest average squared correlation of .0231 (Table 5). The parallel analysis and the minimum average partial test provide converging evidence that the TEQ comprises a single factor.
FIGURE 1.Scree plot of the eigenvalues for Study 2 exploratory factor analysis and randomly permuted raw data. TEQ = Toronto Empathy Questionnaire.
retest reliability on a second set of responses given by returning participants from Study 2. The aim of this study was to extend the ndings from Study 1 by examining the relation of the TEQ to additional measures of social cognitive processing related to empathy as well as the stability of our measure over time. We included a new self-report measure of empathy developed by Baron-Cohen and Wheelwright (2004): the Empathy Quotient. The development of this 80-item questionnaire was theoretically driven, and it was evaluated psychometrically on individuals with Aspergers syndrome and matched neurologically intact controls. Because this scale was not available when Study 1 was conducted, it was not included in the original battery given to our respondents. As predicted by Baron-Cohen and Wheelwright (2004), individuals with Aspergers syndrome scored lower on this measure of empathy than controls. We expected
TABLE 5.Velicers minimum average partial test results for Study 2. Components 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Average Squared Correlations .0892 .0231 .0272 .0309 .0372 .0474 .0556 .0668 .0835 .1020 .1360 .1689 .2236 .2930 .4761 1
STUDY 3 To explore further the psychometric properties of the TEQ, we once again investigated convergent and discriminant validity through associations with self-report measures of empathy and Autism spectrum disorder symptomatology as well as test
Note. The smallest minimum average partial, indicating the number of components in the data, is in bold.
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TEQ scores to be positively associated with the Empathy Quotient and negatively associated with the Autism Quotient.
SPRENG, MCKINNON, MAR, LEVINE Toronto Empathy Questionnaire Emphasis on the emotional components of empathic responding in the TEQ is consistent with the approach taken by other researchers in forming self-report measures of empathy (e.g., Mehrabian & Epstein, 1972). For example, a conrmatory factor analysis of the IRI found one general dimension of empathy at the apex, Empathic Concern; this dimension overlaps to a great extent with Perspective Taking and Fantasy (Cliffordson, 2002). Consistent with this nding, the TEQ correlated highly with the IRI subscales of Empathic Concern (Studies 1 and 2) and to a lesser degree Perspective Taking (Studies 1 and 2) and Fantasy (Study 2). Taken together, these results suggest that the four-factor (i.e., multiple subscale) solution implicit in the IRI may not be necessary to capture empathic responding in self-report measures. Cognitive accounts of empathy, although not mutually exclusive to affective accounts, emphasize aspects of social responding involving the ability to take the perspective of another (Allport, 1961; Mead, 1934), role-taking (Mead, 1934), and the ability to infer and predict anothers behavior or mental state (Baron-Cohen & Wheelwright, 2004; Dennett, 1987). The TEQ demonstrated an association with this cognitive account and correlated with the IRI subscales of Perspective Taking and Fantasy, described previously as the cognitive components of empathy (Davis, 1983). This association suggests signicant overlap across the cognitive and affective components of empathy described in the literature in which intercorrelation of emotional and cognitive accounts of empathic responding may indicate shared processes (for similar accounts of theory of mind reasoning, see Leslie, Friedman, & German, 2004). Indeed, evidence from neuroimaging and monkey research suggests that the cognitive and affective empathy may be mediated in different domains but are represented by the same underlying process in viscero-motor mirror neurons, neurons that re in response to both executing and observing a goal-directed action or emotional experience of another (Gallese, 2003; Gallese, Keysers, & Rizzolatti, 2004). The TEQ contains 16 questions that encompass a wide range of attributes associated with the theoretical facets of empathy. The affective aspect of empathic responding is thought to be related to such phenomena as emotional contagion (Eisenberg & Miller, 1987; Lipps, 1903), emotion comprehension (Haxby, Hoffman, & Gobbini, 2000), sympathetic physiological arousal (Levenson & Ruef, 1992) and con-specic altruism (Rice, 1964), all of which are represented in TEQ items. Two items specically target the perception of an emotional state in another that stimulates the same emotion in oneself (Items 1 and 4). One item assesses emotion comprehension in others (Item 8). Other items address the assessment of emotional states in others by indexing the frequency of behaviors demonstrating appropriate sensitivity (Items 2, 7, 10, 12, and 15). The TEQ also contains items tapping sympathetic physiological arousal (Items 3, 6, 9, and 11) and altruism (Items 5, 14, and 16). Finally, one item probes the frequency of behaviors engaging higher order empathic responding such as prosocial helping behaviors (Item 13). Eight items are negatively scored (2, 4, 7, 10, 11, 12, 14, and 15), reecting the frequency of situational indifference toward another individual on the previously described parameters. Taken together, these items represent a wide variety of empathy-related behaviors that have been described in current literature surrounding this process.
Methods Participants. A total of 65 University of Toronto students (46 female) aged, on average, 18.6 years (SD = 2.3) returned from Study 2 a mean of 66.1 days (SD = 6.35, range = 5784) following their initial participation and received course credit for participating. Materials. In addition to the TEQ, participants completed the Empathy Quotient (Baron-Cohen & Wheelwright, 2004), and the Autism Quotient (Baron-Cohen, Wheelwright, Skinner, et al., 2001). Analysis. We examined the validity of the TEQ by correlating its total with the Empathy Quotient and Autism Quotient. Additionally, we calculated item-remainder coefcients and Cronbachs alpha. We determined testretest reliability by calculating the correlation between returning participants scores attained during Study 2 and readministration of the TEQ. To assess an effect of attrition, we calculated a paired-samples t test to determine differences in TEQ score between test administrations. We assessed gender differences in the TEQ by an independent samples t test and Cohens d. Results and Discussion As predicted, the TEQ correlated positively with the Empathy Quotient, r = .80, p < .001, and negatively with the Autism Quotient, r = .33, p < .01. Item-remainder coefcients for the TEQ were sound, ranging from .34 to .71 (see Table 1). Moreover, the internal consistency of our measure remained good, = .87. Finally, the TEQ demonstrated high testretest reliability, r = .81, p < .001. Differences in TEQ means (Table 3) were not signicant between test administration, t(64) = 1.51, p > .10. As in Study 2, a moderate effect of gender was observed (Table 4). GENERAL DISCUSSION
The construct of empathy has assumed various denitions as reected by the heterogeneous nature of current self-report measures of empathy. In an EFA, we determined what was shared by the corpus of empathy questionnaires by determining a single common factor. We then used items forming this factor to construct a new unidimensional scale, the TEQ, for the assessment of empathy. This new scale captures the underlying consensus among questionnaire measures currently in use and may prove an important tool in capturing performance on this elusive construct. The items represented in this single factor suggest that among current measures of empathy, the most commonly measured construct reects primarily an emotional process or an accurate affective insight into the feeling state of another. The results of Studies 1 through 3 demonstrate that the TEQ possesses a robust single factor structure, high internal consistency, and convergent validity with existing self-report scales as well as behavioral measures of interpersonal skills and high test retest reliability. Overall, the TEQ is a psychometrically sound, easily administered, and brief self-report measure of empathy.
TEQ: A BRIEF SELF-REPORT MEASURE OF EMPATHY Associations With Other Measures We predicted that the TEQ would diverge from measures surveying autism spectrum disorder because the latter taps decits in social processing among other symptoms of this disorder. Consistent with this prediction, the TEQ showed a negative correlation with poor interpersonal and social responding as partially assessed by the Autism Quotient, a measure of autism spectrum disorder symptomatology (Baron-Cohen, Wheelwright, Skinner, et al., 2001), demonstrating concurrent validity. As expected, the magnitude of this association was not too great in light of the fact that the Autism Quotient also measures other symptoms of autism not related to social skill. The TEQ demonstrated convergent validity in the positive correlations observed, not only with self-report measures of empathy but with two behavioral measures that require the processing of complex interpersonal stimuli. Interpersonal information must be interpreted accurately to facilitate the task of responding in an empathic fashion (Bernieri, 2001). This is in contrast to previous ndings in which empathy questionnaires and behavioral tasks often do not correlate (Ickes, 1997; cf. Zaki et al., 2008). Importantly, tasks such as the MIE and IPT that directly assess interpersonal sensitivity demonstrate a higher degree of ecological validity than do self-report tasks. Behavioral measures of interpersonal sensitivity, however, carry the disadvantage of being time and effort intensive. The TEQ provides a quick and easy way of assessing interpersonal sensitivity in a way consistent with these behavioral measures whereas providing substantial time savings and ease of administration. Notably, the IRI, a commonly used self-report measure of empathy, demonstrated weaker and statistically unreliable associations with these same tasks in our data set (see also Mar, Oatley, Hirsh, dela Paz, & Peterson, 2006). The TEQ also correlated highly with a signicantly lengthier measure of empathic responding, the 80-item Empathy Quotient (Baron-Cohen & Wheelwright, 2004). Shorter questionnaires such as the TEQ are especially useful for inclusion in masstesting packets, Internet research, or in any other instance in which time and participant fatigue is an issue. CONCLUSION In developing the TEQ, we created a parsimonious scale that is short, clear, and homogenous and has strong psychometric properties including a robust single factor structure, high internal consistency, construct validity, and testretest reliability. One limitation of this study is that our data were derived from a relatively small sample composed of college-aged students. Further work is required to assess the generalization of our ndings to a wider age range. The observed central tendency and variability of the IRI, Autism Quotient, Empathy Quotient, MIE, and IPT15 across our studies are, however, consistent with previously publications, suggesting that these samples are generalizable. Inconsistent gender differences, with effect sizes ranging from trivial to moderate, will need to be addressed in larger sample sizes. The TEQ, with its brevity and ease of administration, could be useful in patient populations. Altered empathic responding has been reported in patients with Axis I (clinical syndromes; Deardorff, Kendall, Finch, & Sitarz, 1977; L. E. OConnor, Berry, Weiss, & Gilbert, 2002) and Axis II (developmental and personality disorders; Guttman & Laporte, 2000; Tantam, 1995) psychiatric disorders, as well
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as in neurological patients with acquired sociopathy (Blair & Cipolotti, 2000), frontal lobe lesions (Eslinger, 1998), and frontotemporal lobar degeneration (Rankin et al., 2005). These decits pose serious challenges to the quality of life of the patient, family members, and caregivers. Work is currently underway in our laboratory to develop a second caregiver-report measure based on the TEQ. Decits in empathic understanding may be better understood through assessment and quantication, leading to effective intervention.
ACKNOWLEDGMENTS R. N. Spreng and M. C. McKinnon contributed equally to this work. We thank Ewa Munro and Pheth Sengdy for assistance in compiling the questionnaire measures and Colin De Young for assistance with the MAP test. This study was supported by Canadian Institutes of Health Research (MGP62963) and the National Institute of Child Health and Human Development (HD4238501) grants to B. Levine. REFERENCES
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APPENDIX Toronto Empathy Questionnaire Instructions Below is a list of statements. Please read each statement carefully and rate how frequently you feel or act in the manner
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described. Circle your answer on the response form. There are 10. I do not feel sympathy for people who cause their own serious illnesses no right or wrong answers or trick questions. Please answer each 11. I become irritated when someone cries question as honestly as you can. 12. I am not really interested in how other people feel 1. When someone else is feeling excited, I tend to get excited 13. I get a strong urge to help when I see someone who is upset too 14. When I see someone being treated unfairly, I do not feel very 2. Other peoples misfortunes do not disturb me a great deal much pity for them 3. It upsets me to see someone being treated disrespectfully 15. I nd it silly for people to cry out of happiness 4. I remain unaffected when someone close to me is happy 16. When I see someone being taken advantage of, I feel kind of 5. I enjoy making other people feel better protective towards him/her 6. I have tender, concerned feelings for people less fortunate Scoring Item responses are scored according to the following than me 7. When a friend starts to talk about his/her problems, I try to scale for positively worded Items 1, 3, 5, 6, 8, 9, 13, 16. Never = 0; Rarely = 1; Sometimes = 2; Often = 3; Always = 4. The steer the conversation towards something else 8. I can tell when others are sad even when they do not say following negatively worded items are reverse scored: 2, 4, 7, 10, 11, 12, 14, 15. Scores are summed to derive total for the anything Toronto Empathy Questionnaire. 9. I nd that I am in tune with other peoples moods