Article summary of Empathy from infancy to adolescence: An attachment perspective on the development of individual differences by Stern & Cassidy - Chapter

What is the definition of empathy?

Empathy refers to the capacity to comprehend the minds of others, to feel emotions outside our own, and to respond with concern, kindness, and care to others’ suffering. It is a relational construct and central in the formation and maintenance of social bonds. Individual differences in empathic ability and the tendency to be empathic have significant implications for social functioning across development:

• In childhood, low empathy is associated with poor peer relationships, hostility, and bullying.

• In adolescence, low empathy manifests in aggression and antisocial behaviour.

• In adulthood, this deficit is associated with child abuse, violence, and psychopathy.

On the other hand, greater empathy is associated with social competence and prosocial behaviour across the lifespan. Individual differences in empathy result from the complex interweaving of a child’s biological predisposition and environment. Theories of empathic development have emphasized the role of parenting: Children’s level of empathy may be seen as a product of specific parenting behaviours such as authoritativeness, gentle discipline, inductive reasoning, and sensitive responding to children’s distress. In line with attachment theories, parents’ sensitive responses to children’s distress serve as a key antecedent to children’s healthy social and emotional development. Research demonstrates that behavioral and physiological indicators of self-regulation are positively associated with children’s empathy and prosocial behavior, whereas personal distress is negatively related or unassociated with empathy and prosociality. 

How does empathy develop during early attachment?

According to attachment theories, infants’ expression of need, distress, or bids for closeness, referred to as attachment behaviors, are aimed at eliciting proximity, protection, and comfort of their attachment figures in times of threat, referred to as caregiving behaviours. Attachment theory states that all infants possess an adaptive, biologically based tendency to forge an attachment bond to a close caregiver, and that infants’ own social behavior will grow from the foundation of this primary relationship. These early patterns of interaction between infant and caregiver shape enduring mental representations of social relationships, what Bowlby termed internal working models (IWMs). IWMs organize cognitive processing of social information, inform emotional and physiological responses to threat, and guide social behavior across development. Secure and insecure IWMs differentially shape psychological functioning throughout childhood, with securely attached children consistently demonstrating greater social competence and better quality peer relationships than their insecure peers.

From an attachment perspective, we view empathy as arising out of the experience of relational security, in complex interaction with moderators at multiple levels of analysis. Cognitive models, language, emotional and self-regulatory capacities, neurobiological programming and parenting antecedents are mechanisms of influence in the relationship between early attachment and empathy.

• Recently, attachment researchers have proposed that the secure IWM may be an important mediator of the link between attachment and empathy. Secure base scripts reflect specific knowledge of how caregiving events typically proceed. Secure attachment may provide a salient behavioral script, activated in times of threat, for how to recognize and respond empathically to others’ bids for help. Furthermore, secure adult attachment is associated with positive IWMs of self and others in ways relevant to empathy.
• Language may function as an additional mechanism linking attachment to empathic development. Parents’ and children’s use of emotion-focused language, in turn, has been linked to children’s empathy and concern for others.
• Dimensions of emotional functioning are also thought to play a key role in understanding the link between attachment and empathy. Measures of emotional competencies such as emotion recognition and understanding, affective resonance, effortful control, and self-regulation are central to empathic responding across development, allowing children to see, interpret, and feel others’ emotions without becoming overly distressed themselves. Attachment theory proposes that security lays the foundation for children’s capacity to regulate emotions: Securely attached children are better able to regulate emotion, as assessed via physiological, behavioural, and questionnaire measures.
• A growing body of literature demonstrates that attachment experiences shape biological responses to threat, with secure attachment generally predicting less neuroendocrine and physiological reactivity to stressors. Child attachment insecurity predicts lower vagal regulation, as indexed by respiratory sinus arrhythmia (RSA). RSA has been repeatedly linked to empathic behaviour. Furthermore, over time, attachment-related experiences also become biologically embedded by programming HPA-axis reactivity.
• Parents’ sensitive responsiveness to children’s distress is a key building block of secure attachment. Related evidence shows that parents’ own empathy predicts secure child attachment.

In addition to socialization, attachment likely interacts with other moderating factors at multiple levels of analysis.

• At the individual level, child gender, genetics, and temperament may influence the degree to which attachment contributes to empathic development.
• At the group level, gender and group norms for empathic responding, as well as the group membership of the target, may moderate the link between attachment and empathy.
• Finally, at the societal level, cultural factors likely moderate the degree to which attachment is influential in children’s empathic development. 

Importantly, each of the mediating and moderating processes described occur in the context of the developing child, and it is likely that the relation between attachment and empathy is developmentally constructed. The proposed link between attachment and empathy may be indirect, working through multiple mediating mechanisms in a cascade of influences over time. It also may take time for this relationship to consolidate, and therefore may be weakest in infancy, when children’s capacity for emotion regulation and cognitive representation are primitive.

How does empathy develop during preschool years?

Research on attachment and empathy in infants and toddlers to date is sparse, providing only preliminary evidence for a link between security and empathy in young children. The link between attachment and empathy is weakest in infancy, when representations and self-regulatory abilities are still consolidating.

As children enter the preschool years, their empathic capacities become increasingly selective, reflecting greater understanding of display rules, gender norms, and contextual factors such as group membership and the proximal causes for others’ distress. The evidence on attachment-related differences in empathy in preschool children is particularly mixed, and appears to depend upon study design and methodology: Longitudinal studies employing observational measures of children’s empathy have generally found that preschoolers with secure attachment histories are more likely to respond empathically to strangers and peers in distress. In contrast, mixed and null results have emerged from cross-sectional studies and studies assessing preschoolers’ empathy toward their mothers or siblings. The evidence from this developmental period suggests that attachment-related differences in empathy may indeed be developmentally constructed, with differences emerging principally from longitudinal investigations. Data also point to the importance of contextual and methodological moderators, given evidence that a child’s relationship to the target—as well characteristics of the target such as maternal mental health— represent important moderators of the link between attachment and empathy.

How does empathy develop in school-aged children? 

In early and middle childhood, the focus of children’s social world begins to shift toward peers, yet attachment to parents continues to influence children’s everyday interactions. Emotion regulation appears to be a key mechanism linking attachment with social functioning in middle childhood. Middle school students’ self-reports of attachment and empathy together were found to predict their role in bullying situations. Furthermore, insecure IWMs of attachment in early and middle childhood have been associated with increased risk for callous-unemotional traits, foremost among which are lack of empathy and poor attunement to others’ emotions.

How does empathy develop in adolescence?

The period of adolescence is marked by the increasing importance of peers, who may at times provide a secure base for the adolescent or call upon the adolescent to provide a secure base for them in times of distress. Adolescent research has consistently demonstrated a positive association between secure attachment and empathy. The majority of studies to date, however, have employed cross-sectional designs and self-report assessments of attachment and empathy, raising concerns regarding shared method variance and highlighting the need for more longitudinal, observational work in this developmental period. Nevertheless, this body of work helps to build a bridge linking earlier studies of attachment and empathy in childhood with the robust findings on security and empathy in adulthood. Across numerous studies utilizing a variety of methodologies, adult attachment researchers have repeatedly demonstrated an association between security and empathy for others in distress. The strong evidence in adulthood, coupled with the promising research in adolescence, suggest that studying the developmental roots of empathy from an attachment perspective is indeed a worthwhile pursuit. 

What recommendations for future research can be made?

The body of work examining attachment and empathy in childhood is surprisingly small, and the evidence is mixed. There are multiple possible explanations for these mixed findings.

• Firstly, the proposed link between attachment and empathy may be developmentally constructed.
• Aside of this, it is also likely that any influence attachment may exert on empathy would be indirect, operating through multiple mediating mechanisms in a developmental cascade.
• Third, the methodology used to measure both attachment and empathy varies widely across development, with observational measures most common in the first years of life, use of adult-report increasing in preschool, and self-report dominating in adolescence.
• Fourth, beyond target characteristics, attachment may interact with additional moderators in the prediction of empathy. More specifically, evidence suggests that children with high reactivity temperamental traits or certain genes are differentially susceptible to their caregiving environment.
• Finally, we must bear in mind the possibility that attachment is in fact unrelated to children’s empathy, and that the positive results to date can be explained by a third variable or by measurement error.

What directions can be advised for future research?

Several directions can be advised for future research towards the development of empathy.

• First, understanding empathy in childhood from any perspective requires taking a developmental approach.  
• Future examination of attachment and empathy requires appropriate and careful measurement of each construct, particularly given the wide variation in methodologies used to study both attachment and empathy in children. 
• Then, integrating behavioural and biological indices of children’s responses to naturalistic displays of distress may be optimal for capturing empathy.
• Fourth, future research should go beyond simple direct effects to examine potential indirect pathways and mediating mechanisms linking attachment and empathy.
• Fifth, it will be important to examine potential moderators of the link between attachment and empathy, and to examine attachment itself as a moderator of other influences on children’s empathy, such as socialization. In addition to parent- and child-level moderators, research may benefit from greater sensitivity to the role of context and culture in shaping children’s relationships to their caregivers, as well as their empathic development.
• In order to test potential causal links between attachment and empathy, researchers could employ experimental designs.
• Finally, future research should examine potential implications of the model proposed here for intervention.