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Une caractéristique centrale des individus psychopathiques est leur disposition réduite à l’empathie. Au cours des dernières années, l’étude neurophysiologique de la perception de la douleur d’autrui s’est avérée une avenue pertinente à l’exploration neuroscientifique de l’empathie. Plusieurs études ont démontré que les systèmes cérébraux impliqués dans les dimensions affectives et sensorielles de la douleur le sont également au cours de la perception de la douleur d’autrui. Le fonctionnement du système sensoriel demeure toutefois méconnu chez les individus psychopathiques. Ainsi, par le biais de l’électroencéphalographie (EEG), la présente thèse propose deux études portant sur l’évaluation des réponses somatosensorielles à la perception de la douleur d’autrui et du lien unissant ces réponses aux traits psychopathiques. Une première étude a été réalisée auprès d’étudiants masculins et une seconde au sein d’un groupe clinique de patients présentant un trouble sévère de la personnalité narcissique. Cette thèse avait également comme objectif de faire le pont entre la recherche en neurosciences sociales et le champ de la pratique clinique auprès des troubles de la personnalité par l’entremise d’un article théorique intégrateur. Les résultats des deux études démontrent une modulation plus importante de la réponse somatosensorielle au cours de l’observation de la douleur d’autrui chez les individus présentant des traits psychopathiques en dépit d’une plus faible disposition à l’empathie. La première étude montre plus particulièrement l’existence d’une relation entre les traits associés à la dimension interpersonnelle et affective de la psychopathie et la réponse somatosensorielle. La seconde étude met en lumière une modulation plus importante de la réponse somatosensorielle durant la phase anticipatoire à la douleur d’autrui chez les patients narcissiques présentant des traits psychopathiques. L’ensemble des résultats suggère que le modèle de la perception de la douleur d’autrui appliqué aux individus psychopathiques puisse être considéré en terme d’hyperactivation du système somatosensoriel. En conjonction avec d’autres données empiriques, cette plus grande activation du système somatosensoriel pourrait traduire une hyporéactivité du système impliqué dans la réponse affective à la douleur d’autrui. Finalement, les résultats de la présente thèse contribuent au raffinement du modèle de l’empathie appliqué à la psychopathie et à une meilleure compréhension des composantes de l’empathie. / At the core of psychopathic individuals is their reduced disposition for empathy. Over the last few years, the neurophysiological investigation of pain perception in others has become an interesting pathway to study empathy from a neuroscientific point of view. Numerous studies have shown that the affective and sensory systems involved in the experience of pain are also triggered by the perception of pain in others. However, the functional mechanisms underlying the sensory system in psychopathic individuals remain misunderstood. Using EEG, this thesis proposes two studies aimed at assessing the somatosensory responses during pain perception in others and evaluating the link between these responses and psychopathic personality traits. A first study was realized with a community sample of male college students and a second one using a clinical sample of high psychopathic traits narcissistic patients. This thesis also aimed at bridging the gap between the fields of social neurosciences and personality pathology from a clinical perspective via an integrative theoretical paper. Results from both studies suggest a significantly stronger modulation of somatosensory responses during pain perception in participants showing high psychopathic traits despite their lower disposition for empathy. Furthermore, the first study critically showed that interpersonal and affective dimension of psychopathy is related to this somatosensory response. Data from the second study point out to a stronger modulation of somatosensory responses during the anticipation of pain perception in others in high psychopathic traits narcissistic patients. Overall, the data suggests that the pain perception model applied to psychopathic individual could be considered in term of a hyperactivation of the somatosensory system. In conjunction with others empirical evidences, this stronger activation of the somatosensory system might be explained by a hyporeactivity of the system involved in the affective response to the pain of others. In sum, results contribute to refine the empathy model related to psychopathy and help better disentangle the components of empathy.

Abstract Authors: Veronica Axeborg & Malin Devida Carlsson Title: Indirect strain and compassion fatigue- a qualitative study of working conditions in social work Supervisor: Roddy Nilsson Assessor: Rickard Ulmestig   High levels of sick leave can often be detected in social work, especially within the group of social workers that have contact and relationship building professions. Direct collaboration with clients requires that the social worker uses him or herself as a tool. On top of a heavy workload with complex cases that are time consuming and the pressure of getting tasks ready on time, these social workers are also exposed to an indirect workload when they listen to the suffering and pain of their clients’ problems. Compassion fatigue is a phenomenon and condition that can occur when a person repeatedly hears about difficulties without experiencing it for themselves.  The purpose of this study was to investigate social workers views and experiences with indirect strain and compassion fatigue and also how these phenomena are made aware of and handled or not handled in the workplace. This study consists of six semi-structured interviews with social workers that have a contact and relationship building profession. The results of the interviews are presented through prominent themes and analysed with Antonovskys theory of Sense of coherence.  Results showed that several of the respondents has experiences of indirect strain, sometimes so invisible they don´t notice or reflect over it themselves. Only one respondent experience compassion fatigue due to contact with clients whereas the others are aware of the existence of the phenomenon but do not suffer from it. Both indirect strain and compassion fatigue arises at times in workplaces but nothing structural is organised to prevent or handle the phenomena. Collegial support has proven to be the chosen way of dealing with it. A prominent conclusion of this study is that the direct workload and time pressure is what’s burdening in the social worker´s profession and that the line between the indirect and direct strain sometimes is difficult to draw. They often go into each other’s fields or become each other’s consequences.

Burnout is a construct first proposed by Freudenberger to describe a condition that develops in people who work with people such as teachers, nurses and first responders (Shan, 2005). Professionals who are burned out demonstrate a lack of concern for the people they service and often perform poorly on the job. In recent years, the construct of Burnout has been largely replaced by the construct of Compassion Fatigue. Interestingly, mental health professionals who work with children as their predominant client base have not been extensively studied, although these professionals arguably could be experiencing some of the highest levels of Compassion Fatigue (Eastwood, 2008). Research shows that Burnout and Compassion Fatigue impact the work that an individual performs, but the impact of these on the use of particular therapeutic practices as an area is less studied. The present study sought to determine if there is a relationship between Burnout, Compassion Fatigue, and the use of evidence-based practices in mental health professionals. Using research by Craig and Sprang (2010) as the starting point, this study also investigated whether mental health professionals who work with children experience more or less Burnout and Compassion Fatigue than those who work with adults. Mental health professionals from a variety of mental health facilities in the Philadelphia region served as subjects in this study. Participants were given the Trauma Practices Questionnaire (TPQ), a 22-item treatment practices utilization scale, the Professional Quality of Life Scale-V (PRoQOL-V), a 30-item scale that required respondents to assess their thoughts and feelings in relation to their work, and a questionnaire formulated by this investigator that included demographic information, background information, as well a question that focused on the age of the mental health professional's client base and a question that focused on years of professional experience. The results showed that the mental health professionals who worked with adults were older, more typically white, had higher levels of education and had undergraduate majors that were in psychology or a psychology-related area (e.g., social work) than mental health professionals who worked with children. Burnout and Compassion Fatigue correlated negatively with all practices, evidence based and non-evidence based. Males used more evidence-based and total practices than females. Females had a higher level of Compassion Satisfaction but also a higher level of Burnout. The results showed that the mental health professionals who worked with children had higher levels of Compassion Satisfaction, but also higher levels of Burnout. The data show that the group that works with children used less cognitive and behavioral approaches. The broader implications of the results are discussed in the conclusion. / Educational Psychology

Bakgrund: I sjuksköterskans roll ingår ett etiskt- och personcentrerat förhållningsätt där den empatiska förmågan är betydelsefull. Empatitrötthet är ett tillstånd som innebär att empatin brister till följd av exponering för lidande och kan beskrivas som priset för att man bryr sig. Symtomen av empatitrötthet kan vara såväl psykiska som fysiska och komma att påverka individers välmående, privat- och arbetsliv. Hjälpande yrken som involverar ett stort empatiskt engagemang löper en större risk för att utveckla empatitrötthet, däribland sjuksköterskor. Syfte: ​​Syftet med studien var att beskriva sjuksköterskors upplevelse av empatitrötthet.​ Metod: En allmän litteraturöversikt har genomförts baserat på tio kvalitativa artiklar som inhämtats från databaserna PubMed, Cinahl Complete samt Ovid Emcare. Materialet har analyserats i fyra steg, se dataanalys. Resultat: Tre huvudteman identifierades med totalt åtta underteman. En inblick i sjuksköterskors upplevelse av bakomliggande orsaker: Den empatiska förmågan, Vårdrelationen och Arbetsförhållanden. Empatitrötthetens avtryck: Konsekvenser för sjuksköterskans privata jag och Konsekvenser för sjuksköterskans professionella jag. Sjuksköterskors upplevelse av att ta sig igenom empatitrötthet: Stöd, Hantering och Egenvård. Slutsats: Den empatiska förmågan är en förutsättning för att utveckla empatitrötthet hos sjuksköterskor som exponeras för lidande under bristande arbetsförhållanden. Tillståndet leder till att empatin brister, vilket resulterar i en emotionell avtrubbning. Empatitrötthet kan ha negativa effekter på både arbetslivet och privatlivet, samtidigt som stöd från kollegor och familj kan vara betydelsefullt. / Background: Nursing involves an ethical and patient-centred care, where empathy is significant. Compassion fatigue is a condition that involves a lack of empathy due to exposure to suffering and can be described as the cost of caring. Symptoms of compassion fatigue can be both psychological and physical and may affect individuals´ well-being, personal as well as professional lives. Helping professions that involve a high level of emphatic engagement are at a greater risk of developing compassion fatigue, including nurses. Purpose: The aim of the study was to describe nurses' experience of compassion fatigue. Method: A literature review was conducted based on ten qualitative original articles retrieved from the Pubmed, Cinahl Complete and Ovid Emcare databases. The material was analysed in four stages, see data analyses. Results: Three main themes were identified, with a total of eight associated subthemes. Insight into nurses' experiences of underlying causes: The empathic ability, Care relationship and Working conditions. The Impact of Compassion Fatigue: Consequences for the nurses’ personal self and Consequences for the nurses’ professional self. Nurses' experience of navigating through compassion fatigue: Support, Coping, and Self-care. Conclusion: The ability to empathize is a prerequisite for developing compassion fatigue among nurses who are exposed to suffering, combined with poor working conditions. Compassion fatigue leads to a lack of empathy, resolution an emotional numbness. Compassion fatigue can have negative effects on both work and personal life, while support from colleagues and family can be meaningful.

Empatitrötthet knackar på  Abstrakt Bakgrund: Begreppet empatitrötthet beskrivs som ett successivt och tilltagande slitage på vårdarens förmåga att engagera, känna med och bry sig om sina patienter. Ett biologiskt, psykologiskt och socialt tillstånd av utmattning och dysfunktion som kommer av långvarig exponering för andras lidande. Empatitrötthet kan skapa negativa känslor som skam, sorg, skuld, irritation, otålighet, otillräcklighet och ökad rädsla. Andra faktorer i privatlivet som sitt eget mående, hälsa eller missnöje kan också öka risken för empatitrötthet. Motiv: Empatitrötthet är ett problem i vården. Förhoppningen för studien är att det kan belysa kunskapsluckor i hur personalen upplever empatitrötthet och vad som kan förbättras för att minska risken. Syftet med studien var att utforska personals upplevelser av empatitrötthet, belyst från deras erfarenheter av att arbeta på en psykiatrisk slutenvårdsavdelning.  Metod: Studien genomfördes med semistrukturerade intervjuer och materialet analyserades med kvalitativ innehållsanalys. Samtliga deltagare i studien arbetar som vårdpersonal på en sluten psykiatrisk vårdavdelning. Tio individuella intervjuer genomfördes med fem sjuksköterskor samt fem undersköterskor. Resultat: Resultatet visade att Empatitrötthet skapar processer i arbetsgruppen, Patientmötet påverkas, Empatitrötthet går under radarn och Frustration leder till likgiltighet. Konklusion: Empatitrötthet finns inom den psykiatriska vården, det är något som de flesta upplever och som hämmar personalen i sitt dagliga liv. Det leder till frustration och irritation mot både kollegor och patienter. Med hjälp av varandra och insatser och strategier från arbetsledning kan det minskas eller hållas i schack. Genom att uppmärksamma hur viktig gruppdynamiken är i kampen mot empatitrötthet kan omvårdnaden och bemötandet förbättras. Denna studie kan bidra till en djupare förståelse för empatitrötthet och vad som anses viktigt av vårdpersonal när man hamnar i det. Eventuellt kan det även leda till att man pratar mer öppet och uppmärksammar det i arbetsgruppen. / Compassion fatigue comes knocking  Abstract Background: The term compassion fatigue as a successive and increasing wear on the staff’s ability to engage, feel and care with its patient. Biological, psychological and social condition of exhaustion and dysfunction that comes from a prolonged exposion of others suffering. Compassion fatigue can create negative feelings of guilt, shame, sorrow, irritation, impatience, inadequacy and increased fear. Other factors are problems in the private life and that health or dissatisfaction can increase compassion fatigue. Motive: Compassion fatigue is a problem in health care. Our hope is that the study can enlighten the knowledge gap on how the staff experience compassion fatigue. Aim: The aim of the study was to explore staff's experiences of compassion fatigue, highlighted from their experiences of working in a psychiatric inpatient ward. Methods: The study was conducted with interviews and the data vas analyzed with qualitative content analysis. All participants work as staff in an inpatient psychiatric ward. Ten individual semi-structured interviews were conducted with five registered nurses and five undergraduated nurses. Result: The result shows that Compassion fatigue creates processes in the work group, The patient meeting is affected, Compassion fatigue goes under the radar and Frustration leads to indifference. Conclusion: Compassion fatigue exists in the psychiatric care, and is hampering the staff’s social life. It leads to frustration and irritation towards booth patient and colleagues. With the help of each other and strategies from the work management, it can be reduced. By paying attention to how important group dynamics are in the fight against compassion fatigue, care and treatment can be improved. This study can contribute to a deeper understanding of compassion fatigue. It can also lead to talking more openly and paying attention to it in the work group.

Bakgrund: En stor andel av personer som arbetar som sjuksköterskor riskerar att drabbas av empatitrötthet. Empatitrötthet kan resultera i negativa konsekvenser för sjuksköterskan, verksamheten och patienten. Syfte: Litteraturöversiktens syfte var att beskriva sjuksköterskors erfarenheter av empatitrötthet. Metod: Litteraturöversikt är baserad på elva kvalitativa studier. Databassökning genomfördes i PubMed och Cinahl. Analysprocessen verkställdes med hjälp av Fribergs modell i fem steg. Resultat: Ur analysen framkom fyra kategorier ’’Risken att utveckla empatitrötthet påverkas av höga krav, stress, brist på stöd och sjuksköterskans tidigare erfarenheter’’, ’’Empatitrötthet påverkar hälsan’’, ’’ Det finns olika sätt att hantera empatitrötthet’’ och ’’ Empatitrötthet påverkas av relationen mellan sjuksköterska patient och närstående’’. Konklusion: Empatitrötthet uppstår på grund av krav, stress och en brist på stöttning. Sjuksköterskor har olika sätt att hantera empatitrötthet, där vissa metoder anses bättre för att lösa problemet. Empatitrötthet har en inverkan på sjuksköterskan psykiskt, fysiskt, emotionellt och socialt, vilket påverkar sjuksköterskans privatliv och arbetsliv.

Life satisfaction among students is a complex phenomenon linked to avariety of factors. This study aimed to examine the relationshipbetween perfectionism, self-compassion, perceived stress, and lifesatisfaction. The aim was also to examine how well the threevariables perfectionism, self-compassion, and perceived stress predictlife satisfaction. The sample consisted of 154 students (Mage = 24.84,SDage = 5.09). Quantitative data was collected through an onlinesurvey where respondents were asked to answer statements andquestions linked to the scales: Clinical Perfectionism Questionnaire,Self-Compassion Scale Short Form, Perceived Stress Scale, andSatisfaction With Life Scale. The results showed that there is astatistically significant relationship between perfectionism,self-compassion, perceived stress, and life satisfaction. The resultsalso showed that self-compassion and perceived stress are statisticallysignificant predictors of life satisfaction. Perfectionism, on the otherhand, is not a statistically significant predictor. Future researchshould use longitudinal studies as a complement, examine morevariables that may be related to life satisfaction, and conductmoderation and mediation analyses. / Livstillfredsställelse bland studenter är ett komplext fenomen kopplattill en mängd olika faktorer. Den här studien syftade till att undersökasambandet mellan perfektionism, självmedkänsla, upplevd stress ochlivstillfredsställelse. Syftet var även att undersöka hur väl de trevariablerna perfektionism, självmedkänsla och upplevd stresspredicerar livstillfredsställelse. Urvalet bestod av 154 studenter (Målder= 24.84, SDålder = 5.09). Kvantitativ data samlades in genom enonline-enkät där respondenterna fick besvara delfrågor kopplat tillskalorna: Clinical Perfectionism Questionnaire, Self-CompassionScale Short Form, Perceived Stress Scale och Satisfaction With LifeScale. Resultaten visade att det finns ett statistiskt signifikant sambandmellan perfektionism, självmedkänsla, upplevd stress ochlivstillfredsställelse. Resultaten visade även att självmedkänsla ochupplevd stress är statistiskt signifikanta prediktorer förlivstillfredsställelse. Perfektionism är däremot inte en statistisktsignifikant prediktor. Framtida forskning bör komplettera medlongitudinella studier, undersöka fler variabler som kan tänkas vararelaterade till livstillfredsställelse och genomföra moderations- ochmediationsanalyser.

The subject of this thesis is the ethics of German 19th century philosopher Arthur Schopenhauer. The study examines Schopenhauer’s ethics and investigates his criticism of the ethics of his older German colleague Immanuel Kant. By arguing that all true morally acceptable and good actions originate from compassion, Schopenhauer distinguishes his view from the deontological ethics held by Kant. The study focuses on Schopenhauer’s view on the basis of morals. Its purpose is to consider an ethical perspective that interconnect moral considerations with human empathy. By comparing the arguments presented by these two philosophers one can get a clearer view of the extent to which Schopenhauer’s criticism of Kant’s ethics is justified. In the analysis, five major parts of Schopenhauer’s criticism are identified and studied one by one. The findings suggest that Schopenhauer’s ethics and the ethics of Kant can be represented as two different ethical paradigms.

Cette recherche constitue une incursion dans la bioéthique de l’Asie. Elle vise à vérifier s’il existe une approche de la bioéthique spécifique pour l’Asie et, s’il s’avère que tel est le cas, d’identifier les particularités les plus apparentes de la nature de cette ‘bioéthique asiatique’. La recherche a été réalisée à même des sources documentaires constituées d’un corpus d’articles publiés entre 2001 et 2005, dans les versions électroniques de revues scientifiques reconnues. La recherche conclut à l’existence d’une ‘bioéthique asiatique’ qui accorde à certaines valeurs humaines une prédominance spécifique, de même qu’un sens différent qui lui est propre. Le lien, entre la culture et les traditions morales locales d’une part, et l’ordre de prédominance et l’interprétation des valeurs éthiques d’autre part, doit être reconnu et pris en compte pour que la bioéthique soit pertinente et applicable aux personnes touchées par les enjeux évalués en Asie. La recherche identifie également quatre particularités de la ‘bioéthique asiatique’ qui constitue le début d’une tentative pour en cerner la nature : le rapport entre ‘soi’ et les autres, la compassion, l’harmonie, de même qu’une conception spirituelle du monde dont la base est l’interdépendance et l’interconnexion d’un ordre universel entrelacé et participatif. / This research study represents an incursion into Asian bioethics. The goal is to verify whether a specific bioethics approach is attributed to Asia and, if so, to identify its most obvious distinctiveness. This research was based on a corpus of articles published between 2001 and 2005 in electronic versions from acknowledged scientific magazines. This research infers the existence of an Asian bioethics which allows for a specific predominance to certain human values as well as unique and distinct meaning. On one hand, the cultural and local moral traditions relationship and, on the other hand, the predominance and interpretation of ethical values, must be recognized and considered so bioethics become relevant and applicable to those affected by the assessed issues in Asia. This study also identifies four distinctiveness in ‘Asian bioethics’ which represent the beginning of an endeavor to define their nature: The correlation between ‘the self’ and the others, compassion, harmony and a spiritual idea of the world based upon interdependence and networking in an intertwined and participative universal order.