***THIS IS A WORKING PAPER THAT HAS NOT BEEN PEER-REVIEWED*** Emerging infectious outbreak inhibits pain empathy mediated prosocial behaviour Siqi Cao1,2, Yanyan Qi3, Qi Huang4, Yuanchen Wang5, Xinchen Han6, Xun Liu1,2*, Haiyan Wu1,2* 1CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China 2Department of Psychology, University of Chinese Academy of Sciences, Beijing, China 3Department of Psychology, School of Education, Zhengzhou University, Zhengzhou, China 4College of Education and Science, Henan University, Kaifeng, China 5Department of Brain and Cognitive Science, University of Rochester, Rochester, NY, United States 6School of Astronomy and Space Sciences, University of Chinese Academy of Sciences, Beijing, China Corresponding author Please address correspondence to Xun Liu ([email protected]) or Haiyan Wu ([email protected]) Disclaimer: This is preliminary scientific work that has not been peer reviewed and requires replication. We share it here to inform other scientists conducting research on this topic, but the reported findings should not be used as a basis for policy or practice. 1 Abstract People differ in experienced anxiety, empathy, and prosocial willingness during the coronavirus outbreak. Although increased empathy has been associated with prosocial behaviour, little is known about how does the pandemic change people’s empathy and prosocial willingness. We conducted a study with 1,190 participants before (N=520) and after (N=570) the COVID-19 outbreak, with measures of empathy trait, pain empathy and prosocial willingness. Here we show that the prosocial willingness decreased significantly during the COVID-19 outbreak, in accordance with compassion fatigue theory. Trait empathy could affect the prosocial willingness through empathy level. Through distance from the epicentre (i.e. Wuhan) moderated trait empathy and empathy level, anxiety generated by this outbreak impaired prosocial willingness. Further, news discriminability also played a role in trait empathy change. Given how emergency health events influence emotion and the effects of personal traits on prosocial willingness, social media users and providers should understand the negative effects of information over-exposure on mental health during the outbreak. 2 Introduction The impact of the current global health emergency, termed COVID-19 by the World Health Organization (WHO), has significantly changed people's lives worldwide, casting a shadow over the mind of an enormous population. Although clarity and immediacy guaranteed the right to be informed, people are bombarded by various information and their moods enter a cycle of complexity (Thompson, Jones, Holman, & Silver, 2019). Encouraging slogan and unequivocal instruction can stabilize mood, while aversive news induces emotional responses to pain in others such as sadness and anxiety (Batson et al., 1991). For example, when we see the pain or even death of a patient and the desperation of the health care workers, a heart-breaking feeling hits us and tears well up. The capacity associated with feeling and evaluating the pain level of other as well as further understanding others is specifically referred to as pain empathy (Fitzgibbon, Giummarra, Georgiou-Karistianis, Enticott, & Bradshaw, 2010), which is a fundamental feature of our innate capacity (Van der Graaff et al., 2014). Watching others’ pain experiences may activate one’s own sensory region of the brain (Lamm, Decety, & Singer, 2011) as if it were a personal experience (Carr, Iacoboni, Dubeau, Mazziotta, & Lenzi, 2003). For decades, research have shown empathy is a potential motivator for prosocial behaviours. From rescuing behaviour in ants (Nowbahari, Scohier, Durand, & Hollis, 2009) to the feeding each other in bats, prosocial behaviour is observed throughout the non-human species (Wascher, Scheiber, & Kotrschal, 2008). Decety et.al (2016) emphasized the mediation effect of empathy on pro-sociality in conspecifics, when one is sensitive to others’ stress and well-being. A spontaneous motivation to alleviate the 3 pain of others is generated when people feel others’ suffering (Inagaki & Eisenberger, 2016; Roberts, Strayer, & Denham, 2014), and the implementation of altruistic behaviour to a certain extent relieves negative feelings (Singer et al., 2006), or even physical pain on oneself (Y. Wang, Ge, Zhang, Wang, & Xie, 2020). Although empathy is an aspect of social responsiveness, compassion fatigue (i.e., physical and emotional exhaustion and a profound decrease in empathy) happens when one’s empathy reaches its limit (Joinson, 1992), or caused by a short-term, intense, or numbness and depression exposure to unfortunate situation (Figley, 2002). With the COVID-19 outbreak and massive news updating, global people experience heavy exposure to victims’ pain or negative news (McAlonan et al., 2007). Here we tested whether people’s empathy and prosocial tendency varies before and during this outbreak. At the early outbreak stage, Wuhan was widely reported as the epicentre of COVID-19, which captured global attention and concern. There are two contrary effects would indicate about psychological effect from epicentre: 1) the ripple effect suggests that the impact of an unfortunate event decays gradually as ripples spread outward from the epicentre (Slovic, 1987), while 2) the ‘Psychological Typhoon Eye’ effect (PTE), posit the closer one is to the epicentre of a devastated area, the lower a resident's concern/anxiety about health and safety. Both of the two models place emphasis on the distance from the outbreak epicentre on human emotions, and raise hypothesis regarding the influencing direction of the COVID-19 outbreak (i.e. facilitating or decreasing concern/anxiety levels along with further distance to Wuhan). Given the importance of empathy and prosocial behaviour for collaboration during a crisis, it is crucial to assess the relationship between empathy level and prosocial willingness across individuals near to or far from the epicentre. Moreover, several 4 psychological factors may contribute to this link between empathy and pro-sociality, like exposure to adverse life events, information seeking or news reading, anxiety etc, should be taken into consideration. During a life-threatening period, altruistic behaviours would be selected to facilitate cooperation and enable group members to collectively survive various crises, such as food shortages and natural disasters (Fehr & Fischbacher, 2003). However, the impact of quarantines strongly influences approach motives (Brooks et al., 2020), and people immersed in emergency-related information could lead to compassion fatigue and decrease prosocial tendency. We asked whether people would be numb to other’s pain and hypothesized that (i) as the COVID-19 outbreak and news reports increase, empathy-induced prosocial willingness (pain-sharing willingness) would decrease during the outbreak, and this prosocial willingness shift would be most strongly evidenced by empathy levels (pain ratings of the performer) decreasing in our online task; (ii) the overexposure to various information influences empathy; (iii) outbreak-generated anxiety may influence empathy and prosocial behaviour in terms of distance to the epicentre (Wuhan). Methods Participants The first dataset (539 participants, 274 females, Mage = 28.43, SD = 7.84) was collected before the emerging infectious disease outbreak of COVID-19 (2019.11.21~2019.11.23), while the second dataset (570 participants, 366 females, Mage = 25.08, SD = 8.75) was collected during the peak period of public concern about COVID-19 (2020.2.23~2020.2.24). We distributed the task and questionnaires on an online platform. As Table 1 shows, in pre- and post-outbreak, the groups were unevenly distributed in terms of age (t(1088)=6.64, P<0.001) and gender (χ2(df=1, 5 N=1090)=14.89, P<0.001). Hence, we controlled for age and gender as possible confounding variables when we compared the response variables cross the timepoints. Stimuli The stimuli consisted of 12 video clips portraying actors telling either the truth or lies about the pain induced by electric shocks. Twelve participants in Beijing (six females and six males, Mage = 22.4) were recruited as actors for video recording. All actors were asked to either express their true feelings about pain (electric shock pain) or lie when they were not really experiencing pain. In the real pain scenario (i.e. telling the truth about their pain), participants were asked to express and describe their genuine feelings of pain evoked by the electric shock induction approach. The electric shock approach is a commonly used pain induction method, in which an electric shock is delivered to the participants fingers. In the fake pain scenario (i.e. lying about the pain), the participants were asked to pretend to have been shocked and to describe those fake feelings. The actors in the fake pain scenario had been sitting in the room and watched videos of people getting electric shocks, but they were not shocked personally. The research paradigm was approved by the China Academy of Science ethics committee, and all performers in the video recording gave informed consent to participate in the study. Online study task Figure 1 illustrates the present study components in both the first and second online study tasks. 6 Fig.1. Online data components Video rating task Twelve video clips (six genuine pain and six vicarious pain) were presented to the participants in randomized order. After each video clip played,