138 Chapter 5 For the own child and unfamiliar child versus self, parents, indeed, exhibited significantly increased neural activation in the cognitive empathy network in right TPJ, right dmPFC, vmPFC, left precuneus, right IFG and right MFG. These brain regions have been found to be involved in cognitive processes important for self-other distinction, such as distinguishing between own pain and that of another person (TPJ and precuneus) and taking the perspective of another person (dmPFC and vmPFC) (Lamm et al., 2011). Also, despite the finding that the sentences in general elicited significant activity in bilateral AI and aMCC, we found no evidence of differential levels of activity within these regions for self compared to “other” perspectives. This is partially in agreement with prior studies that reported neural activation in these brain regions in response to imagined pain in both self and others (Cheng et al., 2010; Christian et al., 2015; Decety et al., 2013; Jackson et al., 2006), although in most studies there was increased activation in imagining self versus others in pain. A possible explanation for this difference is that the stimuli in the present study consisted of both physical and social suffering, while in the other studies only physically painful stimuli were included. A remarkable finding is that parents showed differences in neural activation towards their own child versus an unfamiliar child, in predominantly the cognitive rather than the affective empathy network. Although the sentences with adverse situations did elicit neural activation in bilateral AI and aMCC in both own and unfamiliar child condition, no differences in activation were found in these regions within the affective empathy network between these perspectives. This lack of differential activation, despite heightened subjective responses to sentences of their own (versus an unfamiliar) child, is not in line with our expectation and in contrast with prior research about empathic responses to pictures and video vignettes of parents’ own versus unfamiliar babies and children (Abraham et al., 2018; Atzil et al., 2011; Barrett et al., 2012; Elmadih et al., 2016; Kuo et al., 2012; Leibenluft et al., 2004; Lenzi et al., 2009; Wan et al., 2014). In general, these studies did not find enhanced neural activation in the cognitive empathy network, but reported greater activation in insular and cingulate regions in response to one’s own child versus another child. One explanation for this difference is that the imagined suffering of one’s own child in the current task might have elicited more cognitive rather than affective empathy processes in parents, compared to the more direct, and passive observation of pictures or video vignettes of the own child in the other studies. This could indicate that in situations in which parents need to imagine their child in an unpleasant situation rather than directly observe their child, parents need to engage brain regions important for cognitive rather than affective aspects of empathy. Given that situations of imagined suffering are more applicable to parents of adolescents than parents of younger children, one might speculate that recruitment of the cognitive empathy network becomes more important in parenting during adolescence compared to infancy. An alternative factor that might have contributed to the more pronounced involvement of the cognitive empathy network is that the task we used required more verbal and cognitive processing compared to tasks in which parents are presented with photos or videos of their own child. As a consequence,
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