140 Chapter 5 parental care and neural activation in left anterior OFG did not remain significant after controlling for confounding variables (i.e., gender of parents, current psychopathology or psychotropic medication status), which implies that these effects need to be interpreted with caution and need to be replicated in larger samples. Also, parental care was based on the perspective of the child. Obviously, this is only one perspective and the inclusion of parents’ own view or the discrepancy between both perspectives on parental care might give more insight into the nature of these emotion regulation processes. To increase the ecological validity of our empathy task, both social and physical situations were presented to parents in order to cover a wide range of adverse events that people are exposed to in daily life. Although this was not the main aim of the study, several interesting differences became apparent when comparing brain activation in response to the adverse physical versus social situations. Parents showed higher levels of self-reported distress towards physical versus social suffering of both self and others, including their own child, and increased neural activation in right AI, dACC, MCG and various frontal and temporal brain regions. This is in accordance with prior studies that focused on differences in neural activation between physical and social pain (Bruneau et al., 2013; Eisenberger, 2012). A possible explanation for this finding is that the brain prioritizes physical pain over social pain because physical threats might be more impeding for immediate survival (Bruneau et al., 2013). Noticing someone else in pain might indicate that one is surrounded by a physical threat itself. As such, a quick response to physical threat might be biologically adaptive and evolutionary beneficial. The need to quickly detect social pain in others, however, is less strong as the sources of such responses were thought of being more internally driven and indirect (Timmers et al., 2018). However, it should be noted that the differences between the social and physical situations should not be exaggerated. With respect to self-reported distress the differences in response to physical and social suffering were rather small (d = 0.12). Moreover, several regions of the brain showed largely similar activation patterns, indicating also large resemblance in the responses to imagined social and physical adverse events. In sum, although some previous studies focused on the effect of familiarity and interpersonal closeness on empathic responses to others, this study uniquely determined neural empathic responses to the suffering of others in the context of parent-adolescent relationships. The involvement of parent-adolescent dyads in the present study contributes to the field of neuroimaging of sensitive parenting behavior during adolescence, as prior studies were predominantly limited to parents of babies or very young children. Moreover, the newly developed parental empathy task used in this study benefits from a personalized task design, allowing for a proper comparison between behavioral and neural parental empathic responses towards their own versus an unfamiliar child. In addition, the inclusion of both mothers and fathers in the study is a major contribution to the current literature and increased the generalizability of the results.
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