5 141 Neural signatures of parental empathic responses to imagined suffering of their adolescent child Furthermore, the inclusion of both physically and socially unpleasant stimuli of various negative intensities covers a wide variety of real-life situations, contributing to the task’s ecological validity. Nevertheless, this study is not without limitations. Neural responses could be explained by empathic processes towards the own child (versus an unfamiliar child), but also by additional cognitive processes engaged when imagining one’s own child, such as emotion regulation processes or a more general sensitivity of parents in response to the own child. Due to the lack of a neutral (versus negative) event condition, we cannot disentangle exactly whether the enhanced neural responses to the own child (versus the unfamiliar child) are the result of enhanced empathic responding or also reflect the engagement of such other processes. Future studies might benefit from the inclusion of a neutral condition to the task in order to gain more insight into the general neural responses to the own child versus responses to one’s own child’s suffering. Furthermore, including a specific measure of parental empathy towards their own child, such as the Parental Affective and Cognitive Empathy Scale (PACES) or the reflective functioning scale (Luyten et al., 2017; Stern et al., 2015), could further help to examine how neural activity during the task relates to self-reported parental empathy. Another limitation is that by asking parents how they felt themselves after imagining the suffering of their own child, we may have tapped more into a self-oriented than an other-oriented response. It is plausible, however, that imagining an unpleasant situation involving one’s own child may elicit feelings of distress similar to the distress the child may experience. Moreover, for a prosocial response to the own child it is important to regulate one’s own distress before focusing on how the child is feeling. Nevertheless, including an additional question assessing other-oriented feelings (e.g. “how does your child feel?”) may provide important insight into which brain regions are involved in feelings of empathic distress and which regions are more involved in feelings of sympathy. However, asking such a question may also have increased the difficulty of the task due to a constant shifting in perspectives. Additionally, not incorporating a question about the feelings of the child allowed for similarity and consistency between sentences about the self and other perspectives. Also, a potential limitation of our study is that by asking participants to report on their affect during the task this may have elicited ‘affect identification’ as an emotion regulation strategy, which might have impacted neural responses to imagined suffering for self and others. However, as this was similar in all conditions, these effects may have been averaged out. Furthermore, we did not control for the fact that some parents might have experienced some of the unpleasant situations themselves or with their child. Prior research proposed that our representations of others are based on prior (self-referential) experiences, and thus this might have influenced the empathic responses of parents towards themselves or their child (Mitchell, 2009; Waytz & Mitchell, 2011). Future studies could ask parents about personal experiences with situations presented in the task and whether they or their child suffers from (a history of) chronic pain to be able to examine how such personal experiences may modulate neural responses. Lastly, although the present study focusses on parental responses to negative events of their
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