Relationships between Empathy, Executive Functions, and Internalizing and Externalizing Symptoms in Early Adolescents

Background Previous studies have shown associations between internalizing and externalizing symptoms, executive functions, and empathy. However, the mechanisms that affect this relationship remain unclear. This study employed regression analysis to explore the predictive effect of internalizing and externalizing symptoms and executive functions on empathy. Method Our study consisted of three consecutive stages. In the first stage, we assessed 2150 adolescents’ parents of 2150 adolescents aged 10–12 years using the Strengths and Difficulties Questionnaire to determine which participants should be included in the subsequent stages. In the second stage, we conducted a pilot study with 50 participants to assess the validity of the assessment system and the six film scenes to be used in the following stage. Finally, in the third stage, we obtained the participants' state empathy, trait empathy, and executive functioning. Results The regression analysis showed that working memory performance ( β  = 0.261) and externalizing symptoms ( β = -0.157) predicted cognitive empathy, but only externalizing symptoms predicted affective empathy ( β = -0.193). Conclusion This study highlights the effect of externalization on both cognitive and affective empathy and the effect of working memory on cognitive empathy. These findings may serve to inform psychological interventions to improve empathic abilities in early adolescence.