Zupan, BNeumann, DBabbage, DWiller, B2025-11-242025-11-242018-07-01Neuropsychology, ISSN: 0894-4105 (Print); 1931-1559 (Online), AMER PSYCHOLOGICAL ASSOC, 32(5), 554-563. doi: 10.1037/neu00004620894-41051931-1559http://hdl.handle.net/10292/20195Objective: To examine sex differences in self-ratings for affective and cognitive empathy for males and females with traumatic brain injury (TBI) and compare these to observer ratings. Method: Self and observer (e.g., spouse) ratings of affective and cognitive empathy were obtained for 160 participants (116 males) with severe TBI, using the Interpersonal Reactivity Index Empathic Concern (EC) and Perspective Taking (PT) subscales, respectively. Results: When compared to sex norms, female self-ratings were significantly lower for both subscales, whereas men's self-report ratings were only lower for PT. For EC, more women (44%) were found to be substantially below the normative means (≥2 SDs) than men (17%), p < .001. When comparing women and men with TBI, self-report and observer ratings indicated both sexes had similar empathy levels (both subscales). Self versus observer ratings showed that women's self-ratings were significantly higher than observer's ratings on PT (p < .001); men's self-ratings were significantly higher than observer's ratings on PT (p < .001) and EC (p = .009). Conclusions: In contrast to the typically observed superior female empathy, this study suggests this advantage may disappear after a TBI, and possibly result in a disadvantage compared to their uninjured female peers. Theoretical implications of self-awareness and cultural gender expectations for empathy are discussed.This is the Author's Accepted Manuscript of an article published in Neuropsychology © The American Psychological Association. The Version of Record is available at DOI: 10.1037/neu0000462empathyaffective empathycognitive empathysextraumatic brain injurySocial SciencesScience & TechnologyLife Sciences & BiomedicinePsychology, ClinicalNeurosciencesPsychologyNeurosciences & Neurologytraumatic brain injuryInterpersonal reactivity indexgender differencessocial cognitionemotional cognitionself-awarenessindividual differencesfacial expressionsaffect recognitionfemale advantagedeficits5203 Clinical and Health Psychology5205 Social and Personality Psychology52 PsychologyClinical ResearchPhysical Injury - Accidents and Adverse EffectsTraumatic Head and Spine InjuryBehavioral and Social ScienceNeurosciencesBrain DisordersWomen's HealthTraumatic Brain Injury (TBI)1109 Neurosciences1701 Psychology1702 Cognitive SciencesExperimental Psychology3209 Neurosciences5202 Biological psychology5204 Cognitive and computational psychologyAdultAffectAgedBrain Injuries, TraumaticCognitionEmpathyFemaleHumansMaleMiddle AgedSelf ReportSex CharacteristicsYoung AdultJournal ArticleOpenAccess10.1037/neu0000462