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Psychiatry Research 165 (2009) 252 – 262

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Empathy and recognition of facial expressions of emotion in

sex offenders, non-sex offenders and normal controls
Isabelle Gery a,⁎, Raphaële Miljkovitch a , Sylvie Berthoz b , Robert Soussignan c,⁎
a
Laboratoire de Développement Social et Emotionnel, Université Paris X Nanterre, France
b
Service de Psychiatrie de l'Adolescent et du Jeune Adulte, Institut Mutualiste Montsouris, Université Rene Descartes, Paris, France
c
Laboratoire Vulnérabilité, Adaptation et Psychopathologie, CNRS, Centre Hospitalier Universitaire de la Salpêtrière, Paris, France
Received 24 February 2007; received in revised form 16 June 2007; accepted 8 November 2007

Abstract

Research conducted on empathy and emotional recognition in sex offenders is contradictory. The present study was aimed to clarify
this issue by controlling for some affective and social variables (depression, anxiety, and social desirability) that are presumed to influence
emotional and empathic measures, using a staged multicomponent model of empathy. Incarcerated sex offenders (child molesters),
incarcerated non-sex offenders, and non-offender controls (matched for age, gender, and education level) performed a recognition task of
facial expressions of basic emotions that varied in intensity, and completed various self-rating scales designed to assess distinct
components of empathy (perspective taking, affective empathy, empathy concern, and personal distress), as well as depression, anxiety,
and social desirability. Sex offenders were less accurate than the other participants in recognizing facial expressions of anger, disgust,
surprise and fear, with problems in confusing fear with surprise, and disgust with anger. Affective empathy was the only component that
discriminated sex offenders from non-sex offenders and was correlated with accuracy recognition of emotional expressions. Although
our findings must be replicated with a larger number of participants, they support the view that sex offenders might have impairments in
the decoding of some emotional cues conveyed by the conspecifics' face, which could have an impact on affective empathy.
© 2007 Elsevier Ireland Ltd. All rights reserved.

Keywords: Empathy; Emotion; Emotional recognition; Sex offenders; Anxiety; Depression

1. Introduction 2002; Decety and Jackson, 2004; Blair, 2005). Although

The construct of empathy has received much attention
in different domains of research (e.g., psychology, ethol-
ogy, cognitive neuroscience, and psychiatry) (see Eisen-
berg and Strayer, 1987; Ickes, 1997; Preston and de Waal,
⁎ Corresponding authors. Soussignan is to be contacted at Laboratoire
Vulnérabilité, Adaptation, Psychopathologie, Centre Émotion, CNRS
UMR 7593, Hôpital de la Salpêtrière, 47 Bd de l'Hôpital, 75013 Paris.
Tel.: +33 1 42161744.
E-mail addresses: musette45@hotmail.com (I. Gery),
soussign@ext.jussieu.fr (R. Soussignan).
0165-1781/$ - see front matter © 2007 Elsevier Ireland Ltd. All rights reserved.
doi:10.1016/j.psychres.2007.11.006
there is little consensus among theorists regarding its
definition and its constitutive components, most agree that
empathy is a multidimensional phenomenon that involves
an understanding of a person's subjective experience, a
perspective taking, and a vicarious sharing of emotional
states in response to another's affective cues, often re-
sulting in feelings of concern or compassion for this person
(i.e., sympathy), although it also can lead to self-oriented
feelings (i.e., personal distress) (Davis, 1983; Hoffman,
1984; Decety and Jackson, 2004). Although it is unclear
whether all the components are required for the unfolding
of the empathetic process, it is usually acknowledged that
 I. Gery et al. / Psychiatry Research 165 (2009) 252–262
they play important functions in social bonds (Anderson
and Keltner, 2002), prosocial behaviors (Eisenberg and
Miller, 1987), altruism (Batson, 1991) and moral judgment
(Hoffman, 1987). In contrast, empathy impairments have
been related to aggressive, delinquent and antisocial
behaviors (Miller and Eisenberg, 1988; Jolliffe and
Farrington, 2004; Lovett and Sheffield, 2007), and deficits
in specific components of empathy have been proposed as
a feature of autism or psychopathy (Blair, 2005).
The inverse relationship typically found between
empathy and aggression led a number of researchers
and clinicians to suggest that sex offenders (e.g., child
molesters, rapists) are likely deficient in their capacity to
empathize with their conspecifics (e.g., Marshall and
Barbaree, 1990). More specifically, it was assumed that
because of a lack of compassion for the victim's distress, a
child molester or a rapist does not inhibit an attack when
he becomes sexually aroused toward a potential victim.
However, empirical research on empathy in sexually
aggressive persons conducted during the last three
decades provided inconsistent findings (for reviews, see
Marshall et al., 1995; Geer et al., 2000; Covell and
Scalora, 2002). Some studies reported lower levels of
generalized empathy or for some of its components (e.g.,
empathic concern, perspective taking) in sexual offenders
compared with non-sexual offenders (Rice et al., 1994;
Lisak and Ivan, 1995; Lindsey et al., 2001; Marshall and
Moulden, 2001) or their non-offending counterparts
(Hudson et al., 1993: study 2; Chaplin et al., 1995;
Burke, 2001), whereas other studies have found no
differences between sexual offenders and other groups of
participants (Hoppe and Singer, 1976; Langevin et al.,
1988; Hudson et al., 1993: study 1; Hanson and Scott,
1995), or showed empathy deficits in sex offenders
only in specific situations or toward their own victims
(Pithers, 1999; Fernandez and Marshall, 2003).
Marshall et al. (1995) proposed an appealing staged
multicomponent model of empathy that was designed to
examine potential deficiencies in sexual offenders at
each stage of the process. According to this model, the
ongoing process of empathy involves four discriminable
steps: (1) emotional recognition, (2) perspective taking,
(3) emotion replication, and (4) response decision. Stage
1, the emotion-recognition stage, is needed to decode or
read emotional signals of others and is considered nec-
essary for the unfolding of subsequent stages. Such
signals, more specifically those conveyed by the face,
constitute a primary way for communicating basic emo-
tional states or current intentions and play a powerful role
in the regulation of social interactions (e.g., Fridlund,
1994; Ekman and Rosenberg, 2005). Stage 2, perspective
taking, which is the ability to understand another person's
253
viewpoint, is thought to be an essential component in the
mechanisms that account for the theory of mind. Stage 3,
emotion replication, involves some level of sharing or
similarity in the feelings experienced by self and other.
Finally, the last stage, response decision, refers to the
observer's decision to exhibit or not, on the basis of his/
her feelings, a socially oriented behavior (e.g., helping or
comforting behaviors).
The present study aims to focus on the first step of
empathy process (recognition of emotional cues) in
different groups of participants (sex offenders, non-sex
offenders, and normal controls) and investigates the
relationship between the ability to recognize emotional
facial expressions and self-reported empathy. The few
available findings suggest that sex offenders might be less
accurate than controls or non-sex offenders in recognizing
the emotional states of others (Hudson et al., 1993; Lisak
and Ivan, 1995), although some negative findings have
also been reported in the form of dissertation abstracts
(Franklin, 2000; Cuevas, 2004). To date, the most detailed
findings reported by Hudson et al. (1993) provided
evidence that sexually aggressive men (child molesters
and rapists) were less accurate than were violent non-sex
offenders at recognizing emotional expressions, with
confusions between fear and surprise on the one hand,
and disgust and anger on the other hand. Such confusions
between fear and surprise, in return, have been hypothe-
sized to lead sex offenders to have difficulties in reading
the distress in the “eyes” of another. However, because sex
offenders often display affective disturbances (i.e., anxiety
and depression) (Becker et al., 1991; Ahlmeyer et al.,
2003; Dunsieth et al., 2004), which were not controlled for
in previous studies, it is unclear whether these negative
effects have contributed to the variance of data and, thus,
may explain inconsistency among findings. More speci-
fically, because substantial evidence indicated that depres-
sion or anxiety in non-offenders may bias the recognition
of emotional facial expressions (Gur et al., 1992;
Surguladze et al., 2004; Montagne et al., 2006), it is
important for studies examining emotion recognition in
sex offenders to partial out the effects of depression and
anxiety. In the present study, such variables were entered as
covariates in a design examining the ability of sex
offenders (child molesters) to decode facial expressions
of basic emotions compared with non-sex offenders and
normal controls. Furthermore, because self-report mea-
sures may be affected by self-presentation, and because
socially desirable responding has been reported in studies
of sex offenders (Curwen, 2003), various scales presumed
to assess distinct constitutive components of empathy
(perspective taking, affective empathy, empathy concern,
personal distress) entered self-reported social desirability
254 I. Gery et al. / Psychiatry Research 165 (2009) 252–262
as a covariate. By partialling out potential confounding
effects such as depression, anxiety, and social desirability,
we expected that our study should provide a more stringent
assessment of the empathy process in both sex and non-sex
offenders. The ability to decode distinct intensity levels of
emotional expressions was also investigated in order to
assess whether sex offenders were less accurate in
recognizing emotions when affective cues expressed by
others were reduced. Finally, by examining relationships
between recognition accuracy of emotions and distinct
components of empathy in offenders and non-offenders,
our study was also designed to explore the relevance of the
multidimensional staged process of empathy suggested by
Marshall et al. (1995).
2. Methods
2.1. Participants
Thirty males divided into three groups matched for age
and high school education level (E.L.) (P N 0.05) were
recruited from a prison located south of Paris: a) a group of
10 inmates (age= 43± 4.49 years; E.L. = 4.5 ± 1.96 years)
incarcerated for child sexual abuse (SO: sex offenders); b)
a group of 10 inmates (age= 38.1 ± 3.81 years; E.L. = 4.9 ±
1.37 years) incarcerated for theft or fraud (NSO: non-sex
offenders); and c) a group of 10 prison staff members
(age = 40.3± 4.21 years; E.L. = 5.8 ± 1.55 years) directly
involved in the supervision of inmates (non-offender
controls). The criminal justice records were used to select
the groups of offenders. All the offenders had already had
an experience of incarceration before being transferred to
the prison after their conviction. None of them were
followed by the psychiatric service of the prison or were
being treated during the study. Written informed consent
was obtained from all participants.
2.2. Stimuli and material
2.2.1. Emotion recognition test
Black-and-white slides of models (6 males and 6
females), each one displaying a distinct facial expression
of a basic emotion (happiness, sadness, anger, surprise,
fear, and disgust), and an emotionally neutral face were
chosen as prototype images from Ekman and Friesen's
(1976) Pictures of Facial Affect. The slides were scanned
to 700 × 466 pixels to allow computerised presentation on
a 17″ screen of a laptop. For each prototypical emotion,
facial expressions differing in intensity by 10% steps were
then constructed using the MorphMan 4.0 software on the
neutral face (0% of emotional intensity) and the full-
blown expression (100% of emotional intensity). From
this series, we selected three intensity levels for each
emotional expression (40% = mild, 70% = moderate, and
100% = strong) giving a total of 36 emotional stimuli and
12 neutral faces.
2.2.2. Empathy questionnaires
2.2.2.1. The empathy scale of the Impulsivity–Venture-
someness–Empathy-7 questionnaire (ES-IVE-7, Eysenck
et al., 1985). The IVE-7 is a 54-item questionnaire in a
yes/no format that includes three scales: Impulsiveness
(19 items), Venturesomeness (16 items), and Empathy
(19 items). We used only the empathy scale, which is
presumed to assess the affective component of empathy.
This scale was derived from the Questionnaire Measure
of Emotional Empathy (QMEE) of Mehrabian and
Epstein (1972), who defined emotional empathy as
“vicariously emotional response to the perceived
emotional experiences of others”. Eysenck et al.
(1985) reported an acceptable internal reliability
(alpha = 0.69) and published age norms for males
(n = 559) and females (n = 761). Comparable findings
of reliability and mean scores of empathy have been
reported in a sample of French males and females (Caci
et al., 2003).
2.2.2.2. The Interpersonal Reactivity Index (IRI, Davis,
1983). The IRI consists of four 7-item subscales –
Perspective Taking (PT), Fantasy (FS), Empathic
Concern (EC), and Personal Distress (PD). The first
two subscales (PT and FS) measure the cognitive facet
of empathy, whereas the other subscales (EC and PD)
are presumed to tap the affective facet of empathy.1
The PT subscale assesses the ability to adopt the
viewpoint of another person. The FS subscale mea-
sures the tendency to identify oneself with fictional
characters in books, movies, or plays. The EC subscale
reflects feelings of sympathy or compassion for
another person. The PD subscale assesses self-oriented
feelings of distress or anxiety in emergency situations
or in reaction to negative emotions of another. Each
item of the IRI is scored on a 5-point Likert scale
ranging from 0 (does not describe me well) to 4
(describes me very well). Satisfactory internal (from
0.71 to 0.77) and test–retest (from 0.62 to 0.71)
reliabilities have been reported for the four subscales
(Davis, 1983), and sufficient external validity of the
1
Although EC was designed to assess affective empathy, this
subscale is usually considered as a measure of sympathy and contains
few items assessing affective sharing.
 I. Gery et al. / Psychiatry Research 165 (2009) 252–262
IRI was provided by comparing it with other measures
of empathy (Davis and Franzoi, 1991).
2.2.2.3. The Empathy Quotient (EQ, Lawrence et al.,
2004). The EQ is a self-report questionnaire contain-
ing 40 empathy items and 20 filler items included to
distract the participant from a relentless focus on
empathy. Unlike other scales, it was explicitly devel-
oped to measure global empathy in both healthy
individuals and psychiatric populations with empathic
dysfunction (e.g., autistic spectrum disorders).
Responses are given on a 4-point scale ranging from
‘strongly agree’ to ‘strongly disagree’. Baron-Cohen and
Wheelwright (2004) reported high test–retest reliability
for the EQ over a period of 12 months, and satisfactory
concurrent validity evidenced by moderate correlations
with the EC and PT subscales of the IRI. Satisfactory
psychometric qualities of the French version of the
EQ have been reported in a healthy sample of 201
males and 209 females (Berthoz et al., 2008).
2.2.3. The Depression Inventory—short form
Depression was measured with the French version of
the shortened 13-item Beck Depression Inventory (BDI)
(Beck et al., 1974; Collet and Cottraux, 1986), a widely
used self-rating scale with established reliability and
validity (Beck et al., 1988).
2.2.4. The State-Trait Anxiety Inventory (STAI-Y;
Spielberger, 1983)
The state form of the STAI (French version:
Bruchon-Schweitzer and Paulhan, 1993) was used in
this study. The state form (S-STAI) is a well-validated
self-report scale containing 20 items from which
participants must indicate their degree of approval on
a 4-point Likert-type scale ranging from 1 ‘‘No’’ to 4
‘‘Yes’’.
2.2.5. The Social Desirability Scale (SDS)
The SDS (Crowne and Marlowe, 1960) contains 33
true–false items tapping the tendency to respond to
items in a socially desirable manner. A high score on this
scale indicates that persons tend to over-report socially
desirable information about themselves.
2.3. Procedure
Participants were tested individually in a quiet room. At
the beginning of the session, the experimenter told them
that a series of photographs showing men and women
displaying emotional expressions would be presented over
a few seconds on the screen of a laptop. Using a forced
255
choice response format, participants had to judge, after
each stimulus presentation, the emotion portrayed on the
photograph by choosing one of the seven labels displayed
on the screen (anger, disgust, fear, happiness, neutral,
sadness, and surprise). They were also asked to rate the
intensity of each emotional expression from 0 (no intensity
— neutral) to 9 (extremely strong). Participants were
shown examples of facial expressions of emotions
differing in intensity (40%, 70%, and 100%) to ensure
that they perceived differences between intermediate
expressions of a specific emotion. Furthermore, in order
to familiarize the participants with the procedure, they
were asked to complete two practice trials during which
the experimenter helped them if they did not understand
the task. The 48 photographs were presented in a random
order across participants for 6 s at a distance of about
40 cm. Stimulus presentation and timing were controlled
using the SuperLab software. After the emotion-recogni-
tion test, the participants completed self-report question-
naires to assess empathy, depression, anxiety and social
desirability.
2.4. Statistical analyses
Because the offenders reported higher depression and
anxiety scores than the participants of the control group
(see Section 3), recognition-accuracy, scores (hit rate) and
intensity ratings of emotional expressions were submitted
to a 6 × 3 × 3 (Emotion × Group × Intensity) multivariate
analysis of covariance (MANCOVA, Pillai's Trace), using
BDI and S-STAI scores as covariates. Emotion (anger,
disgust, fear, happiness, sadness, surprise) and Intensity
(40%, 70%, and 100%) were introduced as within-subject
factors, and Group (sex offenders, non-sex offenders,
controls) as the between-subjects factor. Signal detection
statistics were used to assess discriminability/sensitivity
and response bias. Sensitivity, defined as the overlap
between the signal and the noise distributions, was
calculated by d′ (Stanislaw and Todorov, 1999). The
estimation of d′ was obtained by subtracting the z score
corresponding to the false alarm rate (FAR) from the z
score corresponding to the hit rate (HR). FAR is the
proportion of choices of a facial expression not matched to
the appropriate emotion. Larger positive values of d′
indicate greater sensitivity; values close to 0 indicate a low
sensitivity to the presence of the target emotional
expression. Values less than 0 indicate a lack of sensitivity
that might result from response confusion. Response bias,
which measures the general tendency to provide yes or no
responses to the target stimulus, was assessed by C = −1/
2 * (ZHR +ZFAR). When C is negative, the participant is
liberal (i.e., tends to select an emotional expression more
256 I. Gery et al. / Psychiatry Research 165 (2009) 252–262

often), whereas when C is positive, the participant is nificant difference was detected between sex offenders
conservative (i.e., tends to underestimate the presence of (M = 11.7, S.D. = 4) and non-sex offenders (M = 15.2,
the emotional target). Then, d′ and C were submitted to a S.D. = 3.08), P N 0.05.
MANCOVA using Emotion as a within-subject factor,
Group as a between-subjects factor, and BDI and S-STAI 3.2. Accuracy rates of emotional recognition
scores as covariates.
Because self-reports of empathy were strongly cor- Table 1 shows mean rates of accuracy as a function of
related with depression, anxiety and social desirability emotion category, group and intensity level of facial
(see Section 3), these variables were entered as covariates expressions. The MANCOVA indicated a significant
using analyses of covariance (ANCOVAs) on ES-IVE, main effect of BDI covariate on the accuracy rates of
EQ, and IRI subscales scores (PT, EC, FS, PD). To control emotional recognition, F(1, 25) = 4.04, P = 0.05, ηp2 =
the familywise error rate due to multiple post hoc 0.14. A main effect for Group was also found, F(2, 25) =
comparisons, Bonferroni correction of alpha level was 47.76, P b 0.0001, ηp2 = 0.79, indicating that the sex
used (Bonferroni t). The strength of association between
significant effects and the dependent variables (i.e., effect
size) was estimated by partial eta squared (ηp2). Table 1
Accuracy rates of emotion recognition as a function of group (SO = sex
offenders, SNO = non-sex offenders, controls = non-offenders controls)
3. Results
and intensity levels (40% = mild, 70% = moderate, 100% = strong) of
facial expressions
3.1. Depression, anxiety and social desirability and
Emotion Group
their relations with other measures intensity
SO NSO Controls Total
level (%)
An analysis of variance (ANOVA) revealed that the Mean S.D. Mean S.D. Mean S.D. Mean S.D.
sex offenders (SO) reported higher depression scores Neutral 0.82 0.13 0.86 0.12 0.94 0.08 0.87 0.12
(M = 25.3, S.D. = 4.14) than the other participants Anger 0.70 0.26 1 0 1 0 0.90 0.20
(NSO: M = 13, S.D. = 2.21; controls: M = 0.9, S.D. = (40%)
Anger 0.75 0.35 1 0 1 0 0.92 0.23
1.28), F (2, 27) = 188.67, P b 0.001, with the non-sex
(70%)
offenders having more depressive mood than the controls Anger 0.90 0.21 1 0 1 0 0.96 0.13
(P b 0.001, Bonferroni test). The SO group also obtained (100%)
higher S-anxiety scores (M = 67.9, S.D. = 3.93) than did Disgust 0.05 0.16 0.55 0.16 0.65 0.24 0.43 0.32
the other groups (NSO: M = 61, S.D. = 2.79; controls: (40%)
Disgust 0 0 1 0 1 0 0.67 0.48
M = 28.4, S.D. = 3.50), and the NSO were more anxious
(70%)
than the controls [F(2, 27) = 376.38 and Bonferroni test, Disgust 0.05 0.16 1 0 1 0 0.68 0.46
P b 0.0001]. When social desirability was entered as a (100%)
covariate, the pattern of findings between the groups of Fear (40%) 0.10 0.21 0.75 0.26 0.95 0.16 0.60 0.42
participants did not change for depression and anxiety. Fear (70%) 0 0 1 0 1 0 0.67 0.48
Fear (100%) 0.10 0.32 1 0 0.95 0.16 0.68 0.46
BDI scores correlated significantly (P b 0.002) across
Happiness 0.90 0.21 1 0 1 0 0.97 0.13
groups with the following empathic measures: rs (28) = (40%)
−0.92 for EQ, −0.92 for ES-IVE, −0.93 for PT, −0.55 for Happiness 1 0 1 0 1 0 1 0
FS, −0.93 for EC, and 0.83 for PD. Similarly, strong (70%)
significant correlations were found between empathic Happiness 1 0 1 0 1 0 1 0
(100%)
measures and S-STAI scores (P b 0.0001): rs (28) = −0.93
Sadness 0.65 0.42 0.80 0.26 0.90 0.32 0.78 0.34
for EQ, −0.82 for ES-IVE, −0.91 for PT, −0.70 for FS, (40%)
−0.91 for EC, and 0.71 for PD. Social desirability also Sadness 0.60 0.46 1 0 1 0 0.87 0.32
correlated significantly (P b 0.01) with the following (70%)
measures: rs (28) = 0.81 for EQ, 0.66 for ES-IVE, 0.79 Sadness 0.95 0.16 1 0 1 0 0.98 0.09
(100%)
for PT, 0.49 for FS, 0.78 for EC, and −0.67 for PD.
Surprise 0.40 0.32 0.80 0.26 1 0 0.73 0.34
Furthermore, an ANOVA carried out on scores of social (40%)
desirability revealed a main effect of Group, F(2, 27) = Surprise 0.55 0.44 0.95 0.16 0.95 0.16 0.82 0.33
27.84, P b 0.0001. Controls had higher scores of social (70%)
desirability (M = 23.3, S.D. = 3.62) than the other groups Surprise 0.50 0.41 0.95 0.16 0.95 0.16 0.80 0.34
(100%)
of subjects (P b 0.001, Bonferroni tests), while no sig-
 I. Gery et al. / Psychiatry Research 165 (2009) 252–262 257

offenders (M = 0.51, S.D. = 0.096) were less accurate than sex offenders, P = 0.09 (controls: M = −0.14, S.D. = 0.29;
the non-sex offenders (M = 0.93, S.D. = 0.03) and the NSO: M = −0.21, S.D. = 0.60; SO: M = 0.10, S.D. = 0.67).
controls (M = 0.96, S.D. = 0.03) for recognizing emotional
expressions (Bonferroni test, P b 0.0001). Significant 3.3. Intensity ratings of facial expressions
Emotion × Group, F(10, 44) = 4.16, P b 0.0001, ηp2 = 0.49,
and Emotion × Intensity × Group interactions were de- The MANCOVA failed to show significant effects for
tected, F(20, 34) = 2.56, P = 0.008, ηp2 = 0.60. One-way the distinct variables. Only the Emotion × Intensity × BDI
ANCOVAs conducted on each emotional expression interaction reached significance, F(10, 16) = 2.55,
showed that these effects mainly reflect the fact that the P b 0.05, ηp2 = 0.61, suggesting the importance of depres-
sex offenders recognized less accurately disgust, F(2, 25) = sion for explaining differences in intensity ratings of
65.83, P b 0.0001, ηp2 = 0.84, fear, F(2, 25) = 29.13, emotional expressions as a function of their intensity
P b 0.0001, ηp2 = 0.70, and anger expressions, F(2, 25) = level. Significant effects were found for the distinct
10.22, P = 0.001, ηp2 = 0.45, than did the other groups variables (Intensity, Group, Emotion, Emotion × Group,
of participants. They also decoded less accurately sur- and Intensity × Group) only when the covariates were
prise, F(2, 25) = 3.75, P = 0.04, ηp2 = 0.23, than the non- excluded from the analysis.
sex offenders (Bonferroni test, P b 0.05). Furthermore, the
sex offenders were less accurate in decoding mild levels 3.4. Empathy ratings
of disgust F(2, 25) = 5.75, P = 0.009, ηp2 = 0.315, and fear
expressions, F(2, 25) = 4.12, P = 0.03, ηp2 = 0.25, than Self-rated empathy scores from the three question-
were the non-sex offenders (Bonferroni tests, all naires are reported in Table 2. The ANCOVA and the
P b 0.05). It should be noted that the effect sizes are Bonferroni test indicated that the controls had signifi-
large, more particularly when the significant effects cantly higher EQ scores than the offenders, F(2,24) =
concerned the three groups of participants (i.e., see effect 7.18, P b 0.003, ηp2 = 0.37. Differences between SO and
sizes for fear and disgust), suggesting that the effects can NSO approached significance, P = 0.053 (Bonferroni
be accepted with confidence. test). For the ES-IVE score, a group effect was also
Significant effects for Group, F(2, 25) = 27.49, found, F(2,24) = 8.41, P = 0.002, ηp2 = 0.41; the SO
P b 0.001, ηp2 = 0.69, and Emotion × Group interaction group reported lower affective empathy scores than
were found for the emotional sensitivity index (d′), F(10, the other groups, P b 0.05, whereas no difference was
44) = 3.01, P = 0.006, η2p = 0.41, with sex offenders being found between the NSO and the controls. An ANCOVA
less sensitive (M = 0.041, S.D. = 0.78) than the other groups was also applied on each IRI subscale. For PT, a
(controls: M = 4.18, S.D. = 0.49; NSO: M = 3.59, S.D. = significant difference was found among the three
0.47). One-way ANCOVAs, using Group as the between- groups, F(2, 24) = 4.04, P = 0.03, ηp2 = 0.25. The controls
subjects factor, were also conducted on d′ to specific target had a higher score on the PT subscale than the other
faces (e.g., surprise responses to fear faces). The analyses groups (P b 0.05, Bonferroni test), but no significant
revealed that sex offenders falsely identified disgust
expressions as anger expressions, F(2, 25) =22.633,
P b 0.001, ηp2 = 0.64 (controls: M = 3.55, S.D. =0.87; Table 2
NSO: = 3.00, S.D. = 0.87; SO: M = −2.98, S.D. =1.32). Mean scores on Empathy Quotient (EQ) scale, and on subscales of
Furthermore, sex offenders provided more false surprise Empathy–IVE and Interpersonal Reactivity Index (IRI) in sex
offenders (SO), non-sex offenders (NSO) and controls
responses when viewing fear faces, F(2, 25) =15.39,
P b 0.001, ηp2 = 0.55 (controls: M = 4.33, S.D. =1.03; SO NSO Controls
NSO: M = 3.42, S.D. = 1.36; SO: M = −3.87, S.D. =1.74). Mean S.D. Mean S.D. Mean S.D.
No differences were detected between non-sex offend- Empathy 5.60 1.07 19.8 5.39 50.5 6.36
ers and normal controls (P N 0.05, Bonferroni test). The Quotient (EQ)
bias index (C) submitted to the MANCOVA indicated an Empathy 4.60 1.57 12.3 2.06 17.0 1.70
effect for depression, F(1, 25) = 6.22, P = 0.02, η2p = 0.20), subscale-IVE
Perspective 6.60 1.26 12.2 2.39 20.9 1.66
and for Emotion × Group interaction, F(10,44) = 2.06,
Taking (PT-IRI)
P = 0.049, η2p = 0.32). The ANCOVAs conducted on C Fantasy (FS-IRI) 10.50 1.58 8.50 3.44 16.7 3.77
yielded a significant main effect of Group only for the Empathic 4.60 1.90 12.0 2.79 23.9 2.60
sadness expression, F(2,25) = 4.08, P = 0.03, η2p = 0.25). Concern (EC-IRI)
Post hoc comparisons revealed only that sex offenders Personal 18.10 1.20 12.7 1.49 10.3 2.58
Distress (PD-IRI)
tended to select less frequently the sad label than the non-
258 I. Gery et al. / Psychiatry Research 165 (2009) 252–262
difference was found between SO and NSO. For the FS
subscale, the Group factor did not reach significance,
F(2, 24) = 1.82, P = 0.13. Differences between groups
were also found for EC, F(2, 24) = 3.73, P = 0.04,
ηp2 = 0.24. Post hoc analysis revealed that the controls
had higher ratings of EC than the SO only, P b 0.05.
Finally, a significant difference between the groups
was observed for PD, F(2, 24) = 3.55, P = 0.04,
ηp2 = 0.23. Bonferroni tests revealed that the SO had
higher PD scores than the NSO, P = 0.05. The
inspection of size effects for the IRI subscales indicates
that they are rather small (b 0.3), suggesting that the
relationships between empathy components and delin-
quency are not consistent. In contrast, only the ES-IVE
scale revealed a moderate size effect (N 0.4).
3.5. Relationships between accuracy rates of emotion
recognition and empathy scores
Partial correlations (pr), using BDI and S-STAI scores
as covariates, were performed between emotional recog-
nition accuracy and empathy scores across participants.
Positive correlations were found between ES-IVE scores
and accuracy rates for the following emotions: disgust
(pr= 0.56, P = 0.002), fear (pr = 0.45, P = 0.02), surprise
(pr= 0.33, P = 0.08), and sadness (pr= 0.33, P = 0.08). In
other terms, the ability to recognize some emotions was
greater in participants who obtained high scores of
affective empathy. No significant correlations, however,
were detected between EQ, PT, FS or EC scores and
accuracy rates of emotion recognition. Nevertheless, ne-
gative correlations were found between PD and recogni-
tion accuracy rates for the following emotions: disgust
(pr= −0.34, P = 0.08), fear (pr = −0.364, P = 0.057), sur-
prise (pr = −0.43, P = 0.02), anger (pr = −0.48, P = 0.01),
and sadness (pr = −0.36, P = 0.06).
Partial correlations between empathic and recognition
accuracy rates were also examined for the distinct levels
of facial expressions of emotions. Recognition accuracy
rates were positively correlated with ES-IVE scores for
moderate (pr = 0.57, P = 0.001) and strong (pr = 0.50,
P = 0.006) levels of fear, and for mild (pr = 0.36,
P = 0.058) and strong (pr = 0.36, P = 0.058) levels of
surprise. Finally, a positive correlation was found
between the ability to decode moderate expressions of
sadness and ES-IVE scores (pr = 0.42, P = 0.02). In
contrast, PD scores were negatively correlated with
recognition accuracy rates for moderate (pr = − 0.46,
P = 0.01) and strong pr = − 0.39, P = 0.03) levels of
disgust. PD scores were also negatively correlated with
recognition accuracy rates for moderate expressions of
anger (P = − 0.52, P = 0.006), fear (pr = − 0.46, P = 0.01),
surprise (pr = − 0.46, P = 0.01) and sadness (pr = − 0.45,
P = 0.02).
4. Discussion
This research addressed two main issues derived from
the multidimensional staged model of empathy proposed
by Marshall et al. (1995). The first objective was to
investigate whether sex offenders, compared with other
participants, were impaired in their ability to recognize
emotional cues (first stage of the model) conveyed by a
conspecific's face. The present study demonstrated that
sex offenders, and more particularly child molesters, were
less accurate in decoding emotional facial signals than
non-sex offenders or normal controls. More specifically,
the sex offenders were less sensitive than the other
participants in recognizing facial expressions of anger,
disgust, surprise and fear. These findings reflected the fact
that they often confused fear with surprise on the one
hand, and disgust with anger on the other hand. When
viewing fear expressions, sex offenders frequently
interpreted them as surprise signals, whereas disgust
expressions were frequently decoded as anger signals.
Such findings cannot be explained by offenders' self-
reported negative affective states, such as depression and
anxiety, which were partialled out in the present study.
Taken together, the pattern of results on emotional
confusion is consistent with that obtained by Hudson et
al. (1993) on a sample of sex offenders including both
child molesters and rapists. Impairments in the recogni-
tion of fearful cues from the face have also been reported
in adolescents with antisocial or aggressive behaviors
(Blair and Coles, 2000; Carr and Lutjemeier, 2005).
What kind of explanation could account for the high
rates of confusion in sex offenders' emotional recogni-
tion? Regarding fear and surprise, one possibility is to
consider the degree of similarity in the perceptual
properties of these expressions that have in common a
number of muscular actions in the upper part of the face
(i.e., brow raising, and upper lid raising). Similarly, for
anger and disgust, although the morphology of facial
configurations is somewhat different, they also share a
muscular action in the upper part of the face (i.e., brow
lowering). Thus, one cannot rule out the hypothesis that
the sex offenders' misinterpretation in the decoding
of basic emotions was possibly biased by selective
processing of some facial cues. Additional studies are
needed to test this hypothesis by manipulating the nature
of facial cues presented to sex offenders.
Another level of analysis for explaining sex offenders'
difficulties in interpreting emotional recognition of
conspecifics might be related to their history or past
 I. Gery et al. / Psychiatry Research 165 (2009) 252–262
experiences. Although our findings cannot resolve this
issue, a tentative interpretation may be proposed by
examining studies that have highlighted the potential
influence of early adverse social environments on the
recognition of emotional signals. Because many sex
offenders have been exposed to negative interpersonal
experiences and trauma during childhood (i.e., physical or
sexual abuses) (e.g., Burton, 2000; Jonson-Reid and Way,
2001), research on emotional recognition in abused
children is likely relevant. For instance, abused children
were found to be less accurate than non-abused children in
recognizing anger expressions (Camras et al., 1988),
tended to over-interpret expressive signals as threatening,
and over-identified anger relative to fear and sadness
(Pollak and Kistler, 2002). It might be that abused
children, by becoming defensively hypervigilant to
hostile cues, could display a hostile attributional bias
toward others (Dodge et al., 1995), more particularly
when the affective cues are ambiguous or are conveyed by
distinct expressions. It is, thus, possible that sex offenders
in our study also displayed a hostile attribution bias when
viewing distinct facial expressions (e.g., anger vs. disgust)
conveying a similar affective cue. Regarding fear and
surprise, although we have no clear explanation account-
ing for their confusion in sex offenders, Blair and Coles
(2000) have hypothesized that individuals who display
antisocial behaviors are less responsive to fearful signals
of others because they have not learned during socialisa-
tion to associate harmful actions with the victim's
aversive cues that are thought to act as punishing stimuli.
In the case of sexual offenders, one cannot rule out the
possibility that, because of their history of maltreatment or
negative interpersonal experience, they have difficulties
in attributing social meaning to fear/distress cues and in
associating them with related contextual information.
Whether this theoretical interpretation is relevant for our
findings remains to be investigated. The issue of the role
of past experience in fear recognition could be indirectly
explored by measuring emotional recognition via the
generation of associated knowledge (Adolphs, 2002).
More specifically, because fear expressions may activate
conceptual knowledge related to both causal antecedents
(e.g., punishment, danger, or aggression) and subsequent
behavior (e.g., running away, inhibiting an action), it
would be interesting in future studies to examine whether
such contextual social knowledge is impaired in sexual
offenders.
A second main objective of the current study was to
examine self-reports of constitutive components of
empathy and their relationships with emotional recogni-
tion in sex offenders, non-sex offenders and controls.
Unlike previous studies, by using multiple rating scales of
259
empathy and partialling out both negative affective states
(depression and anxiety) and social desirability, we
expected to sort out conflicting results in the literature
and assess the relevance of the multidimensional staged
model of empathy proposed by Marshall et al. (1995). Our
findings revealed that the non-offender controls reported
higher levels of empathy than did the offenders for the
three scales used in this study. However, inspection of size
effects indicated that the findings were more consistent for
the ES-IVE scale (i.e., an index of affective empathy),
which was the only empathy component that discrimi-
nated sex offenders from non-sex offenders. Compared
with IRI-affective subscales (empathy concern, and
personal distress), the ES-IVE scale is more affective
sharing-oriented. Although the ES-IVE scale is not
designed to specifically assess affective sharing/similarity
between the self and the other, it is usually considered that
it targets affective empathy more than the IRI subscales of
empathy concern and distress, which are designed to tap
sympathy and self-oriented distress, respectively. Because
the available data on empathy in sex offenders are
inconsistent, we suggest that, if differences exist between
these persons and other control groups, affective empathy,
and possibly affective sharing, are likely more altered than
cognitive empathy (i.e., perspective taking) and sympathy
(i.e., empathy concern). For personal distress, our findings
revealed that the sex offenders reported a higher level than
did the non-sex offenders, which can be interpreted as a
proclivity of sex offenders to display more negative self-
oriented feeling. However, it should be noted that the IRI
subscale of personal distress imperfectly assesses the
distress dimension of empathy because most of the items
tap anxious and distress reactions not related to negative
emotional expressions of others. Thus, further research is
necessary to delineate more clearly whether distress
would be observed in sex offenders in response to
emotional displays of their conspecifics.
The view that affective empathy is more impaired than
cognitive empathy or sympathy in sex offenders is also
supported by the correlational findings that indicated that
only ES-IVE scores were positively related to recognition
accuracy of emotional expressions such as disgust, fear,
surprise, and sadness, whereas personal distress negatively
correlated with these emotions. Thus, these findings give
some support to the multidimensional staged model of
empathy proposed by Marshall et al. (1995). Although the
correlational nature of our data does not permit a causal
relationship to be established between emotion recognition
and empathy processes, the pattern of findings obtained in
our study is consistent with the hypothesis that the
recognition of affective cues from conspecifics might be
crucial in inducing affective empathy, and that difficulties
260 I. Gery et al. / Psychiatry Research 165 (2009) 252–262
in recognizing some emotional expressions in sex
offenders might be involved in impairments in affective
empathy. Obviously, our findings did not rule out the
view that other constitutive components, such as perspec-
tive taking, may induce affective empathy or sympathy,
via other pathways, even if individuals have no direct
access to perceptually visible emotional cues. For instance,
imaging the reactions and feelings of persons that were
exposed to painful stimuli may induce personal distress
(‘imagine self’) or empathic concern (‘imagine other’), and
these two forms of perspective taking (self vs. other) are
related to distinct patterns of cerebral activation (Lamm
et al., 2007).
The link between emotion recognition (perception)
and affective empathy (feeling and action) is also
supported by both psychophysiological and cognitive
neuroscience research, which has suggested that the link
stems from an automatic perception–action mechanism
leading to emotional contagion (Decety and Lamm,
2006). For instance, when unconsciously viewing angry
and happy facial expressions, participants reacted with
facial muscular actions corresponding to these emotions
(Dimberg et al., 2000). Accumulating evidence from
neuroimaging studies also suggests that the same cerebral
network is activated when humans perceive emotional
expressions and when they feel these emotions or
represent the actions associated with them (Wicker
et al., 2003; de Gelder et al., 2004; see also Decety and
Lamm, 2006 for a recent review). For example, observing
people expressing disgust faces and experiencing disgust
oneself activated the same brain areas (e.g., anterior
insula, and anterior cingulate cortex) (Wicker et al., 2003).
Thus observing and feeling emotions may lead to a shared
neural network between self and other. It is likely that such
neuroimaging studies, if they were conducted in sex
offenders in the future, could help to clarify whether such
shared representations between perception and feeling are
altered in sex offenders participating in emotional
recognition and emotional induction tasks.
Finally, several limitations of our study must be
acknowledged. First, despite the fact that our results
showed strong size effects, they should be replicated on
a larger sample of sex offenders. Second, although
offenders and controls had similar education levels, they
were not matched for IQ. Thus, the possibility that
variations of IQ among groups could be related to
differences in expression recognition data cannot be
ruled out. Third, although the sex offenders of this study
were probably not psychopaths (given their increased
levels of depression and anxiety), no data on psycho-
pathy was reported in the present sample. In the future, it
would be interesting to study a large sample of sex
offenders to investigate whether the association between
sex offending and psychopathy is related to differences
in measures of empathy and emotional recognition.
Finally, given the shortcomings of self-report measures
of empathy, which imperfectly assess distinct facets of
empathy (e.g., affective sharing), our findings should be
replicated using not only emotional recognition tasks
and self-reported empathy scales, but also experimental
paradigms designed to measure both subjective and
psychophysiological (i.e., autonomic and facial electro-
myographic activity) indices of affective sharing.
Acknowledgements
We thank the Head of the prison of Fresnes (France),
who gave us permission to meet the prisoners and made
the study possible. We are also grateful to all the
participants (offenders and controls) without whom this
study could not have been carried out.
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