Rachel Terry a, Gisli Gudjonsson b & Susan Young c. Psychiatry, London, UK. To cite this article: Rachel Terry, Gisli Gudjonsson & Susan Young (2009)

Originally published as: Rachel Terry, Gisli Gudjonsson & Susan Young (2009) Psychometric properties and validity of the Victim Empathy Response Assessment (VERA) in a community adult male sample, The Journal of Forensic Psychiatry & Psychology, 20:5, 752-768, DOI: 10.1080/14789940903174071 The Journal of Forensic Psychiatry & Psychology Psychometric properties and validity of the Victim Empathy Response Assessment (VERA) in a community adult male sample Rachel Terry a, Gisli Gudjonsson b & Susan Young c a South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK b Department of Psychology, Institute of Psychiatry, London, UK c Department of Forensic Mental Health Science, Institute of Psychiatry, London, UK To cite this article: Rachel Terry, Gisli Gudjonsson & Susan Young (2009) Psychometric properties and validity of the Victim Empathy Response Assessment (VERA) in a community adult male sample, The Journal of Forensic Psychiatry & Psychology, 20:5, 752-768, DOI: 10.1080/14789940903174071 To link to this article: http://dx.doi.org/10.1080/14789940903174071

Psychometric properties and validity of the Victim Empathy Response Assessment (VERA) in a community adult male sample Rachel Terry a *, Gisli Gudjonsson b and Susan Young c a South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK; b Department of Psychology, Institute of Psychiatry, London, UK; c Department of Forensic Mental Health Science, Institute of Psychiatry, London, UK (Received 15 September 2008; final version received 16 April 2009) The Victim Empathy Response Assessment (VERA) was developed to provide an assessment of cognitive and affective empathy in forensic services. Initial validation data using a clinical forensic sample group suggested that it was a potentially useful measure. The aim of this study was to further evaluate the validity of the VERA, with a community sample group. Data analysis supported the factor structure and high reliability identified by the authors of the measure. Some construct validity was found, but unexpectedly the forensic patients had higher empathy scores than the community control sample. The higher empathy scores among the forensic sample have important theoretical and practical implications. Important findings emerged in relation to affective and cognitive empathy and types of scenarios rated, suggesting that global measures of empathy are more related to affective than cognitive empathy and to non-crime-related scenarios. Keywords: Victim Empathy Response Assessment ( VERA ); victim empathy; cognitive versus affective empathy; forensic assessment; assessment; offending; mentally disordered offenders Introduction A deficit in empathy is generally regarded as a factor that contributes to anti-social and offending behaviour. However, support for a general empathy deficit in offenders is lacking (McGrath, Cann, & Konopasky, 1998). An alternative hypothesis proposes that empathy deficits in offenders may be situation and target-specific (Marshall, Hudson, Jones, & Fernandez, 1995). Responding to the need for a scale that assesses empathy responses to victims of specific offences, Young, Gudjonsson, Terry, and Bramham (2008) developed the Victim Empathy Response Assessment (VERA). The VERA requires respondents to rate their cognitive and affective empathy following five staged, audio interviews with victims of offences (e.g., assault) and non-offences (e.g., accidents).

As part of the development of the VERA, Young et al. (2008) explored the factor structure and internal reliability with a sample of male inpatients (N = 82) in secure mental health services. Principal components analysis (PCA) indicated that the measure had a robust factor structure and supported the hypothesised separate dimensions of cognitive and affective empathy across all five interviews. Analyses indicated that subscales had high internal reliability across all vignettes (Cronbach s alpha ranging from.85 to.94). The initial validation did not, however, assess the correlation between the VERA and existing empathy measures or related constructs. Additionally, the measure was validated on a clinical offending sample only. The authors suggested that the VERA should be further validated using a control sample (i.e., those without a history of mental illness or offending behaviour) in order to provide normative data for comparison with forensic populations. In assessing the construct validity of the VERA, the literature points to various socio-demographic variables with which empathy may be related. Significant positive correlations have been found between age and empathy measures in a sample of male adolescent sex offenders (Curwen, 2003) and research that empathy is positively correlated with reading ability (Bryant, 1982). Furthermore when intelligence is controlled for statistically, differences in empathy between offenders and nonoffenders are reduced (Jolliffe & Farrington, 2004). With regard to personality variables, research suggests a relationship between empathy and traits such as neuroticism, psychoticism and impulsivity. Eysenck and Eysenck (1991) define psychoticism as a personality trait involving solitary behaviour and a lack of care, sensitivity and empathy for others. Offenders with high psychoticism scores have a tendency to make external attributions for their offences (Fox, De Koning, & Leicht, 2003) which might also suggest low empathy. This was supported by Eysenck and Eysenck (1978) who found that empathy was negatively correlated with psychoticism. The same study found that empathy was positively correlated with neuroticism. Studies have also linked empathy and impulsivity, with research suggesting that low empathy may be linked with poor impulse control (Johnson, Cheek & Smither, 1982; Nussbaum et al., 2002). A link has also been suggested between empathy and emotional intelligence. Salovey and Mayer (1990) defined emotional intelligence as the ability to monitor one s own and others feelings and emotions, to discriminate amongst them and to use this information to guide one s thinking and actions (p.189). Ciarrochi, Chan, and Caputi (2000) found a statistically significant positive correlation of moderate effect size between emotional intelligence and empathy. The present study utilised a non-offending sample to assess the psychometric properties and validity of the VERA. The study had three principle aims. First, to assess the factor structure and internal consistency of the VERA in an adult male community sample. We expected a two-factor structure would emerge corresponding to affective and cognitive empathy, with satisfactory internal consistency. Second, to assess the construct validity of the VERA by examining its relationship with existing global empathy measures and other socio-demographic and personality variables. We expected that VERA scores would correlate positively with scores on other empathy measures, and with age, neuroticism, emotional intelligence and intellectual functioning. Conversely, we hypothesised that VERA scores would be negatively correlated with psychoticism and impulsivity scores. The third aim was to provide

evidence for the discriminant validity of the VERA by comparing data from the adult community sample with the clinical offender sample data collected by Young et al. (2008). We expected empathy scores to be lower in the clinical offender sample. The difference between groups was expected to be particularly prominent for the offencerelated scenarios as it has been argued that offenders might have particular empathy deficits in relation to offending situations (Marshall et al., 1995). Method Participants One hundred and three adult male participants were recruited aged between 16 and 70 (M = 33.71, SD = 15.25) through a range of sources (Job Centre Plus 31%; Snowball Sampling 26%; University Students 16%; Construction College Students 10%; Adult Education Students 10%; Working Mens Clubs 7%). Participants were excluded if English was not their first language (or if they had not attended an English-speaking school since primary level) or if they were identified as having a learning disability. Learning disability was defined as a predicted full-scale IQ score of less than 70 on the Wechsler Test of Adult Reading (Weschler, 2001). Measures The Victim Empathy Response Assessment (VERA; Young et al., 2008) The VERA comprises five radio interviews between a female victim and a male interviewer. Two interviews have a non-offending focus (car accident, accidental house fire), two have a sexual offence focus (sexual assault, child sexual abuse) and one focuses on a violent assault. After each interview, participants rate the extent to which they personally experienced (affective empathy rating) 13 emotions (nine negative, four positive) and the extent to which they believe the victim experienced (cognitive empathy rating) the same emotions. The measure uses a five-point Likert scale ranging from 0 (not at all) to 4 (very much so). When the VERA was originally developed, it included a subscale measuring cognitive distortions. Young et al. (2008), however, failed to confirm this subscale as a reliable factor in their analysis. The current study also failed to find sufficient support for this factor and, therefore, it is not reported upon here. Interpersonal Reactivity Index (IRI, Davis, 1980) The IRI is a 28-item self-report measure, composed of four, seven-item subscales, each said to be tapping some aspect of the global concept of empathy. The Perspective-Taking (PT) subscale assesses the tendency to consider the point of view of others. The Fantasy (FS) subscale taps respondent tendencies to use their imagination to identify with the feelings and actions of fictitious characters in books, films and plays. The Empathic Concern (EC) scale assesses the extent to which respondents experience warmth, compassion and concern for another. The Personal Distress (PD) subscale measures the respondent s own negative emotions after witnessing another s unpleasant experience. This measure was chosen because it is widely used in empathy research and has proven reliability and validity (Baron- Cohen, & Wheelwright, 2004; Marshall et al., 1995).

The Impulsiveness, Venturesomeness, Empathy Scale (IVE; Eysenck & Eysenck, 1991) The IVE is a 54-item true/false self-report questionnaire. The measure consists of three subscales measuring impulsivity, venturesomeness and empathy. Nineteen items in the measure make up the Empathy Scale and are designed to assess the affective component of empathy. This measure has also been widely used in empathy research and has been shown to be a reliable and valid measure. None of the existing measures of victim empathy were included because they have all been designed specifically to measure empathy towards victims of sexual offences, considered too specific for this study. They also require the respondent to complete a section for their own victim which would be irrelevant to non-offenders. Emotional Intelligence Scale (EIS; Schute et al., 1998) This is a 33-item self-report measure respondents are asked to rate how well a list of statements describes them on a five-point scale ranging from 1 (strongly disagree) to 5 (strongly agree). This measure was chosen because it has been widely used in emotional intelligence research (Austin, Saklofske, Huang, & McKenney, 2004). Eysenck Personality Questionnaire-Revised (EPQ-R; Eysenck & Eysenck, 1991) This is a 106-item true or false questionnaire, designed to assess self-reported extraversion, neuroticism, psychoticism, criminality and proneness to addiction. In addition, it includes a Lie Scale to assess socially desirable responding. This personality measure was chosen because it has frequently been used in research studies with offending populations, and is often used in conjunction with the IVE. It also has demonstrable reliability and validity. Wechsler Test of Adult Reading (WTAR; Wechsler, 2001) The WTAR is a well-validated test designed to assess reading ability in adults, and was included because it can be used to provide a quick estimate of intellectual functioning. Procedure

The protocol was piloted on 10 adult males from the community. Almost half expressed uncertainty about the meaning of the emotion-labelled sorry in the VERA. Therefore, a brief explanation to clarify this was added to the item for the main study. In the proper study, participants completed the measures in the presence of one of the authors (RT). Participants completed the self-report questionnaires in the following order: EIS, IRI, IVE and EPQ-R. For those participants who experienced difficulty reading (N = 3), items were read aloud by the researcher. Following completion of the self-report questionnaires, participants completed the WTAR and then the VERA. Results Aim 1: factor structure and internal consistency of the VERA As in the initial validation study by Young et al. (2008), the 13 questionnaire items were analysed using PCA. This was done for each of the five vignettes for affective (how the participant was feeling) and cognitive (how the victim was feeling) ratings separately. For each of the PCAs conducted, between three and four factors emerged. The results showed that eight items ( worried, sad, upset inside, distressed, disturbed, angry, disgusted, frightened ) consistently loaded onto one factor across all five scenarios. The factor loadings for these items are summarised in Table 1. These eight items were all negative emotions, which appear to be measuring the distress experienced by the participant and the perceived distress of the victim. The five remaining items ( sorry, interested, happy, excited and thrilled ), including all of the more positive, arousal emotions, loaded differently onto the remaining factors depending on the interview. The item groupings that emerged in these factors did not appear meaningful and therefore could not usefully be interpreted. These items were therefore excluded from the remainder of the analyses. The results of the PCA largely support the factor structure identified by Young et al. (2008). One clear factor was identified composed of the distress emotions, with the four positive emotions failing to form a coherent factor. However, the results of the current analysis did not support the inclusion of the item labelled Sorry. This had been the item that participants in the pilot study had expressed uncertainty about. Therefore the negative emotion factor comprised eight rather than nine items. Although the factor identified included one less item than Young et al. s factor, the percentage of the variance accounted for in the community data was similar to that found by Young et al. (38 46% in the community data compared to 42 48% in the Young et al. offender sample). The reliability analyses were also very similar with Cronbach s alpha ranging from.90 to.94 in the community data compared to.85.94 found by Young et al. Five additional PCA s were completed (one for each scenario) combining the eight distress items for the affective and cognitive empathy questionnaires. Consistent with Young et al s., study, two clear factors consistently emerged, separating the respondent s ratings of their own feelings and the victim s feelings. Discrete Affective and Cognitive Empathy scores were derived for each participant for each scenario by summing the eight distress emotion scores for how the participant had rated that they were feeling (affective) and how they rated the victim was feeling (cognitive). Scores across the five scenarios were summed to provide a Total Affective Empathy, Total Cognitive Empathy and Total Empathy score, the

latter being the sum of Cognitive and Affective Empathy scores.

Table 1. Item loadings and internal reliability for the affective and cognitive empathy factors.

Item Mugging Car accident Rape House fire Child sexual abuse Affective Cognitive Affective Cognitive Affective Cognitive Affective Cognitive Affective Cognitive empathy empathy empathy empathy empathy empathy empathy empathy empathy empathy Worried.779.652.828.814.779.710.756.819.725.804 Sad.751.512.606.626.790.789.719.600.898.839 Upset inside.853.560.770.647.893.810.869.668.874.866 Distressed.801.850.810.797.909.887.876.815.872.814 Disturbed.789.830.766.792.828.762.839.824.811.869 Angry.602.814.846.795.724.790.809.878.820.848 Disgusted.603.586.735.778.536.768.737.824.740.793 Frightened.885.797.826.856.715.788.830.766.687.817 % variance 41.75% 38.88% 41.81% 40.04% 40.77% 45.32% 41.50% 41.97% 44.53% 46.26% Cronbach s Alpha.91.90.92.91.91.91.92.91.93.94

Aim 2: evidence of construct validity of the VERA In order to explore construct validity, the relationship between the VERA and other variables predicted to be associated with empathy was explored. Non-parametric tests (two-tailed) were used because some of the VERA s subscale scores were not normally distributed. In analyses not involving the VERA, parametric tests are reported when the data requirements for such tests were met. The alpha level was set at.01 to reduce the likelihood of committing Type I error due to use of multiple significance tests, but avoiding the stringency associated with Bonferroni correction and consequent inflation of the Type II error rate. The Spearman s Rho correlations between the VERA and the other empathy measures are shown in Table 2. The hypothesis that VERA scores would be positively correlated with the other empathy measures was not consistently supported. There was a significant positive correlation between the Affective Empathy subscale and the Personal Distress Subscale of the IRI for the two non-offence interviews: car accident (rs =.33, p<.001) and house-fire (rs =.26, p<.01) and with the Empathy subscale of the IVE, for three of the interviews: car accident (rs =.33, p<.001); rape (rs =.28, p<.01); and house fire (rs =.28, p<.01). Total VERA Affective Empathy score was positively correlated with the Empathy Scale of the IVE (rs =.28, p<.01). VERA Cognitive Empathy scores for each interview and the Total Cognitive Empathy score were not correlated with any other empathy measures. The relationship between VERA and other variables associated with empathy is summarised in Table 3. The hypothesis that VERA scores would be positively correlated with the Neuroticism and Emotional Intelligence and negatively correlated with Psychoticism and Impulsivity were not supported. The Affective Empathy scale correlated positively with the Neuroticism scale for two interviews: mugging and rape (both with r =.26, p<.01). Effect sizes were slightly lower for the other interviews but failed to attain significance at the.01 level. Conversely, the VERA Cognitive Empathy scale showed no significant correlations with the Neuroticism scale. Contrary to expectation, cognitive empathy was consistently positively correlated with Psychoticism and Impulsivity scale scores. The hypothesis that VERA scores would be positively correlated with age and intellectual functioning was not supported. The data indicated no significant correlations between Affective and Cognitive Empathy and age. Intellectual functioning was inversely related to VERA Affective and Cognitive Empathy. Almost all of the subscales of the VERA were significantly negatively correlated with predicted full-scale IQ. Effect sizes were generally larger and significant for the Cognitive Empathy scores with effect sizes ranging from -.42 to -.56 across the different interviews (p<.001 for all). Effect sizes for Affective Empathy ranged from -.26 to -.47 and were significant for the mugging and child sexual abuse interviews only (at p<.001). Finally, Spearman s Rho was used to assess the relationship between VERA scores and socially desirable responding (assessed using the L scale of the EPQ-R). None of

the VERA scales were significantly related to socially desirable responding.

Table 2. Spearman s Rho correlation coefficients between VERA subscale scores and other measures of empathy. Interview 1: Interview 2: car Interview 3: Interview 4: Interview 5: child VERA total mugging accident rape house-fire sexual abuse subscale scores Affective Cognitive Affective Cognitive Affective Cognitive Affective Cognitive Affective Cognitive Total Total (affective þ empathy empathy empathy empathy empathy empathy empathy empathy empathy empathy affective cognitive cognitive Subscale subscale subscale subscale subscale subscale subscale subscale subscale subscale subscale empathy empathy empathy) Total empathy Interpersonal Reactivity -.03 -.17 -.06 -.20.05 -.12 -.08 -.16 -.06 -.06 -.07 -.16 -.11 Index (IRI) Fantasy subscale IRI Perspective Taking.03 -.18.08 -.05.06 -.06 -.04 -.06 -.08 -.15 -.01 -.11 -.06 subscale IRI Empathic Concern.18.09.24.13.15.10.05.13.09.06.16.12.15 subscale IRI Personal Distress.07 -.06.33**.11.22.01.26*.19.13.15.24.10.19 subscale IRI total score.10 -.11.19 0.20 -.01.05.06.05.01.12 0.08 Impulsiveness.23 -.01.33**.07.28*.08.28*.18.13.09.28*.10.21 Venturesomeness and Empathy scale (IVE) Empathy subscale Note: **p<.001; *p<.01.

Table 3. Spearman s Rho correlation coefficients and significance values. Interview 1: Interview 2: Interview 4: Interview 5: child VERA total mugging car accident Interview 3: rape house-fire sexual abuse subscale scores Total empathy Affective Cognitive Affective Cognitive Affective Cognitive Affective Cognitive Affective Cognitive Total Total (affective þ empathy empathy empathy empathy empathy empathy empathy empathy empathy empathy affective cognitive cognitive Subscale subscale subscale subscale subscale subscale subscale subscale subscale subscale subscale empathy empathy empathy) EPQ-R Neuroticism.26*.18.24.20.26*.16.19.21.15.21.25.22.26* Scale EPQ-R Psychoticism.01.37**.01.28*.07.33**.14.24.11.25*.10.33**.22 Scale IVE Impulsiveness.09.36**.05.24.23.35**.16.22.28*.29*.21.32**.29* Scale Emotional Intelligence.14.05.03.04.07.18 0.02.14.08.10.08.10 Scale (EIS) EPQ-R Lie Scale.14 0.11 -.03.03.03.07.05.10.16.13.04.09 Participant age.02 -.09 -.04 -.02 -.04 -.08 -.11 -.04 -.07 -.14 -.08 -.09 -.08 WTAR Predicted Full- -.40** -.53** -.29 -.53** -.26 -.48** -.29 -.42** -.47** -.56** -.43** -.58** -.54** Scale IQ Note: **p<.001; *p<.01.

Aim 3: discriminant validity of the VERA VERA scores from the initial validation study (Young et al., 2008) were compared to the results from the current study. Young et al. calculated Cognitive and Affective Empathy subscale scores using all nine distress emotions (i.e., the sorry emotion was not excluded). In order to compare the two groups, VERA scores were recalculated for the current sample including this item. A summary table of the descriptive statistics of the VERA subscale for the community and forensic inpatient groups is presented in Table 4. Mann Whitney tests were used to explore whether these differences were statistically significant. It was predicted that empathy scores would be higher in the adult community sample than in the clinical offender sample, particularly in the offence-related scenarios. This was not supported and contrary to prediction, the forensic inpatient group scored significantly higher than the community sample across most scenarios. The difference was particularly apparent on the affective empathy subscales. Both sample groups scored higher on the cognitive empathy subscales than those measuring affective empathy. It is noteworthy that the effect sizes, using Cohen s d (Cohen, 1988), were consistently higher for affective than cognitive empathy. Discussion Exploratory factor analysis supported the initial factor structure and reliability identified by Young et al. (2008) and suggested the VERA has a robust factor structure and a consistently high reliability across subscales. Test retest data are, however, lacking in both forensic and community samples and need to be gathered to assess the temporal stability of the measure. Data also need to be gathered on female offenders. The data analysis provided limited evidence of the concurrent validity of the VERA. Indeed, several of the correlations between the VERA and the other global empathy measures, demographic and personality variables did not support our hypotheses. However, some significant findings did emerge and merit a discussion. These relate to the relationship between the VERA and the global self-report measures of empathy, and the relationship between the VERA and other measures (e.g., IQ and personality traits). With regard to the relationship of the VERA to global self-report empathy measures, three important findings emerge. The first was that the IRI Personal Distress Subscales and the IVE-Empathy Subscale correlated significantly with the VERA, whereas no significant relationship was found for the other measures. The second was that the correlations were only significant in relation to the Car Accident and House Fire scenarios, but not for the other three (crime-related) scenarios. Third, the correlations were only sig significant in relation to affective empathy. What do these findings tell us? They tell us that global measures of empathy, such as the IRI and the IVE, are more related to affective than cognitive empathy (i.e., being able to share the emotional experiences of another person rather than simply grasping intellectually and

conceptually how the other person is feeling), and perhaps more importantly, it suggests that global empathy is more related to empathy generated in accident-related scenarios rather than in relation to specific crimes. This may explain why global measures of empathy have been consistently found to be poorly related to offending behaviour. Global empathy may only be activated in relation to incidents with which people can personally identify. In relation to offenders and their victims, empathy for specific crimes may be mediated by strong cognitive distortions and external attribution of blame, found among offenders (Gudjonsson, 1990). It is likely that cognitive distortions and external attribution of blame are more closely associated with cognitive than affective empathy, because all involve cognitive processes. This supports the argument put forward by Jolliffe and Farrington (2004) that cognitive empathy is more strongly related to offending than affective empathy, which implies that cognitive empathy should be the primary treatment target. Cognitive distortions and external attribution of blame are directly relevant to offence-related work and should be incorporated into treatment targets (Gudjonsson and Young, 2007). The most salient findings in relation to the non-specific empathy measures and the VERA are as follows. EPQ-R Neuroticism, which is a broad measure of emotional reactivity, appears to be overall related to both affective and cognitive empathy, whereas EPQ-R Psychoticism and IVE-Impulsivity are significantly correlated with cognitive empathy but not with affective empathy across the scenarios, but the correlations are in the opposite direction to that predicted. Why should this be the case? One possible explanation is that a high Psychoticism score and high impulsivity, which have been found to be associated with creativity and an overinclusive thinking style (Eysenck, 1993), made them more able to quickly grasp cognitively how the victim might be feeling about the incidents. The significant negative correlations between IQ and the VERA affective and cognitive empathy scores across the scenarios, is puzzling. One possible explanation is that the brighter participants did not view the VERA scenarios in the same way as the less intellectually able participants (i.e., not seeing them as being authentic or tangible). This raises important issues about transparency of the scenarios (i.e., they scenarios were presented by actors rather than real victims and this may influence the responses given b by the participants). At this stage, it is unclear the extent to which the null findings may be due to inherent problems with the validity of the VERA. It could be that global empathy and victim empathy are distinct concepts with little correlation. This is supported by other validation studies using newly developed measures of victim empathy that have similarly been unable to demonstrate a correlation between victim empathy and global empathy measures. For example, Tierney and McCabe (2001) found a correlation of r =.01 between the Empathy Scale-Child which measures empathy towards victims of child sexual abuse, and the Empathy Scale-General, measuring global empathy and a correlation of r =.13 between the Empathy Scale (Child) and the Questionnaire Measure of Emotional Empathy in a community group sample of 40 males. They concluded that general empathy and victim empathy may be unrelated. Similarly,

Table 4. Comparison of VERA scores in a male community sample and a secure hospital inpatient sample. Adult male community Secure hospital inpatients (N = 82) from sample (N = 103) Young et al. (2008) U Cohen s d Assault Mean affective empathy score (SD) 13.40 (8.40) 16.39 (9.97) 3147** 70.32 Mean cognitive empathy score (SD) 25.50 (7.86) 26.54 (8.04) 3572 70.13 Car accident Mean affective empathy score (SD) 12.02 (8.20) 17.67 (10.84) 2612*** 70.59 Mean cognitive empathy score (SD) 20.94 (8.43) 24.76 (9.64) 2685*** 70.42 Rape Mean affective empathy score (SD) 19.24 (8.82) 22.56 (10.30) 2870*** 70.35 Mean cognitive empathy score (SD) 27.94 (7.63) 28.32 (9.19) 3539 70.04 House fire Mean affective empathy score (SD) 14.38 (8.89) 20.02 (11.32) 2652*** 70.55 Mean cognitive empathy score (SD) 24.01 (8.45) 26.17 (9.28) 3062** 70.24 Child sexual abuse Mean affective empathy score (SD) 21.50 ( 9.44) 21.49 (11.17) 3608 0.00 Mean cognitive empathy score (SD) 25.53 (8.81) 25.34 (9.28) 3550 0.02 VERA total Mean total affective empathy score (SD) 80.53 (36.84) 98.13 (45.5) 2586*** 70.43 Mean total cognitive empathy score (SD) 123.93 (35.81) 131.09 (41.0) 2968* 70.19

Curwen (2003) found that victim empathy (as measured by therapists ratings) was not significantly correlated with IRI scores in a sample of 60 adolescent male sexual offenders. Therefore, the lack of significant positive correlations between the VERA and other global empathy measures may not indicate a lack of evidence for the validity of the VERA, but may actually provide some evidence for the validity of the measure. An important point discussed above, are the apparent differences in relation to affective and cognitive empathy and types of scenarios rated. These differences have both theoretical and practical implications for understanding and researching offence-related empathy. The lessons for future research are that affective and cognitive empathy need to be measured separately and a range of offence-related scenarios need to be rated. If global empathy and victim empathy are distinct and potentially unrelated concepts, then victim empathy may not be related to the same personality and demographic factors as global empathy. This would provide some explanation why VERA scores did not correlate in the hypothesized direction with IQ and personality variables. However, this does leave open the question of what evidence might be marshalled to provide construct validity for victim empathy measures in future, one option could be clinician ratings of victim empathy when using an offending sample group. The data analysis was also unable to demonstrate the discriminant validity of the VERA as the forensic inpatient group scored significantly higher than the community sample and failed to confirm the predicted differences in levels of empathic response across offending versus non-offending scenarios. This could be because the VERA failed to effectively measure victim empathy. Alternatively when measuring emotions like empathy and remorse, forensic patients may have elevated scores due to their general level of emotional disturbance. For example, Gudjonsson and Roberts (1983) found that forensic patients scored significantly higher than the community controls on measures of guilt which was related to their poor self-concept and negative preoccupations, rather than genuine feelings of guilt. Some support is found for this in the present study in community controls where the effect sizes were consistently higher for the affective empathy subscales than for cognitive empathy subscales. This may suggest that they were responding more emotionally to the test than the community controls. Another point to consider is that the forensic patients were detained on a secure unit where relation to differences between the patients and their level of risk to others is consistently being evaluated and this may make them hypervigilant to questions related to empathy. What is not known is the extent to which the measurement of self-reported victim empathy is helpful in terms of identifying treatment targets or assessing risk of future offending in forensic settings. For example, Hanson and Morton-Bourgon (2005) found that victim empathy had little or no relationship with sexual or violent recidivism. Empirical research is now needed with regard to the predictive validity of the VERA. At present, there is limited evidence for the validity of the VERA, and further investigation is needed before the measure s clinical and research utility can be established. Some critiques of the measure in its current format and suggestions for its future development were made by Young et al. (2008). One issue the authors identified was

the level of realism of the interviews and this may be one way of framing the counter-intuitive correlations that were evident in this study. In order to enhance the realism of the VERA, victim support groups could have input into scenario design, and professional actors could be utilised in the production of the interviews. Currently, it could be argued that responses to the VERA are contaminated by variability in the age of victim, time elapsed since the offence, and the degree to which empowerment of the victim is portrayed in the scenarios (for example, the child abuse scenario presents the narrative of a woman who has set up a charity to support victims of such abuse). Ideally, such contaminating factors should be minimised. Empathy and more specifically victim empathy is a complex construct, which is difficult to assess through self-report measures. There is still a great deal of uncertainty regarding the relationship between victim empathy (cognitive and affective) and offending which means that developing and testing new assessment tools is particularly important. Acknowledgements The authors wish to thank Dr Laura Simonds, Department of Psychology, University of Surrey and Dr Jessica Bramham, Institute of Psychiatry for their contribution to this study. References Austin, E.J., Saklofske, D.H., Huang, S.H., & Mckenney, D. (2004). Measurement of trait emotional intelligence: Testing and cross-validating a modified version of Scutte et al. s (1991998). Personality and Individual Differences, 36, 555 562. Baron-Cohen, S., & Wheelwright, S. (2004). The empathy quotient: An inves-tigation of adults with Asperger syndrome or high functioning autism, and normal sex differences. Journal of Autism and Developmental Disorders, 34(2), 163 175. Bryant, B. (1982). An index of empathy for children and adolescents. Child Development, 53, 413 425. Ciarrochi, J.V., Chan, A.Y., & Caputi, P. (2000). A critical evaluation of the emotional intelligence construct. Personality and Individual Differences, 28, 539 561. Cohen, J. (1988). Statistical power analysis for the behavioural sciences. Hillsdale, NJ: Erlbaum. Curwen, T. (2003). The importance of offence characteristics, victimisation history, hostility, and social desirability in assessing empathy of male adolescent sex offenders. Sexual Abuse: Journal of Research and Treatment, 15(4), 347 364. Davis, M.H. (1980). A multi-dimensional approach to individual differences in empathy. JSAS Catalogue of Selected Documents in Psychology, 10, 85.

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