Disrupted self-referential processing and empathy-based interventions in mental disorders: neural mechanisms, cognitive biases, and therapeutic integration
Frontiers in Psychiatry July 6, 2026 Qinglin Bao, Dezhi Yang, Zhiheng Dong et al.
Disruptions in self-referential processing (SRP), the mental activity of linking experiences to the self, are a transdiagnostic feature across psychiatric disorders such as schizophrenia, major depressive disorder, and anxiety disorders. These disruptions involve distorted self-perception, negative cognitive-affective biases, and altered connectivity in the default mode network and medial prefrontal cortex. SRP and empathy have a bidirectional relationship: impaired self-processing can hinder understanding others' states, while poor empathic attunement may worsen maladaptive self-focus. This interplay contributes to social withdrawal and emotional dysregulation. Interventions like metacognitive therapy, mindfulness, and psychedelic-assisted psychotherapy show preliminary promise for modulating shared neurocognitive mechanisms and improving social functioning.