Sanford Research Fellows Program

Barak Sabbagh

Project: Modulating the Social Transfer of Pain with De Novo Designed Protein Agonists
Call: RFA-RCSF-07

Mentor: Joseph Wang, (Dept: Aiiso Yufeng Li Department of Chemical and Nano Engineering)

Project Description: Empathy in healthcare relies on understanding a patient's emotional experience. Yet stress, a key component of this experience, remains deeply subjective and difficult to objectively assess in real time. This project will establish a unified wearable framework linking biochemical and behavioral indicators of stress into a multimodal model capable of capturing and interpreting stress dynamics during everyday activities. This technology will enable investigation into how objective awareness of stress can enhance recognition of emotional states and promote more empathetic responses, ultimately improving patient-clinician communication and supporting more compassionate, patient-centered care.

Araz Majnoonian

Project: Designing Empathic Care in Refugee Hypertension Management: Multilevel Patient, Provider, and Health System Processes
Call: RFA-RCSF-07

Mentor: Tala Al-Rousan (Dept: Herbert Wertheim School of Public Health and Human Longevity Science)

Project Description: Empathic care is central to effective clinical care, yet little is known about how it operates within community health worker (CHW) models serving refugee populations. This project examines empathic communication as a relational mechanism within BPCARE, an NIH-funded trial delivering CHW-led motivational interviewing to Arab refugees with hypertension in San Diego. Using mixed methods, the study measures patient-perceived empathy across both arms, explores care experiences through interviews with patients, providers, and health system staff, and engages stakeholders in co-designing an empathy-centered resource for safety-net clinics. Findings will inform how healthcare systems can design and sustain compassionate care for displaced populations.

Scott Kooiman

Project: Neural Substrates Underlying Empathetically Driven Helping Behavior
Call: RFA-RCSF-07

Mentor: Lara Rangel (Dept: Cognitive Science)

Project Description: To help others, individuals must perceive distress through empathy. This process is especially important in healthcare, where medical professionals are regularly exposed to patients’ suffering. However, repeated exposure can lead to emotional exhaustion and empathy decline in the caregiver-patient relationship. This project will study empathy by examining multi-region brain activity in rats as they observe a conspecific in distress and can choose to help. By identifying neural signals associated with empathy and helping behavior, this work will improve our understanding of empathy modulation and identify strategies that allow caregivers to maintain empathetic care while protecting their own emotional well-being.

Manas Bedmutha

Project: EmpathIQ: Advancing Empathic and Compassionate Communication in Medical Training with Generative AI
Renewed for Year 2 Funding

 Mentor: Nadir Weibel

Project Description: EmpathIQ is a research project at UC San Diego building AI tools to help medical students strengthen empathic, compassionate communication with patients. Developed in partnership between the Design Lab, the HXI Research Lab, and the Sanford Institute for Empathy and Compassion, the project pairs automated analysis of conversation with AI-simulated patients, letting students safely practice difficult conversations. In Year 1, the team built a system that detects empathy behaviors in conversations and created an AI patient simulator. Supported by the Sanford Research Fellowship, the project is now in Year 2, moving toward a student pilot.

Findings: In our first year, we built AI tools to help train medical students in empathic, compassionate communication with patients. We created software that can automatically detect meaningful behaviors, like tone of voice and turn-taking, in patient conversations, and built an AI-simulated patient students can practice talking with. We also learned that our original method for scoring empathy needed improvement, so we worked with a clinical psychologist to design a better one, and interviewed people with lived experience of HIV-related stigma to ensure our virtual patients reflect real experiences. In Year 2, we will test this system with medical students.

Mariel Kristine Micael

Project: Role of Astrocyte-Neuron Communication in Observational Fear Learning and Memory
Renewed for Year 2 Funding

Mentor: Justin Trotter

Project Description: The ability to vicariously experience another's fear--observational fear (OF)--is a form of emotional contagion that supports social learning. Recent studies implicate the hippocampus, anterior cingulate cortex (ACC) and amygdala in integrating prior fear experiences and social familiarity to guide OF learning and memory. While neuronal circuits involved in OF are partially defined, the role of astrocytes--non-neuronal regulators of synaptic transmission and plasticity--remains unknown. Our central question is: Does astrocyte-neuron communication at tripartite synapses within the hippocampus, ACC, and amygdala contribute to OF learning and memory? We hope this work will provide novel insight into the cellular mechanisms shaping empathetic behavior.

Nikki Keisler

Project: Anterior Cingulate Encoding of State-matching and Allogrooming in Mice
Renewed for Year 2 Funding

Mentor: Monique Smith

Project Description: Empathy deficits are found in disorders such as depression, Autism Spectrum Disorder, and Alzheimer’s Disease, and dysregulation in empathy has had a profound impact on caregivers and healthcare professionals. The goal of this proposal is to identify how neural substrates for two forms of empathy, state-matching and consolation, may diverge. This will contribute to our understanding of the underlying biology of empathy, which is a crucial step in developing targeted therapies to address social dysfunction in neuropsychiatric, neurodevelopmental, and neurodegenerative disorders, as well as improve the lives of healthcare professionals and their patients.

Lauren Ostrowski

Project: Neural processing of paralinguistic features and emotional content in speech
Renewed for Year 2 Funding

 Mentor: Timothy Gentner

Project Description: Understanding others’ emotions through speech is critical for empathy and compassion in social relationships, but the neurobiological bases supporting these abilities remain unknown. Better understanding how emotional knowledge is acquired from speech and guides downstream cognitive processes can advance professional training programs and therapies that promote empathetic, compassionate listening. This project will employ magnetoencephalography (MEG) to study how emotional expression in speech is processed by the brain. We ask how a listener's emotional response to a speaker arises from the perception of paralinguistic acoustic features—such as prosody, speech rate, and voice quality—and explore the neurodynamics facilitating empathetic responses to speech.

Findings: Recognizing a speaker's emotional state from speech requires integrating paralinguistic cues, such as prosody and rhythm, with the semantic content of the words themselves. Combining a large-scale behavioral study with time-continuous emotion ratings, we found that listeners dynamically reweight these two information sources over the course of an utterance. We then used MEG to characterize the neural dynamics underlying this process, comparing medical students at different stages of clinical training to non-medical-student controls. These findings provide a mechanistic account of how listeners construct emotional understanding from speech, with direct relevance to training programs in empathetic communication, especially in clinical settings.

Gregory Depow

Project: Wise Empathy in Medical Practice
Renewed for Year 2 Funding

Mentor: Timothy Gentner

Project Description: This project investigates whether training medical practitioners to engage in wise empathy—a strategic regulation of empathy that involves sharing positive patient emotions while responding to negative emotions with compassion—can enhance practitioners’ well-being and reduce burnout. Using a randomized controlled trial with 300 medical practitioners, the study will deliver wise empathy training to one group in week one and to a wait-list control group in week two, with daily diary assessments capturing well-being, burnout, and empathic experiences. The study will employ multilevel models and structural equation modeling to test the intervention’s direct effects and mediation pathways, while also tracking patient outcomes.

Findings: We found that feeling positive emotions with another person key when individuals are experiencing positive emotions. When someone feels positive with us while we share good news, we perceive them as responding well to our capitalization attempts, which predicts greater well-being, and a deeper connection. We found that training individuals to focus on feeling what others feel during positive emotions (share, don't compare) but focus on compassion for negative emotions (caring rather than sharing) changes how they experience empathy online, and these changes lead to improved well-being.

Satish Jaiswal

Research Project: Developing an Objective Measure of Interoceptive Attention and Evaluating its Sensitivity to change across the Lifespan with Compassion Training

Mentor: Jyoti Mishra

Findings: In aim 1 of our project, we have developed a breath-focused interoceptive attention task that offers an objective neurocognitive evaluation of the efficacy of any breath-focused contemplative intervention program. Most importantly in our second part of the project, we implemented a Breath-focused Compassion and Mindfulness Meditation program in a parent-child dyad in the community sample and demonstrated improvement in behavioral symtptoms, emotion-bias processing efficiency an,d neuroplasticity of the default mode network.

Olivia Jurkiewicz

Research Project: Exploring the neurobiological underpinnings of the emotion regulation and empathy relationship

Mentor: Christopher Oveis

Findings: Across two studies involving real interpersonal interactions, we find that emotion suppression is a key barrier to compassion. When individuals hide their negative emotions, their attention turns inward, which reduces both their ability to respond compassionately (Study 1) and how compassionate they are perceived to be by others (Study 2). In a separate set of multi-method studies using longitudinal field data and physiological measures, we find that helping others regulate their emotions has direct benefits for the self. Specifically, regulating others’ emotions in daily interactions increases positive affect over time and is linked to greater life satisfaction and fewer depressive symptoms (Study 1), and buffers physiological stress responses during high-pressure conversations (Study 2).

Alessandro D'Amico

Research Project: Investigating Racially-Modulated Neuromarkers of Pain Empathy with Electrophysiology

Project Description: Racial biases manifest in various forms from a disproportionately Black prison population in the U.S., to Black patients’ pain being consistently underestimated and symptoms inadequately treated. While education and training may be effective at reducing biases, ameliorating biases by increasing empathy and compassion is another worthy goal. In order to accurately measure changes in empathy, we must first better understand the neural correlates of empathy and how those neural correlates are modulated by racial biases. To do this, we will investigate EEG correlates of perceived pain in others versus self. We hypothesize we’ll be able to isolate the neural correlates of empathic pain by comparing the differences between a participant’s response to their own versus other faces and we further expect to see a racial bias such that White participants’ neural responses to their own face look more like those to White faces than to Black faces. Our research is an important first step toward better understanding the neural correlates of racially-modulated empathy and our findings will allow us to design novel interventions in order to ameliorate racial bias in individuals. 

Amy Bellinghausen

Research Project: Development and Implementation of a Mindful Self-Compassion Curriculum to Reduce Burnout in Critical Care Providers

Project Description: Burnout frequently affects critical care workers, due to long work hours and high patient mortality rates. Once burnout develops, providers give less empathetic patient care. My work in the ICU Recovery Clinic – where I see thankful patients who were critically ill but now returning to health and work – has brought fulfillment to myself and others when I bring these stories back to ICU providers. Using these stories as a foundation, I aim to build and implement a compassion curriculum for critical care providers addressing both personal resiliency and moral distress. I will assess burnout pre- and post-intervention using the Maslach Burnout Inventory. The funding provided and proposed course of study will enable me to increase my knowledge of current strategies in empathy and compassion research and establish a foundation as a national leader and funded clinician scientist in critical care-related burnout study and treatment, as well as to refine the burnout curriculum further. 

Jon Dean

Research Project: Brain Mechanisms Supporting Empathy Cultivation and Phantom-limb Based Analgesia by Psilocybin Therapy

Project Description: Psilocybin is a serotonergic psychedelic that induces enhancements in positive affect, social connectedness, and empathy and compassion. Moreover, pilot studies and our own case report have demonstrated that serotonergic psychedelics including psilocybin ameliorate intractable phantom limb pain. Psilocybin decreases default mode network (DMN) activity, circuitry supporting self-referential processing, and increased DMN-sensorimotor cortex connectivity is associated with phantom pain. Existing therapies for phantom limb pain are associated with modulation of classical inhibition of pain. Yet, the psychological and neural mechanisms supporting empathy, compassion, and analgesia by psilocybin are unknown. This trial will test the effects and neural mechanisms supporting psilocybin (versus placebo-niacin) for empathy-cultivation and analgesia in individuals with chronic phantom limb pain.

Zhenggang Zhu

Research Project: The evolutionary origins of empathy – molecular and neuronal basis of social motivation in rodents

Project Description: Motivation elicited by observation of the actions of a conspecific is prominent in mammals and is an evolutionarily conserved proxy for human empathy and compassion. However, the relationship between how the brain encodes self-motivated behaviors versus social motivation is unclear. For example, are there distinct cell types in the brain for self-motivation and observation-evoked empathy, or is there a shared circuitry encoding motivated-behavioral states that reflect convergence points between self-motivated and social behaviors? This question can be investigated in the mouse hypothalamus, which has diverse cell types and is a key integratory site for self-motivation (e.g., feeding and drinking), social interaction, and encoding others' motivation. Our hypothesis is that molecularly defined hypothalamic 'empathy neurons' act as a bridge for integrating social information and interacting with the self-motivation neurons to trigger social empathy. Our project will test the hypothesis by modeling empathy behaviors, functionally identifying empathy neurons via volumetric two-photon calcium imaging, and delineating their molecular identity.

Melissa Karnaze Hedayati

Project: Assessment of Compassion Cultivation Training

Project Description: This qualitative evaluation study will investigate how trainees and professionals in health fields perceive facilitators and barriers to implementing Compassion Cultivation Training (CCT; Compassion Institute) in their daily lives. My main research questions are: (1) How do participants think about facilitators of, and barriers to, compassion prior to, and after completing CCT?; (2) How do they view their ability to implement CCT into daily life?; (3) How do they perceive how it feels to receive compassion, as well as show compassion to others and oneself?; and (4) How do they define compassion and thus describe situations in which compassion occurs?

Jonathan Paden, Robert Twomey, PhD, Cassandra Vieten, PhD, Ying Wu, PhD

Project: Enhancing neurobehavioral Effects if Compassion Training Using Immersive Visual Imagery

Mentor: Erik Viirre

Federica Klaus

Project: Stay-at-home Wellness Ecological Momentary Assessment in Late Life (StayWELL) Study

Mentor: Lisa Eyler

Findings: The StayWELL study explored the feasibility and effectiveness of using smartphone-based ecological momentary assessment (EMA) to track mental health in older adults during the COVID-19 pandemic. Involving 95 participants aged 67–87, the study found high adherence (82%) to daily self-report surveys, with no signs of participant fatigue. Withdrawal was uncommon and mainly due to communication issues rather than individual characteristics. Higher education, shorter time between enrollment and study start, and reaching the midpoint of the study were associated with better adherence. Notably, neither COVID-19 infection nor caregiving responsibilities impacted participation, and engagement did not vary by smartphone operating system or demographic factors, supporting the broad applicability of digital EMA tools in this population. Mental health findings revealed increased levels of anxiety and depression three months into the pandemic compared to pre-pandemic levels, while compassion remained high and stable, suggesting it may serve as a trait-level buffer against stress. Anxiety was linked to lower optimism, higher neuroticism, and greater perceived discrimination, though only perceived discrimination remained a significant predictor in combined models. The protective effect of optimism was not present during the early pandemic phase, but active coping strategies were found to buffer the anxiety linked to discrimination. In contrast, seeking emotional support and self-compassion did not moderate this relationship. Overall, the study highlights that older adults can successfully participate in real-time digital mental health monitoring, even under stressful circumstances. It also identifies key psychological and contextual factors—especially discrimination and coping—that influence emotional well-being and could guide future digital interventions.

Anne White

Project: Compassion Disparities in Emergency Care: A Mixed Methods Pilot Study

Mentor: Federico Rossano