From examining the contents page of this book without knowing its title, it would be difficult to guess its main theme and understand how such a wide range of topics are related. However, the foreword by Peter Woodruff provides an elegant overview which clearly describes the progression of ideas and the overarching structure. The book is a mixture of literature review combined with some original data and is written by well-recognized international contributors. Each chapter presents a stand-alone literature review and discussion, but the book is well edited to minimize the amount of redundant repetition of key concepts across chapters. The underlying premise is that understanding empathy dysfunction increases knowledge regarding normal empathic processes, such as its role as a protective factor against aggression and as an aid to moral judgements and conflict resolution. However, conversely, studies of healthy populations can also raise questions regarding the measurement of empathy and its variability, and this should be integrated into pathological empathy research.

Part I has a very broad scope, covering the literature on empathy in a wide range of psychiatric disorders. These include conditions with well-recognized empathy difficulties such as psychopathy, schizophrenia, autism and brain injury. However, there is the novel inclusion of a chapter on depression as a disorder of empathy ‘turned on the self’ leading to excessive self-blame and guilt about distress caused to others (O'Connor et al.). The chapter by Chris Gillberg was also particularly persuasive with regard to the concept of a normal distribution of empathic abilities, with disorders falling at the extreme ends. This issue of a continuum is sometimes lost in empathy research where a ‘can he/can't he empathize’ dichotomy is often adopted.

Part II provides a slightly more eclectic range of chapters construed to address empathy and related concepts in health, including neuroimaging, neurophysiology and genetics. There is a fascinating chapter on ‘empathogenic agents’ which proposes that ecstasy is an empathy-inducing substance (Velea and Hautefeuille) and suggests a potential neurochemical basis for empathy with reference to mirror neurons, through an increase in imitative behaviour which facilitates social integration. This middle section of the book also covers the bigger picture of empathy including its early development of empathy in infants (Diego and Aaron Jones) and the evolution of empathy (Harris), both important pieces in the jigsaw for understanding potential empathic disturbances. In addition the role of motivation and other softer ‘psychological’ concepts are included in this section, and helpfully complement the neuroscience literature. It seems intuitive that there are multiple external factors contributing to empathy, which are often overlooked with a more reductionist approach.

The final and shortest section of the book covers models, regulation and measurement of empathy. There are a range of original ideas presented including the ‘empathy expense account’ and the disadvantages of ‘over-empathizing’ (Hodges and Biswas-Diener). Several models are provided including a chapter updating the perception-action model of empathy by Preston and de Waal. The Shared Manifold Hypothesis (Gallese) focuses on the concept of simulation and attempts to explain how schizophrenia and autism arise through ‘defective intentional attunement’. The final chapter is the only chapter dedicated to application of knowledge about empathy and proposes that empathy could be trained in medical students by using approaches from the arts. This seems to bring the book full circle back to the issue of understanding empathy disorders in psychiatry and serves as a reminder that furthering our knowledge of these difficulties should ultimately improve care and appropriate interventions. In summary, this book is an excellent addition to the literature on social cognition – an ambitious attempt to draw together the multiple branches of empathy research seems to have been met with success.