"I was told to live happily… without telling me how": Lived experiences of married adolescents, their spouses and families with a life skills intervention in rural Pakistan - A qualitative study.

Social exclusion is a common form of social distress in interpersonal interactions. It can negatively impact children by lowering self-esteem, increasing anxiety and depression, and causing academic struggles (). Researchers consider exclusion a form of relational aggression or bullying, and argue that increased empathy can prevent and mitigate such behaviors (). One study of adolescents found that those with higher empathy levels were more likely to empathize with and protect victims. In comparison, those with lower empathy levels were more likely to reinforce bullying behaviors and exhibit bystander indifference (). Empathy is often described as the ability to understand and share others’ feelings and respond to them appropriately. It includes emotional, cognitive, and behavioral aspects. Emotional empathy involves sharing and experiencing another person’s feelings, while cognitive empathy focuses on recognizing and understanding emotions in oneself and others. Behavioral empathy refers to the willingness, motivation, or actions to help others (). Although many studies have demonstrated that empathy can alleviate the adverse effects of physical pain and social distress, most of this research has focused on adolescents and adults (; ). Research on young children’s empathy for pain has primarily focused on physical pain (). Whether children can empathize with social pain, such as exclusion, is a matter of controversy. Exclusion and bullying are rare in early childhood (). However, from an evolutionary psychological perspective, humans are vulnerable to exclusion from infancy and show a basic understanding of it (). Research has demonstrated that infants aged 7–9 months, when observing a character excluded from group interactions, expect neutral characters to approach and include the excluded individual in later interactions (). The ability to understand and detect exclusion grows quickly during early childhood. Two-year-olds randomly choose either the excluder or the excluded person as a playmate, but three-year-olds are more likely to pick the excluded individual (). Additional studies have shown that most children develop verbal exclusion detection abilities by ages 5 to 6. Although 3- to 4-year-olds cannot verbally state exclusion, they show an implicit understanding through their choice of partners and behavior (; ). Older preschoolers not only detect social exclusion but also make moral evaluations. Research indicates that 3- to 4-year-olds have limited ability to detect exclusion and often hold relatively positive evaluations of the excluder. In contrast, 5- to 6-year-olds not only detect exclusionary behavior but are also more likely to describe the excluder as “mean” (). Another study also found that two-thirds of 4- to 6-year-olds could recall the identity of the excluder, which gave them more negative evaluations (). In summary, children with detection abilities are more likely to perceive the excluder as “mean,” suggesting that bottom-up “exclusion detection” underpins top-down “moral evaluation” (). However, it is important to note that this study did not assess children’s empathy toward the excluded individual.