Altered Empathy for Psychological and Physical Pain in Borderline Personality Disorder

Flasbeck, Vera; Enzi, Björn; Brüne, Martin

doi:10.1521/pedi_2017_31_276

Cited by 30 publications

(26 citation statements)

References 46 publications

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“…Repeated measures ANOVA with the covariates IQ and age revealed main effects and interactions, similar to results reported in previous studies using the SIET in patients with BPD ( 38 , 39 ). Specifically, we detected a three-way interaction of condition * group (BPD/HC) * genotype [ F (1.85) = 3.46; p = 0.036].…”

Section: Resultssupporting

confidence: 85%

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The OXTR Single-Nucleotide Polymorphism rs53576 Moderates the Impact of Childhood Maltreatment on Empathy for Social Pain in Female Participants: Evidence for Differential Susceptibility

et al. 2018

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Previous research has associated genetic variations of the oxytocin receptor with individual differences in human social behavior. Specifically, homozygous carriers of the G-allele of the single nucleotide polymorphism rs53576 have been reported to display more trust, empathy, and prosocial behavior and were less sensitive toward stress and maltreatment during childhood when compared to A-allele carriers. With regard to Borderline Personality Disorder (BPD), a psychiatric condition that is often associated with the experience of childhood adversity, it has been suggested that A-allele carriers are more vulnerable to developing psychopathological signs and symptoms. In the present study we investigated whether childhood trauma, as assessed by the Childhood Trauma Questionnaire (CTQ), affects empathy for somatic and psychological pain, and how this is moderated by genotype, in a sample of 302 individuals (148 of whom were diagnosed with BPD). We found a three-way interaction between genotype, group and pain condition. Posthoc comparisons revealed that patients with BPD carrying at least one A-allele, rated psychological pain as more intense compared to controls, whereas no difference between groups emerged in GG homozygotes. Moreover, a moderating effect of genotype appeared on the impact of childhood trauma on empathy for psychological pain. In addition, a positive correlation of CTQ scores and empathy appeared only in A-allele carriers (GA + AA), independent of diagnosis. Together, A-allele carriers, especially those with BPD, seemed to be responsive to the impact of adversity on empathy-for-pain, while GG homozygotes were not, which is compatible with the idea of differential susceptibility.

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Section: Resultssupporting

confidence: 85%

“…The Social Interaction Empathy Task (SIET) was developed by our group as described elsewhere ( 38 , 39 ). In short, the paradigm investigates empathy for physical or somatic and psychological pain in one paradigm.…”

Section: Methodsmentioning

confidence: 99%

The OXTR Single-Nucleotide Polymorphism rs53576 Moderates the Impact of Childhood Maltreatment on Empathy for Social Pain in Female Participants: Evidence for Differential Susceptibility

et al. 2018

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“…This is especially relevant, since alexithymia seems to be a mediating factor with respect to the link of attachment problems and the development of BPD [ 21 ]. Furthermore, alexithymia also mediates the effect of trauma on altered empathy-for-pain in BPD [ 31 ]. Crucially for patients with BPD, alexithymia is strongly associated with self-harm in women [ 32 ].…”

Section: Resultsmentioning

confidence: 99%

“…Concerning its clinical relevance, alexithymia has been shown to be prognostically relevant for psychotherapy outcome [ 3 ]. Another limiting factor of the present study concerns the lack of emotional challenges during EEG measurement, because it is known that emotional tasks or other stressors may impact on frontal asymmetry [ 12 , 31 , 33 – 35 ]. This might be worth considering in future research.…”

Section: Resultsmentioning

confidence: 99%

Frontal EEG asymmetry in borderline personality disorder is associated with alexithymia

Flasbeck

Popkirov

Brüne

2017

bord personal disord emot dysregul

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BackgroundFrontal EEG asymmetry is a widely studied correlate of emotion processing and psychopathology. Recent research suggests that frontal EEG asymmetry during resting state is related to approach/withdrawal motivation and is also found in affective disorders such as major depressive disorder. Patients with borderline personality disorder (BPD) show aberrant behavior in relation to both approach and withdrawal motivation, which may arguably be associated with their difficulties in emotion processing. The occurrence and significance of frontal EEG asymmetry in BPD, however, has received little attention.ResultsThirty-seven BPD patients and 39 controls underwent resting EEG and completed several psychometric questionnaires. While there were no between-group differences in frontal EEG asymmetry, in BPD frontal EEG asymmetry scores correlated significantly with alexithymia. That is, higher alexithymia scores were associated with relatively lower right-frontal activity. A subsequent analysis corroborated the significant interaction between frontal EEG asymmetry and alexithymia, which was moderated by group.ConclusionsOur findings reveal that lower right frontal EEG asymmetry is associated with alexithymia in patients with BPD. This finding is in accordance with neurophysiological models of alexithymia that implicate a right hemisphere impairment in emotion processing, and could suggest frontal EEG asymmetry as a potential biomarker of relevant psychopathology in these patients.

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“…These findings are consistent with Ridings and Lutz-Zois (2014) , who found that alexithymia correlated with both emotional dysregulation, and BPD tendencies. Regarding a mechanistic link between alexithymia and empathy, Flasbeck et al (2017) found that the effect of early life adversity on empathy for psychological pain was mediated by alexithymia in BPD. Overall, while significant work would be required to scrutinize this speculative IST prediction of the link between affective dysregulation, alexithymia, and diminished empathy, the purpose here is to highlight the utility of IST, and the potential role of alexithymia in BPD empathic deficits.…”

Section: The Role Of the Insula In Alexithymia And Empathy Deficits Amentioning

confidence: 99%

Alexithymia as a Transdiagnostic Precursor to Empathy Abnormalities: The Functional Role of the Insula

et al. 2017

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Distorted empathic processing has been observed across multiple psychiatric disorders. Simulation theory provides a theoretical framework that proposes a mechanism through which empathy difficulties may arise. Specifically, introspection-centric simulation theory (IST) predicts that an inability to accurately interpret and describe internal affective states may lead to empathy difficulties. The purpose of this review is to synthesize and summarize an empirical literature suggesting that simulation theory provides insights into a cognitive and neurobiological mechanism (i.e., alexithymia and insula pathology) that negatively impacts empathic processing, in addition to how disruptions in these processes manifest across psychiatric disorders. Specifically, we review an emerging non-clinical literature suggesting that consistent with IST, alexithymia and associated insula pathology leads to empathy deficits. Subsequently, we highlight clinical research suggesting that a large number of disorders characterized by empathy pathology also feature alexithymia. Collectively, these findings motivate the importance for future work to establish the role of alexithymia in contributing to empathy deficits across clinical symptoms and disorders. The current review suggests that simulation theory provides a tractable conceptual platform for identifying a potential common cognitive and neural marker that is associated with empathy deficits across a wide array of diagnostic classes.

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Altered Empathy for Psychological and Physical Pain in Borderline Personality Disorder

Cited by 30 publications

References 46 publications

The OXTR Single-Nucleotide Polymorphism rs53576 Moderates the Impact of Childhood Maltreatment on Empathy for Social Pain in Female Participants: Evidence for Differential Susceptibility

The OXTR Single-Nucleotide Polymorphism rs53576 Moderates the Impact of Childhood Maltreatment on Empathy for Social Pain in Female Participants: Evidence for Differential Susceptibility

Frontal EEG asymmetry in borderline personality disorder is associated with alexithymia

Alexithymia as a Transdiagnostic Precursor to Empathy Abnormalities: The Functional Role of the Insula

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