Empathy, Mentalization, and Theory of Mind in Borderline Personality Disorder: Possible Overlap With Autism Spectrum Disorders

Vegni, Nicoletta; D’Ardia, Caterina; Torregiani, Giulia

doi:10.3389/fpsyg.2021.626353

Cited by 18 publications

(25 citation statements)

References 36 publications

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“…Interestingly, in our study, in both BPDf and ASDf, ED was associated with alexithymia, which has been linked to interpersonal and mentalizing difficulties, but also emotion processing abnormalities in both disorders. 87,89–93…”

Section: Discussionmentioning

confidence: 99%

Emotion dysregulation is heightened in autistic females: A comparison with autistic males and borderline personality disorder

Weiner

Costache

Bemmouna

et al. 2023

Womens Health (Lond Engl)

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Background: Emotion dysregulation is increasingly recognized as highly prevalent and impairing in autistic individuals. Yet, a large majority of studies have considered emotion dysregulation in youth only, and most of them did not consider sex differences in emotion dysregulation manifestation. Objectives: In the present study, we aim to investigate sex differences relative to emotion dysregulation in autistic adults without intellectual disability as well as its relationship with different factors potentially involved in emotion dysregulation (e.g. camouflaging, alexithymia, suicidality, quality of life). Self-reported emotion dysregulation will be assessed in autistic adults but also in females with borderline personality disorder, given that emotion dysregulation is particularly enhanced in this population. Design: Cross-sectional, prospective, controlled. Methods: Twenty-eight autistic females, 22 autistic males and 24 females with borderline personality disorder were recruited from a dialectical behavior therapy program waiting list. They completed several self-report questionnaires measuring emotion dysregulation, alexithymia, suicidality, quality of life, camouflaging borderline symptoms and autism severity. Results: Most emotion dysregulation subscale scores and alexithymia scores were heightened in autistic females compared to females with borderline personality disorder and, to a lesser extent, compared to autistic males. Independently of borderline personality disorder symptoms, emotion dysregulation was related to alexithymia and poorer psychological health in autistic females, whereas it was mostly related to autism severity, poorer physical health and living conditions in autistic males. Conclusion: Our results suggest that emotion dysregulation is a major difficulty of autistic adults without intellectual disability eligible for dialectical behavior therapy, and this is especially the case for autistic females. There seem to be different sex-specific factors involved in emotion dysregulation found in autistic adults, which highlight the need to target-specific domains (e.g. alexithymia) in the treatment of emotion dysregulation in autistic females. ClinicalTrials.gov Identifier: NCT04737707 https://clinicaltrials.gov/ct2/show/NCT04737707

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Section: Discussionmentioning

confidence: 99%

Emotion dysregulation is heightened in autistic females: A comparison with autistic males and borderline personality disorder

Weiner

Costache

Bemmouna

et al. 2023

Womens Health (Lond Engl)

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“…Difficulties in theory of mind and empathy were also considered when investigating overlaps between ASD and PD. Empathy is a construct composed of two components: one is cognitive, involving the process of understanding another person’s perspective; and one is affective, involving sharing the emotional experiences of others [58]. BPD subjects had higher average levels of affective empathy and lower levels of cognitive empathy compared with ASD [58, 59].…”

Section: Discussionmentioning

confidence: 99%

“…Empathy is a construct composed of two components: one is cognitive, involving the process of understanding another person’s perspective; and one is affective, involving sharing the emotional experiences of others [58]. BPD subjects had higher average levels of affective empathy and lower levels of cognitive empathy compared with ASD [58, 59]. These considerations are relevant for BPD and might play a role for the comorbidity with AN, but research regarding an overlap of ASD and the predominant PDs in our sample, OCPD and APD, is scarce.…”

Section: Discussionmentioning

confidence: 99%

Personality Disorder in Adolescent Patients with Anorexia Nervosa

Laczkovics¹,

Czernin²,

Carlitscheck³

et al. 2022

Psychopathology

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Objective: Anorexia nervosa (AN) is a highly debilitating disease which frequently results in chronification and often originates in adolescence. Personality traits have been associated with the onset and maintenance of AN; moreover, study results indicated a worse treatment outcome in patients with AN and comorbid personality disorder (PD). However, research on PD in adolescent AN is scarce. Methods: The sample consists of 73 female adolescent patients with AN. We investigated comorbid PD and AN symptom severity performing the International Personality Disorder Examination (IPDE) and the Eating Disorder Inventory 2 (EDI-2). Results: Almost a third (27.4%) of all participants were diagnosed with comorbid PD. They had significantly higher EDI-2 total scores reflecting overall stronger symptom severity, as well as significantly higher scores in the subscales “ineffectiveness,” “interpersonal distrust,” “interoceptive awareness,” “asceticism,” “impulse regulation,” and “social insecurity.” Conclusion: PD is an important and frequent comorbid condition in adolescent AN and should be addressed in diagnostic and treatment planning. Early diagnosis of comorbidity could have an impact on choosing specialized treatment for adolescents with AN and PD in order to enhance the outcome.

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“…Similarly, it has been revealed that BPD patients featured higher autistic traits than control group participants and that autistic traits had a significant impact on some clinical features associated with BPD, such as suicidality [ 27 ]. Researchers have argued that difficulties with empathy and theory of mind are overlapping features in BPD and autism [ 28 ]. A modern, impassioned debate on whether BPD should be diagnosed or not [ 29 ] also has resonance in the context of Sukhareva’s summary diagnosis.…”

Section: Acclaim For the Style And ‘Modernity’ Of Sukhareva’s 1926 Pa...mentioning

confidence: 99%

Pioneering, prodigious and perspicacious: Grunya Efimovna Sukhareva’s life and contribution to conceptualising autism and schizophrenia

Sher

Gibson

2021

Eur Child Adolesc Psychiatry

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Grunya Efimovna Sukhareva’s seminal role in being the first to publish a clinical description of autistic traits in 1925, before both Kanner and Asperger, has been revealed relatively recently. Nevertheless, Sukhareva’s work is little known and largely unrecognised beyond Russia. Amidst calls for greater recognition of her pivotal contribution in the genesis of autism conceptualisation and categorisation, this article provides a biographical and historical background. Sukhareva’s wide-ranging psychiatric work is adumbrated and her pioneering efforts in conceptualising both schizophrenia and autism are elucidated. The article reflects on possible explanations for the belated and incomplete recognition of Sukhareva’s role. The current article indicates how Sukhareva’s work was ahead of its time in reflecting modern criteria for autism diagnoses and in its focus on female case studies. Sukhareva’s somewhat precarious position as a foremost psychiatrist condemned in the Stalinist years for being anti-Marxist is explicated. The article outlines further directions for academic research on Sukhareva’s work and contributions.

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Empathy, Mentalization, and Theory of Mind in Borderline Personality Disorder: Possible Overlap With Autism Spectrum Disorders

Cited by 18 publications

References 36 publications

Emotion dysregulation is heightened in autistic females: A comparison with autistic males and borderline personality disorder

Emotion dysregulation is heightened in autistic females: A comparison with autistic males and borderline personality disorder

Personality Disorder in Adolescent Patients with Anorexia Nervosa

Pioneering, prodigious and perspicacious: Grunya Efimovna Sukhareva’s life and contribution to conceptualising autism and schizophrenia

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