Borderline Personality Disorder and Empathic Dysfunction - a Systematic Review

Abstract

Borderline Personality Disorder (BPD) patients strugglewith interpersonal relationships. Although this incapacity to understandothers’ emotions and perspectives is thought to be relevant to these patients’impaired social function, the role of empathic dysfunction in BPD is still amatter of debate. The aim of this systematic review is to examine thecurrent evidence on differences in empathy dimensions in BPD patients. Five databases were searched for studies publishedbetween 2000 and 2012, with the keywords: social cognition, empathy, theory ofmind AND borderline personality disorder. Inclusion criteria were: BPDdiagnoses according to the International Standardized Classification, assessment of empathy and related constructs using validated instruments andpresence of a healthy control group. Fourteen studies were identified which included atotal of 463 BPD patients and 420 healthy controls. Seven studies assessedempathy in a bi-dimensional way; five of them reported lower cognitive empathyin BPD patients, but one study reported the opposite trend, and another one showedno differences between BPD and controls. Concerning emotional empathy, reducedlevels were observed among BPD patients only in two of the studies.?Anothergroup of studies measured emotion recognition ability exclusively, presentingconflicting results: in three of them, BPD patients presented higher scores thancontrols; in the other three, BPD patients had significantly lower accuracythan controls. Although evidence about a specific pattern of empathydysfunction is inconclusive, a trend toward lower levels of (emotional andcognitive) empathy was detected in BPD patients.