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Cited by 287Personality Disorders and PsychopathologyPersonality Traits and PsychologyPsychopathy, Forensic Psychiatry, Sexual Offending

Lack of empathy in patients with narcissistic personality disorder

Ritter, Kathrin, Dziobek, Isabel, Preißler, Sandra, Rüter, Anke, Vater, Aline, Fydrich, Thomas, Lammers, Claas-Hinrich, Heekeren, Hauke R. +1 more·2011·Psychiatry Research
DOI 10.1016/j.psychres.2010.09.013
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Abstract

The study's objective was to empirically assess cognitive and emotional empathy in patients with narcissistic personality disorder (NPD). To date, "lack of empathy" is a core feature of NPD solely based on clinical observation. The study's method was that forty-seven patients with NPD, 53 healthy controls, and 27 clinical controls with borderline personality disorder (BPD) were included in the study. Emotional and cognitive empathy were assessed with traditional questionnaire measures, the newly developed Multifaceted Empathy Test (MET), and the Movie for the Assessment of Social Cognition (MASC). The study's results were that individuals with NPD displayed significant impairments in emotional empathy on the MET. Furthermore, relative to BPD patients and healthy controls, NPD patients did not show deficits in cognitive empathy on the MET or MASC. Crucially, this empathic profile of NPD is not captured by the Structured Clinical Interview for DSM-IV for Axis II Disorders (SCID-II). The study's conclusions were that while NPD involves deficits in emotional empathy, cognitive empathy seems grossly unaffected.

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  • NPD is associated with neurophysiological deficits in emotional empathy, together with intact cognitive empathy, and influenced by a complex interaction between motivational, self-regulatory, and interpersonal processes, as well as by emotional dysregulation and intolerance.

    “NPD is associated with neurophysiological deficits in emotional empathy, together with intact cognitive empathy, and influenced by a complex interaction between motivational, self-regulatory, and interpersonal processes (e.g., engagement versus disengagement), as well as by emotional dysregulation and intolerance (49–52).”

    From Narcissistic Personality Disorder: Progress in Understanding and Treatment (2022) · cites this paper as [49]

  • Subjects affected by narcissistic personality disorder show greater impairment in affective aspects of empathy while their cognitive part of empathy appears preserved.

    “Subjects affected by narcissistic personality disorder show greater impairment in affective aspects while their cognitive part of empathy appears preserved.”

    From The dark side of empathy in narcissistic personality disorder (2023) · cites this paper as [17]

  • People affected by narcissistic personality disorder have issues in emotional, but not cognitive, empathy, possibly because reading others' emotions might be useful to reach personal purposes.

    “Ritter et al. (17) demonstrated that people affected by NPD have issues in emotional, but not cognitive empathy, possibly because reading others’ emotions might be useful to reach personal purposes (31).”

    From The dark side of empathy in narcissistic personality disorder (2023) · cites this paper as [17]

  • Research highlights main obstacles in the bottom-up pathway among narcissists, but the cognitive parts of empathy seem damaged as well.

    “Research highlights main obstacles both in the bottom-up pathway among narcissists, but the cognitive parts of empathy seem damaged as well (3, 17, 18).”

    From The dark side of empathy in narcissistic personality disorder (2023) · cites this paper as [17]

  • In non-clinical subjects, high narcissism is associated with reduced deactivation of the right anterior insula and increased activation of the posterior cingulate cortex, dorsolateral prefrontal cortex, and premotor areas in reaction to non-emotional faces.

    “Evidence demonstrated a reduced deactivation of the right AI (rAI) and an increased activation of the posterior cingulate cortex (PCC), DLPFC, and premotor areas in reaction to non-emotional faces among HN people (17).”

    From The dark side of empathy in narcissistic personality disorder (2023) · cites this paper as [17]

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Authors
Ritter, K., Dziobek, I., Preißler, S., Rüter, A., Vater, A., Fydrich, T., Lammers, C.-H., Heekeren, H. R., & Roepke, S.
Affiliations
  • Charité – Universitätsmedizin Berlin (DE)
  • Max Planck Institute for Human Development (DE)
  • Humboldt-Universität zu Berlin (DE)
  • Asklepios (DE)
  • Freie Universität Berlin (DE)
Corresponding author
  • Ritter, Kathrin
  • Roepke, Stefan
ORCID
Venue
Psychiatry Research
Publisher
Elsevier BV
Published
2011-05
Volume
187
Issue
1-2
Pages
241-247
ISSN
0165-1781 (ISSN-L)
DOI
10.1016/j.psychres.2010.09.013
OpenAlex
W2148003635
Cited by
287
References
75
Citations by year
2026: 9 · 2025: 14 · 2024: 12 · 2023: 20 · 2022: 25 · 2021: 18 · 2020: 20 · 2019: 21 · 2018: 17 · 2017: 22 · 2016: 20 · 2015: 15 · 2014: 27 · 2013: 23 · 2012: 16
FWCI
16.54
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Psychiatry Research (publishedVersion)
  • PubMed (publishedVersion)
  • Max Planck Institute for Plasma Physics (submittedVersion)
  • MPG.PuRe (Max Planck Society) (submittedVersion)
Funders
  • Charité — University Medicine Berlin
  • Sonnenfeld-Stiftung,” Berlin
  • Cluster of Excellence “Languages of Emotion,” Berlin
Topics
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
  • Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
Keywords
narcissistic personality disorder, empathy, affective empathy, cognitive empathy, borderline personality disorder, SCID-II, social cognition
MeSH terms
Adult, Analysis of Variance, Cognition Disorders, Empathy, Female, Humans, Male, Neuropsychological Tests, Personality Disorders, Psychometrics, Reproducibility of Results, Statistics, Nonparametric, Mood Disorders, Young Adult

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