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Lack of empathy in patients with narcissistic personality disorder
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 (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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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 the citing paper
“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]
In the citing paper
“The results obtained show low levels of emotional empathy in narcissists but normal levels of cognitive empathy.”
From Symptom severity and mindreading in narcissistic personality disorder. (2018) · cites this paper as [37]
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Metadata
- 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
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2011-05
- Volume
- 187
- Issue
- 1-2
- Pages
- 241-247
- ISSN
- 0165-1781 (ISSN-L)
- 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
- 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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