Empathie bei Patienten mit multiplen somatoformen Symptomen und gesunden Kontrollen

Empathie ist essentiell für das Gelingen sozialer Interaktionen und wird häufig in Zusammenhang mit altruistischem Verhalten diskutiert. Als Therapeutenvariable ist Empathie wichtiger Untersuchungsgegenstand der Psychotherapieforschung. Als Patientenvariable im Sinne eines Bestandteils klinischer Symptomatik ist ein verändertes Empathieerleben bisher wenig im Fokus klinisch-psychologischer Forschung. Die vorliegende Arbeit liefert einen empirischen Beleg für Postulate gängiger neurowissenschaftlichen Modelle zur Modulation von Empathie, insbesondere auf Basis des Netzwerk-Modells (Engen & Singer, 2013), und untersucht erstmalig Empathie bei einer Gruppe von Somatisierungspatienten. In der ersten Studie wurde der Einfluss experimentell generierter Gruppen auf das Erleben von Schmerzempathie bei 30 gesunden Probanden mittels eines fMRT-Paradigmas untersucht. Auf der neuronalen Ebene zeigten sich Gruppeneinflüsse in Form von Aktivierungsdifferenzen in Arealen, welche mit analgetischen Prozessen und Schmerzhemmung assoziiert sind. Auf der Verhaltensebene hingegen ergaben sich keine Einflüsse der Gruppenzugehörigkeit. Untersuchungsgegenstand der zweiten Studie war der Zusammenhang zwischen Empathie, Somatisierung und Emotionsregulation. Hierzu wurden 48 Patienten mit multiplen somatoformen Symptomen und gesunden Kontrollen untersucht. Patienten gaben - im Vergleich zu Gesunden - eine höhere subjektive Belastung beim Erleben von Empathie und weiterhin ein breites Spektrum an emotionaler Dysregulation an. Zudem konnte gezeigt werden, dass ein Zusammenhang zwischen Somatisierung und Emotionsregulationsdefiziten besteht. Es wurde demonstriert, dass Gruppeneinflüsse auf Empathie in eingeschränktem Maße auch bei experimentell generierten Gruppen zu finden sind. Weiterhin konnte die Annahme, dass eine effektive Emotionsregulation das Erleben von Empathie beeinflusst und Emotionsregulationsprozesse exekutive Funktionen beinhalten, empirisch gestützt werden. Insgesamt wurde deutlich, dass Emotionsregulationsprozesse eng mit dem Erleben von Empathie verknüpft sind und daher in bestehende Modellvorstellungen von Empathie aufgenommen werden sollten

Exploring the neural correlates of (altered) moral cognition in psychopaths

Abstract Research into the neurofunctional mechanisms of psychopathy has gathered momentum over the last years. Previous neuroimaging studies have identified general changes in brain activity of psychopaths. In an exploratory meta‐analysis, we here investigated the neural correlates of impaired moral cognition in psychopaths. Our analyses replicated general effects in the dorsomedial prefrontal cortex, lateral prefrontal cortex, fronto‐insular cortex, and amygdala, which have been reported recently. In addition, we found aberrant brain activity in the midbrain and inferior parietal cortex. Our preliminary findings suggest that alterations in both regions may represent more specific functional brain changes related to (altered) moral cognition in psychopaths. Furthermore, future studies including a more comprehensive corpus of neuroimaging studies on moral cognition in psychopaths should re‐examine this notion

Enhanced Processing of Painful Emotions in Patients With Borderline Personality Disorder: A Functional Magnetic Resonance Imaging Study

Previous research has demonstrated that patients with borderline personality disorder (BPD) are more sensitive to negative emotions and often show poor cognitive empathy, yet preserved or even superior emotional empathy. However, little is known about the neural correlates of empathy. Here, we examined empathy for pain in 20 patients with BPD and 19 healthy controls (HC) in a functional magnetic resonance imaging (fMRI) study, which comprised an empathy for pain paradigm showing facial emotions prior to hands exposed to painful stimuli. We found a selectively enhanced activation of the right supramarginal gyrus for painful hand pictures following painful facial expressions in BPD patients, and lower activation to nonpainful pictures following angry expressions. Patients with BPD showed less activation in the left supramarginal gyrus when viewing angry facial expressions compared to HC, independent of the pain condition. Moreover, we found differential activation of the left anterior insula, depending on the preceding facial expression exclusively in patients. The findings suggest that empathy for pain becomes selectively enhanced, depending on the emotional context information in patients with BPD. Another preliminary finding was an attenuated response to emotions in patients receiving psychotropic medication compared to unmedicated patients. These effects need to be replicated in larger samples. Together, increased activation during the observation of painful facial expressions seems to reflect emotional hypersensitivity in BPD

The role of impairments in self–other distinction in borderline personality disorder: a narrative review of recent evidence

Impairments in maintaining a differentiated sense of “self” and “other” are thought to be a central feature of borderline personality disorder (BPD). However, studies directly focusing on self–other distinction (SOD) in BPD are scarce, and these findings have not yet been integrated with novel insights into the neural mechanism involved in SOD. Here, we present a narrative review of recent behavioral and neuroimaging findings focusing on impairments in SOD in BPD. Behavioral findings of SOD at the embodied level provide preliminary evidence for impairments in multisensory integration in BPD. Furthermore, both behavioral and neuroscientific data converge to suggest that SOD impairments in BPD reflect an inability to shift between self and other representations according to task demands. Research also suggests that disruptions in infant–caregiver synchrony may play a role in the development of these impairments. Based on these findings, we present a new, integrative model linking impairments in SOD to reduced neural and behavioral synchrony in BPD. The implications of these findings for future research and clinical interventions are outlined

Endogenous oxytocin is associated with the experience of compassion and recalled upbringing in Borderline Personality Disorder

Background/Objective The role of the neuropeptide oxytocin (OT) in Borderline Personality Disorder (BPD) is poorly understood. It is particularly unknown how early experiences with caregivers moderate the action of OT in BPD. Here, we examined the association of plasma OT levels in BPD patients with the experience of compassion and recalled parental behavior during childhood. Methods Fifty-seven BPD patients and 43 healthy controls participated in the study. OT plasma levels were analyzed by radioimmunoassay. Subjects additionally completed questionnaires focusing on fears of compassion (FOC) and recalled upbringing (“Questionnaire of Recalled Parental Rearing Behavior/Fragebogen zum erinnerten elterlichen Erziehungsverhalten,” FEE). Results BPD patients had significantly lower OT plasma levels than healthy controls and differed significantly on all FOC and FEE scales; BPD patients had higher FOC scores (indicating more aversion of being compassionate to themselves and others and receiving compassion from others). They also differed in recalled parenting. In the BPD group, scores of the FOC scale “fear of compassion from others” were significantly negatively correlated with OT levels. Moreover, recalled “emotional warmth” of their parents during childhood was positively correlated with OT plasma levels of BPD subjects. No such correlations were found in the control group. Conclusion Our results corroborate findings from previous studies reporting lower OT levels in patients with BPD. Moreover, peripheral OT seems to be linked with the tolerance of compassionate feelings and early experiences with caregivers. This is consistent with other findings that OT is an important mediator of the experience of emotional warmth from others.N/

Neural basis of shame and guilt experience in women with borderline personality disorder.

Borderline personality disorder (BPD) is characterized by instability of affect, emotion dysregulation, and interpersonal dysfunction. Especially shame and guilt, so-called self-conscious emotions, are of central clinical relevance to BPD. However, only few experimental studies have focused on shame or guilt in BPD and none investigated their neurobiological underpinnings. In the present functional magnetic resonance imaging study, we took a scenario-based approach to experimentally induce feelings of shame, guilt, and disgust with neutral scenarios as control condition. We included 19 women with BPD (age 26.4 ± 5.8 years; DSM-IV diagnosed; medicated) and 22 healthy female control subjects (age 26.4 ± 4.6 years; matched for age and verbal IQ). Compared to controls, women with BPD reported more intense feelings when being confronted with affective scenarios, especially higher levels of shame, guilt, and fear. We found increased amygdala reactivity in BPD compared to controls for shame and guilt, but not for disgust scenarios (p = 0.05 FWE corrected at the cluster level; p < 0.0001 cluster defining threshold). Exploratory analyses showed that this was caused by a diminished habituation in women with BPD relative to control participants. This effect was specific to guilt and shame scenarios as both groups showed amygdala habituation to disgust scenarios. Our work suggests that heightened shame and guilt experience in BPD is not related to increased amygdala activity per se, but rather to decreased habituation to self-conscious emotions. This provides an explanation for the inconsistencies in previous imaging work on amygdala involvement in BPD as well as the typically slow progress in the psychotherapy of dysfunctional self-conscious emotions in this patient group

Your Error’s Got me Feeling – How Empathy Relates to the Electrophysiological Correlates of Performance Monitoring

The error-related and feedback-related negativities (ERN and FRN) represent negative event-related potentials associated with the processing of errors and (negative) response outcomes. The neuronal source of these components is considered to be in the anterior cingulate cortex (ACC). Monitoring one’s own behavior and the impact it may have on other people or observing other individuals perform and receive feedback for their actions may also engage empathy-related processes. Empathy is conceived of as a multifaceted construct involving both cognitive and affective components, partly also supported by the ACC. The present mini-review aims to summarize the sparse database linking the electrophysiological correlates of performance monitoring to empathy. While most studies so far provide largely indirect evidence for such an association – e.g., by pointing toward altered ERN/FRN signaling in populations characterized by deviations in empathic responding – fewer investigations establish more explicit links between the two concepts. The relationship between state and, less consistently, trait measures of empathy and action monitoring might be more pronounced for observational than for active participation

Borderline Traits in Mothers and Their Adolescent Daughters: Associations Between Emotion Regulation, Relationship Quality, and Social Cognition

Borderline personality disorder (BPD) is categorized by impairing emotional dysregulation and other difficulties, with traits being more common in females and emerging in adolescence (British Psychological Society, 2009). The mother-daughter relationship has been shown to relate to trait expression (Cheavans et al., 2005), and it is believed social cognition may be impaired in individuals with BPD (Preibler et al., 2010). The current study evaluated how BPD levels, emotion regulation, and social cognition interact within an individual, how similarity between mother and daughter relate to their perception of the relationship, and whether social cognition is a potential moderator between mother and daughter BPD traits and emotion regulation ability. Ninety-five mothers (ages M=45.05, SD=7.97) and daughters (ages M=15.91, SD= 1.4) completed online questionnaires. Mother and daughter frequency of maladaptive emotion regulation use was positively correlated to BPD traits in mothers (r=.75, N=95, pr=.64, N=95, pr=-2.73, N=95, p=.01). Mother and daughter perceived discord was positively correlated to BPD traits in mothers (r=.43, N=95, pr=.39, N=95, pr=.35, N=95, pr= .3, N=95, p\u3c 0.05). Results suggest that emotion regulation and BPD traits are related, even in non-clinical samples. The mother-daughter relationship likely is influenced by and influences BPD traits, emotion regulation ability, and relationship quality, especially during the adolescent years. Future research should consider observational and experimental conditions to understand the directionality of these relationships