Comparing Empathy Among Individuals with Borderline Personality Disorder with and without Other Psychiatric Disorders: A Study in a Clinical Sample

Abstract

Background: Borderline personality disorder (BPD) is characterized by emotional instability and difficulties in interpersonal relationships. Empathy, a key ability for social interactions, has been found to be impaired in individuals with BPD. The presence of other psychiatric diagnoses may exacerbate these difficulties. This work aims to compare empathy levels on individuals with BPD with and without other psychiatric disorders. Methods: This is a cross-sectional study conducted in a clinical sample. Using the Interpersonal Reactivity Index (IRI) to evaluate empathy, this study involved all the patients diagnosed with BPD followed in the psychiatry service of a general hospital in Portugal. Data were analysed with group comparison tests and multiple linear regression. Results: A total of 142 participants (88.7% women) responded to the IRI questionnaire (59.2% with BPD, 40.8% with BPD plus other diagnoses). Mean empathy levels ranged from 14.12 (SD = 5.44) for perspective taking and 14.46 (SD = 6.12) for personal discomfort, to 16.18 (SD = 6.26) for fantasy and 17.22 (SD = 5.89) for empathic concern. Individuals with BPD plus comorbid psychiatric disorders showed lower levels of empathy compared to individuals with BPD alone, specifically in the perspective taking (B = -2.648, S.E. = .938, p = .005) and empathic concern (B = -2.394, S.E. = 1.021, p = .020) dimensions of empathy, even when adjusting for the participant's sex. Conclusion: These findings underline the need to consider comorbidities when assessing and treating BPD, suggesting that empathy-focused interventions may be beneficial for individuals with BPD plus comorbid disorders.