Psychopathy, narcissism, and borderline personality: A critical test of the affective empathy-impairment hypothesis

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Highlights

  • Examined links between psychopathy, narcissism, borderline personality and affective empathy

  • Personality traits were measured and used to predict change in state affective empathy.

  • Narcissistic and borderline personality traits poorly predicted affective empathy change.

  • Psychopathic emotional callousness consistently predicted lower change in affective empathy.

Abstract

Two studies were conducted to test whether psychopathy, narcissism, and borderline personality are linked to impairment in affective empathy experience. In both studies, two forms of affective empathy (emotional contagion and empathic concern) were covertly manipulated and measured. Use of state empathy change scores and data aggregation across both studies and a third previously published study revealed little evidence of a consistent negative association between most measures of narcissistic, borderline, or psychopathic traits and affective empathy change scores. The one exception was the psychopathic trait of Callous Affect, which revealed consistent negative associations with affective empathy change scores. Specifically, relative to neutral stimuli, Callous Affect was associated with lower emotional contagion of sadness to sad faces, lower emotional contagion of sadness, anger, and fear to those in need, and lower empathic concern to those in need. The results suggest that claims of clear links between affective empathy impairment and most traits comprising narcissism and borderline personality are unsubstantiated when subjected to critical test conditions. Moreover, emotional callousness, as opposed to other psychopathic traits, appears to be responsible for the proposed link between psychopathy and affective empathy impairment.

Introduction

A growing body of work spanning the domains of social-personality psychology, neuropsychology, clinical psychology, psychiatry, and forensic psychology has long assumed a link between affective empathy impairment and various divisive personality constructs including psychopathy, narcissism, and borderline personality (American Psychiatric Association, 2013, Blair, 2007, Cleckley, 1941, Dadds et al., 2009, Furnham et al., 2013, Soderstrom, 2003, Woollastan and Hixenbaugh, 2008). However, the evidence supporting this assumed link is based mostly on the use of ambiguous measures of affective empathy and relatively weak test conditions. These limitations may in turn promote overstated conclusions regarding the link between these personality constructs and affective empathy.

Although some have noted similarities among psychopathy, narcissism, and borderline personality (Furnham et al., 2013, Huchzermeier et al., 2007, Miller et al., 2010, Murphy and Vess, 2003, Thoma et al., 2013), they are typically treated as distinct in the literature. Psychopathy refers to a higher-order personality construct characterized by emotional callousness, egocentricity, deceptive and manipulative interpersonal style, and tendency to engage in antisocial behavior that is rash, erratic, and impulsive (Hare, 1996, Hare and Neumann, 2009, Vitacco et al., 2005). Narcissism is characterized by an overly positive and grandiose view of the self, as well as tendency to engage in behavior that is interpersonally exploitive and designed to promote admiration by others and aggrandizement of the self (Cain et al., 2008, Pincus et al., 2009). Borderline personality is marked by instability in self-image, heightened emotional reactivity, and behavioral impulsivity, which may manifest in behavior that is antisocial, self-injurious, or suicidal (Crowell et al., 2009, Domes et al., 2009).

Prominent theoretical approaches typically emphasize that psychopathy, narcissism, and borderline personality are multifaceted. For example, psychopathy has been conceptualized as consisting of two overarching dimensions—an affective–interpersonal dimension and an impulsive–antisocial dimension. The affective–interpersonal and impulsive–antisocial dimensions may be further subdivided into pairs of lower order traits: (a) callous emotionality and tendency to be interpersonally manipulative, and (b) lifestyle impulsivity and tendency to engage in antisocial behavior, respectively (Hare and Neumann, 2009, Vitacco et al., 2005). Likewise, one prominent view of narcissism proposes that it can be explained by seven lower-order traits: a sense of esteem based on the opinions of others, tendency to exploit others, tendency to engage in prosocial behavior to promote self-enhancement, tendency to present a false self, tendency to engage in grandiose fantasy, tendency to devalue others, and a hostile sense of entitlement (Cain et al., 2008, Pincus et al., 2009). Finally, one influential view on borderline personality assumes that it reflects manifestation of four lower-order traits: affect instability, identity uncertainty, tendency to engage in problematic relationship behavior, and tendency to engage in self-harm (Morey, 1991).

Like psychopathy, narcissism, and borderline personality, empathy also is multifaceted. Indeed, it may be best to think of the term empathy as a category label for eight distinct, yet related psychological phenomena. These phenomena include (1) accurately identifying what another person is thinking or feeling; (2) imagining what another person is thinking or feeling; (3) imagining how one would think or feel in the place of another; (4) aesthetically projecting oneself into the state of another person or object; (5) feeling the same emotion as another; (6) feeling other-oriented concern for another; (7) feeling personally distressed by another's negative situation; or (8) matching the behavioral posture of another (Batson, 2011, Lishner et al., 2012). Four of these phenomena may be categorized as cognitive empathy (Concepts 1–4) and one may be categorized as behavioral empathy (Concept 8). Of importance for the present research are the three phenomena that may be categorized as affective empathy (Concepts 5–7) as it is impairment in the emotional forms of empathy that are often implicated in psychopathy, narcissism, and borderline personality.

On the surface, extant empirical work seems consistent with the proposition that psychopathy, narcissism, and borderline personality are linked to an impaired capacity to experience affective empathy. Research has revealed an association between one or more of these personality constructs and (a) lowered physiological reactivity in response to observing others' interpersonal distress (e.g., crying faces, distress expressions; Blair et al., 1997, Verona et al., 2013); (b) difficulty in identifying discrete emotionality in others' facial and vocal expressions (Bagley et al., 2009, Blair et al., 2002, Blair et al., 2004, Del Gaizo and Falkenbach, 2008, Marissen et al., 2012, Minzenberg et al., 2012, Robin et al., 2012); (c) lower scores on dispositional measures of affective empathy (Brouns et al., 2013, Dziobek et al., 2011, Hepper et al., 2014, Jonason and Krause, 2013, Mahmut et al., 2008, New et al., 2012, Salekin et al., 2014, Sandoval et al., 2000, Sellbom and Phillips, 2013, Stanley et al., 2013, Vonk et al., 2013, Wai and Tiliopoulous, 2012, Watson et al., 1984, Watson and Morris, 1991, White, 2014, Zágon and Jackson, 1994); (d) higher ratings of positive valence in response to viewing faces expressing negative emotion (Ali et al., 2009, Lockwood et al., 2013, Wai and Tiliopoulous, 2012); (e) lower neural activity in brain regions thought to be involved in the experience of pain or attachment processes as a consequence of viewing physical injuries or pain expressions of others (Decety et al., 2013a, Decety et al., 2013b, Marsh et al., 2013); and (f) lower state reports of affective empathy to emotionally evocative stimuli (Lishner et al., 2012, Ritter et al., 2011, Wai and Tiliopoulous, 2012).

The apparent convergence of findings across multiple measures seems impressive. However, except for the last aforementioned category, the remaining categories consist of fairly indirect evidence given a more nuanced conceptualization of affective empathy phenomena. For example, lower physiological responding to negative emotional expressions and higher ratings of positive valence in response to negative facial expressions may indicate a lower tendency to feel, or “catch,” the same emotions of others (Concept 5), a lower tendency to experience personal distress (Concept 7) or empathic concern (Concept 6) in response to the needs of others, or alternative responses that are not empathic (e.g., boredom with the stimuli). Given some theorists' claims that empathic concern may become inhibited if one experiences high levels of personal distress (Eisenberg et al., 2006, Eisenberg et al., 1994), a paradoxical conclusion one may draw is that lower physiological arousal actually indicates the potential for more, rather than less, affective empathy depending on which affective empathy phenomenon one considers.

Another complicating issue is that experimental research suggests dispositional measures of affective empathy do not necessarily predict genuine state experiences of affective empathy or the prosocial tendencies typically evoked by such states (e.g., Batson, Bolen, Cross, & Neuringer-Benefiel, 1986). This may be traced back to initial validation studies of dispositional empathy measures that have tended to rely on other trait measures or indirect measures of state empathy as criteria for establishing construct validity (e.g., Davis, 1983). In addition, dispositional measures of affective empathy may share method variance with trait measures of narcissism, borderline personality, and psychopathy (e.g., item and rater social desirability effects, transient or dispositional rater mood effects, rater consistency motif effects; Podsakoff, Mackenzie, Lee, & Podsakoff, 2003), leading to overestimates of the true association between these personality constructs and affective empathy. Ambiguity in the interpretation of findings also exists in the neuroscience literature on psychopathy and affective empathy due to the absence of measures of subjective emotional experience (e.g., Decety et al., 2013a, Marsh et al., 2013). Without corresponding subjective measures of emotional experience, it remains unclear whether differences in brain activity associated with one or more of these constructs reflects corresponding differences in affective empathy.

Finally, one major issue with the research literature involving ambiguous measures of affective empathy is multiple instances of disconfirmation of the proposed link between one of more of the personality constructs and affective empathy. Indeed, disconfirmations even occur in studies conducted by some researchers who also reported confirming evidence of a link depending on the empathy measure adopted or personality construct assessed (Domes et al., 2013, Dziobek et al., 2011, Fertuck et al., 2009, Harari et al., 2010, Hengartner et al., 2014, Jonason and Krause, 2013, Jovev et al., 2011, Konrath et al., 2014, Lannin et al., 2014, Lishner et al., 2012, Lynch et al., 2006, Marissen et al., 2012, Minzenberg et al., 2012, New et al., 2012, Ritter et al., 2011, Stanley et al., 2013, Robin et al., 2012, Vonk et al., 2013, Wagner and Linehan, 1999). It is worth noting that disconfirmation of the link between these personality constructs and affective empathy impairment appears more pronounced in research on narcissism and borderline personality than research on psychopathy.

Contrary to widespread assumptions regarding the link between affective empathy and psychopathy, narcissism, and borderline personality, evaluation of the research testing the affective empathy-impairment hypothesis reveals findings that are fairly equivocal. Generally speaking, the lack of clarity can be traced to questions regarding the construct validity of the affective empathy measure used to test the hypothesis. This issue was raised by Lishner et al. (2012), who sought to provide a more direct test of the affective empathy-impairment hypothesis with regard to psychopathy by using a task designed to covertly manipulate and measure changes in state affective empathy, specifically Concepts 5 and 6 (emotional contagion and empathic concern, respectively). The task included an elaborate cover story and counterbalanced presentation of stimuli designed to minimize the plausibility that state changes in affective empathy could be attributed to experimental demand, socially desirable responding, or many forms of method variance (common rater effects, common item effects, and item context effects).

Importantly, before evaluating whether psychopathic traits predicted impairment in emotional contagion or empathic concern, Lishner et al. (2012) first established that their task stimuli produced predicted changes in state emotional responses that would be expected based on the theoretical and empirical affective empathy literature. Specifically, they demonstrated that stimuli that should evoke different affective empathy states (pictures of adult emotional expressions and infants, and an article about those in need) did so relative to neutral stimuli baselines (neutral adult faces and a neutral article). These predicted change scores in state affective empathy were then used as the basis for evaluating the hypothesized negative association between psychopathy (measured using the Self-Report Psychopathy Scale-Version 3; Paulhus, Neumann, & Hare, 2015) and affective empathy. Surprisingly, evidence of a negative association between affective empathy change scores and psychopathy was fairly weak. Neither overall psychopathy scores nor three of the four lower-order trait scores were negatively associated with affective empathy change scores. Only for the psychopathic trait of Callous Affect were negative associations in the predicted direction obtained.

Section snippets

Overview

The goals of the present research were two-fold. The first goal was to apply the methodology used by Lishner et al. (2012) to test the empathy-impairment hypothesis with regard to narcissism and borderline personality (Study 1). The second goal was to produce a replication of Study 1, with regard to narcissism and borderline personality, and of Lishner et al. (2012, Study 1), with regard to psychopathy.

Replication was important for several reasons. First, it provided two additional evaluations

Study 1

Participants were 182 undergraduate students enrolled in introductory psychology courses at a medium-sized Midwestern University located in the United States. Participants received partial credit toward a course research requirement in return for participation. The majority of participants were female (51.1%) and Caucasian (92.3%), with an age range of 18 to 35 years old (M = 19.31, SD = 2.34).

Study 2

Participants were a second, independent sample of 192 undergraduate students enrolled in introductory

Emotion ratings

Within each study, and for each facial set and story, five rating indexes of self-reported emotional experience were created by averaging participants' ratings on items measuring happiness, sadness, fear, anger, and empathic concern (for a total of 40 rating index scores; Study 1: .79 < Cronbach's alphas < .97, mean alpha = .89; Study 2: .69 < Cronbach's alphas < .96, mean alpha = .88).

Personality trait scores

After reverse coding negatively worded items, participants' overall narcissism (Study 1 and Study 2), borderline

General discussion

The present research tested the hypotheses that psychopathy, narcissism, and borderline personality are linked to impairment in the capacity to experience affective empathy. In contrast to other published studies, the measure of affective empathy used in the present research was task-based, which allowed for an evaluation of its construct validity among study participants. Specifically, the task produced theoretically expected within-subject changes in state emotion in response to covert

Conclusions

An impaired capacity to experience affective empathy for others has long been thought to accompany narcissism, borderline personality, and psychopathy. Yet, for most traits encompassing these personality constructs the presumed links failed to emerge under critical test conditions that (a) sought to minimize social desirability, experimental demand, and shared method bias; (b) created empirical discrimination between different forms of affective empathy identified in the theoretical literature;

Ethical statement

Informed consent was obtained from all human participants.

References (88)

  • M.A.E. Marissen et al.

    Disturbed emotion recognition in patients with narcissistic personality disorder

    Psychiatry Research

    (2012)
  • K. Ritter et al.

    Lack of empathy in patients with narcissistic personality disorder

    Psychiatry Research

    (2011)
  • M. Robin et al.

    Decreased sensitivity to facial emotions in adolescents with borderline personality disorder

    Psychiatry Research

    (2012)
  • P. Thoma et al.

    Empathy and social problem solving in alcohol dependence, mood disorders and selected personality disorders

    Neuroscience and Biobehavioral Reviews

    (2013)
  • J. Vonk et al.

    Mirror, mirror on the wall, which form of narcissist knows self and others best of all?

    Personality and Individual Differences

    (2013)
  • M. Wai et al.

    The affective and cognitive empathic nature of the dark triad of personality

    Personality and Individual Differences

    (2012)
  • P.J. Watson et al.

    Narcissism, empathy and social desirability

    Personality and Individual Differences

    (1991)
  • B.A. White

    Who cares when nobody is watching? Psychopathic traits and empathy in prosocial behaviors

    Personality and Individual Differences

    (2014)
  • I. Zágon et al.

    Construct validity of a psychopathy measure

    Personality and Individual Differences

    (1994)
  • American Psychiatric Association

    Diagnostic and Statistical Manual of Mental Disorders

    (2013)
  • J.B. Asendorpf et al.

    Recommendations for increasing replicability in psychology

    European Journal of Personality

    (2013)
  • A. Bagley et al.

    Vocal affect recognition and psychopathy: converging findings across traditional and cluster analytic approaches to assessing the construct

    Journal of Abnormal Psychology

    (2009)
  • C.D. Batson

    Altruism in Humans

    (2011)
  • C.D. Batson et al.

    Negative-state relief and the empathy–altruism hypothesis

    Journal of Personality and Social Psychology

    (1989)
  • C.D. Batson et al.

    Where is the altruism in the altruistic personality?

    Journal of Personality and Social Psychology

    (1986)
  • C.D. Batson et al.

    Perspective taking: imagining how another feels versus imagining how you would feel

    Personality and Social Psychology Bulletin

    (1997)
  • C.D. Batson et al.

    Anger at unfairness: is it moral outrage?

    European Journal of Social Psychology

    (2007)
  • C. Batson et al.

    Similarity and nurturance: two possible sources of empathy for strangers

    Basic and Applied Social Psychology

    (2005)
  • R. Blair

    Empathic dysfunction in psychopathic individuals

    Empathy in Mental Illness

    (2007)
  • R. Blair et al.

    The psychopathic individual: a lack of responsiveness to distress cues?

    Psychophysiology

    (1997)
  • R. Blair et al.

    Turning a deaf ear to fear: impaired recognition of vocal affect in psychopathic individuals

    Journal of Abnormal Psychology

    (2002)
  • B.H.J. Brouns et al.

    Concurrent and prospective effects of psychopathic traits on affective and cognitive empathy in a community sample of late adolescents

    Journal of Child Psychology and Psychiatry

    (2013)
  • H. Cleckley

    The Mask of Sanity

    (1941)
  • L.J. Cronbach et al.

    Construct validity in psychological tests

    Psychological Bulletin

    (1955)
  • S.H. Crowell et al.

    A biosocial developmental model of borderline personality: elaborating and extending Linehan's theory

    Psychological Bulletin

    (2009)
  • M. Dadds et al.

    Learning to ‘talk the talk’: the relationship of psychopathic traits to deficits in empathy across childhood

    Journal of Child Psychology and Psychiatry

    (2009)
  • M.H. Davis

    Measuring individual differences in empathy: evidence for a multidimensional approach

    Journal of Personality and Social Psychology

    (1983)
  • J. Decety et al.

    An fMRI study of affective perspective taking in individuals with psychopathy: imagining another in pain does not evoke empathy

    Frontiers in Human Neuroscience

    (2013)
  • J. Decety et al.

    Brain response to empathy-eliciting scenarios involving pain in incarcerated individuals with psychopathy

    Journal of American Medical Association Psychiatry

    (2013)
  • G. Domes et al.

    Emotional empathy and psychopathy in offenders: an experimental study

    Journal of Personality Disorders

    (2013)
  • G. Domes et al.

    Emotion recognition in borderline personality disorder—a review of the literature

    Journal of Personality Disorders

    (2009)
  • N. Eisenberg et al.

    The relations of emotionality and regulation to dispositional and situational empathy-related responding

    Journal of Personality and Social Psychology

    (1994)
  • N. Eisenberg et al.

    Prosocial development

  • N. Eisenberg et al.

    Sex differences in empathy and related capacities

    Psychological Bulletin

    (1983)
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