Early affective empathy, emotion contagion, and empathic concern in borderline personality disorder : A systematic review and meta-analysis

Journal article

Blunden, Anthea G., Henry, Julie D., Pilkington, Pamela D. and Pizarro-Campagna, Elizabeth. (2024). Early affective empathy, emotion contagion, and empathic concern in borderline personality disorder : A systematic review and meta-analysis. Journal of Affective Disorders Reports. 367, pp. 462-478. https://doi.org/10.1016/j.jad.2024.08.215
AuthorsBlunden, Anthea G., Henry, Julie D., Pilkington, Pamela D. and Pizarro-Campagna, Elizabeth
Abstract

Background
Individuals with Borderline Personality Disorder (BPD) are theorized to experience lower cognitive empathy but heightened affective empathy. Despite meta-analyses addressing cognitive empathy, affective empathy remains unexplored. This pre-registered systematic review and meta-analysis investigated affective empathy in individuals with BPD or high BPD traits relative to healthy comparisons, using a multidimensional approach including, early affective empathy, emotion contagion, and empathic concern.

Methods
Systematic search of SCOPUS, PubMed, Medline COMPLETE, and PsycINFO (June 27, 2022, May 14, 2023, and July 1, 2024) was completed. Included studies compared affective empathy in those with BPD/high BPD traits with healthy comparisons, utilized experimental or self-report designs, and were peer-reviewed or PhD theses. Risk of bias was assessed using the Newcastle-Ottawa Scale.

Results
Among 22 eligible studies identified, results revealed individuals with BPD/high BPD traits showed significantly higher emotion contagion (Npooled = 1797, g = −1.10, 95 % CI [−1.57, −0.62]). No significant differences were found in empathic concern (Npooled = 1545, g = 0.06, 95 % CI [−0.10, 0.22]), or early affective empathy for anger (Npooled = 245, g = 0.28, 95 % CI [−0.0.53, 1.09]) and happiness, (Npooled = 189, g = 0.34, 95 % CI [−0.1.50, 2.18]).

Limitations
Few included studies for early affective empathy, methodological shortcomings in the broader literature and study heterogeneity suggest caution when interpreting these effects, emphasizing the need for targeted research.

Conclusions
While individuals with BPD/high BPD traits are more likely to subjectively experience others' distress through emotion contagion, no differences were found in early affective empathy or ability to direct sympathy and concern towards others.

Keywordsborderline personality disorder; affective empathy; emotion contagion; empathic concern; facial mimicry
Year2024
JournalJournal of Affective Disorders Reports
Journal citation367, pp. 462-478
PublisherElsevier B.V.
ISSN0165-0327
Digital Object Identifier (DOI)https://doi.org/10.1016/j.jad.2024.08.215
PubMed ID39236884
Scopus EID2-s2.0-85203185071
Open accessPublished as ‘gold’ (paid) open access
Page range462-478
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online07 Sep 2024
Publication process dates
Accepted31 Aug 2024
Deposited05 May 2025
Additional information

© 2024 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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