In this article, Ekaterina Pronizius and Claus Lamm review the core components of empathy and how they are altered in Borderline Personality Disorder (BPD).
A fundamental aspect of empathy is shared neural representation, whereby overlapping brain regions are engaged both during the experience of one’s own emotions and when empathizing with the emotions of others. In individuals with BPD, regions such as the amygdala and insula exhibit hyperactivation, suggesting heightened affective responsiveness.
A second critical component is cognitive emotion regulation, which enables the modulation of emotional responses, for instance, by attenuating or amplifying affective reactions. Empirical evidence indicates that individuals with BPD frequently exhibit impairments in the recruitment of these regulatory mechanisms.
The third component pertains to self-other distinction, a process subserved in part by the temporoparietal junction (TPJ). Aberrant activity in this region in BPD may contribute to difficulties in differentiating one’s own emotions from those of others.
Research on empathy in BPD remains methodologically and conceptually challenging. Heterogeneous clinical presentations and inconsistent terminology impede the development of clear, generalizable conclusions. These findings underscore the need for more precise theoretical frameworks, stronger integration with clinical practice, and collaborative, large-scale initiatives in the spirit of clinical Big Team Science.
If you would like to read the full article but don’t have access, please contact ekaterina.pronizius@univie.ac.at.
This work was supported by the Austrian Science Fund (FWF).
Full text (in german): Pronizius, E., & Lamm, C. (2025). Die Neuronalen Grundlagen der Empathie bei Borderline-Persönlichkeitsstörung [The Neural Foundations of Empathy in Borderline Personality Disorder]. Persönlichkeitsstörungen, 29(4), 452–476. doi.org/10.21706/ptt-29-4-452
Project's webpage: self-other.univie.ac.at
(c) image: pixabay.com/photos/people-women-sad-sisters-cry-2592030/
