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Empathie und Persönlichkeitsstörungen aus neurobiologischer Sicht

  • Sabine C. Herpertz
Übersicht
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Zusammenfassung

Anders als die unscharfe Verwendung des Begriffs Empathie im allgemeinen Sprachgebrauch differenziert die neurobiologische Literatur in kognitive Empathie einerseits und emotionale Empathie andererseits. Erstere umfasst das kognitive Erkennen der seelischen Verfassung des Anderen anhand reflektierter Perspektivenübernahme und „Theory-of-mind“-Funktionen, Letztere das reflexiv-intuitive Mitfühlen und Teilen von Emotionen des Anderen. Beiden, voneinander unabhängigen und interindividuell unterschiedlich ausgeprägten Facetten lassen sich unterschiedliche Hirnnetzwerke zuordnen, die diese Vorgänge prozessieren. Evolutionär früh liegende Prozesse der emotionalen Empathie entwickeln sich bereits beim Säugling auf dem Weg der spiegelbildlichen Nachahmung von Mimik und Gestik primärer Beziehungspersonen und beziehen u. a. prämotorische Regionen, Areale des sensomotorischen Kortex, des inferioren parietalen Lobulus und die vordere Inselregion ein. Phylogenetisch jüngere Prozesse der kognitiven Empathie sind v. a. in Mittellinienstrukturen wie medialem präfrontalem Kortex, superiorem temporalem Sulcus, posteriorem Cingulum bzw. Praecuneus sowie im temporoparietalen Übergang repräsentiert und finden in geteilten Aufmerksamkeitsprozessen in frühen dyadischen Beziehungen ihren Anfang. Beide empathischen Facetten sind an moralischen Entscheidungsprozessen beteiligt. Dabei zeigen neurobiologische Studien, dass „psychopaths“ über ungestörte kognitiv-empathische Fähigkeiten verfügen und grundsätzlich in der Lage sind, moralische Werte zu erkennen und anzuwenden, aber diesen wenig attentionale Bedeutung verleihen, wenn sie mit eigenen Zielen konkurrieren. Individuen mit Borderline-Persönlichkeitsstörung im Unterschied zu „psychopaths“ zeigen Beeinträchtigungen in kognitiver Empathie: Die Defizite betreffen Mentalisierungsfunktionen, die das Verstehen mentaler Zustände anderer und eigener betreffen sowie Ausgangspunkt von vielen Missverständnissen im interpersonellen Kontext sind. Zudem neigen Individuen mit Borderline-Persönlichkeitsstörung dazu, Emotionen mit anderen Menschen zu teilen. Damit gelingen ihnen Mitgefühl und Mitleid, allerdings verbunden mit der Gefahr der Diffusion von Selbst‑/Fremdgrenzen.

Schlüsselwörter

Kognitive Empathie Emotionale Empathie Mentalisierung „Psychopath“ Borderline-Persönlichkeitsstörung 

Empathy and personality disorders from a neurobiological perspective

Abstract

In contrast to the vague application of the term empathy in general usage, the neurobiological literature differentiates between cognitive empathy and emotional empathy. The former includes cognitive recognition of the mental state of someone else due to reflexive acquisition of perspectives and theory of mind functions, the latter includes the reflexive intuitive sympathy and sharing the emotions of others. Both independent from each other and interindividual differently expressed facets can be assigned to different brain networks which process these events. Early evolutionary processes of emotional empathy are already developed in infants by mirror image imitation of mimicry and gestures of the primary contact person. They involve premotor regions, areas of the sensomotor cortex, the inferior parietal lobule and the anterior insular regions. Phylogenetically younger processes of cognitive empathy are represented in particular in midline structures, such as the medial prefrontal cortex, superior temporal sulcus, posterior cingulum or precuneus as well as in the temporoparietal junction. They have their beginning in shared attention processes in early dyadic processes. Both facets of empathy are involved in moral decision-making processes. In this context, neurobiological studies show that psychopaths have undisturbed cognitive empathic capabilities and are principally able to recognize and apply moral values but confer little attentional importance to them when they compete with own targets. Individuals with borderline personality disorders in contrast to psychopaths show impairments in cognitive empathy. The deficits affect mentalization functions, which involve the understanding of the mental state of others and oneself and are also the starting point for many misunderstandings in an interpersonal context. Additionally, individuals with borderline personality disorder have a tendency to share emotions with other people. They therefore succeed in showing sympathy and compassion although associated with the danger of diffusion of self and third party borders.

Keywords

Cognitive empathy Emotional empathy Mentalization Psychopath Borderline personality disorder 

Notes

Interessenkonflikt

S.C. Herpertz gibt an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature 2018

Authors and Affiliations

  1. 1.Klinik für Allgemeine Psychiatrie am Zentrum für Psychosoziale MedizinHeidelbergDeutschland

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