Self-Oriented Empathy and Personality Organisation Level: Insights from a Psychiatric Sample

Empathy functioning is among the criteria to delineate psychiatric diagnosis. However, the self-oriented empathy dimension is almost neglected in the existing literature. On the basis of previous fragmented contributions, we hypothesised that an individual's level of personality organisation is explained by this facet of empathy more than the other components of empathy, both transversally and independently from the specific psychiatric diagnosis.

Fifty-nine psychiatric inpatients were evaluated with clinical interviews inspired by the Structured Clinical Interview for DSM-5, completed the Symptom Checklist-90-Revised, and Interpersonal Reactivity Index (IRI). A panel of experts established each patient's psychiatric diagnosis and the level of personality organisation according to DSM-5 and PDM-2. Thirty-two patients were considered functioning at a psychotic level, 27 at a borderline level, and none at a neurotic level. Multinomial models were compared with the corrected AIC to determine if self-oriented empathy, among all IRI subscales, was the best-fitting model for explaining the levels of personality organisation. A further analogue series of models was used to investigate the best IRI subscale to explain each patient's psychiatric diagnosis.

The first series of models revealed self-oriented empathy (IRI personal distress subscale) as the best empathic dimension to explain levels of personality organisation. The second series revealed that none of the four IRI subscales explained psychiatric diagnoses.

The consistency of our findings with evolutionary concepts pertaining to both traditional psychodynamic models and contemporary models of psychopathology, such as the p factor theory, was illustrated. Despite the many limitations of our consecutive sampling jeopardising the findings' generalisability, the insight of self-oriented empathy as the best predictor of the level of personality organisation, irrespective of psychiatric diagnosis, has several implications from both research and clinical/diagnostic perspectives.