title: Enhanced emotional empathy after mineralocorticoid receptor stimulation in women with borderline personality disorder and healthy women.
abstract: The mineralocorticoid receptor (MR) is highly expressed in the hippocampus and prefrontal cortex. MR have an important role in appraisal processes and in modulating stress-associated emotional reactions but it is not known whether the MR affects empathy. Borderline personality disorder (BPD) is characterized by disturbed emotion regulation and alterations in empathy. In the current study, we examined whether stimulation of the MR enhances empathy in patients with BPD and healthy individuals. In a placebo-controlled study, we randomized 38 women with BPD and without psychotropic medication, and 35 healthy women to either placebo or 0.4 mg fludrocortisone, an MR agonist. Subsequently, all participants underwent two tests of social cognition, the Multifaceted Empathy Test (MET) and the Movie for the Assessment of Social Cognition (MASC), measuring cognitive and emotional facets of empathy. Eighteen BPD patients and 18 healthy women received placebo, whereas 20 BPD patients and 17 healthy women received fludrocortisone. In the MET, fludrocortisone enhanced emotional empathy across groups, whereas cognitive empathy was not affected. In the MASC, no effect of fludrocortisone could be revealed. In both tests, BPD patients and healthy women did not differ significantly in cognitive and emotional empathy and in their response to fludrocortisone. Stimulation of MR enhanced emotional empathy in healthy women and in BPD patients. Whether fludrocortisone might have a therapeutic role in psychotherapeutic processes, remains to be elucidated.
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Wingenfeld
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Linn K
authors.initials: LK
authors.lastname: Kuehl
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Katrin
authors.initials: K
authors.lastname: Janke
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Kim
authors.initials: K
authors.lastname: Hinkelmann
authors.affiliation: Cluster of Excellence Languages of Emotion, Freie Universität Berlin, Berlin, Germany.
authors.forename: Isabel
authors.initials: I
authors.lastname: Dziobek
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Juliane
authors.initials: J
authors.lastname: Fleischer
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Otte
authors.affiliation: Department of Psychiatry and Psychotherapy, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Roepke
mesh_terms: D000328:Adult; D001883:Borderline Personality Disorder / Q000523:psychology*; D003071:Cognition / Q000187:drug effects; D004644:Emotions / Q000187:drug effects*; D004645:Empathy / Q000187:drug effects*; D005260:Female; D005438:Fludrocortisone / Q000494:pharmacology*; D006801:Humans; D018161:Receptors, Mineralocorticoid / Q000819:agonists*; D055815:Young Adult
chemical_list: D018161:Receptors, Mineralocorticoid; D005438:Fludrocortisone