Confusing My Viewpoint With His: Altered Self-Other Distinction Performance in Antisocial Personality Disorder

Deficits of social cognition are regularly but inconsistently reported among individuals with antisocial personality disorder (ASPD). Because of the multifaceted nature of social cognition, deficits might be only observed when assessing specific facets of social cognition and under sufficiently demanding conditions. This study examined self-other distinction performance, a key facet lying at the core of the attachment-based model of mentalizing (Fonagy & Luyten, 2009). Twenty-one forensic inpatients with ASPD and 19 participants from the community completed a visual perspective-taking paradigm allowing to tease apart self-other priority (i.e., how self-focused one is) from self-other distinction performance (i.e., how much one confuses his with others' mental states). The ASPD group made significantly more errors at handling conflicting self-other viewpoints when requiring self-other distinction (19%) than the control group (4%), but the ASPD group was not significantly more self-focused. In contrast, the Interpersonal Reactivity Index self-report scale did not differentiate the two groups. However, a novel measure of self-other distinction based on empathic concern (i.e., the tendency to experience feelings of concern and compassion for others) and personal distress subscales (i.e., the tendency to experience personal distress in response to the distress of others) did differentiate the two groups, albeit to a significantly lower extent than the objective measure of self-other distinction. Altogether, these findings indicate the presence of a self-other distinction deficit in ASPD and advocate for psychometric approaches that embrace the multifaceted nature of social cognition and the need for objective measures with sufficient sensitivity.