Risk or resilience? Empathic abilities in patients with bipolar disorders and their first-degree relatives Eva-Maria Seidel a, b, * , Ute Habel b , Andreas Finkelmeyer b, c , Alexander Hasmann d , Matthias Dobmeier d , Birgit Derntl a, b a Institute for Clinical, Biological and Differential Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria b Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany c Institute of Neuroscience, Newcastle Biomedicine, Newcastle University, Newcastle-upon-Tyne, England, UK d Department of Psychiatry, Psychosomatic and Psychotherapy, University of Regensburg, Regensburg, Germany article info Article history: Received 23 July 2011 Received in revised form 11 November 2011 Accepted 14 November 2011 Keywords: Empathy Endophenotype Relatives Bipolar disorder abstract Endophenotypes are intermediate phenotypes which are considered a more promising marker of genetic risk than illness itself. While previous research mostly used cognitive deficits, emotional functions are of greater relevance for bipolar disorder regarding the characteristic emotional hyper-reactability and deficient social-emotional competence. Hence, the aim of the present study was to clarify whether empathic abilities can serve as a possible endophenotype of bipolar disorder by applying a newly developed task in bipolar patients and their first-degree relatives. Three components of empathy (emotion recognition, perspective taking and affective responsiveness) have been assessed in a sample of 21 bipolar patients, 21 first-degree relatives and 21 healthy controls. Data analysis indicated significant differences between controls and patients for emotion recognition and affective responsiveness but not for perspective taking. This shows that in addition to difficulties in recognizing facial emotional expressions, bipolar patients have difficulties in identifying emotions they would experience in a given situation. However, the ability to take the perspective of another person in an emotional situation was intact but decreased with increasing severity of residual hypomanic and depressive symptoms. Relatives performed comparably bad on emotion recognition but did not differ from controls or patients in affective responsiveness. This study is the first to show that deficient emotion recognition is the only component of empathy which forms a possible endophenotype of bipolar disorder. This has important implications for prevention strategies. Furthermore, changes in affective responsiveness in first-degree relatives show a potential resilience marker. Ó 2011 Elsevier Ltd. All rights reserved. 1. Introduction Higher order emotional competencies, e.g. empathy, are important prerequisites for successful social interaction. In bipolar disorder disruptions of social functioning have been consistently reported (e.g., Begley et al., 2001; Kessler et al., 2006). These defi- cient social competencies may result from a dysfunctional ability to understand and react to emotional expressions of other people. The majority of previous studies examining social-emotional competencies in bipolar disorder focused on emotion recognition, albeit showing inconsistent results. Some studies observed significant impairments in general emotion recognition accuracy (Addington and Addington, 1998; Bozikas et al., 2006; Derntl et al., 2009a; Getz et al., 2003). Others reported only emotion-specific deficits (Summers et al., 2006; Yurgelun-Todd et al., 2000) and some even showed unaffected emotion recognition abilities (Lawrence et al., 2004; Vaskinn et al., 2007; Venn et al., 2004). However, emotion recognition is only one component considered to be important for empathic competencies. According to most models of empathy one can derive at least three components (Decety and Jackson, 2004): emotion recognition, perspective taking (cognitive empathy) and affective responsiveness (emotional empathy). This definition takes into account that empathy not only entails understanding others but also understanding and regulating our own emotional reactions. In order to comprehensively analyze all three components we applied a newly developed task (Derntl et al., 2010, 2009b). * Corresponding author. Institute for Clinical, Biological and Differential Psychology, Faculty of Psychology, University of Vienna, Liebiggasse 5,1010 Vienna, Austria. E-mail address: eva-maria.seidel@univie.ac.at (E.-M. Seidel). Contents lists available at SciVerse ScienceDirect Journal of Psychiatric Research journal homepage: www.elsevier.com/locate/psychires 0022-3956/$ e see front matter Ó 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.jpsychires.2011.11.006 Journal of Psychiatric Research xxx (2011) 1e7 Please cite this article in press as: Seidel E-M, et al., Risk or resilience? Empathic abilities in patients with bipolar disorders and their first-degree relatives, Journal of Psychiatric Research (2011), doi:10.1016/j.jpsychires.2011.11.006