Objectives: This study was undertaken to compare subjects diagnosed with Antisocial Personality Disorder
(ASPD) and healthy controls in terms of alexithymia, empathy and theory of mind.
Material and methods: A total of 43 patients diagnosed with ASPD and 43 healthy controls were included.
Study tools administered include the Sociodemographic Data Form, Barratt Impulsivity Scale - Version 11
(BIS-11), Reading the Mind in the Eyes Test (RMET), Empathy Quotient (EQ), Toronto Alexithymia Scale (TAS-
20) and Beck Depression Inventory (BDI).
Results: As compared to controls, patients had significantly lower RMET and total EQ scores (p<0.001) and
significantly higher BIS total and planning, motor and attention, TAS-20 total, identifying feelings, describing
feelings, and externally oriented thinking scores (p= 0.002; p=0.008; p <0.001; p<0.001; p<0.001; p<0.001;
p<0.001; and p=0.017, respectively). There was a positive significant correlation between RMET and EQ
scores (p=0.006, r=0.415), while EQ scores were negatively and significantly correlated with TAS-20 scores
(p=0.001, r= -0.487). There was a significant negative correlation between EQ and BIS-11 scores (p< 0.001, r=
-0.609), while a positive and significant correlation was identified between TAS-20 and BIS-11 scores
(p=0.012, r=0.379). Patients with self-mutilating behaviors had significantly lower total RMET scores than
patients without such behaviors (p=0.028).
Conclusion: In conclusion, ASPD patients experience difficulty in reading the mind in the eyes, exhibit less
empathy toward others, and have more pronounced alexithymia. Our observations suggest that ASPD
patients experience challenges in the theory of mind concepts as well as in understanding and identifying
the emotions of others and the self. We believe that comprehensive therapy programs specifically developed
for ASPD patients and encompassing both the theory of mind and emotional perception may assist in
improving these concepts that have significant roles in social interactions