structural:reformatting
Impairment

A difference in distribution between affective and cognitive empathy has been observed in various conditions. Psychopathy and narcissism are associated with impairments in affective but not cognitive empathy, whereas bipolar disorder is associated with deficits in cognitive but not affective empathy. People with borderline personality disorder (BPD) may suffer from impairments in cognitive empathy as well as fluctuating affective empathy, although this topic is controversial. Schizophrenia, too, is associated with deficits in both types of empathy. However, even in people without conditions such as these, the balance between affective and cognitive empathy varies.

Atypical empathic responses are associated with some personality disorders such as psychopathy, borderline, narcissistic, and schizoid personality disorders; conduct disorder; schizophrenia; bipolar disorder; and depersonalization. Sex offenders who had been raised in an environment where they were shown a lack of empathy and had endured abuse of the sort they later committed, felt less affective empathy for their victims.