A new task (‘CARER’) was used to test claims of reduced empathy in autistic adults. CARER measures emotion identification (ability to identify another’s affective state), affective empathy (degree to which another’s affective state causes a matching state in the Empathiser) and affect sharing (degree to which the Empathiser’s state matches the state they attribute to another). After controlling for alexithymia, autistic individuals showed intact affect sharing, emotion identification and affective empathy. Results suggested reduced retrospective socio-emotional processing, likely due to a failure to infer neurotypical mental states. Thus, autism may be associated with difficulties inferring another’s affective state retrospectively, but not with sharing that state. Therefore, when appropriate measures are used, autistic individuals do not show a lack of empathy.
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Negative scores would indicate ‘excessive’ Affective Empathy, showing that the Empathiser’s reaction to the Target’s affective state is stronger than the Target’s own reaction.
When checking for homogeneity of variance using Levene’s test, the variable affective emotion identification was significant at T2. Therefore, findings from the ANCOVA relating to the crucial Group x Story type interaction were re-assessed using the non-parametric Kruskal–Wallis test in JASP (JASP Team, 2019). We calculated a difference score between affective and neutral trials to obtain a single difference score and compared this score between the groups. The results of this analysis showed the same pattern of significance as the ANCOVA results (X2(1) = .2, p = .655).
The Levene’s test for the variable emotion identification for affective stories was significant, therefore, the Group x Story type interaction found in the ANCOVA was further assessed with a non-parametric Kruskal–Wallis test. We calculated a difference scores between affective and neutral stories to obtain a single difference score and compared this score between the groups. This analysis supported the ANCOVA results, (X2(1) = 6.88, p = .009).
Adler, N., Dvash, J., & Shamay-Tsoory, S. G. (2015). Empathic embarrassment accuracy in autism spectrum disorder. Autism Research, 8(3), 241–249.
Andreychik, M. R. (2019). I like that you feel my pain, but I love that you feel my joy: Empathy for a partner’s negative versus positive emotions independently affect relationship quality. Journal of Social and Personal Relationships, 36(3), 834–854.
Avenanti, A., Bueti, D., Galati, G., & Aglioti, S. M. (2005). Transcranial magnetic stimulation highlights the sensorimotor side of empathy for pain. Nature Neuroscience, 8(7), 955.
Bagby, R. M., Taylor, G. J., & Parker, J. D. (1994). The twenty-item Toronto Alexithymia Scale—II. Convergent, discriminant, and concurrent validity. Journal of Psychosomatic Research, 38(1), 33–40.
Baron-Cohen, S. (2000). Theory of mind and autism: A fifteen year review. Understanding Other Minds: Perspectives from Developmental Cognitive Neuroscience, 2, 3–20.
Baron-Cohen, S., Leslie, A., & Frith, U. (1985). Does the autistic child have a ‘theory of mind’? Cognition, 21, 37–46.
Baron-Cohen, S., Richler, J., Bisarya, D., Gurunathan, N., & Wheelwright, S. (2003). The systemizing quotient: an investigation of adults with Asperger syndrome or high–functioning autism, and normal sex differences. Philosophical Transactions of the Royal Society B: Biological Sciences, 358(1430), 361–374.
Baron-Cohen, S., & Wheelwright, S. (2004). The empathy quotient: An investigation of adults with Asperger syndrome or high functioning autism, and normal sex differences. Journal of Autism and Developmental Disorders, 34(2), 163–175.
Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The autism-spectrum quotient (AQ): Evidence from asperger syndrome/high-functioning autism, malesand females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31(1), 5–17.
Barnes, J. L., Lombardo, M. V., Wheelwright, S., & Baron-Cohen, S. (2009). Moral dilemmas film task: A study of spontaneous narratives by individuals with autism spectrum conditions. Autism Research, 2(3), 148–156.
Batson, C. D. (2009). These things called empathy: Eight related but distinct phenomena.
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the beck depression inventory-II (Vol. 1, p. 82). San Antonio, TX: Psychological Corporation.
Beversdorf, D. Q., Anderson, J. M., Manning, S. E., Anderson, S. L., Nordgren, R. E., Felopulos, G. J., et al. (1998). The effect of semantic and emotional context on written recall for verbal language in high functioning adults with autism spectrum disorder. Journal of Neurology, Neurosurgery and Psychiatry, 65, 685–692. https://doi.org/10.1136/jnnp.65.5.685.
Bird, G., & Cook, R. (2013). Mixed emotions: the contribution of alexithymia to the emotional symptoms of autism. Translational Psychiatry, 3(7), e285.
Bird, G., Press, C., & Richardson, D. C. (2011). The role of alexithymia in reduced eye-fixation in autism spectrum conditions. Journal of Autism and Developmental Disorders, 41(11), 1556–1564.
Bird, G., Silani, G., Brindley, R., White, S., Frith, U., & Singer, T. (2010). Empathic brain responses in insula are modulated by levels of alexithymia but not autism. Brain, 133(5), 1515–1525.
Bird, G., & Viding, E. (2014). The self to other model of empathy: Providing a new framework for understanding empathy impairments in psychopathy, autism, and alexithymia. Neuroscience & Biobehavioral Reviews, 47, 520–532.
Bothe, E., Palermo, R., Rhodes, G., Burton, N., & Jeffery, L. (2019). Expression recognition difficulty is associated with social but not attention-to-detail autistic traits and reflects both alexithymia and perceptual difficulty. Journal of Autism and Developmental Disorders, 49, 4559–4571.
Brewer, R., Biotti, F., Catmur, C., Press, C., Happé, F., Cook, R., et al. (2016). Can neurotypical individuals read autistic facial expressions? Atypical production of emotional facial expressions in autism spectrum disorders. Autism Research, 9(2), 262–271.
Capps, L., Losh, M., & Thurber, C. (2000). “The frog ate the bug and made his mouth sad”: Narrative competence in children with autism. Journal of Abnormal Child Psychology, 28(2), 193–204.
Coll, M. P., Viding, E., Rütgen, M., Silani, G., Lamm, C., Catmur, C., et al. (2017). Are we really measuring empathy? Proposal for a new measurement framework. Neuroscience & Biobehavioral Reviews, 83, 132–139.
Cook, R., Brewer, R., Shah, P., & Bird, G. (2013). Alexithymia, not autism, predicts poor recognition of emotional facial expressions. Psychological Science, 24(5), 723–732.
Corden, B., Chilvers, R., & Skuse, D. (2008). Emotional modulation of perception in Asperger’s syndrome. Journal of Autism and Developmental Disorders, 38, 1072–1080. https://doi.org/10.1007/s10803-007-0485-y.
Davis, M. H. (1980). A multidimensional approach to individual differences in empathy. JSAS Catalogue of Selected Documents in Psychology, 10, 85.
De Vignemont, F., & Singer, T. (2006). The empathic brain: How, when and why? Trends in Cognitive Sciences, 10(10), 435–441.
Decety, J., & Moriguchi, Y. (2007). The empathic brain and its dysfunction in psychiatric populations: Implications for intervention across different clinical conditions. BioPsychoSocial Medicine, 1(1), 22.
Dziobek, I., Rogers, K., Fleck, S., Bahnemann, M., Heekeren, H. R., Wolf, O. T., et al. (2008). Dissociation of cognitive and emotional empathy in adults with Asperger syndrome using the Multifaceted Empathy Test (MET). Journal of Autism and Developmental Disorders, 38(3), 464–473.
English, M. C., Maybery, M. T., & Visser, T. A. (2017). Threatening faces fail to guide attention for adults with autistic-like traits. Autism Research, 10(2), 311–320.
English, M. C., Maybery, M. T., & Visser, T. A. (2019). Autistic-traits, not anxiety, modulate implicit emotional guidance of attention in neurotypical adults. Scientific Reports, 9(1), 1–10.
Fan, Y. T., Chen, C., Chen, S. C., Decety, J., & Cheng, Y. (2014). Empathic arousal and social understanding in individuals with autism: Evidence from fMRI and ERP measurements. Social Cognitive and Affective Neuroscience, 9(8), 1203–1213.
Faso, D. J., Sasson, N. J., & Pinkham, A. E. (2015). Evaluating posed and evoked facial expressions of emotion from adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 45, 75–89.
Frith, U. (1994). Autism and theory of mind in everyday life. Social development, 3(2), 108–124.
Frith, U. (2012). Why we need cognitive explanations of autism. The Quarterly Journal of Experimental Psychology, 65(11), 2073–2092.
Gaigg, S. B., & Bowler, D. M. (2008). Free recall and forgetting of emotionally arousing words in autism spectrum disorder. Neuropsychologia, 46, 2336–2343. https://doi.org/10.1016/j.neuropsychologia.2008.03.008.
Gaigg, S. B., & Bowler, D. M. (2009a). Brief report: attenuated emotional suppression of the attentional blink in autism spectrum disorder: Another non-social abnormality? Journal of Autism and Developmental Disorders, 39, 1211–1217. https://doi.org/10.1007/s10803-009-0719-2.
Gaigg, S. B., & Bowler, D. M. (2009b). Illusory memories of emotionally charged words in autism spectrum disorder: Further evidence for atypical emotion processing outside the social domain. Journal of Autism and Developmental Disorders, 39, 1031–1038. https://doi.org/10.1007/s10803-009-0710-y.
Hadjikhani, N., Zürcher, N. R., Rogier, O., Hippolyte, L., Lemonnier, E., Ruest, T., et al. (2014). Emotional contagion for pain is intact in autism spectrum disorders. Translational Psychiatry, 4(1), e343.
Harms, M. B., Martin, A., & Wallace, G. L. (2010). Facial emotion recognition in autism spectrum disorders: A review of behavioral and neuroimaging studies. Neuropsychology Review, 20(3), 290–322.
Heaton, P., Reichenbacher, L., Sauter, D., Allen, R., Scott, S., & Hill, E. (2012). Measuring the effects of alexithymia on perception of emotional vocalizations in autistic spectrum disorder and typical development. Psychological Medicine, 42(11), 2453–2459.
Hill, E., Berthoz, S., & Frith, U. (2004). Brief report: Cognitive processing of own emotions in individuals with autistic spectrum disorder and in their relatives. Journal of Autism and Developmental Disorders, 34(2), 229–235.
Ickes, W., Stinson, L., Bissonnette, V., & Garcia, S. (1990). Naturalistic social cognition: Empathic accuracy in mixed-sex dyads. Journal of Personality and Social Psychology, 59, 730–742.
JASP Team. (2019). JASP (Version 0.11.1) [Computer software].
Jeffreys, H. (1961). Theory of probability (3rd ed.). Oxford: Oxford University Press.
Lartseva, A., Dijkstra, T., & Buitelaar, J. K. (2015). Emotional language processing in autism spectrum disorders: A systematic review. Frontiers in Human Neuroscience, 8, 991.
Lawrence, E., Shaw, P., Baker, D., Baron-Cohen, S., & David, A. (2004). Measuring empathy: Reliability and validity of the empathy quotient. Psychological Medicine, 34(5), 911–920. https://doi.org/10.1017/S0033291703001624.
Minio-Paluello, I., Baron-Cohen, S., Avenanti, A., Walsh, V., & Aglioti, S. M. (2009). Absence of embodied empathy during pain observation in Asperger syndrome. Biological psychiatry, 65(1), 55–62.
Morelli, S. A., Lieberman, M. D., & Zaki, J. (2015). The emerging study of positive empathy. Social and Personality Psychology Compass, 9(2), 57–68.
Morrison, A. S., Mateen, M. A., Brozovich, F. A., Zaki, J., Goldin, P. R., Heimberg, R. G., et al. (2016). Empathy for positive and negative emotions in social anxiety disorder. Behaviour Research and Therapy, 87, 232–242.
Oakley, B. F., Brewer, R., Bird, G., & Catmur, C. (2016). Theory of mind is not theory of emotion: A cautionary note on the Reading the Mind in the Eyes Test. Journal of Abnormal Psychology, 125(6), 818.
Raftery, A. E. (1995). Bayesian model selection in social research. Sociological Methodology, 25, 111–163.
Rueda, P., Fernández-Berrocal, P., & Baron-Cohen, S. (2015). Dissociation between cognitive and affective empathy in youth with Asperger syndrome. European Journal of Developmental Psychology, 12(1), 85–98.
Salminen, J. K., Saarijärvi, S., Äärelä, E., Toikka, T., & Kauhanen, J. (1999). Prevalence of alexithymia and its association with sociodemographic variables in the general population of Finland. Journal of Psychosomatic Research, 1, 75–82. https://doi.org/10.1016/S0022-3999(98)00053-1.
Schilbach, L. (2014). On the relationship of online and offline social cognition. Frontiers in Human Neuroscience, 8, 278.
Schilbach, L., Timmermans, B., Reddy, V., Costall, A., Bente, G., Schlicht, T., et al. (2013). Toward a second-person neuroscience 1. Behavioral and Brain Sciences, 36(4), 393–414.
Shamay-Tsoory, S. G., Tomer, R., Yaniv, S., & Aharon-Peretz, J. (2002). Empathy deficits in Asperger syndrome: A cognitive profile. Neurocase, 8(2), 245–252.
Sifneos, P. E. (1973). The prevalence of ‘alexithymic’ characteristics in psychosomatic patients. Psychotherapy and Psychosomatics, 22(2-6), 255–262.
Silani, G., Bird, G., Brindley, R., Singer, T., Frith, C., & Frith, U. (2008). Levels of emotional awareness and autism: An fMRI study. Social Neuroscience, 3(2), 97–112.
Smith, A. (2009). The empathy imbalance hypothesis of autism: a theoretical approach to cognitive and emotional empathy in autistic development. The Psychological Record, 59(3), 489–510.
Trevisan, D. A., Bowering, M., & Birmingham, E. (2016). Alexithymia, but not autism spectrum disorder, may be related to the production of emotional facial expressions. Molecular Autism, 7(1), 46.
Volker, M. A., Lopata, C., Smith, D. A., & Thomeer, M. L. (2009). Facial encoding of children with high-function autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 24(4), 195–204.
Wechsler, D. (2009). Wechsler memory scale-fourth edition (WMS–IV) technical and interpretive manual. San Antonio, TX: Pearson.
Zaki, J., Bolger, N., & Ochsner, K. (2008). It takes two: The interpersonal nature of empathic accuracy. Psychological Science, 19(4), 399–440.
The authors wish to thank Dr Jeffrey M Girard for programming the CARER empathy task and Ella Belfield and Laura Didymus for assistance during early data collection. This work was supported by an Economics and Social Research Council (ESRC) Grant awarded to IS [ES/N00325X/1]. MJB is also supported by an ESRC Grant [ES/R007527/1]. GB is supported by the Baily Thomas Charitable Trust.
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Santiesteban, I., Gibbard, C., Drucks, H. et al. Individuals with Autism Share Others’ Emotions: Evidence from the Continuous Affective Rating and Empathic Responses (CARER) Task. J Autism Dev Disord 51, 391–404 (2021). https://doi.org/10.1007/s10803-020-04535-y