Abstract
Research has consistently shown that individuals with Autism Spectrum Disorder (ASD) exhibit Empathy deficits. The aim of this study was to systematically review and meta-analyze the research conducted in the domain of cognitive and affective Empathy in Autism. The author also attempted to see the influence of moderators, such as age, culture, and measure-used, on the effect sizes. To fulfill the objective, the meta-analysis was performed on 35 studies that fulfilled the inclusion criteria with the help of the Meta-essentials, which is a free excel meta-analysis tool that facilitates the integration of effect sizes from various studies. The results indicated that the ASD group differs significantly from typically developing (TD) group in both cognitive and affective empathy. The effect size for cognitive empathy was very large (1.26), whereas, for affective empathy, the effect size was medium (0.58). Further, there was a significant moderating effect of the type of measure used on cognitive empathy. However, there are a few limitations of the present meta-analysis. Firstly, it does not shed light on how symptom severity in Autism influences empathy. Secondly, all the possible moderating variables influencing empathy could not be considered. Lastly, the generalizability of the findings may be limited owing to the limitations present in the included studies themselves. The present meta-analysis has implications for conceptualizing cognitive and affective empathy appropriately, and developing appropriate measures to assess empathy in the Autism population.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data Availability
All datasets analyzed for this study are included in the manuscript and any additional data can be made available from the corresponding author, Mehreen Fatima (mehreen.f28@gmail.com), upon request.
References
Adler, N., Dvash, J., & Shamay-Tsoory, S. G. (2015). Empathic embarrassment accuracy in autism spectrum disorder. Autism Research, 8(3), 241–249. https://doi.org/10.1002/aur.1439
Althaus, M., Groen, Y., Wijers, A. A., Noltes, H., Tucha, O., & Hoekstra, P. J. (2015). Oxytocin enhances orienting to social information in a selective group of high functioning male adults with autism spectrum disorder. Neuropsychologia, 79(Pt A), 53–69. https://doi.org/10.1016/j.neuropsychologia.2015.10.025
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Atkins, D., Uskul, A. K., & Cooper, N. R. (2016). Culture shapes empathic responses to physical and social pain. Emotion, 16(5), 587–601. https://doi.org/10.1037/emo0000162
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., Hill, J., Raste, Y., & Plumb, I. (2001). The “Reading the Mind in the Eyes” test revised version: A study with normal adults, and adults with Asperger syndrome or high-functioning autism. Journal of Child Psychology and Psychiatry, 42(2), 241–251. https://doi.org/10.1111/1469-7610.00715
Begg, C. B., & Mazumdar, M. (1994). Operating characteristics of a rank correlation test for publication bias. Biometrics, 50(4), 1088–1101. https://doi.org/10.2307/2533446
Bellebaum, C., Brodmann, K., & Thoma, P. (2014). Active and observational reward learning in adults with autism spectrum disorder: Relationship with empathy in an atypical sample. Cognitive Neuropsychiatry, 19(3), 205–225. https://doi.org/10.1080/13546805.2013.823860
Blair, R. J. (2005). Responding to the emotions of others: Dissociating forms of empathy through the study of typical and psychiatric populations. Consciousness and Cognition, 14, 698–718.
Bollen, M. (2023). A reflective guide on the meaning of empathy in autism research. Methods in Psychology, 8. https://doi.org/10.1016/j.metip.2022.100109
Bons, D., van den Broek, E., Scheepers, F., Herpers, P., Rommelse, N., & Buitelaar, J. K. (2013). Motor, emotional, and cognitive empathy in children and adolescents with autism spectrum disorder and conduct disorder. Journal of Abnormal Child Psychology, 41(3), 425–443. https://doi.org/10.1007/s10802-012-9689-5
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2009). Introduction to meta-analysis. Wiley.
Borenstein, M., Hedges, L. V., Higgins, J. P., & Rothstein, H. R. (2010). A basic introduction to fixed-effect and random-effects models for meta-analysis. Research Synthesis Methods, 1(2), 97–111. https://doi.org/10.1002/jrsm.12
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2011). Comprehensive meta-analysis (Version 2). Biostat.
Bos, J., & Stokes, M. A. (2018). Cognitive empathy moderates the relationship between affective empathy and wellbeing in adolescents with autism spectrum disorder. European Journal of Developmental Psychology. https://doi.org/10.1080/17405629.2018.1444987
Brewer, R., Biotti, F., Catmur, C., Press, C., Happé, F., Cook, R., & Bird, G. (2016). Can neurotypical individuals read autistic facial expressions? Atypical production of emotional facial expressions in autism spectrum disorders. Autism Research, 9(2), 262–271. https://doi.org/10.1002/2Faur.1508
Card, N. A. (2012). Applied meta-analysis for social science research. Guilford Press.
Cassels, T. G., Chan, S., & Chung, W. (2010). The role of culture in affective empathy: Cultural and bicultural differences. Journal of Cognition and Culture, 10(3–4), 309–326. https://doi.org/10.1163/156853710X531203
Chapple, M., Davis, P., Billington, J., Williams, S., Corcoran, R. (2022). Challenging empathic deficit models of autism through responses to serious literature. Frontiers in Psychology, 13. Article 828603. https://doi.org/10.3389/fpsyg.2022.828603
Chopik, W. J., O’Brien, E., & Konrath, S. H. (2016). Differences in empathic concern and perspective taking across 63 countries. Journal of Cross-Cultural Psychology, 48(1), 23–38. https://doi.org/10.1177/0022022116673910
Chown, N. (2014). More on the ontological status of autism and double empathy. Disability & Society, 29, 1672–1676. https://doi.org/10.1080/09687599.2014.949625
Christov-Moore, L., Simpson, E. A., Coudé, G., Grigaityte, K., Iacoboni, M., & Ferrari, P. F. (2014). Empathy: Gender effects in brain and behavior. Neuroscience & Biobehavioral Reviews, 46(Pt 4), 604–627. https://doi.org/10.1016/j.neubiorev.2014.09.001
Chung, S., Son, J. W., Lee, S., Ghim, H. R., Lee, S. I., Shin, C. J., Kim, S., Ju, G., Choi, S. C., Kim, Y. Y., & Koo, Y. J. (2016). Neural correlates of cognitive and emotional empathy in patients with autism spectrum disorder. Journal of the Korean Academy of Child and Adolescent Psychiatry, 27, 196–206. https://doi.org/10.5765/jkacap.2016.27.3.196
Cicardo, J. (2015). Cognitive and Affective Empathy in Children with Autism Spectrum Disorders (Unpublished Master’s thesis). Baylor University, Texas.
Corbera, S., Wexler, B. E., Bell, M. D., Pearlson, G., Mayer, S., Pittman, B., Belamkar, V., & Assaf, M. (2021). Predictors of social functioning and quality of life in schizophrenia and autism spectrum disorder. Psychiatry Research, 303, 114087. https://doi.org/10.1016/j.psychres.2021.114087
Dadds, M. R., Hunter, K., Hawes, D. J., Frost, A. D., Vassallo, S., Bunn, P., Merz, S., & Masry, Y. E. (2008). A measure of cognitive and affective empathy in children using parent ratings. Child Psychiatry and Human Development, 39(2), 111–122. https://doi.org/10.1007/s10578-007-0075-4
Davis, M. H. (1980). A multidimensional approach to individual differences in empathy. JSAS Catalog of Selected Documents in Psychology, 10, 85.
Davis, M. H. (1983). Measuring individual differences in empathy: Evidence for a multidimensional approach. Journal of Personality and Social Psychology, 44(1), 113–126.
De Coster, L., Wiersema, J. R., Deschrijver, E., & Brass, M. (2018). The effect of being imitated on empathy for pain in adults with high-functioning autism: Disturbed self-other distinction leads to altered empathic responding. Autism, 22(6), 712–727. https://doi.org/10.1177/1362361317701268
Decety, J. (2011). Dissecting the neural mechanisms mediating empathy. Emotion Review, 3(1), 92–108. https://doi.org/10.1177/1754073910374662
Decety, J., & Cowell, J. M. (2015). Empathy, justice, and moral behavior. AJOB Neuroscience, 6(3), 3–14. https://doi.org/10.1080/21507740.2015.1047055
Decety, J., Bartal, I. B., Uzefovsky, F., & Knafo-Noam, A. (2016). Empathy as a driver of prosocial behaviour: Highly conserved neurobehavioural mechanisms across species. Philosophical Transactions of the Royal Society B: Biological Sciences, 371(1686), 20150077. https://doi.org/10.1098/rstb.2015.0077
DeDe, G., Caplan, D., Kemtes, K., & Waters, G. (2004). The Relationship between age, verbal working memory, and language comprehension. Psychology and Aging, 19(4), 601–616. https://doi.org/10.1037/0882-7974.19.4.601
Deschamps, P. K. H., Been, M., & Matthys, W. (2014). Empathy and empathy induced prosocial behavior in 6- and 7-Year-Olds with autism spectrum disorder. Journal of Autism and Developmental Disorders, 44(7). https://doi.org/10.1007/s10803-014-2048-3
D’Mello, A. M., Frosch, I. R., Li, C. E., Cardinaux, A. L., & Gabrieli, J. D. E. (2022). Exclusion of females in autism research: Empirical evidence for a “leaky” recruitment-to-research pipeline. Autism Research, 15(10), 1929–1940.
Duan, C., Wei, M., & Wang, L. (2008). The role of individualism-collectivism in empathy: An exploratory study. Asian Journal of Counselling, 15(1), 57–81.
Dvash, J., & Shamay-Tsoory, S. G. (2014). Theory of mind and empathy as multidimensional constructs: Neurological foundations. Topics in Language Disorders, 34(4), 282–295. https://doi.org/10.1097/TLD.0000000000000040
Dwan, K., Gamble, C., Williamson, P. R., & Kirkham, J. J. (2013). Systematic review of the empirical evidence of study publication bias and outcome reporting bias - an updated review. PLoS One, 8(7), e66844. https://doi.org/10.1371/journal.pone.0066844
Dyussenbayev, A. (2017). Age periods of human life. Advances in Social Sciences Research Journal, 4(6). https://doi.org/10.14738/assrj.46.2924
Dziobek, I., Rogers, K., Fleck, S., Bahnemann, M., Heekeren, H. R., Wolf, O. T., & Convit, A. (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. https://doi.org/10.1007/s10803-007-0486-x
Dziobek, I., Fleck, S., Kalbe, E. Rogers, K., Hassenstab, J., Brand, M., Kessler, J., Woike, J. K., Wolf, O. T., Convit, A. (2006). Introducing MASC: A Movie for the Assessment of Social Cognition. Journal of Autism and Developmental Disorders, 36, 623–636. https://doi.org/10.1007/s10803-006-0107-0
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997). Bias in meta-analysis detected by a simple graphical test. British Medical Journal, 315(7109), 629–634. https://doi.org/10.1136/bmj.315.7109.629
Erthal, J. A. (2015). Empathy as a Predictor of Co-morbid Psychopathology, Executive Functioning, and Social Communication in Adolescents and Adults with Autism Spectrum Disorder (Unpublished master’s thesis). The George Washington University, US.
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. https://doi.org/10.1093/scan/nst101
Fletcher-Watson, S., & Bird, G. (2020). Autism and empathy: What are the real links? Autism, 24(1), 3–6. https://doi.org/10.1177/1362361319883506
Frith, C. (2009). Role of facial expressions in social interactions. Philosophical Transactions of the Royal Society b Biological Sciences, 364(1535), 3453–3458. https://doi.org/10.1098/rstb.2009.0142
Gernsbacher, M.A., Morson, E.M., & Grace, E.J. (2016). Language and Speech in Autism. Annual Review of Linguistics, 2, 413–425. https://doi.org/10.1146/annurev-linguist-030514-124824
Golson, M. E., Ficklin, E., Haverkamp, C. R., McClain, M. B., & Harris, B. (2022). Cultural differences in social communication and interaction: A gap in autism research. Autism Research, 15(2), 208–214.
Gonzalez-Liencres, C., Shamay-Tsoory, S. G., & Brüne, M. (2013). Towards a neuroscience of empathy: Ontogeny, phylogeny, brain mechanisms, context and psychopathology. Neuroscience & Biobehavioral Reviews, 37(8), 1537–1548. https://doi.org/10.1016/j.neubiorev.2013.05.001
Grühn, D., Rebucal, K., Diehl, M., Lumley, M., & Labouvie-Vief, G. (2008). Empathy across the adult lifespan: Longitudinal and experience-sampling findings. Emotion, 8(6), 753–765. https://doi.org/10.1037/a0014123
Hadjikhani, N., Zürcher, N. R., Rogier, O., Hippolyte, L., Lemonnier, E., Ruest, T., Ward, N., Lassalle, A., Gillberg, N., Billstedt, E., Helles, A., Gillberg, C., Solomon, P., Prkachin, K. M., & Gillberg, C. (2014). Emotional contagion for pain is intact in autism spectrum disorders. Translational Psychiatry, 4(1), e343. https://doi.org/10.1038/tp.2013.113
Harrison, J. L., Brownlow, C. L., Ireland, M. J., & Piovesana, A. M. (2022). Empathy measurement in autistic and nonautistic adults: A COSMIN systematic literature review. Assessment, 29(2), 332–350.
Heasman, B., Gillespie, A. (2020). Perspective-taking. In The Palgrave Encyclopedia of the Possible. Palgrave Macmillan. https://doi.org/10.1007/978-3-319-98390-5_36-1
Hedges, L. V. (1981). Distribution theory for glass’s estimator of effect size and related estimators. Journal of Educational Statistics, 6(2), 107–128. https://doi.org/10.3102/10769986006002107
Hedges, S. H., Kirby, A. V., Sreckovic, M. A., Kucharczyk, S., Hume, K., & Pace, S. (2014). “Falling through the Cracks”: Challenges for high school students with autism spectrum disorder. The High School Journal, 98(1), 64–82. https://doi.org/10.1353/hsj.2014.0014
Hirvelä, S., & Helkama, K. (2011). Empathy, values, morality and Asperger’s syndrome. Scandinavian Journal of Psychology, 52(6), 560–572. https://doi.org/10.1111/j.1467-9450.2011.00913.x
Hofmann, S. G., & Doan, S. N. (2018). The social foundations of emotion: Developmental, cultural, and clinical dimensions. American Psychological Association. https://doi.org/10.1037/0000098-000
Huedo-Medina, T. B., Sánchez-Meca, J., Marín-Martínez, F., & Botella, J. (2006). Assessing heterogeneity in meta-analysis: Q statistic or I2 index? Psychological Methods, 11(2), 193–206. https://doi.org/10.1037/1082-989x.11.2.193
Icht, M., Zukerman, G., Ben-Itzchak, E., & Ben-David, B. M. (2021). Keep it simple: Identification of basic versus complex emotions in spoken language in individuals with autism spectrum disorder without intellectual disability: A meta-analysis study. Autism Research, 14, 1948–1964. https://doi.org/10.1002/aur.2551
Ickes, W. (1997). Empathic accuracy. Guildford Press.
Imai, M., Kanero, J., & Masuda, T. (2016). The relation between language, culture, and thought. Current Opinion in Psychology, 8, 70–77. https://doi.org/10.1016/j.copsyc.2015.10.011
Isaksson, J., Van’t Westeinde, A., Cauvet, É., Kuja-Halkola, R., Lundin, K., Neufeld, J., Willfors, C., Bölte, S. (2019). Social Cognition in Autism and Other Neurodevelopmental Disorders: A Co-twin Control Study. Journal of Autism and Developmental Disorders, 49, 2838–2848. https://doi.org/10.1007/s10803-019-04001-4.
Izuma, K., Matsumoto, K., Camerer, C. F., & Adolphs, R. (2011). Insensitivity to social reputation in autism. Proceedings of the National Academy of Sciences of the United States of America, 108(42), 17302–17307. https://doi.org/10.1073/pnas.1107038108
Keating, C. T., & Cook, J. L. (2020). Facial expression production and recognition in autism spectrum disorders: A shifting landscape. Child and Adolescent Psychiatric Clinics of North America, 29(3), 557–571. https://doi.org/10.1016/j.chc.2020.02.006
Khanjani, Z., Jeddi, E. M., Hekmati, I., Khalilzade, S., Etemadi Nia, M., Andalib, M., & Ashrafian, P. (2015). Comparison of cognitive empathy, emotional empathy, and social functioning in different age groups. Australian Psychologist, 50(1), 80–85. https://doi.org/10.1111/ap.12099
Lim, N. (2016). Cultural differences in emotion: Differences in emotional arousal level between the East and the West. Integrative Medicine Research, 5(2), 105–109.
Lipsey, M. W. (2003). Those confounded moderators in meta-analysis: Good, bad and ugly. Annals of the American Academy of Political and Social Science, 587, 69–81. https://doi.org/10.1177/0002716202250791
Littell, J. H., Corcoran, J., & Pillai, V. (2008). Systematic reviews and meta-analysis. Oxford University Press.
Lombardo, M. V., Barnes, J. L., Wheelwright, S. J., & Baron-Cohen, S. (2007). Self-referential cognition and empathy in autism. PLoS ONE, 2(9), e883. https://doi.org/10.1371/journal.pone.0000883
Lovett, B. J., & Sheffield, R. A. (2007). Affective empathy deficits in aggressive children and adolescents: A critical review. Clinical Psychology Review, 27(1), 1–13. https://doi.org/10.1016/j.cpr.2006.03.003
Luchini, C., Veronese, N., Nottegar, A., Shin, J. I., Gentile, G., Granziol, U., Soysal, P., Alexinschi, O., Smith, L., & Solmi, M. (2021). Assessing the quality of studies in meta-research: Review/guidelines on the most important quality assessment tools. Pharmaceutical Statistics, 20(1), 185–195. https://doi.org/10.1002/pst.2068
Mathersul, D., McDonald, S., & Rushby, J. A. (2013). Understanding advanced theory of mind and empathy in high-functioning adults with autism spectrum disorder. Journal of Clinical and Experimental Neuropsychology, 35(6), 655–668. https://doi.org/10.1080/13803395.2013.809700
Mazza, M., Pino, M. C., Mariano, M., Tempesta, D., Ferrara, M., De Berardis, D., Masedu, F., & Valenti, M. (2014). Affective and cognitive empathy in adolescents with autism spectrum disorder. Frontiers in Human Neuroscience, 7(8), 791. https://doi.org/10.3389/fnhum.2014.00791
McIntosh, D. N., Reichmann-Decker, A., Winkielman, P., & Wilbarger, J. L. (2006). When the social mirror breaks: Deficits in automatic, but not voluntary, mimicry of emotional facial expressions in autism. Developmental Science, 9(3), 295–302.
McKenzie, K., Russell, A., Golm, D., & Fairchild, G. (2022). Empathic accuracy and cognitive and affective empathy in young adults with and without autism spectrum disorder. Journal of Autism and Developmental Disorders, 52(5), 2004–2018. https://doi.org/10.1007/s10803-021-05093-7
Mehrabian, A., & Epstein, N. (1972). A measure of emotional empathy. Journal of Personality, 40(4), 525–543.
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. https://doi.org/10.1016/j.biopsych.2008.08.006
Milton, D. E. M. (2012). On the ontological status of autism: The ‘double empathy problem’. Disability & Society, 27(6), 883–887. https://doi.org/10.1080/09687599.2012.710008
Mitchell, P., Sheppard, E., & Cassidy, S. (2021). Autism and the double empathy problem: Implications for development and mental health. British Journal of Developmental Psychology, 39, 1–18.
Mul, C., Stagg, S. D., Herbelin, B., & Aspell, J. E. (2018). The feeling of me feeling for you: Interoception, alexithymia and empathy in autism. Journal of Autism and Developmental Disorders, 48(9), 2953–2967. https://doi.org/10.1007/s10803-018-3564-3
Neumann, D. L., Chan, R. C. K., Boyle, G. J., Wang, Yi., & Westbury, H. R. (2015). Measures of empathy: Self-report, behavioral, and neuroscientific approaches. In G. J. Boyle, D. H. Saklofske, & G. Matthews (Eds.), Measures of personality and social psychological constructs (pp. 257–289). Elsevier Academic Press. https://doi.org/10.1016/B978-0-12-386915-9.00010-3
Nummenmaa, L., Hirvonen, J., Parkkola, R., & Hietanen, J. K. (2008). Is emotional contagion special? An fMRI study on neural systems for affective and cognitive empathy. NeuroImage, 43(3), 571–580. https://doi.org/10.1016/j.neuroimage.2008.08.014
Oberman, L. M., Winkielman, P., & Ramachandran, V. S. (2009). Slow echo: Facial EMG evidence for the delay of spontaneous, but not voluntary, emotional mimicry in children with autism spectrum disorders. Developmental Science, 12(4), 510–520. https://doi.org/10.1111/j.1467-7687.2008.00796.x
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., et al. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Pepper, K. L., Demetriou, E. A., Park, S. H., Boulton, K. A., Hickie, I. B., Thomas, E. E., & Guastella, A. J. (2019). Self-reported empathy in adults with autism, early psychosis, and social anxiety disorder. Psychiatry Research, 281, 112604. https://doi.org/10.1016/j.psychres.2019.112604
Pouw, L. B., Rieffe, C., Oosterveld, P., Huskens, B., & Stockmann, L. (2013). Reactive/proactive aggression and affective/cognitive empathy in children with ASD. Research in Developmental Disabilities, 34(4), 1256–1266. https://doi.org/10.1016/j.ridd.2012.12.022
Queirós, A., Fernandes, E., Reniers, R., Sampaio, A., Coutinho, J., & Seara-Cardoso, A. (2018). Psychometric properties of the questionnaire of cognitive and affective empathy in a Portuguese sample. PLoS ONE, 13(6), e0197755. https://doi.org/10.1371/journal.pone.0197755
Reniers, R. L. E. P., Corcoran, R., Drake, R., Shryane, N. M., & Völlm, B. A. (2011). The QCAE: A questionnaire of cognitive and affective empathy. Journal of Personality Assessment, 93(1), 84–95. https://doi.org/10.1080/00223891.2010.528484
Rieffe, C., O’Connor, R., Bülow, A., Willems, D., Hull, L., Sedgewick, F., Stockmann, L., & Blijd-Hoogewys, E. (2021). Quantity and quality of empathic responding by autistic and non-autistic adolescent girls and boys. Autism, 25(1), 199–209. https://doi.org/10.1177/1362361320956422
Rigby, S. N., Stoesz, B. M., & Jakobson, L. S. (2018). Empathy and face processing in adults with and without autism spectrum disorder. Autism Research, 11, 942–955. https://doi.org/10.1002/aur.1948
Rogers, K., Dziobek, I., Hassenstab, J., Wolf, O. T., & Convit, A. (2007). Who cares? Revisiting empathy in Asperger syndrome. Journal of Autism and Developmental Disorders, 37(4), 709–715. https://doi.org/10.1007/s10803-006-0197-8
Rosenthal, R. (1979). The file drawer problem and tolerance for null results. Psychological Bulletin, 86, 638–641.
Roza, S. A., & Guimarães, S. R. K. (2021). Affective and Cognitive Empathy on the Autism Spectrum Disorder (ASD): An integrative literature review. Revista Brasileira de Educação Especial, 27. https://doi.org/10.1590/1980-54702021v27e0028
Rueda, P., Fernández-Berrocal, P., & Schonert-Reichl, K. A. (2014). Perspective-taking and empathic concern as mediators for happiness and positive affect in adolescents with and without Asperger syndrome. Journal of Developmental and Physical Disabilities, 26, 717–735. https://doi.org/10.1007/s10882-014-9391-3
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. https://doi.org/10.1080/17405629.2014.950221
Santiesteban, I., Gibbard, C., Drucks, H., Clayton, N., Banissy, M. J., & Bird, G. (2021). Individuals with autism share others’ emotions: Evidence from the Continuous Affective Rating and Empathic Responses (CARER) Task. Journal of Autism and Developmental Disorders, 51, 391–404. https://doi.org/10.1007/s10803-020-04535-y
Schulte-Rüther, M., Greimel, E., Markowitsch, H. J., Kamp-Becker, I., Remschmidt, H., Fink, G. R., & Piefke, M. (2011). Dysfunctions in brain networks supporting empathy: An fMRI study in adults with autism spectrum disorders. Social Neuroscience, 6(1), 1–21. https://doi.org/10.1080/17470911003708032
Schwenck, C., Mergenthaler, J., Keller, K., Zech, J., Salehi, S., Taurines, R., Romanos, M., Schecklmann, M., Schneider, W., Warnke, A., & Freitag, C. M. (2012). Empathy in children with autism and conduct disorder: Group-specific profiles and developmental aspects. Journal of Child Psychology and Psychiatry, 53(6), 651–659.
Shalev, I., Warrier, V., Greenberg, D., Smith, P., Allison, C., Baron-Cohen, S., Alal, E., & Florina, U. (2022). Reexamining empathy in autism: Empathic disequilibrium as a novel predictor of autism diagnosis and autistic traits. Autism Research. https://doi.org/10.1002/aur.2794
Shamay-Tsoory, S. G. (2011). The neural bases for empathy. The Neuro-Scientist, 17, 18–24. https://doi.org/10.1177/1073858410379268
Shamay-Tsoory, S. G., Tomer, R., Yaniv, S., & Aharon-Peretz, J. (2002). Empathy deficits in Asperger syndrome: A cognitive profile. Neurocase, 8(3), 245–252.
Shirayama, Y., Matsumoto, K., Hamatani, S., Muneoka, K., Okada, A., & Sato, K. (2022). Associations among autistic traits, cognitive and affective empathy, and personality traits in adults with autism spectrum disorder and no intellectual disability. Scientific Reports, 12(1), 3125. https://doi.org/10.1038/s41598-022-07101-x
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. https://doi.org/10.1080/17470910701577020
Singer, T. (2006). The neuronal basis and ontogeny of empathy and mind reading: Review of literature and implications for future research. Neuroscience & Biobehavioral Reviews, 30(6), 855–863. https://doi.org/10.1016/j.neubiorev.2006.06.011
Sonmez, D. (2020). Examining The Relationship Between Cognitive Empathy, Affective Empathy and Social Anxiety In Autism Spectrum Disorder (Unpublished Master’s Thesis). Ibn Haldun University, Turkey.
Soto, J. A., & Levenson, R. W. (2009). Emotion recognition across cultures: The influence of ethnicity on empathic accuracy and physiological linkage. Emotion, 9, 874–884. https://doi.org/10.1037/a0017399
Suurmond, R., van Rhee, H., & Hak, T. (2017). Introduction, comparison and validation of Meta-Essentials: A free and simple tool for meta-analysis. Research Synthesis Methods, 8(4), 537–553. https://doi.org/10.1002/jrsm.1260
Tahazadeh, S., Barahmand, U., Yaghooti, F., & Nazari, M. A. (2020). Mind reading in films task to assess social cognitive deficits in autism spectrum conditions. Journal of Evidence-Based Psychotherapies, 20(2), 79–100. https://doi.org/10.24193/jebp.2020.2.13
Thaler, H., Skewes, J. C., Gebauer, L., Christensen, P., Prkachin, K. M., & Elmholdt, E. J. (2018). Typical pain experience but underestimation of others’ pain: Emotion perception in self and others in autism spectrum disorder. Autism, 22(6), 751–762. https://doi.org/10.1177/1362361317701269
Tone, E. B., & Tully, E. C. (2014). Empathy as a “risky strength”: A multilevel examination of empathy and risk for internalizing disorders. Development and Psychopathology, 26(4pt2), 1547–1565.
Trimmer, E., McDonald, S., & Rushby, J. A. (2017). Not knowing what I feel: Emotional empathy in autism spectrum disorders. Autism, 21(4), 450–457. https://doi.org/10.1177/1362361316648520
Trommsdorff, G., Friedlmeier, W., & Mayer, B. (2007). Sympathy, distress, and prosocial behavior of preschool children in four countries. International Journal of Behavioral Development, 31(3), 284–293. https://doi.org/10.1177/0165025407076441
van Berkhout, E. T., & Malouff, J. M. (2016). The efficacy of empathy training: A meta-analysis of randomized controlled trials. Journal of Counseling Psychology, 63(1), 32–41. https://doi.org/10.1037/cou0000093
van der Zee, E., & Derksen, J. J. L. (2020). Reconsidering empathy deficits in children and adolescents with autism. Journal of Developmental and Physical Disabilities, 32, 23–39. https://doi.org/10.1007/s10882-019-09669-1
Van Rhee, H.J., Suurmond, R., & Hak, T. (2015). User manual for Meta-Essentials: Workbooks for meta-analysis (Version 1.2) Rotterdam, The Netherlands: Erasmus Research Institute of Management. Retrieved from: www.erim.eur.nl/research-support/meta-essentials. Accessed 8 May 2022
Vilas, S. P., Reniers, R. L. E. P., & Ludlow, A. K. (2021). An investigation of behavioural and self-reported cognitive empathy deficits in adolescents with autism spectrum disorders and adolescents with behavioural difficulties. Frontiers in Psychiatry, 12, 717877. https://doi.org/10.3389/fpsyt.2021.717877
Volkmar, F. R., Reichow, B., Westphal, A., & Mandell, D. S. (2014). Autism and the autism spectrum: Diagnostic concepts. In F. R. Volkmar, S. J. Rogers, R. Paul, & K. A. Pelphrey (Eds.), Handbook of autism and pervasive developmental disorders (4th ed.). Wiley.
Volkmar, F., Jackson, S., & Hart, L. (2017). Transition issues and challenges for youth with autism spectrum disorders. Pediatric Annals, 46(6), e219–e223.
Walter, H. (2012). Social cognitive neuroscience of empathy: Concepts, circuits, and genes. Emotion Review, 4(1), 9–17. https://doi.org/10.1177/1754073911421379
Werling, D. M., & Geschwind, D. H. (2013). Sex differences in autism spectrum disorders. Current Opinion in Neurology, 26(2), 146–153. https://doi.org/10.1097/WCO.0b013e32835ee548
Westbury, H. R., & Neumann, D. L. (2008). Empathy-related responses to moving film stimuli depicting human and non-human animal targets in negative circumstances. Biological Psychology, 78(1), 66–74. https://doi.org/10.1016/j.biopsycho.2007.12.009
Wieck, C., & Kunzmann, U. (2015). Age differences in empathy: Multidirectional and context-dependent. Psychology and Aging, 30(2), 407–419. https://doi.org/10.1037/a0039001
Yarar, E. Z., Howlin, P., Charlton, R., & Happé, F. (2021). Age-related effects on social cognition in adults with autism spectrum disorder: A possible protective effect on theory of mind. Autism Research, 14(5), 911–920. https://doi.org/10.1002/aur.2410
Zampella, C. J., Csumitta, K. D., Simon, E., & Bennetto, L. (2020). Interactional synchrony and its association with social and communication ability in children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders, 50(9), 3195–3206. https://doi.org/10.1007/s10803-020-04412-8
Ziermans, T., de Bruijn, Y., Dijkhuis, R., Staal, W., & Swaab, H. (2019). Impairments in cognitive empathy and alexithymia occur independently of executive functioning in college students with autism. Autism, 23(6), 1519–1530. https://doi.org/10.1177/1362361318817716
Acknowledgements
We are thankful to Radhika Khurana, PhD Scholar, University of Delhi for being the third reviewer for the present meta-analysis.
Author information
Authors and Affiliations
Contributions
The literature search and data-analysis for the present meta-analysis was conducted by Mehreen Fatima under the supervision of Dr. Nandita Babu. The draft of the meta-analysis was prepared by Mehreen Fatima and was critically revised by Dr. Nandita Babu.
Corresponding author
Ethics declarations
Research Involving Human Participants and/or Animals
Not applicable as it is a systematic review and meta-analysis research.
Informed Consent
Not applicable as it is a systematic review and meta-analysis research.
Financial Interests
The authors have no relevant financial or non-financial interests to disclose.
Competing Interest
The authors declare no competing interests.
Disclosure of Potential Conflicts of Interest
The authors declare no potential conflict of interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Appendices
Appendix 1
Coding Sheet
Appendix 2
Objective Coding Document for Study Quality Standards
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Fatima, M., Babu, N. Cognitive and Affective Empathy in Autism Spectrum Disorders: A Meta-analysis. Rev J Autism Dev Disord (2023). https://doi.org/10.1007/s40489-023-00364-8
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s40489-023-00364-8