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Empathic Accuracy and Cognitive and Affective Empathy in Young Adults with and Without Autism Spectrum Disorder

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Empathic Accuracy and Cognitive and Affective Empathy in Young Adults with and Without Autism Spectrum Disorder Journal of Autism and Developmental Disorders https://doi.org/10.1007/s10803-021-05093-7 ORIGINAL PAPER Empathic Accuracy and Cognitive and Afective Empathy in Young Adults With and Without Autism Spectrum Disorder K. McKenzie1 · A. Russell1 · D. Golm2 · G. Fairchild3 Accepted: 14 May 2021 © The Author(s) 2021 Abstract This study investigated whether young adults with ASD (n = 29) had impairments in Cognitive Empathy (CE), Afective Empathy (AE) or Empathic Accuracy (EA; the ability to track changes in others’ thoughts and feelings) compared to typically- developing individuals (n = 31) using the Empathic Accuracy Task (EAT), which involves watching narrators recollecting emotionally-charged autobiographical events. Participants provided continuous ratings of the narrators’ emotional intensity (indexing EA), labelled the emotions displayed (CE) and reported whether they shared the depicted emotions (AE). The ASD group showed defcits in EA for anger but did not difer from typically-developing participants in CE or AE on the EAT. The ASD group also reported lower CE (Perspective Taking) and AE (Empathic Concern) on the Interpersonal Reactivity Index, a self-report questionnaire. Keywords Autism · ASD · Empathy · Afective empathy · Empathic accuracy · Alexithymia Introduction and “trait empathy”, a personality tendency which is rela- tively stable over time (Song et al., 2019). Empathy can be defned as the ability to share others’ feel- A wide range of methods have been used to measure CE ings or ‘put yourself in their shoes’ (Singer & Lamm, 2009). and AE within the literature, with self-report questionnaire The literature suggests that empathy is a multi-dimensional measures being most commonly used. One widely-used concept (Davis, 1980, 1983; Decety, 2015), which includes questionnaire is the Interpersonal Reactivity Index (IRI) cognitive empathy (CE), defned as the ability to under- (Davis, 1980), a trait measure of empathy which includes stand others’ feelings, beliefs and intentions (Baron-Cohen two scales thought to measure AE (‘empathic concern’ and & Wheelwright, 2004; Bos & Stokes, 2019), and afective ‘personal distress’), and two which are considered to repre- empathy (AE), which is characterised by “an emotional sent CE (‘fantasy’ and ‘perspective-taking’) (Davis, 1983). response in an individual that stems from and parallels the However, self-report measures of empathy are subject to sev- emotional state of another individual” (Smith, 2009, p. 490). eral limitations such as social desirability biases, as being Empathy can further be divided into “state empathy”, a psy- empathetic is typically seen as a positive quality. People chological state induced by a specifc stimulus or situation, may also lack insight into their empathic abilities, believing themselves to be more empathic than they really are. State empathy is usually measured via experimental tasks, such as the Multi-Faceted Empathy Test (MET; Dziobek * K. McKenzie et al., 2008). The MET requires participants to infer the [email protected] mental states of people in photographs (measuring CE) and 1 Centre for Applied Autism Research, Department to report their emotional reactions to the pictures (measuring of Psychology, University of Bath, Claverton Down, AE). Spontaneous mimicry of another’s emotions is another Bath, Somerset BA2 7AY, UK index of state empathy. For instance, Drimalla et al. (2019) 2 Centre for Innovation in Mental Health, School found that one’s tendency to engage in facial mimicry was of Psychology, University of Southampton, positively related to AE and CE scores on the MET. Some Southampton SO17 1BJ, UK studies have measured empathy via physiological (e.g., heart 3 Department of Psychology, University of Bath, rate and skin conductance) responses to emotional stimuli, Bath, Somerset BA2 7AY, UK Vol.:(0123456789)1 3 Journal of Autism and Developmental Disorders as these measures are thought to refect AE (Levenson & predictable ways. However, the theory also indicates that Ruef, 1992; Trimmer et al., 2016; Kaplan et al., 1960). people with ASD struggle with empathy because it is not Most existing measures of empathy rely on self-reports of ‘truth-oriented’; there are no laws which can be applied to dispositional tendencies or assess subjective or physiological understand emotions in others, as diferent people express responses to static images (e.g., of sad faces); consequently, emotions in different ways. Using self-report methods, they fail to assess the ability to monitor rapidly changing Greenberg et al. (2018) measured the “brain types” (classi- social cues, a skill that is very important in navigating real- fying them as either empathising or systemising) of over half life social interactions. The ability to track another person’s a million people, including individuals with a diagnosis of (the ‘target’s’) transient thoughts and feelings is known as ASD. They found that, when compared to TD participants, Empathic Accuracy (EA) (Zaki & Ochsner, 2011; Zaki et al., the brain types of people with a diagnosis of ASD were bal- 2008). Existing measures of EA involve watching vide- anced in favour of ‘systemising’ at the expense of ‘empathis- otaped social interactions and assessing a person’s ability ing’ to either a strong or very strong degree. to infer the thoughts/feelings of the target (Ickes, 2001), or The Empathy Imbalance Hypothesis (Smith, 2009) viewing narrators talking about emotionally-charged experi- provides a more nuanced view on empathy by suggesting ences and judging the intensity and valence of the target’s that people with a diagnosis of ASD experience “empathic emotions (Levenson & Ruef, 1992; Zaki et al., 2009). EA overarousal”, leading them to experience increased distress has received less attention in the literature on empathy in in response to others’ emotions compared with TD individu- ASD compared to CE and AE. als. Consequently, Smith (2009) argues that people with a diagnosis of ASD have heightened AE in comparison to TD Empathy in ASD individuals, despite showing impairments in CE. An abun- dance of research has provided evidence for impaired CE ASD is characterised by qualitative diferences in social in ASD (Baron-Cohen et al., 1997; Dziobek et al., 2008; communication/interaction and a pattern of repetitive, Baron-Cohen et al., 1997; Ozonof et al., 1990; Rogers et al., restricted behaviours, interests and activities (American 2007; Zalla et al., 2009), as measured via self-report ques- Psychiatric Association, 2013). People with a diagnosis of tionnaires such as the IRI or experimental tasks such as the ASD1 are commonly thought to have difculties in empathy MET. However, the evidence regarding AE in ASD is mixed, compared with typically-developing (TD) individuals; as with the majority of studies indicating that people with ASD such, ASD has been characterised as an “empathy disorder” have either higher or similar levels of AE compared with (Gillberg, 1992). There are several theories which discuss people without ASD (Dziobek et al., 2008; Murray et al., possible mechanisms underlying empathy defcits in people 2017; Rogers et al., 2007; Song et al., 2019). with ASD. A leading theory of autism suggests that indi- Supporting the Empathy Imbalance Hypothesis, in a viduals with ASD lack Theory of Mind, meaning they fnd meta-analysis of 51 studies, Song et al. (2019) found that it difcult to infer the mental states of others (Baron-Cohen, people with ASD scored higher on IRI Personal Distress, 2000). People with ASD typically perform worse on ‘false- and the AE subscale of the Questionnaire of Cognitive and belief’ tasks which measure Theory of Mind by assessing Afective Empathy (QCAE) (Di Girolamo et al., 2019) com- one’s ability to distinguish between events in reality, versus pared to TD individuals, suggesting higher trait AE. How- how events may be (incorrectly) represented in another per- ever, they found that people with ASD scored lower overall son’s mind (Baron-Cohen et al., 1985). In contrast, the social on the Empathic Concern subscale of the IRI compared to motivation hypothesis (Chevallier et al., 2012) proposes that TD participants. Song et al.’s (2019) fndings also indicated individuals with ASD are less socially motivated than TD that people with ASD performed similarly to TD individuals individuals, which contributes to social impairments such in experimental tasks measuring AE—most commonly the as empathic defcits. Finally, Baron-Cohen’s (2009) ‘Empa- MET. For example, Dziobek et al. (2008) used the MET in thising-Systemising’ theory of ASD suggests that people a sample of adults with ASD and found defcits in CE, but with ASD have a preference towards tasks which involve not AE, when compared to TD individuals. systemising (e.g., solving maths problems, making lists, fx- More nuanced fndings were reported by Mazza et al. ing bikes, etc.), because systems often change in lawful and (2014), who found that, in comparison to TD participants, individuals with ASD showed defcits in AE (measured by the MET) specifcally for negative emotions (such as sad- 1 A large scale study by Kenny et al. (2016) indicated that there is ness, anger and disappointment); AE for positive emotions no single preferred term to describe people with a diagnosis of ASD. (such as happiness and positive surprise) was unimpaired Furthermore, there is debate regarding the use of person-frst or iden- in the ASD group. Contrary to this, Jankowski and Pfeifer tity-frst language when describing ASD (Vivanti, 2020). Considering
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