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Motor, Emotional and Cognitive Empathic Abilities in Children with Autism and Conduct Disorder Danielle M.A

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Motor, Emotional and Cognitive Empathic Abilities in Children with Autism and Conduct Disorder Danielle M.A Motor, Emotional and Cognitive Empathic Abilities in Children with Autism and Conduct Disorder Danielle M.A. Bons1,2 Floor E. Scheepers1 [email protected] [email protected] +31 (0)488 – 469 611 Nanda N.J. Rommelse1,2 Jan K. Buitelaar1,2 [email protected] [email protected] +31 (0)24 351 2222 1Karakter child- and adolescent psychiatry 2Department of Psychiatry UMC St. Radboud University Centre Nijmegen, Zetten-Tiel P.O. Box 9101, 6500HB Nijmegen, The P.O. Box 104, 6670AC Zetten, The Netherlands Netherlands ABSTRACT repetitive patterns of behavior, interests and activities. This paper gives an overview of the studies that Children with conduct disorder (CD) show a pattern of investigated motor, emotional and cognitive empathy in behavior violating the basic rights of others and age- juveniles with autism or conduct disorder. Studies that appropriate norms and rules, which may develop in measured response to emotional faces with use of facial antisocial behavior in adulthood. At first sight these EMG, ECG, skin conductance, eye-tracking or emotion disorders appear to have little in common. However, lack of recognition are discussed. In autism facial mimicry and empathy is a core symptom in both ASD and CD. emotion recognition, as well as attention to the eyes, seem to be reduced. In conduct disorder facial mi micry seems to Empathy is assumed to consist out of three components: be impaired as well as recognition of fear and sad facial motor, emotional and cognitive empathy [5]. Motor expressions, and possibly associated with lack of attention empathy refers to unconsciously mirroring the facial to the eyes. Further research is needed to investigate expressions of another, which is suggested to induce shared autonomic emotional empathic response to emotional faces representations of perception and emotional contagion. in both patient groups. Major differences between ASD and Emotional empathy refers to the experience of emotions CD are hypothesized. consistent with and in response to those of others. Cognitive empathy is the ability to rationally understand the emotional Author Keywords state of others. These three aspects of empathy have been Empathy, Autism, Conduct Disorder, facial mimicry, EMG, frequently studied, mostly using facial expressions as heart rate, skin conductance, eye-tracking, emotion stimuli, since facial expressions are essential in social recognition communication and empathy. Our aim was to review the studies that investigated the three components of empathy ACM Classification Keywords in juveniles with ASD or CD and normal intelligence, in J.3 Life and medical sciences: Health, Medical information order to determine the overlap and specificity of empathic systems, J.4 Social and behavioral sciences: Psychology abilities in these disorders. Studies were included that used the 6 universal basic emotions; happy, angry, sad, fear, INTRODUCTION disgust and surprise [11]. In addition, eye-tracking studies Autism spectrum disorders (ASD; including autism and are included, since attention to the eyes may play an Asperger syndrome) are characterized by atypical essential role in facial emotion recognition as well as motor communication, impaired social interaction and restricted and emotional empathy, and possibly explaining impairments in these young patients. ______________________________ MOTOR EMPATHY Motor empathy is usually measured as facial mimicry using Permission to make digital or hard copies of all or part of this work for electromyography (EMG) electrodes to record muscle personal or classroom use is granted without fee provided that copies are activity, on the cheek at the zygomator major muscle not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. For any other use, (smiling muscle) and corrugator supercilii muscle above at please contact the Measuring Behavior secretariat: the inside of the eyes (frowning muscle). EMG amplitude in [email protected]. response to emotional faces is compared to a pre-stimulus Proceedings of Measuring Behavior 2010 (Eindhoven, The Netherlands, August 24-27, 2010) Eds. A.J. Spink, F. Grieco, O.E. Krips, L.W.S. Loijens, L.P.J.J. Noldus, and P.H. Zimmerman 109 baseline level. Normal facial reaction patterns are increased sadness- and anger inducing film fragments from zygomaticus activity during happy faces or positive pictures documentaries with a length of 58 to 158 seconds. No and increased corrugator activity during angry faces or differences were found for happy facial expression or negative images [10]. happiness inducing film clips. Motor empathy seems to be impaired in DBD for negative emotions, although only a Motor Empathy in Autism few children with CD were included in these studies, Recently, two studies measuring motor empathy in autism therefore further research is needed in CD specifically. were conducted with children. Results were inconsistent, as were findings in adults. One study investigated spontaneous EMOTIONAL EMPATHY facial mimicry to emotional faces (happy, angry and fear) Emotional empathy is usually measured as heart rate (HR) without using an emotion recognition task [3]. Children or skin conductance response (SCR) to distressing or with ASD (n=11, age 7-13) did not show congruent rapid threatening pictures as compared to pleasant pictures. facial EMG responses to happy, angry or fearful faces. The Though faces may be included, the stimuli are usually not second study [18], focused on timing of facial mimicry. No emotional facial expressions only. Thus, these stimuli might significant differences were found in emotion recognition provoke an emotional response and induce increased or facial mimicry. However, facial mimicry appeared to be arousal, but not necessarily shared basic emotional delayed in ASD (n=13, age 8-12) across all emotional experiences with others. A better indicator for emotional expressions. This delay of facial mimicry in ASD might empathy would be the autonomic response to emotional explain the inconsistent findings. When EMG response was facial expressions, which is discussed below. measured within the first second after stimulus onset reduced facial mimicry in ASD was found [3]. Whereas Emotional Empathy in Autism measuring facial mimicry up to 2 seconds after stimulus Autonomic response to facial emotional expressions onset showed no significant differences [18]. In addition, specifically, has not been studied yet in ASD. No difference inconsistent results between studies may also be explained was found in SCR to distressing stimuli between juveniles by using an emotion recognition task or measuring with ASD and controls [4]. Further research is needed spontaneous responses. Indeed, it has to be noted that the concerning emotional empathy in ASD, investigating study without a task and automatic facial EMG response autonomic response to emotional facial expressions of other within 1 second did find reduced facial mimicry in ASD people and sharing these emotions, rather than showing [3]. In contrast, results of the other study using an emotion situations where just one’s own emotion is triggered. recognition task and EMG response measured up to 2 seconds after stimulus onset showed no significant Emotional Empathy in Conduct Disorder difference between ASD and control subjects [18]. A reduced basal heart rate, increased heart rate reactivity Therefore, voluntary imitation associated with active and reduced basal SC was found associated with conduct cognitive emotion processing may explain different results. problems and antisocial behavior [14,19]. Four studies Based on these results it seems to be that juveniles with investigated autonomic response in juveniles with CD or ASD are impaired in motor empathy, at the level of DBD to movie scenes. The presence of callous unemotional spontaneous automatic facial mimicry (<1second). If they (CU) traits (e.g., lack of guilt and empathy, callous use of are cognitively processing and naming the emotion in an others) may be determining findings. CD children (n=33, emotion recognition task they may use voluntary imitation age 7-11) with CU traits showed reduced basal HR and HR in order to do so, which is delayed (1<second<2) as response to a scared boy, while no differences were found compared to automatic responses. The impairment in for CD children without CU traits (n=29) [1]. In two other spontaneous automatic facial mimicry may be related to the studies HR response to film clips with sad people in DBD lack of empathy in ASD, since empathy has been shown to was investigated. Reduced HR response in DBD (n=22, age be associated with facial mimicry in healthy individuals 8-12) was shown in one study [9], but no difference was [20]. found in the other study [16]. Using dynamic emotional faces, rather than movie scenes, no difference in HR Motor Empathy in Conduct Disorder response for the DBD (n=22, age 8-12) and control group Up to date there are only two reports of facial mimicry in was found [8]. Effects may be extinguished due to 22 boys (age 8 – 12) with disruptive behavior disorder heterogeneity in the patient groups. DBD might include (DBD, including CD and oppositional defiant disorder, children with CU traits being autonomic hyporesponsive, ODD). In the first report [8], film clips were shown with hence showing reduced HR/SC response and lacking 2600ms dynamic happy or angry expression. Boys with normal emotionality, as well as autonomic hyperresponsive DBD showed significantly reduced mean EMG amplitude children being highly emotional reactive. corrugator response during the dynamic phase of angry faces, as compared to the control group. In addition, they COGNITIVE EMPATHY scored lower on an emotional empathy self-report. Cognitive empathy can be measured with an emotion In the second report [9], again reduced corrugator EMG recognition task, using static or dynamic stimuli of reactivity was found in the DBD boys in response to both emotional faces, or pictures of the eyes. Proceedings of Measuring Behavior 2010 (Eindhoven, The Netherlands, August 24-27, 2010) 110 Eds. A.J. Spink, F. Grieco, O.E.
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