![](/develop/static/imgs/pdf.png)
Individuals with high levels of autistic traits exhibit impaired cognitive but not affective theory of mind and empathy
Bei-lin Le, Yi-hang Huang, Ling-ling Wang, Hui-xin Hu, Xuan Wang, Yi Wang, Ya Wang, Jia Huang, Simon S. Y. Lui, Raymond C. K. Chan
Individuals with high levels of autistic traits exhibit impaired cognitive but not affective theory of mind and empathy
Theory of mind (ToM) and empathy are considered key components of social cognition that are often impaired in individuals with autism spectrum disorders (ASD). However, it remains unclear whether individuals with high levels of autistic traits exhibit similar impairments in these two functions. This study examined the affective and cognitive domains of ToM and empathy in individuals with high levels of autistic traits. We recruited 84 participants with high levels and 78 participants with low levels of autistic traits to complete a set of self-reported checklists and performance-based tasks capturing affective and cognitive components of ToM and empathy. The results showed that participants with high levels of autistic traits exhibited significant impairments in cognitive but not in affective ToM and empathy compared with their counterparts with low levels of autistic traits. We also found that empathy impairments in people with high levels of autistic traits were confounded by alexithymia and depressive traits.
autistic traits / empathy / theory of mind
[1] |
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
CrossRef
Google scholar
|
[2] |
Bagby, R. M., Parker, J. D. A., & Taylor, G. J. (1994). The twenty-item Toronto Alexithymia Scale—I. Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38(1), 23–32.
CrossRef
Google scholar
|
[3] |
Baldimtsi, E., Nicolopoulou, A., & Tsimpli, I. M. (2020). Cognitive and Affective Aspects of Theory of Mind in Greek-Speaking Children with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 51(4), 1142–1156.
CrossRef
Google scholar
|
[4] |
Baron-Cohen, S., Hoekstra, R. A., Knickmeyer, R., & Wheelwright, S. (2006). The autism-spectrum quotient (AQ)—Adolescent version. Journal of Autism and Developmental Disorders, 36(3), 343–350.
CrossRef
Google scholar
|
[5] |
Baron-Cohen, S., Leslie, A. M., & Frith, U. (1985). Does the autistic child have a “theory of mind”? Cognition, 21(1), 37–46.
CrossRef
Google scholar
|
[6] |
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.
CrossRef
Google scholar
|
[7] |
Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., & Plumb, I. (2003). 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.
CrossRef
Google scholar
|
[8] |
Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The Autism-Spectrum Quotient (AQ): Evidence from Asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31(1), 5–17.
CrossRef
Google scholar
|
[9] |
Beaudoin, M., & Beauchamp, M. H. (2020). Social cognition. In R. J. Nelson & M. Luciana (Eds.), Handbook of developmental cognitive neuroscience (3rd ed., pp. 519–536). MIT Press.
|
[10] |
Bird, G., & Cook, R. (2013). Mixed emotions: The contribution of alexithymia to the emotional symptoms of autism. Translational Psychiatry, 3(7), e285.
CrossRef
Google scholar
|
[11] |
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.
CrossRef
Google scholar
|
[12] |
Bohler, T. E., Brown, R. F., & Dunn, S. (2021). Relationship between affective state and empathy in medical and psychology students. Australian Psychologist, 56(4), 311–323.
CrossRef
Google scholar
|
[13] |
Butera, C. D., Harrison, L., Kilroy, E., Jayashankar, A., Shipkova, M., Pruyser, A., & Aziz-Zadeh, L. (2023). Relationships between alexithymia, interoception, and emotional empathy in autism spectrum disorder. Autism, 27(3), 690–703.
CrossRef
Google scholar
|
[14] |
Chen, S., Chiu, H., Xu, B., Ma, Y., Jin, T., Wu, M., & Conwell, Y. (2010). Reliability and validity of the PHQ-9 for screening late-life depression in Chinese primary care. International Journal of Geriatric Psychiatry, 25(11), 1127–1133.
CrossRef
Google scholar
|
[15] |
Constantino, J. N., Davis, S. A., Todd, R. D., Schindler, M. K., Gross, M. M., Brophy, S. L., Metzger, L. M., Shoushtari, C. S., Splinter, R., & Reich, W. (2003). Validation of a brief quantitative measure of autistic traits: Comparison of the social responsiveness scale with the autism diagnostic interview-revised. Journal of Autism and Developmental Disorders, 33(4), 427–433.
CrossRef
Google scholar
|
[16] |
Davis, M. H. (1980). A multidimensional approach to individual differences in empathy. JSAS Catalog of Selected Documents in Psychology, 10(4), 85.
|
[17] |
Decety, J., & Jackson, P. L. (2004). The functional architecture of human empathy. Behavioral and Cognitive Neuroscience Reviews, 3(2), 71–100.
CrossRef
Google scholar
|
[18] |
Deutsch, F., & Madle, R. A. (1975). Empathy: Historic and current conceptualizations, measurement, and a cognitive theoretical perspective. Human Development, 18(4), 267–287.
CrossRef
Google scholar
|
[19] |
Devine, R. T., & Hughes, C. (2013). Silent films and strange stories: Theory of mind, gender, and social experiences in middle childhood. Child Development, 84(3), 989–1003.
CrossRef
Google scholar
|
[20] |
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(5), 623–636.
CrossRef
Google scholar
|
[21] |
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.
CrossRef
Google scholar
|
[22] |
Eisenberg, N., Fabes, R. A., Schaller, M., Carlo, G., & Miller, P. A. (1991). The relations of parental characteristics and practices to children's vicarious emotional responding. Child Development, 62(6), 1393–1408.
CrossRef
Google scholar
|
[23] |
Frith, U., & Frith, C. D. (2007). Social cognition in humans. Current Biology, 17(16), R724–R732.
CrossRef
Google scholar
|
[24] |
Gillespie, S. M., Mitchell, I. J., & Abu-Akel, A. M. (2017). Autistic traits and positive psychotic experiences modulate the association of psychopathic tendencies with theory of mind in opposite directions. Scientific Reports, 7(1), 6485.
CrossRef
Google scholar
|
[25] |
Greenberg, D. M., Warrier, V., Abu-Akel, A., Allison, C., Gajos, K. Z., Reinecke, K., Rentfrow, P. J., Radecki, M. A., & Baron-Cohen, S. (2023). Sex and age differences in “theory of mind” across 57 countries using the English version of the “Reading the Mind in the Eyes” test. Proceedings of the National Academy of Sciences of the United States of America, 120(1), e2022385119.
CrossRef
Google scholar
|
[26] |
Happé, F. G. (1994). An advanced test of theory of mind: Understanding of story characters' thoughts and feelings by able autistic, mentally handicapped, and normal children and adults. Journal of Autism and Developmental Disorders, 24(2), 129–154.
CrossRef
Google scholar
|
[27] |
Ho, K. K. Y., Lui, S. S. Y., Hung, K. S. Y., Wang, Y., Li, Z., Cheung, E. F. C., & Chan, R. C. K. (2015). Theory of mind impairments in patients with first-episode schizophrenia and their unaffected siblings. Schizophrenia Research, 166(1–3), 1–8.
CrossRef
Google scholar
|
[28] |
IBM. (2013). Statistical package for the social sciences, SPSS base version. IBM Corporation.
|
[29] |
Jack, D. B., & Murray, T. M. (2022). Understanding oneself to understand others: The role of alexithymia and anxiety in the relationships between autistic trait dimensions and empathy. Journal of Autism and Developmental Disorders, 52(5), 1971–1983.
CrossRef
Google scholar
|
[30] |
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613.
CrossRef
Google scholar
|
[31] |
Lai, M. C., Lombardo, M. V., & Baron-Cohen, S. (2014). Autism. Lancet, 383(9920), 896–910.
CrossRef
Google scholar
|
[32] |
Lau, W. Y. P., Gau, S. S. F., Chiu, Y. N., Wu, Y. Y., Chou, W. J., Liu, S. K., & Chou, M. C. (2013). Psychometric properties of the Chinese version of the Autism Spectrum Quotient (AQ). Research in Developmental Disabilities, 34(1), 294–305.
CrossRef
Google scholar
|
[33] |
Liang, Y. S., Yang, H. X., Ma, Y. T., Lui, S. S. Y., Cheung, E. F. C., Wang, Y., & Chan, R. C. K. (2019). Validation and extension of the questionnaire of cognitive and affective empathy in the Chinese setting. PsyCh Journal, 8, 439–448.
CrossRef
Google scholar
|
[34] |
Livingston, L. A., & Happé, F. (2017). Conceptualising compensation in neurodevelopmental disorders: Reflections from autism spectrum disorder. Neuroscience & Biobehavioral Reviews, 80, 729–742.
CrossRef
Google scholar
|
[35] |
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, 8, 791.
CrossRef
Google scholar
|
[36] |
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.
CrossRef
Google scholar
|
[37] |
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), 818–823.
CrossRef
Google scholar
|
[38] |
Premack, D., & Woodruff, G. (1978). Does the chimpanzee have a theory of mind? Behavioral and Brain Sciences, 1(4), 515–526.
CrossRef
Google scholar
|
[39] |
Reniers, R. L., Corcoran, R., Drake, R., Shryane, N. M., & Vollm, B. A. (2011). The QCAE: A questionnaire of cognitive and affective empathy. Journal of Personality Assessment, 93(1), 84–95.
CrossRef
Google scholar
|
[40] |
Santiesteban, I., Gibbard, C., Drucks, H., Clayton, N. S., 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(2), 391–404.
CrossRef
Google scholar
|
[41] |
Shalev, I., & Uzefovsky, F. (2020). Empathic disequilibrium in two different measures of empathy predicts autism traits in neurotypical population. Molecular Autism, 11(1), 59.
CrossRef
Google scholar
|
[42] |
Shamay-Tsoory, S. G., Shur, S., Barcai-Goodman, L., Medlovich, S., Harari, H., & Levkovitz, Y. (2007). Dissociation of cognitive from affective components of theory of mind in schizophrenia. Psychiatry Research, 149(1–3), 11–23.
CrossRef
Google scholar
|
[43] |
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.
CrossRef
Google scholar
|
[44] |
Stevenson, J. L., & Hart, K. D. R. (2017). Psychometric properties of the autism-spectrum quotient for assessing low and high levels of autistic traits in college students. Journal of Autism and Developmental Disorders, 47(6), 1838–1853.
CrossRef
Google scholar
|
[45] |
Stone, V. E., Baron-Cohen, S., & Knight, R. T. (1998). Frontal lobe contributions to theory of mind. Journal of Cognitive Neuroscience, 10(5), 640–656.
CrossRef
Google scholar
|
[46] |
Tin, L. N. W., Lui, S. S. Y., Ho, K. K. Y., Hung, K. S. Y., Wang, Y., Yeung, H. K. H., Wong, T. Y., Lam, S. M., Chan, R. C. K., & Cheung, E. F. C. (2018). High-functioning autism patients share similar but more severe impairments in verbal theory of mind than schizophrenia patients. Psychological Medicine, 48(8), 1264–1273.
CrossRef
Google scholar
|
[47] |
Watanabe, T., Kondo, M., Sakai, M., Takabatake, S., Furukawa, T. A., & Akechi, T. (2021). Association of autism spectrum disorder and attention deficit hyperactivity disorder traits with depression and empathy among medical students. Advances in Medical Education and Practice, 12, 1259–1265.
CrossRef
Google scholar
|
[48] |
Yang, H.-X., Hu, H.-X., Zhang, Y.-J., Wang, Y., Lui, S. S. Y., & Chan, R. C. K. (2022). A network analysis of interoception, self-awareness, empathy, alexithymia, and autistic traits. European Archives of Psychiatry and Clinical Neuroscience, 272(2), 199–209.
CrossRef
Google scholar
|
[49] |
Zalla, T., Sav, A. M., Stopin, A., Ahade, S., & Leboyer, M. (2009). Faux pas detection and intentional action in Asperger syndrome. A replication on a French sample. Journal of Autism and Developmental Disorders, 39(2), 373–382.
CrossRef
Google scholar
|
[50] |
Zhang, F., Dong, Y., Wang, K., Zhan, Z., & Xie, L. (2010). Reliability and validity of the Chinese version of the interpersonal reactivity index-C. Chinese Journal of Clinical Psychology, 18(2), 155–157.
|
[51] |
Zhu, C.-Y., Lee, T. M. C., Li, X.-S., Jing, S.-C., Wang, Y.-G., & Wang, K. (2007). Impairments of social cues recognition and social functioning in Chinese people with schizophrenia. Psychiatry and Clinical Neurosciences, 61(2), 149–158.
CrossRef
Google scholar
|
[52] |
Zhu, X., Yi, J., Yao, S., Ryder, A. G., Taylor, G. J., & Bagby, R. M. (2007). Cross-cultural validation of a Chinese translation of the 20-item Toronto Alexithymia Scale. Comprehensive Psychiatry, 48(5), 489–496.
CrossRef
Google scholar
|
/
〈 |
|
〉 |