Whose Planet Is It Anyway?

Friday, March 20, 2009

Empathy and Autism/Asperger Research

As part of the ongoing effort to debunk the damaging myth that autistics lack empathy, I'm posting a citation to a research study that addressed the issue: Rogers K, Dziobek I, Hassenstab J, Wolf OT, Convit A. Who cares? Revisiting empathy in Asperger syndrome. J Autism Dev Disord. 2007 Apr; 37(4):709-15.

This is not a new study, as can be seen from the date of the citation, but I don't recall having read any articles on the neurodiversity blogs discussing it. (If anyone wrote a blog entry that I overlooked, feel free to post a link to it in my comments.) The abstract describes the study's findings as follows:

Abstract A deficit in empathy has consistently been cited as a central characteristic of Asperger syndrome (AS), but previous research on adults has predominantly focused on cognitive empathy, effectively ignoring the role of affective empathy. We administered the Interpersonal Reactivity Index (IRI), a multi-dimensional measure of empathy, and the Strange Stories test to 21 adults with AS and 21 matched controls. Our data show that while the AS group scored lower on the measures of cognitive empathy and theory of mind, they were no different from controls on one affective empathy scale of the IRI (empathic concern), and scored higher than controls on the other (personal distress). Therefore, we propose that the issue of empathy in AS should be revisited.

The authors explain that "cognitive empathy" refers to the process of understanding another person's perspective, while "affective empathy" is an observer's emotional response to the affective state of others.

In other words, the autistic participants in the study displayed less understanding of others' perspectives than the control group; they showed about the same amount of sympathy and compassion toward others; and they experienced higher levels of personal distress when observing others in distressing situations.

As I have mentioned in previous posts on this blog, tests measuring cognitive empathy and theory of mind are both culturally and linguistically dependent. That is to say, in order to understand others' perspectives accurately, it is first necessary to share common cultural points of reference and to have a sufficiently similar understanding of the words used. The more that a minority community diverges from the majority in its culture and its use of language, the lower its members will score on such tests.

I rather suspect that if anyone were to conduct a research study measuring the ability to understand perspectives that are commonly found in the autistic community, the autistic participants in the study would show more understanding than the non-autistic participants.

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  • This is such an important discussion! I appreciate that you're so clearly making the distinction between cognitive and affective empathy. I wrote about Zosia Zak's beautifully written essay on a related topic in my Social Skills for Kids blog a while ago.(http://blog.patriciarobinsonmft.com/social_skills_for_kids/2008/08/empathy-social.html) John Robison discussed the same idea in his Psychology Today blog. (http://blogs.psychologytoday.com/blog/my-life-with-asperger039s/200811/are-aspergians-really-rude-and-inconsiderate)

    Too often I see that different ways of interpreting and expressing social signals can result in misunderstandings about empathy.

    By Anonymous Anonymous, at 6:57 PM  

  • Nice work, ABFH! The reality is that given the time to analyse incoming information (which the NT world abuse as slow) conclusions made by those at the higher functioning end of the Spectrum tend to be more accurate.

    We're good at empathy once that analyse is done. We just need to be given time to do that analysis. The fact that usually we aren't is the problem - and that's not our fault.

    By Anonymous Anonymous, at 6:58 PM  

  • Whoa, where did that comment come from? :)

    That last paragraph is exactly what I'm talking about. That's what happens when we are rushed.

    By Anonymous Anonymous, at 7:00 PM  

  • I wonder if it was verbal or written? Maybe I should check the link!

    By Anonymous Anonymous, at 7:26 PM  

  • Fascinating. I've always thought that the issue is difference, rather than lack. You only have to spend a few minutes with a lot of autistic people to see hyper-awareness of the feeling of those around them.

    By Blogger VAB, at 7:57 PM  

  • The difference between connotative and affective empathy is an excellent point. I hadn't heard it put so well before.

    You said: "The more that a minority community diverges from the majority in its culture and its use of language, the lower its members will score on such tests."

    That isn't brought up nearly often enough and I don't think how much it that affects things is recognized.

    I think there are neurological differences/vulnerabilities for autistics as well as social situations encountered by any oppressed minority that can affect how we (in your words)

    "experience higher levels of personal distress when observing others in distressing situations."

    I can see some real dangers of describing a group of people as not caring about others feellings and as much or more dangers in claiming that the autism spectrum can be a way to claim that those who are considered the "lowest functioning" members are lowest *because* they care the least about others feelings.

    That not only isn't true, it's outrageous to even suggest it.... but yet it happens and is used as a reason for describing autism as a disaster.

    By Blogger Ed, at 8:30 PM  

  • oops.... I misspelled cognitive. I wrote connotative instead. That's what I get for getting a spell checker before learning to spell. I trust it to know what I'm thinking when really it doesn't. ;/

    By Blogger Ed, at 8:46 PM  

  • I want to mention that I'm much better at working out what other people are feeling and thinking (what's being referred to here as cognitive empathy, I guess) through passive observation than through active, conscious analysis. Some of the *most* accurate insights I've had about social dynamics took place when I was basically a passive nonparticipant sitting in the corner, figuratively or literally. (These sometimes included picking up on attitudes or feelings that some of the people involved were trying to hide.)

    But it also becomes harder for me to do that if I'm expected to be an active participant in a multi-person conversation and to try to take in every word, and it becomes almost impossible if I'm being asked to emulate socially normative mannerisms. When I have to make eye contact with a person, I can't understand what they're saying *or* pick up anything they might be expressing through body language and patterns.

    And yeah, it disturbs me to no end to see people equating autism with sociopathy. It hits me particularly hard, because I was raised by a parent who had some sociopathic tendencies, and I'm still affected by it to this day. What people seem to be missing here is that the vast majority of sociopaths come across initially as very socially adept, even charismatic. While I've seen autistics who have their own kind of charisma, as well as autistics who seemed to lack a developed conscience (I don't see that as being a byproduct of autism, just as representative of the fact that there are some people like that in any group of humans), I've never seen any who have that kind of highly slick, socially adept presentation that makes them the focus of any room the moment they enter it.

    ...it seems to me like this "empathy" thing is just another prong of the sword that has been used to justify atrocities against disabled people, various ethnic groups, children and infants, etc, which can basically be summed up as "It's okay to do this to Them, because They don't feel the way we do." And possibly some weird re-animated zombified version of the eugenic idea that the "feeble-minded" were amoral and more likely to be criminals.

    Thinking about it, I also wonder how much of a role books by prominent autistic authors have had in getting this whole idea started. I'm thinking in particular of Temple Grandin, who portrays herself as being unable to view cattle slaughter with anything other than detachment due to the fact that she's autistic, and implies that this is a broad characteristic of all autistics or all "high-functioning" ones, or something. (Or Oliver Sacks concluded that, or people just concluded from the fact that she said it about herself that it was true for all auties.) In fact, though, I've known several autistic vegetarians and vegans, who couldn't eat meat because they empathized too deeply with the animals being slaughtered. But because they aren't bestselling authors or token autistic spokespersons, nobody pays attention to their own voices.

    By Anonymous Anonymous, at 9:44 PM  

  • Not a blog blog, but I've been flogging the IRI for a while, have collected and posted scores on my website, and posted about this paper on Wrong Planet as well.

    My web page with links to the two WP threads:

    By Anonymous Anonymous, at 9:54 PM  

  • Patricia Robinson: Thanks!

    Timelord: Your comment made sense to me. :)

    Maddy: The IRI is a written test. You can follow Anemone's link to look at it (thanks Anemone!)

    VAB: I sometimes find that when I am tired and not processing speech as quickly as usual, I respond more to body language and tone of voice.

    Ed: I also wondered whether the higher level of personal distress reflected actual neurological differences or whether it was a result of having had more distressing experiences.

    Riel^Amorpha: Yes, I agree that there is an intuitive aspect to cognitive empathy and that having to focus on too many things at once can impair it.

    By Blogger abfh, at 10:16 AM  

  • I am sure that all people, autistic or NT, make conscious decisions about who we empathize with. Consider this scenario: you are in the waiting room of an emergency department of a large hospital, and there is a man across the way who is clearly in great distress, he is groaning and clutching his abdomen and looks pale, you feel sorry for the man and hope that the triage nurse puts him through to see the doctors before you, then you overhear a conversation between the triage nurses and you learn that the waiting patient's distress is the result of his use of illegal drugs. Would you still feel the same level of empathy for the waiting man following this discovery? Might your own empathic distress suddenly be transformed into a feeling of annoyance?

    Let's stop pretending that empathy is solely a psycho-biological phenomenon that is uninfluenced by social judgements and social influences. Autistic people are a social minority, and studying the way we function socially in a hostile society cannot be reduced to studying amygdala size or eye contact duration.

    By Blogger Lili Marlene, at 10:20 AM  

  • Nice article and important subject. This is a persistent myth which hurts us auties.

    I have a theory ... that Autism is purely neurological and should not be described in behavioral or social terms.

    It is essentially a deficit in weaving together sensory information. The 'coprocessers' which organize huge chunks of sensory data seem to be diminished in us. This results in problems recognizing facial expressions and integrating other social cues.

    But it's very wrong to conclude from this that we lack desire to understand others or the ability to due so. It's simply mis-cuing.

    And I don't believe it's an impairment for auties. The sensory integration 'coprocessors' of the brain were necessary for pack-hunters like our ancient ancestors.

    They are no longer needed at this stage in humanity's evolution. I theorize these 'coprocessors' are being recycled into more important cognitive areas : memory, abstract thought, language, creative ability.

    This accounts for the unreasonable achievements of auties and their unflagging insistence that they are not 'sick'.

    The talents are not mere side effects of pathology. Rather, the 'pathology' is a mere side effect of the talent.

    In the medical literature, the talents themselves are often recast as pathology. One study I saw studied Aspie kids and noticed they avoid slang and speak in polished, correct english.

    Another study, which observed that Aspies do better on the embedded image test, explained it by saying we lack 'central coherence' so aren't as easily fooled by distracting imagery.

    It seems, if we were to walk on water, doctors would say that we cannot swim.

    By Blogger Unknown, at 11:15 AM  

  • (... missing sentence above ...)

    in the study where aspie kids spoke better english and avoided slang, this was reported as speaking in an 'inappropriate social register' ...

    By Blogger Unknown, at 11:18 AM  

  • I sometimes wonder how much the kind of trauma involved in growing up autistic influences this question, also. One might come to ignore cues from other people if one consistently gets teased, tricked, harassed, or punished for picking up on them.

    Just a thought.

    By Anonymous Anonymous, at 7:35 PM  

  • A very good thought, Anon! You'll find that many on the Spectrum who want a cure for example are victims of abuse and instead of fighting it they take it like they are a bad person and hate themselves.

    By Anonymous Anonymous, at 7:11 PM  

  • I remember having read about this study before, but couldn't for the life of me remember where.
    Thanks much for bringing it up, it's so badly needed.

    By Blogger Gonzo, at 1:12 PM  

  • See the following theory:
    The ‘theory of mind’ (ToM) hypothesis of autism. Tom is an hypothesis first published in 1985.
    Other articles ask what caused the autism epidemic?
    The CDC studies say it is not MMR or Thimerosal. Other hypotheses have included autoimmune diseases, etc.

    Individuals with Disabilities Education Act (IDEA) Data website:
    Pregnancy Risk Assessment Monitoring System (PRAMS) sleep position data:
    Centers for Disease Control (CDC) Birth Data:
    2006 Median Income Data: - U.S. Department of Housing and Urban Development
    NOTICE PDR-2006-01

    Autism Spectrum Disorders, Asperger's Syndrome, and Pervasive Developmental Disorders - Not Otherwise specified (PDD-NOS)
    Gastrointestinal Disorders also known as GER is a common comorbidity
    Autism patients tend to have minicolumn abnormalities and increased amounts of white matter
    Casanova MF, van Kooten IA, Switala AE, Ven Engeland H, Heinsen H, Steinbusch HW, Hof PR, Trippe J, Stone J, Schmitz C. Minicolumnar abnormalities in autism. Acta Neuropathol. 2006 Sep; 112(3); 287-303.
    Mostofsky SH, Burgess MP, Larson JCG. Increased motor cortex white matter volume predicts motor impairment in autism. Brain (2007), 130, 2117-2122

    Maternal smoking decreased significantly between 1990 and 2002
    Infant suffocation deaths increased 14% per year on average between 1996 and 2004
    Centers for Disease Control. Smoking & Tobacco Use - Morbidity and Mortality Weekly Reports (MMWRs) – Smoking During Pregnancy – United States, 1990-2002 – October 7, 2004 / Vol. 53/ No. 39 http://www.cdc.gov/tobacco/data_statistics/MMWR/2004/mm5339_highlights.htm
    Shapiro-Mendoza CK, Kimball M, Tomashek KM, Anderson RN, Blanding S.US Infant Mortality Trends Attributable to Accidental Suffocation and Strangulation in Bed From 1984 Through 2004: Are Rates Increasing? Pediatrics 2009;123;533-539

    Here is a good article on diagnosing this:
    Filipek P, Accardo P, Ashwal S, Baranek G, Cook E, Dawson G, Gordon B, Gravel J, Johnson C, Kallen R, Levy S, Minshew N, Ozonoff S, Prizant B, Rapin I, Rogers S, Stone W, Teplin S, Tuchman R, Volkmar F. Practice parameter: Screening and diagnosis of autism Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Child Neurology Society NEUROLOGY 2000;55:468–479 http://internet.dscc.uic.edu/forms/medicalhome/AutismRef.pdf

    SIDS, Autism, Autism Spectrum Disorder, Plagiocephaly, etc. are all
    conditions that the medical profession is trying to treat.
    The SIDS back sleep (Supine) sleep recommendations began in 1992
    The SIDS "Back to Sleep" campaign began in 1994.
    In 1996 the AAP SIDS Task Force, led by Dr. John Kattwinkel recommended the supine sleep position and not the side(lateral) or front(prone).
    THe Netherlands began their SIDS Back to Sleep Campaign in 1987.
    Sleep is necessary for memory consolidation, declarative learning, and procedural learning.

    The following are useful articles which discuss many of these issues indepth:
    American Academy of Pediatrics Task Force on Infant Positioning and SIDS. Positioning and SIDS. Pediatrics. 1992;89:1120-1126
    Hogberg U, Bergstrom E. Suffocated Prone: The Iatrogenic Tragedy of SIDS. American Journal of Public Health. 2000;90:527-531
    National Infant Sleep Position Household Survey. Summary Data. updated: 10/16/08 Website: http://dccwww.bumc.bu.edu/ChimeNisp/NISP_Data.asp
    Kattwinkel J, Hauck F.R., Moon R.Y., Malloy M and Willinger M Infant Death Syndrome: In Reply, Bed Sharing With Unimpaired Parents Is Not an Important Risk for Sudden. Pediatrics 2006;117;994-996
    Buzsáki, G. 1989. Two-stage model of memory trace formation: A role for “noisy” brain states. Neuroscience 31: 551–570.
    Hasselmo, M.E. 1999. Neuromodulation: Acetylcholine and memory consolidation. Trends Cogn. Sci. 3: 351–359.
    Wierzynski DM, Lubenov EV, Gu M, Siapas AG. State-Dependent Spike-Timing Relationships between Hippocampal and Prefrontal Circuits during Sleep. Neuron 61, 587-596, February 26, 2009
    Walker MP, Stickgold R. Sleep, Memory, and Plasticity. Annu. Rev. Psychol. 2006. 57: 139-66
    Gais S, Born J. Declarative memory consolidation: Mechanisms acting during human sleep. Learn Mem. 2004 Nov-Dec; 11(6): 679-685
    Davis BE, Moon RY, Sachs HC, Ottolini MC. Effects of sleep position on infant motor development. Pediatrics. 1998 Nov; 102(5):1135-40.
    Skadberg BT, Markestad T. Consequences of Getting the Head Covered During Sleep in Infancy. Pediatrics 1997;100;e6
    AJ Williams, RD Jitendra, JB Phillips, Y Lin, T McCabe, FC Tortella. Neuroprotective Efficacy and Therapeutic Window of the High-Affinity N-Methyl-D-aspartate Antagonist Conantokin-G: In Vitro (Primary Cerebellar Neurons) and In Vivo (Rat Model of Transient Focal Brain Ischemia) Studies1
    Stradling JR, Thomas G, Warley AR, Williams P, Freeland A. Effect of adenotonsillectomy on nocturnal hypoxaemia, sleep disturbance, and symptoms in snoring children. Lancet. 1990;335 :249 –253

    By Anonymous Anonymous, at 10:36 PM  

  • Many months late, but I hope someone interested in understanding, analyzing, discussing, or criticizing theory of mind research conducted among autistic children might find it interesting to also check out research conducted among deaf children. Some potentially interesting parallels there, including some concerns about flaws in past research among deaf children. Check out this on-line video:

    Schick Language and Theory of Mind in Deaf Children
    Speaker shares results of research on Theory of Mind among Deaf children. Past research among deaf children has typically shown very large delays in developing theory of mind which the researcher attributes in part to flawed testing methods that fail to adequately account for linguistic
    differences in communication among deaf children. Her research study, in which signing deaf children are tested by deaf native signing testers, still shows a delay but a smaller one than in past research. Researcher discusses implication of delayed theory of mind for developing social and academic skills (eg, children who are better able to guess what the teacher wants may do better in school). The researcher recommends that parents and teachers receive more support in learning how to talk about theory of mind concepts with deaf children as a way of promoting this skill (for example, talking more extensively about past events, thoughts, feelings, emotions, why people do certain things, etc.) 83-minute video. Requires Windows Media Player. The one-hour lecture and the 20 minutes of questions and answers at the end are in American Sign Language. Spoken translation in English is provided for hearing non-signers. Unfortunately no captions are available for deaf non-signers or for hearing non-signers with auditory processing disorders.

    By Anonymous Andrea S., at 10:45 AM  

  • This comment has been removed by a blog administrator.

    By Blogger Joeker, at 11:55 PM  

  • Joeker, please do not use my blog as a platform for personal attacks that have nothing to do with my posts. Take that stuff somewhere else.

    By Blogger abfh, at 8:30 AM  

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