A Little Bit More About Empathy

EXECUTIVE SUMMARY: I'm reproducing a table from one of the (freely available, so I think I'm in the clear, copyright-wise) articles I cited in my last post, with commentary. The table shows average scores --- totals and subscales --- from the three alexithymia- and empathy-related questionnaires used in those studies: the Toronto Alexithymia Scale (TAS-20), the Bermond-Vorst Alexithymia Questionnaire (BVAQ) and the Interpersonal Reactivity Index (IRI). The places where autistic people do, and don't, differ from non-autistic people in Silani et al.'s (2008) use of these questionnaires don't mesh with the stereotypical, extreme-systemizer understanding of autism popularized by Simon Baron-Cohen.
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I couldn't fit it into this post, but there was something else I wanted to highlight in the results of this study (full text here).

It isn't all that important to the conclusions of the research itself, and it doesn't have much more than anecdotal value, since it's drawing from such a small sample, but because it runs somewhat counter to the conventional understanding of empathy in autism I wanted to showcase it anyway.

Think of it as a numerical version of Michelle Dawson's "Verbatim" series.

Anyway, here are the mean scores (totals and subscales; standard deviations shown in parentheses) of the fourteen autistic (there were fifteen, but one didn't finish all the tests) and fifteen control subjects on the Toronto Alexithymia Scale (TAS), Bermond-Vorst Alexithymia Questionnaire (BVAQ), and Interpersonal Reactivity Index (IRI)*.

Toronto Alexithymia Scale

(Total)

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Controls (n = 15)..................................43.7 (12.7)

Autism/Asperger (n = 14)........................55.6 (9.7)

(Subscale F1 - difficulty identifying feelings)

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Controls............................................14.3 (5.3)

Autism/Asperger..................................18.5 (6.5)

(Subscale F2 - difficulty describing feelings to others)

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Controls............................................11.8 (4.4)

Autism/Asperger..................................17.2 (4.2)

(Subscale F3 - externally oriented thinking**)

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Controls............................................17.6 (5.3)

Autism/Asperger..................................19.9 (3.1)

Total TAS scores were significantly higher for the autistic group than for the control group, but only one subscale showed significant differences: the "difficulty describing feelings" subscale. This is not at all surprising when you consider how many autistic people --- even speaking autistic people --- even speaking autistic people who never exactly lose their capacity for speech; they're just better at it some days and worse at it other days --- say they have a lot of trouble with language, especially in the "finding the right words for whatever it is I'd like to communicate" sector.

Bermond-Vorst Alexithymia Questionnaire

(Total)

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Controls............................................47.0 (11.1)

Autism/Asperger..................................53.2 (8.7)

(Subtotal - Cognitive Component)

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Controls............................................27.0 (7.6)

Autism/Aspeger...................................32.4 (4.9)

(Subtotal - Emotional Component)

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Controls............................................20.0 (5.4)

Autism/Asperger..................................20.9 (6.0)

(Subscale 1 - Verbalizing)

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Controls............................................9.7 (3.5)

Autism/Asperger..................................11.7 (2.3)

(Subscale 2 - Fantasizing)

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Controls............................................10.2 (3.5)

Autism/Asperger..................................10.6 (2.8)

(Subscale 3 - Insight)

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Controls............................................8.9 (2.9)

Autism/Asperger..................................12.4 (3.0)

(Subscale 4 - Emotional Excitability)

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Controls............................................9.8 (2.7)

Autism/Asperger..................................10.2 (3.9)

(Subscale 5 - Concrete Thinking)

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Controls............................................8.4 (3.1)

Autism/Asperger..................................8.2 (3.0)

On the BVAQ, total scores do not differ significantly between the autistic and non-autistic groups; significant differences between groups only appear on one of the five subscales --- the Insight subscale, which in other versions of the test might be called Analyzing. It reflects your ability to think about what you're feeling and why you might be feeling it. There is also a significant disparity in the whole cognitive component of the BVAQ, which is the sum of the Insight, Verbalizing and Concrete Thinking subscales. (While only the Insight subscale showed a significant difference between the autistic and non-autistic groups' average scores, the Verbalizing subscale showed a difference that, while it did not rise to statistical significance, wasn't negligible either; by contrast, scores on the Concrete Thinking subscale are virtually identical).

Interpersonal Reactivity Index

(Total)

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Controls...........................................59.6 (8.8)

Autism/Asperger.................................52.8 (11.0)

(Perspective-Taking Scale)

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Controls...........................................16.1 (4.5)

Autism/Asperger.................................9.8 (3.1)

(Fantasy Scale)

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Controls...........................................14.7 (4.3)

Autism/Asperger.................................12.2 (5.0)

(Empathic Concern Scale)

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Controls...........................................17.7 (4.2)

Autism/Asperger.................................16.4 (4.2)

(Personal Distress Scale)

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Controls...........................................11.3 (5.0)

Autism/Asperger.................................14.6 (6.3)

Several things are worth pointing out about the IRI scores. First, there's no significant difference in overall scores --- according to this measure of empathy, in this instance, autistic people are not significantly less empathetic than non-autistic people. Second, only one of the subscales shows a significant difference between autistic and NT study participants, and that's the perspective-taking subscale, which measures the (cognitive and imaginative) ability to put oneself in another's shoes. This disparity could be explained by invoking Baron-Cohen's (and, I think, also Uta Frith's --- she's an author of both of the studies I just finished writing about) idea that autistic people are lacking in Theory of Mind; it could also be explained by pointing out that autistic people and non-autistic people have very different experiences, even of the simplest and most fundamental sorts. Our emotions and senses work differently from theirs, and we have to work hard adjusting for that in our attempts to consider things from a non-autistic person's perspective. (Curiously, non-autistic people are never asked to consider things from an autistic person's perspective. Maybe if some researchers asked them to do that, they would find a corresponding impairment in neurotypicals' Theory of (Autistic) Minds!) On the more purely emotional measures --- the empathic-concern subscale, which measures one's capacity for pity, tenderness and worry on another person's behalf, and the personal-distress scale, which measures the extent to which you become upset at another person's distress --- the differences are either vanishingly small (the difference between the average scores of the autistic group and the control group on the empathic-concern subscale is just a little over one-quarter of a standard deviation) or favor the autistic group (on the personal-distress subscale, the autistic group scores about three points higher --- about half a standard deviation --- than the non-autistic group).

So, while according to these measures we do indeed have trouble "mind-reading," we are not any more concrete, literal-minded or fantasy-deprived than non-autistics, and even if we can't infer another person's state of mind, we feel for them just the same. In fact, our distress when they are unhappy might even be greater than non-autistic people's.

Autistic people are emotionless robots?

Myth busted.

*Anemone has posted the IRI as an interactive quiz on her website, so, if you want to, you can go there and take it yourself.

**This refers to a preference for thinking and talking about concrete, external objects or events rather than feelings. An example question from this subscale asks whether, when you're talking with someone about your day, you prefer to focus on what happened rather than on how you felt about it.

Silani, G., Bird, G., Brindley, R., Singer, T., Frith, C., & Frith, U. (2007). Levels of emotional awareness and autism: An fMRI study Social Neuroscience, 3 (2), 97-112 DOI: 10.1080/17470910701577020