Cognitive Styles, Stereotypes and Collateral Damage

(Cross-posted from my Tumblr)

I saw a really interesting post on Tumblr about, among other things, different disability stereotypes and some of the less-than-perfect ways different subsets of cognitively or developmentally disabled people cope with them.

The part of the post I'm responding to:

You know how there is a subset of badbrains people who are like “ACTUALLY, our BADBRAINS MAKE US SMARTER. We are not disabled, we are the NEXT EVOLUTIONARY STAGE, we are BETTER. There is us on the top, then normals in the middle, then unsmart r-word badbrains people on the bottom. Given time they will see.” And I was attracted to that subset of badbrains people for a while before I realise they were assholes (And also stopped being academically smart.) And there was a subset of the subset who said “the unsmart r-word badbrains were just expensive useless people who should die, I NEVER thought that (not that I deserve some kind of “not a murderer” cookie) but those people existed and exist. 

But I feel like there is also a subset of badbrains people who are like “ACTUALLY, our BADBRAINS MAKE US KINDER, we are a PURER  type of human, more whole and loving and sane, more Hufflepuff, than the normals. There is us on top, normals in the middle, and the evil heartless non-sensory, abstraction-based, heartless badbrains people on the bottom, they probably all worship Richard Dawkins and watch my little pony and are racist and rape everyone they meet. They are all just like Elliot Rodger, we should probably kill them before they kill us.”

The bolded parts ring true for me too.

I know that both types of “badbrains people” — the ones whose minds handle abstract concepts well, but don’t really get emotions or people*, and the ones whose minds don’t handle abstract concepts or words well but are good at empathy and perceptual, sensory stuff** — exist and have to deal with ableism from NTs, and have various ways of coping with that and saying, no, actually we have value and are good at things.

And I know that those coping mechanisms can turn into ways of hurting other DD/MI people — the ones whose cognitive styles are as different from our own as they are from the norm. We might think we’re trashing a stereotype but actually be trashing real people who share traits with the stereotype. 

I actually overlap a bit with both of the subsets of people you’re describing — most of the mockery I got in grade school was of the “look at the stupid R-word, she believes whatever you tell her” variety; I do live primarily in a world of sensory information and sometimes I’m not exactly within reach of words; I sort of straddle a line between very concrete, literal thought and more abstract, logical, analogy- and metaphor-based thought; I think very slowly and sometimes speak haltingly; but at the same time I’m very good at academics, including STEM subjects, I can be pretty far removed from my emotions (like, it took me until my 20s to even realize I was capable of certain emotions, or to express them), and I am ridiculously insensitive to nonverbal cues and emotional subtext in conversation.

The latter set of traits make me very much a stereotypical “Aspie” that autistics who don’t have those traits have been bashing as non-representative of what actual autism is like. I’m not really bothered by it because I know they’re right. My observations do tell me I’m in the minority in having those traits, especially the lack of affective empathy. 

The stuff I’ve seen from other autistic people has been more along the lines of “this type of autistic person doesn’t really exist” than “this type of autistic person is evil,” though.

(From NTs, of course, I've seen a whole lot of "this type of autistic person is evil" stereotyping. It's almost coming to replace the autism stereotypes I remember more from childhood, the ones that imagine us as having no inner life.)

*Continuing with the Harry Potter Sorting Hat theme in the quoted passage, it would probably make the most sense to associate this cognitive style with Ravenclaw, and maybe Slytherin.

**Probably more likely to be in Hufflepuff or Gryffindor

Another "Extreme Female Brain" Sighting

EXECUTIVE SUMMARY: Simon Baron-Cohen's E-S theory of autism, sex differences and whatever else he's applied it to lately states that people have one of three basic cognitive styles: Type E, the empathizer, who understands people and relationships; Type S, the systemizer, who understands abstract ; and Type B, who can do both. Prof. Baron-Cohen has identified autism as exemplifying the Type S cognitive style taken to extremes, but hasn't written much about its opposite, the extreme Type E, or Extreme Female Brain. He allows that it must exist, but he doesn't think it would be as disabling in modern society as an Extreme Male Brain --- autism --- is. Other people (Crespi and Badcock) have suggested paranoid psychosis as the condition typical of the Extreme Female Brain, as it involves being morbidly obsessed with other people. In the paper I discuss here, a pair of evolutionary psychologists make the case that the psychopathology characteristic of the Extreme Female Brain is disordered eating.

The paper I discuss in this blog post describes a series of four different "experiments" in which groups of college students, of varying size (as large as n = 160, as small as n = 37), are given multiple psychometric exams. They are tested for the following things: disordered eating, sensitivity to other people's judgments, Empathizing Quotient (EQ), Systemizing Quotient (SQ), performance on various tasks considered representative of either empathizing or systemizing (e.g. guessing what emotion people in photographs are feeling, or mentally rotating three-dimensional objects), and schizotypal personality disorder. Some of the data are compatible with the idea of a high-empathizing, low-systemizing Extreme Female Brain that is particularly susceptible to disordered eating, and some are not.
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Thought to exist, but seldom glimpsed in the wild

Today on the fascinating psychology blog BPS Research Digest, I saw that some other researchers think they've found a candidate for an Extreme Female Brain, which according to Simon Baron-Cohen's E-S theory ought to exist, probably in about the same numbers as the Extreme Male Brain (which he identifies as autism) does, but which hasn't been described in the psychological literature.

The new article, by evolutionary psychologist Gordon G. Gallup, Jr. and assistant professor of psychology Jennifer Bremser --- both affiliated with the State University of New York --- and published in the journal Evolutionary Psychology, tries to make the case that eating disorders stem from the heightened sensitivity to others' judgments that is characteristic of the Extreme Female Brain.

What they did was to give a group of undergraduate psychology students at SUNY a battery of tests: the Eating Attitudes Test (EAT), which looks for disordered attitudes about eating (sample questions: "I feel extremely guilty after eating"; "I feel that food controls my life"); the Fear of Negative Evaluation Scale, which measures how anxious you are about what other people think of you (sample questions: "I often worry that I will say or do the wrong thing"; "I feel very upset when I commit some social error"; "When I am talking to someone, I worry about what they may be thinking about me"); Simon Baron-Cohen's Empathizing and Systemizing Quotients (which I have critiqued here and here); the Schizotypal Personality Questionnaire (PDF), which tests for nine traits associated with schizotypal personality disorder: ideas of reference (which means thinking that other people, or the media, are talking specifically to or about you when they aren't really), excessive social anxiety, odd beliefs or magical thinking, unusual perceptual experiences, odd or eccentric behavior, a lack of close interpersonal relationships, odd speech, constricted affect (i.e., not being very good at showing one's feelings), and general suspiciousness; and several tests that measure skills that would be associated with either an empathizing or systemizing cognitive style: the Reading the Mind in the Eyes Test, the Intuitive Physics Test and the Redrawn Vandenburg and Kuse Mental Rotations Test (Version A). Then they looked for relationships between all of these different test scores, and between any given score and the test taker's sex.

Their hypothesis --- that an empathizing cognitive style is more characteristic of women than of men, and tends in its extreme form towards disordered eating and social anxiety --- would predict the following: women scoring higher, on average, on the EQ and Mind in the Eyes tests, and lower on the SQ, Intuitive Physics, and Mental Rotation tests; women scoring higher than men on the measures of disordered eating and fear of negative evaluation, and high scores on those measures being correlated with high scores on the EQ and Mind in the Eyes tests for both sexes. 

They found significant differences between the sexes on the measures of disordered eating and fear of negative evaluation (both were higher for women), and also on the EQ, but not on the SQ. Women were also likelier to display something called "empathizing bias", which they defined numerically as each study participant's z-score on the EQ minus their z-score on the SQ. (Z-scores are a measure of how far an individual's score on a given statistical measure is above or below the average score. A negative number means the person, or sub-group, scored below average, while a positive number means they scored above average). Thus, the empathizing bias score is supposed to represent how much better a person does at empathizing than systemizing (or not, if it's zero or a negative number).

There was also a disparity between how participants scored on the EQ and SQ versus how they did on the more "objective" measures of systemizing or empathizing skill, the Intuitive Physics, Reading the Mind in the Eyes and mental rotation tests. The sexes differed strongly on their (self-reported) EQ scores, but performed almost identically on the Reading the Mind in the Eyes test. Obviously guessing what emotion a black-and-white photograph of a stranger's eyes is meant to convey is very different from accurately gauging the emotional states of one's relatives and friends, so that still leaves open the possibility that women perform better at this task when it involves real people who are known to them, but it's just as likely that women tend to overrate, and men to underrate, their interpersonal sensitivity on self-reported measures, and that real differences between the sexes on this ability are minimal. 

The opposite pattern occurred between the SQ and one of the "objective" measures of systemizing ability: men and women scored equally on the SQ, but men outperformed women on the Intuitive Physics test. (I can't find any results on the mental-rotation test broken down by sex).

There was also a very inconsistent pattern of correlations between disordered eating, fear of negative evaluation and the various systemizing and empathizing variables. High scores on the disordered-eating measure correlated with high scores on the fear-of-negative-evaluation (FNE) measure, and also with high scores on the EQ. There was no relationship between SQ scores and either disordered eating or fear of negative evaluation, and EQ and SQ scores were positively correlated with each other. Most strangely, SQ scores were correlated positively with empathizing bias: the number that reflects the imbalance between one's empathizing and systemizing abilities!

Also, within each sex the overall pattern of disordered eating patterns correlating with greater empathic ability (whether self-reported or "objectively" measured) seems to fall apart. 

Two graphs, Figure 1 and Figure 2, show bars for average male and female performance on both the EQ and the Reading the Mind in the Eyes Test, at low and high ends of the disordered-eating spectrum. According to these graphs, women score about the same on these tests regardless of whether they show disordered eating patterns or not, and for men the results are all over the place. On one test (the Mind in the Eyes), men who score low on the Eating Attitudes Test do equally well with all women, while men who score higher do more poorly on average, but their range of results is very, very broad. The error bar is wider than the bar on the graph is tall. 

On the EQ, the men show more or less the pattern the researchers expected: men at the high end of the disordered-eating spectrum scored higher than men at the low end on average, but for the former group especially there was a lot of within-group variation.

They also found correlations between disordered eating, fear of negative evaluation and several of the traits that make up schizotypal personality disorder: disordered eating correlates positively with ideas of reference (i.e., thinking everything refers to you, specifically), magical thinking and suspicion. Fear of negative evaluation correlates positively with ideas of reference, suspicion, social anxiety and constricted affect. (This latter makes sense --- if you are afraid people are judging you, of course you are going to try and minimize the extent to which those people are able to tell what you're thinking or feeling! It's called a "poker face".)

They also wanted to see if any of these psychological problems --- disordered eating, fear of negative evaluation, schizotypal personality disorder or any of its component traits --- interfered with one's ability to rotate three-dimensional objects in one's head. (Their reasoning for doing this wasn't just for giggles --- let's take a bunch of emotionally stressed people and ask them to do something both pointless and difficult! Hilarious! --- it can be hard to shake the idea that a lot of psychological experiments are done with precisely that objective --- but because they wanted to see if people who were unusually and morbidly concerned with what other people thought of them, and were thus "hyper-mentalizers" who would be reckoned extreme empathizers in Simon Baron-Cohen's typology would also show the expected impairment in systemizing tasks. 

Annoyingly, they did not compare people's scores on the mental-rotation task with their scores on other direct measures of systemizing or empathizing ability: they assumed, given earlier findings, that high scorers on the measures of disordered eating and fear of negative evaluation are also high empathizers. As I have said above, the data are less than clear in their support of this assumption. 

They found that people (they do not break it down by sex, probably because at this stage in the study they were dealing with a lot fewer participants) who scored high on their measure of disordered eating tended to do worse at mental rotations, consistent with their prediction. However, they also found a small (too small to be significant) positive correlation between mental-rotation scores and fear of negative evaluation. Of those two things, I'd consider the FNE score to be the more pure indicator of a "hypermentalizing" excess of concern for what other people think; there's a lot that's still unknown about the psychology of eating disorders, to the point that calling disordered eating a behavior born out of a fear of negative evaluation by others would be speculative.

The correlations they found between the various schizotypal personality traits and mental rotation ability surprised me, too. You'd think, if greater skill at mental rotation of three-dimensional objects indicated a logical, "systemizing" type of mind, that there would be a strong negative correlation between mental-rotation scores and those schizotypal traits that bespeak irrationality, like magical thinking or ideas of reference. (Especially magical thinking). But no, there's no correlation between either of those things and how well one does at mental-rotation tasks. The only components of schizotypal personality disorder that showed any significant relationship to mental rotation were social anxiety and constricted affect, both of which were negatively correlated. 

A negative correlation between skill at mental rotation and one's score on the social anxiety subscale of the Schizotypal Personality Questionnaire does fit with the researchers' idea of "hyper-mentalizing" at the expense of systemizing. But the lack of such a correlation with fear of negative evaluation does not fit, and instead makes one wonder if what's going on is, instead, anxious people's anxiety interfering with their ability to perform the rotations. 

In their Discussion section, the researchers do not comment on most of these discrepancies, but the one they do address --- worse performance on the Reading the Mind in the Eyes Test* by people with more severely disordered eating --- they attribute to those people's having greater, not less, emotional sensitivity**. Why, they're so sensitive they see things that aren't even there, so they do poorly on certain tests of emotional sensitivity and interpersonal acuity like the Reading the Mind in the Eyes Test.

I'm being silly, but that really is their explanation:

Comparable to the heightened sensitivity to sensory stimuli (auditory, visual and tactile) common among people with autism, individuals with the EFB [Extreme Female Brain] may be hypersensitive to social stimuli. Disordered eating may ameliorate the experience of negative evaluation anxiety that results from heightened sensitivity to social stimulation. 

Consistent with this idea, emotional processing deficits have been linked with eating disorders including the inability to recognize, label and describe emotions in detail and to link feelings with bodily correlates (Bourke, Taylor, Parker and Bagby, 1992 [link]; Eizaguirre, de Cabezon, de Alda, Olariaga and Juaniz, 2004 [PDF]; Garner, Olmsted and Polivy, 1983 [link]) Also, compared to healthy controls, women with anorexia had difficulty recognizing emotions from facial expressions and vocal tones (Jansch, Harmer and Cooper, 2009 [link]; Kucharska-Pietura, Masiak and Treasure, 2003 [link]).

Jones, Harmer, Cowen and Cooper (2008) [link] investigated emotional face processing in female undergraduates with high and low levels of disordered eating. Participants completed the Eating Attitudes Test-26 and the Facial Expression Recognition Task, a computer task in which participants view faces depicting 7 different expressions (anger, disgust, fear, happiness, sadness, surprise, and neutral) at different intensities. The participants with higher levels of disordered eating were less accurate in identifying happy and neutral faces. Among participants with high levels of disordered eating, there was a tendency to classify more happy faces as neutral, and more neutral faces as either angry or sad. In addition, there was evidence that reaction times to recognize disgust were longer, while reaction times to recognize fear were faster than participants with low levels of disordered eating. When disordered eating reaches clinical levels, the effects of hyper-mentalizing may manifest as mental state misattributions. This may be because they are using their own experience to model the experience of others, and their bias to classify emotions with a negative bias may influence their attributions. For instance, when shown pictures of women who are said to have overeaten, females with high levels of disordered eating ascribed more negative emotional states to these women than control participants do. Thus, women with higher levels of disordered eating appeared to use their own experience of overeating to describe how the other women would feel (Beebe, Holmbeck, Schober, Lane, Rosa, 1996 [link]).

It is also possible that the physiological and cognitive effects of starvation produce deficits in performance. In a study looking at performance on the Reading the Mind in the Eyes Test, individuals with anorexia performed worse compared to healthy controls (Russell, Schmidt, Doherty, Young and Tchanturia, 2009 [link]. 

An alternative explanation is that low scores on the Reading the Mind in the Eyes task does not represent a deficit of theory of mind ability, but rather an excess that reflects hypermentalizing. Abu-Akel (2003) [PDF] suggests that theory of mind dysfunctions range from the complete absence of the ability to represent other people's mental states (as shown in severe autism) to having the representational understanding of mental states, but a deficit in the ability to apply this understanding (as in Asperger's syndrome) to the abnormal or excessive attribution of mental states (as in schizotypy). It may be that this third class of dysfunction is misconstrued as a deficit, rather than an excess. Consistent with this interpretation, the RME is one of the most widely used instruments to investigate theory of mind performance in adults; however, scores on the RME depend only on accuracy. The test does not identify the nature of the errors that impede performance. For example, there can be errors of absence (failing to detect a mental state when it is present) and errors of excess (wrongly inferring a mental state in its absence). We suspect the second class of errors (errors of excess) account for most of the lower scores on this test among individuals with anorexia.

(They also seem to be arguing that people cursed with an excessive degree of awareness of other people's judgment of them might be self-medicating by starving themselves: if they are women, they will produce much less estrogen, which the authors believe "may also produce changes in empathizing and theory of mind performance." So that's a novel proposal --- people with eating disorders starve themselves to dull their razor-keen interpersonal sensitivity, in the interests of making their lives bearable. Obviously there's no evidence for this, and I've never seen anyone who has an eating disorder describe it like that, but at least it does people with eating disorders the courtesy of treating them as rational beings, which not all of the accepted explanations do.)

I do not doubt at all that people who have this kind of hypersensitvity exist --- I know a few! What I doubt is that 1) these people are all the same, and all have this skill for the same reason; 2) these people are any likelier to develop eating disorders than the general population; and 3) these people are necessarily bad at "systemizing," which seems to include such things as logical reasoning, pattern recognition, organization and spatial cognition. Indeed, the data from this same study suggest that people who are good at one half of the empathizing/systemizing duality seem to be good at the other half, too.

You can also count me as agnostic, still, on the question of whether women are, overall, better empathizers and men better systemizers. I don't rule it out, as at least some cognitive differences between the sexes do seem to exist, and show up consistently in studies, but as yet I don't see strong empirical support for it. 

Also, they dance around this in their Discussion section, but never directly address it: disordered eating is quite common in autistic girls and women, and even non-autistic people with eating disorders, particularly anorexia, perform similarly to autistic people on tests of mentalizing ability (the Reading the Mind in the Eyes test again), mirror self-recognition, emotion recognition, body awareness, executive function and central coherence (the Embedded Figures Test).

If autism is supposed to be the Extreme Male Brain, and the Extreme Female Brain is supposed to be its opposite, doesn't that complicate things a lot? 

Bremser JA, and Gallup GG Jr (2012). From one extreme to the other: Negative evaluation anxiety and disordered eating as candidates for the extreme female brain. Evolutionary psychology : an international journal of evolutionary approaches to psychology and behavior, 10 (3), 457-86 PMID: 22947672

*In the present study, it was only the male participants who showed this pattern, but the researchers cite lots of other studies of people with eating disorders, particularly anorexia nervosa, who show the same impairment. Some of the other researchers hypothesized that insufficient nutrition made those patients less able to perform complex cognitive operations of any sort, which sounds convincing to me.

**I am having UNBELIEVABLE trouble spelling "sensitivity" today. I always seem to leave out one of the "I's".  

Simon Baron-Cohen Responds to Criticism from an Autistic Blogger - Part II

Now, I'd like to focus on the first two points in Simon Baron-Cohen's response to Rachel Cohen-Rottenburg, where he addresses her argument that autistic people's generally heightened perceptual sensitivity, and our lack of any sort of filtering mechanism, tends to make us more empathic, not less.

She says:

Many of us experience such a high degree of empathy that we are constantly putting ourselves in other people's shoes and trying to see all sides in any controversy or conflict. Many of our problems with sensory and emotional overload derive from an excess of this ability, not a deficit.

He replies:

1. Rachel challenges whether people with autism have 'theory of mind' difficulties and instead argues that people with autism have high degrees of empathy.

This is however hard to reconcile with the scientific evidence. Literally dozens of studies from around the world have documented the theory of mind difficulties in autism. And the empathy difficulties are also well documented and widely replicated, both on performance tests (e.g., emotion-recognition tests from the face and voice) and on self-report measures (such as the Empathy Quotient or EQ).

Consider the latter, where 81% of people with autism score less than 30/80 on the EQ, by their own self-report, whilst only 12% of people without autism score at this low level. These results are mirrored when parents complete the EQ about their children, in many independent samples. So, whilst some people believe that theory of mind and empathy difficulties in autism are mythical, the results of many independent scientific studies suggest otherwise.
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2. Rachel challenges whether people with autism have difficulty knowing when they have hurt others, and wishes I had not stated that children with Asperger syndrome (AS) are delayed in being able to figure out what might hurt another person. Indeed, she finds my statement hurtful.

As a working scientist, all I can do is summarize the empirical evidence. An example is the Faux Pas Test, where children are asked to identify if anyone said anything they shouldn't have said, whilst listening to short audio recorded stories. Children with AS as a group on average scored significantly lower than children without AS, despite being older than the comparison group. Indeed, the design of this experiment allowed us to estimate the size of the developmental delay in AS, since the 12 year old children with AS performed more like typical 9 year olds. So, although Rachel may not like hearing these results, this is what the science finds.

I am not Rachel, but it seems to me like she wasn't denying the existence of those results at all; just saying that those results don't tell us much of anything about what the autistic people in the various studies were actually thinking that led them to do the test "wrong." We know that autistic people don't interpret social situations the same way non-autistic people do; what we don't know is how autistic people do interpret them.

(I am basing the above paragraph on what Rachel has written in this post on the Sally-Anne test for Theory of Mind, as well as her three-part series critiquing the EQ. Her post on the Sally-Anne test, in particular, is interesting because it describes an alternate thought process for a hypothetical autistic child taking the test, and coming up with reasons why Sally might look in other places than where the researcher wants her to look. What's important is that it's not that the kid in this example can't imagine Sally's point of view, it's that ze is drawing on different thought processes and experiences to arrive at different predictions for what Sally will do. The problem with the test is that it treats all wrong answers as failures to imagine Sally's mental state.)

Because I understand Prof. Baron-Cohen's need for empirical validation of these possibilities, I've even come up with an experimental design he (or anyone) could use to evaluate the two-way-street hypothesis that I've been promulgating here.

You'd have a bunch of people, half of them autistic and half of them not, and you would group them into pairs, with each pair including one autistic and one non-autistic member, both the same sex, same age and roughly similar verbal abilities, and just have them interact together for a short while, like 5-10 minutes. You would record their interaction on video, and then you would ask each person, separately, some questions about what happened between them. What they thought felt at certain points (decided on by the researchers sometime between the actual exchange and the individual Q&A sessions), what they thought the other person was thinking or feeling at certain points. You would then compare the two participants' answers to see how well they overlapped. You would also do this with autistic/autistic and NT/NT pairings, and then compare the average degree of similarity of the paired accounts across all three permutations.

This would allow you to see whether autistic people seem to understand each other better than they do NTs, or whether NTs are equally baffled by autistics.

It would also end the stalemate between Baron-Cohen's "well, the evidence says autistic people just don't understand social situations" and autistic people's self-reported experiences of both understanding other autistic people, and of having non-autistic people spectacularly fail to understand, or empathize with, them.

Simon Baron-Cohen Responds to Criticism from an Autistic Blogger - Part I

EXECUTIVE SUMMARY: Many autistic and feminist bloggers have criticized Simon Baron-Cohen's theories about autism and gender differences, but not very many have had him respond to their criticisms personally. Rachel Cohen-Rottenburg is one of those lucky people; she posted a critique of his E-S theory on her blog a couple years ago, and he has just now written a ten-point response to it. In this part of the post, I talk about Rachel's objection that the characterization of autistic people as poor empathizers ignores the differences between cognitive and affective empathy, and that even autistic people who lack cognitive empathy often have great capacity for affective empathy. I also talk about Baron-Cohen's response to this objection, and how his thought on empathy and autism has undergone a further evolution in the two years since Rachel wrote her post.
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Sandrine (a French woman living in Turkey, who has an autistic son) at The Paris Ankara Express pointed me to this guest post by the famous autism researcher Simon Baron-Cohen at the Autism Blogs Directory.

In his guest post, Prof. Baron-Cohen responds to criticism of his Empathizing-Systemizing (E-S) theory of autism from Rachel Cohen-Rottenburg, who writes the blog Journeys with Autism and also curates a web-anthology on Autism and Empathy.

He identifies ten points that Rachel makes in her essay, and writes a paragraph (or two or three) addressing each one. They seem to be split about half and half between questioning Baron-Cohen's conception of empathy (as in, autistic people actually tend to be quite sensitive to other people's emotions, particularly distress) and questioning whether his model is actually any more descriptive, or helpful, than older "deficit" models.

(You could argue --- and many people do --- that the E-S/Extreme Male Brain theory is still a deficit model since it considers a deficit in empathizing skills to be a defining characteristic of autism; it offsets this by also including normal or superior systemizing skills as part of the definition, but if you look at most of the psychological, educational, or behavioral literature on autism, you find all sorts of articles on remediating, or sounding the depths of, autistic deficits and not very much on nurturing or characterizing autistic strengths. So the offset deficit model isn't actually offset all that much, in practice.)

Rachel's post is a response to this paper from 2009 (Rachel's post is also from 2009) spelling out what the E-S theory says about autism. The article describes the E-S theory, particularly its evolution from Baron-Cohen's earlier "mindblindness" theory of autism. He lists five things the earlier model failed to explain that he thinks the newer one does adequately explain: 1) nonsocial aspects of autism, like attention to detail, love of patterns or routines, stimming etc., 2) empathy isn't just "mind-reading", it's also feeling something for the other person, and the "mindblindness" model only deals with mind-reading, 3) autism isn't the only condition that can produce mind-blindness, 4) some studies have failed to find any differences in Theory of Mind between autistic and non-autistic subjects, and 5) autistic strengths.

Rachel responds that, no, actually the E-S theory doesn't do any better at explaining these things. She thinks he totally misreads stimming, for one thing: to her, it's not about "systemizing" at all, it's about self-calming. It's a way to handle emotions, not a form of empirical investigation.

She also takes issue with his contention that we lack both cognitive and affective empathy:

The everyday experience of many autistic people, all across the spectrum, contradicts the professor's theory. Many of us experience such a high degree of empathy that we are constantly putting ourselves in other people's shoes and trying to see all sides in any controversy or conflict. Many of our problems with sensory and emotional overload derive from an excess of this ability, not a deficit.
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From my contact with autistic people, it's clear to me that our empathy leads many of us to constantly question the impact of our words. While I am far from perfect, choosing my words carefully may very well rank as one of my Aspie obsessions. However, the professor believes that "the typical 9-year-old can figure out what might hurt another's feelings and what might therefore be better left unspoken. Children with Asperger syndrome are delayed by around 3 years in this skill." (Baron-Cohen, 69)
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Baron-Cohen goes on to say that, in addition to not empathizing well, we don't know how to respond to someone even after the person tells us what's wrong.

News flash: Once someone tells me how he or she feels, I don't usually have a problem with an empathetic response. Sometimes, I'll make sure that my response is welcome, out of respect for the other person's boundaries. For instance, if a person is crying, I might ask whether the person would like a hug, or whether the person would like to talk. Some people want hugs, and some people want to be left alone. I consider it courteous to ask. Once I know people fairly well, however, and I know what works for them, I simply respond. Just ask my husband, my daughter, my daughter's friends, my friends, my former co-workers, my neighbors, and all the animals I've ever helped care for in various stages of illness.

I feel like I have to back up now, because Prof. Baron-Cohen says explicitly in his response to her (he even draws a picture!) that he thinks autistic people are only impaired in cognitive empathy, and that we are just as capable of affective empathy as anybody, which is pretty close to what Rachel was saying, too.

His thinking has shifted somewhat since he wrote the paper Rachel was responding to; in that paper, he not only doesn't say that autistic people have affective empathy, but he also implies that we are deficient in both kinds of empathy --- he mentions the EQ as a measure of both affective and cognitive empathy, and also mentions that autistic people tend to score lower on the EQ than non-autistic people:

Most people regard [Theory of Mind] as just the cognitive component of empathy in that it simply involves identifying someone else's (or your own) mental states. ... [M]issing from ToM is the second component of empathy, the response element: having an appropriate emotional reaction to another person's thoughts and feelings. This is referred to as affective empathy (Davis 1994). On the Empathy Quotient (EQ), a questionnaire is filled out either by an adult about themselves or by a parent about their child, both cognitive and affective empathy are assessed. On this scale, people with autism spectrum conditions score lower than comparison groups.

So, while Rachel's objection --- yes, we do have affective empathy --- might seem redundant to someone who has read Baron-Cohen's more recent writing on the subject of empathy (his most recent book, Zero Degrees of Empathy, contrasts autistic people with psychopaths: the former group has poor cognitive empathy but normal affective empathy, while the latter has normal cognitive empathy but poor affective empathy), she is actually bringing up something that is not addressed in the text she's working with.

(I also think there is still a problem in Baron-Cohen's work with measuring empathy --- measuring it at all, much less measuring each component separately --- in that most of the tests he uses that directly measure some aspect of empathy, like the Sally-Anne test, the Faux Pas test, or the Reading the Mind in the Eyes test, are measures of cognitive empathy only. The indirect measures, which are usually questionnaires, have their own problems. With any self-reported measures, there's a risk of stereotype threat, where the test takers' awareness of stereotypes about some group to which they belong biases their answers toward whatever the stereotype predicts: women/girls and members of some ethnic minorities, like African-Americans, Latin@s, or Native Americans, tend to do worse on math tests when they are reminded of their group membership, even by something as innocuous as a check-box at the top of the page for race and gender. Since autistic people are often taught from early childhood that their way of speaking, acting, feeling, or relating to other people is weird and wrong, I would not be surprised if they tended to rate themselves low on things like fitting in, participating in conversations or getting along with other people. Also, a lot of the questions on things like the EQ measure some mixture of cognitive and affective empathy; they ask about intuitively knowing what a person feels and then reacting to it, like knowing to comfort someone who is upset. There is one measure that has subscales geared just toward having intense feelings on other people's behalf, and that is the Interpersonal Reactivity Index, which one study found autistic people scored either very close to, or even better than, non-autistic people on all but one subscale.)

So his position on affective vs. cognitive empathy in autism has shifted somewhat since he wrote the paper Rachel was responding to, and he doesn't explicitly acknowledge that in his response to her; instead, he makes it sound like that's what he was saying all along:

Rachel says "once someone tells me how he or she feels, I don't usually have a problem with an empathic response." This is exactly the point. For most people, they don't need to be told by the other person, "I am upset." They can just read this information in the other person's facial expression, vocal intonation, or 'body language', and they can make inferences about what the other person might be thinking, in the absence of being directly told. For many people with autism these non-verbal cues may be hard to read and instead they may only know how someone feels if they are told explicitly. The evidence for this again comes from many scientific studies documenting difficulties by people with autism in reading the mind in the eyes, the face, the voice, or in action (e.g., film). Rachel's own self-description seems consistent with this: "Now, I will readily admit that I cannot infer a person's mental state by reading nonverbal cues."

But I completely agree that once it is explicitly pointed out, people with autism are very capable of an empathic response. Rachel may be surprised to hear that I agree with her on this one, but it hinges on the distinction between 'cognitive' and 'affective' empathy. Cognitive empathy is the ability to identify another person's state of mind (not just through language) and affective empathy is the drive to respond with an appropriate emotion to another person's state of mind. A growing number of studies suggest that the empathy difficulties in autism are largely restricted to the cognitive component, whilst the affective component is often intact. For this reason, people with autism are often highly motivated not to upset others or hurt others, and are themselves upset to hear that they may have done this if it is pointed out. And once they know that someone else is upset or suffering, they are very often motivated to want to help or offer comfort.

(This seems like a really patronizing response to me. She has addressed theory of mind in other parts of her post; with the passage he's quoting, she is explicitly addressing the "emotional response" aspect of empathy. To make the point that her capacity to form an empathic emotional response is working just fine, thank you, she's describing that faculty in isolation. He ignores that context so that he can go, "Ah-ha, see, she has to be TOLD what someone is feeling!" Well, no, she doesn't always. She's just describing a particular scenario where her cognitive empathy cannot be called into question --- because she doesn't have to use it --- in order to focus on her affective empathy.)

No, I am glad he understands that we care about other people, too. I still disagree somewhat with his assessment of our difficulties with cognitive empathy; that, I think, stems as much from our being profoundly different from other people in terms of our sensory and emotional responses as it does from any objective inability to "read" other people. I think he ignores just how badly non-autistic people fail to notice the signs of our distress, or misinterpret our body language or tone of voice. I think they are just as bad at reading us as we are at reading them; it's just that because they're the majority, their failure to understand us is not as disabling as our failure to understand them.

I had more things I wanted to point out about his response to Rachel, but I've ended up spending so much time untangling this one little snag where they seem to be talking past each other that I think I will split this into multiple posts.

Another Writer Uses "Autism" Where He Means "Selfishness" or "Amorality"

I'm getting quite a collection of examples of this sort of rhetoric, in which the writer/speaker tries to discredit someone else's political philosophy by calling it, or them, "autistic."

So far, I have a literary critic contrasting Jean-Paul Sartre's nihilism and profound alienation from other people (which he calls "autistic") with Albert Camus's more humanistic philosophy; a liberal editorial writer asking "Are Republicans Autistic?"; a liberal talk-radio host comparing Republican reliance on "talking points" to autistic verbal stims; and a liberal podcast blaming President Barack Obama's inability to overcome opposition by a vocal Republican minority on his inability to understand them, coupled with his overly scrupulous adherence to rules.

The latest addition to this group, which I saw on Emily's blog, A Life Less Ordinary?, is the author, neuroscientist and outspoken atheist Sam Harris talking about why he thinks Ayn Rand's philosophy of rational selfishness is unrealistic, morally obtuse and incompatible with actual human nature.

Here is the relevant part of that post (I'm including a bit more context for the offending one-liner than Emily did, because I'm interested in exactly what "autism" is supposed to imply here):

Many readers were enraged that I could support taxation in any form [in an earlier post on taxes and income inequality in the US]. It was as if I had proposed this mad scheme of confiscation for the first time in history. Several cited my framing of the question --- "how much wealth can one person be allowed to keep?" --- as especially sinister, as though I had asked, "How many of his internal organs can one person be allowed to keep?"

For what it's worth --- and it won't be worth much to many of you --- I understand the ethical and economic concerns about taxation. I agree that everyone should be entitled to the fruits of his or her labors and that taxation, in the State of Nature, is a form of theft. But it appears to be a form of theft that we require, given how selfish and shortsighted most of us are.

Many of my critics imagine that they have no stake in the well-being of others. How could they possibly benefit from other people getting first-rate educations? How could they be harmed if the next generation is hurled into poverty and despair? Why should anyone care about other people's children? It amazes me that such questions require answers.

...

As someone who has written and spoken at length about how we might develop a truly "objective" morality, I am often told by followers of Rand that their beloved guru accomplished this task long ago. The result was Objectivism --- a view that makes a religious fetish of selfishness and disposes of altruism and compassion as character flaws. If nothing else, this approach to ethics was a triumph of marketing, as Objectivism is basically autism rebranded. ...

And I say this as someone who considers himself, in large part, a "libertarian" --- and who has, therefore, embraced everything that was more or less serviceable in Rand's politics. The problem with pure libertarianism, however, has long been obvious: We are not ready for it. Judging from my recent correspondence, I feel this more strongly than ever. There is simply no question that an obsession with limited government produces impressive failures of wisdom and compassion in otherwise intelligent people.

This passage rests on the same assumption I noticed in the editorial "Are Republicans Autistic?", which is that autism is the same thing as selfishness. There is also the implication that to be autistic is to be profoundly ignorant of how the world works, how people are (Randians try to live by a philosophy that might work for some alien species that is 100% rational and naturally solitary, but which does not map very well onto human lives), or even the circumstances of their own lives (later in the article he mentions how much luck is involved in even the most "self-made" person's success, and alludes to people erroneously attributing to their efforts things that practically fell into their laps by virtue of their being in the right place at the right time, knowing the right people, and being the right "kind" of person).

It seems to me that it's no accident that all these rhetorical uses of "autism" to characterize a deeply selfish person or worldview are cropping up at the same time the popular conception of autism is shifting to "someone without empathy." It seems to me that those two things are actually mirror images of each other; as long as people talk about autistic people as being without empathy, autism will be the metaphorical diagnosis of choice whenever someone wants to talk about an actual lack of empathy.

So the stereotype gets reinforced from both ends.

"Zero Degrees of Empathy" Link Roundup

I'm holding off until I've actually read Zero Degrees of Empathy (or, for the edition I'm most likely to get my hands on, The Science of Evil), but there are plenty of other people writing interesting things about it:

Lili Marlene, who lives in Australia and writes skeptically about psychology on her blog, Incorrect Pleasures, has written several posts about her thoughts on the book as she's been reading it.

Here they are in chronological order:
Just a little bit reductionist don't you think?
A very horrible story that can't be ignored
Mathematician's test score does not add up
A quick word or two regarding the Reading the Mind in the Eyes Test and the Austrian study
Professor Simon Baron-Cohen, empathy expert
Is this guy for real? Baron-Cohen's latest book is a real urban legend!

Indigo Jo has written a double review of Zero Degrees of Empathy and an earlier book on E-S Theory, The Essential Difference. (And Lisa Harney at Questioning Transphobia has enlarged on it; the comment thread on her post is also worth reading).

Rachel Cohen-Rottenberg has a very detailed post about empathy; she has also started a web-anthology of essays addressing myths about autistic people and our capacity for empathy.

On Tumblr (a platform which continues to confuse me, but which is apparently really popular), Emily posted at F*** Yeah Autism Spectrum: So I read the first chapter of Simon Baron-Cohen's new book

Beyond Good and Evil: Does Simon Baron-Cohen's E-S Theory Help Us Understand Why People Do Bad Things?

I found out from browsing Sarah's Tumblr (which I do not regularly read like I used to read her blog, because I find Tumblr annoying, confusing and unreadable with its text-overlapping-text and other format wonkiness*) that Kim Wombles, who writes Countering Age of Autism, has interviewed Simon Baron-Cohen for a website called Science 2.0.

The occasion for this interview is that Baron-Cohen has apparently written a new book, one that extends his ideas about empathizing and systemizing from their usual territory (autism, psychological sex differences) to relatively new ground (explaining the human capacity for antisocial acts).

The American edition of the book is called The Science of Evil: On Empathy and the Origins of Cruelty, and it's reviewed at length (also by Kim Wombles!) here.

I haven't read the book, so I won't bother critiquing it without knowing what it actually says, but I will reproduce some of Wombles's Q&A with Baron-Cohen.

KW: Do you think readers will potentially ... get confused as to why you've placed the ASDs in a book titled The Science of Evil?

SBC: ... [Z]ero degrees of empathy does not necessarily lead to acts of cruelty. In the case of people with autism spectrum conditions, their low empathy usually leads them to avoid other people because they find other people confusing. Their low empathy doesn't lead them to commit acts of cruelty any more than anyone else in the population, but it does often lead them to feel socially isolated, with the added risk of depression.

...

The key difference [between autistics and psychopaths] seems to be that in psychopaths the 'cognitive' component of empathy is intact but the 'affective' component is not. In autism, both components may be impaired, or just the cognitive component. But their strong systemizing leads them, through powerful logic, to develop a moral code based on 'fairness' and 'justice'. Psychopaths lack the moral compass that most people develop using their empathy, and lack the moral compass that people with autism develop using their strong systemizing. People with autism spectrum conditions often end up as 'super-moral', developing a set of rules they expect people to live up to consistently (such as honesty), arriving at the conclusion that one should 'treat others as you would have others treat you' because it is the most logical approach.

...

KW: The online autism community is very vocal (and fairly well in agreement, considering the wide divides usually tearing it apart) that you are incorrect in your belief that autistic people lack empathy (and theory of mind). How do you respond to that charge and what evidence do you have that people with ASDs have zero empathy?

SBC: The online autism community is just one sector of the autistic population: namely, those with at least average intelligence, who can therefore use the internet. They are sometimes referred to as having "high-functioning autism" or Asperger Syndrome. This sector of the autistic population may not have zero degrees of empathy, but they do tend to have below average levels of empathy on different measures that research[ers] have used. These include (but are not restricted to) the 'Reading the Mind in the Eyes' Test, or the Empathy Quotient (EQ).

Many people with autism in the remainder of the spectrum may well have absolutely zero degrees of empathy, as shown in failing the False Belief Test (theory of mind) that even a typical 4 year old child can pass, but which is failed by many children with autism with a mental age above 4 years old. Many may not even show 'joint attention' that even a typical 18 month old toddler can show, such as spontaneously following another person's gaze. A meta-analysis review of false belief studies by Francesca Happe in 1995 found that most children with autism take until the age of 11 years old to pass this test, which is a 7 year delay (see attached graph and the recent paper by Senju, 2011). Even among children with Asperger Syndrome or high functioning autism, delays in 'social sensitivity' (such as detecting faux pas) are seen, despite their average or above average IQ.

...

So why might people with autism in the online community challenge this view? One possibility is that it is in the nature of empathy that people who are low in empathy are often the last people to be aware of it. ... An analogy might be with colour blindness. Many people who are colour blind are the last people to know about it, until they are given a test of it by an optician or vision scientist. They simply assumed that they were seeing the same colours as everyone else.

...

In my experience whilst even adults with Asperger Syndrome may have difficulties figuring out why someone else's remark was considered funny, or why their own remark was considered rude, or may judge others as liars when they simply are inconsistent in not doing what they said they would do, they may nevertheless have a highly developed emotional empathy, caring about how someone feels and not wanting to hurt them. If they do hurt them it is often unintentional and they feel mortified when it is pointed out, and want to rectify this. In this respect, they do have some of the components of empathy.

Many people with autism also form very strong emotional relationships with their pets ... whilst they struggle to 'read' human behaviour and human intentions, they can read the arguably more predictable behaviour of a pet.

Right now, I'm going to restrict myself to a few brief, superficial comments: first, in response to Professor Baron-Cohen's contention that everyone who says they are autistic on the Internet is a highly verbal, high-IQ computer geek with Asperger's --- no, we're not. There's a wide variety of autistic people on the Internet, including people with all sorts of functioning labels. The format of the Internet itself actually makes it easier for the less verbal, likely-to-be-called-low-functioning autistics to participate, since they don't have to produce speech. We might not be represented on the Internet in the exact proportions that we exist in the real world, but neither do we all belong to the same narrow subcategory of autism.

(And yay for him pointing out the difference between cognitive and emotional empathy, and also for pointing out that autistic people can be very emotionally empathic! That often gets lost, even in his own previous discussions of this subject.)

Also, I'm just going to express my skepticism at the idea that most of the abusive state employees described in the New York Times stories I referenced in this post had any psychiatric diagnoses, much less diagnoses that would explain their startling lack of empathy for the developmentally disabled people in their care. While Baron-Cohen does mention that failures of empathy can occur in people whose faculties are theoretically intact, he doesn't go into detail about how this happens. I guess I'll have to read the book to see what kind of case he makes that there is an "empathy circuit" in the brain that is bypassed or otherwise disabled when a person acts in a nasty way toward other people.

Finally, the "moral code[s] based on 'fairness' and 'justice'" that autistic people are supposed to develop through our amazing abilities to reason logically and think abstractly, sound a lot like the "mental widgets" that are so baffling to Amanda Baggs, and to (what seems to be) a significant subset of other autistic/non-neurotypical people! So I very much doubt that *all* of us are intellectualizing our way toward a system of ethics, even if I were to grant that some of us do that.

*I am a living refutation of the common stereotype that being autistic automatically makes you technologically gifted. Oh, how I wish!

Autistic Woman Writes Terrible Column; Speculation About Her Capacity for Empathy Ensues

There's this woman, Penelope Trunk, who writes about climbing the corporate ladder on her blog, and in her book Brazen Careerist: The New Rules for Success. She's founded several startup companies, has worked in marketing and is now a full-time writer, focusing on career advice for young people.

She also has Asperger syndrome.

A few days ago, she wrote a column about Dominique Strauss-Kahn, the former head of the International Monetary Fund who is accused of sexually assaulting a hotel maid. In her column, Trunk advances the bizarre hypothesis that women who occupy the lowest rungs of the socioeconomic ladder, who work low-paying, menial jobs with no possibility of advancement, have greater freedom than higher-paid, professional women do to report sexual abuse by bosses, co-workers or clients.

Her notion is that someone working a low-paying job will not have the same incentive to hold onto that job that someone with a better job would have:

It has been clear for at least a decade that women who want to have a high-flying career should not report sexual harassment. I have written about this a zillion times, and before you argue with me, read the quotes from all the labor lawyers (representing plaintiffs) who agree.

The bottom line is that just about every woman who has entered the workplace has experienced sexual harassment, but the women who report it face retribution. ... [W]omen who complain about harassment generally lose their jobs in some convoluted but ultimately predictable way.
...
But, what about women who don't care if they get fired? Those women hold a lot of power in this equation.

It used to be that women with low-level jobs did not have the socioeconomic backing to stand up for themselves in the face of harassment. Today, women feel more empowered - even women in a low pay grade. And women across the economic spectrum can identify what crosses the line.

These women have nothing to lose when they report men who cross the line sexually. So the maid reported. And then, it turns out, all sorts of women in higher-up positions spoke up against Strauss-Kahn. The women wouldn't report the harassment on their own. They don't want to suffer retribution. But now there will be no retribution, so it's safe to come forward.

This is why men are going to focus harassment at the higher ranks of the corporate ladder. These are the women who have to keep their mouths shut if they want to keep climbing the ladder.

But God help the guy who harasses a woman with nothing to lose.

It's a great moment in history. Poor women are empowered to fight against lecherous men, and rich women can finally come out of the sexual-harassment closet because of it.

Matt Yglesias at Think Progress and Amanda Marcotte at Pandagon have both covered why this is astonishingly, massively wrong --- not just off, but actually the opposite of what's really true, which is that poorer women working menial jobs are more, not less, vulnerable to exploitation and abuse at work, and have fewer options for escaping or combating it. In believing otherwise, Trunk seems to have forgotten that, for some people, losing a job means not being able to pay rent, not having enough money to buy enough food, having to put off needed medical treatments or go without needed medications because they can't pay for them.

She also assumes that, if one quits a menial job, one can quickly and easily find another. This is just not true in an economy where almost one-tenth of all people in the U.S. are officially unemployed, and many more are working fewer hours than they'd like to. These low-wage service jobs are actually really competitive right now, since there are relatively few of them (since companies have mostly been weathering the Great Recession by laying off all the employees they could conceivably do without) and lots of people needing work.

There's a lot of other important stuff she leaves out, but I think the most important failing in her article is her assumption that women working low-paying jobs don't need those jobs. As a commenter on Pandagon noted, it's as if she's assuming that everyone has well-off relatives who can support them for a time, or has a trust fund or significant savings to fall back on. She doesn't seem to understand what poverty is.

Anyway, enough about Trunk. She's ignorant, naive and starry-eyed, and her good fortune and financial security have given her the (mistaken) impression that life is as easy for everyone as it has been for her.

Now, I want to talk about her critics.

It shouldn't surprise anyone reading this blog that commenters on both Pandagon and Yglesias's site have brought up her autism as a possible explanation for her failure to grasp basic economic and social realities.

From Pandagon:

Penelope Trunk's deal is that she has Asperger's and spends a great deal of time and energy figuring out the "rules" for social interaction. (Note: she is open about this and has written a great deal about it.) I got reading her because her perspective can bring some real insight into human interactions. But she can also get things dead, dead wrong.

If Ms. Trunk actually suffers from an illness which damages her ability to feel empathy, that both absolves her (partially) and leads to the next question --- why is she indistinguishable from the average conservative/libertarian?

My understanding is that while the inability to read nonverbal cues is quite acute, the practical effect of Asperger's also includes a lesser capacity for empathy, especially in relatively swift interactions.

From Yglesias's:

Trunk is wrong, obviously. But Asperger's Syndrome makes what she's trying to do here --- put herself in both DSK's and the maid's position and see who's right --- incredibly difficult. This isn't Tom Friedman telling us we gotta say "suck on that" to Iraq b/c he's a dick, this is someone with a legitimate medical condition exercising poor judgment by choosing to comment on something it's very hard for her to understand given that condition.

These comments are actually not representative of the threads in which they appear; these four comments are the only comments on both websites to blame Trunk's classism on her Asperger's diagnosis, and both threads also include other comments telling the quoted commenters that they are wrong to do so.

But it still depresses me that her diagnosis comes up at all in a discussion of why her article is wrong. One of the reasons it depresses me is because --- as the last comment I quote indicates --- it effectively bars all autistic people from participating* in discussions about workplace harassment. "Oh, you're autistic, you don't understand how normal people act." Because our "condition" prevents us from understanding other people, nothing we say about anything other people do --- even things they do to us --- has to be taken seriously. This is especially troubling when it's workplace (or school) harassment we're talking about, since autistic people are especially likely to be targeted for such harassment. (Indeed, we are often blamed for being bullied --- it's our own fault for being so weird, we're told as children.)

It also depresses me somewhat to see Trunk's excessive optimism about most people's ability to quit jobs at will, and find new jobs quickly and easily, attributed to her Asperger's rather than to her having a lot of resources at her disposal that she takes for granted, when most people with autism, when they can work, have terrible trouble finding jobs, and then holding on to those jobs for longer than a few weeks. If anything, we probably have a keener grasp than most people do of the risks inherent in quitting a job, because those risks are heightened for us.

I'd also like to point out, in two of those comments --- both written by the same person --- the use of autism as a metaphor for a self-serving political philosophy.

I've seen this once before, in an article on CommonDreams.org:

The language used in this passage --- citing "self-centered" behavior as the characteristic feature of autism, for example, or saying autistic people lack "linguistic, social, cultural or logical constraints to manage [our] lives" --- draws strong, if implicit, parallels between autism (a neurological condition) and selfishness (a moral quality).

These comments do a similar thing, with the "lack of empathy" that is so often cited as the core deficit of Asperger's syndrome. In the psychological literature on autism, the "empathy" being spoken of is usually cognitive --- we are unable to understand non-autistic people's behavior, feelings or states of mind, even though we are perfectly capable of caring about them. Yet, in the comment quoted above, the implication is that this lack of understanding also entails a lack of feeling for these incomprehensible others.

Autism is not a moral failing. Autistic people have moral failings, but they have them because they are people, not because they are autistic.

*Not in the literal sense of "You are not allowed to speak," but in the more nebulous sense of "You can speak, but if I know that you're autistic, I will attribute everything you say to your being autistic, and if any of it conflicts with what I think is true, or right, I will disregard whatever you say because your mind is diseased and mine is not."

Fetal Testosterone and Autistic Traits - Part III: Empathy

EXECUTIVE SUMMARY: This post looks at two studies by Simon Baron-Cohen's group dealing with the effects of testosterone on the development of empathy. Both of the studies' subjects come from a cohort of children whose mothers underwent amniocentesis and agreed to have their amniotic fluid hormone levels tested. The first study I discuss looks for a relationship between amniotic testosterone and performance on two psychological tests that are supposed to measure empathy: a children's version of the Empathy Quotient and a children's version of the Reading the Mind in the Eyes test. The other study involved having the children watch a short animated film and describe what they saw in it, with researchers keeping track of what kind of words the children used --- did they tend to speak of the animated shapes in human terms, as having thoughts, intentions, and feelings?

Girls did indeed tend to speak more readily of the animated shapes as if they were thinking, feeling characters in a story, though for the most part this trait did not have any relation to amniotic testosterone levels. Girls also scored higher on the Empathy Quotient, but their scores likewise bore no relation to prenatal testosterone. (There was such a relationship for boys, however). Only the Reading the Mind in the Eyes Test results showed the expected negative correlation with amniotic testosterone, and that test failed to show the expected sex difference in favor of girls.
______________________________________________

Empathy --- or the lack thereof --- is crucial to Simon Baron-Cohen's conception of autism, and also to his conception of the "essential difference" between the sexes.
In this 2006 paper published in Social Neuroscience (full text here), a group of researchers affiliated with Cambridge University looked for a relationship between children's scores on two measures of empathy, the Reading the Mind in the Eyes test and a children's version of the Empathy Quotient (EQ-C), and the amount of testosterone that was present in their mothers' amniotic fluid.

The two tests were given in separate experiments, to different groups of children whose mothers all underwent amniocentesis in the Cambridge region of the U.K. between June of 1996 and June of 1999; at the time of testing, the children were all between six and nine years old. The EQ study involved 193 children --- 100 boys and 93 girls --- and had those children's parents fill out the questionnaire about the children, rather than having the children take the test themselves. Three outliers --- one boy and two girls --- were left out of the statistical analysis, leaving 99 boys and 91 girls.

(Figure 1, in Chapman et al., 2006 --- scatter plot showing the distribution of boys' and girls' scores on the children's Empathy Quotient in relation to the amount of testosterone, expressed in nanomoles per liter, present in their mothers' amniotic fluid)

There were significant sex differences in EQ-C scores; the boys' average score was 32.62 (out of a possible 58), while the girls' was 39.12. That's a difference of a little less than a standard deviation (roughly), with effect size d = 0.76. Fetal-testosterone levels correlated significantly with EQ-C scores when both sexes' data was analyzed together, and also in the within-sex analysis for boys; for girls, however, there was no relation between fetal testosterone and EQ-C score.

Due to the very close relationship between two of the variables being looked at --- amniotic testosterone level and sex (which in this study were correlated with r = -0.65) --- the researchers did further analysis to try and isolate the effect of each one:

A combined sex analysis showed there to be a significant negative correlation between fT level and performance on the EQ-C: r(193) = -.28, p < .01. However, there was also a significant difference between girls' and boys' EQ-C scores. Within-sex analyses revealed that there was a significant correlation between fT and EQ-C scores for the boys: r(99) = -.35, p ≤ .01, but not for the girls. The fact that a correlation is observed between fT and EQ-C for the boys may in part be due to a larger variation in fT levels for boys (0.10-2.05 nmol/L) compared to girls in this study (0.05-0.85 nmol/L). We investigated the influence of fT and sex on EQ-C scores by running a stepwise analysis, which revealed a main effect of sex, but not fT in the final model. The strong correlation between sex and fT means that fT cannot be ruled out as a factor in producing the observed sex difference, but it is clear that the sex difference is larger than that which would be predicted by fT alone.

I can think of something that might be at work here, that would explain a wider gap between the sexes than differences in amniotic testosterone levels would account for: remember that the metric used to measure empathy in this (quasi-)experiment, the Empathy Quotient, isn't a direct assessment of a skill but rather asks you to agree or disagree that various general statements (like "I can easily tell if someone else wants to enter a conversation" or "It is hard for me to see why some things upset people so much") describe you. Also remember that, in this instance, the person answering the questions isn't answering them about hirself, but is answering them for hir children. Both of those aspects of the EQ-C allow for quite a bit of subjective wiggle room --- even when you are answering questions about yourself, if the questions are fairly general in nature (like "Are you a 'people person'?" or "Are you good at math?"), the same person might answer them differently at different times or in response to different cues. (One of these cues, as Cordelia Fine persuasively argues in Delusions of Gender, is the checkbox at the top of many standardized tests --- including the EQ and SQ --- that asks you to specify whether you are male or female).

The "Mind in the Eyes Test" experiment involved a much smaller study population: 39 boys and 37 girls, from the same cohort of six-to-nine-year-old children as the participants in the EQ-C study. The test involves looking at a series of pairs of eyes and choosing (from four available words) the word that best describes what the owner of those eyes is feeling.

Here are some of the eyes:

The children's mean scores didn't really differ between the sexes --- 15.23 (out of 28 possible) for boys versus 16.29 for girls, with standard deviations of 3.50 for boys and 3.29 for girls --- but, looking at the graph, I get the impression that, although the score distributions for each sex are pretty much right on top of each other, there seem to be more low scorers among the boys than among the girls.
(Figure 2, in Chapman et al., 2006 --- scatter plot showing the distribution of boys' and girls' scores on the children's version of the Mind in the Eyes Test in relation to levels of testosterone present in amniotic fluid)

Weirdly, although no sex differences were found, the researchers did see a relationship between amniotic testosterone levels and Mind in the Eyes test scores. This relationship held true within each sex, as well as in the combined-sex analysis. The correlation was somewhat weaker for the girls, though: r = -0.29, as opposed to the boys' r = -0.42 and both sexes' r = -0.43.

There was also another variable that correlated significantly (r = 0.29) with performance on this test: the age of the child. That just makes sense --- children's verbal fluency, degree of insight and social intelligence all improve as they develop. (They also measured the children's IQs, and found no relationship between verbal IQ and test scores, though. So that aspect of development seems not to be implicated in this study).

Another study (full text here) published that year in Hormones and Behavior --- by many of the same researchers who worked on the one I already described --- looked for a relationship between amniotic testosterone and a different, somewhat whimsical, measure of empathy: they looked for the proportion of words relating to mental states that children used to describe the movements and interactions of cartoon shapes in a short, wordless film.

Here's a description of the short films the children (25 boys and 14 girls, all four years old) were shown:

Computer-presented animations were provided by Fulvia Castelli and were used in the studies by Abell et al. (2000) and Castelli et al. (2000). The animations showed one large red and one small blue triangle moving around a screen which contained a rectangular enclosure. One animation (random) showed the triangles moving about purposelessly (bouncing off the sides) and not interacting with each other (this was chosen from a possible set of 4). Two animations were designed to convey ToM (these were taken from a possible set of 6). One film showed the big triangle coaxing the little one out of the enclosure (see Fig. 1). One showed the little triangle hiding behind a door and surprising the big triangle. Sequences lasted 34 to 45 s each. Children watched the film once and were then asked what was happening. They were then asked to describe the film as it was playing (to reduce the memory burden). For the random film, only these initial descriptions were recorded. For the ToM films, after the first descriptions were given, children were asked a series of questions designed to elicit more information and to encourage them to view the sequence in human terms. ... The children's narratives were tape-recorded and then transcribed.

Later, researchers who hadn't participated in the interviews read through the transcripts and counted the number of "mental-state terms" (words describing thoughts, plans, wishes, motives, etc.), "affective-state terms" (words describing feelings), "intentional propositions" (phrases describing the animated shapes as characters doing things), and "neutral propositions" (phrases that just describe how the shapes are moving, or what they look like, without any attempt to turn them into characters in a story) that appeared.

Because an earlier study found that autistic children were less likely than typically developing children to ascribe mental states to similar animated triangles, the authors of this study (Rebecca Knickmeyer, Simon Baron-Cohen, Peter Raggatt, Kevin Taylor and Gerald Hackett) predicted 1) that the girls in this study would use more mental- and affective-state terms than the boys, and 2) that, within each sex, the concentration of testosterone found in each child's mother's amniotic fluid would vary inversely with that child's use of mentalizing language.

While they pretty much found the sex differences they expected to find (the girls used significantly more affective-state terms than the boys did (d = 0.82), while the boys used significantly more neutral propositions than the girls did (d = 0.63), and there was a trend that just barely missed the cutoff for statistical significance (d = 0.62) for the girls to use more intentional propositions), their results were more ambiguous in their support (or nonsupport) of the proposed link with fetal testosterone exposure.

Two of the outcome variables, mental-state terms and affective-state terms, showed no relationship to amniotic testosterone levels whatsoever; two others, intentional propositions and neutral propositions, showed a significant relationship* to testosterone when all the subjects' data were analyzed together, but that relationship failed to show up in the within-sex analyses**, which suggests that the relationship observed for the pooled data might just be an artifact of the sex differences I described in the last paragraph.

These data, along with the data from the first study I described in this post, provide only incomplete, ambiguous support for the idea that testosterone exposure during development suppresses a person's ability to imagine another person's mental state.

Both studies also fail to make the case that the link with testosterone exposure is strong enough to stand on its own, rather than simply being another indicator of sex differences, which may have any number of biological, psychological, social or cultural causes. Is testosterone driving this sex difference, or merely reflecting it?

*They tested for this relationship in two ways: first, they just looked for Pearson correlations (r) between all the variables they had measured; next, they used hierarchical regression analyses to try to isolate the contributions of individual variables --- to test each one to see how well it predicts how much of each type of language any given child's description will contain. Only one of the Pearson correlations --- that between testosterone and use of intentional propositions --- was significant, at r = -0.43. The other kind of significant relationship Knickmeyer and colleagues are talking about is one that produces a significant F change when it is included in their statistical model. Fetal testosterone produced such a change for both intentional and neutral propositions.

**Neither sex showed such a relationship when use of intentional propositions was the outcome variable of interest; when they looked at neutral propositions, there was a significant relationship to amniotic testosterone levels among the boys, but not among the girls.

Sources:
Chapman, E., Baron-Cohen, S., Auyeung, B., Knickmeyer, R., Taylor, K., & Hackett, G. (2006). Fetal testosterone and empathy: Evidence from the Empathy Quotient (EQ) and the "Reading the Mind in the Eyes" Test Social Neuroscience, 1 (2), 135-148 DOI: 10.1080/17470910600992239

KNICKMEYER, R., BARONCOHEN, S., RAGGATT, P., TAYLOR, K., & HACKETT, G. (2006). Fetal testosterone and empathy Hormones and Behavior, 49 (3), 282-292 DOI: 10.1016/j.yhbeh.2005.08.010