Am I a psychopath or an autistic person?

Empathy in people with autism

Research Report 2008 - Max Planck Institute for Human Development

Neurocognition of Decision Making (Heekeren) (Dr. med. Hauke ​​Heekeren), MPI for Educational Research, Berlin
Human empathy is a multidimensional construct that consists of elements of perception and emotional components. Although systematic studies have so far been lacking, a lack of empathy is considered to be a central characteristic of autism spectrum diseases. With the help of a new photo-based test, it was shown that people with autism are limited in their cognitive, but not in their emotional empathy.
Empathy is a multidimensional construct entailing cognitive and emotional components. Despite a paucity of research, individuals on the autism spectrum are generally believed to lack empathy. In a study researchers from the Max Planck Institute for Human Development used a new, photo-based measure, the Multifaceted Empathy Test (MET), to assess empathy multidimensionally. Results suggested that while individuals with autism are impaired in cognitive empathy, they do not differ from control persons in emotional empathy.

In everyday life - and especially in interaction with others - decision-making situations are highly complex and unstructured. For example, if we want to make a decision about how trustworthy or upset someone is, information about facial expression, gestures, and tone of voice must be included in this judgment Voice and the use of linguistic stylistic devices such as sarcasm or irony are included. The ability to understand the thoughts, feelings and intentions of our fellow human beings is known as “social cognition” or “theory of mind”. Based on this understanding of the mental states of others, we predict behavior and adjust our own behavior.

Another quality that helps us understand and predict the behavior of others is the ability to empathize. Empathy supplements “social cognition” with a warm, emotional component: so-called empathy. When we see a person in need, we not only understand their situation in thought, but can actually empathize with it.

Perceiving and feeling emotions

At least since the movie Rainman the general public is familiar with the clinical picture of autism. And just as widespread is the opinion that people with autism cannot empathize with others. This lack of empathy is considered to be the central characteristic of autism. It is therefore all the more surprising that in only a few studies with autistic people the characteristic empathy has been systematically examined and so far no distinction has been made between cognitive and affective empathy components. The aim of the study by the Max Planck Institute for Educational Research was therefore to differentiate between the cognitive empathy, the recognition and understanding of emotional states of mind, and the affective empathy, the emotional evaluation and perception, in people with autism.

In order to be able to differentiate between cognitive and affective empathy, a new, multidimensional test first had to be developed: The Multifaceted Empathy Test (MET) consists of a series of photos that show people in emotionally charged situations, such as a crying child in front of a burned down house. The study participants were asked to look at the photos and, in order to assess their cognitive empathy, to describe the feelings of the people depicted. Before they were asked in the second step what they felt when looking at them or to what extent they affected the depicted situation emotionally (affective empathy), the feelings of the depicted persons were correctly described. A total of 17 men and women from the autism spectrum and 18 women and men with normal language and social skills took part in the study.

Compassion and concern are just as pronounced in autistic people as in healthy people

It was found that the autism group actually had difficulties in correctly describing the feelings presented and had significantly lower cognitive empathy compared to the control group. However, both groups showed no difference in terms of emotional empathy. Compassion and concern were just as pronounced in the autism group as in the control group. The use of the Multifaceted Empathy Test thus refuted the opinion of the general lack of empathic skills in autistic people. Rather, people from the autism spectrum seem to be less able to “read” the social signs that reveal our inner being - gestures, facial expressions, tone of voice - and are therefore often experienced as indifferent. However, this has nothing to do with the long-assumed inability to show compassion. As the test shows, people with autism react emotionally adequately if they are given a correct description of the feelings and thus the lack of cognitive empathy is compensated.

These results on cognitive empathy are supported by further studies in which instead of the images of the Multifaceted Empathy Test (MET) a film was used. The Movie for the Assessment of Social Cognition (MASC) is a film test in which the study participants were asked to put themselves into the mental states of the performing characters. The use of a film format is based on the idea that the representation of emotions through sound and moving images is even more lifelike and that the film test is more relevant to everyday life than the picture test.

In further studies it will now be shown how cognitive and emotional empathy functions are represented in the brain in healthy people and people with autism. It is assumed that the two groups recruit different brain networks primarily for cognitive empathy functions. In addition to the use of MASC and MET, a combination of structural and functional imaging examination methods (brain volumetry and functional magnetic resonance tomography) with which different areas and functional states of the brain can be displayed is planned.

Original publications

I. Dziobek, K. Rogers, S. Fleck, M. Bahnemann, H. R. Heekeren, O. T. Wolf:
Convit A. Dissociation of Cognitive and Emotional Empathy in Adults with Asperger Syndrome Using the Multifaceted Empathy Test (MET).
Journal of Autism and Developmental Disorders 38 (3), 464-473 (2008).
I. Dziobek, S. Fleck, E. Kalbe, K. Rogers, J. Hassenstab, M. Brand, J. Kessler, J. K. Woike, O. T. Wolf:
Convit A. Introducing MASC: A Movie for the Assessment of Social Cognition.
Journal of Autism and Developmental Disorders 36 (5), 623-636 (2006).