Empathy and Emotion Recognition In People with Autism and Their First-Degree Relatives

Background:  

Impairments in empathy are an important characteristic feature of Autism Spectrum Conditions (ASC) (Baron-Cohen, 2002). Difficulties in identifying other people’s thoughts and feelings and problems responding to these mental states appropriately has an adverse impact on the formation of social relationships. Studies indicate that the first-degree relatives of individuals with ASC display higher rates of mild social and communication impairments compared to the general population (Wheelwright et al, 2010; Constantino et al. 2006).

The Empathy Quotient (EQ) is a self-report questionnaire designed to quantify empathy (Baron-Cohen and Wheelwright, 2004). We also designed a basic emotion recognition task using stimuli from the Karolinska Directed Emotional Faces (KDEF; Lundqvist et al. 1998) database. Basic emotion recognition is a fundamental component of social understanding and a core building block in the development of empathy.

Objectives:  

To assess whether (i) adults with ASC and (ii) first-degree relatives (parents) of a child with ASC show difficulties on a self-report measure of empathy (the EQ) and a performance measure of emotion recognition compared to a control group with no psychiatric diagnoses.

Methods:  

338 adults with ASC (167 male, 171 female), 317 parents of a child with ASC (279 mothers, 38 fathers) and 193 controls (96 male, 97 female) participated in this study. All data were collected using an online test interface and groups were matched on non-verbal IQ. Total EQ scores were calculated; basic emotion recognition performance was measured using accuracy-adjusted response time.

Results:  

A Group* Sex analysis of covariance (ANCOVA) with non-verbal IQ as a covariate revealed a significant main effect of Group (p < 0.001) and Sex (p < 0.001) on total EQ score, with males obtaining lower scores than females. There was a significant interaction effect between Group and Sex (p < 0.001). Planned contrasts revealed that fathers, but not mothers of a child with autism, scored significantly lower (p < 0.05) than same-sex controls. Both males and females with ASC scored significantly lower (p < 0.001) than their sex-matched controls.

For the emotion recognition test a similar ANCOVA revealed significant main effects of Group ( p < 0.001) and Sex (p < 0.001), with females outperforming males. Interaction effects were absent. Planned contrasts revealed that both adults with ASC (p < 0.001) and parents of children with autism (p < 0.05) showed significant impairments on basic emotion recognition. A Group* Sex MANCOVA analysing the 6 distinct basic emotions separately indicated that the ASC group showed impaired performance across all emotions, whilst for the autism parent group impaired recognition of individual emotions was restricted and less consistent.

Conclusions:  

This study indicates that the social and communication difficulties characteristic for individuals with ASC are reflected in significant impairments on a self-rated measure of empathy and in performance on a basic emotion recognition test. The first-degree relatives of individuals with ASC exhibited more subtle deficits on these tests, which are indicative of the Broader Autism Phenotype. These results suggest that some of the underlying components of empathy are heritable.