Persons with the diagnosis of Autism Spectrum Disorder (ASD) are characterized by an impairment to predict their social interaction partners' behaviors by hypothesizing on their thoughts and feelings, i.e., by impaired mentalizing (Frith and Frith, 2003). It has remained unresolved, whether persons with the diagnosis of ASD can empathically share others’ feeling states in an embodied manner (Bird et al., 2010). In a previous study we showed that empathically sharing an awkward situation with an observed protagonist (e.g., a person slipping in the mud) and accordingly his or her experience of the social pain embarrassment, yields cortical activation in a network including the anterior insula (AI) and the dorsal anterior cingulate cortex (dACC) (Krach et al., 2011), a network coding the affective reaction during empathy for physical pain (Singer et al., 2004).
In the present study we aimed at identifying the neural substrates involved in processing others' social pain experiences and the corresponding vicarious emotional reaction of embarrassment in a group of persons with the diagnosis of ASD. We hypothesized the ASD group to exhibit diminished activation of the so-called pain matrix in response to such situations. Based on the strong implications of alexithymic traits in ASD (Bird et al. 2010), we predicted that the subjectively reported intensity of vicarious embarrassment experiences would be less correlated with neural activation in these regions in individuals with ASD compared to the control group (CG).
Fifteen young men who matched the DSM IV criteria for ASD and who had a confirmed ICD-10 diagnosis of high-functioning ASD participated in the fMRI study. Stimuli consisted of validated sketches displaying protagonists during various forms of public norm violations in every-day life situations (Krach et al., 2011). Stimuli were presented for 12s, followed by a rating period to indicate the intensity of the vicarious embarrassment experience with button a press.
On the behavioural level, the ASD group and CG showed comparable vicarious embarrassment reactions. The results of the fMRI study yielded a more distributed engagement of the pain matrix and brain areas implicated in mentalizing in the CG as compared to ASD group. The parametric modulations indicated significantly stronger associations of hemodynamic responses with the subjectively reported intensity of vicarious embarrassment experiences within the pain matrix in CG as contrasted to ASD.
The present results show, for the first time, that persons with a diagnosis of ASD do indicate to experience empathy for another’s social pain as demonstrated for vicarious embarrassment. The neuroimaging data indicates that although central components of the pain matrix are implicated in this social pain experience in ASD, neural-activation measures in these regions were not informed by the subjective indication of this emotion. Our results help explaining the heretofore finding that persons with high-functioning ASD are capable to behaviourally indicate feelings of social emotions such as embarrassment (potentially via explicit recall of learned social norms), while at the same time they display profound difficulties in resonating with others’ emotional events (Bird et al., 2010).
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