Exploring Levels of Self-Reported Sympathy and Distress in Individuals with Autism

Background: Difficulties with aspects of social interaction, including empathy, comprise a core symptom of autism spectrum conditions (autism). Sympathy is considered an aspect of empathy involving both cognitive and affective empathy components.

Objectives: Here we present data from a new task of self-reported sympathy and personal distress. Aims: 1) To examine group differences between those with and without autism; 2) To examine sex differences within the autism and control groups; 3) To test for any association between the sympathy task, measures of personal distress, with the Empathy Quotient (EQ).

Methods: Participants with autism (93 males; 161 females) and controls (40 males, 93 females) took part in an online survey via the Autism Research Centre or Cambridge Psychology websites. Participants completed a task where they were asked rate 80 images according to the amount of sympathy they had for the individual and the personal distress they felt. The images consisted of emotionally distressing and non-distressing control images. Participants also completed the EQ and Autism Spectrum Quotient (AQ) questionnaires.

Results: Significant differences (p < 0.001) were found between the autism and control groups for both self-reported sympathy and distress, with participants with autism giving lower ratings than controls. When analysing the data from males and females independently the difference between females with autism and control females (p<.001) was more pronounced. Males with autism gave significantly lower sympathy ratings compared to controls (p=.039) but there was no significant difference for distress ratings. Typical females scored significantly higher than typical males in both sympathy (p=.001) and distress (p=.011). However sympathy and distress ratings did not differ significantly by sex in the autism group.  EQ showed positive correlations with sympathy (r=.332) and distress scores (r=.403).

Conclusions: Using a new measure to assess levels of self-reported sympathy, this study showed that both males and females with autism gave lower ratings of sympathy when viewing people in distressing scenarios, compared to controls. Females with autism also reported lower levels of distress. Task ratings were correlated with self-reported scores of empathy, providing some validation for this task. The absence of the typical sex difference in autism confirms a pattern seen on other measures of sex differences in empathy. The findings provide further evidence of empathy performance in autism. This task could be useful tool in assessing sympathy as it is less dependent on language ability compared to some other measures. Future research could analyse performance in different subgroups and test physiological arousal to distressing scenarios as another index of how people with autism are different in their experience of sympathy. These results should not be taken to indicate that people with autism are uncaring, as there is considerable evidence that they do care; only that their processing of emotional cues in distressing scenes does not elicit the same level of self-reported sympathy or distress.