Social Pain and Emotional Egocentricity in High-Functioning Autism-Spectrum-Disorder: Behavioral and Neurophysiological Evidence

Background: Empathy is a crucial social skill that is relevant for everyday social interactions, and therefore has already been widely studied in both neurotypical as well as clinical populations. It is defined as the individual ability to feel with and understand another person's emotional state (Singer & Lamm, 2009). Given that humans primarily use their own emotions and perceptions in guiding their thoughts about conspecifics, self-projection mechanisms can lead to empathic judgments that are sometimes egocentrically biased towards one's own perspective – a so called emotional egocentricity bias (EEB) may occur (Silani, Lamm, Ruff, & Singer, 2013). Therefore, a cognitive component of empathy, called self-other distinction (SOD), plays an essential role during empathic interactions, mainly to avoid confusion between the self and emotions of others. This ability is necessary in order to generate a full empathic response. Multiple studies have shown impairments in empathic responses in individuals with autism spectrum disorders (ASD) (e.g. Dziobek et al., 2008). To date, only few studies have tried to investigate if reduced empathic responses can be due to an impairment of SOD.

Objectives: To investigate SOD abilities in ASD as indicated by the occurrence of emotional egocentricity biases.

Methods: Using a virtual ball-tossing game called Cyberball, we aimed to induce congruent as well as incongruent feelings of social inclusion/exclusion between the participant and a confederate, in order to test the occurrence of the EEB. The paradigm was first validated in a pilot study with 52 healthy subjects. In our main study, we then investigated 17 participants with high-functioning ASD as well as 17 matched neurotypical (NT) controls by means of a behavioral task as well as functional magnetic resonance imaging (fMRI).

Results: Replicating the results from the pilot study, the results of the main study indicated a significant EEB during incongruent emotional empathic judgments. However, no significant group differences regarding the EEB could be found, suggesting similar ability for SOD in both the NT and ASD participants in this sample. In spite of a similar behavioral EEB in the NT and ASD populations, brain differences in the right temporo-parietal junction (rTPJ) and right dorso-lateral prefrontal cortex (rDLPFC), two key areas involved in Theory of Mind and SOD, were detected in situations of incongruent emotions between the self and other.

Conclusions: The present study adds valuable preliminary insights to the investigation of social cognition in this population and expands them to the domain of social pain. Furthermore, the results suggest neurophysiological differences between neurotypical and autistic individuals, possibly underpinning differences in the neural processes involved in SOD during empathic judgments. Investigating the ability of SOD in ASD will ultimately pave the way to better understand their social and emotional impairments and provides an important contribution for current and future research in this area.