Impairments in Cognitive Empathy and Alexithymia Occur Independently of Executive Functioning in College Students with Autism

Background: Impairments in the cognitive domains of empathy and alexithymia are commonly reported across the autism spectrum and are associated with social dysfunction. Such cognitive impairments in autism may arise as the result of underlying differences in executive functioning (EF), although previous findings are inconclusive about their relative contribution. Furthermore, it is unknown whether such cognitive domains are relatively spared in intellectually advanced individuals with autism spectrum disorder (ASD).

Objectives: To examine whether college students with ASD experience difficulties in empathy and alexithymia, and whether this can be partially explained by their cognitive levels of EF.

Methods: The ASD sample consisted of 51 college students, aged 18.3 to 28.1 years old, 72% male. This group was compared to an age- and gender-matched group of typically developing students (n = 29) on empathy and alexithymia, as measured with well-validated parent- and self-report questionnaires. Furthermore, a broadly used cognitive test battery was used to measure EF. For the ASD group, associations between the relevant constructs were further investigated with analyses of covariance and regression analyses.

Results: The ASD group scored significantly higher on cognitive alexithymia (d = 0.70) and lower on cognitive empathy (d = 0.84), while no group differences on the affective components appeared. The difference in cognitive empathy remained significant after controlling for the potential influence of (cognitive) alexithymia. No significant relations between executive functioning and cognitive alexithymia or empathy were detected.

Conclusions: Intellectually advanced individuals with ASD experience serious impairments in the cognitive processing of social-emotional information. However, these impairments cannot be attributed to individual levels of EF. This suggests that interventions aimed predominantly at enhancing EF skills are likely to have limited benefits for social-emotional information processing in ASD individuals with intact intellectual functioning.