Reexamining empathy in autism: Empathic disequilibrium as a novel predictor of autism diagnosis and autistic traits

A large body of research showed that autistic people have intact emotional (affective) empathy alongside reduced cognitive empathy. However, there are mixed findings and these call for a more subtle understanding of empathy in autism. Empathic disequilibrium refers to the imbalance between emotional and cognitive empathy and is associated with a higher number of autistic traits in the typical population. Here we examined whether empathic disequilibrium predicts both the number of autistic traits and autism diagnosis. In a large sample of autistic (N = 1905) and typical individuals (N = 3009), we examined empathic disequilibrium and empathy as predictors of autistic traits and autism diagnosis, using a polynomial regression with response surface analysis. Empathy and autistic traits were measured using validated self-report questionnaires. Both empathic disequilibrium and empathy predicted linearly and non-linearly autism diagnosis and autistic traits. Specifically, a tendency towards higher emotional than cognitive empathy (empathic disequilibrium towards emotional empathy) predicted both autism diagnosis and the social domain of autistic traits, while higher cognitive than emotional empathy was associated with the non-social domain of autism. Empathic disequilibrium was also more prominent in autistic females. This study provides evidence that beyond empathy as was measured thus far, empathic disequilibrium offers a novel analytical approach for examining the role of empathy. Empathic disequilibrium allows for a more nuanced understanding of the links between empathy and autism.

Automated summary

Research shows that individuals with autism have intact emotional empathy but reduced cognitive empathy. Empathic disequilibrium, or the imbalance between emotional and cognitive empathy, is associated with a higher number of autistic traits in the general population. This study examined the predictive role of empathic disequilibrium and empathy on autism traits and diagnosis. The findings suggest that empathic disequilibrium, specifically a tendency towards higher emotional empathy, predicts both autism diagnosis and social traits, while higher cognitive empathy is associated with non-social autistic traits. Empathic disequilibrium is more prominent in autistic females.