Abstract
Emotional self-awareness is increasingly suggested to be an area of difficulty in autism that may predict socioemotional outcomes for this population. However, whether emotional self-awareness is consistently diminished in autism across age and methodology remains unclear. We systematically reviewed 47 papers measuring emotional self-awareness in autistic (n = 1387) and non-autistic (n = 1433) participants. Most studies relied on self-report. Of studies testing for group differences, the majority (32/41) found significantly poorer emotional self-awareness in autism. Meta-analyses of self-report measures found that emotional self-awareness was significantly poorer in autism (d = 1.16). However, when examining age groups individually, autistic children of age 12 years and under were not significantly different from their peers (d = 0.03). Instead, difficulties emerged during adolescence (d = 0.63) and increased with age (d = 1.16 – 1.58). The pattern of emotional self-awareness difficulties being more common in autism, and worsening with age is similar to the development of mental health difficulties in autism. However, findings rely on self-perception and so may reflect poor self-beliefs of socioemotional competence. We propose that negative self-beliefs in autistic populations may account for findings of low emotional self-awareness.Lay abstractAutistic people are thought to have difficulties with identifying and understanding their own emotions. This is referred to as emotional self-awareness. It is important to study emotional self-awareness as people who are more able to understand their own emotions, whether they are autistic or not, are more able to respond to them appropriately, as well as to identify them in other people. It has not yet been confirmed whether autistic people have difficulties with emotional self-awareness, or if any reported difficulties are actually due to the way in which emotional self-awareness is measured in autistic people. If these difficulties do exist, it is also not known when these difficulties emerge. In this research, we reviewed 47 existing studies that measured emotional self-awareness in autistic and non-autistic adults and children. We also compared studies that measured emotional self-awareness in different ways. We found that autistic adults did seem to have poorer emotional self-awareness compared to their neurotypical peers. However, this was not the case with autistic children of age 12 years and below. Instead, differences in emotional self-awareness only seemed to emerge during adolescence. Moreover, these difficulties seemed to increase with age. These results suggest that difficulties with emotional self-awareness may not be inherent in autism. Instead, they may emerge alongside the greater social and mental health difficulties that are experienced by many autistic people during adolescence. We therefore suggest that it is important to find out more about, and subsequently support, the emotional self-awareness difficulties that autistic adolescents may encounter.
Highlights
Lay abstract Autistic people are thought to have difficulties with identifying and understanding their own emotions
Work suggests that emotional self-awareness is diminished in autism (Kinnaird et al, 2019) and that these difficulties predict poorer emotional contagion and recognition in this population (Bird & Cook, 2013)
Inclusion criteria were as follows: (a) participants had a diagnosis of autism spectrum disorder (ASD), including Autism, Asperger’s, Pervasive Developmental Disorder– Not Otherwise Specified (PDD-NOS), and autism spectrum condition (ASC); (b) the study included a healthy, non-autistic control group; (c) the study included at least one measure explicitly assessing the participant’s awareness of their own emotional states, which is clearly distinct from measures assessing ability to identify or describe others’ emotional states
Summary
Lay abstract Autistic people are thought to have difficulties with identifying and understanding their own emotions. We reviewed 47 existing studies that measured emotional self-awareness in autistic and non-autistic adults and children. These results suggest that difficulties with emotional self-awareness may not be inherent in autism Instead, they may emerge alongside the greater social and mental health difficulties that are experienced by many autistic people during adolescence. Work suggests that emotional self-awareness is diminished in autism (Kinnaird et al, 2019) and that these difficulties predict poorer emotional contagion and recognition in this population (Bird & Cook, 2013). This is the second part of a two-part review. The ability to represent one’s own mind may be fundamental to representing the minds of others (Decety & Meyer, 2008), making emotional selfawareness an increasing area of interest in autism research
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