Abstract
Background: Although empathy has always been considered to be impaired in individuals with autism spectrum conditions (ASCs), the relevant findings have been inconsistent. The present meta-analysis aims to determine which empathy components are impaired and how culture, gender, and age moderate such empathy impairment.Methods: By using “Autism,” “Asperger Syndrome,” “Empathy,” and related Chinese synonyms as keywords, we searched the databases of Weipu, Wanfang, CNKI, Web of Science, Science Direct, SpringerLink, and Elsevier through “subject” and “keyword” searches. We also conducted a manual search according to the references. In total, 51 studies from Eastern and Western countries were included in this meta-analysis, which comprised 144 independent effects, 2,095 individuals with ASCs and 2,869 controls without ASCs. For the retrieved data, Hedge's g was taken as the quantitative measure of effect, and CMA V2.0 software was used for publication bias tests (by using Rosenthal's Classic Failsafe-N and Egger's methods), heterogeneity tests (by using a Q-test, I2-test, and H-test) and a moderating effect test (by using a univariate regression model).Results: The results showed that the empathy impairment evident in individuals with ASCs is component specific; that is, trait-cognitive empathy, trait-empathic concern, state-cognitive empathy, and state-empathic concern are impaired, whereas state-empathic accuracy remains intact, and trait-empathic accuracy is superior to the trait-empathic accuracy in neurotypical individuals. The univariate regression model showed that gender moderates the impairment of the trait-empathic concern, trait-empathic accuracy, and state-cognitive empathy in autistic individuals and that age moderates the impairment of the trait-cognitive empathy, trait-empathic accuracy, state-empathic concern, and state-empathic accuracy in autistic individuals. However, culture does not moderate any empathy components (trait-cognitive empathy, trait-empathic concern, or state-cognitive empathy) involved in the present meta-analysis.Conclusions: These findings contribute to ending the controversy over the empathic integrity of individuals with ASCs and shed some light on future research about the empathy impairment of autistic individuals. More specifically, subsequent studies should distinguish specific empathy components and consider the role of gender and age when demonstrating empathy impairment in individuals with ASCs. Moreover, related studies based on Asian collectivist cultural samples and female samples should be further enriched.
Highlights
Autism spectrum conditions (ASCs) refer to a class of generalized developmental disorders characterized by social interaction and communication disorders, narrow interests, repetition, and stereotypical behaviors (American Psychiatric Association, 2013)
We found only two studies that addressed the division of empathy components at the state level: Van der Graaff et al (2016) divided state empathy into state-cognitive empathy and state-affective empathy based on specific problem guidance, and Powell and Roberts (2017) further divided state empathy into statecognitive empathy, state-compassionate empathy, and state-affective empathy
We found that the diagnostic scores of ASC individuals (Mage ± SD = 20.92 ± 3.31, MADOSscore ± SD = 11.88 ± 2.83) reported by McVey et al (2016) were significantly higher than the diagnostic scores of ASC individuals reported by Silani et al (2008) (Mage ± SD = 36.90 ± 11.8, MADOSscore ± SD = 9.77 ± 2.40), t = 2.34
Summary
Autism spectrum conditions (ASCs) refer to a class of generalized developmental disorders characterized by social interaction and communication disorders, narrow interests, repetition, and stereotypical behaviors (American Psychiatric Association, 2013). ASCs are characterized by high morbidity (Sun et al, 2013), a low cure rate (Gor et al, 2012), an early onset, and lifelong duration (Fulton et al, 2014). Because of these characteristics, ASCs cause lifelong obstacles to the development of the patients themselves and places a considerable economic burden on their families (Sun et al, 2013). As one of the core features of ASCs, reduced social interaction behavior has been considered to be associated with the impaired empathy of individuals with ASCs (Mul et al, 2018). Empathy has always been considered to be impaired in individuals with autism spectrum conditions (ASCs), the relevant findings have been inconsistent. The present meta-analysis aims to determine which empathy components are impaired and how culture, gender, and age moderate such empathy impairment
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