Do you feel me? Autism, empathic accuracy and the double empathy problem

Empathy deficits in autism, particularly cognitive empathy, have been a long-held, but much debated assumption. An alternative perspective challenging this deficit model is the ‘double empathy problem’, proposing that empathy difficulties are bidirectional between autistic and non-autistic people. Despite this view gaining popularity, there has been limited research examining whether non-autistic people can empathise accurately, cognitively and affectively with autistic people. Addressing this gap, 81 adults from the general population, divided into groups based on how likely they are to share personality traits common in autistic people, were examined using an empathic accuracy task, modified to include autistic and non-autistic narrators and combined with a body mapping tool. Results showed participants had significantly lower empathic accuracy scores when viewing autobiographical accounts of emotional events from autistic narrators, compared to non-autistic narrators, especially for happy and sad emotions. However, participants also experienced significantly higher intensity in the body when viewing autistic narrators compared to non-autistic narrators, especially for anger and fear emotions. These findings support the double empathy problem and have strong implications for therapeutic and interpersonal relationships with autistic people. Lay Abstract The assumption that autistic people lack empathy, particularly imagining how others feel, has been much debated and is now being challenged by an alternative view: the ‘double empathy problem’. This suggests that non-autistic people may find it equally difficult to imagine how autistic people feel. Although this perspective is gaining popularity, research testing whether non-autistic people can accurately imagine and feel an autistic person’s emotions is still limited. Our study used video clips of autistic and non-autistic people recounting emotional events to test if participants from the general population could: track the intensity of the narrators’ emotions; name and feel the same emotion; match where the narrator felt the emotion and indicate how intensely they felt the emotion using a body map. Our results show that participants found it significantly harder to track autistic narrators’ emotions compared to non-autistic narrator’s emotions, especially when viewing clips of narrators feeling happy and sad. We also found that participants felt emotions more intensely in the body when viewing clips of autistic narrators compared to non-autistic narrators, especially when describing anger and fear. These findings support the double empathy problem and have strong implications for therapeutic and interpersonal relationships with autistic people.