Relationships between alexithymia, interoception, and emotional empathy in autism spectrum disorder.
Christiana D Butera, Laura Harrison, Emily Kilroy and 4 others
PMID 35833505WHAT IT FOUND
Youths with autism showed intact emotional empathy and interoception, but higher alexithymia linked to lower empathic concern and higher personal distress.
This suggests empathy difficulties may stem from alexithymia rather than autism itself.
Key findings
01No significant differences were found between autistic and typically developing youths in emotional empathy (empathic concern or personal distress) or interoceptive sensibility.
02In the ASD group, higher alexithymia was associated with lower empathic concern but higher personal distress when exposed to others' emotions.
03Alexithymia predicted personal distress above and beyond ASD group membership, supporting the view that this aspect of empathy is driven by alexithymia rather than autism diagnosis.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Small sample size (35 ASD, 40 TD) limits generalizability to the broader, heterogeneous ASD population. Participants were verbal with IQs > 80, so findings may not apply to those with intellectual disability or limited verbal ability. Reliance on self-report measures for empathy, alexithymia, and interoception, which may be affected by metacognitive difficulties in ASD. Cross-sectional design prevents conclusions about causality or development over time.
Declared interests
The authors declared no known conflicts of interest.
The easy way to misread this
Do not conclude that youths with ASD have intact empathy overall. The study found intact emotional empathy capacity but significant deficits in cognitive empathy (Theory of Mind) and social impairment. Furthermore, the presence of alexithymia complicates the picture: while they may feel distress (personal distress), they may struggle to express or act on other-oriented concern (empathic concern), which can still impact social functioning.