Abstract
The social symptoms of autism spectrum disorder are likely influenced by multiple psychological processes, yet most previous studies have focused on a single social domain. In school-aged autistic children (n = 49), we compared the amount of variance in social symptoms uniquely explained by theory of mind (ToM), biological motion perception, empathy, social reward, and social anxiety. Parent-reported emotional contagion—the aspect of empathy in which one shares another’s emotion—emerged as the most important predictor, explaining 11–14% of the variance in social symptoms, with higher levels of emotional contagion predicting lower social symptom severity. Our findings highlight the role of mutual emotional experiences in social-interactive success, as well as the limitations of standard measures of ToM and social processing in general.
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Notes
Throughout this paper, we use “social difficulties,” “social impairment,” “social dysfunction,” and “social symptoms” interchangeably, with all four referring to behaviors (or lack of behaviors) that characterize the social dimension of the diagnostic criteria of ASD—for example, reduced initiation of social interactions, reduced social-emotional reciprocity, and abnormal nonverbal communication.
We use identity-first language because this is preferred by many autistic self-advocates (Brown 2011).
We refer to the constructs measured by the Strange Stories and Reading the Mind in the Eyes Test as verbal-cognitive and visual-affective ToM, respectively, to highlight the fact that these tasks differ not only in the type of mental state inference being assessed (cognitive vs. affective), but also in the modality of stimulus presentation (verbal vs. visual).
We did not administer three items from the original SRQ that form the Sexual Relationships subscale. The omission of these items did not affect our subscales of interest.
Sadikova, E., Kirby, L. A., Pecukonis, M., Warnell, K., & Redcay, E. (2017, May). Developmental relations between social reward, social cognition, and total severity in ASD. Poster presented at the International Meeting for Autism Research, San Francisco, CA.
We emphasize the specificity of our measure of emotional contagion within the larger construct of empathy. Whereas another aspect, cognitive empathy/affective ToM, is captured by the RMET and the ToMI (particularly the Early subscale, which includes several items pertaining to emotion recognition and understanding), our study lacks a measure of empathic concern.
Self-reports are also imperfect measures of emotional contagion in autistic individuals, who are more likely than TD individuals to experience alexithymia—that is, difficulty interpreting and verbalizing one’s own emotional state (Bird & Viding 2014). The study by Trimmer et al. (2017) illustrates this: autistic individuals under-reported their affective responses to distressing videos despite exhibiting typical levels of physiological arousal and facial affect.
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Acknowledgments
This study was supported by the University of Maryland and a grant from the National Institute of Mental Health to Elizabeth Redcay (R01-MH107441). The authors wish to thank Aiste Cechaviciute, Jacqueline Thomas, Heather Yarger, Dan Levitas, Ruth Ludlum, Eleonora Sadikova, Meredith Pecukonis, Sydney Maniscalco, Tova Rosenthal, Sabine Huber, Alex Mangerian, Zoey Maggid, Hunter Rogoff, Dylan Selbst, Debbie Choi, Alexandra Hickey, Sarah Rivas, Tina Nguyen, Micah Plotkin, Kathryn Bouvier-Weinberg, Matthew Kiely, Ryan Stadler, Dominic Smith-DiLeo, Avi Warshawsky, Aliceann Trostle, Katie Beverley, Maddie Reiter, and Yardena Sultan-Reisler for their assistance with data collection.
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DA conceived of the present study and methods, analyzed the data, and wrote the manuscript. ER served in an advisory role throughout the research and is the principal investigator of the larger study from which these data are derived. KRW and LAK contributed to material development, and KRW and DA oversaw scoring procedures. LAK conducted the majority of assessments to confirm ASD diagnoses. KRW, LAK, DM, and DA assisted with data collection. KRW, LAK, DM, and ER critically reviewed and contributed to the preregistration of the study and the final manuscript.
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Alkire, D., Warnell, K.R., Kirby, L.A. et al. Explaining Variance in Social Symptoms of Children with Autism Spectrum Disorder. J Autism Dev Disord 51, 1249–1265 (2021). https://doi.org/10.1007/s10803-020-04598-x
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DOI: https://doi.org/10.1007/s10803-020-04598-x