The emotion regulation and recognition account of empathy-related processes in autism: a multimodal, multilevel case-control study.
Abstract
Background
Recent evidence suggests that many autistic individuals exhibit heightened emotional responsiveness to others' affect despite greater difficulty recognizing others' emotions and accurately inferring their perspectives. This study introduces and preliminarily evaluates the Emotion Regulation and Recognition Account (ERRA), a model proposing that susceptibility to emotion dysregulation and challenges with emotion cue interpretation jointly shape empathy-related processing in autism.
Methods
Children aged 6-13 years (Nautistic = 103; Nnon-autistic = 40) participated; groups were matched demographically. Children watched five videos of youth exhibiting strong affect (e.g. sad and angry) and answered questions about their reactions to and understanding of the videos. These responses were coded for empathy-related processes such as emotional contagion and perspective taking. Electrodermal reactivity to and eye gaze towards the videos were also measured. Multilevel models were employed to test hypothesized pathways in the ERRA.
Results
Autistic children experienced greater affective intensity but exhibited less accurate emotion recognition than non-autistic children when observing youth exhibiting strong affect. Greater physiological and affective intensity were associated with greater attention shifting, and more frequent attention shifting among autistic children was associated with less accurate emotion recognition. Less accurate emotion recognition was, in turn, associated with less emotional synchrony and perspective taking, which were linked with less prosocial motivation.
Conclusions
The findings provide initial support for the ERRA by suggesting that, rather than experiencing indifference, many autistic individuals have strong affective reactions when observing others in distress. These reactions may lead to attention shifting, which can reduce awareness of others' emotional cues, potentially interrupting the unfolding of empathic understanding and responding. Empathy-supporting interventions can build upon the affective responsiveness to others experienced by many autistic individuals.