Empathy as a Predictor of Co-morbid Psychopathology, Executive Functioning, and Social Communication in Adolescents and Adults with Autism Spectrum Disorder

Social communication is a core deficit area for individuals with autism spectrum disorder (ASD) and empathy is a common treatment target amongst speech language pathologists and mental health workers to address these deficits. Therefore, it is important to determine a) if empathy deficits are present in ASD populations compared to typically developing (TD) controls and b) if empathy skills are predictive of other measures important to social communication including co-morbid psychopathology, real-world executive functioning, and pragmatic language/social communication behaviors. The Interpersonal Reactivity Index (IRI) was used to investigate cognitive and affective empathy skills in 33 adolescents and adults with ASD compared to 55 age-, IQ-, and sex ratio-matched TD controls. Across both groups, mean age was 26 and mean IQ was 116. Three questionnaires measuring co-morbid psychopathology symptoms, executive functioning deficits, and pragmatic language/social communication skills, respectively, were administered to the ASD group and multiple regression analyses investigated associations between IRI scores and ratings in those three domains.;Cognitive empathy was significantly reduced in the ASD group compared to TD controls. In the ASD group, cognitive empathy was not associated with depression or anxiety symptoms; however, it was significantly predictive of executive functioning skills including self-monitoring, shifting, initiating, and planning/organizing. It was also significantly predictive of passive social communication skills, but not pragmatic language skills. These findings firmly establish cognitive empathy deficits in adolescents and adults with ASD compared to TD controls. Given that empathy skills were found to be predictive of domains important to social communication such as executive functioning and passive social communication behaviors, cognitive empathy and perspective taking appear to be appropriate treatment targets to potentially improve overall social communication in persons with ASD via either direct or cascading effects.