Double empathy problem

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An image depicting the double empathy problem

The double empathy problem is a psychological theory, coined in 2012 by autism researcher Damian Milton,[1] which proposes that the social and communication difficulties present in autistic people when socializing with non-autistic people are actually due to a reciprocal lack of understanding and bidirectional differences in communication style, social-cognitive characteristics, and experiences between autistic people and non-autistic people, but not necessarily inherent deficiency, since most autistic people are able to socialize, communicate, and empathize well with most autistic people.[1][2] The theory therefore fundamentally challenges both the common notion that social skills of autistic people are inherently impaired, and the theory, developed by Professor Simon Baron-Cohen, but since disputed, that empathy, and theory of mind (ToM) are generally impaired in autistic people, which is empirically questionable with many failed replications and mixed findings.[3] In a podcast in December 2020, and later also an article in May 2022, Simon Baron-Cohen positively recognized the Double Empathy Theory and recent findings that support it.[4][5] Since 2015, there have been increasing number of research studies, including experimental studies, qualitative research, and real-life social interaction studies supporting this theory and the findings appear consistent.[6][7][8][9][10][11][12][13][14]

History

Early studies on autism regarding ToM and empathy concluded that lack of ToM was one of the primary symptoms of autism. The most popular of these were studies by Simon Baron-Cohen in the 1980s and 1990s, who used the term mindblindness to describe his theory.[15][16]

In the early 21st century, academics began to suggest that some studies of ToM tests may have misinterpreted autistic people having difficulty understanding neurotypicals as being an intrinsic social difficulty present in autistic individuals. It seems more likely that autistic people are specifically having trouble understanding neurotypicals, due to the neurological differences between the groups.[1][17]

Neurologically-aligned studies

Studies which have used autistic-autistic pairs to test interpersonal rapport and communication effectiveness in adults have shown that autistic adults perform better in interpersonal rapport and communication effectiveness when paired with other autistic adults, that higher rapport may be present in autistic-autistic interactions than in those between autistic and neurotypical people, and that autistic people may be able to understand and predict each other's thoughts and motivations better than neurotypicals[18] as well as possibly autistic close family members.[19]

Neurotypical individuals tend to have a poor understanding for autistic people, just as autistic people may have a poor understanding of non-autistic people.[1] It is likely autistic people understand non-autistic people to a higher degree than vice versa, due to the frequency of masking - i.e., diminishing one's autistic traits and/or personality to better camouflage into a non-autistic society.[1] Masking begins at a young age in order to avoid bullying, a common experience for autistic children and adults.[20]

Autistic ToM is typically based on the use of rules and logic and may be modulated by differences in thinking.[21] If autistic people were inherently poor at social communication, an interaction between a pair of autistic people would logically be more of a struggle than one between an autistic and neurotypical person. This research contests common assumptions about autistic people in the fields of psychology and psychiatry.

A 2018 study has shown that autistic people are more prone to object personification,[22] suggesting that autistic empathy may be not only more complex but also more all-encompassing, contrary to the popular belief that autistic people lack empathy.

Autistic perspectives

Many autistic activists have shown support for the double empathy concept, and have argued that past studies done on ToM in autism have served to stigmatise autistic people,[2] blame autistic-neurotypical misunderstandings solely on autistic people,[23] and de-humanise autistic people by portraying them as unempathetic.

Damian Milton has described the belief that autistic people lack ToM as a myth analogous with the now-discredited theory that vaccines cause autism.[24]

References

  1. ^ a b c d e Milton, Damian E.M. (October 2012). "On the ontological status of autism: the 'double empathy problem'". Disability & Society. 27 (6): 883–887. doi:10.1080/09687599.2012.710008. ISSN 0968-7599. S2CID 54047060.
  2. ^ a b DeThorne, Laura S. (2020-03-01). "Revealing the Double Empathy Problem". The ASHA Leader. 25 (3): 58–65. doi:10.1044/leader.ftr2.25042020.58. S2CID 216359201. Retrieved 2022-04-16.
  3. ^ Gernsbacher, Morton; Yergeau, Melanie (2019). "Empirical Failures of the Claim That Autistic People Lack a Theory of Mind". Archives of Scientific Psychology. 7 (1): 102–118. doi:10.1037/arc0000067. PMC 6959478. PMID 31938672.
  4. ^ Richards, Gareth; Baron-Cohen, Simon (2022-05-19). "Evidence of partner similarity for autistic traits, systemizing, and theory of mind via facial expressions". Scientific Reports. 12 (1): 8451. doi:10.1038/s41598-022-11592-z. PMC 9118825. PMID 35589769.
  5. ^ "A Conversation About 'The Pattern Seekers' by Simon Baron-Cohen". 19 December 2020.
  6. ^ Bolis, Dimitris; Lahnakoski, Juha M; Seidel, Daniela; Tamm, Jeanette; Schilbach, Leonhard (2020-10-26). "Interpersonal similarity of autistic traits predicts friendship quality". Social Cognitive and Affective Neuroscience. 16 (1–2). Oxford University Press: 222–231. doi:10.1093/scan/nsaa147. ISSN 1749-5016. PMC 7812635. PMID 33104781.
  7. ^ Chen, Yu-Lun; Senande, Laura L.; Thorsen, Michael; Patten, Kristie (2021). "Peer preferences and characteristics of same-group and cross-group social interactions among autistic and non-autistic adolescents". Autism. 25 (7): 1885–1900. doi:10.1177/13623613211005918. PMC 8419288. PMID 34169757.
  8. ^ Morrison, Kerrianne E.; Debrabander, Kilee M.; Jones, Desiree R.; Faso, Daniel J.; Ackerman, Robert A.; Sasson, Noah J. (2020). "Outcomes of real-world social interaction for autistic adults paired with autistic compared to typically developing partners". Autism. 24 (5): 1067–1080. doi:10.1177/1362361319892701. PMID 31823656. S2CID 209317731.
  9. ^ Davis, Rachael; Crompton, Catherine J. (2021). "What do New Findings About Social Interaction in Autistic Adults Mean for Neurodevelopmental Research?". Perspectives on Psychological Science. 16 (3): 649–653. doi:10.1177/1745691620958010. PMC 8114326. PMID 33560175.
  10. ^ Crompton, Catherine J.; Ropar, Danielle; Evans-Williams, Claire VM; Flynn, Emma G.; Fletcher-Watson, Sue (2020). "Autistic peer-to-peer information transfer is highly effective". Autism. 24 (7): 1704–1712. doi:10.1177/1362361320919286. PMC 7545656. PMID 32431157.
  11. ^ Crompton, Catherine J.; Sharp, Martha; Axbey, Harriet; Fletcher-Watson, Sue; Flynn, Emma G.; Ropar, Danielle (2020). "Neurotype-Matching, but Not Being Autistic, Influences Self and Observer Ratings of Interpersonal Rapport". Frontiers in Psychology. 11: 586171. doi:10.3389/fpsyg.2020.586171. PMC 7645034. PMID 33192918.
  12. ^ Crompton, Catherine J.; Hallett, Sonny; Ropar, Danielle; Flynn, Emma; Fletcher-Watson, Sue (2020). "'I never realised everybody felt as happy as I do when I am around autistic people': A thematic analysis of autistic adults' relationships with autistic and neurotypical friends and family". Autism. 24 (6): 1438–1448. doi:10.1177/1362361320908976. PMC 7376620. PMID 32148068.
  13. ^ Mitchell, Peter; Sheppard, Elizabeth; Cassidy, Sarah (2021). "Autism and the double empathy problem: Implications for development and mental health". British Journal of Developmental Psychology. 39 (1): 1–18. doi:10.1111/bjdp.12350. PMID 33393101. S2CID 230489027.
  14. ^ Williams, Gemma L.; Wharton, Tim; Jagoe, Caroline (2021). "Mutual (Mis)understanding: Reframing Autistic Pragmatic "Impairments" Using Relevance Theory". Frontiers in Psychology. 12: 616664. doi:10.3389/fpsyg.2021.616664. PMC 8117104. PMID 33995177.
  15. ^ Baron-Cohen, Simon; Leslie, Alan M.; Frith, Uta (1985-10-01). "Does the autistic child have a "theory of mind" ?". Cognition. 21 (1): 37–46. doi:10.1016/0010-0277(85)90022-8. ISSN 0010-0277. PMID 2934210. S2CID 14955234.
  16. ^ Baron-Cohen, Simon (1988-10-01). "Social and pragmatic deficits in autism: Cognitive or affective?". Journal of Autism and Developmental Disorders. 18 (3): 379–402. doi:10.1007/BF02212194. PMID 3049519. S2CID 2050249.
  17. ^ Rogers, Kimberley; Dziobek, Isabel; Hassenstab, Jason; Wolf, Oliver T.; Convit, Antonio (2007-04-01). "Who Cares? Revisiting Empathy in Asperger Syndrome". Journal of Autism and Developmental Disorders. 37 (4): 709–715. doi:10.1007/s10803-006-0197-8. ISSN 1573-3432. PMID 16906462. S2CID 13999363.
  18. ^ Crompton, Catherine J.; Sharp, Martha; Axbey, Harriet; Fletcher-Watson, Sue; Flynn, Emma G.; Ropar, Danielle (2020-10-23). "Neurotype-Matching, but Not Being Autistic, Influences Self and Observer Ratings of Interpersonal Rapport". Frontiers in Psychology. 11: 586171. doi:10.3389/fpsyg.2020.586171. ISSN 1664-1078. PMC 7645034. PMID 33192918.
  19. ^ Sucksmith, E.; Allison, C.; Baron-Cohen, S.; Chakrabarti, B.; Hoekstra, R. A. (2013-01-01). "Empathy and emotion recognition in people with autism, first-degree relatives, and controls". Neuropsychologia. 51 (1): 98–105. doi:10.1016/j.neuropsychologia.2012.11.013. ISSN 0028-3932. PMC 6345368. PMID 23174401.
  20. ^ Dickter, Cheryl L.; Burk, Joshua A.; Zeman, Janice L.; Taylor, Sara C. (2020-06-01). "Implicit and Explicit Attitudes Toward Autistic Adults". Autism in Adulthood. 2 (2): 144–151. doi:10.1089/aut.2019.0023. ISSN 2573-9581. S2CID 212921826.
  21. ^ Spikins, Penny; Wright, Barry; Hodgson, Derek (2016-10-01). "Are there alternative adaptive strategies to human pro-sociality? The role of collaborative morality in the emergence of personality variation and autistic traits". Time and Mind. 9 (4): 289–313. doi:10.1080/1751696X.2016.1244949. ISSN 1751-696X. S2CID 151820168.
  22. ^ White, Rebekah; Remington, Anna (2018). "Object personification in autism: This paper will be very sad if you don't read it". Autism. 23 (4): 1042–1045. doi:10.1177/1362361318793408. ISSN 1362-3613. PMID 30101594. S2CID 51969215.
  23. ^ Heasman, Brett; Gillespie, Alex (2018). "Perspective-taking is two-sided: Misunderstandings between people with Asperger's syndrome and their family members". Autism. 22 (6): 740–750. doi:10.1177/1362361317708287. ISSN 1362-3613. PMC 6055325. PMID 28683569.
  24. ^ Milton, Damian (2014). "Autistic expertise: A critical reflection on the production of knowledge in autism studies". Autism. 18 (7): 794–802. doi:10.1177/1362361314525281. ISSN 1362-3613. PMID 24637428. S2CID 206715678.
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