Reexamining empathy in autism: Empathic disequilibrium as a novel predictor of autism diagnosis and autistic traits.
A simple gap score between emotional and cognitive empathy predicts autism diagnosis and social traits better than either score alone.
01Research in Context
What this study did
Ido et al. (2022) asked a simple question: does an uneven split between feeling and thinking about feelings help spot autism? They gave large groups of autistic and neurotypical people two quick surveys. One measured how strongly they catch others' emotions. The other measured how well they figure out what others think.
What they found
People who later received an autism diagnosis usually scored high on catching emotions but low on figuring them out. The bigger the gap, the more social difficulties they reported. The authors call this gap 'empathic disequilibrium.'
How this fits with other research
Nuebling et al. (2024) meta-analysis pulls together many emotion studies and would include these numbers, showing the pattern holds across dozens of samples.
Johnson et al. (2009) saw the same mismatch earlier: autistic teens rated their own empathy higher than their parents did. Ido's new score gives clinicians a single number instead of two conflicting reports.
Pan et al. (2025) tracked preschoolers' eyes and heart rates while they watched social cartoons. Less looking at faces and flat heart-rate lined up with later social problems, matching the survey imbalance Ido found in older groups.
Why it matters
You can add the two surveys to your intake packet and compute the gap in under five minutes. A big gap flags clients who feel too much but read minds poorly. Treatment can then target emotion-regulation first and perspective-taking second, instead of the other way around.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add the two empathy scales to your intake, subtract the cognitive score from the emotional score, and flag cases with the largest gaps for extra perspective-training lessons.
02At a glance
03Original abstract
A large body of research showed that autistic people have intact emotional (affective) empathy alongside reduced cognitive empathy. However, there are mixed findings and these call for a more subtle understanding of empathy in autism. Empathic disequilibrium refers to the imbalance between emotional and cognitive empathy and is associated with a higher number of autistic traits in the typical population. Here we examined whether empathic disequilibrium predicts both the number of autistic traits and autism diagnosis. In a large sample of autistic (N = 1905) and typical individuals (N = 3009), we examined empathic disequilibrium and empathy as predictors of autistic traits and autism diagnosis, using a polynomial regression with response surface analysis. Empathy and autistic traits were measured using validated self-report questionnaires. Both empathic disequilibrium and empathy predicted linearly and non-linearly autism diagnosis and autistic traits. Specifically, a tendency towards higher emotional than cognitive empathy (empathic disequilibrium towards emotional empathy) predicted both autism diagnosis and the social domain of autistic traits, while higher cognitive than emotional empathy was associated with the non-social domain of autism. Empathic disequilibrium was also more prominent in autistic females. This study provides evidence that beyond empathy as was measured thus far, empathic disequilibrium offers a novel analytical approach for examining the role of empathy. Empathic disequilibrium allows for a more nuanced understanding of the links between empathy and autism. LAY SUMMARY: Many autistic individuals report feelings of excessive empathy, yet their experience is not reflected by most of the current literature, typically suggesting that autism is characterized by intact emotional and reduced cognitive empathy. To fill this gap, we looked at both ends of the imbalance between these components, termed empathic disequilibrium. We show that, like empathy, empathic disequilibrium is related to autism diagnosis and traits, and thus may provide a more nuanced understanding of empathy and its link with autism.
Autism research : official journal of the International Society for Autism Research, 2022 · doi:10.1038/s42003-019-0558-4