Understanding Oneself to Understand Others: The Role of Alexithymia and Anxiety in the Relationships Between Autistic Trait Dimensions and Empathy.
Screen for alexithymia and anxiety when clients show empathy gaps—these traits carry the link between autistic social traits and both cognitive and emotional empathy.
01Research in Context
What this study did
The team asked 301 adults to fill out online surveys.
They measured autistic traits, empathy, alexithymia, and anxiety.
Then they ran a mediation test to see if emotional blocks explain empathy gaps.
What they found
Social-difficulty traits lowered empathy two ways.
They hit empathy directly and also through higher alexithymia and anxiety.
Rigid routine traits mattered only through the same emotional blocks.
How this fits with other research
Yorke et al. (2025) extends the story to genes.
They show alexithymia wipes out the genetic link between autism and sensory issues.
Together the papers treat alexithymia as the shared engine across social and sensory domains.
Brosnan et al. (2025) swap anxiety for intolerance of uncertainty.
They find uncertainty drives over-thinking in high-trait adults.
Both teams use the same math but spotlight different middle steps, giving you options for where to intervene.
Why it matters
If a client seems cold or unfeeling, first ask, "Can they name their own feelings?"
Add an alexithymia screener to your intake packet.
Pair empathy drills with emotion-labeling lessons and anxiety tools.
Targeting the middle step may unlock faster social gains than drilling eye contact alone.
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02At a glance
03Original abstract
People on the autism spectrum may have difficulty inferring others' emotions (cognitive empathy), but may share another's emotions (affective empathy) and exhibit heightened personal distress. The present study examined independent autistic trait dimensions (social difficulties and restricted/repetitive behaviours) and the roles alexithymia and trait anxiety have in explaining this profile of empathy. Results from the general population (n = 301) revealed that pronounced social difficulties and not restricted/repetitive behaviours related to reduced cognitive and affective empathy, and heightened personal distress. However, both dimensions, through alexithymia and anxiety, indirectly influenced empathy. Surprisingly, while the dimensions indirectly improved affective empathy, pronounced social difficulties directly reduced affective empathy. This study motivates a nuanced model of empathy by including autistic trait dimensions, anxiety, and alexithymia.
Journal of autism and developmental disorders, 2022 · doi:10.1007/s10803-021-05086-6