Self-Referential Cognition and Empathy in Autism

Lombardo, Michael; Barnes, Jennifer L.; Wheelwright, Sally; Simon Baron‐Cohen · 2007 · OpenAlex-citations

DOI: 10.1371/journal.pone.0000883

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Summary

This study investigates whether individuals with autism spectrum conditions (ASC) exhibit impairments in self-referential cognition, a domain previously less understood than their well-documented social deficits. Motivated by the "absent self" theory and simulation theory—which posits that understanding others relies on modeling one’s own mental states—the researchers aimed to determine if ASC involves concurrent deficits in both self-referential processing and empathy, and whether these domains are intrinsically linked. The study included 30 adults with high-functioning autism or Asperger Syndrome and 30 age-, sex-, and IQ-matched controls. Participants completed a self-reference effect (SRE) paradigm, a depth-of-processing task where they judged trait adjectives as descriptive of themselves, a close friend, Harry Potter, or for linguistic content, followed by a surprise recognition memory test. Additionally, participants completed multiple validated measures: self-report and performance tests for self-referential cognition (including alexithymia, private self-consciousness, and self-focused attention) and empathy (including the Empathy Quotient, Interpersonal Reactivity Index, Emotional Contagion Scale, and the Reading the Mind in the Eyes Test). Statistical analyses included ANOVAs for memory performance and multiple regression models to examine the relationship between self-referential cognition and mentalizing ability. Results indicated that while individuals with ASC showed a significant self-reference effect in memory, this bias was significantly reduced compared to controls. Specifically, the ASC group demonstrated reduced memory for self-referential information and information regarding similar close others, but no impairment for dissimilar others or non-social information. Concurrently, the ASC group scored significantly lower on all four empathy measures and higher on measures of alexithymia and lower on self-focused attention. Crucially, individual differences in self-referential cognition predicted mentalizing ability and autistic traits regardless of diagnosis. Higher alexithymia and lower self-memory were associated with greater mentalizing impairments and higher Autism Spectrum Quotient scores. Furthermore, the relationship between self-focused attention and mentalizing differed by group: in ASC, higher self-focused attention correlated with better mentalizing, whereas in controls, it correlated with decreased mentalizing. The authors conclude that ASC involves broad impairments in both self-referential cognition and empathy, supporting the hypothesis that these domains are intrinsically linked. These findings provide empirical support for simulation theory, suggesting that deficits in modeling the self impair the ability to model others. The results also highlight a specific dysfunction in cortical midline structures, such as the medial prefrontal cortex, which are critical for both self-referential processing and theory of mind. This study underscores the importance of examining intrapersonal cognitive processes to fully understand the social impairments characteristic of autism.

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• cognitive capacity variation