A systematic review and meta-analysis of empathy in autism: The influence of measures

IF 12.2 1区心理学 Q1 PSYCHOLOGY, CLINICAL

Clinical Psychology Review Pub Date : 2025-08-01 DOI:10.1016/j.cpr.2025.102623

Noémie M. Cusson , Alexa J. Meilleur , Boris C. Bernhardt , Isabelle Soulières , Laurent Mottron

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Abstract

Empathy deficits are considered a core attribute of autism and are scored in standardized autism diagnostic instruments. However, empirical evidence concerning empathy in autism is contradictory. This systematic review, which included 226 studies, thus offers a comprehensive overview of empathy in autism. It additionally examined the impact of the chosen empathy measure and the effect of several moderators. The results reveal a large effect size for cognitive empathy (g = −0.85) and unidimensional empathy (g = −1.70), but only a small effect size for affective empathy (g = −0.17), which became non-significant when limiting analyses to high-quality studies. Meta-regressions suggest that publication year, study quality, alexithymia, verbal IQ, and age do not moderate empathy, whereas sex specifically moderates unidimensional empathy. Critically, there were notable differences in effect sizes obtained across empathy measures and even between subscales of the same measure. For instance, results for the affective empathy subscales of the Interpersonal Reactivity Index reveal lower empathic concern (g = −0.59) but increased personal distress (g = 0.67) in autistic relative to typical participants. A qualitative review of ecological and neuroimaging tasks mostly demonstrated minimal autistic versus non-autistic differences. This meta-analysis thus suggests that measuring empathy as a unidimensional construct may both distort and increase the notion of an empathy deficit in autism.

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自闭症共情的系统回顾与元分析：措施的影响

共情缺陷被认为是自闭症的核心特征，并在标准化的自闭症诊断工具中得到评分。然而，关于自闭症的共情的经验证据是矛盾的。这篇系统综述，包括226项研究，因此提供了自闭症共情的全面概述。它还检查了所选择的共情测量的影响和几个调节因子的影响。结果显示，认知共情（g = - 0.85）和一维共情（g = - 1.70）的效应量很大，但情感共情的效应量很小（g = - 0.17），当分析仅限于高质量研究时，这种效应量就变得不显著了。元回归表明，出版年份、研究质量、述情障碍、语言智商和年龄对共情没有调节作用，而性别对单向度共情有调节作用。至关重要的是，在共情测量中，甚至在同一测量的子量表之间，获得的效应大小存在显著差异。例如，人际反应指数的情感共情分量表的结果显示，相对于典型参与者，自闭症患者的共情关注较低（g = - 0.59），但个人痛苦增加（g = 0.67）。一项关于生态和神经成像任务的定性研究表明，自闭症与非自闭症之间的差异微乎其微。因此，本荟萃分析表明，将共情作为一种单向度的结构来测量，可能会扭曲和增加自闭症患者共情缺陷的概念。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Psychology Review PSYCHOLOGY, CLINICAL-

CiteScore

23.10

自引率

1.60%

发文量

期刊介绍： Clinical Psychology Review serves as a platform for substantial reviews addressing pertinent topics in clinical psychology. Encompassing a spectrum of issues, from psychopathology to behavior therapy, cognition to cognitive therapies, behavioral medicine to community mental health, assessment, and child development, the journal seeks cutting-edge papers that significantly contribute to advancing the science and/or practice of clinical psychology. While maintaining a primary focus on topics directly related to clinical psychology, the journal occasionally features reviews on psychophysiology, learning therapy, experimental psychopathology, and social psychology, provided they demonstrate a clear connection to research or practice in clinical psychology. Integrative literature reviews and summaries of innovative ongoing clinical research programs find a place within its pages. However, reports on individual research studies and theoretical treatises or clinical guides lacking an empirical base are deemed inappropriate for publication.