Dissociation of Cognitive and Emotional Empathy: The Multifaceted Empathy Test for Children and Adolescents: MET-J

Background: Empathy, generally defined as the ability to understand and share another peronßs emotional state, is a multidimensional construct, consisting of cognitive (inferring mental states) and emotional (observer's emotional response to another person's emotional state ) components.  Both autism spectrum disorders (ASD) and conduct disorders (CD) have been described as disorders with empathy impairment. While most instruments assessing empathy focused rather on one component of empathy, the Multifaceted Empathy Test (MET) was designed to measure cognitive and emotional empathy simultaneously and independently using a series of photorealistic stimuli (Dziobek et al., 2008).

Objectives: To test a modified and age adapted version of the MET for adolescents from 10 to 17 years (MET-J) to differentiate empathy components in adolescents with ASD and CD.           

Methods: We examined 15 adolescents with ASD (diagnoses were confirmed with ADI and ADOS), (mean age 13,6, SD=1,14 mean VIQ=107; SD=12,72)  15 adolescents with CD (mean age 14,4; SD=1,29; mean VIQ=101; SD=8,0) and 15 typically developing controls matched for age, sex  and verbal IQ (mean age 13,6; SD=1,13; mean VIQ=110, SD=7,80). The age adapted version of the Multifaceted Empathy Test for adolescent (MET-J) was administered to all subjects; results were compared to results of well-validated self-report questionnaires assessing empathy (IRI, EQ).

Results: Groups differed significantly on both components of empathy, assessed with the MET-J. Adolescent with ASD showed impairments in cognitive empathy, but did not differ from healthy controls in emotional empathy. Adolescent with CD showed a inverted pattern of dissociation of empathy components, compared to adolescents with ASD .

Conclusions: As our results suggest, the Multifaceted Empathy Test for Children and Adolecents (MET-J) is an appropriate and feasible instrument to measure empathy in this age group. According to our findings, adolescent with ASD are impaired in their capacity to take the perspective of another person and infer the correct mental state; however they do not differ in their ability to respond with adequate concern to the distress of others. Adolescents with CD show an inverse pattern of empathy compared to adolescents with ASD (unimpaired cognitive empathy vs. impaired emotional empathy). The double dissociation of cognitive and emotional empathy observed in ASD and CD could provide  a more precise characterization of  the behavioral phenotype of individuals affected by empathy impairments.  A common classification of ASD and disorders with disruptive behaviors or psychopathic traits as “empathy disorders” should be regarded with caution.