Demands in Reflecting about Another's Intentions Modulate Vicarious Embarrassment in Autism Spectrum Disorders

Background: The affective responses to another person’s condition are not fully independent of the abilities to reflect about another’s thoughts and intentions. This is highly relevant also for high-functioning individuals with ASD who have considerable difficulties in reading the intentions of others.

Objectives: Using a novel paradigm to induce vicarious embarrassment as a form of social pain, we aimed to demonstrate that ASD may indeed modulate the affective response to another person’s state.We predicted that the vicarious embarrassment of high-functioning individuals with ASD should specifically decline in context of situations that require understanding others’ intentions and reflecting on the motives that cause another’s actions.

Methods: The ASD group consisted of 32 young male adults who had a confirmed ICD-10 diagnosis of high-functioning Autism, Asperger Syndrome, or Atypical Autism. The control group was group-matched for age (ASD: M = 20.19, SD = 2.82, CG: M = 21.44, SD = 2.31), gender, and verbal IQ (ASD: M = 114.47, SD = 15.47, CG: M = 114.33, 12.38). Vicarious embarrassment was examined with a selected set of previously validated stimuli. Stimuli consisted of 30 German sentences that described vicarious embarrassing situations and 10 neutral scenarios. All vicarious embarrassment situations showed a protagonist who either accidentally or intentionally transgressed a social norm in public and participants rated their own vicarious embarrassment in response to the situation on a scale from 1 (“not at all”) to 7 (“very strong”).

Results:   Results indicated statistically significant main effects for Group F(1,62) = 5.27, p = .03 and Situation F(2.53, 156.59) = 14.33, p < .001. Importantly, the two-way interaction between Group and Situation was statistically significant with F(2.53, 156.59) = 4.34, p < .01. Post-hoc comparisons indicated that the effects were driven by the ASD group who showed similar vicarious embarrassment in response to observing another’s accidental norm transgressions but significantly reduced vicarious embarrassment when observing another who intentionally violated socials norms. Further, vicarious embarrassment was significantly correlated with self-reported empathy in the ASD group (41 < r < .46, ps < .05).

Conclusions: The results provide first evidence for vicarious social pain experiences in high-functioning individuals with ASD. High-functioning individuals with ASD indeed reported vicarious embarrassment as do non-autistic controls, however, their vicarious embarrassment significantly declined when it was necessary to understanding others’ intentions and reflecting on the motives that cause another’s actions. These results demonstrate that the ASD associated impairments have considerable impact on the affective responses towards another person’s state in the context of complex social scenarios. This is also in line with earlier reports of children with ASD to have difficulties to understand the concept of deception and a very recent study that showed individuals with ASD to have difficulties to integrate the intention of another’s actions when judging the morality of another’s behavior. The present study thus contributes to a more comprehensive understanding of how ASD influences the diversity of empathic processes in the social, everyday life environment they are embedded in.