Being Imitated and Empathy for Pain in Adults with High Functioning Autism

Background: Imitation and empathy skills are thought to be impaired or delayed in adults with high functioning autism (HFA), and have theoretically been linked to dysfunctional shared representational mechanisms (‘broken mirror’ theory). However, more and more research on this theory shows conflicting results. In a recent study, we have related imitation literature and research on observing others in pain in typically developing adults. It was shown that being imitated enhances affective responding to seeing someone else in pain (empathy for pain), and we provided evidence for the role of shared representations in the sensory and the motor domain as a core underlying mechanism. If the shared representational system is important in understanding the problems of adults with HFA, it may be expected that the influence of being imitated on empathy for pain is different in this group compared to typically developing adults.  

Objectives: To investigate the influence of being imitated on empathy for pain in adults with HFA compared to typically developing adults, and gain insight into the role of (dysfunctional) shared representational mechanisms.

Methods: We used startle eye blink data and skin conductance responses as indices of empathy for pain. Physiological data were obtained from 12 typically developing adults (mean age = 28 years, SD = 4.85) and 20 adults with HFA (mean age = 31 years, SD = 6.01). Startle blink and skin conductance responses were measured during presentation of a pain movie in which a hand on a screen received painful stimulation. Data were obtained in two conditions, in which 1) participants made finger movements which were imitated by the hand on the screen prior to watching the pain movie, or 2) participants made finger movements which were not imitated by the hand on the screen.  

Results: Although still preliminary, results show that for both physiological measures, overall affective responses while watching the pain movies were the same, if not higher, in adults with HFA compared to typically developing adults. However, results also suggest a three-way interaction between group, condition (imitation versus non-imitation), and half (first versus second half of the experiment). Typically developing adults showed higher empathy for pain after being imitated during the whole experiment, replicating previous studies. Adults with HFA, however, showed a reversal of the effect over time: while affective responding was lower after being imitated during the first half of the experiment, affective responding in the second half of the experiment was higher after being imitated (mimicking the pattern found in the group with typically developing adults).  

Conclusions: In adults with HFA, the influence of being imitated on empathy for pain changes over time, with a reversed effect compared to typically developing adults in the beginning of the experiment and a similar effect at the end. Together with equal overall affective responding in both groups, these results suggest intact empathy for pain in adults with HFA and do not provide evidence for the ‘broken mirror’ hypothesis, but rather suggest dysfunctional control over these shared representational systems in adults with HFA.