Understanding Yourself to Understand Others: The Role of Alexithymia and Anxiety in the Relationship between Autistic Traits and Empathy

Research output: Contribution to conferenceConference presentation/ephemerapeer-review


A common misconception is that people on the autism spectrum have no empathy. On the contrary, many can share others’ emotions (indicating intact affective empathy) and even exhibit heightened personal distress. Unfortunately, some may have difficulty understanding others' emotions (indicating decreased cognitive empathy). This decrease in cognitive empathy may be due to co-occurring alexithymia. Alexithymia is a sub-clinical trait characterised by difficulties identifying, describing, and focussing on one's own emotions. These difficulties have also been shown to increase anxiety for people on the spectrum. Likely, this increased anxiety may be responsible for heightened personal distress. This study investigated whether alexithymia, along with anxiety, explain this empathy imbalance. Non-autistic adult participants (n=351), recruited from a university population and the general public, completed questionnaires assessing autistic traits, empathy, alexithymia, and anxiety. We investigated social difficulties and repetitive and restrictive behaviours as separate autistic trait dimensions, to provide deeper understanding of how the core features of autism influence empathy, alexithymia, and anxiety. Serial mediation analyses revealed that alexithymia, either alone or with anxiety, mediated heightened personal distress (B=.0205, 95% CI [.0073/.0385]) and decreased cognitive empathy (B=-.0961, 95% CI [-.1602/-.0358]). Surprisingly, through alexithymia and anxiety, higher levels of both autistic trait dimensions were related to an increase in affective empathy (B=.0308, 95% CI [.0148/.0501]). However, after accounting for alexithymia and anxiety, social difficulties directly decreased affective empathy (B=-.1393, p=.004). This study highlights the importance of alexithymia and motivates a more nuanced model of empathy in autism.
Original languageEnglish
Publication statusPublished - 10 Dec 2020
EventAustralasian Society for Autism Research Conference - , Virtual
Duration: 10 Dec 202011 Dec 2020


ConferenceAustralasian Society for Autism Research Conference


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