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Advanced mind-reading inadults with Aspergersyndrome

K O E N S . P O N N E T Ghent University, Belgium

H E R B E R T R O E Y E R S Ghent University, Belgium

A N N B U Y S S E Ghent University, Belgium

A R M A N D D E C L E R C Q Ghent University, Belgium

E VA VA N D E R H E Y D E N Ghent University, Belgium

A B S T R A C T This study investigated the mind-reading abilities of 19adults with Asperger syndrome and 19 typically developing adults. Twostatic mind-reading tests and a more naturalistic empathic accuracy taskwere used. In the empathic accuracy task, participants attempted toinfer the thoughts and feelings of target persons, while viewing avideotape of the target persons in a naturally occurring conversationwith another person. The results are consistent with earlier findings.The empathic accuracy task indicated significant between-group differ-ences, whereas no such differences were found on the static mind-reading tasks. The most innovative finding of the present study is thatthe inference ability of adults with PDD and controls depends on thefocus of the target’s thoughts and feelings, and that the empathicaccuracy of adults with Asperger syndrome and control adults mightbe different in terms of quantity and quality.

A D D R E S S Correspondence should be addressed to: K O E N S . P O N N E T , GhentUniversity,Research Group Developmental Disorders,Henri Dunantlaan 2,B-9000 Ghent,Belgium. e-mail: koen.ponnet@UGent.be

One of the most striking characteristics of people with autism or a relatedpervasive developmental disorder (PDD) appears to be their qualitativeimpairment in social interaction, which affects almost every aspect of theirdaily lives (Howlin, 1998; Zager, 1999). Among the theories that have beenproposed to account for the social interaction problems are an inability toprocess emotional information (the socio-affective hypothesis) and aninability to comprehend the perspectives of others, otherwise known as the‘theory of mind’ hypothesis.

autism © 2004SAGE Publicationsand The National

Autistic SocietyVol 8(3) 249–266; 045214

1362-3613(200409)8:3

www.sagepublications.comDOI: 10.1177/1362361304045214

K E Y W O R D S

Aspergersyndrome;empathicaccuracy;

perspectivetaking;

socialcognition

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The socio-affective theory was proposed by Hobson and colleagues, whofound children with autism to be impaired in their comprehension offacial, vocal and bodily affect, and in their associations of these expressionswith each other (Hobson, 1986; 1991; 1999; Hobson and Lee, 1989;Weeks and Hobson, 1987). Consequently, Hobson has argued that theprimary psychological deficit in autism is an early failure of direct per-ception of bodily expressions, including emotions. However, the socio-affective theory has been criticized for the inconsistent results that werefound when subjects with autism were matched with intellectuallyimpaired controls (Rutter and Bailey, 1993). The theory of mind hypothesissuggests that the impairments of people with PDD can be explained interms of a failure to attribute mental states to oneself and to others (for anoverview, see Baron-Cohen et al., 2000). Without a theory of mind, peopleare unable to develop a normal understanding that other people havemental states, which in turn results in socially inadequate behaviour. Overthe past decades, a large number of studies has demonstrated the robust-ness of the theory of mind hypothesis, although a substantial proportionof able children (and older people) with PDD were found to pass second-order theory of mind tasks (Bowler, 1992; Ozonoff et al., 1991; Tager-Flusberg and Sullivan, 1995).

However, it is important to be aware that the tests currently used tomeasure the social difficulties of individuals with PDD have little demon-strable ecological validity. Indeed, the use of static stimuli (such as tales,drawings, photographs and others) is hardly a naturalistic way to evaluatesocial understanding (Baron-Cohen et al., 1997; 2001; Kleinman et al.,2001). The present study adopts the approach that since individuals withautism experience difficulties with social interaction, investigators shouldattempt to measure their social functioning in contexts that mirror asclosely as possible real-life social interactions. In addition, researchersshould aim to measure the ability of persons with PDD to comment onsocial events using the language of internal mental states, without (explic-itly or implicitly) being committed to any particular theoretical perspec-tive. The approach of the present study is therefore an eclectic one, withthe aim of improving methodologies.

One possible approach utilizes the empathic accuracy design of Ickesand colleagues (Ickes, 1997; Ickes et al., 1990a). The development ofempathic accuracy has deep roots in developmental psychology, but the ter-minology used has varied over the years (Eisenberg et al., 1997). Accord-ing to Ickes and colleagues, empathic accuracy can be defined as the degreeto which someone is able accurately to infer the specific content of anotherperson’s thoughts and feelings (Ickes et al., 1990b). Ickes (1997) suggeststhat the most unequivocal way to measure empathic accuracy is by rating

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the similarity between the content of the target’s actual thought or feelingand the content of the perceiver’s inferences. The term ‘empathy’ includesa cognitive as well as an emotional component. While the cognitive com-ponent refers to the capacity to understand others’ internal states, theemotional component refers to the emotional response resulting from therecognition of another person’s emotional state or condition (Eisenberget al., 1991).

Recently, Roeyers et al. (2001) tested high-functioning adults with PDDusing two static mind-reading tests and a more naturalistic EmpathicAccuracy Task. The two static mind-reading tests used were an adapted andshortened version of Happé’s (1994) Strange Stories, and an adaptedversion of Baron-Cohen et al.’s (1997) Eyes Task. The more naturalistic testwas derived from the empathic accuracy design (Ickes, 1997; Ickes et al.,1990b). On the basis of these tests Roeyers et al. (2001) designed anEmpathic Accuracy Task in which individual participants each attempt toinfer aspects of a target person’s actual subjective experience while viewinga videotape of the target person in a naturally occurring conversation withanother person.

Roeyers et al. (2001) found adults with PDD to be unimpaired withregard to the static tasks compared with controls. These findings differ fromother studies (Baron-Cohen et al., 1997; Happé, 1994; Jolliffe and Baron-Cohen, 1999; Kleinman et al., 2001), although it should be noted thatparticipants in the Roeyers et al. (2001) study had higher cognitive abilities(mean IQ 113) than those in the other studies. On the naturalistic EmpathicAccuracy Task there was a difference between the groups (in favour of thecontrols) but only on the second videotape. This may be because of thegreater social and communicative skills required for the second videotape,which involves targets in a conversation of the ‘getting acquainted’ type.Conversation of the targets in video 1 is mainly structured around a boardgame and this may be more predictable and less complex.

The present study attempts to extend the study of Roeyers et al. (2001)in two ways. First, all participants with an autism spectrum disorder wereclinically diagnosed as having Asperger syndrome (i.e. having abnormali-ties in reciprocal social interaction and in patterns of behaviour, interestsand activities, but no clinically significant delay in spoken or receptivelanguage or cognitive development: ICD-10, World Health Organization,1992). Despite the diagnostic difficulties in distinguishing between thesesyndromes and the controversy concerning whether or not autism andAsperger syndrome lie on the same continuum (Bishop, 2000; Howlin,2003; Mayes and Calhoun, 2001; Wing, 1998), Asperger syndrome isgenerally understood as a form of autism in which the cognitive and speechdeficits are relatively mild (Attwood, 1998; Gilchrist et al., 2001; Miller and

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Ozonoff, 2000; Ozonoff et al., 2000; Rinehart et al., 2001; Szatmari et al.,1995). Thus, replicating the findings of Roeyers et al. (2001) wouldstrengthen the hypothesis that problems in empathic accuracy reflect subtlemind-reading differences between adults with Asperger syndrome andadult controls. In this study, the participants with Asperger syndrome werecompared with typically developing adults.

Second, the mixed results of Roeyers et al. (2001) indicated the needfor further explanation of the ‘theme(s)’ of the targets’ original thoughts/feelings entries. In this study the thematic topic of the targets’ actualthoughts and feelings in both videotapes were explained. In particular thestudy assessed whether the focus of the original thoughts and feelings wason (1) the self, (2) the interaction partner, (3) other person(s), (4) theresearch context, (5) a tangible environmental object or event, or (6) a pastmemory. Such an analysis would allow for an assessment of potential groupdifferences in interpreting the targets’ actual thoughts/feelings. Theempathic accuracy scores of each participant for all the thought/feelingentries belonging to the six different categories were also calculated inorder to examine possible group differences with regard to the level ofempathic accuracy.

The earlier methodology of the Empathic Accuracy Task was improvedby digitizing the analogue using VIDANN, a system specifically designed tocomputerize each of the phases in the task (see De Clercq et al., 2001, fordetails). The advantages of a digitized Empathic Accuracy Task arenumerous: digitization leads to improved standardization and, in turn,results in more accurate empathic accuracy scores; using VIDANN mini-mizes the inaccuracies related to the use of a manual remote control systemto stop a videotape at specific time moments; and a less active role isrequired of the research assistant, thus decreasing the possibility of dis-traction for participants with PDD.

On the basis of the Roeyers et al. (2001) study, it was predicted that therewould be no between-group differences with regard to the static mind-reading tasks, but significant group differences with regard to the EmpathicAccuracy Task. In addition, the study aimed to investigate different patternsbetween the Asperger group and the control group with regard to theempathic accuracy for thoughts and feelings with a specific topic.

Method

ParticipantsTwo groups of normally intelligent adolescents and adults participated inthe present study: 19 people with Asperger syndrome and a control group

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of 19 typically developing individuals. The male/female ratio (14/5) wasthe same in each group. Participants were recruited via parent associationsand schools. All participants with Asperger syndrome had been diagnosedby a multidisciplinary team of experienced clinicians and fulfilled ICD-10criteria as closely as possible, given the nosologically controversial diagnosisof Asperger syndrome (see Eisenmajer et al., 1996; Leekam et al., 2000;Mayes and Calhoun, 2001). They showed qualitative deficiencies in recip-rocal social interaction and restricted stereotyped patterns of behaviour,interests and activities. Individuals with a history of delay in developmentof spoken language were excluded (i.e. phrase speech was present by age3 years). Motor clumsiness was present in some but not all participants.None of the participants had comorbid diagnoses of attention deficitdisorder and/or Tourette’s disorder. All participants with Asperger syndromewere studying or employed; some lived independently or were married.

Only participants with full IQ scores above 80 were included in thesample. The controls were assessed using a shortened version of theWAIS–R, comprising block design, vocabulary, arithmetic, and picturearrangement. The mean IQ scores for the subjects with Asperger syndromewere: full scale IQ 106.58 (SD = 15.11), verbal IQ 108.32 (SD = 13.99)and performance IQ 104.05 (SD = 18.08). The mean IQ scores for thecontrol subjects were: full scale IQ 114.05 (SD = 15.84), verbal IQ 116.00(SD = 18.39) and performance IQ 110.58 (SD = 14.03). A series of uni-variate analyses of variance (ANOVAs) revealed no significant between-group differences for full scale IQ (F(1, 36) = 2.21), verbal IQ (F(1, 36)= 2.10) or performance IQ (F(1, 36) = 1.54). Furthermore, no significantdifference (ANOVA) was found between the mean chronological age of thesubjects with Asperger syndrome (21.06 years, SD = 4.77) and that of thecontrol subjects (21.93 years, SD = 6.60; F(1, 36) < 1).

Materials

Stories Task The Stories Task of Roeyers et al. (2001) is an adapted andshortened version of Happé’s (1994) Strange Stories. The presented stimuliconsisted of six different stories, each accompanied by an illustrativepicture and containing two questions, an open-ended question (‘Was ittrue, what X said?’) and a justification question (‘Why did X say that?’).

Eyes Photographs Task The Eyes Photographs Task (Roeyers et al.,2001) is an adapted version of the Eyes Task of Baron-Cohen et al. (1997)and consists of 25 photographs of the eye region of the faces of male andfemale adults, together with three basic (e.g. happy, afraid, sad) or morecomplex (e.g. guilty, blasé) mental states. Participants were asked to make

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a forced choice between the three mental state terms. To be sure that everyparticipant was attending to the task, they were also asked to identify thegender of the person in each photograph.

Empathic Accuracy Stimulus Tapes The two videotapes used in theEmpathic Accuracy Task were exactly the same as those used in the studyof Roeyers and colleagues (see Roeyers et al., 2001, p. 273). The stimulustapes were prepared as follows. Four typically developing individuals(targets) were invited to the laboratory. They were seen in pairs(male–female dyads) and, initially, were strangers to each other. They weretold in advance that they were about to meet another stranger and that theirinteraction would be videotaped for use in future research. Once theyarrived at the laboratory the research assistant explained they were to playa board game together. However, when both targets were seated, theresearch assistant pretended to have a problem with the sound equipment.Promising to return in a few minutes and telling the participants that hehad to look for technical assistance, he left the room. At this point, a videocamera was activated and recorded the initial conversation between the twotargets. After approximately 11 minutes, the research assistant returned andpartly debriefed the participants, who were also informed that their writtenconsent was required for the tape to be used. The stimulus tapes consistedof two initial conversations between two strangers. In the first videotape,the participants immediately started to play a board game. The targets invideo 2 did not touch any of the board game materials and had a conver-sation of the ‘getting acquainted’ type.

After signing the written consent form, the targets were asked to viewtheir videotape and to make a written record of all their unexpressedthoughts and feelings (see also Ickes et al., 1990a; Roeyers et al., 2001).More specifically, the targets were instructed to stop the videotape at eachpoint during the interaction when they remembered having had a specificthought or feeling. They were asked to write down (1) the time when thethought or feeling occurred (as displayed by a digital clock on the video-tape), (2) whether the entry was a thought or a feeling, and (3) the specificcontent of the thought or feeling. Two additional instructions were given.First of all, the targets were instructed to report all thoughts and feelingsthey remembered having had as accurately and honestly as possible; andsecond, they were instructed not to report any new thoughts or feelings thatmay have occurred to them while they were viewing the videotape. Thetargets were assured of complete anonymity of their data and were informedthat their interaction partner would never be shown their thought/feelingresponses. After recording the thoughts and feelings, the targets weredebriefed more thoroughly and were asked to sign a written consent form.

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The first videotape contained 85 thought/feeling entries and videotape2 contained 36 thought/feeling entries. Because of the large number ofthoughts and feelings in video 1, the number of thoughts and feelings wasrandomly reduced to 36 (see Roeyers et al., 2001). Video 1 contained 18male and 18 female thought/feeling entries and video 2 contained 13 maleand 23 female thought/feeling entries.

ProcedureAll participants were seen individually and were given the three differentmind-reading tasks. They first viewed each of the videotapes, with the orderof videotape presentation counterbalanced among participants. Whileparticipants were viewing the videotape, the tape was paused at the precisemoments when a target had recorded a specific thought or feeling. Thevideotapes were paused automatically with the use of VIDANN (De Clercqet al., 2001). Whenever the videotape was paused, the participants wereasked to make inferences about the specific content of the unexpressedthought/feeling entries and to write down (1) whether the entry waspresumed to be a thought or feeling, and (2) the specific content of thethought/feeling entry. To ensure that the task was fully understood, anadvanced preparatory session was given.

After the Empathic Accuracy Task had been completed, the two staticmind-reading tasks were given. First, each of the six stories was placedin front of the participants. After each of the stories had been read out ina fixed order, the comprehension and the mental state question wereasked. Following the Stories Task, the 25 photographs of the eye regionwere presented in a fixed order, together with three mental state terms.Each perceiver had to make a forced choice between the three mental stateterms and was asked to identify the gender of the person in the photo-graph.

Measures

Stories Task Participants were scored on their answers to the justificationquestion. The justification could be a physical or a mental explanation, andcould be rated as correct or incorrect (see Happé, 1994; Roeyers et al.,2001).

Eyes Photographs Task Participants scored 1 point for a correct answeron both the emotion recognition and gender recognition tasks (seeBaron-Cohen et al., 1997). Twenty-five photographs were presented, withminimum and maximum scores ranging from 0 to 25, for both theemotion recognition and gender recognition task.

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Empathic Accuracy Task: measuring actual thoughts and feelings Sixindependent coders watched the videotapes that were stopped at the timesthe targets had reported having had a thought or feeling. The coders wereinstructed to assess for each of the targets’ thought/feeling entries, whetherthe focus of the thought/feeling entry was on (1) the self, (2) the inter-action partner, (3) other person(s), (4) the research context, (5) a tangibleenvironmental object or event, or (6) a past memory. The interrater relia-bilities (Cronbach’s alpha) for five of the six categorical classifications wereabove 0.80, except for the ‘tangible environmental object or event’ category(? = 0.57).

Empathic Accuracy Task: measuring inferred thoughts and feelingsFollowing the procedures described by Ickes and colleagues (Ickes, 1997;Ickes et al., 1990a; Marangoni et al., 1995), the global empathic accuracyscores were computed by comparing each participant’s inference with thecorresponding thought/feeling entry obtained from the targets.

Five naive and independent coders were asked to compare each partici-pant’s inferred thought/feeling with the corresponding original thought/feeling entry and to rate the level of similarity on a three-point scale,ranging from 0 (essentially different content) through 1 (somewhat similarbut not the same content) to 2 (essentially the same content) (‘don’t know’and missing responses were rated 0). The internal consistency of the fivejudges’ content accuracy ratings was 0.92 for the Asperger group and 0.76for the control group. Then, as explained in more detail in Appendix 1, theglobal empathic accuracy score was calculated for each participant and eachvideotape.

Similarly, 12 empathic accuracy scores for each participant for each videowere computed for all the thoughts and feelings, whether or not theybelonged to the six different categories of the actual thoughts and feelings(i.e. self, interaction partner, other person(s), the research context, a tangibleenvironmental object or event, or a past memory). The internal consistency(Cronbach’s alpha) was calculated for each topic and each videotape. Allinternal consistencies were acceptable, with one exception (see Appendix 2).

Results

Stories TaskThe ANOVA testing revealed no between-group differences for the totalnumber of correct and incorrect mental justifications (see Table 1). Simi-larly, no between-group differences were found for the total number ofcorrect and incorrect physical justifications. The mean scaled scores andstandard deviations obtained by each group are presented in Table 1.

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Eyes Photographs TaskThe mean scores of both groups were almost identical on the Eyes Photo-graphs and the Gender Tasks (see Table 1). Univariate analyses of variance(ANOVAs) revealed no between-group differences on the Eyes Photographsand the Gender Tasks.

Empathic Accuracy Task

Differences between both videotapes in targets’ actual thoughts andfeelings A series of univariate analyses (ANOVAs), with the differenttopics of the targets’ selected thoughts/feelings as dependent variable andvideotape as factor, revealed significant differences between both video-tapes. Table 2 shows that, compared with the targets of video 2, the targets

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Table 1 Between-group differences on static mind-reading tasks

Asperger Control F(1, 36)

M SD M SD

Stories Task:Correct justifications:

Mental 4.57 1.21 4.61 0.92 0.01Physical 1.10 0.94 1.19 0.67 0.11

Incorrect justifications:Mental 0.22 0.73 0.13 0.32 0.23Physical 0.10 0.46 0.06 0.23 0.13

Eyes Photographs Task:Eyes Photographs 18.63 3.27 19.31 3.20 0.42Gender Task 21.37 1.50 21.53 1.58 0.10

Global empathic accuracy:Video 1 32.63 20.38 40.76 13.01 2.15Video 2 19.59 13.23 31.55 12.77 8.03**

**p < 0.01.

Table 2 Thoughts/feelings with a specific topic (%)

Total Video 1 Video 2 F(1, 68)

Self 61.3 47.6 76.3 6.49**Interaction partner 45.0 35.7 55.3 3.73Other person(s) 21.3 19.0 23.7 0.98Research context 61.3 83.3 36.8 15.97***Tangible environmental object or event 50.0 64.3 34.2 10.96***Past memory 6.3 11.9 0.0 4.13*

*p < 0.05; **p < 0.01; ***p < 0.005.

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of video 1 had significantly more thoughts and feelings that focused on theresearch context and on a tangible environmental object or event. Con-versely, the targets of video 1 had fewer thoughts and feelings focused onself and a past memory. There were no differences between videotapes withregard to the number of thoughts/feelings concerning the interactionpartner and other person(s).

Differences between both groups in perceivers’ inferred thoughts andfeelings As shown in Table 1, the ANOVA for between-group differenceson the Empathic Accuracy Task revealed no significant difference withregard to the inferences of the unexpressed thoughts/feelings of the targetsin video 1. As expected, a significant between-group difference was foundon video 2.

The mean empathic accuracy scores of thoughts/feelings belonging toa specific topic are shown in Table 3, represented separately for both video-tapes and for each group. A series of 2 � 2 ANOVAs was conducted, withgroup (Asperger versus control) as between-subjects factor and topic(presence versus absence of a particular focus) as within-subjects factor. Asalready noted, video 1 did not distinguish between the groups, whereasvideo 2 did (see Table 1). The detailed analyses displayed in Table 4 confirmour previous findings and revealed no significant between-group differ-ences for the more detailed empathic accuracy scores in video 1. In contrast,

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Table 3 Empathic accuracy along topic-relevant thoughts and feelings (%)

Thoughts/feelings Asperger Control

With a focus on Without a With a focus on Without afocus on focus on

M (SD) M (SD) M (SD) M (SD)

Video 1Self 63.00 (25.02) 55.84 (22.04) 63.79 (20.87) 60.62 (15.37)Partner 48.49 (20.80) 65.22 (25.16) 56.14 (16.53) 65.46 (18.81)Other person(s) 78.55 (36.20) 54.52 (21.04) 84.08 (28.54) 57.12 (16.64)Research context 61.95 (22.74) 45.71 (30.79) 65.17 (17.23) 46.92 (20.25)Object or event 62.42 (24.00) 53.54 (24.31) 64.99 (17.84) 56.98 (19.20)Past memory 57.05 (32.68) 59.54 (21.96) 76.42 (27.74) 60.20 (17.08)

Video 2Self 35.72 (16.74) 31.23 (22.52) 44.21 (12.97) 45.61 (15.63)Partner 32.68 (16.87) 36.84 (16.07) 43.06 (13.06) 46.26 (16.55)Other person(s) 24.21 (15.27) 37.82 (16.50) 35.79 (14.38) 47.16 (13.28)Research context 50.03 (18.58) 25.97 (14.97) 63.37 (20.33) 32.76 (11.05)Object or event 30.53 (20.01) 34.41 (12.93) 44.14 (12.06) 41.34 (13.46)

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a significant between-group difference was found for each of the empathicaccuracy scores in video 2, with controls reaching higher empathicaccuracy than participants with Asperger syndrome.

As shown in Table 4, the analyses revealed five main effects of topic forvideo 1, indicating that the participants obtained higher accuracy scores forthoughts/feelings focused on the self, other persons, the research context anda tangible environmental object or event, than those without such a focus.In video 1 the thoughts/feelings that focused on the interaction partnerwere less accurately inferred than the thoughts/feelings without this focus.

In addition, an interaction effect (topic � group) was found for video1 between groups and absence versus presence of past memory. TheAsperger group displayed less empathic accuracy when the focus of thethoughts and feelings was on a past memory; the control group displayedmore empathic accuracy when the focus of the thought/feeling entries wason a past memory.

With regard to video 2, two main effects of topic were found. The meanempathic accuracy scores of thoughts/feelings that focused on the researchcontext reached higher accuracy rates than those of thoughts and feelingswithout such a focus. On the other hand the thoughts and feelings thatfocused on other persons were less accurately inferred than thethoughts/feelings without such a focus. Moreover, the group and topiceffects were found to be additive for two out of the five empathic accuracyscores in video 2. While the empathic accuracy rates of both groups were

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Table 4 F-values for topic and group effect

Topic Group Topic � groupF(1, 36) F(1, 36) F(1, 36)

Video 1Self 4.54* 0.68 0.68Interaction partner 25.93*** 0.41 2.10Other person(s) 35.06*** 0.29 0.11Research context 23.70*** 0.11 0.08Object or event 8.56** 0.22 0.02Past memory 2.92 1.90 5.43*

Video 2Self 0.23 6.18* 0.83Interaction partner 2.25 4.90* 0.04Other person(s) 30.69*** 5.97* 0.25a

Research context 109.52*** 5.01* 1.14a

Object or event 0.07 5.53* 2.51

*p < 0.05; **p < 0.01; ***p < 0.005.ap > 0.25, which indicates that the main effects of topic and group are additive.

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lowest for thoughts/feelings with a focus on other persons (see Table 4),the significant main effect of group indicated that adults with Aspergersyndrome had generally lower empathic accuracy scores than controls. Theadditive effect suggests that, within the Asperger group, thought/feelingentries that did not focus on the research context had the lowest empathicaccuracy rates.

Time required to complete the Eyes Photographs Task and the Empathic Accuracy TaskWe assessed the time required to complete the Eyes Photographs Task andthe Empathic Accuracy Task (see Table 5). The ANOVAs testing for between-group differences revealed no group differences in the average timerequired to complete the Eyes Photographs Task. However, time differenceswere found for video 1 and video 2 of the Empathic Accuracy Task.

Correlates of the mind-reading tasksThe correlations and intercorrelations between the mind-reading tasks, thechronological age and the IQ scores were calculated. Significant positivecorrelations (Pearson) were found between video 1 and video 2 (r(38) =0.56, p < 0.001) and between the Strange Stories and the Eyes PhotographsTask (r(38) = 0.33, p < 0.05). No other correlations were found.

Discussion

In the present study, two static mind-reading tasks and a more naturalistictask were completed by high-functioning adults with Asperger syndromeand controls. The results are consistent with those reported in the study ofRoeyers et al. (2001) of adults with PDD. Thus, the Asperger group was notimpaired with regard to the static tasks compared with the control group.However, on the second videotape of the Empathic Accuracy Task thecontrol group performed significantly better than the Asperger group.

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Table 5 Required time to complete the tasks (seconds)

Asperger Control F(1, 36)

M SD M SD

Empathic Accuracy TaskVideo 1 2794.11 1156.80 2178.11 476.52 4.61*Video 2 3341.26 1273.79 2313.74 533.27 10.52***

Eyes Photographs Task 418.32 175.83 345.68 150.08 1.88

*p < 0.05; ***p < 0.005.

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The finding of no between-group differences on the first videotape ofthe Empathic Accuracy Task and significant between-group differences onthe second videotape led to an exploration of possible differences betweenthe targets’ actual thoughts/feelings on both videotapes. Analyses revealedthat the percentages of the first videotape’s original thoughts/feelingsbelonging to a specific topic differed from those of video 2. There were nosignificant between-group differences on the detailed empathic accuracyscores in video 1, but significant between-group differences were found forall detailed empathic accuracy scores in video 2. Furthermore, analysesrevealed some main effects of topic on empathic accuracy for video 1 andvideo 2, and a significant interaction effect for video 1 between topic andgroup, indicating that the controls were more accurate in inferringthoughts/feelings that focused on a past memory, whereas the individualswith Asperger syndrome were more accurate in inferring thoughts/feelingswithout a focus on past memory (cf. also Bowler et al., 2000). Previouswork in this area suggests that finding an interaction effect with theempathic accuracy design is quite rare, and may indicate that people withAsperger syndrome use qualitatively different strategies from controls toinfer thoughts/feelings focusing on a past memory. The additive effectsfound for the empathic accuracy scores on video 2 also suggest that theadults with Asperger syndrome probably use the same mechanism as thecontrols to infer the thoughts/feelings of video 2 that focus on otherpersons or on the research context. Thus the empathic accuracy of bothgroups appears to differ both quantitatively and qualitatively.

In summary, the study represents an initial attempt to investigate themind-reading abilities of adults with Asperger syndrome, using a natural-istic design. The design of the empathic accuracy task has revealed signifi-cant differences between high-functioning individuals with Aspergersyndrome and controls, where static mind-reading tasks failed to do so. Thedata also suggested that there were both qualitative and quantitative differ-ences in the empathic accuracy scores of the group with Asperger and thoseof the controls.

The study might be criticized for the fact that the presentation of staticversus dynamic tasks was not counterbalanced, and that this lack ofcounterbalancing could have affected the results. Based on prior research(Roeyers et al., 2001) the authors were well aware that the EmpathicAccuracy Task required considerable mental effort and hence this task waspresented first. The fact that no between-group differences were found onthe static tasks suggests that the demands of the Empathic Accuracy Taskdid not affect participants with Asperger syndrome more than the controls,otherwise the Asperger group would have performed less well on the statictasks than the controls.

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In future research, it would be worthwhile to examine the role of thetargets’ behaviours on the inference abilities of persons with or without adevelopmental disorder. One possibility is that people with an autismspectrum disorder rely on different behavioural cues to infer the thoughtsand feelings of others interacting together. For instance, in a study ofKoning and Magill-Evans (2001), adolescents with Asperger syndromereported that they used facial more often than other cues to infer emotionsand, in general, they reported using fewer of all available cues to inferemotional states. Therefore, it would be interesting to assess the frequencywith which the targets of our videotapes verbalize and make eye contactwith each other. It would also be informative to examine the congruencebetween the verbalization of the interacting targets and the specific contentof the targets’ thoughts and feelings, in that typically developing individualsmight be better at inferring ‘incongruent’ thoughts/feelings than thosewith PDD. Furthermore, it is possible that while the supporting gestures ofthe two interacting protagonists assist the typically developing individualsto infer their unexpressed thoughts/feelings, difficulties in interpretingsuch movements may actually make it more difficult for individuals withPDD to infer other people’s thoughts and feelings.

It must also be emphasized that our naturalistic paradigm still differsfrom the real social world in several ways. First, the design permits allparticipants to take as much time as needed to infer the thoughts/feelingsof the targets. As noted above, participants with Asperger syndrome neededmore time than the controls to administer the Empathic Accuracy Task. Inreal life, people have to infer the thoughts and feelings of others instantly,and thus the experimental situation is much easier than normal life. Second,in our design, participants serve only as perceivers, not as targets. Thisdiffers from typical dyadic conversations where not only do participantshave to infer the thoughts and feelings of their interactive partner, but alsotheir partner has to infer their thoughts and feelings. By doing so, partici-pants are both perceivers and targets at the same time. Currently, we areconducting a study in which adults with a pervasive developmentaldisorder are videotaped using a concealed camera, while having an initialconversation with a typically developing stranger. The procedure of theempathic accuracy design (Ickes et al., 1990a) will enable us to investigatehow well each of them is able to infer the thoughts/feelings of their partner.We predict that making an online assessment of the unexpressed thoughtsand feelings of another person during an unstructured interaction will bemore difficult for adults with PDD than for controls.

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Appendix 1: empathic accuracyThe mean of the accuracy scores rated by the five judges was calculated for each indi-vidual inference. We then calculated aggregated accuracy scores from the averagedscores for each inference. The mean ratings were therefore summed across the thoughtsand feelings for each of the two videotapes. These summed scores were divided by thetotal number of thoughts and feelings for each target and multiplied by 100. Thus theminimum and maximum empathic accuracy score of each participant could varybetween 0 and 100.

As in previous studies (Ickes et al., 1990a; 1990b), the baseline empathic accuracywas derived by randomly pairing the actual and inferred thoughts and feelings and ratingthe content of these randomly paired actual/inferred thoughts and feelings on similarity.The five judges’ internal consistency (Cronbach’s alpha) was 0.59 for the baselineempathic accuracy scores. Similarly to the procedure described above, the baselineaccuracy scores rated by the five judges were averaged for each individual thought/feeling, divided by the total number of thoughts and feelings and multiplied by 100. Bysubtracting the baseline empathic accuracy score for each participant from the originalscore for that participant, we derived a revised measure of global empathic accuracy.

Following this logic, the 12 empathic accuracy scores for each participant for eachvideo were computed for all the thoughts and feelings, whether or not belonging tothe six different categorical classifications of the actual thoughts and feelings. In theresults the empathic accuracy scores are presented in percentages. For each participantand each topic, the accuracy score is divided by the number of corresponding thoughtsand feelings and then multiplied by 100.

Appendix 2: internal consistencies of topics and videotapesTable 6 shows the internal consistency (Cronbach’s alpha) for each topic and eachvideotape.

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Table 6 Internal consistency of the topics per video

Video 1 Video 2

SelfPresence 0.79 0.82Absence 0.72 0.85

Interaction partnerPresence 0.71 0.80Absence 0.79 0.83

Other person(s)Presence 0.82 0.76Absence 0.74 0.82

Research contextPresence 0.77 0.82Absence 0.84 0.79

Tangible environmental object or eventPresence 0.78 0.87Absence 0.26 0.77

Past memoryPresence 0.79 –Absence 0.78 0.82

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