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Background  Empathy is a vital component for social understanding involving the ability to recognise emotion (cognitive empathy) and provide an appropriate affective response (emotional empathy). Autism spectrum conditions have been described as disorders of empathy. First-degree relatives may show some mild traits of the autism spectrum, the broader autism phenotype (BAP). Whether both cognitive and emotional empathy, rather than cognitive empathy alone, are impaired in autism and the BAP is still under debate. Moreover the association between various aspects of empathy is unclear. This study aims to examine the relationship between different components of empathy across individuals with varying levels of genetic vulnerability to autism.    Methods  Factor analyses utilising questionnaire and performance-based task data were implemented among individuals with autism, parents of a child with autism and controls. The relationship between performance-based tasks and behavioural measures of empathy was also explored.    Results  A four-factor model including cognitive empathy, emotional empathy, social skills and a performance-based factor fitted the data best irrespective of genetic vulnerability. Individuals with autism displayed impairment on all four factors, with parents showing intermediate difficulties. Performance-based measures of empathy were related in almost equal magnitude to cognitive and emotional empathy latent factors and the social skills factor.    Conclusions  This study suggests individuals with autism have difficulties with multiple facets of empathy, while parents show intermediate impairments, providing evidence for a quantitative BAP. Impaired scores on performance-based measures of empathy, often thought to be pure measures of cognitive empathy, were also related to much wider empathy difficulties than impairments in cognitive empathy alone.

The latent structure of cognitive and emotional empathy in individuals with autism, first-degree relatives and typical individuals