The curious incident of the misdiagnosed emotional blindness

  • Emotional blindness not a symptom of autism
  • Research will have implications on the diagnostic practices and treatment of individuals with autism.

Inability to recognise and interpret emotional states in other people, so-called emotional blindness, which is commonly identified as a symptom of autism, is actually caused by a co-occurring condition called alexithymia, according to a new study.

The research, co-authored by Dr Richard Cook from City University London’s Department of Psychology, could have significant implications for the diagnosis of autistic spectrum conditions (ASCs), and may necessitate the development of new diagnostic criteria that do not include emotional impairment. The findings also raise the possibility of targeted interventions for autism, tailored to those individuals with and without co-occurring alexithymia, reflecting their different needs and abilities.

The research team, a collaboration between Dr Cook and researchers from The Institute of Psychiatry, tested 32 participants with varying degrees of alexithymia, 16 of whom also had a clinical diagnosis of autism. They  found that alexithymia, rather than autism, predicted subjects’ ability to recognise facial expressions.

These findings provide evidence of sub-groups within the autistic population, defined by the presence or absence of alexithymia, and will allow for intervention strategies that can be tailored to meet the specific needs of each subgroup.

The report suggests that therapeutic approaches could address the emotional problems of individuals with alexithymia, and build on the emotional abilities of those autistic individuals without alexithymia, to help their social interaction.

Dr Richard Cook said: “The study shows impaired emotion recognition – currently considered a feature of autism – is in fact caused by alexithymia, a condition that is more common in individuals with autism than in the general population.

“Many practitioners currently regard impaired emotion recognition, together with reduced empathy and subjective experience of emotion as diagnostic markers of autism. However, if these difficulties are in fact due to co-occurring alexithymia, autistic individuals without alexithymia may not receive the support they need to build on their emotional abilities.

“Our findings represent a significant step toward helping researchers and clinicians understand the traits of ASC and we hope that it will prompt more research into alexithymia by cognitive scientists.”

For more information, or if you would like to speak with Dr Cook, please contact Ben Sawtell on 020 7040 8782, or via email benjamin.sawtell.1@city.ac.uk

City University London is a global University committed to academic excellence, with a focus on business and the professions and an enviable central London location. It is in the top five per cent of universities in the world according to the Times Higher Education World University Rankings 2012/13 and in the top thirty universities in the UK according to the Times Higher Education Table of Tables 2012. It is ranked in the top 10 in the UK for both graduate-level jobs (The Sunday Times University Guide 2013) and starting salaries (Which University?).

The University attracts over 17,000 students (35% at postgraduate level) from more than 150 countries and academic staff from over 50 countries. Its academic range is broadly-based with world leading strengths in business; law; health sciences; engineering; mathematical sciences; informatics; social sciences; and the arts including journalism and music. The University's history dates back to 1894, with the foundation of the Northampton Institute on what is now the main part of City's campus. In 1966, City was granted University status by Royal Charter and the Lord Mayor of London was invited to be Chancellor, a unique arrangement that continues today. Professor Paul Curran has been Vice-Chancellor of City University London since 2010.

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About City University London City University London is a global University committed to academic excellence, with a focus on business and the professions and an enviable central London location. It is in the top five per cent of universities in the world according to the Times Higher Education World University Rankings 2012/13 and in the top thirty universities in the UK according to the Times Higher Education Table of Tables 2012. It is ranked in the top 10 in the UK for both graduate-level jobs (The Sunday Times University Guide 2013) and starting salaries (Which University?). The University attracts over 17,000 students (35% at postgraduate level) from more than 150 countries and academic staff from over 50 countries. Its academic range is broadly-based with world leading strengths in business; law; health sciences; engineering; mathematical sciences; informatics; social sciences; and the arts including journalism and music. The University's history dates back to 1894, with the foundation of the Northampton Institute on what is now the main part of City's campus. In 1966, City was granted University status by Royal Charter and the Lord Mayor of London was invited to be Chancellor, a unique arrangement that continues today. Professor Paul Curran has been Vice-Chancellor of City University London since 2010.

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