自闭症患者共情体验与自闭症共情缺失叙事

IF 9.5 Q1 PSYCHOLOGY, DEVELOPMENTAL Autism in Adulthood Pub Date : 2023-09-11 DOI:10.1089/aut.2023.0001
Lesley Kimber, Diarmuid Verrier, Stephen Connolly
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This study directly asked autistic people about their own experience of empathy and of the empathy deficit narrative to provide a richer description than is afforded by traditional studies that typically use questionnaire measures. We asked a diverse group of 76 autistic adults to tell us how they experience empathy and what their views were of the autistic empathy deficit narrative via an online survey. These data were then analyzed, and themes created, using qualitative content analysis. The first theme, heterogeneity of empathic experiences, captured the diverse ways in which autistic people experience empathy. Some did report a lack of empathy, whereas others did not, and some reported experiencing extreme emotional responses (hyper-empathy). The second theme, empathy as an effortful process, captured some of the challenges experienced during the empathy process and the strategies used to overcome these. 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引用次数: 0

摘要

背景:在临床文献和整个学术文献中,有一种主流话语认为自闭症患者缺乏同理心;然而,在过去的十年里,临床医生和学术界越来越多地拒绝以缺陷为基础的自闭症描述,而倾向于对自闭症患者在社会中的经历进行更细致入微的解释。方法:本研究询问了76名自闭症患者的共情经历和常被提及的共情缺陷。对数据进行了主题分析,揭示了受访者中广泛的共情自我概念。结果:值得注意的是,高共情体验的比例很高。许多受访者表示,他们的移情反应是压倒性的,甚至是痛苦的。这些不同的共情体验与社会对共情的期望形成对比,这往往导致自闭症患者在非自闭症中心的世界中导航时需要额外的劳动。结论:虽然在某些领域,学术文献正在慢慢地从缺陷的角度出发,但更广泛地说,对自闭症患者和同理心的误解仍然会产生负面影响。进一步的工作不仅需要在社会(而不是学术)层面探索这种误解,还需要更好地弥合共鸣观念的变化和现实世界对自闭症共鸣的理解之间的差距。有一种刻板印象认为自闭症患者缺乏同理心,这可能会导致消极的看法和偏见的行为。这种刻板印象源于早期关于自闭症的学术文献。然而,尽管随着时间的推移,这些文献变得更加细致入微,但这种刻板印象在普通人群中仍然存在。这项研究直接询问了自闭症患者关于他们自己的同理心经历和同理心缺失的叙述,提供了比传统研究更丰富的描述,这些研究通常使用问卷调查的方法。我们通过一项在线调查询问了76名不同类型的自闭症成年人,让他们告诉我们他们是如何体验共情的,以及他们对自闭症共情缺陷叙事的看法。然后对这些数据进行分析,并使用定性内容分析创建主题。第一个主题,共情体验的异质性,抓住了自闭症患者体验共情的不同方式。有些人确实报告缺乏同理心,而另一些人则没有,有些人报告经历了极端的情绪反应(超同理心)。第二个主题,同理心作为一个努力的过程,捕捉了在同理心过程中遇到的一些挑战以及克服这些挑战的策略。第三个主题是条件共情,它捕捉到他人的特征,这些特征或多或少会让人产生共情。一些参与者发现,与亲近的人、动物和其他自闭症患者产生共鸣更容易。第四个主题,挑战共情缺失叙事,捕捉了参与者对共情缺失叙事的观点,从坚定的同意到坚定的不同意,以及这种叙事带来的伤害感知,如人际偏见或不良的临床实践。先前使用自我报告测量的定量研究发现,自闭症患者和非自闭症患者在共情方面存在各种差异。这项研究为这些发现增加了质的细微差别;描述了自闭症患者不同的共情生活经历,特别是与超共情经历有关;并阐明了自闭症患者对基于同理心缺失叙事的有害刻板印象的抵制。由于我们的招募方法,参与者样本只包括那些活跃的在线自闭症社区。因此,这里的研究结果可能在多大程度上反映了广泛的经验方面是有限的。此外,尽管在线调查允许从相对较多的人那里收集数据进行定性研究,但这也意味着,与更典型的定性数据收集方法不同,不可能要求参与者详细阐述或澄清他们的观点。我们希望这项研究能够强调对自闭症患者共情体验给予更多关注的必要性。这些问题的清晰表达可能有助于自闭症患者反思自己的经历,并感到“被看到”。同时,需要在社会一级进行教育,以提高对这些问题的认识,减少非自闭症人群中的非人化、陈规定型和偏见。
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Autistic People's Experience of Empathy and the Autistic Empathy Deficit Narrative
Background: There is a dominant discourse, both in clinical texts and throughout the academic literature, that autistic people lack empathy; however, over the past decade, both clinicians and academics have increasingly rejected deficit-based descriptions of autism in favor of more nuanced explanations of the experience of autistic individuals in a social world. Methods: This study asked 76 autistic individuals about their own experience of empathy and the oft-cited empathy deficit. Data were thematically analyzed and revealed a wide array of empathic self-concepts among respondents. Results: Notably, there was a high proportion of hyper-empathic experiences. Many respondents reported their empathic responses to be overwhelming, or even distressing. These different experiences of empathy contrast with societal expectations of empathy, which often result in additional labor for autistic people as they navigate the non-autistic centered world. Conclusion: Although the academic literature is, in some areas, slowly moving away from a deficit perspective, more broadly there is still a negative impact from misconceptions around autistic people and empathy. Further work needs to be done to not only explore this misconception at a societal (rather than academic) level, but also better bridge the gap around the changing ideas of empathy and real-world understanding of autistic empathy. There is a stereotype that autistic people lack empathy, which can potentially lead to negative perceptions and biased behaviors. This stereotype has roots in earlier academic literature around autism. However, although this literature has become more nuanced over time, the stereotype persists among the general population. This study directly asked autistic people about their own experience of empathy and of the empathy deficit narrative to provide a richer description than is afforded by traditional studies that typically use questionnaire measures. We asked a diverse group of 76 autistic adults to tell us how they experience empathy and what their views were of the autistic empathy deficit narrative via an online survey. These data were then analyzed, and themes created, using qualitative content analysis. The first theme, heterogeneity of empathic experiences, captured the diverse ways in which autistic people experience empathy. Some did report a lack of empathy, whereas others did not, and some reported experiencing extreme emotional responses (hyper-empathy). The second theme, empathy as an effortful process, captured some of the challenges experienced during the empathy process and the strategies used to overcome these. The third theme, conditional empathy, captured the features of others that made it more or less likely that empathy would be experienced. Some participants found it easier to empathize with close others, animals, and other autistic people. The fourth theme, challenging the empathy deficit narrative, captured participants' perspectives on the empathy deficit narrative, which ranged from firm agreement to firm disagreement, and the perception of harm that comes from this narrative, such as interpersonal prejudice or poor clinical practice. Previous quantitative studies using self-report measures have found various differences in empathy between autistic and non-autistic people. This study added qualitative nuance to these findings; described diverse lived experiences of empathy among autistic people, particularly in relation to hyper-empathic experiences; and articulated the resistance of autistic people to the harmful stereotypes that are based on the empathy deficit narrative. Due to our recruitment method, the participant sample included only those who were engaged in active online autism communities. As such, the findings here may be limited in terms of how well they capture a broad range of experiences. In addition, although an online survey allowed data collection from a relatively large number of people for a qualitative study, it also meant that, unlike more typical qualitative data collection methods, it was not possible to ask participants to elaborate or to clarify their views. We hope that this study highlights the need for greater attention to the experience of empathy in autistic people. Articulation of these issues may help autistic people reflect on their own experiences and feel “seen.” Simultaneously, education at a societal level is needed to increase awareness of these issues and reduce dehumanization, stereotyping, and prejudice among non-autistic people.
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14.70%
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47
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