Empathy quotient

Empathy quotient (EQ) is a psychological self-report measure of empathy developed by Simon Baron-Cohen and Sally Wheelwright at the Autism Research Centre at the University of Cambridge. EQ is based on a definition of empathy that includes cognition and affect. According to the authors of the measure, empathy is a combination of the ability to feel an appropriate emotion in response to another's emotion and the ability to understand the others' emotion (associated with the theory of mind). EQ was developed in response to what the authors considered to be a lack of questionnaires which measure empathy exclusively: other measures such as the questionnaire measure of emotional empathy and the empathy scale have multiple factors which are uncorrelated with empathy, often associated with social skills or the ability to be emotionally aroused in general.[1] EQ was designed to test the empathizing–systemizing theory, a theory which places individuals in different brain-type categories based on their tendencies toward empathy and system creation, and was intended especially for clinical use to determine the role of lack of empathy in psychopathology, in particular to screen for autism spectrum disorder.[2]

Empathy quotient
Purposemeasure of empathy

Format and scoring

The EQ consists of 60 items, 40 items relating to empathy and 20 control items. "On each empathy item a person can score 2, 1, or 0[3]". A 40-item version of the test containing only the relevant questions is also available, but may be less reliable in certain applications. Each item is a first-person statement which the administree must rate as either "strongly agree", "slightly agree", "slightly disagree", or "strongly disagree". All questions must be answered.[1]

The instrument is scored on a scale of 0 (being the least empathetic possible) to 80 (being the most empathetic possible). A useful cut-off of 30 was established when screening for autism spectrum disorders.[1]

Development of the measure

Together with the systematizing quotient, the empathy quotient was developed by Simon Baron-Cohen and is used to test his empathizing-systemizing (E-S) theory of autism. This cognitive theory attempts to account for two different aspects of autism disorder: the social and communication barriers and the narrow interest and attention to detail. Baron-Cohen associated the social and communication barriers with a lack of empathy, not only a lack of theory of mind but also an inability to respond to others' thoughts and emotions. He associated the narrow interest and attention to detail with a special ability to systematize or analyze.[4] This theory is consistent with the findings that individuals with autism score significantly higher scores on the systemizing quotient and lower scores on the empathizing quotient than the general population.[5] Although these scores have been found consistently, there is controversy about whether the autistic brain differs qualitatively or quantitatively.[6]

The E-S theory is also associated with a theory of autism called the extreme male brain theory. The extreme male brain theory is based on the finding that males score significantly higher on the systemizing quotient[4] and lower on the empathy quotient than females in both adult and child populations.,[1][7] and that scores of the autistic population were also higher on systemizing and lower on empathizing but to an extreme. Baron-Cohen hypothesized that the tendencies of autistic scores to be similar to male scores might imply that the autistic brain is more like the male than the female brain in general, and that this might be due to prenatal testosterone. This is one hypothesis that accounts for the sex difference in the prevalence of autism (male-female ratio: 4:1 for autism, 10.8:1 for Asperger syndrome).[7]

The extreme male brain theory has led to some controversy, and tests of the hypothesis had mixed findings on the correlation between biological indicators of prenatal testosterone and scores on the systemizing quotient and empathy quotient. Chapman et al. found that male children who had been exposed to more prenatal testosterone scored lower on the EQ, indicating that there is not only a sex difference in empathy but also a difference within the male population which is correlated with prenatal testosterone.[8] There is also evidence against this theory. For example, one possible biomarker for prenatal testosterone's effect on the brain is a low ratio of the second to fourth finger (the 2D:4D ratio), which has been found to be associated with several male specific psychological factors. A significantly lower 2D:4D ratio than the general population has been found in autistic individuals, however there was no correlation between the empathizing and systemizing quotients and the 2D:4D ratio. The authors give many possible explanations for this finding which are contrary to the extreme male brain theory of autism, for example it is possible that the psychometric properties of the quotients are lacking or that the theory itself is incorrect and the difference in autistic brains is not an extreme of normal functioning but of a different structure altogether.[6]

Psychometric properties

There is evidence for the face validity of the EQ from the method by which the measure was created. In initial testing, the EQ was examined by a panel of six experimental psychologists, who were asked to rate the match of the items in the measure to the following definition of empathy: "Empathy is the drive or ability to attribute mental states to another person/animal, and entails an appropriate affective response in the observer to the other person’s mental state."[9] This definition is based on Baron-Cohen's theory of empathy which includes both a cognitive and affective response to another individual's emotions. Each of the 40 empathy items were rated as relating to the definition of empathy, while all 20 control items were rated as not related, by at least 5 out of 6 experimenters.[1]

The EQ has also demonstrated several kinds of reliability. Lawrence et al. found strong inter-rater reliability and test-retest reliability for the EQ. They also found that the EQ has a moderate correlation with the 'empathetic concern’ and ‘perspective taking’ sub-scales of the Interpersonal Reactivity Index[2] This is another measure of empathy which the authors of the EQ considered to be the best empathy measure before creating their own, but which includes sub-scales which measure more than empathy.[1] This indicates that the EQ has concurrent validity.[2]

There has been concern that social desirability might influence EQ score because certain items correlate with the social desirability scale. It is suggested that these items either be dropped or that social desirability be measured in conjunction with the EQ. The authors of this study also suggest that the EQ be revised to include only 28 items divided into three separate categories of empathy including 'cognitive empathy, emotional reactivity and social skills.'[2]

There has also been some doubts about the validity and reliability of the EQ. As stated above, one study found a lack of correlation between the EQ and the 2D:4D ratio which is the ratio between the second and fourth fingers determined by prenatal testosterone and estrogen. The ratio is associated with sex differences in several psychological factors. According to the extreme male brain theory of autism, should be a correlation, but there is not. The authors hypothesize that this could be due either to biological factors, a theoretical problem with the E-S theory of autism, or could be due to problems with the psychometric properties of the measures. This study did not directly measure the psychometric properties of the empathy quotient, but indicates that there may be an issue either with the E-S theory or with the measure itself.[6]

Revised questionnaires

Based on the findings about the psychometric properties of the EQ, there is evidence for the division of the EQ into three sub-categories (the three-factor model): cognitive empathy, emotional reactivity, and social skills.[2] The original authors had not created these divisions because they considered it impossible to separate the cognitive from the emotional aspects of empathy.[1]

Based on an analysis of the internal consistency of the scale, a team which included the original authors found that the original questionnaire contained some irrelevant questions and produced a shortened version of the scale containing 28 items. Principal component analysis indicated that this shortened questionnaire was able to measure empathy reliably.[10]

The EQ has been translated into several languages including Serbian, Russian and Dutch. The reliability of the Serbian 40-question scale was lower than the English version, and the original theory that empathy is a one-factor concept was not confirmed. The translation of the shortened 28-question version had higher reliability and there was evidence for the three-factor understanding of empathy.[11] The Russian study also confirmed the three-factor model.[12] A study of the Dutch version also confirmed the three-factor model, and indicated good cross-cultural validity in Europe and the US, but less so in Asia.[13]

References
  1. Baron Cohen, S., & Wheelwright, S. (2004). The empathy quotient: An investigation of adults with Asperger syndrome or high functioning autism, and normal sex differences. Journal of Autism and Developmental Disorders, 34(2), 163–175. doi:10.1023/B:JADD.0000022607.19833.00
  2. Shaw, P., Baker, D., Baron Cohen, S., Lawrence, E. J., & David, A. S. (2004). Measuring empathy: Reliability and validity of the empathy quotient. Psychological Medicine, 34(5), 911–919. doi:10.1017/S0033291703001624
  3. https://pubmed.ncbi.nlm.nih.gov/15162935/
  4. Baron-Cohen, S., Richler, J., Bisarya, D., Gurunathan, N., & Wheelwright, S. (2003). The systemizing quotient: An investigation of adults with asperger syndrome or high–functioning autism, and normal sex differences. The Royal Society, 358(1430), 361–374. doi:10.1098/rstb.2002.1206
  5. Wheelwright, S., Baron Cohen, S., Goldenfeld, N., Delaney, J., Fine, D., Smith, R., . . . Wakabayashi, A. (2006). Predicting autism spectrum quotient (AQ) from the systemizing quotient-revised (SQ-R) and empathy quotient (EQ). Brain Research, 1079(1), 47–56. doi:10.1016/j.brainres.2006.01.012
  6. Voracek, M., & Dressler, S. (2006). Lack of correlation between digit ratio (2D:4D) and baron-Cohen’s “Reading the mind in the eyes” test, empathy, systemising, and autism-spectrum quotients in a general population sample. Personality and Individual Differences, 41(8), 1481–1491. doi:10.1016/j.paid.2006.06.009
  7. Auyeung, B., Wheelwright, S., Allison, C., Atkinson, M., Samarawickrema, N., & Baron Cohen, S. (2009). The Children’s empathy quotient and systemizing quotient: Sex differences in typical development and in autism spectrum conditions. Journal of Autism and Developmental Disorders, 39(11), 1509–1521. doi:10.1007/s10803-009-0772-x
  8. Chapman, E., Baron Cohen, S., Auyeung, B., Knickmeyer, R., Taylor, K., & Hackett, G. (2006). Fetal testosterone and empathy: Evidence from the empathy quotient (EQ) and the “Reading the mind in the eyes” test. Social Neuroscience, 1(2), 135–148. doi:10.1080/17470910600992239
  9. Baron Cohen, S., & Wheelwright, S. (2004). The empathy quotient: An investigation of adults with Asperger syndrome or high functioning autism, and normal sex differences. Journal of Autism and Developmental Disorders, 34(2), 163–175, pg. 168. doi:10.1023/B:JADD.0000022607.19833.00
  10. Wakabayashi, A., Baron Cohen, S., Wheelwright, S., Goldenfeld, N., Delaney, J., Fine, D., . . . Weil, L. (2006). Development of short forms of the empathy quotient (EQ-short) and the systemizing quotient (SQ-short). Personality and Individual Differences, 41(5), 929–940. doi:10.1016/j.paid.2006.03.017
  11. Dimitrijevic, A., Hanak, N., Vukosavljevic Gvozden, T., & Opacic, G. (2012). Psychometric properties of the Serbian version of the empathy quotient (S-EQ).Psihologija, 45(3), 257–276. doi:10.2298/PSI1203257D
  12. Kosonogov V. (2014). The psychometric properties of the Russian version of the Empathy Quotient. Psychology in Russia: State of the Art, 7(1), 96-104.
  13. Groen, Y., Fuermaier, A. B. M., Den Heijer, A. E., Tucha, O., & Althaus, M. (2015). The Empathy and Systemizing Quotient: The Psychometric Properties of the Dutch Version and a Review of the Cross-Cultural Stability. Journal of Autism and Developmental Disorders, 45(9), 2848–2864. http://doi.org/10.1007/s10803-015-2448-z
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