Empathy Measurement in Autistic and Nonautistic Adults: A COSMIN Systematic Literature Review

Empathy is essential for social functioning and is relevant to a host of clinical conditions. This COSMIN review evaluated the empirical support for empathy self-report measures used with autistic and nonautistic adults. Given autism is characterized by social differences, it is the subject of a substantial proportion of empathy research. Therefore, this review uses autism as a lens through which to scrutinize the psychometric quality of empathy measures. Of the 19 measures identified, five demonstrated "High-Quality" evidence for "Insufficient" properties and cannot be recommended. The remaining 14 had noteworthy gaps in evidence and require further evaluation before use with either group. Without tests of measurement invariance or differential item functioning, the extent to which observed group differences represent actual trait differences remains unknown. Using autism as a test case highlights an alarming tendency for empathy measures to be used to characterize, and potentially malign vulnerable populations before sufficient validation.