The “Reading the Mind in the Eyes” Test: Complete Absence of Typical Sex Difference in ~400 Men and Women with Autism
Open accessAbstract
The "Reading the Mind in the Eyes" test (Eyes test) is an advanced test of theory of mind. Typical sex difference has been reported (i.e., female advantage). Individuals with autism show more difficulty than do typically developing individuals, yet it remains unclear how this is modulated by sex, as females with autism have been under-represented. Here in a large, non-male-biased sample we test for the effects of sex, diagnosis, and their interaction. The Eyes test (revised version) was administered online to 395 adults with autism (178 males, 217 females) and 320 control adults (152 males, 168 females). Two-way ANOVA showed a significant sex-by-diagnosis interaction in total correct score (F(1,711) = 5.090, p = 0.024, ηp2 = 0.007) arising from a significant sex difference between control males and females (p < 0.001, Cohen's d = 0.47), and an absence of a sex difference between males and females with autism (p = 0.907, d = 0.01); significant case-control differences were observed across sexes, with effect sizes of d = 0.35 in males and d = 0.69 in females. Group-difference patterns fit with the extreme-male-brain (EMB) theory predictions. Eyes test-Empathy Quotient and Eyes test-Autism Spectrum Quotient correlations were significant only in females with autism (r = 0.35, r = -0.32, respectively), but not in the other 3 groups. Support vector machine (SVM) classification based on response pattern across all 36 items classified autism diagnosis with a relatively higher accuracy for females (72.2%) than males (65.8%). Nevertheless, an SVM model trained within one sex generalized equally well when applied to the other sex. Performance on the Eyes test is a sex-independent phenotypic characteristic of adults with autism, reflecting sex-common social difficulties, and provides support for the EMB theory predictions for both males and females. Performance of females with autism differed from same-sex controls more than did that of males with autism. Females with autism also showed stronger coherence between self-reported dispositional traits and Eyes test performance than all other groups.
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RMET scores were similar to those seen in other publications with autistic participants.
“Likewise, scores in the RMET are similar to those seen in other publications with autistic participants [41, 71].”
From A 'choice', an 'addiction', a way 'out of the lost': Exploring self-injury in autistic people without intellectual disability (2019) · cites this paper as [71]
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- Authors
- Baron-Cohen, S., Bowen, D. C., Holt, R. J., Allison, C., Auyeung, B., Lombardo, M. V., Smith, P., & Lai, M.-C.
- Affiliations
- University of Cambridge (GB)
- Centre for Addiction and Mental Health (CA)
- Corresponding author
- Lai, Meng-Chuan
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2015-08-27
- Volume
- 10
- Issue
- 8
- Pages
- e0136521
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4552377
- OpenAlex
- W1943649909
- Cited by
- 238
- References
- 129
- Citations by year
- 2026: 12 · 2025: 10 · 2024: 19 · 2023: 18 · 2022: 29 · 2021: 29 · 2020: 28 · 2019: 28 · 2018: 24 · 2017: 27 · 2016: 14
- FWCI
- 13.02
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- CentAUR (University of Reading) (acceptedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
- Apollo (University of Cambridge) (submittedVersion, cc-by)
- Funders
- Wellcome Trust (091774, 091774/Z/10/Z)
- National Institute for Health and Care Research
- Medical Research Council (G0600977)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Developmental and Educational Psychology › Child and Animal Learning Development
- Life Sciences › Neuroscience › Cognitive Neuroscience › Face Recognition and Perception
- Keywords
- autism spectrum disorder, theory of mind, Reading the Mind in the Eyes Test, sex differences, extreme male brain theory, empathy, Autism Spectrum Quotient, social cognition, autistic adults
- MeSH terms
- Autism Spectrum Disorder, Adult, Female, Humans, Male, Reading, Sex Characteristics, Support Vector Machine
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