Simon Baron Cohen- Keynote speech: Understanding sex differences in autism

Keynote speech given by Simon Baron Cohen from the Autism Research Centre, Cambridge University (UK) at the Autism-Europe's 12th International Congress 2019: "A New Dynamic for Change and Inclusion", held the 13-15th September 2019 in Nice, France.

Multiple studies now show that in the general population, females
on average show higher levels of empathy and males on average
show a stronger drive to systemize. Empathy involves both a cognitive element (recognizing another person’s mental state) and
an affective element (responding to another person’s mental state
with an appropriate emotion). Systemizing is the drive to analyse or
build systems (whether these are mechanical, mathematical, musical, natural, abstract, motoric, or collectible). Systems are anything that follows if-and-then rules.

I present evidence that autistic people score below average on
different measures of cognitive empathy and that they are intact
and even sometimes superior on measures of systemizing. If one
takes the difference (D scores) between one’s scores on empathy
and on systemizing then autism can be viewed as an extreme of
the typical male brain. Autism is strongly genetic and is diagnosed
more often in males than females. This is likely to be true even after taking into account under-diagnosis of females. One candidate biological epigenetic mechanism that might influence typical sex differences and may play a role in ‘masculinizing’ the autistic brain is prenatal sex steroid hormones, that shape brain development, and which themselves are under genetic control.

I summarize work from our lab testing whether levels of prenatal sex steroid hormones such as testosterone and estrogen are associated with typical sex differences in empathy and systemizing, and with autism and autistic traits.

Books

Baron-Cohen, S, (2003) The Essential Difference: men, women
and the extreme male brain. Penguin/Basic Books.

Baron-Cohen, S, et al (2005) Prenatal testosterone in mind: Studies of amniotic fluid. MIT Press/Bradford Books.

Links: www.autismresearchcentre.com

Key Journal Articles

Baron-Cohen, S, et al (2005) Sex differences in the brain: implications for explaining autism. Science, 310, 819-823.
Baron-Cohen, S, et al (2011) Why are Autism Spectrum Conditions
more prevalent in males? Public Library of Science Biology, 9, 1-10;
and Supplementary Material.
Baron-Cohen, S, et al (2015) ‘The “Reading the Mind in the Eyes”
Test: Complete absence of typical sex difference in ~400 men and
women with autism’. PLoS ONE.
Baron-Cohen, S, et al (2015) Elevated fetal steroidogenic activity in
autism. Molecular Psychiatry, 1-8. and Supplementary Material.
Baron-Cohen, S, et al (2019) Foetal estrogens and autism. Molecular Psychiatry.
Greenberg, D, M, et al (2018) Testing the Empathizing-Systemizing
theory of sex differences and the Extreme Male Brain theory of autism in half a million people. PNAS, 115, 12152-7.
Lai, et al (2013) Biological sex affects the neurobiology of autism.
Brain, 136, 2799-2815.
Lombardo, et al (2012) Fetal testosterone influences sexually dimorphic gray matter in the human brain. Journal of Neuroscience. 32(2): 674-80.
Pohl, et al (2014) Uncovering steroidopathy in women with autism: a latent class analysis. Molecular Autism, 5, 27.
Ruta, L, et al (2011) Increased serum androstenedione in adults with Autism Spectrum Conditions. Psychoneuroendocrinology. 36(8),1154-63.
Schwarz, E, et al (2010) Sex-specific serum biomarker patterns in
adults with Asperger’s Syndrome. Molecular Psychiatry. 16 (12):
1213-20.
Warrier, V, et al (2018) Genome-wide meta-analysis of cognitive empathy: heritability, and correlates with sex, neuropsychiatric conditions and cognition. Molecular Psychiatry, 23, 1402–1409.
Warrier, V, et al (2018) Genome-wide analyses of self-reported empathy: correlations with autism, schizophrenia, and anorexia nervosa. Translational Psychiatry, 8.

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