People with autism spectrum disorder (ASD) tend to have higher levels of discomfort (personal distress) while other people experience negative emotions. Further, personal distress is related to self-focused rather than other-focused cognitive processes. However, the characteristics of self-focused and other-focused cognitive processes among adolescents with ASD have not been clarified by previous research. The present study examined empathy in adolescents with ASD, focusing on their self-focused and other-focused cognitive processes. Fifteen adolescents with ASD and 577 typically developing adolescent males were presented with 3 pictures, of a person who felt fear, sad, and anger, and they were asked to express their thoughts (open response), and to evaluate whether their thoughts were self-focused or other-focused (choice response). The results showed no group differences in open responses; however, on the choice response task adolescents with ASD had a higher tendency to rate their thoughts as self-focused than did the typically developing adolescents, for the picture depicting fear. These findings suggest that people with ASD may have had many fearful experiences, which relates to excessively self-focused cognitive process when they perceive a person who feels fear.