A fine-grained analysis of facial expression processing in high-functioning adults with autism

The independence of expression and identity in face-processing: evidence from neuropsychological case studies

The processing of facial identity and facial expression have traditionally been seen as independent—a hypothesis that has largely been informed by a key double dissociation between neurological patients with a deficit in facial identity recognition but not facial expression recognition, and those with the reverse pattern of impairment. The independence hypothesis is also reflected in more recent anatomical models of face-processing, although these theories permit some interaction between the two processes. Given that much of the traditional patient-based evidence has been criticized, a review of more recent case reports that are accompanied by neuroimaging data is timely. Further, the performance of individuals with developmental face-processing deficits has recently been considered with regard to the independence debate. This paper reviews evidence from both acquired and developmental disorders, identifying methodological and theoretical strengths and caveats in these reports, and highlighting pertinent avenues for future research.

Gaze Behavior of Children with ASD toward Pictures of Facial Expressions

Atypical gaze behavior in response to a face has been well documented in individuals with autism spectrum disorders (ASDs). Children with ASD appear to differ from typically developing (TD) children in gaze behavior for spoken and dynamic face stimuli but not for nonspeaking, static face stimuli. Furthermore, children with ASD and TD children show a difference in their gaze behavior for certain expressions. However, few studies have examined the relationship between autism severity and gaze behavior toward certain facial expressions. The present study replicated and extended previous studies by examining gaze behavior towards pictures of facial expressions. We presented ASD and TD children with pictures of surprised, happy, neutral, angry, and sad facial expressions. Autism severity was assessed using the Childhood Autism Rating Scale (CARS). The results showed that there was no group difference in gaze behavior when looking at pictures of facial expressions. Conversely, the children with ASD who had more severe autistic symptomatology had a tendency to gaze at angry facial expressions for a shorter duration in comparison to other facial expressions. These findings suggest that autism severity should be considered when examining atypical responses to certain facial expressions.

Processing of Spontaneous Emotional Responses in Adolescents and Adults with Autism Spectrum Disorders: Effect of Stimulus Type

Recent research has shown that adults with autism spectrum disorders (ASD) have difficulty interpreting others' emotional responses, in order to work out what actually happened to them. It is unclear what underlies this difficulty; important cues may be missed from fast paced dynamic stimuli, or spontaneous emotional responses may be too complex for those with ASD to successfully recognise. To explore these possibilities, 17 adolescents and adults with ASD and 17 neurotypical controls viewed 21 videos and pictures of peoples' emotional responses to gifts (chocolate, a handmade novelty or Monopoly money), then inferred what gift the person received and the emotion expressed by the person while eye movements were measured. Participants with ASD were significantly more accurate at distinguishing who received a chocolate or homemade gift from static (compared to dynamic) stimuli, but significantly less accurate when inferring who received Monopoly money from static (compared to dynamic) stimuli. Both groups made similar emotion attributions to each gift in both conditions (positive for chocolate, feigned positive for homemade and confused for Monopoly money). Participants with ASD only made marginally significantly fewer fixations to the eyes of the face, and face of the person than typical controls in both conditions. Results suggest adolescents and adults with ASD can distinguish subtle emotion cues for certain emotions (genuine from feigned positive) when given sufficient processing time, however, dynamic cues are informative for recognising emotion blends (e.g. smiling in confusion). This indicates difficulties processing complex emotion responses in ASD. Autism Res2015, 8: 534–544. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Lost for emotion words: what motor and limbic brain activity reveals about autism and semantic theory

Autism spectrum conditions (ASC) are characterised by deficits in understanding and expressing emotions and are frequently accompanied by alexithymia, a difficulty in understanding and expressing emotion words. Words are differentially represented in the brain according to their semantic category and these difficulties in ASC predict reduced activation to emotion-related words in limbic structures crucial for affective processing. Semantic theories view 'emotion actions' as critical for learning the semantic relationship between a word and the emotion it describes, such that emotion words typically activate the cortical motor systems involved in expressing emotion actions such as facial expressions. As ASC are also characterised by motor deficits and atypical brain structure and function in these regions, motor structures would also be expected to show reduced activation during emotion-semantic processing. Here we used event-related fMRI to compare passive processing of emotion words in comparison to abstract verbs and animal names in typically-developing controls and individuals with ASC. Relatively reduced brain activation in ASC for emotion words, but not matched control words, was found in motor areas and cingulate cortex specifically. The degree of activation evoked by emotion words in the motor system was also associated with the extent of autistic traits as revealed by the Autism Spectrum Quotient. We suggest that hypoactivation of motor and limbic regions for emotion word processing may underlie difficulties in processing emotional language in ASC. The role that sensorimotor systems and their connections might play in the affective and social-communication difficulties in ASC is discussed.

Empathy and empathy induced prosocial behavior in 6- and 7-year-olds with autism spectrum disorder

The present study aimed to assess empathy and prosocial behavior in 6-7 year old children with autism spectrum disorders (ASDs). Results showed, first, lower levels of parent- and teacher-rated cognitive empathy, and similar levels of affective empathy in children with ASD compared to typically developing (TD) children. Second, emotion recognition for basic emotions, one aspect of cognitive empathy, in a story task was adequate in ASD children, but ASD children with severe impairments in social responsiveness had difficulties in recognizing fear. Third, prosocial behavior in response to signals of distress of a peer in a computer task was similar in ASD as in TD children. In conclusion, early elementary school children with ASD show specific impairments in cognitive empathy.

Facial emotion recognition in paranoid schizophrenia and autism spectrum disorder

Schizophrenia (SZ) and autism spectrum disorder (ASD) share deficits in emotion processing. In order to identify convergent and divergent mechanisms, we investigated facial emotion recognition in SZ, high-functioning ASD (HFASD), and typically developed controls (TD). Different degrees of task difficulty and emotion complexity (face, eyes; basic emotions, complex emotions) were used. Two Benton tests were implemented in order to elicit potentially confounding visuo-perceptual functioning and facial processing. Nineteen participants with paranoid SZ, 22 with HFASD and 20 TD were included, aged between 14 and 33 years. Individuals with SZ were comparable to TD in all obtained emotion recognition measures, but showed reduced basic visuo-perceptual abilities. The HFASD group was impaired in the recognition of basic and complex emotions compared to both, SZ and TD. When facial identity recognition was adjusted for, group differences remained for the recognition of complex emotions only. Our results suggest that there is a SZ subgroup with predominantly paranoid symptoms that does not show problems in face processing and emotion recognition, but visuo-perceptual impairments. They also confirm the notion of a general facial and emotion recognition deficit in HFASD. No shared emotion recognition deficit was found for paranoid SZ and HFASD, emphasizing the differential cognitive underpinnings of both disorders.

Using the circumplex model of affect to study valence and arousal ratings of emotional faces by children and adults with autism spectrum disorders

The affective circumplex model holds that emotions can be described as linear combinations of two underlying, independent neurophysiological systems (arousal, valence). Given research suggesting individuals with autism spectrum disorders (ASD) have difficulty processing emotions, we used the circumplex model to compare how individuals with ASD and typically-developing (TD) individuals respond to facial emotions. Participants (51 ASD, 80 TD) rated facial expressions along arousal and valence dimensions; we fitted closed, smooth, 2-dimensional curves to their ratings to examine overall circumplex contours. We modeled individual and group influences on parameters describing curve contours to identify differences in dimensional effects across groups. Significant main effects of diagnosis indicated the ASD-group’s ratings were constricted for the entire circumplex, suggesting range constriction across all emotions. Findings did not change when covarying for overall intelligence.

Influences of semantic and prosodic cues on word repetition and categorization in autism

PURPOSE

To investigate sensitivity to prosodic and semantic cues to emotion in individuals with high-functioning autism (HFA).

METHOD

Emotional prosody and semantics were independently manipulated to assess the relative influence of prosody versus semantics on speech processing. A sample of 10-year-old typically developing children (n = 10) and children with HFA (n = 10) were asked to repeat words that were either emotionally congruent or incongruent in form and content (Experiment 1A). In a second task (Experiment 1B), the same participants were asked to classify stimuli on the basis of emotional prosody. A final experiment (Experiment 2) focused on sensitivity to congruence in a non-emotional source of variation: talker gender.

RESULTS

The results revealed a selective impairment in spontaneous integration of prosodic and semantic cues to emotion in HFA; however, the same participants were able to categorize emotions on the basis of prosody under reduced task demands. Individuals with HFA were highly sensitive to another surface characteristic in speech: talker gender.

CONCLUSIONS

The study reveals impairment in the spontaneous integration of prosodic and semantic cues to emotion in HFA; however, insensitivity to surface detail, such as prosody, in HFA appears to be highly task dependent and selective to the domain of emotion.

Implicit racial attitudes influence perceived emotional intensity on other-race faces

An ability to accurately perceive and evaluate out-group members' emotions plays a critical role in intergroup interactions. Here we showed that Chinese participants' implicit attitudes toward White people bias their perception and judgment of emotional intensity of White people's facial expressions such as anger, fear and sadness. We found that Chinese participants held pro-Chinese/anti-White implicit biases that were assessed in an evaluative implicit association test (IAT). Moreover, their implicit biases positively predicted the perceived intensity of White people's angry, fearful and sad facial expressions but not for happy expressions. This study demonstrates that implicit racial attitudes can influence perception and judgment of a range of emotional expressions. Implications for intergroup interactions were discussed.

Improvement of facial affect recognition in children and adolescents with attention-deficit/hyperactivity disorder under methylphenidate

INTRODUCTION AND HYPOTHESIS

Some authors draw a connection between the dopaminergic pathways and emotional perception. The present study is based on that association and addresses the question whether methylphenidate and the resulting amelioration of the disturbed dopamine metabolism lead to an improvement of the facial affect recognition abilities in children with attention-deficit/hyperactivity disorder (ADHD).

METHODS

A computer test was conducted on 21 participants, aged 7-14 years and with a diagnosis of ADHD - some with comorbid oppositional defiant disorder - conducted the FEFA (Frankfurt Test and Training of Facial Affect), a computer test to examine their facial affect recognition abilities. It consists of two subtests, one with faces and one with eye pairs. All participants were tested in a double-blind cross-over study, once under placebo and once under methylphenidate.

RESULTS AND DISCUSSION

The collected data showed that methylphenidate leads to amelioration of facial affect recognition abilities, but not on a significant level. Reasons for missing significance may be the small sample size or the fact that there exists some overlapping in cerebral connections and metabolic pathways of the site of action of methylphenidate and the affected dopaminergic areas in ADHD. However, consistent with the endophenotype concept, certain gene locations of the dopaminergic metabolism as both an aetiological factor for ADHD and the deficient facial affect recognition abilities with these individuals were considered. Consulting current literature they were found to be not concordant. Therefore, we conclude that the lacking significance of the methylphenidate affect on facial affect recognition is based on this fact.

Impairments in facial affect recognition associated with autism spectrum disorders: a meta-analysis

Autism spectrum disorders (ASDs) are characterized by social impairments, including inappropriate responses to affective stimuli and nonverbal cues, which may extend to poor face-emotion recognition. However, the results of empirical studies of face-emotion recognition in individuals with ASD have yielded inconsistent findings that occlude understanding the role of face-emotion recognition deficits in the development of ASD. The goal of this meta-analysis was to address three as-yet unanswered questions. Are ASDs associated with consistent face-emotion recognition deficits? Do deficits generalize across multiple emotional expressions or are they limited to specific emotions? Do age or cognitive intelligence affect the magnitude of identified deficits? The results indicate that ASDs are associated with face-emotion recognition deficits across multiple expressions and that the magnitude of these deficits increases with age and cannot be accounted for by intelligence. These findings suggest that, whereas neurodevelopmental processes and social experience produce improvements in general face-emotion recognition abilities over time during typical development, children with ASD may experience disruptions in these processes, which suggested distributed functional impairment in the neural architecture that subserves face-emotion processing, an effect with downstream developmental consequences.

Recognition of emotion from facial expressions with direct or averted eye gaze and varying expression intensities in children with autism disorder and typically developing children

Eye gaze direction and expression intensity effects on emotion recognition in children with autism disorder and typically developing children were investigated. Children with autism disorder and typically developing children identified happy and angry expressions equally well. Children with autism disorder, however, were less accurate in identifying fear expressions across intensities and eye gaze directions. Children with autism disorder rated expressions with direct eyes, and 50% expressions, as more intense than typically developing children. A trend was also found for sad expressions, as children with autism disorder were less accurate in recognizing sadness at 100% intensity with direct eyes than typically developing children. Although the present research showed that children with autism disorder are sensitive to eye gaze direction, impairments in the recognition of fear, and possibly sadness, exist. Furthermore, children with autism disorder and typically developing children perceive the intensity of emotional expressions differently.

Recognition of facial expressions and prosodic cues with graded emotional intensities in adults with Asperger syndrome

This study investigated the ability of adults with Asperger syndrome to recognize emotional categories of facial expressions and emotional prosodies with graded emotional intensities. The individuals with Asperger syndrome showed poorer recognition performance for angry and sad expressions from both facial and vocal information. The group difference in facial expression recognition was prominent for stimuli with low or intermediate emotional intensities. In contrast to this, the individuals with Asperger syndrome exhibited lower recognition accuracy than typically-developed controls mainly for emotional prosody with high emotional intensity. In facial expression recognition, Asperger and control groups showed an inversion effect for all categories. The magnitude of this effect was less in the Asperger group for angry and sad expressions, presumably attributable to reduced recruitment of the configural mode of face processing. The individuals with Asperger syndrome outperformed the control participants in recognizing inverted sad expressions, indicating enhanced processing of local facial information representing sad emotion. These results suggest that the adults with Asperger syndrome rely on modality-specific strategies in emotion recognition from facial expression and prosodic information.

Social approach and emotion recognition in fragile X syndrome

Evidence is emerging that individuals with Fragile X syndrome (FXS) display emotion recognition deficits, which may contribute to their significant social difficulties. The current study investigated the emotion recognition abilities, and social approachability judgments, of FXS individuals when processing emotional stimuli. Relative to chronological age- (CA-) and mental age- (MA-) matched controls, the FXS group performed significantly more poorly on the emotion recognition tasks, and displayed a bias towards detecting negative emotions. Moreover, after controlling for emotion recognition deficits, the FXS group displayed significantly reduced ratings of social approachability. These findings suggest that a social anxiety pattern, rather than poor socioemotional processing, may best explain the social avoidance observed in FXS.

Misinterpretation of facial expressions of emotion in verbal adults with autism spectrum disorder

Facial emotion perception is significantly affected in autism spectrum disorder, yet little is known about how individuals with autism spectrum disorder misinterpret facial expressions that result in their difficulty in accurately recognizing emotion in faces. This study examined facial emotion perception in 45 verbal adults with autism spectrum disorder and 30 age- and gender-matched volunteers without autism spectrum disorder to identify patterns of emotion misinterpretation during face processing that contribute to emotion recognition impairments in autism. Results revealed that difficulty distinguishing emotional from neutral facial expressions characterized much of the emotion perception impairments exhibited by participants with autism spectrum disorder. In particular, adults with autism spectrum disorder uniquely misinterpreted happy faces as neutral, and were significantly more likely than typical volunteers to attribute negative valence to nonemotional faces. The over-attribution of emotions to neutral faces was significantly related to greater communication and emotional intelligence impairments in individuals with autism spectrum disorder. These findings suggest a potential negative bias toward the interpretation of facial expressions and may have implications for interventions designed to remediate emotion perception in autism spectrum disorder.

Can adults with autism spectrum disorders infer what happened to someone from their emotional response?

Can adults with autism spectrum disorders (ASD) infer what happened to someone from their emotional response? Millikan has argued that in everyday life, others' emotions are most commonly used to work out the antecedents of behavior, an ability termed retrodictive mindreading. As those with ASD show difficulties interpreting others' emotions, we predicted that these individuals would have difficulty with retrodictive mindreading. Sixteen adults with high-functioning autism or Asperger's syndrome and 19 typically developing adults viewed 21 video clips of people reacting to one of three gifts (chocolate, monopoly money, or a homemade novelty) and then inferred what gift the recipient received and the emotion expressed by that person. Participants' eye movements were recorded while they viewed the videos. Results showed that participants with ASD were only less accurate when inferring who received a chocolate or homemade gift. This difficulty was not due to lack of understanding what emotions were appropriate in response to each gift, as both groups gave consistent gift and emotion inferences significantly above chance (genuine positive for chocolate and feigned positive for homemade). Those with ASD did not look significantly less to the eyes of faces in the videos, and looking to the eyes did not correlate with accuracy on the task. These results suggest that those with ASD are less accurate when retrodicting events involving recognition of genuine and feigned positive emotions, and challenge claims that lack of attention to the eyes causes emotion recognition difficulties in ASD.

Perception of social cues of danger in autism spectrum disorders

Intuitive grasping of the meaning of subtle social cues is particularly affected in autism spectrum disorders (ASD). Despite their relevance in social communication, the effect of averted gaze in fearful faces in conveying a signal of environmental threat has not been investigated using real face stimuli in adults with ASD. Here, using functional MRI, we show that briefly presented fearful faces with averted gaze, previously shown to be a strong communicative signal of environmental danger, produce different patterns of brain activation than fearful faces with direct gaze in a group of 26 normally intelligent adults with ASD compared with 26 matched controls. While implicit cue of threat produces brain activation in attention, emotion processing and mental state attribution networks in controls, this effect is absent in individuals with ASD. Instead, individuals with ASD show activation in the subcortical face-processing system in response to direct eye contact. An effect of differences in looking behavior was excluded in a separate eye tracking experiment. Our data suggest that individuals with ASD are more sensitive to direct eye contact than to social signals of danger conveyed by averted fearful gaze.

Gender differences in the relationship between social communication and emotion recognition

OBJECTIVE

To investigate the association between autistic traits and emotion recognition in a large community sample of children using facial and social motion cues, additionally stratifying by gender.

METHOD

A general population sample of 3,666 children from the Avon Longitudinal Study of Parents and Children (ALSPAC) were assessed on their ability to correctly recognize emotions using the faces subtest of the Diagnostic Analysis of Non-Verbal Accuracy, and the Emotional Triangles Task, a novel test assessing recognition of emotion from social motion cues. Children with autistic-like social communication difficulties, as assessed by the Social Communication Disorders Checklist, were compared with children without such difficulties.

RESULTS

Autistic-like social communication difficulties were associated with poorer recognition of emotion from social motion cues in both genders, but were associated with poorer facial emotion recognition in boys only (odds ratio = 1.9, 95% CI = 1.4, 2.6, p = .0001). This finding must be considered in light of lower power to detect differences in girls.

CONCLUSIONS

In this community sample of children, greater deficits in social communication skills are associated with poorer discrimination of emotions, implying there may be an underlying continuum of liability to the association between these characteristics. As a similar degree of association was observed in both genders on a novel test of social motion cues, the relatively good performance of girls on the more familiar task of facial emotion discrimination may be due to compensatory mechanisms. Our study might indicate the existence of a cognitive process by which girls with underlying autistic traits can compensate for their covert deficits in emotion recognition, although this would require further investigation.

A reversal coarse-grained analysis with application to an altered functional circuit in depression

INTRODUCTION

When studying brain function using functional magnetic resonance imaging (fMRI) data containing tens of thousands of voxels, a coarse-grained approach - dividing the whole brain into regions of interest - is applied frequently to investigate the organization of the functional network on a relatively coarse scale. However, a coarse-grained scheme may average out the fine details over small spatial scales, thus rendering it difficult to identify the exact locations of functional abnormalities.

METHODS

A novel and general approach to reverse the coarse-grained approach by locating the exact sources of the functional abnormalities is proposed.

RESULTS

Thirty-nine patients with major depressive disorder (MDD) and 37 matched healthy controls are studied. A circuit comprising the left superior frontal gyrus (SFGdor), right insula (INS), and right putamen (PUT) exhibit the greatest changes between the patients with MDD and controls. A reversal coarse-grained analysis is applied to this circuit to determine the exact location of functional abnormalities.

CONCLUSIONS

The voxel-wise time series extracted from the reversal coarse-grained analysis (source) had several advantages over the original coarse-grained approach: (1) presence of a larger and detectable amplitude of fluctuations, which indicates that neuronal activities in the source are more synchronized; (2) identification of more significant differences between patients and controls in terms of the functional connectivity associated with the sources; and (3) marked improvement in performing discrimination tasks. A software package for pattern classification between controls and patients is available in Supporting Information.

A comparison of social cognitive profiles in children with autism spectrum disorders and attention-deficit/hyperactivity disorder: a matter of quantitative but not qualitative difference?

The aim of this study was to compare social cognitive profiles of children and adolescents with Autism Spectrum Disorders (ASD) and ADHD. Participants diagnosed with an ASD (n = 137) were compared to participants with ADHD (n = 436) on tests of facial and vocal affect recognition, social judgment and problem-solving, and parent- and teacher-report of social functioning. Both groups performed significantly worse than the normative sample on all measures. Although the ASD group had more severe deficits, the pattern of deficits was surprisingly similar between groups, suggesting that social cognitive deficit patterns may be more similar in ASD and ADHD than previously thought. Thus, like those with ASDs, individuals with ADHD may also need to be routinely considered for treatments targeting social skills.

Emotion recognition and visual-scan paths in Fragile X syndrome

This study investigated emotion recognition abilities and visual scanning of emotional faces in 16 Fragile X syndrome (FXS) individuals compared to 16 chronological-age and 16 mental-age matched controls. The relationships between emotion recognition, visual scan-paths and symptoms of social anxiety, schizotypy and autism were also explored. Results indicated that, compared to both control groups, the FXS group displayed specific emotion recognition deficits for angry and neutral (but not happy or fearful) facial expressions. Despite these evident emotion recognition deficits, the visual scanning of emotional faces was found to be at developmentally appropriate levels in the FXS group. Significant relationships were also observed between visual scan-paths, emotion recognition performance and symptomology in the FXS group.

Evidence for impaired verbal identification but intact nonverbal recognition of fearful body postures in Asperger's syndrome

While most studies of emotion recognition in Asperger's Syndrome (AS) have focused solely on the verbal decoding of affective states, the current research employed the novel technique of using both nonverbal matching and verbal labeling tasks to examine the decoding of emotional body postures and facial expressions. AS participants performed as accurately as controls at matching fear body postures, but were significantly less accurate than controls verbally identifying these same stimuli. This profile arguably indicates that that while the AS participants were aware that the fear body posture stimuli represented a distinct emotion, they were unsure as to which specific emotion. In addition, the AS participants took significantly longer than the controls to respond to anger body posture stimuli on a matching task. However, in contrast to previous studies, AS and control participants did not differ significantly in their responses to facial expression stimuli, in terms of either accuracy or response times.

Emotional resonance deficits in autistic children

According to some theories imitation, defined as an action resonance mechanism, is deficient in autism. In contrast, other theories (e.g., the "top down control of imitation" hypothesis) state that the problem is not in imitation per se but in the way social cues modulate imitative responses. In this study, 15 high-functioning children with autism and 15 matched controls were tested for their ability to imitate finger movements preceded by neutral and emotional facial expressions (primes) in a stimulus-response compatibility task. Hand movements performed after neutral expressions did not differ between the two groups (i.e., they both showed a normal imitative tendency). However, hand movements performed after emotional expressions significantly differed between the two populations, with controls, but not autistic spectrum disorder (ASD), showing enhanced imitation in the emotional condition. This study supports the view that, in ASD, imitation abilities are spared but they are not modulated according to the emotional and social context.

Mixed emotions: the contribution of alexithymia to the emotional symptoms of autism

It is widely accepted that autism is associated with disordered emotion processing and, in particular, with deficits of emotional reciprocity such as impaired emotion recognition and reduced empathy. However, a close examination of the literature reveals wide heterogeneity within the autistic population with respect to emotional competence. Here we argue that, where observed, emotional impairments are due to alexithymia-a condition that frequently co-occurs with autism-rather than a feature of autism per se. Alexithymia is a condition characterized by a reduced ability to identify and describe one's own emotion, but which results in reduced empathy and an impaired ability to recognize the emotions of others. We briefly review studies of emotion processing in alexithymia, and in autism, before describing a recent series of studies directly testing this 'alexithymia hypothesis'. If found to be correct, the alexithymia hypothesis has wide-reaching implications for the study of autism, and how we might best support subgroups of autistic individuals with, and without, accompanying alexithymia. Finally, we note the presence of elevated rates of alexithymia, and inconsistent reports of emotional impairments, in eating disorders, schizophrenia, substance abuse, Parkinson's Disease, multiple sclerosis and anxiety disorders. We speculate that examining the contribution of alexithymia to the emotional symptoms of these disorders may bear fruit in the same way that it is starting to do in autism.

Undifferentiated facial electromyography responses to dynamic, audio-visual emotion displays in individuals with autism spectrum disorders

We examined facial electromyography (fEMG) activity to dynamic, audio-visual emotional displays in individuals with autism spectrum disorders (ASD) and typically developing (TD) individuals. Participants viewed clips of happy, angry, and fearful displays that contained both facial expression and affective prosody while surface electrodes measured corrugator supercilli and zygomaticus major facial muscle activity. Across measures of average and peak activity, the TD group demonstrated emotion-selective fEMG responding, with greater relative activation of the zygomatic to happy stimuli and greater relative activation of the corrugator to fearful stimuli. In contrast, the ASD group largely showed no significant differences between zygomatic and corrugator activity across these emotions. There were no group differences in the magnitude and timing of fEMG response in the muscle congruent to the stimuli. This evidence that fEMG responses in ASD are undifferentiated with respect to the valence of the stimulus is discussed in light of potential underlying neurobiological mechanisms.

Alexithymia, Not Autism, Predicts Poor Recognition of Emotional Facial Expressions

Despite considerable research into whether face perception is impaired in autistic individuals, clear answers have proved elusive. In the present study, we sought to determine whether co-occurring alexithymia (characterized by difficulties interpreting emotional states) may be responsible for face-perception deficits previously attributed to autism. Two experiments were conducted using psychophysical procedures to determine the relative contributions of alexithymia and autism to identity and expression recognition. Experiment 1 showed that alexithymia correlates strongly with the precision of expression attributions, whereas autism severity was unrelated to expression-recognition ability. Experiment 2 confirmed that alexithymia is not associated with impaired ability to detect expression variation; instead, results suggested that alexithymia is associated with difficulties interpreting intact sensory descriptions. Neither alexithymia nor autism was associated with biased or imprecise identity attributions. These findings accord with the hypothesis that the emotional symptoms of autism are in fact due to co-occurring alexithymia and that existing diagnostic criteria may need to be revised.

Are emotion impairments unique to, universal, or specific in autism spectrum disorder? A comprehensive review

There is widespread belief that individuals with autism spectrum disorders (ASDs) are "emotionally detached" from others. This comprehensive review examines the empirical evidence for this assumption, addressing three critical questions: (1) Are emotion-processing impairments universal in ASD? (2) Are they specific, or can they be explained by deficits in other domains? (3) Is the emotion processing profile seen in ASD unique to these conditions? Upon review of the literature (over 200 studies), we conclude that: (1) emotion-processing impairments might not be universal in ASD, as suggested by variability across participants and across emotion-processing tasks; (2) emotion-processing impairments might not be specific to ASD, as domain-general processes appear to account for some of these impairments; and (3) the specific pattern of emotion-processing strengths and weaknesses observed in ASD, involving difficulties with processing social versus non-social, and complex versus simple emotional information (with impairments more consistently reported on implicit than explicit emotion-processing tasks), appears to be unique to ASD. The emotion-processing profile observed in ASD might be best understood as resulting from heterogeneous vulnerabilities in different components of an "emotional communication system" that, in typical development, emerges from the interplay between domain-general cognitive, social and affective processes.

The Interplay between Emotion and Cognition in Autism Spectrum Disorder: Implications for Developmental Theory

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that is clinically defined by abnormalities in reciprocal social and communicative behaviors and an inflexible adherence to routinised patterns of thought and behavior. Laboratory studies repeatedly demonstrate that autistic individuals experience difficulties in recognizing and understanding the emotional expressions of others and naturalistic observations show that they use such expressions infrequently and inappropriately to regulate social exchanges. Dominant theories attribute this facet of the ASD phenotype to abnormalities in a social brain network that mediates social-motivational and social-cognitive processes such as face processing, mental state understanding, and empathy. Such theories imply that only emotion related processes relevant to social cognition are compromised in ASD but accumulating evidence suggests that the disorder may be characterized by more widespread anomalies in the domain of emotions. In this review I summarize the relevant literature and argue that the social-emotional characteristics of ASD may be better understood in terms of a disruption in the domain-general interplay between emotion and cognition. More specifically I will suggest that ASD is the developmental consequence of early emerging anomalies in how emotional responses to the environment modulate a wide range of cognitive processes including those that are relevant to navigating the social world.

Cognition in males and females with autism: similarities and differences

The male bias in autism spectrum conditions (ASC) has led to females with ASC being under-researched. This lack of attention to females could hide variability due to sex that may explain some of the heterogeneity within ASC. In this study we investigate four key cognitive domains (mentalizing and emotion perception, executive function, perceptual attention to detail, and motor function) in ASC, to test for similarities and differences between males and females with and without ASC (n = 128 adults; n = 32 per group). In the mentalizing and facial emotion perception domain, males and females with ASC showed similar deficits compared to neurotypical controls. However, in attention to detail and dexterity involving executive function, although males with ASC showed poorer performance relative to neurotypical males, females with ASC performed comparably to neurotypical females. We conclude that performance in the social-cognitive domain is equally impaired in male and female adults with ASC. However, in specific non-social cognitive domains, performance within ASC depends on sex. This suggests that in specific domains, cognitive profiles in ASC are modulated by sex.

Emotional recognition in autism spectrum conditions from voices and faces

The present study reports on a new vocal emotion recognition task and assesses whether people with autism spectrum conditions (ASC) perform differently from typically developed individuals on tests of emotional identification from both the face and the voice. The new test of vocal emotion contained trials in which the vocal emotion of the sentence were congruent, incongruent, or neutral with respect to the semantic content. We also included a condition in which there was no semantic content (an 'mmm' was uttered using an emotional tone). Performance was compared between 11 adults with ASC and 14 typically developed adults. Identification of emotion from sentences in which the vocal emotion and the meaning of sentence were congruent was similar in people with ASC and a typically developed comparison group. However, the comparison group was more accurate at identifying the emotion in the voice from incongruent and neutral trials, and also from trials with no semantic content. The results of the vocal emotion task were correlated with performance on a face emotion recognition task. In decoding emotion from spoken utterances, individuals with ASC relied more on verbal semantics than did typically developed individuals, presumably as a strategy to compensate for their difficulties in using prosodic cues to recognize emotions.

Perception of emotions from facial expressions in high-functioning adults with autism

Impairment in social communication is one of the diagnostic hallmarks of autism spectrum disorders, and a large body of research has documented aspects of impaired social cognition in autism, both at the level of the processes and the neural structures involved. Yet one of the most common social communicative abilities in everyday life, the ability to judge somebody's emotion from their facial expression, has yielded conflicting findings. To investigate this issue, we used a sensitive task that has been used to assess facial emotion perception in a number of neurological and psychiatric populations. Fifteen high-functioning adults with autism and 19 control participants rated the emotional intensity of 36 faces displaying basic emotions. Every face was rated 6 times-once for each emotion category. The autism group gave ratings that were significantly less sensitive to a given emotion, and less reliable across repeated testing, resulting in overall decreased specificity in emotion perception. We thus demonstrate a subtle but specific pattern of impairments in facial emotion perception in people with autism.

Reduced accuracy and sensitivity in the perception of emotional facial expressions in individuals with high autism spectrum traits

Autism spectrum disorder (ASD) is among other things characterized by specific impairments in emotion processing. It is not clear, however, to what extent the typical decline in affective functioning is related to the specific autistic traits. We employed The Autism Spectrum-Quotient (AQ) to quantify autistic traits in a group of 500 healthy individuals and investigate whether we could detect similar difficulties in the perception of emotional expressions in a broader autistic phenotype. The group with high AQ score was less accurate and needed higher emotional content to recognize emotions of anger, disgust, and sadness. Our findings demonstrate a selective impairment in identification of emotional facial expressions in healthy individuals that is primarily related to the extent of autistic traits.

Gamma activation in young people with autism spectrum disorders and typically-developing controls when viewing emotions on faces

BACKGROUND

Behavioural studies have highlighted irregularities in recognition of facial affect in children and young people with autism spectrum disorders (ASDs). Recent findings from studies utilising electroencephalography (EEG) and magnetoencephalography (MEG) have identified abnormal activation and irregular maintenance of gamma (>30 Hz) range oscillations when ASD individuals attempt basic visual and auditory tasks.

METHODOLOGY/PRINCIPAL FINDINGS

The pilot study reported here is the first study to use spatial filtering techniques in MEG to explore face processing in children with ASD. We set out to examine theoretical suggestions that gamma activation underlying face processing may be different in a group of children and young people with ASD (n = 13) compared to typically developing (TD) age, gender and IQ matched controls. Beamforming and virtual electrode techniques were used to assess spatially localised induced and evoked activity. While lower-band (3-30 Hz) responses to faces were similar between groups, the ASD gamma response in occipital areas was observed to be largely absent when viewing emotions on faces. Virtual electrode analysis indicated the presence of intact evoked responses but abnormal induced activity in ASD participants.

CONCLUSIONS/SIGNIFICANCE

These findings lend weight to previous suggestions that specific components of the early visual response to emotional faces is abnormal in ASD. Elucidation of the nature and specificity of these findings is worthy of further research.

Diminished sensitivity to sad facial expressions in high functioning autism spectrum disorders is associated with symptomatology and adaptive functioning

Prior studies implicate facial emotion recognition (FER) difficulties among individuals with autism spectrum disorders (ASD); however, many investigations focus on FER accuracy alone and few examine ecological validity through links with everyday functioning. We compared FER accuracy and perceptual sensitivity (from neutral to full expression) between 42 adolescents with high functioning (IQ > 80) ASD and 31 typically developing adolescents (matched on age, IQ, sex ratio) across six basic emotions and examined links between FER and symptomatology/adaptive functioning within the ASD group. Adolescents with ASD required more intense facial expressions for accurate emotion identification. Controlling for this overall group difference revealed particularly diminished sensitivity to sad facial expressions in ASD, which was uniquely correlated with ratings of autism-related behavior and adaptive functioning.

Face processing in children with autism spectrum disorder: independent or interactive processing of facial identity and facial expression?

The current study investigated if deficits in processing emotional expression affect facial identity processing and vice versa in children with autism spectrum disorder. Children with autism and IQ and age matched typically developing children classified faces either by emotional expression, thereby ignoring facial identity or by facial identity disregarding emotional expression. Typically developing children processed facial identity independently from facial expressions but processed facial expressions in interaction with identity. Children with autism processed both facial expression and identity independently of each other. They selectively directed their attention to one facial parameter despite variations in the other. Results indicate that there is no interaction in processing facial identity and emotional expression in autism spectrum disorder.

The specific impairment of fearful expression recognition and its atypical development in pervasive developmental disorder

Several studies have examined facial expression recognition in pervasive developmental disorder (PDD), including autism and Asperger's disorder, but the results have been inconsistent. We investigated the relationship between facial expression recognition and age, face recognition, and symptom severity. Subjects were 28 individuals with mild PDD subtypes and 28 age- and gender-matched controls. Among six emotions, fearful expression recognition was specifically impaired in PDD subjects. Age had positive effects on fearful expression recognition directly and indirectly via the development of face recognition in controls, but not in PDD subjects. Furthermore, fearful expression recognition was related to the severity of PDD symptoms. We conclude that individuals with PDD show an atypical development of facial expression recognition. Moreover, impaired fearful expression recognition is closely related to social dysfunction.

Strength of lateralisation for processing facial emotion in relation to autistic traits in individuals without autism

A great number of studies have shown that non-clinical individuals rely predominantly on the right hemisphere to process facial emotion. Previous studies have shown that males suffering from Asperger's syndrome show a typical right hemisphere bias for processing facial emotion (happiness and sadness) but a reduced right hemisphere bias for processing facial identity. This study looks at the lateralisation of all six basic emotions using the chimeric faces test in 64 non-clinical participants (32 males, 32 females) and correlates it with their autistic traits measured using the Broad Autistic Phenotype Questionnaire. For males only, regression analyses showed a relationship between the aloof personality trait and lateralisation for fear, happiness, and surprise. Males with high autistic scores on the aloof personality subscale (showing a lack of interest in social interaction) were more strongly lateralised to the right hemisphere for processing fear, happiness, and surprise. For males there was no relationship with anger, disgust, sadness, or non-facial stimuli, and for females there were no significant relationships at all. The autistic traits of rigidity and pragmatic language were not significant predictors of emotion lateralisation. The over-reliance on the right hemisphere for processing facial emotion in males seems to support the idea that the autistic brain could be seen as hyper-masculinised, possibly due to prenatal testosterone exposure.

A multimodal approach to emotion recognition ability in autism spectrum disorders

BACKGROUND

Autism spectrum disorders (ASD) are characterised by social and communication difficulties in day-to-day life, including problems in recognising emotions. However, experimental investigations of emotion recognition ability in ASD have been equivocal, hampered by small sample sizes, narrow IQ range and over-focus on the visual modality.

METHODS

We tested 99 adolescents (mean age 15;6 years, mean IQ 85) with an ASD and 57 adolescents without an ASD (mean age 15;6 years, mean IQ 88) on a facial emotion recognition task and two vocal emotion recognition tasks (one verbal; one non-verbal). Recognition of happiness, sadness, fear, anger, surprise and disgust were tested. Using structural equation modelling, we conceptualised emotion recognition ability as a multimodal construct, measured by the three tasks. We examined how the mean levels of recognition of the six emotions differed by group (ASD vs. non-ASD) and IQ (≥ 80 vs. < 80).

RESULTS

We found no evidence of a fundamental emotion recognition deficit in the ASD group and analysis of error patterns suggested that the ASD group were vulnerable to the same pattern of confusions between emotions as the non-ASD group. However, recognition ability was significantly impaired in the ASD group for surprise. IQ had a strong and significant effect on performance for the recognition of all six emotions, with higher IQ adolescents outperforming lower IQ adolescents.

CONCLUSIONS

The findings do not suggest a fundamental difficulty with the recognition of basic emotions in adolescents with ASD.

Social perception and WAIS-IV Performance in adolescents and adults diagnosed with Asperger's Syndrome and Autism

Previous research using the Wechsler scales has identified areas of cognitive weaknesses in children, adolescents, and adults diagnosed with Autism or Asperger's syndrome. The current study evaluates cognitive functioning in adolescents and adults diagnosed with Autism or Asperger's syndrome using the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) and the Social Perception subtest from the Advanced Clinical Solutions. Deficits in social perception, verbal comprehension, and processing speed were found in the Autism sample. Additionally, they exhibited inconsistent performance on auditory working memory and perceptual reasoning tasks. The Asperger's syndrome group had better overall cognitive skills than the Autism group, but compared with controls, they had weaknesses in processing speed, social perception, and components of auditory working memory. Both groups had relatively low scores on the WAIS-IV Comprehension subtest compared with the other verbal comprehension subtests. Clinical application and utility of the WAIS-IV and Social Perception in Autism Spectrum Disorders are discussed.

Congenital prosopagnosia: multistage anatomical and functional deficits in face processing circuitry

Face recognition is a primary social skill which depends on a distributed neural network. A pronounced face recognition deficit in the absence of any lesion is seen in congenital prosopagnosia. This study investigating 24 congenital prosopagnosic subjects and 25 control subjects aims at elucidating its neural basis with fMRI and voxel-based morphometry. We found a comprehensive behavioral pattern, an impairment in visual recognition for faces and buildings that spared long-term memory for faces with negative valence. Anatomical analysis revealed diminished gray matter density in the bilateral lingual gyrus, the right middle temporal gyrus, and the dorsolateral prefrontal cortex. In most of these areas, gray matter density correlated with memory success. Decreased functional activation was found in the left fusiform gyrus, a crucial area for face processing, and in the dorsolateral prefrontal cortex, whereas activation of the medial prefrontal cortex was enhanced. Hence, our data lend strength to the hypothesis that congenital prosopagnosia is explained by network dysfunction and suggest that anatomic curtailing of visual processing in the lingual gyrus plays a substantial role. The dysfunctional circuitry further encompasses the fusiform gyrus and the dorsolateral prefrontal cortex, which may contribute to their difficulties in long-term memory for complex visual information. Despite their deficits in face identity recognition, processing of emotion related information is preserved and possibly mediated by the medial prefrontal cortex. Congenital prosopagnosia may, therefore, be a blueprint of differential curtailing in networks of visual cognition.

Facial emotion recognition in autism spectrum disorders: a review of behavioral and neuroimaging studies

Behavioral studies of facial emotion recognition (FER) in autism spectrum disorders (ASD) have yielded mixed results. Here we address demographic and experiment-related factors that may account for these inconsistent findings. We also discuss the possibility that compensatory mechanisms might enable some individuals with ASD to perform well on certain types of FER tasks in spite of atypical processing of the stimuli, and difficulties with real-life emotion recognition. Evidence for such mechanisms comes in part from eye-tracking, electrophysiological, and brain imaging studies, which often show abnormal eye gaze patterns, delayed event-related-potential components in response to face stimuli, and anomalous activity in emotion-processing circuitry in ASD, in spite of intact behavioral performance during FER tasks. We suggest that future studies of FER in ASD: 1) incorporate longitudinal (or cross-sectional) designs to examine the developmental trajectory of (or age-related changes in) FER in ASD and 2) employ behavioral and brain imaging paradigms that can identify and characterize compensatory mechanisms or atypical processing styles in these individuals.

Empathic brain responses in insula are modulated by levels of alexithymia but not autism

Difficulties in social cognition are well recognized in individuals with autism spectrum conditions (henceforth 'autism'). Here we focus on one crucial aspect of social cognition: the ability to empathize with the feelings of another. In contrast to theory of mind, a capacity that has often been observed to be impaired in individuals with autism, much less is known about the capacity of individuals with autism for affect sharing. Based on previous data suggesting that empathy deficits in autism are a function of interoceptive deficits related to alexithymia, we aimed to investigate empathic brain responses in autistic and control participants with high and low degrees of alexithymia. Using functional magnetic resonance imaging, we measured empathic brain responses with an 'empathy for pain' paradigm assessing empathic brain responses in a real-life social setting that does not rely on attention to, or recognition of, facial affect cues. Confirming previous findings, empathic brain responses to the suffering of others were associated with increased activation in left anterior insula and the strength of this signal was predictive of the degree of alexithymia in both autistic and control groups but did not vary as a function of group. Importantly, there was no difference in the degree of empathy between autistic and control groups after accounting for alexithymia. These findings suggest that empathy deficits observed in autism may be due to the large comorbidity between alexithymic traits and autism, rather than representing a necessary feature of the social impairments in autism.