A comprehensive psychometric analysis of autism-spectrum quotient factor models using two large samples: Model recommendations and the influence of divergent traits on total-scale scores

Face perception and facial emotional expression recognition ability: Both unique predictors of the broader autism phenotype

Autism spectrum disorder (ASD) and the broader autistic phenotype (BAP) have been suggested to be associated with perceptual-cognitive difficulties processing human faces. However, the empirical results are mixed, arguably, in part due to inadequate samples and analyses. Consequently, we administered the Cambridge Face Perception Test (CFPT), the Reading the Mind in the Eyes Test (RMET), a vocabulary test, and the Autism Quotient (AQ) to a sample of 318 adults in the general community. Based on a disattenuated path analytic modelling strategy, we found that both face perception ability (β = -.21) and facial emotional expression recognition ability (β = -.27) predicted uniquely and significantly the Communication dimension of AQ. Vocabulary failed to yield a significant, direct effect onto the Communication dimension of the AQ. We conclude that difficulties perceiving information from the faces of others may contribute to difficulties in nonverbal communication, as conceptualised and measured within the context of BAP.

Autistic traits specific to communication ability are associated with performance on a Mooney face detection task

Difficulties in global face processing have been associated with autism. However, autism is heterogenous, and it is not known which dimensions of autistic traits are implicated in face-processing difficulties. To address this gap in knowledge, we conducted two experiments to examine how identification of Mooney face stimuli (stylized, black-and-white images of faces without details) related to the six subscales of the Comprehensive Autistic Trait Inventory in young adults. In Experiment 1, regression analyses indicated that participants with poorer communication skills had lower task sensitivity when discriminating between face-present and face-absent images, whilst other autistic traits had no unique predictive value. Experiment 2 replicated these findings and additionally showed that autistic traits were linked to a reduced face inversion effect. Taken together, these results indicate autistic traits, especially communication difficulties, are associated with reduced configural processing of face stimuli. It follows that both reduced sensitivity for identifying upright faces amongst similar-looking distractors and reduced susceptibility to face inversion effects may be linked to relatively decreased reliance on configural processing of faces in autism. This study also reinforces the need to consider the different facets of autism independently.

Exploring phenotypic overlap across schizotypy and autism spectrum conditions in American and Chinese young adults

Competing theories have been proposed to explain the considerable overlap in social-cognitive features and risk factors across schizotypy and autism spectrum conditions (ASCs). Six previous factor analyses have been reported in the literature, yet all have major limitations; evidence for the clear superiority of any of the competing theories is insufficient and warrants further investigation. The primary aim of the present research was to identify dimensions that cut across schizotypy and ASCs while addressing limitations of past research. Data were collected from three independent samples (n = 1006, 544, and 2469) in the U.S. and China using the Autism-Spectrum Quotient, the Schizotypal Personality Questionnaire, and the Wisconsin Schizotypy Scales. Exploratory factor analyses in Sample 1 identified an interpretable three-factor structure, which was replicated in Samples 2 and 3 using confirmatory factor analyses. We found consistent evidence for three dimensions (Aberrant Salience, Asociality, and Concrete Thinking) underlying schizotypy and ASCs. This three-dimension model is consistent with a common vulnerability model of schizotypy and ASCs. Implications of these findings for the schizotypy and ASCs literature are discussed.

The factor structure and measurement invariance of the Autism Spectrum Quotient-28: A cross-cultural comparison between Malaysia and the Netherlands

LAY ABSTRACT

The AQ-28 is a questionnaire measuring autistic traits, that is, traits that are related to Autism Spectrum Conditions, but its reliability in other cultures has not been thoroughly evaluated. We, therefore, tested whether the properties of the AQ-28 are comparable between two countries with different cultures, Malaysia and the Netherlands. A total of 437 Malaysian and 818 Dutch participants completed the AQ-28 online. We measured whether the AQ-28 measures autistic traits similarly in Malaysia and the Netherlands. The AQ-28 measures autistic traits similarly, and the reliability was acceptable and good in the general population of Malaysia and the Netherlands, respectively. However, Malaysians scored higher than Dutch participants. Moreover, 11 AQ-28 items showed cultural bias, indicating that these items are answered/interpreted differently in Malaysia and the Netherlands. Cross-cultural differences in interpreting, reporting, and/or expressing autistic traits highlighted in this study could potentially explain why some items are culturally biased and why Malaysians score higher on these items. The findings of this work imply that cutoff scores derived from one culture should not be generalised to another culture. Moreover, the findings are informative for future development of culturally neutral or appropriate screening and diagnostic tools for autism.

Modelling the overlap and divergence of autistic and schizotypal traits on hippocampal subfield volumes and regional cerebral blood flow

Psychiatric disorders show high co-morbidity, including co-morbid expressions of subclinical psychopathology across multiple disease spectra. Given the limitations of classical case-control designs in elucidating this overlap, new approaches are needed to identify biological underpinnings of spectra and their interaction. We assessed autistic-like traits (using the Autism Quotient, AQ) and schizotypy - as models of subclinical expressions of disease phenotypes and examined their association with volumes and regional cerebral blood flow (rCBF) of anterior, mid- and posterior hippocampus segments from  structural MRI scans in 318 and arterial spin labelling (ASL) in 346 nonclinical subjects, which overlapped with the structural imaging sample (N = 298). We demonstrate significant interactive effects of positive schizotypy and AQ social skills as well as of positive schizotypy and AQ imagination on hippocampal subfield volume variation. Moreover, we show that AQ attention switching modulated hippocampal head rCBF, while positive schizotypy by AQ attention to detail interactions modulated hippocampal tail rCBF. In addition, we show significant correlation of hippocampal volume and rCBF in both region-of-interest and voxel-wise analyses, which were robust after removal of variance related to schizotypy and autistic traits. These findings provide empirical evidence for both the modulation of hippocampal subfield structure and function through subclinical traits, and in particular how only the interaction of phenotype facets leads to significant reductions or variations in these parameters. This makes a case for considering the synergistic impact of different (subclinical) disease spectra on transdiagnostic biological parameters in psychiatry.

Revisiting the ownership effect in adults with and without autism

Self-owned items are better remembered than other-owned items; this ownership effect reflects privileged processing of self-related information. The size of this ownership effect has been shown to decrease in neurotypical adults as the number of autistic traits increases, and is reduced in autistic adults. However, emerging evidence has questioned the reliability of these findings. This paper aimed to replicate previous work using well-powered, pre-registered designs, and Bayesian analyses. Experiment 1 (N = 100) found a significant ownership effect in neurotypical adults; however, the size of this was unrelated to individual differences in autistic traits. Experiment 2 (N = 56) found an ownership effect in neurotypical but not autistic adults. The findings suggest that individual differences in autistic traits in the neurotypical population do not impact the ownership effect, but a clinical diagnosis of autism might. We discuss how these findings can be explained by differences in psychological self-awareness in autism.

Measuring the Autistic Women's Experience (AWE)

We developed a Dutch questionnaire called the Autistic Women's Experience (AWE) and compared its psychometric properties to the Autism Spectrum Quotient (AQ). Whilst attenuated gender differences on the AQ have been widely replicated, this instrument may not fully capture the unique experience of autistic women. The AWE was co-developed with autistic women to include items that reflect autistic women's experience. We investigated the AWE (49 items) and compared it with the AQ (50 items) in Dutch autistic individuals (N = 153, n = 85 women) and in the general population (N = 489, n = 246 women) aged 16+. Both the AQ and AWE had excellent internal consistency and were highly and equally predictive of autism in both women and men. Whilst there was a gender difference on the AQ among non-autistic people (men > women), there was no gender difference among autistic people, confirming all earlier studies. No gender differences were detected on the AWE overall scale, yet subtle gender differences were observed on the subscales. We conclude that the AQ is valid for both genders, but the AWE provides an additional useful perspective on the characteristics of autistic women. The AWE needs further validation in independent samples using techniques that allow for testing gender biases, as well as a confirmatory factor analysis in a larger sample.

An Open Science MRI Database of over 100 Synaesthetic Brains and Accompanying Deep Phenotypic Information

We provide a neuroimaging database consisting of 102 synaesthetic brains using state-of-the-art 3 T MRI protocols from the Human Connectome Project (HCP) which is freely available to researchers. This database consists of structural (T1- and T2-weighted) images together with approximately 24 minutes of resting state data per participant. These protocols are designed to be inter-operable and reproducible so that others can add to the dataset or directly compare it against other normative or special samples. In addition, we provide a 'deep phenotype' of our sample which includes detailed information about each participant's synaesthesia together with associated clinical and cognitive measures. This behavioural dataset, which also includes data from (N = 109) non-synaesthetes, is of importance in its own right and is openly available.

The three-factor structure of the Autism-Spectrum Quotient Japanese version in pregnant women

Background

There is a rising interest in perinatal mental health studies, and proper psychometric tools to assess autistic traits among this population in Japan are vital.

Objective

This study aimed to clarify the optimal factor structure of the AQ as part of a perinatal mental health research project.

Methods

We used the Japanese version of the AQ (AQ-J) to measure autistic-like traits in pregnant women. Participants were 4,287 Japanese women who were pregnant or who had given birth within the last month. We performed exploratory factor analysis (EFA) using the first sample group (n = 2,154) to obtain factor structures for the final item selections. We performed confirmatory factor analysis (CFA) using the second sample group (n = 2,133) to obtain a model with good fit, then compared the model to all previously proposed models to determine the best-fitting model.

Results

The EFA analysis identified a model consisting of 25 items distributed across three factors. Cronbach's alpha for the total 25-item AQ-J, 9-item "Social interaction" factor, 11-item "Non-verbal communication" factor, and 5-item "Restricted interest" factor was 0.829, 0.829, 0.755, and 0.576, respectively. McDonald's omega and its 95% confidence interval were 0.826 (0.821-0.836), 0.835 (0.821-0.837), 0.755 (0.744-0.766), and 0.603 (0.556-0.596), respectively. CFA confirmed that the three-factor structure had an acceptable fit (goodness of fit index: 0.900, comparative fit index: 0.860, root mean square error of approximation: 0.066). These findings indicated that the three-factor model was better than the 13 existing models.

Conclusion

The findings are discussed in relation to the adequacy of the AQ-J for assessing autistic traits in perinatal women. We recommend the use of this 25-item, three-factor AQ-J model for this population owing to its superiority to all previous models.

Emotional dysregulation as a part of the autism spectrum continuum: a literature review from late childhood to adulthood

The concept of emotional dysregulation (ED) has recently gained interest in the scientific literature and is commonly defined as the inability to use the modulatory mechanisms involved in emotion regulation, resulting in a functioning meaningfully below the baseline. Even though the data available are still limited, an increasing number of studies have hypothesized a promoting role for some of the core features of autism spectrum disorder (ASD) in the development of ED, in particular being repetitive behaviors, social difficulties and alexythimia. In this framework, the purpose of this study was to review the literature that is currently available about presence and correlates of ED in young adults with autism spectrum conditions as well as to offer some insights about possible implications for illness trajectories. The data reported seems to point to a shared etiology between ED and repetitive/restricted ASD symptoms, with perseveration features serving as the foundation for the inability to control one's emotions. In this context, a neurodevelopmental basis for ED could be consistent with the transnosographic conceptualization of ASD, which hypothesizes a potential neurodevelopmental basis for several psychiatric disorders, whose autistic traits would be the phenotypical presentation.

No differences in implicit hand maps among different degrees of autistic traits

People with autism spectrum disorder (ASD) or higher levels of autistic traits have atypical characteristics in sensory processing. Atypicalities have been reported for proprioceptive judgments, which are tightly related to internal bodily representations underlying position sense. However, no research has directly investigated whether self-bodily representations are different in individuals with ASD. Implicit hand maps, estimated based on participants' proprioceptive sensations without sight of their hand, are known to be distorted such that the shape is stretched along the medio-lateral hand axis even for neurotypical participants. Here, with the view of ASD as falling on a continuous distribution among the general population, we explored differences in implicit body representations along with autistic traits by focusing on relationships between autistic traits and the magnitudes of the distortions in implicit hand maps (N ~ 100). We estimated the magnitudes of distortions in implicit hand maps both for fingers and hand surfaces on the dorsal and palmar sides of the hand. Autistic traits were measured by questionnaires (Autism Spectrum [AQ] and Empathy/Systemizing [EQ-SQ] Quotients). The distortions in implicit hand maps were replicated in our experimental situations. However, there were no significant relationships between autistic traits and the magnitudes of the distortions as well as within-individual variabilities in the maps and localization performances. Consistent results were observed from comparisons between IQ-matched samples of people with and without a diagnosis of ASD. Our findings suggest that there exist perceptual and neural processes for implicit body representations underlying position sense consistent across levels of autistic traits.

Comorbidity and Overlaps between Autism Spectrum and Borderline Personality Disorder: State of the Art

Despite the relationship between Autism spectrum disorder (ASD) and personality disorders (PD) still being scarcely understood, recent investigations increased awareness about significant overlaps between some PD and autism spectrum conditions. In this framework, several studies suggested the presence of similarities between BPD and ASD symptoms and traits, based on the recent literature that increasingly reported increased comorbidity rates and significant symptomatologic overlaps between the two conditions. The aim of this review is to describe the available studies about the prevalence of the association between different forms of autism spectrum (full-fledged clinical conditions as well as subthreshold autistic traits) and BPD. Despite some controversial results and lack of homogeneity in the methods used for the diagnostic assessment, the reviewed literature highlighted how subjects with BPD reported higher scores on tests evaluating the presence of AT compared to a non-clinical population and hypothesized the presence of unrecognized ASD in some BPD patients or vice versa, while also describing a shared vulnerability towards traumatic events, and a greater risk of suicidality in BPD subjects with high autistic traits. However, the specific measure and nature of this association remain to be explored in more depth.

Autism traits dimensionality and multivariate relationship with alexithymia and anxiety in the general population

BACKGROUND

Autism is characterized by social and non-social alterations observed beyond the clinical diagnosis. Research analyzing the expression of autism traits in the general population helps to unravel the relationship between autism dimensions and other associated variables, such as alexithymia and anxiety. The Autism-Spectrum Quotient (AQ) was developed to assess autism traits in the general population; however, inconsistent results regarding its dimensionality have emerged.

AIMS

This study aimed to extend evidence about the AQ measurement model, and explore the multivariate relationship between autism traits, alexithymia, and trait anxiety.

METHODS

292 adults of the general population were recruited. An Exploratory Factor Analysis and Confirmatory Factor Analysis were performed to assess the factorial structure of AQ. A path analysis was carried out to explore the relationship between autism traits, alexithymia, and trait anxiety.

RESULTS

The results supported a three-factor model of AQ. The path analysis model showed evidence of a significant role of alexithymia as a mediator of the relationship between autism traits and anxiety.

CONCLUSIONS AND IMPLICATIONS

The present study provides empirical support for a three-factor model of AQ in the general population. The association between autism traits, alexithymia, and anxiety dimensions highlights the multidimensional nature of these variables and the need to account for their distinct impact on autism-related variables.

Theories on the Link Between Autism Spectrum Conditions and Trans Gender Modality: a Systematic Review

While research on the prevalence of co-occurring autism spectrum conditions (ASC) and trans gender modality (TGM) is available, less is known about the underlying mechanism of this association. Insight is needed to improve treatment of trans autistic people. This review provides an overview of theories on the ASC-TGM link and the available evidence for/against them published between January 2016 and October 2020. A systematic search was performed in PubMed, PsycINFO, Web of Science, and Scopus. This resulted in 36 studies, in which 15 theories were identified. Results indicate all theories lack substantial empirical support. Unlikely and promising theories were identified. The most promising theories were those on resistance to social norms and weakened sex differences. Future directions are provided.

Impaired Biological Motion Processing and Motor Skills in Adults with Autistic Traits

The present study explored the relationship between biological motion (BioM) processing, motor skills, and autistic traits within a non-clinical sample of 621 adults (18-73 years, 51.8% female). Results indicated that adults with greater autistic traits also endorsed difficulties associated with developmental coordination disorder (DCD) in childhood and adulthood. Traits associated with autism spectrum disorder and DCD were predictive of BioM processing abilities. The results also revealed sex differences in DCD, autistic traits, and BioM processing. Overall, these findings suggest that adults with greater autistic traits experience both deficits in motor activities as well as underlying motor perceptual abilities.

The effect of autistic traits on disembedding and mental rotation in neurotypical women and men

Recent data has revealed dissociations between social and non-social skills in both autistic and neurotypical populations. In the present study, we investigated whether specific visuospatial abilities, such as figure disembedding and mental rotation, are differently related to social and non-social autistic traits, in neurotypical women and men. University students (N = 426) completed the Autism Spectrum Quotient (AQ), figure disembedding and mental rotation of two-dimensional figures tasks. AQ social skills (AQ-social) and attention-to-details (AQ-attention) subscales were used as measures of social and non-social autistic traits, respectively. Mental rotation was affected by a significant interaction between sex, social and non-social traits. When non-social traits were above the mean (+ 1 SD), no sex differences in mental rotation were found. Instead, below this value, sex differences depended on the social traits, with men on average outperforming women at middle-to-high social traits, and with a comparable performance, and with women on average outperforming men, at lower social traits. A small positive correlation between figure disembedding and social traits was observed in the overall sample. These results are interpreted in terms of the hyper-systemizing theory of autism and contribute to the evidence of individual differences in the cognitive style of autistic people and neurotypical people with autistic traits.

Associations among autistic traits, cognitive and affective empathy, and personality traits in adults with autism spectrum disorder and no intellectual disability

Reported empathy deficits in autism spectrum disorder (ASD) could be attributable to other ASD-related features. We evaluated 28 ASD adults with no intellectual disability and 24 age-matched non-ASD control subjects using the Autism-Spectrum Quotient (AQ), Questionnaire of Cognitive and Affective Empathy (QCAE), Interpersonal Reactivity Index (IRI), and NEO Personality Inventory-Revised (NEO). Compared to the controls, ASD participants showed lower scores for perspective taking, online simulation, cognitive empathy, and peripheral responsivity on the QCAE, and lower scores for perspective taking and empathic concern on the IRI. Within the ASD group, the AQ scores showed significant relationships with perspective taking, online simulation and cognitive empathy on the QCAE, and perspective taking on the IRI. The ASD group also showed higher scores for neuroticism and lower scores for extraversion on the NEO compared to the controls. However, there were no relationships between AQ scores and NEO factors within the ASD group. Multiple regression analysis with stepwise linear regression demonstrated that perspective taking score on the QCAE and extraversion score on the NEO were good predictor variables to autistic traits on the AQ. These findings help us to understand empathy and personality traits in ASD adults with no intellectual disability.

The role of alexithymia and autistic traits in predicting quality of life in an online sample

BACKGROUND

Autistic people tend to report poorer Quality of Life (QOL) than comparison groups, though some studies do report more optimistic findings. Higher autistic traits are also related to poorer QOL. However, the role of alexithymia in this relationship has not been explored.

METHOD

A total of 163 participants (N = 53 autistic and N = 111 comparison) consented to take part; however, 30 participants were excluded due to missing data (who did not differ from those who were retained on age, gender, education, employment, or living status), leaving a final sample of 133 (N = 42 Autistic and 91 Comparison participants). Demographic information (including age, gender) was collected, alongside self-report measures of autistic traits, mental health, alexithymia, and QOL. We estimated regression models based on pre-registered analysis, and we conducted exploratory network analyses.

RESULTS

Alexithymic traits did not predict QOL when controlling for covariates. Depression significantly predicted Physical, Psychological, and Social QOL. When examining the impact of just alexithymic traits and autistic traits, both were significantly associated with Physical and Psychological QOL. For participants with a low depression score, the correlation between alexithymia and QOL was strong; suggesting that depression occludes the association between alexithymia and QOL. Network analyses suggested that depression and anxiety exert direct effects on Physical and Psychological QOL, whereas alexithymia scores may influence Physical QOL via autistic traits.

CONCLUSION

In sum, depression is a pervasive negative predictor of multiple QOL domains. The role of alexithymia in predicting QOL dimensionally and categorically was not ruled out, given our exploratory analyses, we suggest that interventions which target alexithymia may positively impact QOL for those who score low on depressive symptoms.

Hyperfocus or flow? Attentional strengths in autism spectrum disorder

The comorbidity of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) diagnoses is well established. An ASD diagnosis is associated with elevated ADHD traits and symptoms, as well as strengths in attention. In the ASD literature, attentional strengths have been described as maladaptive (e.g., hyperfocus), in contrast with positive portrayals in the typically developing population (e.g., flow). The objective of this study was to (1) compare profiles of attentional strengths and weaknesses in ASD and ADHD and (2) determine whether attentional strengths in ASD are associated with impairment, poorer cognitive flexibility, and perseveration/perfectionism. In a community sample of 5,744 children and youth, 131 children were reported as having a diagnosis of ASD (mean age 10.3 years) and 346 children were reported as having a diagnosis of ADHD (mean age 10.7 years). We used the Strengths and Weaknesses of Attention-Deficit/Hyperactivity-symptoms and Normal-behaviors (SWAN) rating scale to calculate attentional and hyperactive/impulse control strength and weakness counts and scores. The Autism-Spectrum Quotient Switching factor served as a measure of cognitive flexibility. Impairment was assessed with the Columbia Impairment Scale. We used the symmetry/ordering factor on the Toronto Obsessive-Compulsive Scale as a measure of perseveration/perfectionism. No differences were found between the ADHD and ASD groups in SWAN weakness scores, symptoms, or hyperactive/impulse control strengths; however, autistic children had higher rates of attentional strengths [odds ratio: 5.7, 95% CI (2.8, 11.6), p < 0.0001]. Post-hoc pairwise testing identified four attentional strengths with significantly higher rates in ASD than in ADHD. Attentional strength scores were not associated with impairment or poor cognitive flexibility, but predicted levels of perseveration/perfectionism. The effect of attentional strengths on impairment and cognitive flexibility did not differ between autistic and Control children, but the higher perseveration/perfectionism scores seen in ASD were not found in Control children. ASD is associated with a pattern of attentional strengths that is not found in ADHD Characterizing the full range of attentional abilities in autistic children may explain variability in outcomes such as quality-of-life indicators and identify protective factors, providing targets for strength-based behavioral interventions. The clinical and etiological implications of the subgroup of autistic children with attentional strengths require further investigation.

Language Matters: The Autism-Spectrum Quotient in English, Mandarin and Bahasa Malaysia

The autism-spectrum quotient (AQ) measures autistic traits and has been studied in different countries, sometimes with the English version, and sometimes with translated versions. However, the language of the questionnaire might influence non-native English speakers' answering tendency. In the current study we compared the responses on the AQ of multilingual Malaysians (96 participants filled out the AQ in English and Mandarin, and 79 participants filled out English and Bahasa Malaysia). Participants scored higher on the English AQ compared to the Mandarin AQ, whereas there was no difference between the English and Bahasa Malaysia AQ score. Analysis of the response style suggests the same person might display discrepant response styles in different languages, which seems to be related to language proficiency.

The Autism-Spectrum Quotient (AQ) Adolescent's Version in Turkey: Factor Structure, Reliability and Validity

We assessed the reliability and validity of the Turkish version of the autism spectrum quotient (AQ)-adolescent. Three assessment groups of adolescents, aged 11-18, were: 80 with Asperger syndrome/high-functioning autism (AS/HFA), 71 with other psychiatric disorders (PDs; 35 major depression, 18 obsessive-compulsive disorder, 18 social phobia), and 249 healthy controls. The scores of the AS/HFA group were significantly higher than the healthy control and PD groups. Cronbach α value was 0.829. Ordinal alpha value was 0.90. We showed the AQ-adolescent four-factor structure in the factor analysis. In the test-retest of AQ-adolescent and subscale scores, "very strong" significant correlation values were detected. A cut-off score of 24 best distinguished the autism group from healthy controls with 0.975 sensitivity and 0.991 specificity.

Anxiety Sensitivity Domains are Differently Affected by Social and Non-social Autistic Traits

Anxiety sensitivity (AS) is implicated in the development and maintenance of several psychopathological conditions. Non-clinical individuals with high autistic traits may develop anxiety disorders and depressive symptoms. Here, we investigated the relationships of autistic traits with AS dimensions and depression, considering sex. We referred to the two-factor model of the autism spectrum quotient to distinguish social and non-social autistic traits and assessed 345 university students on AS and depression scales. Results showed that only social autistic traits predicted general AS and anxiety-related concerns regarding social and cognitive domains. The present results emphasize the need of assessing multiple domains of anxiety in individuals on the autistic spectrum, differentiating social and non-social traits.

Brief Report: Facial Asymmetry and Autistic-Like Traits in the General Population

Atypical facial morphology, particularly increased facial asymmetry, has been identified in some individuals with Autism Spectrum Conditions (ASC). Many cognitive, behavioural and biological features associated with ASC also occur on a continuum in the general population. The aim of the present study was to examine subthreshold levels of autistic traits and facial morphology in non-autistic individuals. Facial asymmetry was measured using three-dimensional facial photogrammetry, and the Autism-spectrum Quotient was used to measure autistic-like traits in a community-ascertained sample of young adults (n = 289). After accounting for covariates, there were no significant associations observed between autistic-like traits and facial asymmetry, suggesting that any potential facial morphology differences linked to ASC may be limited to the clinical condition.

No relationship between prenatal or early postnatal androgen exposure and autistic traits: evidence using anogenital distance and penile length measurements at birth and 3 months of age

BACKGROUND

Autism is more prevalent in males than in females. Hypotheses related to the extreme male brain theory of autism suggest that heightened androgen exposure during early development contributes to autistic traits. Whilst prior research focused mostly on the prenatal period, the current study tests the influences of androgen exposure during both the prenatal and the early postnatal periods on autistic traits during childhood.

METHODS

Anthropometric measures that are putative biomarkers of early androgen exposure were employed. Anogenital distance (AGD) was measured at birth and 3 months of age in boys and girls. Penile length at birth and 3 months of age was also measured in boys. When the children were 9-13 years old, a parent-reported questionnaire (the 10-item children's version of the Autism Spectrum Quotient; AQ-10 Child) was used to assess autistic traits in 97 boys and 110 girls.

RESULTS

There were no significant associations between any of the AGD or penile length measures and scores on the AQ-10 Child in boys, girls or the entire sample.

CONCLUSIONS

The current study provides the first test of whether early measurements of AGD and/or penile length predict subsequent autistic traits. The current findings do not support a relationship between prenatal or early postnatal androgen exposure and autistic traits. The current study augments prior research showing no consistent relationship between early androgen exposure and autistic traits.

Is it Possible to Assess the Two-Domain Definition of the Broad Autism Phenotype Using the Available Measurement Tools?

Although, the operationalization of the autism spectrum disorder has been updated around two domains, the broad autism phenotype (BAP) one has not. Additionally, the items of the three common BAP measures, the Broad Autism Phenotype Questionnaire (BAPQ), the Autism Quotient, and the Social Responsiveness Scale (SRS), remain organized around a non-consensual number of factors. We explored whether the items of these measures matched with the two-domain operationalization through a parallel analysis, which has suggested two main components, and two expert judgments which have assessed item wording, relevance, and construct representativeness. A remaining pool of 48 BAP-relevant items suggested a possible under-representation of two subdomains. Despite the relevance of all the BAPQ items, only the SRS ones tapped in all subdomains.

Autistic Traits are Associated with Less Precise Perceptual Integration of Face Identity

Face recognition difficulties are common in autism and could be a consequence of perceptual atypicalities that disrupt the ability to integrate current and prior information. We tested this theory by measuring the strength of serial dependence for faces (i.e. how likely is it that current perception of a face is biased towards a previously seen face) across the broader autism phenotype. Though serial dependence was not weaker in individuals with more autistic traits, more autistic traits were associated with greater integration of less similar faces. These results suggest that serial dependence is less specialised, and may not operate optimally, in individuals with more autistic traits and could therefore be a contributing factor to autism-linked face recognition difficulties.

Are Autistic and Alexithymic Traits Distinct? A Factor-Analytic and Network Approach

Despite the heterogeneity in autism, socioemotional difficulties are often framed as universal. Increasing evidence, however, suggests that socioemotional difficulties may be explained by alexithymia, a distinct yet frequently co-occurring condition. If, as some propose, autistic traits are responsible for socioemotional impairments, then alexithymia may itself be a symptom of autism. We aimed to determine whether alexithymia should be considered a product of autism or regarded as a separate condition. Using factor-analytic and network approaches, we provide evidence that alexithymic and autistic traits are distinct. We argue that: (1) models of socioemotional processing in autism should conceptualise difficulties as intrinsic to alexithymia; and (2) assessment of alexithymia is crucial for diagnosis and personalised interventions.

Understanding Oneself to Understand Others: The Role of Alexithymia and Anxiety in the Relationships Between Autistic Trait Dimensions and Empathy

People on the autism spectrum may have difficulty inferring others' emotions (cognitive empathy), but may share another's emotions (affective empathy) and exhibit heightened personal distress. The present study examined independent autistic trait dimensions (social difficulties and restricted/repetitive behaviours) and the roles alexithymia and trait anxiety have in explaining this profile of empathy. Results from the general population (n = 301) revealed that pronounced social difficulties and not restricted/repetitive behaviours related to reduced cognitive and affective empathy, and heightened personal distress. However, both dimensions, through alexithymia and anxiety, indirectly influenced empathy. Surprisingly, while the dimensions indirectly improved affective empathy, pronounced social difficulties directly reduced affective empathy. This study motivates a nuanced model of empathy by including autistic trait dimensions, anxiety, and alexithymia.

Prior information use and response caution in perceptual decision-making: No evidence for a relationship with autistic-like traits

Interpreting the world around us requires integrating incoming sensory signals with prior information. Autistic individuals have been proposed to rely less on prior information and make more cautious responses than non-autistic individuals. Here, we investigated whether these purported features of autistic perception vary as a function of autistic-like traits in the general population. We used a diffusion model framework, whereby decisions are modelled as noisy evidence accumulation processes towards one of two bounds. Within this framework, prior information can bias the starting point of the evidence accumulation process. Our pre-registered hypotheses were that higher autistic-like traits would relate to reduced starting point bias caused by prior information and increased response caution (wider boundary separation). 222 participants discriminated the direction of coherent motion stimuli as quickly and accurately as possible. Stimuli were preceded with a neutral cue (square) or a directional cue (arrow). 80% of the directional cues validly predicted the upcoming motion direction. We modelled accuracy and response time data using a hierarchical Bayesian model in which starting point varied with cue condition. We found no evidence for our hypotheses, with starting point bias and response caution seemingly unrelated to Adult Autism Spectrum Quotient (AQ) scores. Alongside future research applying this paradigm to autistic individuals, our findings will help refine theories regarding the role of prior information and altered decision-making strategies in autistic perception. Our study also has implications for models of bias in perceptual decision-making, as the most plausible model was one that incorporated bias in both decision-making and sensory processing.

The Comprehensive Autistic Trait Inventory (CATI): development and validation of a new measure of autistic traits in the general population

BACKGROUND

Traits and characteristics qualitatively similar to those seen in diagnosed autism spectrum disorder can be found to varying degrees in the general population. To measure these traits and facilitate their use in autism research, several questionnaires have been developed that provide broad measures of autistic traits [e.g. Autism-Spectrum Quotient (AQ), Broad Autism Phenotype Questionnaire (BAPQ)]. However, since their development, our understanding of autism has grown considerably, and it is arguable that existing measures do not provide an ideal representation of the trait dimensions currently associated with autism. Our aim was to create a new measure of autistic traits that reflects our current understanding of autism, the Comprehensive Autism Trait Inventory (CATI).

METHODS

In Study 1, 107 pilot items were administered to 1119 individuals in the general population and exploratory factor analysis of responses used to create the 42-item CATI comprising six subscales: Social Interactions, Communication, Social Camouflage, Repetitive Behaviours, Cognitive Rigidity, and Sensory Sensitivity. In Study 2, the CATI was administered to 1068 new individuals and confirmatory factor analysis used to verify the factor structure. The AQ and BAPQ were administered to validate the CATI, and additional autistic participants were recruited to compare the predictive ability of the measures. In Study 3, to validate the CATI subscales, the CATI was administered to 195 new individuals along with existing valid measures qualitatively similar to each CATI subscale.

RESULTS

The CATI showed convergent validity at both the total-scale (r ≥ .79) and subscale level (r ≥ .68). The CATI also showed superior internal reliability for total-scale scores (α = .95) relative to the AQ (α = .90) and BAPQ (α = .94), consistently high reliability for subscales (α > .81), greater predictive ability for classifying autism (Youden's Index = .62 vs .56-.59), and demonstrated measurement invariance for sex.

LIMITATIONS

Analyses of predictive ability for classifying autism depended upon self-reported diagnosis or identification of autism. The autistic sample was not large enough to test measurement invariance of autism diagnosis.

CONCLUSIONS

The CATI is a reliable and economical new measure that provides observations across a wide range of trait dimensions associated with autism, potentially precluding the need to administer multiple measures, and to our knowledge, the CATI is also the first broad measure of autistic traits to have dedicated subscales for social camouflage and sensory sensitivity.

Associations of subclinical autistic-like traits with brain structural variation using diffusion tensor imaging and voxel-based morphometry

Background

Previous case–control studies of autistic spectrum disorder (ASD) have identified altered brain structure such as altered frontal and temporal cortex volumes, or decreased fractional anisotropy (FA) within the inferior fronto-occipital fasciculus in patients. It remains unclear whether subclinical autistic-like traits might also be related to variation in these brain structures.

Methods

In this study, we analyzed magnetic resonance imaging (MRI) data of 250 psychiatrically healthy subjects phenotyped for subclinical autistic-like traits using the Autism Spectrum Quotient (AQ). For data analysis, we used voxel-based morphometry of T1-MRIs (Computational Anatomy Toolbox) and tract-based spatial statistics for diffusion tensor imaging data.

Results

AQ attention switching subscale correlated negatively with FA values in the bilateral uncinate fasciculus as well as the bilateral inferior fronto-occipital fasciculus. Higher AQ attention switching subscale scores were associated with increased mean diffusivity and radial diffusivity values in the uncinate fasciculus, while axial diffusivity values within this tract show a negative correlation. AQ attention to detail subscale correlated positively with gray matter volume in the right pre- and postcentral gyrus.

Conclusions

We demonstrate that individuals with higher levels of autism-spectrum-like features show decreased white matter integrity in tracts associated with higher-level visual processing and increased cortical volume in areas linked to movement sequencing and working memory. Our results resemble regional brain structure alterations found in individuals with ASD. This offers opportunities to further understand the etiology and pathogenesis of the disorder and shows a subclinical continuum perspective.

Avoiding Ableist Language: Suggestions for Autism Researchers

In this commentary, we describe how language used to communicate about autism within much of autism research can reflect and perpetuate ableist ideologies (i.e., beliefs and practices that discriminate against people with disabilities), whether or not researchers intend to have such effects. Drawing largely from autistic scholarship on this subject, along with research and theory from disability studies and discourse analysis, we define ableism and its realization in linguistic practices, provide a historical overview of ableist language used to describe autism, and review calls from autistic researchers and laypeople to adopt alternative ways of speaking and writing. Finally, we provide several specific avenues to aid autism researchers in reflecting on and adjusting their language choices.

Lay summary

Why is this topic important?: In the past, autism research has mostly been conducted by nonautistic people, and researchers have described autism as something bad that should be fixed. Describing autism in this way has negative effects on how society views and treats autistic people and may even negatively affect how autistic people view themselves. Despite recent positive changes in how researchers write and speak about autism, "ableist" language is still used. Ableist language refers to language that assumes disabled people are inferior to nondisabled people.What is the purpose of this article?: We wrote this article to describe how ableism influences the way autism is often described in research. We also give autism researchers strategies for avoiding ableist language in their future work.What is the perspective of the authors?: We believe that ableism is a "system of discrimination," which means that it influences how people talk about and perceive autism whether or not they are aware of it, and regardless of whether or not they actually believe that autistic people are inferior to nonautistic people. We also believe that language choices are part of what perpetuates this system. Because of this, researchers need to take special care to determine whether their language choices reflect ableism and take steps to use language that is not ableist.What is already known about this topic?: Autistic adults (including researchers and nonresearchers) have been writing and speaking about ableist language for several decades, but nonautistic autism researchers may not be aware of this work. We have compiled this material and summarized it for autism researchers.What do the authors recommend?: We recommend that researchers understand what ableism is, reflect on the language they use in their written and spoken work, and use nonableist language alternatives to describe autism and autistic people. For example, many autistic people find terms such as "special interests" and "special needs" patronizing; these terms could be replaced with "focused interests" and descriptions of autistic people's specific needs. Medicalized/deficit language such as "at risk for autism" should be replaced by more neutral terms such as "increased likelihood of autism." Finally, ways of speaking about autism that are not restricted to particular terms but still contribute to marginalization, such as discussion about the "economic burden of autism," should be replaced with discourses that center the impacts of social arrangements on autistic people.How will these recommendations help autistic people now or in the future?: Language is a powerful means for shaping how people view autism. If researchers take steps to avoid ableist language, researchers, service providers, and society at large may become more accepting and accommodating of autistic people.

Individual Differences in Tendencies Toward Internet Use Disorder, Internet Literacy and Their Link to Autistic Traits in Both China and Germany

Recent evidence demonstrates that Internet Use Disorder tendencies (IUD; formerly known as Internet Addiction) are associated with higher tendencies toward autistic traits. In the present study, we aimed to further explore this association between IUD tendencies and autistic traits in a large cohort of German and Chinese subjects (total N = 1,524; mostly student background) who completed the short Internet-Addiction-Test, the Autism-Spectrum-Quotient, and the Internet-Literacy-Questionnaire. Moreover, the present research also enabled us to study potential differences in the investigated variables between the Chinese and German cultures. First, the results indicated higher occurrence of IUD symptoms in China. Moreover, Chinese subjects scored significantly higher on all ILQ dimensions than German participants, with the exception of self-regulation where the reverse picture appeared. Second, results confirmed a positive association between IUD tendencies and autistic traits both in China and Germany, although effect sizes were low to medium (China: r = 0.19 vs. Germany: r = 0.36). Going beyond the literature, the present study also assessed individual differences in Internet Literacy and shows in how far variables such as technical expertise, production and interaction, reflection and critical analysis as well as self-regulation in the realm of the Internet usage influence the aforementioned association between IUD tendencies and autistic traits. Although the present study is limited by being of correlational nature it is discussed how the association between IUD tendencies and autistic traits might be explained.

Sensory Processing in the Autism Spectrum: The Role of Attention to Detail and Somatic Trait Anxiety in the Olfactory Perception of the General Population

Autism Spectrum Disorders, as well as autism traits (AT), have been associated with altered sensory processing. However, the role of AT in olfactory processing is still unclear. We analyzed the impact of AT and trait anxiety (TANX), relevant in the context of autism and olfactory perception, in the olfactory abilities of a nonclinical adult sample. Participants (N = 116) completed the Autism-Spectrum Quotient (AQ), the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) and the Sniffin' Sticks Extended Test to measure AT, TANX and olfactory abilities, respectively. A hierarchical multiple regression analysis suggested that women and higher scores on the Attention to Detail subscale of AQ were associated with better odor discrimination, and higher somatic TANX was related to poorer odor discrimination.

Positive Predictors of Life Satisfaction for Autistic College Students and Their Neurotypical Peers

Background

Positive psychological traits are associated with higher life satisfaction, academic success, and fewer mental health problems in neurotypical (NT) college students. However, it is unclear whether this is similar for autistic students. This study explores college-specific positive traits, including academic satisfaction, self-efficacy, gratitude, and school connectedness, and their relationship with life satisfaction in autistic college students and their NT peers.

Method

Autistic (n = 42) and NT (n = 50) college students completed an online survey containing measures of autistic traits, college well-being, and life satisfaction. We explored differences in life satisfaction and college well-being between groups using analysis of variances and explored these relationships based on self-reported autistic traits across groups using correlations. We assessed whether a relationship between college-specific well-being and life satisfaction was moderated by autistic traits using linear regression.

Results

Results showed emerging differences in school connectedness such that autistic students were less likely to report feeling connected despite similar scores on other domains of college well-being and life satisfaction; correcting for multiple comparisons this difference was no longer significant. However, autistic traits were significantly related to life satisfaction and school connectedness across the full sample. Differences in school connectedness also explained a significant amount of variance in life satisfaction over and above the influence of autistic traits. The interaction between connectedness and autistic traits was not significant.

Conclusions

Results suggests that students who experience higher levels of connection with their university and peers, regardless of the number of autistic traits they endorse, report higher satisfaction with life. Given the importance of social connectedness in college-specific and overall well-being, significant attention should be paid to the protective role of social support systems in addition to academic services when understanding how to support autistic individuals as well as individuals who do not meet diagnostic criteria, but share some similar clinical traits.

Lay summary

What was the purpose of this study?: College well-being is related to life satisfaction in neurotypical (NT) college students. However, it is unclear whether this is similar for autistic college students. The purpose of this study was to understand how different aspects of college well-being support life satisfaction in autistic college students compared with their NT peers.What did the researchers do?: We invited both autistic and NT college students to complete an online survey. The survey asked about college well-being and life satisfaction. We looked at similarities and differences in responses between autistic and NT students. We also looked at whether college well-being was related to life satisfaction and whether that depended on the number of autistic traits that individuals selected to describe themselves.What were the results of the study?: We found that there were no group differences between autistic and NT college students in their overall college well-being or life satisfaction. However, there were differences in life satisfaction and one individual aspect of college well-being, school connectedness, based on autistic traits. Students with more autistic traits were less likely to report feeling connected to their university and peers and were less satisfied with life overall. We also found that school connectedness and the number of autistic traits, rather than diagnostic status, were related to life satisfaction. Students who feel more connected to their university and peers, regardless of the number of autistic traits they endorse, report higher satisfaction with life.What do these findings add to what was already known?: While there are many studies of life satisfaction in autistic individuals, most focus on the negative aspects. Our study is the first to look at positive factors, such as college well-being, in autistic students and their NT peers. This is important because both autistic and NT students struggle with academics, social isolation, and mental health in college. However, understanding the positive traits that can help counteract those challenges is important in supporting all students in college. Our findings show that both autistic traits and school connectedness are important, but separate, components for understanding life satisfaction in college students with and without autism.What are the potential weaknesses in the study?: This study only recruited autistic participants from disability resource centers of 4-year colleges, so students who were attending community colleges, private institutions, or who did not disclose their diagnosis to the disability resource centers were not included. As autistic students may be more likely to attend community or private colleges or may not disclose their diagnostic status, our results may not apply to other people. Our sample of students was also small, which limits our ability to find differences and have confidence in the results.How will these findings help autistic adults?: These findings show the importance of social integration for the well-being of neurodivergent and NT college students and support ongoing requests from autistic students for more nonacademic supports in college. Screening for college well-being and improving social integration are potential ways to increase life satisfaction for neurodivergent college students.