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Antezana L, Valdespino A, Wieckowski AT, Coffman MC, Carlton CN, Garcia KM, Gracanin D, White SW, Richey JA. Social Anxiety Symptoms Predict Poorer Facial Emotion Recognition in Autistic Male Adolescents and Young Adults Without Intellectual Disability. J Autism Dev Disord 2024; 54:2454-2470. [PMID: 37120659 DOI: 10.1007/s10803-023-05998-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 05/01/2023]
Abstract
Utilizing a novel computerized task, we aimed to examine whether social anxiety symptoms would be related to individual differences in facial emotion recognition (FER) in a sample of autistic male adolescents and young adults without intellectual disability. Results indicated that social anxiety and IQ predicted poorer FER, irrespective of specific emotion type. When probing specific effects within emotion and condition types, social anxiety impacted surprise and disgust FER during a truncated viewing condition and not full viewing condition. Collectively, results suggest that social anxiety in autism may play a larger role in FER than previously thought. Future work should consider the role of social anxiety within autism as a factor that may meaningfully relate to FER assessment and intervention.
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Affiliation(s)
- Ligia Antezana
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield Drive, Blacksburg, VA, 24061, USA.
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Andrew Valdespino
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield Drive, Blacksburg, VA, 24061, USA
- James A. Haley Veterans' Hospital, Tampa, FL, USA
| | - Andrea T Wieckowski
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield Drive, Blacksburg, VA, 24061, USA
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
| | - Marika C Coffman
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield Drive, Blacksburg, VA, 24061, USA
- Duke University Center for Autism and Brain Development, Duke University, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Corinne N Carlton
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield Drive, Blacksburg, VA, 24061, USA
| | - Katelyn M Garcia
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield Drive, Blacksburg, VA, 24061, USA
| | - Denis Gracanin
- Department of Computer Science, Virginia Tech, Blacksburg, VA, USA
| | - Susan W White
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield Drive, Blacksburg, VA, 24061, USA
- Center for Youth Development and Intervention and Department of Psychology, The University of Alabama, Tuscaloosa, AL, USA
| | - John A Richey
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield Drive, Blacksburg, VA, 24061, USA
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Pirinen V, Eggers K, Dindar K, Helminen T, Kotila A, Kuusikko-Gauffin S, Mäkinen L, Ebeling H, Hurtig T, Mäntymaa M, Loukusa S. Associations between social anxiety, physiological reactivity, and speech disfluencies in autistic young adults and controls. JOURNAL OF COMMUNICATION DISORDERS 2024; 109:106425. [PMID: 38593561 DOI: 10.1016/j.jcomdis.2024.106425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 02/02/2024] [Accepted: 04/01/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION The aim of this study was to examine possible associations of social anxiety (SA) and speaking-related physiological reactivity with the frequencies of a) total disfluencies, b) typical disfluencies, and c) stuttering-like disfluencies, as well as d) stuttering-severity in autistic young adults and controls. METHODS Thirty-two autistic young adults and 35 controls participated in this study. Participants were presented with video clips (viewing condition) and were then asked to talk about the videos (narrating condition). SA was measured by the self-report Social Phobia and Anxiety Inventory (SPAI). Speaking-related physiological reactivity was measured by the electrodermal activity (EDA), an index of emotional arousal. The speech samples from the narrating condition were analyzed for type and frequency of speech disfluencies and used for determining the stuttering severity. SA and speaking-related physiological reactivity were compared between the groups. Correlation between SA, physiological reactivity, disfluency frequencies, and stuttering severity were tested separately for both groups. RESULTS No between-group differences were found in the overall SA, yet differences were found in SPAI subscales of social interaction, group interaction, and avoidance, as well as in agoraphobia. Both groups had higher physiological arousal in narrating condition in comparison to the video viewing condition, yet there was no between-group difference in the reactivity. No associations were found between SPAI measures, physiological reactivity, disfluency frequencies, and stuttering severity in the autistic group. In the control group, a negative association was found between physiological reactivity and total and typical disfluency frequencies. CONCLUSIONS SA or speaking-related physiological reactivity were not associated with disfluency frequencies or stuttering severity in autistic persons. Negative association between physiological reactivity and disfluency frequencies found in the control group may indicate that the physiological arousal may impact the speech production process by reducing the overt disfluencies.
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Affiliation(s)
- Veera Pirinen
- Research Unit of Logopedics, University of Oulu, Finland.
| | - Kurt Eggers
- Dept. of Rehabilitation Sciences, Ghent University, Belgium; Dept. of Speech-Language Pathology, Thomas More University College, Antwerp, Belgium; Dept. of Psychology and Speech-Language Pathology, University of Turku, Finland
| | - Katja Dindar
- Research Unit of Logopedics, University of Oulu, Finland
| | - Terhi Helminen
- Faculty of Social Sciences, Psychology, Tampere University, Finland
| | - Aija Kotila
- Research Unit of Logopedics, University of Oulu, Finland
| | | | - Leena Mäkinen
- Research Unit of Logopedics, University of Oulu, Finland
| | - Hanna Ebeling
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu, Finland; Child Psychiatry, Oulu University Hospital, Finland
| | - Tuula Hurtig
- Child Psychiatry, Oulu University Hospital, Finland; Research Unit of Clinical Medicine, Psychiatry, Child Psychiatry, University of Oulu, Finland
| | - Mirjami Mäntymaa
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu, Finland; Child Psychiatry, Oulu University Hospital, Finland
| | - Soile Loukusa
- Research Unit of Logopedics, University of Oulu, Finland
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Gurbuz E, Riby DM, South M, Hanley M. Associations between autistic traits, depression, social anxiety and social rejection in autistic and non-autistic adults. Sci Rep 2024; 14:9065. [PMID: 38643251 PMCID: PMC11032319 DOI: 10.1038/s41598-024-59532-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 04/11/2024] [Indexed: 04/22/2024] Open
Abstract
Autistic people frequently experience negative judgements from non-autistic people, often fuelled by misconceptions that autistic people lack empathy. Understanding responses to negative social judgement among autistic people is crucial because of the potential negative impact on wellbeing and future interactions. We investigated the role of autistic traits, social anxiety, and depression on behavioural indices of social rejection in 20 autistic (AUT; 11 males) and 40 non-autistic (N-AUT; 21 males) university students. Participants completed the Social Judgement Task (SJT) where they predicted whether they were liked by another person, then received feedback on whether those evaluations were correct. Participants also completed an Age Judgement Task (AJT) where they estimated the age of the pictured person. The AUT group had lower positive expectation scores, meaning less tendency to predict being liked. Across the whole sample, higher social anxiety predicted greater tendency to anticipate rejection from others, not autistic traits. These findings suggest early experiences of rejection might lead to a negative self-bias in autistic people and emphasise the importance of using a transdiagnostic approach by showing that social anxiety rather than autistic traits is associated with expectation of social rejection.
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Affiliation(s)
- Emine Gurbuz
- Department of Psychology, University of Portsmouth, King Henry Building, King Henry I Street, Portsmouth, PO1 2DY, UK.
- Centre for Interaction, Development and Diversity, University of Portsmouth, Portsmouth, UK.
| | - Deborah M Riby
- Department of Psychology, Durham University, Durham, UK
- Centre for Neurodiversity & Development, Durham University, Durham, UK
| | - Mikle South
- Emory University School of Medicine and Emory Brain Health Center, Atlanta, USA
| | - Mary Hanley
- Department of Psychology, Durham University, Durham, UK
- Centre for Neurodiversity & Development, Durham University, Durham, UK
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Huntjens A, van den Bosch LMCW, Sizoo B, Kerkhof A, Smit F, van der Gaag M. The effectiveness and safety of dialectical behavior therapy for suicidal ideation and behavior in autistic adults: a pragmatic randomized controlled trial. Psychol Med 2024:1-12. [PMID: 38606582 DOI: 10.1017/s0033291724000825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
BACKGROUNDS Many autistic people in mental health are suicidal. This study evaluated the effectiveness of dialectical behavior therapy (DBT) v. treatment as usual (TAU) in reducing suicidal ideation and suicide attempts. METHODS At six Dutch mental health centers, 123 outpatients (18-65 years) with DSM-5 diagnosed autism spectrum disorder (ASD) and suicidal behavior were randomly assigned to the DBT intervention group (n = 63) or TAU control group (n = 60). Assessments were conducted at baseline, post-treatment at 6 months and 12-month follow-up. The primary outcomes were severity of suicidal ideation and frequency of suicide attempts. The severity of depression and social anxiety were secondary outcomes. RESULTS At end-of-treatment, DBT significantly reduced both suicidal ideation (z = -2.24; p = 0.025; b = -4.41; s.e. = 197.0) and suicide attempts (z = -3.15; p = 0.002; IRR = 0.046; s.e. = 0.045) compared to TAU, but lost statistical significance at the 12-month follow-up. Depression severity significantly decreased with DBT (z = -1.99; p = 0.046: b = -2.74; s.e. = 1.37) remaining so at 12 months (z = -2.46; p = 0.014; b = -3.37; s.e. = 1.37). No effects were observed on social anxiety. Severe adverse events included two suicides in the TAU condition. CONCLUSIONS DBT is an acceptable, safe, and short-term effective intervention to reduce suicidal ideation and suicide attempts in autistic adults with suicidal behavior.
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Affiliation(s)
- Anne Huntjens
- Department of Clinical Psychology and Public Mental Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
- Parnassia Psychiatric Institute, The Hague, Netherlands
| | | | | | - Ad Kerkhof
- Department of Clinical Psychology and Public Mental Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Filip Smit
- Department of Clinical Psychology and Public Mental Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology and Public Mental Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
- Parnassia Psychiatric Institute, The Hague, Netherlands
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Loukusa S, Gabbatore I, Kotila AR, Dindar K, Mäkinen L, Leinonen E, Mämmelä L, Bosco FM, Jussila K, Ebeling H, Hurtig TM, Mattila ML. Non-linguistic comprehension, social inference and empathizing skills in autistic young adults, young adults with autistic traits and control young adults: Group differences and interrelatedness of skills. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023. [PMID: 36722699 DOI: 10.1111/1460-6984.12848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 12/09/2022] [Indexed: 05/24/2023]
Abstract
BACKGROUND Despite increasing knowledge of social communication skills of autistic peole, the interrelatedness of different skills such as non-linguistic comprehension, social inference and empathizing skills is not much known about. A better understanding of the complex interplay between different domains of social communication helps us to develop assessment protocols for individuals with social communication difficulties. AIMS To compare the performances of autistic young adults, young adults with autistic traits identified in childhood and control young adults in social communication tasks measuring non-linguistic comprehension, social inference and empathizing skills. In addition, to examine associations between the different social communication measures. METHODS & PROCEDURES Autistic young adults (n = 34), young adults with autistic traits (n = 19) and control young adults (n = 36) completed the extra- and paralinguistic scales of the Assessment Battery for Communication (ABaCo), the Faux Pas Recognition Test, Social-Pragmatic Questions (SoPra) and the Empathy Quotient (EQ). OUTCOMES & RESULTS Group differences were found in the performance in the ABaCo, SoPra and EQ scores. Compared with the control young adults, autistic young adults scored lower. The performance of the young adults in the autistic traits group fell in between the other two groups. There were no group differences in the Faux Pas Recognition Test. The variability within the groups was large in all measurements. In the control group, there was a significant correlation between EQ and SoPra scores and between the Faux Pas and SoPra scores. In the autistic group, a significant correlation was found between Faux Pas and SoPra scores. Also, other patterns were observed but these were not statistically significant. CONCLUSIONS & IMPLICATIONS The young adults with autistic traits fell in between the control and autistic young adults, highlighting the presence of the continuum in the terms of features of social communication. The results support other current research that suggests that theory of mind and other social communication skills may not be universally or widely impaired in all autistic individuals without cognitive deficits. Although all tasks examined social communication skills, only a small number of significant correlations were found between test scores. This highlights that clinical conclusions about a person's social communication should be based on the outcomes of different types of methods measuring different aspects of social communication. It is clear that the interrelatedness of different social communication skills needs further research. WHAT THIS PAPER ADDS What is already known on this subject For successful communication, the ability to infer others' emotions, intentions and mental states is crucial. Autistic people have difficulty with many aspects of social communication. However, the associations between different aspects of social communication need to be better understood. What this paper adds to existing knowledge The unique contribution of this study is to compare the performance of autistic people not only with that of a control group but also with people with childhood autistic traits. This provides an understanding of the interrelatedness of different social communication skills in people with varying degrees of autistic traits. This study used four assessment methods focusing on three different social communication elements (non-linguistic comprehension, social inference and empathizing skills). These elements have complex relationships to one another, some being closely overlapping, some more distally related and some reflect more complex multifactorial elements. This study shows that although groups differ from each other in most of the assessments, the performance of different groups overlapped showing that many autistic young adults can perform well in non-linguistic and social inference tasks in structured assessment contexts. What are the potential or actual clinical implications of this work? Our findings suggest that in the assessment of social communication, self-reports and clinical assessments can be used effectively together. They can complement each other, pointing out the strengths and weaknesses of a person, leading to more personalized therapeutic interventions.
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Affiliation(s)
- Soile Loukusa
- Research Unit of Logopedics, University of Oulu, Oulu, Finland
| | - Ilaria Gabbatore
- GIPSI Research Group, Department of Psychology, University of Turin; Institute of Neurosciences of Turin, Italy
| | - Aija R Kotila
- Research Unit of Logopedics, University of Oulu, Oulu, Finland
| | - Katja Dindar
- Research Unit of Logopedics, University of Oulu, Oulu, Finland
| | - Leena Mäkinen
- Research Unit of Logopedics, University of Oulu, Oulu, Finland
| | - Eeva Leinonen
- Kathleen Lonsdale Institute for Human Health Research, Maynooth University, Maynooth, Ireland
| | - Laura Mämmelä
- Research Unit of Logopedics, University of Oulu, Oulu, Finland
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu and Oulu University Hospital, Division of Psychology, VISE, Faculty of Education and Psychology, Oulu, Finland
| | - Francesca M Bosco
- GIPSI Research Group, Department of Psychology, University of Turin; Institute of Neurosciences of Turin, Italy
| | - Katja Jussila
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu and Oulu University Hospital, Division of Psychology, VISE, Faculty of Education and Psychology, Oulu, Finland
| | - Hanna Ebeling
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Tuula M Hurtig
- Research Unit of Clinical Medicine, Psychiatry, Child Psychiatry, University of Oulu, Finland, Clinic of Child Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Marja-Leena Mattila
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu and Oulu University Hospital, Oulu, Finland
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