Proneness to Self-Conscious Emotions in Adults With and Without Autism Traits

The effect of reappraisal on the emotional regulation of shame in young adults with ASD and typical peers

Young adults with ASD experience shame in social interactions, and if poorly mishandled, it may interfere with their attempts to participate in their social environment. One strategy to reduce shame is cognitive reappraisal, yet the efficacy of this strategy was not examined in ASD. Here, we investigated the effect of reappraisal in reducing feelings of shame in ASD and the thematic contents used. Young adults with high-functioning ASD and typical participants were shown shame-arousing pictures. They imagined themselves as the primary character in each scenario and rated their feelings of shame. Then, they were trained to reappraise shame-arousing pictures less negatively. Finally, they viewed other shame-arousing photos, reappraised them, stated aloud their new interpretations, and rated their feelings. We found lower shame ratings in participants with ASD than in typical participants. In addition, we found a similar reduction in shame ratings after reappraising these pictures in both groups. Qualitative analysis revealed that participants with ASD used fewer positive narratives and more neutral and unrealistic descriptions than their typical peers. These findings highlight shame-regulation abilities in individuals with ASD while pointing to their unique narratives. We recommend that clinical interventions in ASD emphasize generating positive reappraisals of social situations.

Compassion-focused therapy with autistic adults

Some autistic adults experience repeated adverse events, including rejection, victimization and stigmatization. They also describe others being critical and negatively judging them, such as for how they socially interact or for expressing passion for particular interests. The impact of these adverse events can be substantial, including increasing vulnerability for poorer mental health, and contributing to development of negative self beliefs (such as "I am different" or "I do not fit in") and shame-based difficulties. Not all evidence-based psychological therapies are well-received by autistic people, or effective. Given high rates of self-harm and suicidality, finding acceptable and effective therapies for autistic adults is paramount. Here, writing as autistic and non-autistic clinicians and researchers, we outline the theoretical principles of compassion-focused theory and therapy (CFT). We propose that: (1) compassion-focused theory can provide a useful framework for conceptualizing shame-based difficulties some autistic adults experience; (2) CFT can be appropriate for addressing these; and (3) there is an impetus for practitioners to adopt compassion-focused approaches when supporting autistic adults.

See the self through others' eyes: The development of moral emotions in young children with autism spectrum disorder

Despite the important social functions of moral emotions, they are understudied in the autism spectrum disorder (ASD) population. This three-wave longitudinal study is among the first to examine the development of moral emotions and their associations with theory of mind in 3- to 7-year-old children with ASD, using observational tasks. One hundred and forty-two children (52 with ASD) were followed over a period of 2 years. We found that while the expressions of shame and guilt remained stable in non-ASD children, they decreased with age in children with ASD. No group differences were found in the levels or the developmental trajectories of pride. Besides, better false-belief understanding was uniquely related to the expressions of pride in children with ASD. Our findings highlight the importance of enhancing understanding of moral emotion development and related factors in children with ASD.

Successful emotion regulation via cognitive reappraisal in authentic pride: Behavioral and event-related potential evidence

The present study explored whether authentic pride (AP) and hubristic pride (HP) were differently associated with cognitive reappraisal strategy. In study 1, undergraduates (n = 235) completed a battery of self-report questionnaires, including the Authentic and Hubristic Pride-Proneness Scale (AHPPS), Emotion Regulation Questionnaire (ERQ), and emotion regulation questionnaire (ERP-R). The results showed that AP significantly predicted successful down-regulation of negative emotions via a spontaneous cognitive reappraisal strategy. However, hubristic pride (HP) was negatively associated with spontaneous cognitive reappraisal. In study 2, participants with trait AP (n = 31) and trait HP (n = 29) undergoing continuous electroencephalogram (EEG) recording were required to reinterpret emotional pictures to down-regulate/up-regulate their negative/positive emotional reactions. The results showed that individuals with AP reported lower levels of emotional arousal and lower amplitudes of late positive potentials (LPPs) than did individuals with HP in response to negative pictures during the down-regulation of negative emotions, but not during passive viewing or up-regulation of positive emotions. Across two studies, these findings showed that individuals with AP could utilize the cognitive reappraisal strategy (spontaneously in daily life and under experimental instructions) to down-regulate negative emotions more successfully relative to individuals with HP.

Implicit and Explicit Gender-Related Cognition, Gender Dysphoria, Autistic-Like Traits, and Mentalizing: Differences Between Autistic and Non-Autistic Cisgender and Transgender Adults

Evidence indicates a link between autism spectrum disorder (ASD) and gender diversity, yet this intersection remains insufficiently understood. Here, we investigated whether (1) ASD affects gender-related cognition (i.e., mental processes of perceiving and interpreting one's own gender self-concept), (2) autistic people have increased gender dysphoria and recall limited gender-typed behavior from childhood, and (3) transgender individuals have increased ASD-like traits and difficulties in mentalizing. A total of 106 non-autistic cisgender (51 birth-assigned female), 107 autistic cisgender (57 birth-assigned female), 78 non-autistic transgender (41 birth-assigned female), and 56 autistic transgender adults (27 birth-assigned female) participated in the study. The mean age of participants was 31.01 years (range = 18 to 70). Using an explicit as well as an implicit measure, for the first time, we found that ASD affected gender-related cognition only in autistic cisgender people. Sex differences were also observed in this group. Whereas autistic cisgender birth-assigned males showed a stronger implicit gender-group identification than non-autistic cisgender birth-assigned males, autistic cisgender birth-assigned females showed a weaker gender-group identification than non-autistic cisgender birth-assigned females. Furthermore, autistic cisgender people reported significantly more gender dysphoric feelings and recalled significantly less gender-typed behavior from childhood than non-autistic cisgender individuals. No difference was observed between non-autistic and autistic transgender people. We also found that relative to non-autistic cisgender individuals, both non-autistic transgender and autistic transgender people reported significantly more ASD-like traits. However, mentalizing difficulties were observed only in the latter group. This research enhances our understanding of the link between ASD and gender diversity.

Social Anxiety and Shame Among Young Adults with Autism Spectrum Disorder Compared to Typical Adults

Social anxiety (SA) is common among young adults with autism spectrum disorder (ASD). While shame feelings predict SA among typical adults, the relationship between shame and SA in ASD remains unclear. The current study compared the relationship between SA and shame in ASD. SA, shame, and autistic self-assessment questionnaires were administered to 33 young adults with ASD (28 M/5F) and 38 typical young adults (32 M/6F, Mage = 24 years, range = 20-28 in both groups). Results showed higher SA levels in ASD than typical adults, but lower levels of shame characteristics in the former than in the latter group. Moreover, a significant moderation model showed that some aspects of shame were related to SA only in the typical group but not in ASD.

Shame and guilt in youth at ultra-high risk for psychosis

OBJECTIVE

Feelings of shame and guilt have rarely been investigated in people at ultra-high risk (UHR) for psychosis. We aimed to outline differences in shame and guilt in relation to empathy and theory of mind (ToM) in young people, particularly those at UHR for psychosis.

METHODS

First, 166 young healthy controls were assessed for their proneness to shame and guilt using the Test of Self-Conscious Affect, empathy and its four subdomains (perspective taking, fantasy, empathic concern, and personal distress) using the Interpersonal Reactivity Index (IRI), ToM using the ToM picture stories task, and neurocognitive performance using the Raven's Standard Progressive Matrices (SPM). Next, we evaluated shame and guilt in 24 UHR individuals comparing them to 24 age- and sex-matched healthy controls. Finally, we explored relationships for shame and guilt in relation to empathy and ToM in the UHR individuals.

RESULTS

In the healthy youth, a regression analysis showed fantasy and personal distress in IRI to be significant determinants of shame, while perspective taking and empathic concern in IRI, ToM, and SPM were independent predictors of guilt. Meanwhile, compared to the healthy controls, individuals with UHR exhibited higher levels of shame, which was associated with increased personal distress.

DISCUSSION

Our findings showed that four subdomains of empathy, ToM, and neurocognition were differentially associated with shame and guilt in healthy young people. Given the correlation between excessive feelings of shame and high levels of the personal distress dimension of empathy in UHR for psychosis, redressing the tendency to focus on self-oriented negative emotions upon witnessing distress of others could possibly reduce self-blame or self-stigma of help-seeking individuals.

[Lifetime Prevalence of Feelings of Guilt in the German Adult Population - Results of a Nation-Wide Telephone Survey]

OBJECTIVE

To provide information on lifetime prevalence of feelings of guilt in the German adult population based on data from a nation-wide telephone survey (n = 1.003; 18+ years; May-June 2019).

METHODS

We calculated weighted lifetime prevalence rates with confidence intervals (95 %-CI) and used multivariable logistic regression analyses to evaluate the association of guilt feelings with covariates.

RESULTS

We identified a weighted lifetime prevalence of experienced feelings of guilt of 68.5 % (95 %-CI = 65.6-71.3). Younger age, higher education and current depressive symptoms were associated with higher prevalence rates. No association was found with regard to gender and major depression.

CONCLUSION

A substantial part of the adult population experienced some sort of guilt feelings in their lives. Further research efforts are required to answer the question whether feelings of guilt are only a criterion of depression or whether they may contribute to an increased risk of the disorder.

Proneness to guilt, shame, and pride in children with Autism Spectrum Disorders and neurotypical children

Self-conscious emotions (e.g., guilt, shame, and pride) are complex emotions that require self-reflection and self-evaluation, and are thought to facilitate the maintenance of societal norms and personal standards. Despite the importance of self-conscious emotions, most research has focused on basic emotion processing in children with Autism Spectrum Disorders (ASD). Therefore, in the present study, we used the Test of Self-Conscious Affect for Children (TOSCA-C) to assess proneness to, or propensity to experience, the self-conscious emotions guilt, shame, and pride in children with ASD and neurotypical children. The TOSCA-C is designed to capture a child's natural tendency to experience a given emotion across a range of everyday situations [Tangney, Stuewig, & Mashek, 2007]. We also assessed how individual characteristics contribute to the development of proneness to self-conscious emotions, including theory of mind (ToM) and ASD symptomatology. In comparison to neurotypical children, children with ASD showed less proneness to guilt, although all children showed relatively high levels of proneness to guilt. Greater ToM ability was related to more proneness to guilt and authentic pride in children with ASD. Additionally, we found that children with ASD with more severe symptomatology were more prone to hubristic pride. Our results provide evidence of differences in proneness to self-conscious emotions in children with ASD, as well as highlight important mechanisms contributing to how children with ASD may experience self-conscious emotions. Autism Res 2018,11:883-892. ©2017 International Society for Autism Research, Wiley Periodicals, Inc.

LAY SUMMARY

This research examined proneness to guilt, shame, and pride in children with Autism Spectrum Disorders (ASD) and neurotypical children. We found that children with ASD showed less proneness to guilt than neurotypical children. Better understanding of theory of mind was related to greater proneness to guilt and pride, but only for children with ASD. These findings are important because these complex emotions are linked with both positive and negative social behaviors towards others and oneself.

Leo Kanner and autism: a 75-year perspective

In 1943, Leo Kanner published the first systematic description of early infantile autism. He concluded that this was a neurodevelopmental disorder and that 'these children have come into the world with an innate inability to form the usual, biologically provided contact with people'. Moreover, his astute descriptions of parental behavior in his first publications were prescient and underlie later recognition of the importance of genetics. Our understanding has grown over the ensuing years with revisions in diagnostic classification, recognition of the broader autism phenotype in families, appreciation of the importance of developmental models, advances in genetic methodology, better understanding of the relationship to intellectual deficits, recognition of syndromic autism in neurogenetic sydromes, advances in neuroimaging, and advances in animal models, both mutant mouse models and transgenic non human primate models. Kanner recognized diagnostic heterogeneity and opined that the children had not read those diagnostic manuals and did not easily fall into clear cut categories. Such heterogeneity continues to confound our diagnostic efforts. Always an advocate for children, when reviewing the DSM III criteria in 1980, Kanner emphasized that no matter how well developed our criteria each child must be treated as a unique person.