1
|
Macchia A, Albantakis L, Zebhauser PT, Brandi ML, Schilbach L, Brem AK. Autistic Adults Avoid Unpredictability in Decision-Making. J Autism Dev Disord 2024:10.1007/s10803-024-06503-2. [PMID: 39158770 DOI: 10.1007/s10803-024-06503-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2024] [Indexed: 08/20/2024]
Abstract
Decision-making under unpredictable conditions can cause discomfort in autistic persons due to their preference for predictability. Decision-making impairments might furthermore be associated with a dysregulation of sex and stress hormones. This prospective, cross-sectional study investigated decision-making in 32 autistic participants (AP, 14 female) and 31 non-autistic participants (NAP, 20 female) aged 18-64 years. The Iowa Gambling Task (IGT) and the Cambridge Risk Task (CRT) were used to assess decision-making under ambiguity and under risk with known outcome probabilities, respectively. Cortisol, estradiol, and testosterone serum levels were related to decision-making performance. Groups did not differ in overall IGT and CRT performance, but compared with NAP, AP preferred less profitable card decks with predictable outcomes while avoiding those with unpredictable outcomes. AP required more time to reach decisions compared to NAP. Additionally, AP without comorbid depression performed significantly worse than NAP in the IGT. Estradiol and cortisol concentrations were significant predictors of CRT scores in NAP, but not in AP. The study results imply that AP are 'risk-averse' in decision-making under ambiguity as they avoided choice options with unpredictable losses in comparison to NAP. Our findings highlight the intolerance for uncertainty, particularly in ambiguous situations. Thus, we recommend being as transparent and precise as possible when interacting with autistic individuals. Future research should explore decision-making in social situations among individuals with ASD, factoring in person-dependent variables such as depression.
Collapse
Affiliation(s)
- Ana Macchia
- Max Planck Institute of Psychiatry, Munich, Germany
- Clinic for Psychiatry/Psychotherapy III, Ulm University, Ulm, Germany
| | - Laura Albantakis
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Munich, Germany
- Department of Psychiatry and Psychotherapy, Ludwig Maximilians University, Munich, Germany
| | - Paul Theo Zebhauser
- School of Medicine, Department of Neurology, Technical University of Munich, Munich, Germany
| | - Marie-Luise Brandi
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany
| | - Leonhard Schilbach
- Independent Max Planck Research Group for Social Neuroscience, Max Planck Institute of Psychiatry, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Munich, Germany
- Department of General Psychiatry 2, LVR-Klinikum Duesseldorf/Kliniken der Heinrich-Heine-Universitaet, Duesseldorf, Germany
- Ludwig-Maximilian-University, Munich, Germany
| | - Anna-Katharine Brem
- Max Planck Institute of Psychiatry, Munich, Germany.
- University Hospital of Old Age Psychiatry, University of Bern, Bern, Switzerland.
- Centre for Healthy Brain Ageing, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| |
Collapse
|
2
|
Pellicano E, Hall G, Ying Cai R. Autistic adults' experiences of financial wellbeing: Part II. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1090-1106. [PMID: 37795595 PMCID: PMC11067415 DOI: 10.1177/13623613231191594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
LAY ABSTRACT Money matters in people's lives. It helps to meet people's basic needs (food, clothes, shelter) and live the lives they want to. When people talk about 'financial wellbeing', they mean how much you feel in control over day-to-day finances and how much freedom you have to make choices to enjoy life. We don't know what autistic people think about these things. That's why we did our study. We spoke to 21 autistic adults (24-69 years) about how they felt about their financial situation. We deliberately spoke to people who had told us previously they felt 'financially well' or 'financially unwell' so we could hear a range of opinions. Autistic people told us financial wellbeing meant having enough money to pay for their basics needs, to have a safety net for unexpected bills and not having to worry about money now or in the future. But many felt that good financial wellbeing was not possible for them. They often did not have a stable income to cover day-to-day expenses. This limited the choices they could make. Despite these challenges, autistic people told us they worked hard to budget and save money when they could - because feeling financial insecure was just too stressful, especially when they could not rely on family or friends for support. It made them feel mentally unwell. Our study shows there are many factors that influence autistic people's financial wellbeing. We need more research to help us understand how autistic people can be supported to achieve financial security.
Collapse
Affiliation(s)
- Elizabeth Pellicano
- University College London, UK
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Gabrielle Hall
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
| | - Ru Ying Cai
- Macquarie University, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Australia
- Aspect Australia, Australia
| |
Collapse
|
3
|
van der Plas E, Mason D, Happé F. Decision-making in autism: A narrative review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023:13623613221148010. [PMID: 36794463 DOI: 10.1177/13623613221148010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
LAY SUMMARY Many autistic people report difficulties with real-life decision-making. However, when doing decision-making tests in laboratory experiments, autistic people often perform as well or better than non-autistic people. We review previously published studies on autistic people's decision-making, across different types of tests, to understand what type of decision-making is more challenging. To do this, we searched four databases of research papers. We found 104 studies that tested, in total, 2712 autistic and 3189 comparison participants on different decision-making tasks. We found that there were four categories of decision-making tests that were used in these experiments: perceptual (e.g. deciding which image has the most dots); reward learning (e.g. learning which deck of cards gives the best reward); metacognition (e.g. knowing how well you perform or what you want); and value-based (e.g. making a decision based on a choice between two outcomes that differ in value to you). Overall, these studies suggest that autistic and comparison participants tend to perform similarly well at perceptual and reward-learning decisions. However, autistic participants tended to decide differently from comparison participants on metacognition and value-based paradigms. This suggests that autistic people might differ from typically developing controls in how they evaluate their own performance and in how they make decisions based on weighing up the subjective value of two different options. We suggest these reflect more general differences in metacognition, thinking about thinking, in autism.
Collapse
|
4
|
Pellicano E, Fatima U, Hall G, Heyworth M, Lawson W, Lilley R, Mahony J, Stears M. A capabilities approach to understanding and supporting autistic adulthood. NATURE REVIEWS PSYCHOLOGY 2022; 1:624-639. [PMID: 36090460 PMCID: PMC9443657 DOI: 10.1038/s44159-022-00099-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 12/28/2022]
Abstract
There is little comprehensive research into autistic adulthood, and even less into the services and supports that are most likely to foster flourishing adult autistic lives. This limited research is partly because autism is largely conceived as a condition of childhood, but this focus of research has also resulted from the orthodox scientific approach to autism, which conceptualizes autistic experience almost entirely as a series of biologically derived functional deficits. Approaching autism in this way severely limits what is known about this neurodevelopmental difference, how research is conducted and the services and supports available. In this Review, we adopt an alternative research strategy: we apply Martha Nussbaum's capabilities approach, which focuses on ten core elements of a thriving human life, to research on autistic adulthood. In doing so, we identify areas where autistic adults thrive and where they often struggle, and highlight issues to which researchers, clinicians and policymakers should respond. The resulting picture is far more complex than conventional accounts of autism imply. It also reveals the importance of engaging autistic adults directly in the research process to make progress towards genuinely knowing autism and supporting flourishing autistic lives.
Collapse
Affiliation(s)
- Elizabeth Pellicano
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Unsa Fatima
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
| | - Gabrielle Hall
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
| | - Melanie Heyworth
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
- Reframing Autism, Sydney, New South Wales Australia
| | - Wenn Lawson
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
| | - Rozanna Lilley
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
| | - Joanne Mahony
- Macquarie School of Education, Macquarie University, Sydney, New South Wales Australia
| | - Marc Stears
- UCL Policy Lab, University College London, London, UK
| |
Collapse
|
5
|
Krüttner S, Falasconi A, Valbuena S, Galimberti I, Bouwmeester T, Arber S, Caroni P. Absence of familiarity triggers hallmarks of autism in mouse model through aberrant tail-of-striatum and prelimbic cortex signaling. Neuron 2022; 110:1468-1482.e5. [DOI: 10.1016/j.neuron.2022.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 01/10/2022] [Accepted: 01/28/2022] [Indexed: 12/28/2022]
|
6
|
Qian C, Tei S, Itahashi T, Aoki YY, Ohta H, Hashimoto RI, Nakamura M, Takahashi H, Kato N, Fujino J. Intergroup bias in punishing behaviors of adults with autism spectrum disorder. Front Psychiatry 2022; 13:884529. [PMID: 36061271 PMCID: PMC9437315 DOI: 10.3389/fpsyt.2022.884529] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
Groups are essential elements of society, and humans, by nature, commonly manifest intergroup bias (i.e., behave more positively toward an ingroup member than toward an outgroup member). Despite the growing evidence of various types of altered decision-making in individuals with autism spectrum disorder (ASD), their behavior under the situation involving group membership remains largely unexplored. By modifying a third-party punishment paradigm, we investigated intergroup bias in individuals with ASD and typical development (TD). In our experiment, participants who were considered as the third party observed a dictator game wherein proposers could decide how to distribute a provided amount of money while receivers could only accept unconditionally. Participants were confronted with two different group situations: the proposer was an ingroup member and the recipient was an outgroup member (IN/OUT condition) or the proposer was an outgroup member and the recipient was an ingroup member (OUT/IN condition). Participants with TD punished proposers more severely when violating social norms in the OUT/IN condition than in IN/OUT condition, indicating that their decisions were influenced by the intergroup context. This intergroup bias was attenuated in individuals with ASD. Our findings deepen the understanding of altered decision-making and socioeconomic behaviors in individuals with ASD.
Collapse
Affiliation(s)
- Chenyu Qian
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shisei Tei
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan.,Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Institute of Applied Brain Sciences, Waseda University, Saitama, Japan.,School of Human and Social Sciences, Tokyo International University, Saitama, Japan
| | - Takashi Itahashi
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan
| | - Yuta Y Aoki
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan
| | - Haruhisa Ohta
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan.,Department of Psychiatry, School of Medicine, Showa University, Tokyo, Japan
| | - Ryu-Ichiro Hashimoto
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan.,Department of Language Sciences, Graduate School of Humanities, Tokyo Metropolitan University, Tokyo, Japan
| | - Motoaki Nakamura
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan.,Kanagawa Psychiatric Center, Kanagawa, Japan
| | - Hidehiko Takahashi
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan.,Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Nobumasa Kato
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan
| | - Junya Fujino
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan.,Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
7
|
Greenburgh A, Barnby JM, Delpech R, Kenny A, Bell V, Raihani N. What motivates avoidance in paranoia? Three failures to find a betrayal aversion effect. JOURNAL OF EXPERIMENTAL SOCIAL PSYCHOLOGY 2021. [DOI: 10.1016/j.jesp.2021.104206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
8
|
St John T, Woods S, Bode T, Ritter C, Estes A. A review of executive functioning challenges and strengths in autistic adults. Clin Neuropsychol 2021; 36:1116-1147. [PMID: 34499568 DOI: 10.1080/13854046.2021.1971767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: There has been a steady rise in research characterizing executive functioning (EF) impairments in autistic individuals but limited research investigating EF strengths. This review provides a summary of current EF research in autistic adults with a focus on EF challenges and strengths and potential sources of heterogeneity in research findings. New avenues for addressing gaps in our understanding of EF strengths are proposed.Method: A review of the EF literature was conducted. One hundred twenty-four studies of inhibition, working memory, cognitive flexibility, fluency, planning, decision-making, and subjective measures of EF in autistic adults were included.Results: Autistic adults with average intellectual functioning demonstrate difficulties with cognitive flexibility, phonemic fluency, and working memory. Strengths in planning, decision-making, and semantic verbal fluency were evident in some but not all studies. Findings regarding inhibition are inconclusive. Key findings across each EF domain are discussed and sources of potential heterogeneity across studies were evaluated. The type of measure used appears to contribute to heterogeneous findings. Subjective EF measures revealed more consistent findings of deficits in autistic adults than objective EF measures.Conclusions: Research reveals areas of EF weaknesses as well as strengths in autistic adults. Unlike EF challenges, EF strengths are not well understood. Future research identifying EF strengths is needed to improve services and supports for autistic adults. Further investigation of potential factors that interact with or constrain EF such as comorbid disorders, verbal ability, sensory processing, and other factors specific to autism will be critical to move the field forward and increase understanding of how EF is related to everyday functioning in autistic adults.
Collapse
Affiliation(s)
- Tanya St John
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA.,University of Washington Autism Center, University of Washington, Seattle, WA, USA.,Center on Human Development and Disability, University of Washington, Seattle, WA, USA
| | - Sara Woods
- University of Washington Autism Center, University of Washington, Seattle, WA, USA.,Center on Human Development and Disability, University of Washington, Seattle, WA, USA
| | | | - Cassidy Ritter
- College of Education, University of Washington, Seattle, WA, USA
| | - Annette Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA.,University of Washington Autism Center, University of Washington, Seattle, WA, USA.,Center on Human Development and Disability, University of Washington, Seattle, WA, USA
| |
Collapse
|
9
|
Rozenkrantz L, D'Mello AM, Gabrieli JDE. Enhanced rationality in autism spectrum disorder. Trends Cogn Sci 2021; 25:685-696. [PMID: 34226128 DOI: 10.1016/j.tics.2021.05.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/05/2021] [Accepted: 05/10/2021] [Indexed: 12/18/2022]
Abstract
Challenges in social cognition and communication are core characteristics of autism spectrum disorder (ASD), but in some domains, individuals with ASD may display typical abilities and even outperform their neurotypical counterparts. These enhanced abilities are notable in the domains of reasoning, judgment and decision-making, in which individuals with ASD often show 'enhanced rationality' by exhibiting more rational and bias-free decision-making than do neurotypical individuals. We review evidence for enhanced rationality in ASD, how it relates to theoretical frameworks of information processing in ASD, its implications for basic research about human irrationality, and what it may mean for the ASD community.
Collapse
Affiliation(s)
- Liron Rozenkrantz
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 01239, USA; Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 01239, USA.
| | - Anila M D'Mello
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 01239, USA; Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 01239, USA
| | - John D E Gabrieli
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 01239, USA; Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 01239, USA
| |
Collapse
|
10
|
Curry AE, Metzger KB, Carey ME, Sartin EB, Huang P, Yerys BE. Comparison of Motor Vehicle Crashes, Traffic Violations, and License Suspensions Between Autistic and Non-Autistic Adolescent and Young Adult Drivers. J Am Acad Child Adolesc Psychiatry 2021; 60:913-923. [PMID: 33453361 PMCID: PMC8918049 DOI: 10.1016/j.jaac.2021.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/05/2020] [Accepted: 01/07/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE One-third of autistic individuals obtain a driver's license by age 21 years; however, prior studies suggest they may be at heightened risk for motor vehicle crashes. We compared objective rates of crashes, traffic violations, and license suspensions for newly licensed autistic and non-autistic adolescents. METHOD This retrospective cohort study included New Jersey residents born from 1987 through 2000 who were patients of the Children's Hospital of Philadelphia health care network. Electronic health records were linked with statewide driver licensing and crash databases. Autism status was classified via International Classification of Diseases (ICD) diagnostic codes; individuals with intellectual disability were excluded. We compared rates among 486 autistic and 70,990 non-autistic licensed drivers over their first 48 months of driving. Furthermore, we examined the proportion of crashes attributed to specific driver actions and crash types. RESULTS Compared with non-autistic drivers, autistic drivers were estimated to have lower average monthly rates of crash involvement (adjusted rate ratio (adjRR) = 0.89, 95% CI = 0.75-1.05), moving violations (adjRR = 0.56, 95% CI = 0.48-0.67), and suspensions (adjRR = 0.32, 95% CI = 0.18-0.58). Among drivers involved in a crash, autistic drivers were half as likely to crash because of unsafe speed, but substantially more likely to crash because of their failure to yield to a vehicle/pedestrian and while making left-turns or U-turns. CONCLUSION Newly licensed autistic adolescent drivers have similar to lower estimated rates of adverse driving outcomes; the extent to which these can be attributed to different driving patterns is a critical point for future investigation. There were several notable differences in the characteristics of these crashes, which directly inform interventions to improve driving safety of autistic adolescent drivers.
Collapse
Affiliation(s)
- Allison E Curry
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia and the Division of Emergency Medicine, Perelman School of Medicine at University of Pennsylvania, Philadelphia.
| | - Kristina B Metzger
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Pennsylvania
| | - Meghan E Carey
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Pennsylvania
| | - Emma B Sartin
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Pennsylvania
| | - Patty Huang
- Division of Developmental and Behavioral Pediatrics, Children's Hospital of Philadelphia, Pennsylvania
| | - Benjamin E Yerys
- Center for Autism Research, Children's Hospital of Philadelphia, and the Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
11
|
The effect of autism on information sampling during decision-making: An eye-tracking study. JUDGMENT AND DECISION MAKING 2021. [DOI: 10.1017/s1930297500007762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
AbstractRecent research has highlighted a tendency for more rational and deliberative decision-making in individuals with autism. We tested this hypothesis by using eye-tracking to investigate the information processing strategies that underpin multi-attribute choice in a sample of adults diagnosed with autism spectrum condition. We found that, as the number of attributes defining each option increased, autistic decision-makers were speedier, examined less of the available information, and spent a greater proportion of their time examining the option they eventually chose. Rather than indicating a more deliberative style, our results are consistent with a tendency for individuals with autism to narrow down the decision-space more quickly than does the neurotypical population.
Collapse
|
12
|
Myers RK, Carey ME, Bonsu JM, Yerys BE, Mollen CJ, Curry AE. Behind the Wheel: Specialized Driving Instructors' Experiences and Strategies for Teaching Autistic Adolescents to Drive. Am J Occup Ther 2021; 75:12501. [PMID: 34781345 DOI: 10.5014/ajot.2021.043406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE In the transition to adulthood, driving supports independence. For autistic adolescents, training provided by specialized driving instructors, including occupational therapists, may establish fitness to drive and continued independence. OBJECTIVE To examine specialized driving instructors' experiences providing behind-the-wheel instruction to autistic adolescents. DESIGN We recruited participants through purposive and snowball sampling of members of ADED, the Association for Driver Rehabilitation Specialists. Interviews investigated experiences providing instruction, autistic students' strengths and challenges, strategies used, and recommendations to improve the learning-to-drive process. We coded transcripts using a directed content analysis approach. SETTING Telephone interviews. PARTICIPANTS Specialized driving instructors (N = 17) trained as occupational therapists, driver rehabilitation specialists, or licensed driving instructors with recent experience providing behind-the-wheel training for autistic adolescents participated. RESULTS Behind-the-wheel challenges included mental inflexibility, distractibility, and difficulties with social cues and motor coordination. Instructors acknowledged students' strengths, including adherence to rules of the road, limited risk taking, and careful observations. Instructors scaffolded learning to help students develop skills. Although licensure and driving outcomes were sometimes unknown to instructors, students who became licensed frequently drove with supervision or restrictions. CONCLUSIONS AND RELEVANCE Licensure is possible for autistic adolescents, although developing fitness to drive requires individualization and rigorous specialized instruction, which may culminate in delayed or restricted driving. What This Article Adds: This article highlights challenges and strengths encountered by specialized driving instructors teaching autistic adolescents. Despite requiring prolonged training, autistic adolescents can achieve licensure when supported by specialized instruction that is individualized to their needs and strengths.
Collapse
Affiliation(s)
- Rachel K Myers
- Rachel K. Myers, PhD, MS, is Research Scientist, Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, and Research Assistant Professor, Division of Emergency Medicine, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia;
| | - Meghan E Carey
- Meghan E. Carey, MS, is Doctoral Student, Dornsife School of Public Health, Drexel University, Philadelphia, PA. At the time this work was conducted, Carey was Research Coordinator, Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Janice M Bonsu
- Janice M. Bonsu, MPH, is Medical Student, Ohio State University College of Medicine, Columbus. At the time this work was conducted, Bonsu was Research Assistant, Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Benjamin E Yerys
- Benjamin E. Yerys, PhD, is Scientist, Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, and Assistant Professor, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Cynthia J Mollen
- Cynthia J. Mollen, MD, MSCE, is Professor and Chief, Division of Emergency Medicine, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, and Faculty, PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Allison E Curry
- Allison E. Curry, PhD, MPH, is Senior Scientist and Director of Epidemiology, Center for Injury Research and Prevention, Children's Hospital of Philadelphia, and Assistant Professor, Division of Emergency Medicine, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| |
Collapse
|
13
|
Hedge C, Powell G, Bompas A, Sumner P. Self-reported impulsivity does not predict response caution. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020; 167:110257. [PMID: 33273749 PMCID: PMC7457714 DOI: 10.1016/j.paid.2020.110257] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/10/2020] [Accepted: 07/11/2020] [Indexed: 12/15/2022]
Abstract
The broad construct of impulsivity is one that spans both personality and cognitive ability. Despite a common overarching construct, previous research has found no relationship between self-report measures of impulsivity and people's ability to inhibit pre-potent responses. Here, we use evidence accumulation models of choice reaction time tasks to extract a measure of "response caution" (boundary separation) and examine whether this correlates with self-reported impulsivity as measured by the UPPS-P questionnaire. Response caution reflects whether an individual makes decisions based on more (favouring accuracy) or less (favouring speed) evidence. We reasoned that this strategic dimension of behaviour is conceptually closer to the tendencies that self-report impulsivity measures probe than what is traditional measured by inhibition tasks. In a meta-analysis of five datasets (total N = 296), encompassing 19 correlations per subscale, we observe no evidence that response caution correlates with self-reported impulsivity. Average correlations between response caution and UPPS-P subscales ranged from rho = -0.02 to -0.04. While the construct of response caution has demonstrated value in understanding individual differences in cognition, brain functioning and aging; the factors underlying what has been called "impulsive information processing" appear to be distinct from the concept of impulsivity derived from self-report.
Collapse
Affiliation(s)
- Craig Hedge
- CUBRIC - School of Psychology, Cardiff University, UK
| | | | - Aline Bompas
- CUBRIC - School of Psychology, Cardiff University, UK
| | | |
Collapse
|
14
|
Fujino J, Tei S, Itahashi T, Aoki YY, Ohta H, Kubota M, Hashimoto RI, Nakamura M, Kato N, Takahashi H. Impact of past experiences on decision-making in autism spectrum disorder. Eur Arch Psychiatry Clin Neurosci 2020; 270:1063-1071. [PMID: 31559528 DOI: 10.1007/s00406-019-01071-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 09/18/2019] [Indexed: 12/22/2022]
Abstract
People are often influenced by past costs in their current decision-making, thus succumbing to a well-known bias recognized as the sunk cost effect. A recent study showed that the sunk cost effect is attenuated in individuals with autism spectrum disorder (ASD). However, the study only addressed one situation of utilization decision by focusing on the choice between similar attractive alternatives with different levels of sunk costs. Thus, it remains unclear how individuals with ASD behave under sunk costs in different types of decision situations, particularly progress decisions, in which the decision-maker allocates additional resources to an initially chosen alternative. The sunk cost effect in progress decisions was estimated using an economic task designed to assess the effect of the past investments on current decision-making. Twenty-four individuals with ASD and 21 age-, sex-, smoking status-, education-, and intelligence quotient-level-matched typical development (TD) subjects were evaluated. The TD participants were more willing to make the second incremental investment if a previous investment was made, indicating that their decisions were influenced by sunk costs. However, unlike the TD group, the rates of investments were not significantly increased after prior investments in the ASD group. The results agree with the previous evidence of a reduced sensitivity to context stimuli in individuals with ASD and help us obtain a broader picture of the impact of sunk costs on their decision-making. Our findings will contribute to a better understanding of ASD and may be useful in addressing practical implications of their socioeconomic behavior.
Collapse
Affiliation(s)
- Junya Fujino
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, 157-8577, Japan.
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, Japan.
| | - Shisei Tei
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, Japan
- Institute of Applied Brain Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, Japan
- School of Human and Social Sciences, Tokyo International University, 2509 Matoba, Kawagoe, Saitama, Japan
| | - Takashi Itahashi
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
| | - Yuta Y Aoki
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
| | - Haruhisa Ohta
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
- Department of Psychiatry, School of Medicine, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, Japan
| | - Manabu Kubota
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, Japan
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, Japan
| | - Ryu-Ichiro Hashimoto
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
- Department of Language Sciences, Graduate School of Humanities, Tokyo Metropolitan University, 1-1 Minami-Osawa, Hachioji-shi, Tokyo, Japan
| | - Motoaki Nakamura
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
- Kanagawa Psychiatric Center, 2-5-1 Serigaya, Yokohama, Kanagawa, Japan
| | - Nobumasa Kato
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
| | - Hidehiko Takahashi
- Medical Institute of Developmental Disabilities Research, Showa University, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo, 157-8577, Japan
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaracho, Sakyo-ku, Kyoto, Japan
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan
| |
Collapse
|
15
|
Kube T, Rozenkrantz L. When Beliefs Face Reality: An Integrative Review of Belief Updating in Mental Health and Illness. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2020; 16:247-274. [DOI: 10.1177/1745691620931496] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Belief updating is a relatively nascent field of research that examines how people adjust their beliefs in light of new evidence. So far, belief updating has been investigated in partly unrelated lines of research from different psychological disciplines. In this article, we aim to integrate these disparate lines of research. After presenting some prominent theoretical frameworks and experimental designs that have been used for the study of belief updating, we review how healthy people and people with mental disorders update their beliefs after receiving new information that supports or challenges their views. Available evidence suggests that both healthy people and people with particular mental disorders are prone to certain biases when updating their beliefs, although the nature of the respective biases varies considerably and depends on several factors. Anomalies in belief updating are discussed in terms of both new insights into the psychopathology of various mental disorders and societal implications, such as irreconcilable political and societal controversies due to the failure to take information into account that disconfirms one’s own view. We conclude by proposing a novel integrative model of belief updating and derive directions for future research.
Collapse
Affiliation(s)
- Tobias Kube
- Program in Placebo Studies, Harvard Medical School/Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Koblenz-Landau
| | - Liron Rozenkrantz
- Program in Placebo Studies, Harvard Medical School/Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology
| |
Collapse
|
16
|
Abstract
Over the past 30 years, researchers have shown that human choices are highly sensitive to the ways in which alternatives are presented. For example, when individuals face a choice between a sure and a risky option, their willingness to take risks varies depending on whether the alternatives are framed in terms of gain or loss. The current major hypothesis that explains such a framing effect predicts that compared with an equivalent risky option, sure gains are emotionally attractive and sure losses are emotionally aversive. Using a behavioural paradigm, the main objective of the current study was to experimentally observe the extent to which the emotional attraction to sure gains and aversion to sure losses are at the core of framing susceptibility. First, our results showed that, as the literature suggests, the emotional attraction to sure gains and aversion to sure losses underpin the framing effect. Second, our results showed that methodological factors moderated the role of these emotional mechanisms in the framing effect. Implications and directions for future studies are discussed.
Collapse
Affiliation(s)
- Corentin J Gosling
- Laboratory of Psychopathology and Health Process, Institute of Psychology, Paris Descartes University, Sorbonne Paris Cite, Boulogne-Billancourt, France
| | - Sylvain Moutier
- Laboratory of Psychopathology and Health Process, Institute of Psychology, Paris Descartes University, Sorbonne Paris Cite, Boulogne-Billancourt, France
| |
Collapse
|