Automatic facial responses to affective stimuli in high-functioning adults with autism spectrum disorder

Neurotypical, but not autistic, adults might experience distress when looking at someone avoiding eye contact: A live face-to-face paradigm

LAY ABSTRACT

What is already known about the topic?Autistics are usually reported to share less eye contact than neurotypicals with their interlocutors. However, the reason why autistics might pay less attention to eyes looking at them is still unknown: some autistics express being hyper-aroused by this eye contact, while some eye-tracking studies suggest that eye contact is associated with hypo-arousal in autism.What this paper adds?This study is based on a highly controlled live face-to-face paradigm, combining a wearable eye-tracker (to study eye behaviours) with electrodermal activity sensors (to assess potential stress). We draw a nuanced picture of social attention in autism, as our autistic participants did not differ from our neurotypical group in their eye behaviours nor their skin conductance responses. However, we found that neurotypicals, compared to autistics, seemed to be much more distressed when their interlocutor did not gaze at them during the experiment.Implications for practice, research or policy:Our study encourages to consider social interaction difficulties in autism as a relational issue, instead as an individual deficit. This step might be first taken in research, by implementing paradigms sensitive to the experimenter's role and attitude.

Sensory Gating in Neurodevelopmental Disorders: A Scoping Review

This review aimed to explore the current understanding of sensory gating in neurodevelopmental disorders as a possible transdiagnostic mechanism. We applied methods according to the Joanna Briggs Institute Manual for Evidence Synthesis, following the population, concept, and context scoping review eligibility criteria. Using a comprehensive search strategy in five relevant research databases (Medline, EMBASE, CINAHL, PsychInfo, and Scopus), we searched for relevant peer-reviewed, primary research articles and unpublished data. Two independent reviewers screened the titles and abstracts, full-texts, and completed data extraction. We identified a total of 81 relevant articles and used descriptive analyses to summarize the characteristics and outcomes of all identified studies. Literature regarding sensory gating was most common in autistic populations with relatively fewer studies examining attention-deficit/hyperactivity disorder, tic disorders, and childhood-onset fluency disorder (COFD). The methods to assess sensory gating varied widely both within and between groups and included measures such as habituation, prepulse inhibition, affect-modulated inhibition, medication and other intervention trials. Most consistently, when participants complete questionnaires about their sensory experiences, those who have neurodevelopmental disorders report differences in their sensory gating. Affect-modulated inhibition appears to be discrepant between samples with and without neurodevelopmental disorder diagnoses. Habituation was the most commonly reported phenomenon and many differences in habituation have been found in autistic individuals and individuals with tic disorders whereas concerns with inhibition seemed more common in COFD. Overall, the evidence is inconsistent within and between disorders suggesting there is still much to learn about sensory gating in neurodevelopmental disorders.

State anxiety modulates the effect of emotion cues on visual temporal sensitivity in autism spectrum disorder

Atypical processing of stimulus inputs across a range of sensory modalities in autism spectrum disorder (ASD) is widely reported. Sensory processing is known to be influenced by bodily internal states such as physiological arousal and anxiety. As a sizeable proportion of ASD reportedly have co-morbid anxiety disorders that are linked with dysregulated arousal, we investigated if face emotion arousal cues influenced visual sensory sensitivity (indexed by temporal resolution) in ASD (n = 20) compared to a matched group of typically developed individuals (TD, n = 21). We asked further if emotion-cued changes in visual sensitivity were associated with individual differences in state and trait anxiety. Participants reported the laterality of the second of two consecutive Gaussian-blob flashes in a visual temporal order judgment task (v-TOJ), demanding higher-level visual processing. The key manipulation was presenting a task-irrelevant face emotion cue briefly at unexpected time points preceding the task-relevant flashes. Disgust vs. Neutral emotion signals significantly enhanced the visual temporal resolution in ASD. Individual state-anxiety scores showed a fair correlative trend with the emotion-cued changes in temporal resolution (Disgust versus Neutral) in ASD but missed statistical significance. Both these effects were absent in TD. The results show that individual state-anxiety levels likely modulate the effect of emotions on visual temporal sensitivity in ASD. The findings support a nuanced approach to understand the disparate sensory features in ASD, by factoring in the interplay of the individual reactivity to environmental affective information and the severity of anxiety.

Alexithymia

Humans are highly adept at differentiating, regulating, and responding to their emotions. At the core of all these functions is emotional awareness: the conscious feeling states that are central to human mental life. Disrupted emotional awareness-a subclinical construct commonly referred to as alexithymia-is present in a range of psychiatric and neurological disorders and can have a deleterious impact on functional outcomes and treatment response. This chapter is a selective review of the current state of the science on alexithymia. We focus on two separate but related issues: (i) the functional deficits associated with alexithymia and what they reveal about the importance of emotional awareness for shaping normative human functioning, and (ii) the neural correlates of alexithymia and what they can inform us about the biological bases of emotional awareness. Lastly, we outline challenges and opportunities for alexithymia research, focusing on measurement issues and the potential utility of formal computational models of emotional awareness for advancing the fields of clinical and affective science.

Physiological responses to affiliation during conversation: Comparing neurotypical males and males with Asperger syndrome

We examined the emotional and psychophysiological underpinnings of social interaction in the context of autism spectrum disorder, more specifically, involving participants diagnosed with Asperger syndrome (AS). We recorded participants’ autonomic nervous system (ANS) activation (electrodermal activity, heart rate, and heart rate variability) and facial muscle activation during conversations in two different types of male dyads: (1) ten dyads where one participant has been diagnosed with AS (AS/NT dyads) and (2) nine dyads where both participants are neurotypical (NT/NT dyads). Afterwards, three independent raters assessed continuously each participant’s affiliative and dominant behaviors during the first and last 10 minutes of the conversations. The relationship between the assessed data and ANS responses was examined. We found that, in the NT/NT dyads, a high level of affiliation displayed by the conversational partner calms down the participant when they are actively dominating the interaction. In contrast, when the participants themselves expressed affiliation, their psychophysiological responses indicated increase in arousal, which suggests that the giving of affiliation is physiologically “hard work.” The affiliation-related ANS responses were similar in those NT participants whose conversational partner had AS, while some differences in facial muscle activation did occur in comparison to NT/NT dyads. In the AS participants, in contrast, a high level of affiliation provided by the conversational partner was associated with increase in arousal, suggesting heightened alertness and stress. As for their own affiliative behavior, the AS participants exhibited similar indicators of alertness and stress as the NT participants, but only when their own level of dominance was low. Our results increase understanding of how individuals with AS experience social interaction at the physiological level, and how this experience differs from that in NT individuals. Moreover, our results confirm and further specify our earlier results, where we proposed that affiliation involves the type of “sharing of the burden” that also reverberates in the participants’ bodies.

Emotional valence detection in adolescents with oppositional defiant disorder/conduct disorder or autism spectrum disorder

Oppositional defiant disorder, conduct disorder (ODD/CD), and autism spectrum disorder (ASD) share poor empathic functioning and have been associated with impaired emotional processing. However, no previous studies directly compared similarities and differences in these processes for the two disorders. A two-choice emotional valence detection task requiring differentiation between positive, negative, and neutral IAPS pictures was administered to 52 adolescents (12-19 years) with ODD/CD, 52 with ASD and 24 typically developing individuals (TDI). Callous-unemotional (CU) traits were assessed by self- and parent reports using the Inventory of callous-unemotional traits. Main findings were that adolescents with ODD/CD or ASD both performed poorer than TDI in terms of accuracy, yet only the TDI-not both clinical groups-had relatively most difficulty in discriminating between positive versus neutral pictures compared to neutral-negative or positive-negative contrasts. Poorer performance was related to a higher level of CU traits. The results of the current study suggest youth with ODD/CD or ASD have a diminished ability to detect emotional valence which is not limited to facial expressions and is related to a higher level of CU traits. More specifically, youth with ODD/CD or ASD seem to have a reduced processing of positive stimuli and/or lack a 'positive perception bias' present in TDI that could either contribute to the symptoms and/or be a result of having the disorder and may contribute to the comorbidity of both disorders.

Affective startle modulation and psychopathology: Implications for appetitive and defensive brain systems

Startle reflex potentiation versus startle attenuation to unpleasant versus pleasant stimuli likely reflect priming of the defensive versus appetitive motivational systems, respectively. This review summarizes and systemizes the literature on affective startle modulation related to psychopathologies with the aim to reveal underlying mechanisms across psychopathologies. We found evidence for psychopathologies characterized by increased startle potentiation to unpleasant stimuli (anxiety disorders), decreased startle potentiation to unpleasant stimuli (psychopathy), decreased startle attenuation to pleasant stimuli (ADHD), as well as a general hyporeactivity to affective stimuli (depression). Increased versus decreased startle responses to disorder-specific stimuli characterize specific phobia and drug dependence. No psychopathology is characterized by increased startle attenuation to standard pleasant stimuli or a general hyperreactivity to affective stimuli. This review indicates that the defensive and the appetitive systems operate independently mostly in accordance with the motivational priming hypothesis and that affective startle modulation is a highly valuable paradigm to unraveling dysfunctions of the defensive and appetitive systems in psychopathologies as requested by the Research Domain Criteria initiative.

Facial Expression Production in Autism: A Meta-Analysis

This meta-analysis summarized studies that examined group differences on the production of facial expressions in participants with ASD compared to typically developing or nonautistic clinical comparison groups. The overall summary effect from 67 effect sizes representing the average ASD-comparison group differences in facial expressions was -0.481, indicating a moderate effect size. We conducted subgroup analyses to group effect sizes according to separate facial expression abilities identified in the literature. These analyses revealed that participants with ASD display facial expressions less frequently and for less amount of time, and they are less likely to share facial expressions with others or automatically mimic the expressions of real faces or face stimuli. Their facial expressions are also judged to be lower in quality and are expressed less accurately. However, participants with ASD do not express emotions less intensely, nor is their reaction time of expression onset slower in response to odors, startling sensations, or in response to face stimuli in mimicry studies. ASD-comparison group differences were moderated by matching procedures, age, and intellectual functioning of the ASD participants suggesting that persons with higher IQ and larger number of accumulated life experiences are better able to produce facial expressions that are more consistent with "neurotypical" norms. Group differences were also stronger for "covertly elicited" than "explicitly elicited" facial expressions suggesting individuals with ASD may naturally produce facial expressions differently from other populations, but are less impaired in expressing emotions typically when prompted to do so in a laboratory setting. Autism Research 2018, 11: 1586-1601. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We reviewed studies that compared facial expressions in people with and without autism. Results revealed that facial expressions of people with autism are atypical in appearance and quality and are used atypically to regulate social interactions. The magnitude of these differences was influenced by participant characteristics (e.g. age and intellectual functioning), and by how facial expressions were measured and analyzed in various studies.

A Feasibility Study of Autism Behavioral Markers in Spontaneous Facial, Visual, and Hand Movement Response Data

Autism spectrum disorder (ASD) is a neurodevelopmental disability with atypical traits in behavioral and physiological responses. These atypical traits in individuals with ASD may be too subtle and subjective to measure visually using tedious methods of scoring. Alternatively, the use of intrusive sensors in the measurement of psychophysical responses in individuals with ASD may likely cause inhibition and bias. This paper proposes a novel experimental protocol for non-intrusive sensing and analysis of facial expression, visual scanning, and eye-hand coordination to investigate behavioral markers for ASD. An institutional review board approved pilot study is conducted to collect the response data from two groups of subjects (ASD and control) while they engage in the tasks of visualization, recognition, and manipulation. For the first time in the ASD literature, the facial action coding system is used to classify spontaneous facial responses. Statistical analyses reveal significantly (p <0.01) higher prevalence of smile expression for the group with ASD with the eye-gaze significantly averted (p<0.05) from viewing the face in the visual stimuli. This uncontrolled manifestation of smile without proper visual engagement suggests impairment in reciprocal social communication, e.g., social smile. The group with ASD also reveals poor correlation in eye-gaze and hand movement data suggesting deficits in motor coordination while performing a dynamic manipulation task. The simultaneous sensing and analysis of multimodal response data may provide useful quantitative insights into ASD to facilitate early detection of symptoms for effective intervention planning.

Reinforcement Learning in Autism Spectrum Disorder

Early behavioral interventions are recognized as integral to standard care in autism spectrum disorder (ASD), and often focus on reinforcing desired behaviors (e.g., eye contact) and reducing the presence of atypical behaviors (e.g., echoing others' phrases). However, efficacy of these programs is mixed. Reinforcement learning relies on neurocircuitry that has been reported to be atypical in ASD: prefrontal-sub-cortical circuits, amygdala, brainstem, and cerebellum. Thus, early behavioral interventions rely on neurocircuitry that may function atypically in at least a subset of individuals with ASD. Recent work has investigated physiological, behavioral, and neural responses to reinforcers to uncover differences in motivation and learning in ASD. We will synthesize this work to identify promising avenues for future research that ultimately can be used to enhance the efficacy of early intervention.

An exploration of sarcasm detection in children with Attention Deficit Hyperactivity Disorder

The present research explored the ability of children with ADHD to distinguish between sarcasm and sincerity. Twenty-two children with a clinical diagnosis of ADHD were compared with 22 age and verbal IQ matched typically developing children using the Social Inference-Minimal Test from The Awareness of Social Inference Test (TASIT, McDonald, Flanagan, & Rollins, 2002). This test assesses an individual's ability to interpret naturalistic social interactions containing sincerity, simple sarcasm and paradoxical sarcasm. Children with ADHD demonstrated specific deficits in comprehending paradoxical sarcasm and they performed significantly less accurately than the typically developing children. While there were no significant differences between the children with ADHD and the typically developing children in their ability to comprehend sarcasm based on the speaker's intentions and beliefs, the children with ADHD were found to be significantly less accurate when basing their decision on the feelings of the speaker, but also on what the speaker had said. Results are discussed in light of difficulties in their understanding of complex cues of social interactions, and non-literal language being symptomatic of children with a clinical diagnosis of ADHD. The importance of pragmatic language skills in their ability to detect social and emotional information is highlighted.

Instructions to mimic improve facial emotion recognition in people with sub-clinical autism traits

People tend to mimic the facial expression of others. It has been suggested that this helps provide social glue between affiliated people but it could also aid recognition of emotions through embodied cognition. The degree of facial mimicry, however, varies between individuals and is limited in people with autism spectrum conditions (ASC). The present study sought to investigate the effect of promoting facial mimicry during a facial-emotion-recognition test. In two experiments, participants without an ASC diagnosis had their autism quotient (AQ) measured. Following a baseline test, they did an emotion-recognition test again but half of the participants were asked to mimic the target face they saw prior to making their responses. Mimicry improved emotion recognition, and further analysis revealed that the largest improvement was for participants who had higher scores on the autism traits. In fact, recognition performance was best overall for people who had high AQ scores but also received the instruction to mimic. Implications for people with ASC are explored.

Not knowing what I feel: Emotional empathy in autism spectrum disorders

While there is a general consensus in the literature that individuals with autism spectrum disorder have difficulty with cognitive empathy, much less is known about emotional empathy processing in these individuals. Most research has employed subjective self-report measures, which can often be misinterpreted or under-reported/over-reported. More objective measures such as psychophysiological recordings of arousal offer a more objective response. Furthermore, combining physiological responses with self-report ratings allows us to explore the relationship between these two responses to emotionally charged stimuli. A total of 25 individuals with autism spectrum disorder were compared with 25 matched controls on their physiological (arousal) and psychological (self-report) responses to emotionally distressing video scenes. These responses were also then compared with self-report cognitive and emotional trait empathy. Results indicate that while individuals with autism spectrum disorder appear to respond similarly to controls physiologically, their interpretation of this response is dampened emotionally. Furthermore, this dampening of self-report emotional response is associated with a general reduction in trait empathy.

The role of interstimulus interval and "Stimulus-type" in prepotent response inhibition abilities in people with ASD: A quantitative and qualitative review

Autism spectrum disorders (ASD) are associated with prepotent response inhibition difficulties. However, the large variation between studies suggests that understudied factors, such as interstimulus interval (ISI) and "stimulus-type" (both hypothesized proxies of stressors influencing arousal), might influence the inhibitory abilities of people with ASD. Using meta-analysis, we tested whether differences in prepotent response inhibition between people with and without ASD was influenced by ISI. There was not enough variation in "stimulus-type" between the studies to include it as a moderator. Thirty-seven studies met inclusion criteria, with a combined sample size of 950 people with ASD and 966 typically developing controls. Additionally, a qualitative review including studies comparing a neutral and an arousing condition in one experiment was performed to examine whether fast ISI or specific arousing stimuli directly influence prepotent response inhibition. The meta-analysis indicated that ISI was not a relevant moderator. The qualitative review showed that ISI and "stimulus-type" had the same effect for both groups. Although all studies regarding ISI indicated that fast ISI worsened performance, different types of stimuli had either a positive or a negative influence. This could suggest that distinctive stimuli might affect arousal differently. While we replicated the inhibition difficulties in people with ASD (g = .51), our results do not show strong ASD-specific effects of ISI or "stimulus-type" on inhibition. Nonetheless, ISI and "stimulus-type" do seem to influence performance. Future research focusing on potential underlying factors (e.g., baseline physiological arousal) is needed to examine why this is the case. Autism Res 2016, 9: 1124-1141. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

Facial expression to emotional stimuli in non-psychotic disorders: A systematic review and meta-analysis

Facial expression of emotion is crucial to social interaction and emotion regulation; therefore, altered facial expressivity can be a contributing factor in social isolation, difficulties with emotion regulation and a target for therapy. This article provides a systematic review and meta-analysis of the literature on automatic emotional facial expression in people with non-psychotic disorders compared to healthy comparison groups. Studies in the review used an emotionally salient visual induction method, and reported on automatic facial expression in response to congruent stimuli. A total of 39 studies show alterations in emotional facial expression across all included disorders, except anxiety disorders. In depression, decreases in facial expression are mainly evident for positive affect. In eating disorders, a meta-analysis showed decreased facial expressivity in response to positive and negative stimuli. Studies in autism partially support generally decreased facial expressivity in this group. The data included in this review point towards decreased facial emotional expressivity in individuals with different non-psychotic disorders. This is the first review to synthesise facial expression studies across clinical disorders.

Atypical sympathetic arousal in children with autism spectrum disorder and its association with anxiety symptomatology

Background

Autism spectrum disorder (ASD) has been associated with autonomic atypicalities, although the nature of these differences remains largely unknown. Moreover, existing literature suggests large variability in autonomic function in ASD, motivating the need to examine the existence of subgroups that exhibit more homogeneous autonomic features.

Methods

Electrodermal activity (EDA), a non-invasive physiological indicator of autonomic activity, was measured in typically developing children (n = 33) and those with ASD (n = 38) as participants performed tasks that elicit anxiety, attention, response inhibition, and social cognition processes. The ASD group was divided into low- (n = 18) and high-anxiety (n = 20) participants, and the groups were compared to mean EDA level and electrodermal reactions frequency (EDR).

Results

The ASD group had a significantly blunted mean EDA response to the anxiety tasks (p < 0.004). The EDR response to all tasks, except response inhibition, was also blunted in the ASD group (p < 0.04). For this group, EDR frequency during the anxiety and social cognition tasks was negatively correlated with behavioral scores in the domains that were probed by each task (p < 0.002). The high-anxiety ASD group showed significantly decreased mean EDA compared to both the low-anxiety ASD group (p = 0.02) and the typically developing control group (p = 0.04). The high-anxiety ASD group also had significantly more severe symptoms than the low-anxiety ASD group on domains related to anxiety, attention, rule breaking, aggression, obsessions and compulsions, and depression.

Conclusions

Our results suggest atypical autonomic function in children with ASD, specifically with respect to sympathetic activity. Moreover, anxiety symptomatology defined subgroups with distinct physiological and behavioral profiles. Overall, the results add to the body of literature supporting autonomic dysfunction in ASD and highlight the role of anxiety and autonomic features in explaining the variability in the autism spectrum.

Emotional reactivity to social stimuli in patients with eating disorders

Patients with eating disorders often display a wide range of difficulties in psychosocial functioning. Most of the studies on this subject have focused on theory of mind; however, little is known about the subjective emotional reactivity of patients to social situations. The aim of this study was to evaluate the patients' perceptions of their own emotions when viewing pictures with social content. Emotional reactivity was assessed in 85 women (29 with anorexia nervosa, 28 with bulimia nervosa, and 28 healthy controls) by using 30 images from the International Affective Picture System. Images were divided into categories based on its social content and its emotional valence. The emotional response was evaluated through the Self-Assessment Manikin. Patients with bulimia nervosa presented higher arousal and lower control when viewing images with social content of pleasant, unpleasant, and neutral valence. Patients with anorexia nervosa reported higher arousal and lower control only for social images with neutral valence. There were no differences between groups for the control images. The finding of specific differences in emotional reactivity to pictures with social content contributes to a more accurate understanding of the difficulties of patients in social situations.

Brain-computer interface game applications for combined neurofeedback and biofeedback treatment for children on the autism spectrum

Individuals with autism spectrum disorder (ASD) show deficits in social and communicative skills, including imitation, empathy, and shared attention, as well as restricted interests and repetitive patterns of behaviors. Evidence for and against the idea that dysfunctions in the mirror neuron system are involved in imitation and could be one underlying cause for ASD is discussed in this review. Neurofeedback interventions have reduced symptoms in children with ASD by self-regulation of brain rhythms. However, cortical deficiencies are not the only cause of these symptoms. Peripheral physiological activity, such as the heart rate and its variability, is closely linked to neurophysiological signals and associated with social engagement. Therefore, a combined approach targeting the interplay between brain, body, and behavior could be more effective. Brain–computer interface applications for combined neurofeedback and biofeedback treatment for children with ASD are currently nonexistent. To facilitate their use, we have designed an innovative game that includes social interactions and provides neural- and body-based feedback that corresponds directly to the underlying significance of the trained signals as well as to the behavior that is reinforced.

Understanding advanced theory of mind and empathy in high-functioning adults with autism spectrum disorder

It has been argued that higher functioning individuals with autism spectrum disorders (ASDs) have specific deficits in advanced but not simple theory of mind (ToM), yet the questionable ecological validity of some tasks reduces the strength of this assumption. The present study employed The Awareness of Social Inference Test (TASIT), which uses video vignettes to assess comprehension of subtle conversational inferences (sarcasm, lies/deception). Given the proposed relationships between advanced ToM and cognitive and affective empathy, these associations were also investigated. As expected, the high-functioning adults with ASDs demonstrated specific deficits in comprehending the beliefs, intentions, and meaning of nonliteral expressions. They also had significantly lower cognitive and affective empathy. Cognitive empathy was related to ToM and group membership whereas affective empathy was only related to group membership.

Elevated amygdala response to faces and gaze aversion in autism spectrum disorder

Autism spectrum disorders (ASD) are often associated with impairments in judgment of facial expressions. This impairment is often accompanied by diminished eye contact and atypical amygdala responses to face stimuli. The current study used a within-subjects design to examine the effects of natural viewing and an experimental eye-gaze manipulation on amygdala responses to faces. Individuals with ASD showed less gaze toward the eye region of faces relative to a control group. Among individuals with ASD, reduced eye gaze was associated with higher threat ratings of neutral faces. Amygdala signal was elevated in the ASD group relative to controls. This elevated response was further potentiated by experimentally manipulating gaze to the eye region. Potentiation by the gaze manipulation was largest for those individuals who exhibited the least amount of naturally occurring gaze toward the eye region and was associated with their subjective threat ratings. Effects were largest for neutral faces, highlighting the importance of examining neutral faces in the pathophysiology of autism and questioning their use as control stimuli with this population. Overall, our findings provide support for the notion that gaze direction modulates affective response to faces in ASD.

Psychophysiological correlates of social judgement in high-functioning adults with autism spectrum disorder

Neural structures involved in social cognition (e.g., amygdala, orbitofrontal cortex) have been implicated in judgements of trustworthiness. These regions are also functionally atypical in individuals with autism spectrum disorders (ASDs). Studies investigating judgements of trustworthiness in ASDs have suggested possible disruptions in the allocation of significance to social stimuli. Concurrent measures of autonomic responses provide further insight into these deficits, given their role in the direction of attention and allocation of significance. Thirty high-functioning adults with ASDs and 31 non-clinical controls viewed neutral images piloted as most "positive" and "negative." Skin conductance (SCR, SCL) and evoked cardiac deceleration (ECD) were recorded. Adults with ASDs did not differ from controls in ratings of trustworthiness. However, they displayed atypical SCRs, providing further support for a disruption in the allocation of emotional significance.