Misinterpretation of facial expressions of emotion in verbal adults with autism spectrum disorder

Bilingualism Predicts Affective Theory of Mind in Autistic Adults

PURPOSE

This study examined the impact of bilingualism on affective theory of mind (ToM) and social prioritization (SP) among autistic adults compared to neurotypical comparison participants.

METHOD

Fifty-two (25 autistic, 27 neurotypical) adult participants (ages 21-35 years) with varying second language (L2) experience, ranging from monolingual to bilingual, completed an affective ToM task. A subset of this sample also completed a dynamic eye-tracking task designed to capture differences in time spent looking at social aspects of a scene (SP). Four language groups were compared on task performance (monolingual autism and neurotypical, bilingual autism and neurotypical), followed by analyses examining the contribution of L2 experience, autism characteristics, and social face prioritization on affective ToM, controlling for verbal IQ. Finally, we conducted an analysis to identify the contribution of SP on affective ToM when moderated by autism status and L2 experience, controlling for verbal IQ.

RESULTS

The monolingual autism group performed significantly worse than the other three groups (bilingual autism, monolingual neurotypical, and bilingual neurotypical) on the affective ToM task; however, there were no significant differences between the bilingual autism group compared to the monolingual and bilingual neurotypical groups. For autistic individuals, affective ToM capabilities were positively associated with both verbal IQ and L2 experience but did not relate to autism characteristics or SP during eye tracking. Neurotypical participants showed greater SP during the eye-tracking task, and SP did not relate to L2 or autism characteristics for autistic individuals. SP and verbal IQ predicted affective ToM performance across autism and neurotypical groups, but this relationship was moderated by L2 experience; SP more strongly predicted affective ToM performance among participants with lower L2 experience (e.g., monolingual) and had less of an impact for those with higher L2 experience.

CONCLUSION

This study provides support for a bilingual advantage in affective ToM for autistic individuals.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25696083.

Is she still angry? Intact learning but no updating of facial expressions priors in autism

Autistic people exhibit atypical use of prior information when processing simple perceptual stimuli; yet, it remains unclear whether and how these difficulties in using priors extend to complex social stimuli. Here, we compared autistic people without accompanying intellectual disability and nonautistic people in their ability to acquire an "emotional prior" of a facial expression and update this prior to a different facial expression of the same identity. Participants performed a two-interval same/different discrimination task between two facial expressions. To study the acquisition of the prior, we examined how discrimination was modified by the contraction of the perceived facial expressions toward the average of presented stimuli (i.e., regression to the mean). At first, facial expressions surrounded one average emotional prior (mostly sad or angry), and then the average switched (to mostly angry or sad, accordingly). Autistic people exhibited challenges in facial discrimination, and yet acquired the first prior, demonstrating typical regression-to-the-mean effects. However, unlike nonautistic people, autistic people did not update their perception to the second prior, suggesting they are less flexible in updating an acquired prior of emotional expressions. Our findings shed light on the perception of emotional expressions, one of the most pressing challenges in autism.

Neural sensitivity to facial identity and facial expression discrimination in adults with autism

The fluent processing of faces can be challenging for autistic individuals. Here, we assessed the neural sensitivity to rapid changes in subtle facial cues in 23 autistic men and 23 age and IQ matched non-autistic (NA) controls using frequency-tagging electroencephalography (EEG). In oddball paradigms examining the automatic and implicit discrimination of facial identity and facial expression, base rate images were presented at 6 Hz, periodically interleaved every fifth image with an oddball image (i.e. 1.2 Hz oddball frequency). These distinctive frequency tags for base rate and oddball stimuli allowed direct and objective quantification of the neural discrimination responses. We found no large differences in the neural sensitivity of participants in both groups, not for facial identity discrimination, nor for facial expression discrimination. Both groups also showed a clear face-inversion effect, with reduced brain responses for inverted versus upright faces. Furthermore, sad faces generally elicited significantly lower neural amplitudes than angry, fearful and happy faces. The only minor group difference is the larger involvement of high-level right-hemisphere visual areas in NA men for facial expression processing. These findings are discussed from a developmental perspective, as they strikingly contrast with robust face processing deficits observed in autistic children using identical EEG paradigms.

Inferential Emotion Tracking reveals impaired context-based emotion processing in individuals with high Autism Quotient scores

Emotion perception is essential for successful social interactions and maintaining long-term relationships with friends and family. Individuals with autism spectrum disorder (ASD) experience social communication deficits and have reported difficulties in facial expression recognition. However, emotion recognition depends on more than just processing face expression; context is critically important to correctly infer the emotions of others. Whether context-based emotion processing is impacted in those with Autism remains unclear. Here, we used a recently developed context-based emotion perception task, called Inferential Emotion Tracking (IET), and investigated whether individuals who scored high on the Autism Spectrum Quotient (AQ) had deficits in context-based emotion perception. Using 34 videos (including Hollywood movies, home videos, and documentaries), we tested 102 participants as they continuously tracked the affect (valence and arousal) of a blurred-out, invisible character. We found that individual differences in Autism Quotient scores were more strongly correlated with IET task accuracy than they are with traditional face emotion perception tasks. This correlation remained significant even when controlling for potential covarying factors, general intelligence, and performance on traditional face perception tasks. These findings suggest that individuals with ASD may have impaired perception of contextual information, it reveals the importance of developing ecologically relevant emotion perception tasks in order to better assess and treat ASD, and it provides a new direction for further research on context-based emotion perception deficits in ASD.

Face-Selective Patches in Marmosets Are Involved in Dynamic and Static Facial Expression Processing

The correct identification of facial expressions is critical for understanding the intention of others during social communication in the daily life of all primates. Here we used ultra-high-field fMRI at 9.4 T to investigate the neural network activated by facial expressions in awake New World common marmosets from both male and female sex, and to determine the effect of facial motions on this network. We further explored how the face-patch network is involved in the processing of facial expressions. Our results show that dynamic and static facial expressions activate face patches in temporal and frontal areas (O, PV, PD, MD, AD, and PL) as well as in the amygdala, with stronger responses for negative faces, also associated with an increase of the respiration rates of the monkey. Processing of dynamic facial expressions involves an extended network recruiting additional regions not known to be part of the face-processing network, suggesting that face motions may facilitate the recognition of facial expressions. We report for the first time in New World marmosets that the perception and identification of changeable facial expressions, vital for social communication, recruit face-selective brain patches also involved in face detection processing and are associated with an increase of arousal.SIGNIFICANCE STATEMENT Recent research in humans and nonhuman primates has highlighted the importance to correctly recognize and process facial expressions to understand others' emotions in social interactions. The current study focuses on the fMRI responses of emotional facial expressions in the common marmoset (Callithrix jacchus), a New World primate species sharing several similarities of social behavior with humans. Our results reveal that temporal and frontal face patches are involved in both basic face detection and facial expression processing. The specific recruitment of these patches for negative faces associated with an increase of the arousal level show that marmosets process facial expressions of their congener, vital for social communication.

Impairments in recognition of emotional facial expressions, affective prosody, and multisensory facilitation of response time in high-functioning autism

Introduction

Deficits in emotional perception are common in autistic people, but it remains unclear to which extent these perceptual impairments are linked to specific sensory modalities, specific emotions or multisensory facilitation.

Methods

This study aimed to investigate uni- and bimodal perception of emotional cues as well as multisensory facilitation in autistic (n = 18, mean age: 36.72 years, SD: 11.36) compared to non-autistic (n = 18, mean age: 36.41 years, SD: 12.18) people using auditory, visual and audiovisual stimuli.

Results

Lower identification accuracy and longer response time were revealed in high-functioning autistic people. These differences were independent of modality and emotion and showed large effect sizes (Cohen's d 0.8-1.2). Furthermore, multisensory facilitation of response time was observed in non-autistic people that was absent in autistic people, whereas no differences were found in multisensory facilitation of accuracy between the two groups.

Discussion

These findings suggest that processing of auditory and visual components of audiovisual stimuli is carried out more separately in autistic individuals (with equivalent temporal demands required for processing of the respective unimodal cues), but still with similar relative improvement in accuracy, whereas earlier integrative multimodal merging of stimulus properties seems to occur in non-autistic individuals.

The perception of intonational and emotional speech prosody produced with and without a face mask: an exploratory individual differences study

Face masks affect the transmission of speech and obscure facial cues. Here, we examine how this reduction in acoustic and facial information affects a listener's understanding of speech prosody. English sentence pairs that differed in their intonational (statement/question) and emotional (happy/sad) prosody were created. These pairs were recorded by a masked and unmasked speaker and manipulated to contain audio or not. This resulted in a continuum from typical unmasked speech with audio (easiest) to masked speech without audio (hardest). English listeners (N = 129) were tested on their discrimination of these statement/question and happy/sad pairs. We also collected six individual difference measures previously reported to affect various linguistic processes: Autism Spectrum Quotient, musical background, phonological short-term memory (digit span, 2-back), and congruence task (flanker, Simon) behavior. The results indicated that masked statement/question and happy/sad prosodies were harder to discriminate than unmasked prosodies. Masks can therefore make it more difficult to understand a speaker's intended intonation or emotion. Importantly, listeners differed considerably in their ability to understand prosody. When wearing a mask, speakers should try to speak clearer and louder, if possible, and make intentions and emotions explicit to the listener.

Representations of facial expressions since Darwin

Darwin's book on expressions of emotion was one of the first publications to include photographs (Darwin, The expression of the emotions in Man and animals, 1872). The inclusion of expression photographs meant that readers could form their own opinions and could, like Darwin, survey others for their interpretations. As such, the images provided an evidence base and an 'open source'. Since Darwin, increases in the representativeness and realism of emotional expressions have come from the use of composite images, colour, multiple views and dynamic displays. Research on understanding emotional expressions has been aided by the use of computer graphics to interpolate parametrically between different expressions and to extrapolate exaggerations. This review tracks the developments in how emotions are illustrated and studied and considers where to go next.

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.

The Relationship Between Affective Visual Mismatch Negativity and Interpersonal Difficulties Across Autism and Schizotypal Traits

Sensory deficits are a feature of autism and schizophrenia, as well as the upper end of their non-clinical spectra. The mismatch negativity (MMN), an index of pre-attentive auditory processing, is particularly sensitive in detecting such deficits; however, little is known about the relationship between the visual MMN (vMMN) to facial emotions and autism and schizophrenia spectrum symptom domains. We probed the vMMN to happy, sad, and neutral faces in 61 healthy adults (18-40 years, 32 female), and evaluated their degree of autism and schizophrenia spectrum traits using the Autism Spectrum Quotient (AQ) and Schizotypal Personality Questionnaire (SPQ). The vMMN to happy faces was significantly larger than the vMMNs to sad and neutral faces. The vMMN to happy faces was associated with interpersonal difficulties as indexed by AQ Communication and Attention to Detail subscales, and SPQ associated with more interpersonal difficulties. These data suggest that pre-attentive processing of positive affect might be more specific to the interpersonal features associated with autism and schizophrenia. These findings add valuable insights into the growing body of literature investigating symptom-specific neurobiological markers of autism and schizophrenia spectrum conditions.

A functional MRI facial emotion-processing study of autism in individuals with special educational needs

This study aimed to investigate the functional imaging associations of autism in individuals with special educational needs and demonstrate the feasibility of such research. The study included 18 individuals (3 female,15 male; mean age 24.3; mean IQ 69.7) with special educational needs (SEN), of whom 9 met criteria for autism. The task examined the Blood-oxygen-level dependant response to fearful and neutral faces. Individuals in the autism group had 2 clusters of significantly reduced activity centred on the left superior frontal gyrus and left angular gyrus compared to those with SEN alone in response to the fearful faces. In the response to neutral faces, individuals in the autism group also had a cluster of significantly greater activity centred on the right precentral gyrus compared to those with SEN alone. We suggest that autistic characteristics in individuals with SEN are associated with changes in fearful facial emotion processing analogous to those previously reported in autistic individuals without SEN, and who are of average or above average cognitive ability. The finding of enhanced response to neutral facial stimuli needs further investigation, although we speculate this may relate to reports of the experience of 'hyper-mentalisation' in social situations as reported by some autistic individuals.

Examining the role of neuropsychology in community-based pediatric mental health care

Numerous investigations have demonstrated a link between neuropsychological functioning and mental health. Children with a history of neurological compromise are more vulnerable to mental illness and there is a growing literature indicating that neurocognitive functioning predicts psychosocial outcomes in adulthood. However, not much is known about how neuropsychological information is utilized in community-based mental health care. Thus, we examined what neuropsychological information is available to pediatric centers and how neuropsychological functioning relates to treatment outcomes in these settings. Two content analyses were conducted to identify mental health indicators across different intake sources and these results were compared to a structured intake. Further, a series of standardized neurocognitive and neuroemotional measures were completed and these indices were correlated with treatment outcomes. Qualitative results confirmed that neuropsychological factors are often overlooked when utilizing current approaches and that observable symptoms are a primary focus of treatment. Additionally, neurocognitive deficits were associated with self-reported interpersonal difficulties and caregivers' reports of externalizing; however, only caregiver-reported externalizing challenges correlated with treatment outcomes. Importantly, neurocognitive challenges were associated with long-term treatment responses, suggesting that these factors may be an important therapeutic target. Collectively, these findings indicate a need to incorporate neuropsychological factors in pediatric mental health treatment.

Abnormalities of Gray Matter Volume and Its Correlation with Clinical Symptoms in Adolescents with High-Functioning Autism Spectrum Disorder

BACKGROUND

Previous studies have indicated abnormal gray matter volume (GMV) in individuals with autism spectrum disorder (ASD); however, there is little consistency across the findings within these studies, partly due to small sample size and great heterogeneity among participants between studies. Additionally, few studies have explored the correlation between clinical symptoms and GMV abnormalities in individuals with ASD. Here, the current study examined GMV alterations in whole brain and their correlations with clinical symptoms in a relatively large and homogeneous sample of participants with ASD matched typically developing (TD) controls.

METHODS

Forty-eight adolescents with high-functioning ASD and 29 group-matched TD controls underwent structural magnetic resonance images. Voxel-based morphometry was applied to investigate regional GMV alterations. The participants with ASD were examined for the severity of clinical symptoms with Autism Behavior Checklist (ABC). The relationship between GMV abnormalities and clinical symptoms was explored in ASD group using voxel-wise correlation analysis within brain regions that showed significant GMV alterations in individuals with ASD compared with TD controls.

RESULTS

We found increased GMV in multiple brain regions, including the inferior frontal gyrus, medial frontal gyrus, superior frontal gyrus, superior temporal gyrus, occipital pole, anterior cingulate, cerebellum anterior lobe, cerebellum posterior lobe, and midbrain, as well as decreased GMV in cerebellum posterior lobe in individuals with ASD. The correlation analysis showed the GMV in the left fusiform was negatively associated with the scores of sensory factor, and the GMV in the right cerebellum anterior lobe was positively associated with the scores of social self-help factor.

CONCLUSION

Our results indicated that widespread GMV abnormalities of brain regions occurred in individuals with ASD, suggesting a potential neural basis for the pathogenesis and symptomatology of ASD.

Reduced impact of nonverbal cues during integration of verbal and nonverbal emotional information in adults with high-functioning autism

BACKGROUND

When receiving mismatching nonverbal and verbal signals, most people tend to base their judgment regarding the current emotional state of others primarily on nonverbal information. However, individuals with high-functioning autism (HFA) have been described as having difficulties interpreting nonverbal signals. Recognizing emotional states correctly is highly important for successful social interaction. Alterations in perception of nonverbal emotional cues presumably contribute to misunderstanding and impairments in social interactions.

METHODS

To evaluate autism-specific differences in the relative impact of nonverbal and verbal cues, 18 adults with HFA (14 male and four female subjects, mean age 36.7 years (SD 11.4) and 18 age, gender and IQ-matched typically developed controls [14 m/4 f, mean age 36.4 years (SD 12.2)] rated the emotional state of speakers in video sequences with partly mismatching emotional signals. Standardized linear regression coefficients were calculated as a measure of the reliance on the nonverbal and verbal components of the videos for each participant. Regression coefficients were then compared between groups to test the hypothesis that autistic adults base their social evaluations less strongly on nonverbal information. Further exploratory analyses were performed for differences in valence ratings and response times.

RESULTS

Compared to the typically developed control group, nonverbal cue reliance was reduced in adults with high-functioning autism [t(23.14) = -2.44, p = 0.01 (one-sided)]. Furthermore, the exploratory analyses showed a tendency to avoid extreme answers in the HFA group, observable via less positive as well as less negative valence ratings in response to emotional expressions of increasingly strong valence. In addition, response time was generally longer in HFA compared to the control group [F (1, 33) = 10.65, p = 0.004].

CONCLUSION

These findings suggest reduced impact of nonverbal cues and longer processing times in the analysis of multimodal emotional information, which may be associated with a subjectively lower relevance of this information and/or more processing difficulties for people with HFA. The less extreme answering tendency may indicate a lower sensitivity for nonverbal valence expression in HFA or result from a tendency to avoid incorrect answers when confronted with greater uncertainty in interpreting emotional states.

Creation and validation of the Picture-Set of Young Children's Affective Facial Expressions (PSYCAFE)

The immediate detection and correct processing of affective facial expressions are one of the most important competences in social interaction and thus a main subject in emotion and affect research. Generally, studies in these research domains, use pictures of adults who display affective facial expressions as experimental stimuli. However, for studies investigating developmental psychology and attachment behaviour it is necessary to use age-matched stimuli, where it is children that display affective expressions. PSYCAFE represents a newly developed picture-set of children’s faces. It includes reference portraits of girls and boys aged 4 to 6 years averaged digitally from different individual pictures, that were categorized to six basic affects (fear, disgust, happiness, sadness, anger and surprise) plus a neutral facial expression by cluster analysis. This procedure led to deindividualized and affect prototypical portraits. Individual affect expressive portraits of adults from an already validated picture-set (KDEF) were used in a similar way to create affect prototypical images also of adults. The stimulus set has been validated on human observers and entail emotion recognition accuracy rates and scores for intensity, authenticity and likeability ratings of the specific affect displayed. Moreover, the stimuli have also been characterized by the iMotions Facial Expression Analysis Module, providing additional data on probability values representing the likelihood that the stimuli depict the expected affect. Finally, the validation data from human observers and iMotions are compared to data on facial mimicry of healthy adults in response to these portraits, measured by facial EMG (m. zygomaticus major and m. corrugator supercilii).

Socializing Sensorimotor Contingencies

The aim of this review is to highlight the idea of grounding social cognition in sensorimotor interactions shared across agents. We discuss an action-oriented account that emerges from a broader interpretation of the concept of sensorimotor contingencies. We suggest that dynamic informational and sensorimotor coupling across agents can mediate the deployment of action-effect contingencies in social contexts. We propose this concept of socializing sensorimotor contingencies (socSMCs) as a shared framework of analysis for processes within and across brains and bodies, and their physical and social environments. In doing so, we integrate insights from different fields, including neuroscience, psychology, and research on human-robot interaction. We review studies on dynamic embodied interaction and highlight empirical findings that suggest an important role of sensorimotor and informational entrainment in social contexts. Furthermore, we discuss links to closely related concepts, such as enactivism, models of coordination dynamics and others, and clarify differences to approaches that focus on mentalizing and high-level cognitive representations. Moreover, we consider conceptual implications of rethinking cognition as social sensorimotor coupling. The insight that social cognitive phenomena like joint attention, mutual trust or empathy rely heavily on the informational and sensorimotor coupling between agents may provide novel remedies for people with disturbed social cognition and for situations of disturbed social interaction. Furthermore, our proposal has potential applications in the field of human-robot interaction where socSMCs principles might lead to more natural and intuitive interfaces for human users.

Using Self-Management and Visual Cues to Improve Responses to Nonverbal Social Cues in Adults With Autism Spectrum Disorder

Many individuals with Autism Spectrum Disorder (ASD) experience challenges with social communication, including recognizing and responding to non-verbal cues. The purpose of this study was to assess the efficacy of self-management combined with textual cues to teach adults with ASD to recognize and respond to nonverbal expressions of boredom and confusion during social conversation. A multiple baseline across participants design was used to assess the efficacy of this intervention for three participants. Results showed substantial gains across all participants in their recognition and responsiveness to the targeted nonverbal cues. Moreover, this skill maintained after the completion of intervention and generalized to novel conversation partners and settings with large effect sizes. The findings add to the literature base on interventions for adults with ASD, and further support the use of self-management and textual cues as effective intervention strategies for improving nonverbal communication.

The role of context in verbal humor processing in autism

Difficulties in processing humor have been associated with individuals with autism. The current study investigated whether humor comprehension and appreciation could be augmented in children with autism by providing contextual support suggesting that humor was to be expected. A verbally presented riddle task was used in which participants were assessed for their subjective ratings and comprehension of the materials. They were also filmed to record any smiling or laughing. Both riddles and control stimuli were presented with supporting verbal context and also without it. The results showed that (a) the greater subjective appreciation of riddles than of control stimuli was dependent on the provision of context for the participants with autism and that (b) context statistically equated these ratings of riddles between participants with autism and matched typically developing controls. However, context had no effect on comprehension or affective response. The results of the current study demonstrate that children with autism are, even in the most conservative interpretation, able to use verbal context to recognize verbal humor. This lays the foundation of possible interventions based on training sensitivity to context.

Blocking facial mimicry during binocular rivalry modulates visual awareness of faces with a neutral expression

Several previous studies have interfered with the observer’s facial mimicry during a variety of facial expression recognition tasks providing evidence in favor of the role of facial mimicry and sensorimotor activity in emotion processing. In this theoretical context, a particularly intriguing facet has been neglected, namely whether blocking facial mimicry modulates conscious perception of facial expressions of emotions. To address this issue, we used a binocular rivalry paradigm, in which two dissimilar stimuli presented to the two eyes alternatingly dominate conscious perception. On each trial, female participants (N = 32) were exposed to a rivalrous pair of a neutral and a happy expression of the same individual through anaglyph glasses in two conditions: in one, they could freely use their facial mimicry, in the other they had to keep a chopstick between their lips, constraining the mobility of the zygomatic muscle and producing ‘noise’ for sensorimotor simulation. We found that blocking facial mimicry affected the perceptual dominance in terms of cumulative time favoring neutral faces, but it did not change the time before the first dominance was established. Taken together, our results open a door to future investigation of the intersection between sensorimotor simulation models and conscious perception of emotional facial expressions.

Atypical spatiotemporal activation of cerebellar lobules during emotional face processing in adolescents with autism

Autism spectrum disorder (ASD) is characterized by social deficits and atypical facial processing of emotional expressions. The underlying neuropathology of these abnormalities is still unclear. Recent studies implicate cerebellum in emotional processing; other studies show cerebellar abnormalities in ASD. Here, we elucidate the spatiotemporal activation of cerebellar lobules in ASD during emotional processing of happy and angry faces in adolescents with ASD and typically developing (TD) controls. Using magnetoencephalography, we calculated dynamic statistical parametric maps across a period of 500 ms after emotional stimuli onset and determined differences between group activity to happy and angry emotions. Following happy face presentation, adolescents with ASD exhibited only left‐hemispheric cerebellar activation in a cluster extending from lobule VI to lobule V (compared to TD controls). Following angry face presentation, adolescents with ASD exhibited only midline cerebellar activation (posterior IX vermis). Our findings indicate an early (125–175 ms) overactivation in cerebellar activity only for happy faces and a later overactivation for both happy (250–450 ms) and angry (250–350 ms) faces in adolescents with ASD. The prioritized hemispheric activity (happy faces) could reflect the promotion of a more flexible and adaptive social behavior, while the latter midline activity (angry faces) may guide conforming behavior.

The spatial distribution of eye movements predicts the (false) recognition of emotional facial expressions

Recognizing facial expressions of emotions is a fundamental ability for adaptation to the social environment. To date, it remains unclear whether the spatial distribution of eye movements predicts accurate recognition or, on the contrary, confusion in the recognition of facial emotions. In the present study, we asked participants to recognize facial emotions while monitoring their gaze behavior using eye-tracking technology. In Experiment 1a, 40 participants (20 women) performed a classic facial emotion recognition task with a 5-choice procedure (anger, disgust, fear, happiness, sadness). In Experiment 1b, a second group of 40 participants (20 women) was exposed to the same materials and procedure except that they were instructed to say whether (i.e., Yes/No response) the face expressed a specific emotion (e.g., anger), with the five emotion categories tested in distinct blocks. In Experiment 2, two groups of 32 participants performed the same task as in Experiment 1a while exposed to partial facial expressions composed of actions units (AUs) present or absent in some parts of the face (top, middle, or bottom). The coding of the AUs produced by the models showed complex facial configurations for most emotional expressions, with several AUs in common. Eye-tracking data indicated that relevant facial actions were actively gazed at by the decoders during both accurate recognition and errors. False recognition was mainly associated with the additional visual exploration of less relevant facial actions in regions containing ambiguous AUs or AUs relevant to other emotional expressions. Finally, the recognition of facial emotions from partial expressions showed that no single facial actions were necessary to effectively communicate an emotional state. In contrast, the recognition of facial emotions relied on the integration of a complex set of facial cues.

Impaired Recognition of Static and Dynamic Facial Emotions in Children With Autism Spectrum Disorder Using Stimuli of Varying Intensities, Different Genders, and Age Ranges Faces

A multitude of research on facial emotion recognition (FER) in Autism Spectrum Disorders (ASD) have been published since several years. However, these studies have mainly used static high intensity stimuli, including adult and/or children facial emotions. This current study investigated FER in children with ASD using an innovative task, composed of a combination of static (114 pictures) and dynamic (36 videos) subtests, including children, adolescent, and adult male and female faces, with high, medium, and low intensity of basic facial emotions, and neutral expression. The ASD group consisted of 45 Tunisian verbal children, and the control group consisted of 117 tunisian typically developing children. Both groups were aged 7-12 years. After adjusting for sex, age, mental age, and school grade, the ASD group scored lower than controls on all tests except for the recognition of happiness and fear in the static subtest, and the recognition of happiness, fear, and sadness in the dynamic subtest (p ≥ 0.05). In the ASD group, the total score of both the static and the dynamic subtest were positively correlated with the school grade (p < 0.001), but not with age, or mental age. Children with ASD performed better in recognizing facial emotions in children than in adults and adolescents on videos and photos (p < 0.001). Impairments in FER would have negative impact on the child's social development. Thus, the creation of new intervention instruments aiming to improve emotion recognition strategies at an early stage to individuals with ASD seems fundamental.

From structure to concepts: The two stages of facial expression recognition

Facial expressions are the dominant way of human emotional and social communications. However, it remains unclear that how can perceivers extract emotion from the face. In the present study, we adopted a repetition-priming paradigm in combine with event-related potentials (ERP) to examine neurocognitive processing stages of facial expression perception. Results showed that emotional words were recognized faster than emotional faces, when both of which were primed by emotional faces, indicating the involvement of concepts processes in facial expression recognition. ERP results showed that all emotional faces could evoke responses of N170, while there was no significant difference between positive and negative emotional faces, suggesting that geometrical configurations of faces rather than emotional concepts of faces are processed at the stage of N170. In contrast, both emotional words and faces showed larger P2 in response to anger than happiness, which suggests that emotional concepts are extracted from faces at the stage of P2. To examine the underlying dynamic causal connectivity between facial structure and emotional conception, we conducted information flow analysis, which showed significant decreases of information flow from the fusiform gyrus to dorsal anterior cingulate cortex/dorsal medial prefrontal cortex and increases of information flow from the fusiform gyrus to posterior insula. These results revealed neural mechanisms underlying processes from physical structure to emotional concepts. Our findings suggest that facial expression recognition consists of two stages from geometrical structure of faces to emotional concepts of facial expressions, which provides evidence for facial expression processing and has important implications in the diagnosis and treatment of emotion recognition related disorders.

The Role of Diagnostic Instruments in Dual and Differential Diagnosis in Autism Spectrum Disorder Across the Lifespan

The heterogeneity inherent in autism spectrum disorder (ASD) makes the identification and diagnosis of ASD complex. We survey a large number of diagnostic tools, including screeners and tools designed for in-depth assessment. We also discuss the challenges presented by overlapping symptomatology between ASD and other disorders and the need to determine whether a diagnosis of ASD or another diagnosis best explains the individual's symptoms. We conclude with a call to action for the next steps necessary for meeting the diagnostic challenges presented here to improve the diagnostic process and to help understand each individual's particular ASD profile.

The role of the MTG in negative emotional processing in young adults with autistic-like traits: A fMRI task study

BACKGROUND

Few previous studies explored negative emotion processing in autistic-like traits people using task-based fMRI. In this study, we applied task fMRI to determine the relationship between negative emotion processing and social skill within autistic-like traits people. aimed to find which brain areas specificity play a key role in emotional processing.

METHODS

106 of Chinese individuals measured with AQ. Then applied emotion regulation task to explore the difference in brain activation and functional connectivity in individuals with autistic traits.

RESULTS

The results showed increased activation in the right middle temporal gyrus (MTG). The mediation analysis showed the right MTG mediates the relationship between autistic-like traits and negative emotion. Generalized psychophysiological interaction (gPPI) analysis also suggested that the right MTG shows significant functional connectivity with the left parahippocampal gyrus (PHG) and left precuneus cortex.

LIMITATIONS

Our sample are university students, there may have a bias in the sample compared to sub-average and have no differences between the gender, we will broaden the sample size and take the gender into account. We use two conditions as our focused theme, we want to use a more specific task to explore negative emotion in autistic-like traits people.

CONCLUSIONS

The results showed that the right MTG was an important brain region in individuals with autistic-like traits, and our study provides a wider discussion about autism brain activation and functional connectivity patterns and the use the MTG as a hallmark in individuals with autistic-like traits.

Cognitive and Social Cognitive Self-assessment in Autistic Adults

An aspect of metacognition associated with broader functional abilities in several clinical conditions, but previously unexamined in autism, is self-assessment (i.e., the ability to accurately self-evaluate one's own performance). We compared self-assessment between 37 autistic adults without intellectual disability to 39 non-autistic (NA) controls on a series of three general cognitive and three social cognitive tasks. Whereas autistic adults and NA adults did not differ in their self-assessment accuracy on general cognitive tasks, they did on social cognitive tasks, with autistic adults demonstrating lower accuracy. The direction of their inaccuracy was variable (i.e., both over and underestimation), and self-assessment was largely unrelated to their level of social functioning. Over versus underestimation may have different functional implications, and warrants future investigation.

The Role of Diagnostic Instruments in Dual and Differential Diagnosis in Autism Spectrum Disorder Across the Lifespan

The heterogeneity inherent in autism spectrum disorder (ASD) makes the identification and diagnosis of ASD complex. We survey a large number of diagnostic tools, including screeners and tools designed for in-depth assessment. We also discuss the challenges presented by overlapping symptomatology between ASD and other disorders and the need to determine whether a diagnosis of ASD or another diagnosis best explains the individual's symptoms. We conclude with a call to action for the next steps necessary for meeting the diagnostic challenges presented here to improve the diagnostic process and to help understand each individual's particular ASD profile.

Developing the Multidimensional Visual Scale Assessing Affect, Anxiety, Pride, and Energy Through a Research Partnership with Autistic Scholars

Autism research studies have traditionally failed to represent the full diversity of the autism spectrum due to the lack of measures available for use with participants who prefer to express themselves visually. A multidimensional measure of emotions, which can include both picture- and text-based prompts, may improve accessibility of emotion rating measures and broaden participation in research and educational evaluations to include those who communicate in diverse ways. Picture-based measures designed to assess participants' emotions may be useful for research concerning autistic identity and service evaluation, two areas where representation of diverse perspectives is needed. Our participatory group of autistic and nonautistic researchers developed a Multidimensional Visual Scale Assessing Affect, Anxiety, Pride, and Energy (AAPE) by adapting and expanding upon an existing emotion rating scale. When testing the AAPE with autistic college students (n = 72), their open-ended responses indicated that the AAPE's dimensions of affect (97.2% correct), anxiety (79.2% correct), and energy (84.7% correct) were well comprehended without text-based labels with potential for improvement in how pride (52.8% correct) was represented. When provided with the labels that each dimension was intended to represent, participants generally agreed that each emotional dimension was well represented. When tested in an informal educational summer camp with autistic children and adolescents (n = 50), the AAPE was well received and revealed insights about the students' emotional responses to different instructional strategies that can guide curricular improvements. The AAPE has utility as a tool to help diverse autistic individuals self-advocate and improve research and services.

Lay summary

Why was this study done?: There are very few tools that autistic people can use to share how they feel. We wanted to develop a tool to help autistic people express their emotions using pictures. Pictures can help autistic people share how they feel.What was the purpose of this study?: We wanted to make an easy-to-understand tool that autistic people can use to share how they feel.What did the researchers do?: Our research group is participatory, meaning that autistic and nonautistic researchers worked together to make our tool. An autistic artist drew the tool. We called it the AAPE, which stands for the emotions it assesses: Affect, Anxiety, Pride, and Energy. We worked together to see how well the AAPE worked. We used a survey to see if autistic high school and college students understood our first try at the AAPE and we learned how to make the AAPE better from these students. We worked together to make the AAPE better. Then, we did another survey with autistic college students to see if our second try at the AAPE worked better. Then, we asked autistic kids and teenagers to use the AAPE to share how they felt about different ways of teaching.What were the results of the study?: In our final test, we asked 72 autistic college students to tell us what emotions they thought the AAPE was showing. College students thought that affect (97.2%), anxiety (79.2%), and energy (84.7%) showed the emotions we aimed to show with room for improvement in how pride (52.8%) was shown. After we told participants which emotion each scale was showing, they agreed that affect (average score 4.28 of 5) and anxiety (4.29 of 5) showed the emotions best, followed by energy (4.08 of 5) and pride (3.5 of 5) on a scale from 1 to 5 (strongly agree).Students preferred using the AAPE compared with text-based surveys we used in the past. Results showed that the AAPE does a good job at measuring emotions. Edits may still be needed to better show "pride." Work is needed with nonspeaking people to make sure our measure works well for people who communicate in different ways.What are potential weaknesses in the study?: The autistic adolescents and adults we have tested the AAPE with so far have not been very diverse. We did not include participants who communicate without speaking in these first tests of the AAPE. We plan to use the AAPE with more diverse groups in future studies.How will these findings help autistic adults now or in the future?: In a future study, we will use the AAPE to rate pictures that show experiences of being autistic, like feeling outside a social group, having sensory difficulties, and making patterns. We would like to do this because some studies talk about negative experiences of autism, like feeling the need to hide autistic traits, but other studies describe strengths of autism, like strong memories and advanced knowledge in particular subjects. However, these studies do not talk about the emotions that come with these experiences and if these experiences are shared with autistic people who do not use speech to communicate. The AAPE is a tool that might help us understand how diverse autistic people feel about autism.

Atypical Visual Processing but Comparable Levels of Emotion Recognition in Adults with Autism During the Processing of Social Scenes

Understanding the underlying visual scanning patterns of individuals with autism spectrum disorder (ASD) during the processing of complex emotional scenes remains limited. This study compared the complex emotion recognition performance of adults with ASD (n = 23) and matched neurotypical participants (n = 25) using the Reading the Mind in Films Task. Behaviourally, both groups exhibited similar emotion recognition accuracy. Visual fixation time towards key social regions of each stimuli was examined via eye tracking. Individuals with ASD demonstrated significantly longer fixation time towards the non-social areas. No group differences were evident for the facial and body regions of all characters in the social scenes. The findings provide evidence of the heterogeneity associated with complex emotion processing in individuals with ASD.

Are you angry at me? Negative interpretations of neutral facial expressions are linked to child maltreatment but not to posttraumatic stress disorder

Background: Individuals with a high prevalence of child maltreatment, e.g. those with borderline personality disorder, tend to see neutral facial expressions as negative. Objective: Our aim was to assess whether this bias is present in individuals with posttraumatic stress disorder (PTSD) and whether it is linked to child maltreatment. Methods: Thirty-nine PTSD participants, 44 traumatized and 35 non-traumatized healthy controls watched 300 one-second movies showing 30 neutral and 270 emotional facial expressions, and indicated whether they interpreted each as a neutral or as one of nine emotional expressions. Results: PTSD individuals did not perform differently than the two control groups in the recognition and interpretation of neutral facial expressions (p's < .300). Higher levels of childhood sexual and emotional abuse, and physical neglect were linked to more interpretations of neutral facial expressions as contempt (p's < .043), and (for sexual abuse and physical neglect) to more interpretations of neutral facial expressions as anger (p's < .014). Comparisons of statistical model fits suggested that childhood sexual abuse was the most relevant predictor of recognition accuracy in our sample. Alexithymia, state dissociation, interpersonal trauma, and number of experienced trauma types were not associated with deficits in the interpretation of neutral expressions. Conclusions: Child maltreatment, especially sexual abuse, may shape the interpretation of neutral facial expressions. Future research should explore whether the observed biases extend to real-life situations. If so, therapists might improve the therapeutic relationship with patients with a history of child maltreatment by paying more attention to their own non-verbal communication and their patients' responses to it. Furthermore, similarly to individuals with high depressive and high social anxiety symptoms, facial expression recognition training might counteract negativity bias in individuals with a history of childhood (sexual and emotional) abuse, and (physical) neglect.

Autism Symptoms Modulate Interpersonal Neural Synchronization in Children with Autism Spectrum Disorder in Cooperative Interactions

Previous neuroscience studies exploring the neural mechanisms of social deficits of individuals with autism spectrum disorder (ASD) have mainly examined single participants' brain responses to pictures or video-clips displayed on a monitor from the perspective of a passive observer. The present study examined inter-brain communication between children with ASD and their parents in a socio-interactive context. We used a functional near-infrared spectroscopy (fNIRS)-based hyperscanning technique to simultaneously measure the prefrontal activations in 16 pairs of children with ASD and their parents in a two-person key-press task. The children's task was to press a key together with their parents in a cooperation condition when a "go" signal was present or to press a key as fast as possible under the observation by their parents in a single-person condition. We also measured children's severity of autism symptoms.We found that children with ASD showed increased interpersonal neural synchronization in the frontal cortex when engaging in cooperative interactions with their parents than when performing solo and non-interactive behaviors. Furthermore, this neural synchronization was modulated by the children's autism symptoms, which also covaried with their cooperation task performance. That is, children with severer autism symptoms showed lower level of action and neural synchronization with their parents during cooperation. Our study moved a major step forward in understanding the neural correlates underlying social deficits in ASD and provided important implications for the treatment and behavioral training of ASD.

Impaired Recognition of Basic Emotions from Facial Expressions in Young People with Autism Spectrum Disorder: Assessing the Importance of Expression Intensity

It has been proposed that impairments in emotion recognition in ASD are greater for more subtle expressions of emotion. We measured recognition of 6 basic facial expressions at 8 intensity levels in young people (6-16 years) with ASD (N = 63) and controls (N = 64) via an Internet platform. Participants with ASD were less accurate than controls at labelling expressions across intensity levels, although differences at very low levels were not detected due to floor effects. Recognition accuracy did not correlate with parent-reported social functioning in either group. These findings provide further evidence for an impairment in recognition of basic emotion in ASD and do not support the idea that this impairment is limited solely to low intensity expressions.

Electrophysiological evidence of altered facial expressions recognition in Alzheimer's disease: A comprehensive ERP study

OBJECTIVES

The present study aims to evaluate the amplitude and latency of event-related potentials (ERPs) P100, N170, VPP and N230 in individuals with Alzheimer's disease (AD) compared to healthy elderly controls, using a passive viewing task of emotional facial expressions.

METHODS

Twenty-four individuals with mild to moderate AD and 23 demographically matched healthy elderly controls were included in the study. ERP P100, N170, VPP and N230 amplitude and latency values were compared between groups.

RESULTS

The categorization of emotional facial expressions was intact; yet, increased P100 amplitude and latency, decreased N170 amplitude, and increased VPP amplitude were observed in AD compared to controls. Increased N230 amplitude and latency were observed in response to angry expressions, while neutral expressions elicited decreased amplitude and latency.

CONCLUSIONS

Increased P100 amplitude and latency may reflect reduced amygdala volume and disruptions in the visual system, while decreased N170 and increased VPP amplitudes may reflect impaired perceptual processing, mitigated by a greater involvement of prefrontal areas for task performance in AD.

SIGNIFICANCE

This study is the first to report a complex pattern of ERPs to emotional facial expressions in individuals with AD.

Group Differences in Facial Emotion Expression in Autism: Evidence for the Utility of Machine Classification

Effective social communication relies, in part, on accurate nonverbal expression of emotion. To evaluate the nature of facial emotion expression (FEE) deficits in children with autism spectrum disorder (ASD), we compared 20 youths with ASD to a sample of typically developing (TD) youth (n = 20) using a machine-based classifier of FEE. Results indicate group differences in FEE for overall accuracy across emotions. In particular, a significant group difference in accuracy of FEE was observed when participants were prompted by a video of a human expressing an emotion, F(2, 36) = 4.99, p = .032, η2 = .12. Specifically, youth with ASD made significantly more errors in FEE relative to TD youth. Findings support continued refinement of machine-based approaches to assess and potentially remediate FEE impairment in youth with ASD.

Effects of Cognitive Behavioral Therapy, Existential Psychotherapy and Supportive Counselling on Facial Emotion Recognition Among Patients with Mild or Moderate Depression

OBJECTIVE

This study compared the effects of cognitive behavioral therapy (CBT), existential psychotherapy (ExP) and supportive counseling (SUP) on facial emotion recognition among mildly and moderately depressed patients.

METHODS

21 patients for CBT, and 20 each for ExP and SUP groups with 60 healthy controls were investigated. Eight consecutive weekly sessions and following two monthly boosters were performed. Prior to the sessions, all subjects received Sociodemographic Data Form, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-1), and Facial Emotion Recognition Test (FERT). Patients received Hamilton Depression Rating Scale (HDRS) and FERT at the onset and after weekly and booster sessions.

RESULTS

Patients' ability to recognize surprised and neutral emotions were lower than controls. ExP group improved recognition of almost all emotions, CBT group improved only happy emotions and SUP group did not improve any emotions. HDRS scores declined in all patient groups, ExP and CBT groups had lower scores than SUP.

CONCLUSION

MDD patients recognized surprised and neutral emotions lower than controls. ExP improved ability to recognize almost all emotions, CBT improved only happy emotions, SUP did not improve at all. ExP, CBT and SUP all led to a reduction in MDD. ExP and CBT had comparable effects and both were more helpful than SUP.

Psychometric Evaluation of Social Cognitive Measures for Adults with Autism

Although social cognition is frequently identified as a target in clinical trials and psychosocial interventions for adults with autism spectrum disorder (ASD), these efforts are hampered by a lack of consensus and validation of social cognitive measures. The current study provides psychometric evaluation of 11 frequently used measures encompassing different subdomains of social cognition. Adults with autism (N = 103) and typically developing controls (N = 95) completed 11 commonly used social cognitive tasks spanning the domains of emotion processing, social perception, and mentalizing/theory of mind. We examined each measure's internal reliability and sensitivity to group differences, how performance related to general intellectual ability, and alignment of measures with a proposed two-factor structure of social cognition in ASD. Controls outperformed the ASD group on 8 of the 11 social cognitive tasks, with the largest group differences occurring on two mentalizing measures, The awareness of social inference task (TASIT) and hinting task. In ASD, all tasks demonstrated strong internal consistency and avoided ceiling and floor effects. Social cognitive performance was also related to, but not redundant with, intellectual functioning. We also found support for a two-factor structure of social cognition, with basic social perception and emotional processing aligning into a lower-order social perception factor, while mentalizing tasks aligned into a higher-order social appraisal factor. In sum, eight tasks showed adequate to strong psychometric properties. The psychometric data, effect size estimates, and correlations between measures reported here can be used for study planning for social cognitive interventions in autism. Autism Research 2019, 12: 766-778. © 2019 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. LAY SUMMARY: We examined 11 tasks that measure how adults with autism perceive and interpret social information. Eight of the tasks were reliable and showed lower performance in adults with autism compared to typically-developing controls. Task performance was related to but distinguishable from IQ. These measures evaluated here may be useful in assessing the effectiveness of interventions and treatments to improve social abilities in adults with autism.

Happy and Angry Faces Elicit Atypical Neural Activation in Children With Autism Spectrum Disorder

BACKGROUND

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by significant impairments in social interactions and communication. The ability to accurately perceive and interpret emotional faces is critical to successful social interactions. However, few studies have investigated the spatiotemporal profile of the neural mechanisms underlying emotional face processing in ASD, particularly in children. The current study fills this important gap.

METHODS

Participants were 55 children: 28 children with ASD (mean age = 9.5 ± 1.3 years) and 27 control children (mean age = 8.5 ± 1.3 years). All children completed an implicit emotional face task while magnetoencephalography was recorded. We examined spatiotemporal differences between the groups in neural activation during implicit processing of emotional faces.

RESULTS

Within-group analyses demonstrated greater right middle temporal (300-375 ms) and superior temporal (300-400 ms) activation to angry faces than to happy faces in control children, while children with ASD showed greater activation from 250 to 500 ms to happy faces than to angry faces across frontal and temporal regions. Between-group analyses demonstrated that children with ASD showed similar patterns of late (425-500 ms) posterior cingulate and thalamic underactivity to both angry and happy faces relative to control children, suggesting general atypical processing of emotional information.

CONCLUSIONS

Atypical posterior cingulate cortex and thalamus recruitment in children with ASD to emotional faces suggests poor modulation of toggling between the default mode network and task-based processing. Increased neural activity to happy faces compared with angry faces in children with ASD suggests reduced salience or immature response to anger, which in turn could contribute to deficits in social cognition in ASD.

Deficits in facial emotion recognition and implicit attitudes toward emotion among adolescents with high functioning autism spectrum disorder

OBJECTIVE

Impaired social interaction is one of the core characteristics of autism spectrum disorder (ASD). This study was conducted to compare the facial emotion recognition (FER) abilities and emotional interference of adolescents with and without high-functioning ASD by performing the FER Task (FERT) using the faces of Taiwanese people and the Implicit Association Test (IAT), respectively.

METHODS

This study recruited 71 adolescents with high-functioning ASD who aged at 11 to 18 years old as the ASD group and 63 adolescents without ASD from the Taiwanese community as the non-ASD group. We investigated FER abilities by conducting the FERT on six types of emotional expression with a three-level intensity rating, and we performed the IAT for evaluating the strength of a person's automatic association with mental representations of emotions in memory.

RESULTS

Compared with the non-ASD group, the ASD group performed significantly worse on facial emotion differentiation and the ranking and rating of emotional intensity in the FERT. The ASD group had higher IAT scores than the non-ASD group.

CONCLUSION

The results suggest that adolescents with high-functioning ASD have subtle deficits in facial emotion processing and emotional interference.

Automatic Recognition of Posed Facial Expression of Emotion in Individuals with Autism Spectrum Disorder

Facial expression is impaired in autism spectrum disorder (ASD), but rarely systematically studied. We focus on the ability of individuals with ASD to produce facial expressions of emotions in response to a verbal prompt. We used the Janssen Autism Knowledge Engine (JAKE^®), including automated facial expression analysis software (FACET) to measure facial expressions in individuals with ASD (n = 144) and a typically developing (TD) comparison group (n = 41). Differences in ability to produce facial expressions were observed between ASD and TD groups, demonstrated by activation of facial action units (happy, scared, surprised, disgusted, but not angry or sad). Activation of facial action units correlated with parent-reported social communication skills. This approach has potential for diagnostic and response to intervention measures.Trial Registration NCT02299700.

Patterns of Nonsocial and Social Cognitive Functioning in Adults With Autism Spectrum Disorder: A Systematic Review and Meta-analysis

IMPORTANCE

Many studies have investigated impairments in cognitive domains in adults with autism spectrum disorder (ASD). Yet, to date, a comprehensive overview on the patterns of cognitive functioning is lacking.

OBJECTIVE

To provide an overview of nonsocial and social cognitive functioning in various domains in adults with ASD, allowing for comparison of the severity of deficits between different domains.

DATA SOURCES

A literature search performed in an academic medical setting was conducted using PubMed, PsycINFO, Embase, and Medline databases with the combination of the following free-text and Medical Subject Headings where applicable: [cogniti* OR neurocogniti* OR neuropsycholog* OR executive function* OR IQ OR intelligence quotient OR social cognition OR emotion perception OR affect perception OR emotion recognition OR attribution OR ToM OR mentalising OR mentalizing OR prosody OR social knowledge OR mind reading OR social cue OR social judgment] AND [autis* OR ASD OR Asperger OR Asperger's OR PDD OR pervasive developmental disorder]. The search was further limited to studies published between 1980 (first inclusion of autism diagnosis in the DSM-III) and July 2018.

STUDY SELECTION

Studies included were published as a primary peer-reviewed research article in English, included individuals with ASD 16 years or older, and assessed at least 1 domain of neurocognitive functioning or social cognition using standard measures.

DATA EXTRACTION AND SYNTHESIS

Of 9892 articles identified and screened, 75 met the inclusion criteria for the systematic review and meta-analysis.

MAIN OUTCOMES AND MEASURES

Hedges g effect sizes were computed, and random-effects models were used for all analyses. Moderators of between-study variability in effect sizes were assessed using meta-regressions.

RESULTS

The systematic review and meta-analysis included 75 studies, with a combined sample of 3361 individuals with ASD (mean [SD] age, 32.0 [9.3] years; 75.9% male) and 5344 neurotypical adults (mean [SD] age, 32.3 [9.1] years; 70.1% male). Adults with ASD showed large impairments in theory of mind (g = -1.09; 95% CI, -1.25 to -0.92; number of studies = 39) and emotion perception and processing (g = -0.80; 95% CI, -1.04 to -0.55; n = 18), followed by medium impairments in processing speed (g = -0.61; 95% CI, -0.83 to -0.38; n = 21) and verbal learning and memory (g = -0.55; 95% CI, -0.86 to -0.25; n = 12). The least altered cognitive domains were attention and vigilance (g = -0.30; 95% CI, -0.81 to 0.21; n = 5) and working memory (g = -0.23; 95% CI, -0.47 to 0.01; n = 19). Meta-regressions confirmed robustness of the results.

CONCLUSIONS AND RELEVANCE

Results of this systematic review and meta-analysis suggest that adults with ASD show impairments in social cognitive domains and in specific nonsocial cognitive domains. These findings contribute to the understanding of the patterns of cognitive functioning in adults with ASD and may assist in the identification of targets for cognitive interventions.

Emotion recognition from the eye region in children with and without Autism Spectrum Disorder in Arab and Scandinavian countries

BACKGROUND

Difficulties in facial emotion recognition (ER) skills are linked to autism spectrum disorder (ASD) in studies performed in Western and Eastern Asian countries. However, there is a paucity of research examining ER skills in Arab countries, where face-covering veils are more common than in Western countries.

OBJECTIVE

Our aim was to examine basic ER and ER error patterns in Egyptian and Finnish children with and without ASD.

METHOD

We employed the eye-submodule of the Frankfurt Test and Training of Facial Affect Recognition (FEFA) and the Autism Spectrum Screening Questionnaire (ASSQ).

RESULTS

Arab children with ASD (n = 34, M age = 8.6 years, FSIQ = 96.7) recognized correctly fewer emotions than did Scandinavian children with ASD (n = 32, M age = 12.5 years, FSIQ = 102.8) and Arab typically developing (TD) children (n = 34, M age = 10.3 years, FSIQ = 123.4) in general and specifically on surprise, disgust and neutral scales as well as on a blended emotion scale. Scandinavian children with ASD demonstrated a lower ability to recognize emotions in general and specifically happiness than did Scandinavian TD children. There were no differences between Arab and Scandinavian (n = 28, M age = 13.9 years) TD children in ER accuracy. We found country specific differences in ER error patterns in happiness, sadness and anger: Arab children interpreted these emotions more often as another emotion (happiness = sadness, sadness = anger, anger = sadness and surprise), whereas Scandinavian children interpreted happiness and sadness as neutral expression and anger as disgust. Arab children with ASD labeled sadness and anger in their ER error patterns more negatively than did Arab TD children, but there were no differences between Scandinavian children with ASD and TD in ER error patterns.

CONCLUSIONS

The differences between the Arab and Scandinavian children may reflect cultural differences in ER and ER error patterns.

Pupil response to social-emotional material is associated with rumination and depressive symptoms in adults with autism spectrum disorder

Background

Autism spectrum disorder (ASD) is marked by repetitive thinking and high rates of depression. Understanding the extent to which repetitive negative thinking in ASD reflects autistic stereotypy versus general depressive thinking patterns (e.g., rumination) could help guide treatment research to improve emotional health in ASD. We compared associations between rumination, depressive symptoms, and pupil response to social-emotional material in adults with ASD and typically developing (TD) adults with and without depression.

Methods

N = 53 verbally fluent young adults were recruited to three cohorts: ASD, n = 21; TD-depressed, n = 13; never-depressed TD-controls, n = 19. Participants completed Ruminative Response Scale and Beck Depression Inventory self-reports and a passive-viewing task employing emotionally-expressive faces, during which pupillary motility was assessed to quantify cognitive-affective load. Main and interactive effects of cohort, emotion condition, and time on pupil amplitude were tested via a linear mixed effects analysis of variance using restricted maximum likelihood estimation. Similar procedures were used to test for effects of rumination and depressive symptoms on pupil amplitude over time within ASD.

Results

Responsive pupil dilation in the ASD cohort tended to be significantly lower than TD-depressed initially but increased to comparable levels by trial end. When viewing sad faces, individuals with ASD who had higher depression scores resembled TD-depressed participants’ faster, larger, and sustained pupil response. Within ASD, depressive symptoms uniquely predicted early pupil response to sad faces, while rumination and depression scores each independently predicted sustained pupil response.

Conclusions

People with elevated depressive symptoms appear to have faster and greater increases in pupil-indexed neural activation following sad stimuli, regardless of ASD status, suggesting the utility of conceptualizing rumination as depression-like in treatment. Ruminative processes may increase more slowly in ASD, suggesting the potential utility of interventions that decrease reactions before they are uncontrollable. Findings also reinforce the importance of testing for effects of internalizing variables in broader ASD research.

Brief Report: Is Impaired Classification of Subtle Facial Expressions in Children with Autism Spectrum Disorders Related to Atypical Emotion Category Boundaries?

Impairments in recognizing subtle facial expressions, in individuals with autism spectrum disorder (ASD), may relate to difficulties in constructing prototypes of these expressions. Eighteen children with predominantly intellectual low-functioning ASD (LFA, IQ <80) and two control groups (mental and chronological age matched), were assessed for their ability to classify emotional faces, of high, medium and low intensities, as happy or angry. For anger, the LFA group made more errors for lower intensity expressions than the control groups, classifications did not differ for happiness. This is the first study to find that the LFA group made more across-valence errors than controls. These data are consistent with atypical facial expression processing in ASD being associated with differences in the structure of emotion categories.

Brief Report: Adults with Autism are Less Accurate at Predicting How Their Personality Traits are Evaluated by Unfamiliar Observers

Social cognitive impairments in autism spectrum disorder (ASD) are well-documented, yet little research has examined whether ASD is also characterized by difficulties in meta-perception, or the ability to gauge how one is perceived. In this study, ASD and TD adults (N = 22) largely did not differ on the self-perception of their personality traits or on how they expected to be perceived by unfamiliar observers. However adults with ASD were rated less favorably by TD observers (N = 412) on 19 out of 20 personality items, and adults with ASD were less accurate at predicting how they would be perceived. These findings suggest impaired meta-perception in ASD that may serve as a potential mechanism through which reduced social cognitive ability contributes to social impairment.

Defining behavioral components of social functioning in adults with autism spectrum disorder as targets for treatment

There is increasing recognition that adults with autism spectrum disorder (ASD) would benefit from treatment to improve social functioning, a key factor in adults' overall quality of life. However, the various behavioral components of social functioning (i.e., categories of behaviors underlying social functioning), including social motivation, social anxiety, social cognition, and social skills, have not all been assessed together in any sample of adults with ASD, making it difficult to know the relative levels of impairment in these various categories, the relationships among these categories, or promising targets for treatments. We hypothesized there would be significant correlations among measures within the same category, but fewer correlations of measures between categories, indicating the heterogeneity of impairments in adults with ASD. Twenty-nine adults with ASD without co-occurring intellectual disability completed multiple assessments measuring social motivation, social anxiety, social cognition, and social skills, as well as measures of overall ASD symptom levels and community functioning. Results revealed significant positive correlations among measures within most categories; positive correlations between measures of social motivation and all other categories, except for social cognition; as well as positive cross-domain correlations between measures of anxiety and ASD phenotype; measures of social skills and community functioning; and measures of social skills and ASD phenotype. Further studies are warranted to determine causal relationships among these behavioral categories, across developmental stages. However, the lack of correlations between many categories suggests the potential importance of multidimensional treatments that target the particular components of social functioning most in need of improvement in individuals. Autism Res 2018, 11: 488-502. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

LAY SUMMARY

The goal of this study was to measure behaviors that contribute to social functioning difficulties in adults with ASD, with the ultimate goal of guiding treatment development. We found that motivation to interact with others was significantly related to social anxiety and social skill. Our results suggest that motivation may be important to target in treatment, and that treatments should be tailored to the areas most in need of improvement in each individual.