Linearly integrating speed and accuracy to measure individual differences in theory of mind:Evidence from autistic and neurotypical adults

It has long been theorised that there is a direct link between individual differences in social cognition and behaviour. One of the most popular tests of this theory has involved examination of Theory of Mind (ToM) difficulties in Autism Spectrum Disorder (ASD). However, evidence for associations between ToM and social behaviour is mixed, both when testing the ToM explanation of ASD and when investigating individual differences in ToM in the general population. We argue that this is due to methodological limitations of many ToM measures, such as a lack of variability in task performance, inappropriate non-ToM control tasks, and a failure to account for general mental ability. To overcome these issues, we designed a novel task, which probed individual differences in ToM fluency through mental state attribution in response to cartoons (Cartoons Theory of Mind [CarToM] task). This task, enabling the linear combination of speed and accuracy, was used to quantify ToM ability and its association with self-reported (a)typical social behaviour in adults with and without ASD. In a large sample (N = 237), we found that having an ASD diagnosis and higher autistic traits predicted lower ToM ability, even after accounting for performance on a well-matched non-ToM condition and general mental ability. Overall, our findings provide fresh support for the existence of a link between individual differences in social cognition (specifically, ToM) and behaviour (specifically, autism). This has implications for social-cognitive theory and research, allowing large-scale, online assessment of individual differences in ToM in clinical groups and the general population

Exploring the cognitive, emotional and sensory correlates of social anxiety in autistic and neurotypical adolescents

BACKGROUND: Social anxiety is common in autistic adolescents. While emerging evidence indicates the importance of several mechanisms (including intolerance of uncertainty (IU), alexithymia and sensory processing) for maintaining anxiety, limited research has explored how these factors are associated with social anxiety in autistic adolescents. METHODS: We investigated whether IU, emotional and sensory processing are related to social anxiety in autistic and neurotypical adolescents, gathering experimental and questionnaire data from 61 autistic and 62 neurotypical 11- to 17-year-olds recruited to have similarly high levels of anxiety. RESULTS: In autistic and neurotypical adolescents matched for social anxiety, similar significant associations were observed between social anxiety and IU, alexithymia, maladaptive emotion regulation, sensory hypersensitivity and interoceptive sensibility. Taking a dimensional approach, we found that child- and parent-reported IU, alexithymia and sensory hypersensitivity mediated the relationship between autistic traits and social anxiety symptoms in the combined group of adolescents. CONCLUSIONS: Our findings indicate that similar correlates of social anxiety are evident in autistic and neurotypical youths experiencing social anxiety, and further our understanding of mechanisms that may contribute towards social anxiety in both groups

Experiences of social isolation and loneliness in middle-aged and older autistic adults

Background: Young autistic people often experience social isolation and loneliness. Despite social isolation and loneliness increasing in later life in non-autistic populations, few studies have examined whether middle-aged and older autistic adults are at an increased likelihood of these experiences. Methods: 428 adults (51% female, autistic n=265) aged 40-93 (mean age=60.5 years) completed online questionnaires related to their experiences of social isolation, loneliness, and mental health. Group differences and associations were examined. Results: The autistic group were more socially isolated and lonelier than the non-autistic group. While there were few gender differences in social isolation, women reported being lonelier than men in both groups, including when controlling for age and mental health. While social isolation increased with age in both groups, loneliness only increased with age in the autistic group. For both social isolation and loneliness, the associations with age were significantly stronger in men than women. Conclusions: These findings suggest that autistic adults may be particularly susceptible to social isolation and loneliness in midlife and older age. While autistic women reported being lonelier, autistic men may be at greater risk of increasing social isolation and loneliness with older age. This study highlights the need for evidence-based interventions to address social isolation and to reduce loneliness for autistic people as they age

Face processing in autism spectrum disorder re-evaluated through diffusion models

Objective: Research using cognitive or perceptual tasks in autism spectrum disorder (ASD) often relies on mean reaction time (RT) and accuracy derived from alternative-forced choice paradigms. However, these measures can confound differences in task-related processing efficiency with caution (i.e., preference for speed or accuracy). We examined whether computational models of decision-making allow these components to be isolated. Method: Using data from two face-processing tasks (face recognition and egocentric eye-gaze discrimination), we explored whether adolescents with ASD and wide-ranging intellectual ability differed from an age and IQ matched comparison group on model parameters that are thought to represent processing efficiency, caution, and perceptual encoding/motor output speed. Results: We found evidence that autistic adolescents had lower processing efficiency and caution but did not differ from nonautistic adolescents in the time devoted to perceptual encoding/motor output. These results were more consistent across tasks when we only analyzed participants with IQ above 85. Cross-task correlations suggested that processing efficiency and caution parameters were relatively stable across individuals and tasks. Furthermore, logistic classification with model parameters improved discrimination between individuals with and without ASD relative to classification using mean RT and accuracy. Finally, previous research has found that ADHD symptoms are associated with lower processing efficiency, and we observed a similar relationship in our sample, but only for autistic adolescents. Conclusions: Together, these results suggest that models of decision-making could provide both better discriminability between autistic and nonautistic individuals on cognitive tasks and also a more specific understanding of the underlying mechanisms driving these differences

The mental and physical health of older adults with a genetic predisposition for autism

Autism commonly aggregates in families, with twin studies stimating heritability to be around 80%. Subclinical autism-like characteristics have also been found at elevated rates in relatives of autistic probands. Physical and psychiatric conditions have been reported at elevated rates in autistic children and adults, and also in their relatives. However, to date there has been no exploration of how ageing may affect this pattern. This study examined cross-sectional data from the ongoing online PROTECT study. A total of 20,220 adults aged 50 years and older reported whether they have an autistic first-degree relative. In total, 739 older adults reported having an autistic first-degree relative (AFDR group) and 11,666 were identified as having no family history of any neurodevelopmental disorder (NFD group). The AFDR group demonstrated significantly higher frequencies of self-reported psychiatric diagnoses and a greater total number of co-occurring psychiatric diagnoses than the NFD group. Furthermore, the AFDR group reported elevated current self-report symptoms of depression, anxiety, traumatic experience, and post-traumatic stress than the NFD group. By contrast, few differences between AFDR and NFD groups were observed in physical health conditions, and no differences were observed in the total number of co-occurring physical health diagnoses. These findings suggest that adults who have an autistic first-degree relative may be at greater risk of poor mental, but not physical, health in later life. Older adults with autistic relatives may benefit from close monitoring to mitigate this susceptibility and to provide timely intervention

The mental and physical health profiles of older adults who endorse elevated autistic traits

Objective The mental and physical health profile of autistic people has been studied in adolescence and adulthood, with elevated rates of most conditions being reported. However, this has been little studied taking a dimensional approach to autistic traits, and in older age. Methods A total of 20,220 adults aged 50-81 years from the PROTECT study reported whether they experienced persistent socio-communicative traits characteristic of autism. Approximately 1%, 276 individuals, were identified as endorsing elevated autistic traits in childhood and currently, henceforth the ‘Autism Spectrum Trait’ (AST) group. An age and gender matched comparison group was formed of 10,495 individuals who did not endorse any autistic behavioral traits, henceforth the ‘Control Older Adults’ (COA) group. Differences between AST and COA groups were explored in self-reported psychiatric diagnoses, self-reported symptoms of current depression and anxiety, and self-reported physical health diagnoses. Associations were also examined between autistic traits and health across the whole sample. Results The AST group reported significantly elevated rates of psychiatric diagnoses compared to COAs. Additionally, the AST group showed significantly higher self-reported symptoms of current depression and anxiety than COAs. However, few differences were observed in individual physical health conditions, and no differences in total co-occurring physical diagnoses between groups. Similar associations between autistic traits and health were also found taking a dimensional approach across the whole sample. Discussion These findings suggest that older adults with elevated autistic traits may be at greater risk of poorer mental, but not physical, health in later life. Future studies should incorporate polygenic scores to elucidate the possible genetic links between propensity to autism/high autistic traits and to psychiatric conditions, and to explore whether those with elevated autistic traits experience particular barriers to mental health care

Exploring the neurocognitive correlates of challenging behaviours in young people with autism spectrum disorder

Many young people with autism spectrum disorder display ‘challenging behaviours’, characterised by externalising behaviour and self-injurious behaviours. These behaviours can have a negative impact on a young person’s well-being, family environment and educational achievement. However, the development of effective interventions requires greater knowledge of autism spectrum disorder–specific models of challenging behaviours. Autism spectrum disorder populations are found to demonstrate impairments in different cognitive domains, namely social domains, such as theory of mind and emotion recognition, but also non-social domains such as executive functioning and sensory or perceptual processing. Parent-rated self-injurious behaviour and externalising behaviours, and neurocognitive performance were assessed in a population-derived sample of 100 adolescents with autism spectrum disorder. Structural equation modelling was used to estimate associations between cognitive domains (theory of mind, emotion recognition, executive functioning and perceptual processing) and self-injurious behaviour and externalising behaviours. Poorer theory of mind was associated with increased self-injurious behaviour, whereas poorer perceptual processing was associated with increased externalising behaviours. These associations remained when controlling for language ability. This is the first analysis to examine how a wide range of neurocognitive domains relate to challenging behaviours and suggests specific domains that may be important targets in the development of interventions in adolescents with autism spectrum disorder