An Investigation of Attention to Social and Non-social Stimuli in Autism Spectrum Disorder and Typical Development

Autism Spectrum Disorder (ASD) is a pervasive, neurodevelopmental disorder that can be characterized by deficits in three symptom domains: significant impairments in language, social deficits, and restricted and repetitive behaviors. Narrowed interests, perseverative patterns of attention and reduced visual exploration have been conceptually linked to repetitive behaviors in ASD, specifically what are known as circumscribed interests (CI) within a narrow range of subject areas. Individuals with ASD that have CI partake in activities around their interest (collecting, manipulating, reading, playing, conversing, etc.) and these activities often lead to functional impairments. Eye-tracking research has investigated different responses to categories of images reflecting CI that capture attention during passive viewing tasks. Children and adults with ASD display an attentional bias towards certain categories of nonsocial images (e.g. train, automobiles, electronic devices, computers). This bias has been conceptualized to reflect an increased salience of nonsocial images relative to social images (e.g. faces) or other, more commonplace, nonsocial information (e.g. furniture, clothing, dishes). This dissertation aimed to extend these findings regarding atypical patterns of attention to social and nonsocial information in children with ASD by investigating reflexive attention and cognitive control over attention of images related to CI, skills essential for behavioral and brain development in children with ASD. Analyses included group comparisons across children with ASD and typically developing controls. Children with ASD demonstrated a visual preference for non-social objects relative to social information during a passive viewing attention task. During a visual saccade task, though children with ASD did demonstrate an increased rate of directional errors, task performance did not differ across social and non-social targets. Eye-tracking measures were found to be significantly related to symptom measures of social-communication impairments and restricted and repetitive behaviors in ASD. Exploratory comparisons across children with ASD and a pediatric OCD sample, another development disorder characterized by repetitive behaviors, are also discussed. This study provides support for the use of visual attention and oculomotor behavior to quantify impairments in ASD as well as discrete aspects of the repetitive behavior phenotype.Doctor of Philosoph

Brief Report: Cognitive Control of Social and Nonsocial Visual Attention in Autism

Prosaccade and antisaccade errors in the context of social and nonsocial stimuli were investigated in youth with autism spectrum disorder (ASD; n = 19) a matched control sample (n = 19), and a small sample of youth with obsessive compulsive disorder (n = 9). Groups did not differ in error rates in the prosaccade condition for any stimulus category. In the antisaccade condition, the ASD group demonstrated more errors than the control group for nonsocial stimuli related to circumscribed interests, but not for other nonsocial stimuli or for social stimuli. Additionally, antisaccade error rates were predictive of core ASD symptom severity. Results indicate that the cognitive control of visual attention in ASD is impaired specifically in the context of nonsocial stimuli related to circumscribed interests

Functional Neuroimaging of Social and Nonsocial Cognitive Control in Autism

This study investigated cognitive control of social and nonsocial information in autism using functional magnetic resonance imaging. Individuals with autism spectrum disorders (ASDs) and a neurotypical control group completed an oddball target detection task where target stimuli were either faces or nonsocial objects previously shown to be related to circumscribed interests in autism. The ASD group demonstrated relatively increased activation to social targets in right insular cortex and in left superior frontal gyrus and relatively decreased activation to nonsocial targets related to circumscribed interests in multiple frontostriatal brain regions. Findings suggest that frontostriatal recruitment during cognitive control in ASD is contingent on stimulus type, with increased activation for social stimuli and decreased activation for nonsocial stimuli related to circumscribed interests

Late Positive Potential ERP Responses to Social and Nonsocial Stimuli in Youth with Autism Spectrum Disorder

We examined the late positive potential (LPP) event related potential in response to social and nonsocial stimuli from 9-19 years old youth with (n = 35) and without (n = 34) ASD. Social stimuli were faces with positive expressions and nonsocial stimuli were related to common restricted interests in ASD (e.g., electronics, vehicles, etc.). The ASD group demonstrated relatively smaller LPP amplitude to social stimuli and relatively larger LPP amplitude to nonsocial stimuli. There were no group differences in subjective ratings of images, and there were no significant correlations between LPP amplitude and ASD symptom severity within the ASD group. LPP results suggest blunted motivational responses to social stimuli and heightened motivational responses to nonsocial stimuli in youth with ASD

Common and distinct neural features of social and non-social reward processing in autism and social anxiety disorder

Autism spectrum disorders (ASDs) and social anxiety disorder (SAD) are both characterized by social dysfunction, but no study to date has compared neural responses to social rewards in ASDs and SAD. Neural responses during social and non-social reward anticipation and outcomes were examined in individuals with ASD (n = 16), SAD (n = 15) and a control group (n = 19) via functional magnetic resonance imaging. Analyses modeling all three groups revealed increased nucleus accumbens (NAc) activation in SAD relative to ASD during monetary reward anticipation, whereas both the SAD and ASD group demonstrated decreased bilateral NAc activation relative to the control group during social reward anticipation. During reward outcomes, the SAD group did not differ significantly from the other two groups in ventromedial prefrontal cortex activation to either reward type. Analyses comparing only the ASD and SAD groups revealed greater bilateral amygdala activation to social rewards in SAD relative to ASD during both anticipation and outcome phases, and the magnitude of left amygdala hyperactivation in the SAD group during social reward anticipation was significantly correlated with the severity of trait anxiety symptoms. Results suggest reward network dysfunction to both monetary and social rewards in SAD and ASD during reward anticipation and outcomes, but that NAc hypoactivation during monetary reward anticipation differentiates ASD from SAD

Increased reward value of non-social stimuli in children and adolescents with autism

An econometric choice task was used to estimate the implicit reward value of social and non-social stimuli related to restricted interests in children and adolescents with (n = 12) and without (n = 22) autism spectrum disorder (ASD). Mixed effects logistic regression analyses revealed that groups differed in valuation of images related to restricted interests: control children were indifferent to cash payouts to view these images, but children with ASD were willing to receive less cash payout to view these images. Groups did not differ in valuation of social images or non-social images not related to restricted interests. Results highlight that motivational accounts of ASD should also consider the reward value of non-social stimuli related to restricted interests in ASD (Dichter and Adolphs, 2012)

Neural Mechanisms of Emotion Regulation in Autism Spectrum Disorder

Autism spectrum disorder (ASD) is characterized by high rates of comorbid internalizing and externalizing disorders. One mechanistic account of these comorbidities is that ASD is characterized by impaired emotion regulation (ER) that results in deficits modulating emotional responses. We assessed neural activation during cognitive reappraisal of faces in high functioning adults with ASD. Groups did not differ in looking time, pupilometry, or subjective ratings of faces during reappraisal. However, instructions to increase positive and negative emotional responses resulted in less increase in nucleus accumbens and amygdala activations (respectively) in the ASD group, and both regulation instructions resulted in less change in dorsolateral prefrontal cortex activation in the ASD group. Results suggest a potential mechanistic account of impaired ER in ASD

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Task-induced pupil response and visual perception in adults.

We assessed whether there are differences in pupil response that underlie the selection of local vs. global parts of a stimulus array in healthy adults. We designed a Navon Figures eyetracking paradigm (i.e. large figure composed of small figures), requiring an individual to vary only the information attended to within an image. We found that participants have a characteristic constriction of the pupil waveform during selection of local information relative to global information. Because stimuli and lighting conditions were identical across conditions, this indicates that pupil changes may serve in a visual filtering mechanism important for attentional selection. This work represents the first characterization of pupil response in the context of selective attention, suggesting that mechanisms underlying the earliest stages of visual processes could be relevant for perception and visual selection