Autistic Traits and Symptoms of Social Anxiety are Differentially Related to Attention to Others\u2019 Eyes in Social Anxiety Disorder

Johan Lundin Kleberg,Terje Falck-Ytter,Jens Högström,Eva Serlachius,Sven Bölte,Martina Nord

doi:10.1007/s10803-016-2978-z

Abstract

Autism spectrum disorder (ASD) and social anxiety disorder (SAD) have partly overlapping symptoms. Gaze avoidance has been linked to both SAD and ASD, but little is known about differences in social attention between the two conditions. We studied eye movements in a group of treatment-seeking adolescents with SAD (N = 25), assessing SAD and ASD dimensionally. The results indicated a double dissociation between two measures of social attention and the two symptom dimensions. Controlling for social anxiety, elevated autistic traits were associated with delayed orienting to eyes presented among distractors. In contrast, elevated social anxiety levels were associated with faster orienting away from the eyes, when controlling for autistic traits. This distinction deepens our understanding of ASD and SAD.

Highlights

Social anxiety disorder (SAD) is a psychiatric disorder characterized by intense fear of being scrutinized and negatively evaluated by others and excessive avoidance of social interaction
Fixations were identified in Tobii Studio (Tobii Inc., Danderyd, Sweden) using the Tobii Fixation Filter with distance and velocity thresholds set to 35 pixels
Further analyses were conducted in Matlab (Mathworks Inc., CA, USA) using custom scripts written by the first author

Summary

Introduction

Social anxiety disorder (SAD) is a psychiatric disorder characterized by intense fear of being scrutinized and negatively evaluated by others and excessive avoidance of social interaction. A large proportion of individuals with ASD fulfill the criteria for SAD (Cath et al 2007; White et al 2009; Simonoff et al 2008). The symptomatic overlap between the conditions is mainly found in areas of social interaction and social skills, whereas restricted and repetitive behaviors and atypical social cognition may be unique to ASD (White et al 2011). Learning disabilities and language impairments are prevalent in a large proportion of children and adolescents with ASD (Baird et al 2006), but are typically not seen in SAD. Social anxiety is more likely in older, high-functioning children and adolescents with ASD, suggesting that increased awareness of social difficulties may be a contributing factor (White et al 2009)

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Conclusion