Abstract
Research on predominantly male autistic samples has indicated that impairments in facial emotion recognition typically associated with autism spectrum conditions are instead due to co-occurring alexithymia. However, whether this could be demonstrated using more realistic facial emotion recognition stimuli and applied to autistic females was unclear. In all, 83 females diagnosed with autism spectrum condition completed online self-report measures of autism spectrum condition severity and alexithymia, and afacial emotion recognition deficit that assessed their ability to identify multimodal displays of complex emotions. Higher levels of alexithymia, but not autism spectrum condition severity, were associated with less accurate facial emotion recognition. Difficulty identifying one’s own feelings and externally oriented thinking were the components of alexithymia that were specifically related to facial emotion recognition accuracy. However, alexithymia (and autism spectrum condition severity) was not associated with speed of emotion processing. The findings are primarily discussed with the theoretical view that perceiving and experiencing emotions share the same neural networks, thus being able to recognise one’s own emotions may facilitate the ability to recognise others’. This study is in line with previous similar research on autistic males and suggests impairments in facial emotion recognition in autistic females should be attributed to co-occurring alexithymia.Lay abstractResearch with autistic males has indicated that difficulties in recognising facial expressions of emotion, commonly associated with autism spectrum conditions, may instead be due to co-occurring alexithymia (a condition involving lack of emotional awareness, difficulty describing feelings and difficulty distinguishing feelings from physical bodily sensations) and not to do with autism. We wanted to explore if this would be true for autistic females, as well as to use more realistic stimuli for emotional expression. In all, 83 females diagnosed with autism spectrum condition completed self-report measures of autism spectrum condition traits and alexithymia and completed a visual test that assessed their ability to identify multimodal displays of complex emotions. Higher levels of alexithymia, but not autism spectrum condition features, were associated with less accuracy in identifying emotions. Difficulty identifying one’s own feelings and externally oriented thinking were the components of alexithymia that were specifically related to facial emotion recognition accuracy. However, alexithymia (and levels of autism spectrum condition traits) was not associated with speed of emotion processing. We discuss the findings in terms of possible underlying mechanisms and the implications for our understanding of emotion processing and recognition in autism.
Highlights
Autism spectrum condition (ASC), prevalent in 1%–2% of the UK population (Baron-Cohen et al, 2009), is a heritable developmental condition characterised by impaired social and communication skills, repetitive stereotyped behaviour and restricted interests (American PsychiatricNewcastle University, UK Autism 24(8)Association, 2013; ASC is synonymous with the term autism spectrum disorder used within the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5))
By counteracting some of the limitations of previous research, this study has provided evidence for how the alexithymia hypothesis applies to females diagnosed with ASC
Alexithymia in autistic women, in terms of difficulty identifying their own emotions and externally oriented thinking, but not their ASC, was associated with facial emotion recognition (FER) ability. This was only for FER accuracy, as speed of emotion processing was unrelated to both ASC and alexithymia
Summary
Autism spectrum condition (ASC), prevalent in 1%–2% of the UK population (Baron-Cohen et al, 2009), is a heritable developmental condition characterised by impaired social and communication skills, repetitive stereotyped behaviour and restricted interests (American PsychiatricNewcastle University, UK Autism 24(8)Association, 2013; ASC is synonymous with the term autism spectrum disorder used within the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5)). Autistic infants typically show reduced attention to faces in their environment (Chawarska et al, 2013), while autistic adults have shown an absence of fusiform face area (FFA) activity during face-matching tasks, a brain region central to the detection and recognition of faces (Hoffman & Haxby, 2000; Schultz et al, 2003). Contrasting studies have found that autistic individuals have typical FFA activity (Hadjikhani et al, 2004) and no deficit in recognising facial identity (Deruelle et al, 2004; Neil et al, 2016), face processing impairment in ASC is inconclusive
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