Perception of Embarrassment in Adolescents with Asperger's Syndrome and Implications for Intervention

Background:

Embarrassment is the least researched of the self-conscious emotions among typically developing individuals (Hobson, 2006), and researchers have conducted even less research on embarrassment among individuals with Asperger’s Syndrome (AS). Keltner and Buswell (1977) defined embarrassment as the outcome of violating rules of convention, threatening one’s social identity within the interaction. Though studies are few, the anecdotal AS parent and clinic literature is replete with accounts of individuals with AS’ negative verbal, emotional, and physical response to embarrassing situations.

Objectives:      

We predicted that adolescents with AS would describe personal experiences of embarrassment that  would not be perceived as embarrassing by TD controls, and would involve significantly more unusual and negative physical, emotional, and verbal responses than TD controls. We also predicted that although the AS group would be able to appropriately identify embarrassing vignettes (in contrast to their personal experiences), they would provide inappropriate justifications for their ratings, i.e., they can identify the experience but they cannot intuitively explain why something is embarrassing to them or others.           

Methods:           

40 male and female participants, aged 11-17, read 12 vignettes describing embarrassing situations, including physical, social, positive, and non-embarrassing situations. Participants were asked to rate the situations, and then asked to justify their ratings. We designed an instrument, “The Child Embarrassment Survey”, used to interview participants about their definition of embarrassment, and what embarrassment looks like on the face,  words, and actions of those who are embarrassed. We also asked participants to describe personal experiences with embarrassment at school, home, and in the community.

Results:           

First, we found only slightly significant differences between the embarrassment vignette ratings of the AS and TD groups. In justifying their responses, however, the AS group showed a significantly poorer ability than the TD group to accurately explain why they had rated vignettes as embarrassing. Second, when asked to provide an embarrassing personal experience, we found that the AS group provided significantly fewer embarrassing experiences than the TD group. Raters reported that the events the AS group described would be perceived as non-embarrassing by most TD individuals. Third, the AS group described significantly more unusual and self-injurious behaviors in response to their personal experiences with embarrassment, e.g., picking at skin and drawing blood, hitting, and pulling hair. They further described a significantly higher rate of responses of anger, yelling, screaming, accusing others, and feeling stupid or worthless than the TD group. Finally, we found that the TD group spontaneously described amelioration strategies which they used to confront feelings of embarrassment, e.g., smiling.

Conclusions:           

Adolescents with AS must be taught about the emotion of embarrassment, beyond the simple recognition of an embarrassing situation in a photograph, and the amelioration strategies to navigate embarrassing situations. Further, we must research interventions that will support adolescents with AS in walking through their intense verbal, emotional, psychological, and physical responses. Dealing with embarrassment is a critical social skill and individuals with AS appear to find it painful. Research can lead us to interventions that may lessen these traumatizing responses.