Development of a Method to Study Brain Mechanisms for Emotion Regulation During Social Exclusion and Rule Violation in Autism

Background: Cyberball, a virtual ball-tossing game, elicits feelings of social exclusion, and requires emotion regulation in typically developing (TD) participants. Few studies have explored the effect of social exclusion on individuals with autism spectrum disorders (ASD), a population marked by impairment in social interaction. Adolescents with ASD playing Cyberball report arousal that is often discordant with resulting mood changes. Considering that autism is characterized by cognitive rigidity and preoccupation with patterns, one might predict that participants with autism would show increased emotional sensitivity and distress to rule violations. No studies have compared brain responses to social exclusion and expectancy violation in participants with ASD.

Objectives: Using a novel adaptation of Cyberball (Cybershape) with a shape-matching rule dictating the correct recipient of the ball, along with the original Cyberball, we aimed to develop a method for examining a simple social interaction and related emotion regulation. During a functional magnetic resonance imaging (fMRI) scan of children, adolescents, and adults with and without autism, we aim to identify differences in brain responses to social exclusion compared to rule violation within and between participant groups.

Methods: Participants play Cyberball in alternating blocks of fair play and exclusion. In fair play, the participant receives the ball on one-third of the throws; in exclusion the participant does not receive the ball. Each participant also plays Cybershape in alternating blocks of fair play and rule violation. In fair play, the participant receives the shape one-third of the time; the shape rule is never broken. In rule violation, the participant receives the shape one-third of the time; but one of the players consistently violates the shape rule by throwing the shape to the wrong player. After playing, participants are given ten questions addressing emotional reactions to exclusion or rule violation.

Results: Data from 9 TD adults contrasting fair play to either exclusion or rule violation revealed a dorsal-ventral differentiation in medial prefrontal cortex (mPFC). Social exclusion activates ventral mPFC, posterior cingulate, and superior frontal gyrus, often associated with emotion regulation. Alternatively, rule violation activates dorsal mPFC, extensive lateral regions of the prefrontal cortex, and parietal cortex, which are often associated with conditional rule use and task switching. Having established this paradigm in TD adults, we are now running samples of children and adolescents with and without autism. In preliminary analyses, one child (age 12) with ASD had similarly located brain activation to TD adults in both games. Concordant with our hypothesis, this participant showed greater brain activation to rule violation in the aforementioned regions compared to social exclusion. Adolescent ASD and TD participants have shown a negligible difference between brain responses to rule violation versus fair play, suggesting a decreased sensitivity to rule violation in this age group.

Conclusions: The discussed paradigm uses fMRI to study brain regions engaged in emotion regulation during social exclusion or rule violation, and can be used to study participants with and without autism. Furthermore, self-report measures will explore a potential correlation between neural and emotional responses to social exclusion and rule violation.