Attentional Biases to Emotional Faces in People with Autism Spectrum Disorders & Co-Occurring Anxiety

Background:  

People with ASD are known to display increased levels of anxiety symptoms and disorders. To date, there has been little research examining the cognitive mechanisms of anxiety in ASD. One area of interest is to know whether children with ASD and anxiety show similar attentional biases to threat compared to non-ASD children with anxiety disorder. 

Objectives:  

To examine whether children with an ASD display anxiety related attentional biases towards threatening faces and to investigate possible relationships between biases, anxiety and affect recognition.  

Methods:  

This study is ongoing and currently includes 38 boys with ASD recruited from specialist schools and 41 typically developing controls. At the time of presentation an additional clinically selected group of ~50 children with ASD will also be presented.   All participants were aged between 10 and 16 years and had a full-scale IQ ≥ 70. Anxiety was assessed using the Spence Child Anxiety Scale (SCAS) – parent version. 

Attentional bias was examined using the visual-probe task commonly used in the child anxiety literature. Participants were presented with angry or happy faces paired with neutral faces followed by an emotion-congruent or incongruent probe. Bias scores were calculated by deducting the mean RT for congruent trials from the mean RT for incongruent trials. Affect recognition was also assessed to control for known deficits in emotional face processing in ASD using the affect recognition sub-test of the NEPSY-II test battery.    

Results:

The groups significantly differed on age (ASD mean 12 years vs. controls 14 years, p ≤ .05), full scale IQ (96 vs. 113, p ≤ .01) and the ASD group had significantly higher anxiety ratings (SCAS-P; 29 vs. 8, p ≤ .01). 

Attentional bias - A multivariate regression analyses examined the relationship between group, anxiety and the bias scores from both threat & happy faces. When taking into account both FSIQ and anxiety no significant group differences were found for either angry (β= 3.6, p = .81) or happy faces (β= 6.9, p = .45). 

Affect recognition – Children with ASD performed significantly worse on the standardized test of affect recognition (7.9 vs. 10.2, p ≤ .01). However, affect recognition score was not significantly related to either angry or happy face bias, in the whole sample, or in the ASD and control groups individually. Affect recognition was inversely related to SCAS scores in whole sample (β= -3.3, p = .012), but not in the ASD and control groups individually.    

Conclusions:  

While children with ASD displayed elevated levels of anxiety the expected bias towards threat was not observed.  In addition ability to recognise emotional faces was not related to either bias score or levels of anxiety in the ASD group. Our results may suggest that despite showing elevated levels of anxiety, those with ASD may not display the same cognitive correlates of anxiety seen in non-ASD children.  This may suggest that the underlying cognitive mechanisms of anxiety in ASD are distinct from their typically developing peers. Additional data, study limitations and alternative hypotheses will be discussed.