19632
Emotion Recognition and Mentalising Impairments in Adolescents with ASD and Co-Occurring Alxithymia
Recent research has shown a high proportion of adults with ASD manifest a difficulty in identifying and describing their emotional experiences. This difficulty is encapsulated in the personality trait alexithymia. Nowadays the condition is more broadly conceptualised as an emotion dysregulation disorder, defined by a difficulty in cognitively mapping feeling states onto internal bodily responses. The incidence of alexithymia in ASD is much higher than in typically-developing populations and this has led researchers to speculate whether the difficulties in representing emotional experiences could contribute to other cognitive difficulties within ASD.
Objectives:
The present study aimed to examine if: 1) adolescents with ASD exhibited elevated levels of alexithymia, as is reported in studies with adults 2) all ASD participants had elevated alexihymia or if this was limited to a subgroup 3) the high-alexithymia subgroup was impaired in emotion recognition and if this was emotion specific or if it generalised to broader mentalising ability and ToM.
Methods:
54 participants aged 15 years with a diagnosis of ASD were compared to 32 adolescent controls. Participants completed the Toronto Alexithymia Scale-twenty items (TAS-20, alexithymia) and four cognitive-behavioural tasks, used to test the attribution of mental states to others: Strange Stories(SS), Animated Shapes(AS), Children’s version of Reading the Mind in the Eyes(RME) and Test of Affect Recognition(TAR). Subsequently, the ASD group were split into those with high (TAS score >52, N= 30) and low (TAS score <52, N = 24) alexithymia and their performance on each task was compared.
Results:
Adolescents with ASD exhibited higher levels of alexithymia compared to the controls and had poorer performance on all mentalising and emotion recognition tasks (Table 1). When the ASD group was divided on alexithymia severity, the high-alexithymia group exhibited poorer ability to discern emotional states from faces on the Test of Affect Recogniton than the than the low-alexithymia group, t (54) = 2.01, p < .05. However, there were no significant differences on any of the mentalising tasks (Table 2).
Conclusions:
This study provides evidence that a subgroup of individuals with ASD have high levels of alexithymia. Furthermore, these individuals have difficulties recognising emotions in both self and others. However, other mentalising abilities remain preserved, indicating that the impairments in alexithymia are emotion specific. This is an important development, as previous studies have only been able to make speculative claims on the relationship between difficulties in cognitively representing emotions in self and mentalising.
Table 1 Means, T-Test and P-Values for the Cognitive-Behavioural Tasks
Task |
ASD(SD/n=) |
Controls(SD/n=) |
t-test |
SS |
3.77 (.50/56) |
5.31 (.42/32)
|
t(86) = 3.69, p < 0.001 |
AS(intentionality) |
12.55 (.81/55) |
14.34 (.73/32)
|
t(85) = 2.59, p < 0.05 |
AS(appropriateness) |
2.64 (.48/55) |
4.28 (.49/32)
|
t(85) = 3.85, p < 0.001 |
RME |
18.45 (3.10/55) |
20.28 (3.35/32)
|
t(85) = 2.57, p < 0.05 |
TAR |
45.18 (5.64/56) |
47.66 (4.67/32) |
t(86) = 2.10, p < 0.01 |
| Table 2 Mean Scores on Cognitive-Behavioural Tasks for ASD groups with high and low Alexithymia | |||||
|
SS |
AS(intent) |
AS(approp.) |
RME |
TAR |
Low-alexithymia(SD/n=) |
3.92(.48/25) |
12.54(.68/24) |
2.67(.47/24) |
19.04(2.66/24) |
46.88(5.29/25)* |
High-alexithymia(SD/n=) |
2.07(.52/31) |
12.55(.80/31) |
2.61(.47/31) |
18.00(3.38/31) |
43.81(5.62/31)* |
|
|||||
*p<.005