Exploring the Effect of Social Anxiety on Eye Gaze in Adolescents with ASD Across Emotion Recognition Paradigms

Background: Social anxiety is highly prevalent among adolescents with autism spectrum disorder (ASD) and research suggests that anxiety symptoms might heighten the social impairment often seen in this population. Although not entirely consistent, the extant research generally shows a pattern of diminished gaze to social features in the context of heightened gaze to non-social stimuli in people with ASD, relative to controls. Very little research has considered the potential influence of co-occurring social anxiety, diagnostically or dimensionally, on gaze patterns in youth with ASD. Understanding the possible influence of social anxiety on gaze, and other indicators of social cognition, is important given that social anxiety – like ASD, has been robustly associated with atypical social gaze.

Objectives: The goal of the current study is to explore the role of social anxiety on gaze patterns across two separate samples of adolescents with ASD. Additionally, we explore the influence of stimulus type (static, dynamic) and task instructions (free viewing, directed emotion recognition).

Methods: Participants with ASD (n = 28) and age-matched typically developing (TD) adolescents (n = 32) were drawn from two separate studies and included adolescents aged 12 and 17 years, inclusive. In both studies (emotion recognition and free viewing), participants completed one session in which they completed a computerized task where they viewed a single face expressing an emotion and completed a measure of social anxiety: Screen for Child Anxiety Related Disorders (SCARED; Birmaher et al., 1997) or Social Worries Questionnaire (SWQ; Spence, 1995). The Social Responsiveness Scale (Constantino, 2012) was also gathered for all participants. In the emotion recognition study, participants viewed a video of an adult expressing an emotion. In the free viewing study, participants viewed static stimuli of emotions from the NimStim Set of Facial Expressions.

Results: Internal consistency was high for both SCARED (α = .922) and SWQ (α = .816). For the participants with ASD, partial correlation indicated that accounting for ASD severity, self-reported social anxiety symptoms were negatively associated with gaze duration to eye region of the face across presented emotion type (r = -.474, p = .043). This effect was found for stimuli depicting anger (r = -.458, p = .050), surprise (r = -.507, p = .032), and disgust (r = -.533, p = .025). However, this effect was only found for the free viewing paradigm. For the emotion recognition study, self-reported social anxiety symptoms were positively associated with gaze duration to eye region only for the stimuli depicting sadness (r = .656, p = .039).

Conclusions: Results support prior research suggesting that co-occurring social anxiety influences social gaze in youth with ASD. However, this study promotes further examination of the influence of methodological factors (specifically stimulus type and task instruction) on the role of social anxiety on how individuals with ASD view facial emotion stimuli. We will further explore these factors and their likely influence, as well as the relationships among ASD features, social anxiety, and other gaze metrics within both TD and ASD samples.