Attentional Biases in Autistic Traits: Implications for Social Cognition

Background: Social communication issues, coupled with restricted interests and repetitive behaviors (RRBs), define autism spectrum disorder (ASD). Recent evidence suggests impairments in lower-level processing may contribute to these issues. One possible lower-level process that may impact core issues is attentional bias (AB), where individuals typically favor processing of socio-emotional inputs. We suspect that changes in AB may cascade into core issues that define ASD, particularly as they relate to known anxiety issues in ASD.

Objectives: The present study was driven by two goals: 1) identify the patterns of AB for socio-emotional information and how they relate to traits associated with the diagnostic features of autism, and 2) test whether any such relationships are mediated by anxiety.

Methods: Participants included typically-developed individuals (N=33, data collection ongoing) who completed a well-established dot-probe paradigm, designed to assess AB for socio-emotional cues (Figure 1a). Two images of faces were briefly presented, one featuring a neutral expression and one featuring an emotional expression. A visual target then appeared in the previous location of one image, and participants indicated at which location the target occurred. Faster responses to targets presented in the previously socio-emotional cued location indicated AB for that domain. Eye-tracking was used as a concurrent measure of AB for emotional expressions. Participants completed questionnaires reporting the presence and degree of various ASD-related social (Social Responsiveness Scale; SRS-2), RRB (Repetitive Behaviors Questionnaire; RBQ), and sensory (Sensory Profile) traits, as well as a measure of anxiety (the adult-adapted Spence’s Children’s Anxiety Scale). AB responses were then correlated with the level of ASD-related traits for each measure, as well as anxiety. Mediation analyses were conducted to assess the role of anxiety in the relationship between AB and ASD traits.

Results: Positive correlations were found between AB and scores on the SP-2, RBQ, and SRS (all r-values>0.30, all p-values<0.05). Anxiety significantly correlated with AB (r=0.44, p=0.012), as well as with the three measures of ASD traits (all P-values<0.05). Regression analyses were used to test the hypothesis that anxiety mediated the effect of AB and ASD-related symptom outcomes. Regression analyses and the associated Sobel’s tests revealed anxiety did not mediate the relationship between AB and ASD-related symptom outcomes for scores on the SRS (S=2.56, p=0.01, Figure 1b), but anxiety did mediate the relationship for RBQ (S=1.14, p=0.254, Figure 1c) and SP-2 scores (S=1.92, p=0.054, Figure 1d).

Conclusions: The results demonstrate the relationship between AB for emotional cues, and the core issues associated with ASD. For sensory disruptions and RRBs, this relationship was significantly mediated by overall anxiety levels. While there was a direct relationship between AB and social responsiveness measures, this relationship was not mediated by anxiety. This more direct relationship is likely due to the social nature of the stimuli presented, resulting in a more explicitly direct relationship with social abilities. These findings support the hypothesis that atypical patterns of AB for socio-emotional cues may contribute to autistic traits more generally, and that for non-social symptoms including sensory issues and RRBs, this relationship is mediated by anxiety.