Reduced attentional preference for faces and symptoms of social anxiety are common in autism spectrum disorders (ASDs). The neuropeptide oxytocin triggers anxiolytic functions and enhances eye gaze, facial emotion recognition and neural correlates of face processing in ASD. Here we investigated whether a single dose of oxytocin increases attention to faces in ASD. As a secondary question, we explored the influence of social anxiety on these effects. We tested for oxytocin's effects on attention to neutral faces as compared to houses in a sample of 29 autistic individuals and 30 control participants using a dot-probe paradigm with two different presentation times (100 or 500 ms). A single dose of 24 IU oxytocin was administered in a randomized, double-blind placebo-controlled, cross-over design. Under placebo, ASD individuals paid less attention to faces presented for 500 ms than did controls. Oxytocin administration increased the allocation of attention toward faces in ASD to a level observed in controls. Secondary analyses revealed that these oxytocin effects primarily occurred in ASD individuals with high levels of social anxiety who were characterized by attentional avoidance of faces under placebo. Our results confirm a positive influence of intranasal oxytocin on social attention processes in ASD. Further, they suggest that oxytocin may in particular restore the attentional preference for facial information in ASD individuals with high social anxiety. We conclude that oxytocin's anxiolytic properties may partially account for its positive effects on socio-cognitive functioning in ASD, such as enhanced eye gaze and facial emotion recognition.

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Many eye tracking studies use facial stimuli presented on a display to investigate attentional processing of social stimuli. To introduce a more realistic approach that allows interaction between two real people, we evaluated a new eye tracking setup in three independent studies in terms of data quality, short-term reliability and feasibility. Study 1 measured the robustness, precision and accuracy for calibration stimuli compared to a classical display-based setup. Study 2 used the identical measures with an independent study sample to compare the data quality for a photograph of a face (2D) and the face of the real person (3D). Study 3 evaluated data quality over the course of a real face-to-face conversation and examined the gaze behavior on the facial features of the conversation partner. Study 1 provides evidence that quality indices for the scene-based setup were comparable to those of a classical display-based setup. Average accuracy was better than 0.4° visual angle. Study 2 demonstrates that eye tracking quality is sufficient for 3D stimuli and robust against short interruptions without re-calibration. Study 3 confirms the long-term stability of tracking accuracy during a face-to-face interaction and demonstrates typical gaze patterns for facial features. Thus, the eye tracking setup presented here seems feasible for studying gaze behavior in dyadic face-to-face interactions. Eye tracking data obtained with this setup achieves an accuracy that is sufficient for investigating behavior such as eye contact in social interactions in a range of populations including clinical conditions, such as autism spectrum and social phobia.

ObjectiveFear of eye gaze and avoidance of eye contact are core features of social anxiety disorders (SAD). To measure self-reported fear and avoidance of eye gaze, the Gaze Anxiety Rating Scale (GARS) has been developed and validated in recent years in its English version. The main objectives of the present study were to psychometrically evaluate the German translation of the GARS concerning its reliability, factorial structure, and validity.MethodsThree samples of participants were enrolled in the study. (1) A non-patient sample (n = 353) completed the GARS and a set of trait questionnaires to assess internal consistency, test-retest reliability, factorial structure, and concurrent and divergent validity. (2) A sample of patients with SAD (n = 33) was compared to a healthy control group (n = 30) regarding their scores on the GARS and the trait measures.ResultsThe German GARS fear and avoidance scales exhibited excellent internal consistency and high stability over 2 and 4 months, as did the original version. The English version’s factorial structure was replicated, yielding two categories of situations: (1) everyday situations and (2) situations involving high evaluative threat. GARS fear and avoidance displayed convergent validity with trait measures of social anxiety and were markedly higher in patients with GSAD than in healthy controls. Fear and avoidance of eye contact in situations involving high levels of evaluative threat related more closely to social anxiety than to gaze anxiety in everyday situations.ConclusionsThe German version of the GARS has demonstrated reliability and validity similar to the original version, and is thus well suited to capture fear and avoidance of eye contact in different social situations as a valid self-report measure of social anxiety and related disorders in the social domain for use in both clinical practice and research.