It has recently been demonstrated that eye contact influences bodily self-awareness. Here, we investigated if the belief of being the target of another person's attention may also induce such influence. We created videos of an individual wearing two different pairs of sunglasses. We manipulated the participants to believe that they were in on-line connection with the individual and that one of the pairs of sunglasses was obstructed so that the individual could not see them through it. We demonstrated that the perception of an individual wearing see-through sunglasses, as compared to obstructed sunglasses or a low-level baseline condition, led to a greater correlation between the participants' rating of the intensity of their bodily reactions and their skin conductance response to emotional pictures. This shows that the belief to be watched by another social agent increases bodily self-awareness and further suggests that such belief is embedded in direct gaze perception.
The lack of consensual measures to monitor core change in Autism Spectrum Disorder (ASD) or response to interventions leads to difficulty to prove intervention efficacy on ASD core symptoms. There are no universally accepted outcome measures developed for measuring changes in core symptoms. However, the CARS (Childhood Autism Rating Scale) is one of the outcomes recommended in the EMA Guideline on the clinical development of medicinal products for the treatment of ASD. Unfortunately, there is currently no consensus on the response definition for CARS among individuals with ASD. The aim of this elicitation process was to determine an appropriate definition of a response on the CARS2 scale for interventions in patients with Autism Spectrum Disorder (ASD). An elicitation process was conducted following the Sheffield Elicitation Framework (SHELF). Five experts in the field of ASD and two experts in expert knowledge elicitation participated in an 1-day elicitation workshop. Experts in ASD were previously trained in the SHELF elicitation process and received a dossier of scientific evidence concerning the topic. The response definition was set as the mean clinically relevant improvement averaged over all patients, levels of functioning, age groups ***and clinicians. Based on the scientific evidence and expert judgment, a normal probability distribution was agreed to represent the state of knowledge of this response with expected value 4.03 and standard deviation 0.664. Considering the remaining uncertainty of the estimation and the available literature, a CARS-2 improvement of 4.5 points has been defined as a threshold to conclude to a response after an intervention. A CARS-2 improvement of 4.5 points could be used to evaluate interventions' meaningfulness in indivudals. This initial finding represents an important new benchmark and may aid decision makers in evaluating the efficacy of interventions in ASD.
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