Is it avoidance or hypoarousal? A systematic review of emotion recognition, eye-tracking, and psychophysiological studies in young adults with autism spectrum conditions

Abstract

A systematic review was conducted for studies exploring the link between gaze patterns, autonomic arousal and emotion recognition deficits (ERD) in young adults with Autism Spectrum Conditions (ASC) in the context of the eyeavoidance/hyperarousal and the orientation/hypoarousal hypotheses. These hypotheses suggest that ERD in ASC can be explained by either exacerbated physiological arousal to eye-contact interfering with emotion recognition, or blunted arousal not engaging the necessary attention and awareness mechanisms to process emotionally salient cues, respectively. Most studies have suggested that individuals with ASC display an overall reduced attention to the eyes, however, this was not always associated with ERD, and some studies also reported ERD with no evidence of atypical gaze patterns. The evidence from psychophysiological studies is also mixed. While some studies supported that individuals with ASC are hypoaroused during emotion processing, others reported hyperarousal or even partially supported both. Overall, these results suggest that the current autonomic arousal and gaze hypotheses cannot fully account for ERD in ASC. A new integrative model is proposed, suggesting a two-pathway mechanism, in which avoidance and orientation processes might independently lead to ERD in ASC. Current methodological limitations, the influence of alexithymia, and implications are discussed.

How do core autism traits and associated symptoms relate to quality of life? Findings from the Longitudinal European Autism Project

“…This pattern of results was true after holding co-occurring anxiety and depression symptoms constant, which is important to note since social functioning can be impacted by mental health (e.g. anxiety/low mood leading to social difficulties; Cuve et al, 2018) and vice versa (e.g. social withdrawal leading to anticipatory anxiety/loneliness; Bellini, 2006;Hedley et al, 2018).…”

Visuoperceptual profiles of children using the Flemish cerebral visual impairment questionnaire

“…‘eye contact is absent’) and facial emotional recognition deficits (e.g. ‘does not understand facial expressions’) reflected ASD characteristics . Ventral stream deficits (mostly factor 1) are more specific to CVI, whereas other factors relate to other disorders such as ASD, ADHD, DCD, or CP .…”

Alexithymia explains atypical spatiotemporal dynamics of eye gaze in autism

“…Considering the influential hypotheses concerning the role of atypical eye gaze in emotion recognition in autism (see Hadjikhani, Zurcher, et al, 2017;Kliemann, Dziobek, Hatri, Steimke, & Heekeren, 2010), and the fact that atypical eye gaze is widely regarded as a key diagnostic feature of autism (Senju & Johnson, 2009), it is significant that eye-tracking studies investigating how individuals with autism visually explore emotional faces have produced remarkably mixed results. Although several studies report atypical eye gaze in autism (Hadjikhani, Zurcher, et al, 2017;Kliemann, Dziobek, Hatri, Steimke, & Heekeren, 2010;Senju & Johnson, 2009), others do not (Black et al, 2017;Cuve, Gao, & Fuse, 2018;Guillon, Hadjikhani, Baduel, & Rogé, 2014;Kwon, Moore, Barnes, Cha, & Pierce, 2019).…”

“…Under the other hypothesis, reduced eye gaze stems from hypo-arousal, resulting in diminished social motivation and orienting responses to social stimuli (Dalton et al, 2005). While there is evidence for both hypotheses (for a review see: Cuve, Gao & Fuse, 2018;Kliemmann et al, 2012, Senju et al, 2011, our understanding of how allocation of gaze to faces influences emotion recognition remains far from complete. For instance, previous work demonstrates that an individual's attention to the eye-region of another's face is predictive of the degree to which the individual can recognise the other's emotions (Schurgin et al, 2014).…”