Comparing gaze related anxiety in adult subjects with autism spectrum disorder (ASD) or social anxiety disorder (SAD)

Abstract

Social anxiety is frequently reported by individuals with ASD. If atypical eye gaze in ASD can not be fully explained by emotional models, a subgroup seems to present an active gaze avoidance associated with the report of social anxiety symptoms. The main objective of our study was to examine the gaze related anxiety in a population of adults with ASD compared with what's observed in adults with SAD. The purpose was to confirm the experience of social anxiety for some individuals with ASD and quantify its impact on gaze functioning. We included adult patients diagnosed with ASD without intellectual disability (n = 13) or SAD (n = 11) from three outpatient clinics. Patients were divided in two groups, ASD and SAD, and filled three clinical scales: Gaze Anxiety Rating Scale (GARS, Schneier et al., 2011), Liebowitz Social Anxiety Scale (LSAS, Liebowitz et al., 1999), and Social responsiveness Scale-2 (SRS-2, Constantino et al., 2003). Patients with ASD presented higher scores on SRS-2 (M [SD]: 73.5 [8.9] vs 52.4 [10.4]; P < 0.001) and lower on LSAS (M [SD]: 58.6 (32.1) vs 83.8 [22.8]; P < 0.05) but no difference on GARS scores compared to people with SAD. Furthermore, a sub-group of ASD patients, presenting with more social anxiety, reported greater gaze related anxiety and avoidance than other patients with ASD (M [SD]: 57.8 (20.5) vs 19.4 [23.5]; P < 0.05). Social anxiety can be present in ASD with an impact on gaze functioning. The SRS-2 and LSAS seem to be efficient differentiating anxiety from social ability deficits and maybe useful to guide patients toward a specialised evaluation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Studying “natural” eye movements in an “unnatural” social environment: The influence of social activity, framing, and sub-clinical traits on gaze aversion

“…It is important to note that our study measured gaze aversion anxiety (GARS), rather than social anxiety more generally, and there has been some debate as to whether GARS forms a significant component of social anxiety in clinical populations (e.g. Jouni et al, 2016). Nevertheless, our high precision eye movement measurements taken whilst participants hold a natural conversation (talking and listening) have the potential to provide interesting insights into the potential mechanisms may underpin gaze aversion found in social anxiety.…”

“…Finally, if anxious individuals are afraid of both positive and negative evaluations (Weeks & Howell, 2012), then it would also make sense for them to display increased gaze aversion during the talking as compared with the listening conditions. It is important to note that our study measured gaze anxiety (GARS), rather than social anxiety more generally, and there has been some debate as to whether GARS forms a significant component of social anxiety in clinical populations (e.g., Jouni et al, 2016). Nevertheless, our high precision eye movement measurements taken while participants hold a natural conversation (talking and listening) have the potential to provide interesting insights into the potential mechanisms that may underpin gaze aversion in social anxiety disorder.…”

“…In fact, this self-report measure of avoidance and fear of eye contact has consistently been found to be associated with severity of social anxiety in both clinical and nonclinical samples (Schneier et al, 2011, cf. Jouni, Amestoy, & Bouvard, 2016). Our main objective was to test whether our paradigm could pick up subtle differences in gaze aversion, and whether these differences correlate with self-reported measures of gaze aversion.…”