Facial emotion recognition in autistic adult females correlates with alexithymia, not autism

Abstract

Research on predominantly male autistic samples has indicated that impairments in facial emotion recognition typically associated with autism spectrum conditions are instead due to co-occurring alexithymia. However, whether this could be demonstrated using more realistic facial emotion recognition stimuli and applied to autistic females was unclear. In all, 83 females diagnosed with autism spectrum condition completed online self-report measures of autism spectrum condition severity and alexithymia, and afacial emotion recognition deficit that assessed their ability to identify multimodal displays of complex emotions. Higher levels of alexithymia, but not autism spectrum condition severity, were associated with less accurate facial emotion recognition. Difficulty identifying one’s own feelings and externally oriented thinking were the components of alexithymia that were specifically related to facial emotion recognition accuracy. However, alexithymia (and autism spectrum condition severity) was not associated with speed of emotion processing. The findings are primarily discussed with the theoretical view that perceiving and experiencing emotions share the same neural networks, thus being able to recognise one’s own emotions may facilitate the ability to recognise others’. This study is in line with previous similar research on autistic males and suggests impairments in facial emotion recognition in autistic females should be attributed to co-occurring alexithymia. Lay abstract Research with autistic males has indicated that difficulties in recognising facial expressions of emotion, commonly associated with autism spectrum conditions, may instead be due to co-occurring alexithymia (a condition involving lack of emotional awareness, difficulty describing feelings and difficulty distinguishing feelings from physical bodily sensations) and not to do with autism. We wanted to explore if this would be true for autistic females, as well as to use more realistic stimuli for emotional expression. In all, 83 females diagnosed with autism spectrum condition completed self-report measures of autism spectrum condition traits and alexithymia and completed a visual test that assessed their ability to identify multimodal displays of complex emotions. Higher levels of alexithymia, but not autism spectrum condition features, were associated with less accuracy in identifying emotions. Difficulty identifying one’s own feelings and externally oriented thinking were the components of alexithymia that were specifically related to facial emotion recognition accuracy. However, alexithymia (and levels of autism spectrum condition traits) was not associated with speed of emotion processing. We discuss the findings in terms of possible underlying mechanisms and the implications for our understanding of emotion processing and recognition in autism.

Differences Between Autistic and Non-autistic Adults in the Recognition of Anger From Dynamic Expressions Remain After Controlling for Alexithymia.

“…The ndings of this study support the alexithymia hypothesis: high alexithymic, but not autistic, traits were associated with less accurate facial expression recognition (Ola & Gullon-Scott, 2020). However, this study, conducted by Ola and Gullon-Scott, has two important limitations.…”

“…Sato and colleagues' results thus demonstrate differences, between autistic and non-autistic adults, in the effects of manipulating facial kinematics. To the best of our knowledge, only one study has examined the contribution of autistic and alexithymic traits to dynamic emotion recognition (Ola & Gullon-Scott, 2020).…”

Differences Between Autistic and Non-autistic Adults in the Recognition of Anger From Dynamic Expressions Remain After Controlling for Alexithymia.

“…Sato and colleagues' results thus demonstrate differences, between autistic and non-autistic adults, in the effects of manipulating facial kinematics. To the best of our knowledge, only one study has examined the contribution of autistic and alexithymic traits to dynamic emotion recognition (26). The ndings of this study support the alexithymia hypothesis: high alexithymic, but not autistic, traits were associated with less accurate facial expression recognition (26).…”

“…To the best of our knowledge, only one study has examined the contribution of autistic and alexithymic traits to dynamic emotion recognition (26). The ndings of this study support the alexithymia hypothesis: high alexithymic, but not autistic, traits were associated with less accurate facial expression recognition (26). However, this study, conducted by Ola and Gullon-Scott, has two important limitations.…”

“…However, since our aim was to investigate whether the alexithymia hypothesis applies, not only to emotion recognition from static face stimuli, but also to recognition from dynamic stimuli, it was crucial for the design of the current study that we employ the same measure of alexithymia (i.e. the TAS-20) as has previously been employed in the emotion recognition literature (13,18,19,26).…”