Investigating alexithymia in autism: A systematic review and meta-analysis

Kinnaird, Emma; Stewart, Catherine; Tchanturia, Kate

doi:10.1016/j.eurpsy.2018.09.004

Cited by 324 publications

(261 citation statements)

References 57 publications

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“…This could suggest that autistic people with comorbid alexithymia might be more likely to self-harm to regulate high-intensity states, but this use of self-injury does not incur especial risk of suicidality, besides any acquired capability generally accrued through self-injury [20,21,23]. It might be further extrapolated that alexithymia may be a useful predictor of self-harm but not suicide in autistic people, perhaps due its general ubiquity within this population [72]), but as the present study did not collect data on alexithymia alongside suicidality, this interpretation is highly speculative at present and requires further scrutiny. Another intrapersonal feature predictive of self-injury in our previous study was sensory sensitivity [40], which is consistent with the finding that autistic children use NSSI to regulate hypo-and/or hyper-arousal [50].…”

Section: Discussionmentioning

confidence: 99%

Links between self-injury and suicidality in autism

et al. 2020

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Background: Autistic individuals without intellectual disability are at heightened risk of self-injury, and appear to engage in it for similar reasons as non-autistic people. A wide divergence of autistic perspectives on self-injury, including those who frame it as a helpful coping mechanism, motivate investigating the link between self-injury, suicide ideation, and attempts which has been reported in typically developing individuals. Method: One hundred three autistic participants completed the Non-Suicidal Self-Injury Assessment Tool (NSSI-AT), the Suicide Behaviors Questionnaire (SBQ-R), and the Interpersonal Social Evaluation List (ISEL-12) across two online studies. Logistic regression was conducted to predict self-harming status via responses to questions on suicidality, and to predict whether certain self-injurious behaviors, including cutting, were especially associated with suicide ideation and attempts. Non-parametric correlation analysis examined relationships between suicide ideation/ attempts and other variables that might characterize self-harmers especially at risk of suicidality. These included perceived access to social support, purposes or reasons for self-injury, the number of different self-injurious behaviors engaged in, the duration and lifetime incidence of self-injury, and the individual's feelings about their self-injury. Results: While self-injuring status was significantly predicted by responses to a question on suicide ideation and attempts, there was no relationship between suicide ideation/attempts and a participant's personal feelings about their self-injury. The method of cutting was also predicted by suicide ideation and attempts, though other methods common in autistic people were at borderline significance. Use of self-injury for the regulation of low-energy emotional states like depression, for self-punishment or deterrence from suicide, and for sensory stimulation, was associated with suicide ideation and attempts, as was the number of self-injurious behaviors engaged in. There was no significant relationship between suicide ideation/attempts and the duration and lifetime incidence of self-injury or social support. Conclusions: These preliminary data suggest that while individuals might frame their self-injury as a positive or neutral thing, there remains a concerning relationship between self-injury and suicidality which exists regardless of individual feelings on self-injury. This is consistent with the theoretical perspective that self-injury can be a "gateway" through which individuals acquire capability for lethal suicidal behaviors. The data highlight that particular methods (cutting) and reasons for self-injury may be of significant concern, but this information, which might be of extreme value for clinicians, requires further investigation and validation.

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Section: Discussionmentioning

confidence: 99%

Links between self-injury and suicidality in autism

et al. 2020

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“…Additional, likely multiple, causes might contribute to the exacerbation of socio-communicative impairments of autistic individuals in everyday life. These may include cascading effects of impairments in other domains (e.g., sensory abnormalities [71]), a lower propensity to adopt the intentional stance [72], reduced motivational salience of social and non-social stimuli [73], or direct or indirect effects of comorbid conditions (e.g., alexithymia [74]).…”

Section: Effects Of Diagnosismentioning

confidence: 99%

Social brain activation during mentalizing in a large autism cohort: the Longitudinal European Autism Project

et al. 2020

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Background: Autism spectrum disorder (ASD) is a neurodevelopmental condition with key deficits in social functioning. It is widely assumed that the biological underpinnings of social impairment are neurofunctional alterations in the "social brain," a neural circuitry involved in inferring the mental state of a social partner. However, previous evidence comes from small-scale studies and findings have been mixed. We therefore carried out the todate largest study on neural correlates of mentalizing in ASD. Methods: As part of the Longitudinal European Autism Project, we performed functional magnetic resonance imaging at six European sites in a large, well-powered, and deeply phenotyped sample of individuals with ASD (N = 205) and typically developing (TD) individuals (N = 189) aged 6 to 30 years. We presented an animated shapes task to assess and comprehensively characterize social brain activation during mentalizing. We tested for effects of age, diagnosis, and their association with symptom measures, including a continuous measure of autistic traits. Results: We observed robust effects of task. Within the ASD sample, autistic traits were moderately associated with functional activation in one of the key regions of the social brain, the dorsomedial prefrontal cortex. However, there were no significant effects of diagnosis on task performance and no effects of age and diagnosis on social brain responses. Besides a lack of mean group differences, our data provide no evidence for meaningful differences in the distribution of brain response measures. Extensive control analyses suggest that the lack of case-control differences was not due to a variety of potential confounders.

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“…To our knowledge this is also the first study controlling for ASD when investigating FER in recovered AN. Alexithymia has been reported to be elevated in AN compared to healthy controls (Westwood, Kerr-Gaffney, Stahl, & Tchanturia, 2017) and in ASD (Kinnaird, Stewart, & Tchanturia, 2018) and it has been argued that alexithymia is associated with impairments in emotion recognition independently of clinical status (Grynberg et al, 2012). However, larger numbers of women with recAN+ASD will be needed in future studies in order to specifically examine the differences between AN with and without ASD in facial emotional processing.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Visual scanning during emotion recognition in long‐term recovered anorexia nervosa: An eye‐tracking study

Dinkler

Dobrescu

Råstam

et al. 2019

Intl J Eating Disorders

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Objective: To examine Facial Emotion Recognition (FER) and visual scanning behavior (eye-tracking) during FER in women long-term recovered from teenage-onset anorexia nervosa (recAN) with and without autism spectrum disorder (±ASD) and age-matched comparison women (COMP), using a sensitive design with facial emotion expressions at varying intensities in order to approximate real social contexts.Method: Fifty-seven 38-47-year-old women (26 recAN of whom six with ASD, 31 COMP) participated in the study. They completed a non-verbal FER task, consisting of matching basic emotions at different levels of expression intensity with full emotional expressions. Accuracy, response time and visual scanning behavior were measured.Results: There were no differences between recAN-ASD and COMP in FER accuracy and visual scanning behavior during FER, including eye viewing and hyperscanning. In an exploratory analysis, recAN+ASD were more accurate than recAN-ASD in identifying expressions at low intensity, but not at medium or high expression intensity.Accuracy was not associated with the extent of attention to the eye region.Discussion: Our data indicate that women long-term recovered from adolescentonset AN do not have deficits in basic FER ability and visual scanning behavior during FER. However, the presence of comorbid ASD might affect face processing in recovered AN. Future studies investigating basic FER in acute and recovered AN and other conditions need to ensure that the stimuli used are sensitive enough to detect potential deficits. K E Y W O R D Sanorexia nervosa, autism spectrum disorder, emotion recognition, eye tracking, facial expression

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Investigating alexithymia in autism: A systematic review and meta-analysis

Cited by 324 publications

References 57 publications

Links between self-injury and suicidality in autism

Links between self-injury and suicidality in autism

Social brain activation during mentalizing in a large autism cohort: the Longitudinal European Autism Project

Visual scanning during emotion recognition in long‐term recovered anorexia nervosa: An eye‐tracking study

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