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Emotion Regulation in Asperger's Syndrome and High-Functioning Autism

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It is generally thought that individuals with Asperger's syndrome and high-functioning autism (AS/HFA) have deficits in theory of mind. These deficits have been previously linked to problems with social cognition. However, we reasoned that AS/HFA individuals' Theory of Mind deficits also might lead to problems with emotion regulation. To assess emotional functioning in AS/HFA, 27 AS/HFA adults (16 women) and 27 age-, gender-, and education-matched typically developing (TD) participants completed a battery of measures of emotion experience, labeling, and regulation. With respect to emotion experience, individuals with AS/HFA reported higher levels of negative emotions, but similar levels of positive emotions, compared with TD individuals. With respect to emotion labeling, individuals with AS/HFA had greater difficulties identifying and describing their emotions, with approximately two-thirds exceeding the cutoff for alexithymia. With respect to emotion regulation, individuals with AS/HFA used reappraisal less frequently than TD individuals and reported lower levels of reappraisal self-efficacy. Although AS/HFA individuals used suppression more frequently than TD individuals, no difference in suppression self-efficacy was found. It is important to note that these differences in emotion regulation were evident even when controlling for emotion experience and labeling. Implications of these deficits are discussed, and future research directions are proposed.
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Emotion
Emotion Regulation in Asperger's Syndrome and
High-Functioning Autism
Andrea C. Samson, Oswald Huber, and James J. Gross
Online First Publication, May 28, 2012. doi: 10.1037/a0027975
CITATION
Samson, A. C., Huber, O., & Gross, J. J. (2012, May 28). Emotion Regulation in Asperger's
Syndrome and High-Functioning Autism. Emotion. Advance online publication. doi:
10.1037/a0027975
Emotion Regulation in Asperger’s Syndrome and High-Functioning Autism
Andrea C. Samson
Stanford University
Oswald Huber
University of Fribourg
James J. Gross
Stanford University
It is generally thought that individuals with Asperger’s syndrome and high-functioning autism (AS/HFA)
have deficits in Theory of Mind. These deficits have been previously linked to problems with social
cognition. However, we reasoned that AS/HFA individuals’ Theory of Mind deficits also might lead to
problems with emotion regulation. To assess emotional functioning in AS/HFA, 27 AS/HFA adults (16
women) and 27 age-, gender-, and education-matched typically developing (TD) participants completed
a battery of measures of emotion experience, labeling, and regulation. With respect to emotion experi-
ence, individuals with AS/HFA reported higher levels of negative emotions, but similar levels of positive
emotions, compared with TD individuals. With respect to emotion labeling, individuals with AS/HFA
had greater difficulties identifying and describing their emotions, with approximately two-thirds exceed-
ing the cutoff for alexithymia. With respect to emotion regulation, individuals with AS/HFA used
reappraisal less frequently than TD individuals and reported lower levels of reappraisal self-efficacy.
Although AS/HFA individuals used suppression more frequently than TD individuals, no difference in
suppression self-efficacy was found. It is important to note that these differences in emotion regulation
were evident even when controlling for emotion experience and labeling. Implications of these deficits
are discussed, and future research directions are proposed.
Keywords: emotional reactivity, emotion regulation, autism, autism spectrum disorder, Asperger’s
syndrome
One of the key deficits in individuals with Asperger’s syndrome
and high-functioning autism (AS/HFA) is thought to center around
impairments in their cognitive and affective Theory of Mind and
related perspective taking processes (Shamay-Tsoory, Tomer,
Berger, Goldsher, & Aharon-Peretz, 2005). In particular, individ-
uals with AS/HFA often show an impaired comprehension of other
people’s mental states, such as thoughts, beliefs, and intentions
(e.g., Frith & Frith, 2003; Frith & Happe´, 1994). These deficien-
cies in Theory of Mind previously have been linked to deficits in
social communication such as diminished facial expressivity, low
levels of joint attention, and diminished sharing of emotions
(Baron-Cohen, 1995; Baron-Cohen, Wheelwright, Skinner, Mar-
tin, & Clubley, 2001). We propose that deficits in Theory of Mind
also may help to explain clinical and initial empirical reports that
individuals with AS/HFA have difficulties regulating their emo-
tions (e.g., Laurent & Rubin, 2004; Rieffe et al., 2011).
Theory of Mind and Affective Functioning:
Theoretical Expectations
Although Theory of Mind is typically seen as referring to the
ability to assess other people’s mental states, there is strong evi-
dence that the processes of assessing one’s own and other’s mental
states are closely related (Frith, 1989; Frith & Frith, 2003). This
suggests that Theory of Mind deficits might also lead to difficulties
assessing one’s own mental states (e.g., Moriguchi et al., 2006). It
is important to note that this may not only hold for cognitive states,
but also for emotional states. If this is correct, Theory of Mind
deficits should be related to difficulties reading and labeling one’s
own emotions, as well as those of other people. If AS/HFA
children express little emotion (e.g., Yirmiya, Kasari, Sigman, &
Mundy, 1989) these difficulties might be exacerbated by the fact
that caretakers of these children would have difficulty mirroring
their children’s emotions and teaching them adequate emotional
responses.
What implications might such deficits have for emotion regu-
lation? It has been suggested that the ability to accurately label
one’s emotional states is an important prerequisite for successful
emotion regulation (Barrett, Gross, Conner, & Benvenuto, 2001).
This observation generates the prediction that individuals with
AS/HFA might have difficulties with emotion regulation. In par-
ticular, Theory of Mind deficits might compromise emotion reg-
ulation strategies that rely on cognitive processes related to per-
spective change. One example of such a cognitive emotion
regulation process is reappraisal, an adaptive emotion regulation
Andrea C. Samson and James J. Gross, Department of Psychology,
Stanford University; Oswald Huber, Department of Psychology, University
of Fribourg, Fribourg, Switzerland.
We thank Ilona Papousek, Heribert Freudenthaler, and Janka Bryjova
for their help in recruiting participants for the comparison group, and
Rebecca Podell for comments on the manuscript.
Correspondence concerning this article should be addressed to Andrea C.
Samson, Department of Psychology, Stanford University, 450 Serra Mall,
Building 420, Stanford, CA 94305. E-mail: andrea.samson@stanford.edu
Emotion © 2012 American Psychological Association
2012, Vol. ●●, No. , 000– 000 1528-3542/12/$12.00 DOI: 10.1037/a0027975
1
strategy that is strongly related to cognitive change (Gross & John,
2003). This line of reasoning suggests that individuals with AS/
HFA would be less likely to use reappraisal than typically devel-
oping (TD) individuals.
Emotion Experience, Labeling, and Regulation:
Empirical Findings
Consistent with these expectations, prior research indicates that
the emotional responses of individuals with AS/HFA are less
differentiated, more negative, and less positive than those of con-
trols (e.g., Ben Shalom et al., 2006; Capps, Kasari, Yirmiya, &
Sigman, 1993; Joseph & Tager-Flusber, 1997; Kasari & Sigman,
1997; Samson, Huber, & Ruch, 2011a). In addition, individuals
with AS/HFA experience significant difficulties adequately assess-
ing and labeling their own emotions (i.e., alexithymia; see Berthoz
& Hill, 2005; Fitzgerald & Bellgrove, 2006; Fitzgerald & Moly-
neux, 2004; Hill, Berthoz, & Frith, 2004; Szatmari et al., 2008;
Tani et al., 2004).
Recent studies have also provided initial evidence for emotion
regulation deficits among AS/HFA populations. For example,
Konstantareas and Stewart (2006) showed that children diagnosed
with ASD employ fewer adaptive coping strategies in mildly
frustrating situations. Immature patterns of behavior that might be
related to emotion regulation, such as chewing on clothing or
carrying around unusual objects, have also been observed among
AS/HFA individuals (Geller, 2005; Laurent & Rubin, 2004;
Myles, 2003; Volkmar & Klin, 2003). However, so far no study
has focused on specific, well-defined emotion regulation strategies
such as reappraisal and suppression.
The Present Study
The goal of the present study was to examine emotion regulation
in individuals with AS/HFA, as well as TD individuals. Using an
online survey methodology, adults with and without AS/HFA were
asked to complete a battery of measures concerned with emotional
experience, emotion labeling, and emotion regulation. Under the
assumption that individuals with AS/HFA have more Theory of
Mind deficits, we expected that compared with TD adults, indi-
viduals with AS/HFA would (a) experience more negative and less
positive emotions, (b) have more difficulties labeling their own
emotions, and (c) have more difficulties with emotion regulation,
particularly with strategies associated with cognitive reappraisal.
We expected differences in emotion labeling and regulation to
persist even when statistically controlling for emotion experience,
and differences in emotion regulation to persist even when con-
trolling for expected differences in emotion experience and label-
ing.
Method
Participants
Twenty-seven individuals with AS/HFA and 27 TD control
participants matched on gender, age, and educational level com-
pleted the questionnaires online. Male participants made up 41%
(N11) of both groups. There was no age difference between the
TD (M35.22, SD 12.82, range 18 64 years) and the
AS/HFA group (M33.56, SD 12.82, range 18 –53 years);
F(1, 53) .28, nonsignificant (ns). The two groups did not differ
in their educational level,
2
(1) .77, ns: 63% of individuals with
AS/HFA and 74.1% of the TD group were in college, or already
had a college degree. The other participants were in high school or
had a high school degree.
As expected, individuals with AS/HFA scored higher (M
25.44, SD 4.53) than the controls (M8.19, SD 4.51) on the
short German version (AQ-k; Freitag et al., 2007) of the Autism-
Spectrum Quotient (AQ, original long version by Baron-Cohen et
al., 2001), F(1, 53) 196.77, p.001, ␩⫽.89. A score of 17 is
seen as the cutoff for a diagnosis with autism. One individual with
AS had an AQ-k score of 16 and was therefore excluded from
further analysis. Therefore, all AS/HFA participants (and none of
the TD participants) had scores greater than this cutoff. It is
important to note that the AQ-k is not a formal diagnostic instru-
ment. The reliability was very good in the present sample (Cron-
bach’s alpha .76 for the TD group, .83 for the AS/HFA group).
Procedure
An invitation e-mail with the link to the online survey was sent
to 50 German-speaking individuals who had participated in previ-
ous studies (e.g., Samson, Huber & Ruch, 2011b). All had a
diagnosis of AS (ICD-10: F84.5) or HFA, confirmed by a referring
psychotherapist or psychiatrist. In total, 26 individuals with AS
and 2 individuals with HFA filled out the questionnaires com-
pletely (however, one individual with AS was excluded because of
an AQ-k score of 16). The same invitation e-mail was sent to
approximately 150 control individuals who had previously taken
part in online experiments or were currently on a mailing list at a
German-speaking university. Seventy-six individuals filled out the
questionnaires completely, of whom we selected 27 control par-
ticipants who matched the AS/HFA individuals on gender, age,
and education level. In the online survey, participants received
general instructions regarding the study and were assured that their
data would be handled confidentially. They were then asked for
demographic information. Prior to each of the questionnaires,
participants received specific instructions explaining the answer
formats. In the end, they were thanked for participating in the
online survey.
Measures
Emotion experience. The Positive and Negative Affect
Schedule (PANAS) is a 20-item self-report measure of positive
and negative affect developed by Watson, Clark, and Tellegen
(1988). The German version was used (Krohne, Eggloff, Kohl-
mann, & Tausch, 1996) in the present study. Positive Affect (PA)
reflects the extent to which a person feels enthusiastic, active, and
alert. Negative Affect (NA) reflects the extent to which a person
feels negative affective states, such as being nervous and upset.
The scale ranged from 1 (very slightly or not at all)to5(very
much). In the current study the time frame for responses regarding
emotional experience was “during the past weeks.” Cronbach’s
alpha’s were satisfactorily high for PA (.93 for AS/HFA, .82 for
TD) and NA (.70 for AS/HFA, .79 for TD).
Emotion labeling. The 20-item Toronto-Alexithymia-Scale
(TAS-20; Parker, Bagby, & Taylor, 1993; German version: Bach,
2SAMSON, HUBER, AND GROSS
Bach, de Zwaan, Serim, & Böhmer, 1996) is a 20-item measure
that assesses alexithymia on a 5-point scale from 1 to 5, resulting
in a sum score ranging from 20 to 100. The cutoff of 61
describes high alexithymics (see Franz et al., 2008). The reliability
for both groups was very good for the subscales “difficulty iden-
tifying feelings” (Cronbach’s alpha .76 for AS/HFA, .87 for
TD), “difficulty describing feelings” (.81 for AS/HFA, .73 for
TD), and the total score (.84 for AS/HFA, .87 for TD), but
reliability for “external-oriented thinking” was only moderate (.65
for both groups).
Emotion regulation. The Emotion Regulation Questionnaire
(ERQ; Gross & John, 2003; German version: Abler & Kessler,
2009) measures the frequency of use of two types of emotion
regulation: reappraisal, defined as trying to change the meaning of
a situation in order to change its emotional impact (6 items), and
suppression, defined as trying to inhibit emotion-related behaviors
(4 items). In addition, we administered a parallel set of items that
measure emotion regulation self-efficacy for reappraisal (6 items)
and suppression (4 items; Goldin, Manber-Ball, Werner, Heim-
berg, & Gross, 2009). Reliabilities were adequate to good for
reappraisal frequency (Cronbach’s alpha .86 for both groups),
reappraisal self-efficacy (.93 for AS/HFA, .92 for TD), and sup-
pression self-efficacy (.85 for AS/HFA, .98 for TD). However, the
reliabilty for suppression frequency was .60 in the TD group and
.52 in the AS/HFA group. Therefore, the results related to sup-
pression frequency should be interpreted with caution.
Statistical Analyses
In primary analyses, differences between the AS/HFA and TD
individuals were assessed using one-way analyses of variance. The
pvalues were Bonferroni-adjusted within the domains of emo-
tional experience and emotion regulation to control for Type I
error. In secondary analyses, we computed two sets of analyses of
covariance (ANCOVAs); first, labeling and regulation measures
were outcomes and the experience measures were covariates, and
second, regulation measures were outcomes and the experience
and labeling measures were covariates.
Results
Emotional Reactivity
The group comparisons on the PANAS revealed that individuals
with AS/HFA reported higher levels of negative emotion (M
25.30, SD 5.67) than TD individuals (M18.33, SD 4.70),
F(1, 53) 24.15, p.001, ␩⫽.56, but did not differ from
controls regarding positive emotion (AS/HFA: M33.55, SD
6.05, TD: M31.30, SD 9.26), F(1, 53) 1.13, ns.
Emotion Labeling
Individuals with AS/HFA had more difficulty identifying (M
23.63, SD 4.76) and describing (M18.19, SD 4.24) their
emotions than the control group (identifying: M14.52, SD
5.15), F(1, 53) 45.63, p.001, ␩⫽.68; (describing: M
11.22, SD 3.66), F(1, 53) 41.67, p.001, ␩⫽.66. No
significant differences were found in external-oriented thinking in
individuals with AS/HFA (M19.59, SD 4.67) and TD
individuals (M16.96, SD 3.95), F(1, 53) 4.99, ns. The total
score of the TAS-20, indicating alexithymia, was significantly
higher in AS/HFA (M61.41, SD 10.85) than in TD individ-
uals (M42.70, SD 10.35), F(1, 53) 42.02, p.001, ␩⫽
.66. Sixty-three percent of the individuals with AS/HFA group
exceeded the cutoff score for alexithymia, whereas none of the TD
individuals exceeded the cutoff score of 61.
Emotion Regulation
As expected, individuals with AS/HFA reported using less re-
appraisal, F(1, 53) 9.12, p.05, ␩⫽.39, and indicated less
reappraisal self-efficacy, F(1, 53) 9.65, p.05, ␩⫽.39.
Furthermore, individuals with AS/HFA reported using more sup-
pression, F(1, 53) 11.08, p.01, ␩⫽.42, than the control
group. However, because frequency of suppression yielded very
low Cronbach’s alpha, this scale has to be interpreted with caution.
It is interesting to note that no differences in suppression self-
efficacy were found between the two groups, F(1, 53) 0.00, ns
(Figure 1).
Secondary Analyses
ANCOVAs of the labeling and regulation measures were per-
formed in which positive and negative emotions were entered as
covariates. Even when positive and negative emotions were entered as
covariates, the groups differed in alexithymia, F(3, 50) 16.65, p
.001, ␩⫽.71; reappraisal frequency, F(3, 50) 8.50, p.001, ␩⫽
.58; reappraisal self-efficacy, F(3, 50) 9.47, p.001, ␩⫽.60; and
suppression frequency, F(3, 50) 7.51, p.001, ␩⫽.56.
ANCOVAs of each of the emotion regulation measures were also
conducted in which emotion experience (positive emotion, negative
emotion) and labeling (alexithymia) were entered as covariates. Re-
sults indicated that the groups still differed on reappraisal frequency,
F(4, 49) 7.13, p.001, ␩⫽.61; reappraisal self-efficacy, F(4,
49) 7.78, p.001, ␩⫽.62; and suppression frequency, F(4, 49)
7.10, p.001, ␩⫽.61.
Figure 1. Emotion regulation profiles (means and standard errors) in
individuals with Asperger’s syndrome and high-functioning autism (AS/
HFA) versus typically developing (TD) individuals.
p.05.
ⴱⴱ
p.01.
3
EMOTION REGULATION IN AUTISM
Discussion
Motivated by our analysis of the implications of Theory of
Mind deficits for affective functioning, we examined patterns of
emotion experience, emotion labeling, and emotion regulation
in a sample of individuals with AS/HFA as well as TD indi-
viduals. Our findings suggest that compared with TD partici-
pants, individuals with AS/HFA had greater levels of negative
affect, more difficulty identifying and describing their emo-
tions, lower levels of reappraisal use and self-efficacy, and
greater levels of suppression. These differences between groups
persisted even when differences in emotion experience and
labeling were controlled for.
Emotion Experience and Labeling
Our finding of elevated negative emotion in AS/HFA is
consistent with prior findings (Capps et al., 1993; Joseph &
Tager-Flusbert, 1997; Kasari & Sigman, 1997). Inconsistent
with our expectations, we found comparable levels of positive
emotions in the two groups. One reason for this finding could
be that most of the studies investigating positive emotions in
ASD did so by focusing on emotions in social contexts (see also
Dawson, Hill, Spencer, Galpert, & Watson, 1990; Kasari, Sig-
man, Mundy, & Yirmiya, 1990), whereas the PANAS is context
free. Therefore, other sources might have been taken into ac-
count while the participants responded to the items of the
PANAS, such as concrete emotion-eliciting events, which lead
to more positive emotions in high-functioning adults with au-
tism than social interactions do (Jaedicke, Storoschuk, & Lord,
1994).
As expected, we also found that individuals with AS/HFA have
more difficulty identifying and describing their emotions than TD
individuals do, with approximately two-thirds of the AS/HFA
individuals exceeding the cutoff for alexithymia. This difference
persists even when controlling for emotion experience. This find-
ing suggests that differences in emotion labeling cannot be ex-
plained by differences in emotion experience.
Emotion Regulation
In the domain of emotion regulation, adults with AS/HFA
reported using less cognitive reappraisal than TD individuals. They
also expressed less self-efficacy in reappraising their emotions.
However, they had comparable self-efficacy scores in using sup-
pression, a less adaptive emotion regulation strategy. In addition,
individuals with AS/HFA used more suppression than TD individ-
uals. This suggests a less adaptive emotion regulation profile in
individuals with AS/HFA compared to TD individuals (see
Geraerts, Merckelbach, Jelicic, & Smeets, 2006; Gross & John,
2003; Richards & Gross, 1999).
These emotion regulation effects persisted even when con-
trolling for differences in emotion experience and in the ability
to describe and identify emotions. This is important because
emotion experience, labeling, and regulation influence and af-
fect one other (e.g., Bailey & Henry, 2007; Berthoz & Hill,
2005; Gross, 1999; Sifne´os, 1973; Swart, Kortekaas, & Aleman
2009) and yet, in this case, regulation difficulties cannot be
solely explained by labeling difficulties. It is important to note
that reappraisal, that is, the process of taking another mental
perspective on a stimulus or situation in order to reinterpret its
meaning, is most strongly affected in individuals with AS/HFA.
One potential explanation for this is that reappraisal relies on
abilities linked, or similar, to perspective taking processes and
Theory of Mind, while other strategies, such as suppression, are
distinct from perspective taking processes and therefore less
affected in AS/HFA.
Implications for Assessment and Intervention
The present findings suggest several implications for assess-
ment and intervention. The present findings suggest the value of
assessments that differentiate among multiple types of emotion
regulation including cognitive reappraisal and expressive sup-
pression. With respect to intervention, several strategies might
improve affective functioning in individuals with AS/HFA.
These include techniques that enhance the ability of individuals
with AS/HFA to attend to and discriminate emotions (emotional
attention and clarity), as well as strategies that aim to increase
the ability to respond flexibly to one’s own emotions. Given
that individuals with AS/HFA report that they experience
greater difficulty reappraising stressful and negative life events
or situations as neutral or positive, interventions concerned with
emotional functioning should encourage the development of
cognitive processes associated with reappraisal. For example,
interventions could enhance cognitive flexibility, which seems
to be positively related to emotion regulation success (see, e.g.,
Gyurak, Ayduk, & Gross, 2010), or interventions could focus
more directly on the reappraisal process by teaching and train-
ing reappraisal strategies.
Efforts have been made to develop techniques and strategies for
individuals with ASD that address stress management (Myles,
2003), anger management (Sofronoff, Attwood, Hinton, & Levin,
2007) and emotion regulation (e.g., Prizant, Wetherby, Rubin, &
Lauret, 2003; Scarpa & Reyes, 2011), and suggest the promise of
this research direction. While cognitive-linguistic strategies to
enhance self-regulation (Prizant et al., 2003) and “thinking tools”
as part of the intervention program described by Scarpa and Reyes
(2003) have been described, the findings of the present study
provide an impetus to design an emotional intervention treatment
that specifically aims to teach and ameliorate reappraisal strate-
gies, focusing on improving the perspective changing abilities in
the AS/HFA population.
Limitations and Future Directions
Although the present study adds to our growing understand-
ing of emotion regulation in AS/HFA, it has several limitations.
First, although online studies have been shown to be as reliable
and valid as paper-pencil based assessments (e.g., Gosling,
Vazire, Srivastava, & John, 2004), and previous studies have
shown that individuals with AS/HFA are able to respond to
self-report questionnaires adequately (e.g., Berthoz & Hill,
2005), the format limited our assessment. Future research
should include performance measures for emotion regulation
and Theory of Mind. Although the ERQ correlates with perfor-
mance-based assessments (Fladung, Baron, Gunst, & Kiefer,
2010; McRae, Jacobs, Ray, John, & Gross, 2012), future studies
4SAMSON, HUBER, AND GROSS
should test other emotion regulation strategies including dis-
traction, situation modification, and avoidance to fully under-
stand the nuances and complexities of emotion regulation in
AS/HFA. Moreover, although the Autism Quotient is related to
Theory of Mind, an important step in future research is to
empirically assess Theory of Mind and perspective taking abil-
ities, and their relation to emotion regulation.
A second limitation concerns the generalizability of the results
found in the present study. Usually, the prevalence of alexithymia
ranges between 5% to 15% in normal populations (Kokkonen et
al., 2001; Salminen, Saarija¨rvi, äa¨rela¨, Toikka, & Kauhanen,
1999). However, in our TD group, no one exceeded the cutoff for
alexithymia. The exceptionally low alexithymia scores in our TD
group suggest the importance of investigating whether our findings
extend to other samples. Furthermore, although we have no avail-
able information on IQ scores, we can assume that we had a high
functioning clinical sample, on the basis of the educational level.
Our findings are therefore not necessarily representative of lower
functioning individuals with AS/HFA, for whom additional diffi-
culties with language and IQ might interfere with regulating emo-
tions. Emotional reactivity and regulation in low functioning au-
tism must be explored in future studies. Usually, more males than
females are diagnosed with AS/HFA. This means that females are
overrepresented in the current sample relative to the larger popu-
lation. At the same time this overrepresentation is a strength of the
present study, since information about females with AS/HFA is
limited in the literature. For future work with larger samples, it will
be important to assess the possibility of gender-specific findings
related to emotion regulation.
Finally, as previous studies on emotion regulation difficulties in
ASD have mainly concentrated on children, our study shows that
emotion regulation difficulties are also present in adulthood. It
would be interesting to investigate the developmental trajectories
of emotion regulation in individuals with AS/HFA in more detail.
Our findings suggest that individuals with AS/HFA learn to use
certain specific regulation strategies to manage their emotions, but
not others. In the present study, we found that they use suppression
as well as TD individuals, but are less able to employ reappraisal.
A study investigating developmental aspects and various emotion
regulation strategies would be enlightening for the understanding
of emotion regulation in AS/HFA individuals.
Concluding Comment
Although emotional problems are not usually seen as part of the
core features of ASD, recent findings have shown that there is an
overlap between core diagnostic features and emotional/behavioral
problems in ASD (Georgiades et al., 2011). Our study helps us to
better characterize emotional difficulties in AS/HFA that we sug-
gest may flow from deficits in Theory of Mind and perspective
taking. Our results show that emotion regulation difficulties, most
pronounced in reappraisal, cannot be explained by differences in
the emotion experience or emotion labeling. Moreover, difficulties
in reappraisal, one of the most adaptive emotion regulation strat-
egies, might be specifically associated with deficits in perspective
taking abilities related to Theory of Mind. However, further re-
search is needed to better understand emotion regulation in AS/
HFA and its links to core symptoms of the disorder.
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Received April 23, 2011
Revision received February 15, 2012
Accepted February 16, 2012
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... Supporting this notion, a recent empirical study discovered a moderate association between alexithymia and emotion dysregulation in autistic youths (Gormley et al., 2022). One of the early studies on ER in autistic adults was able to show that autistic individuals still had more ER difficulties than non-autistic individuals, even if alexithymia was controlled for (Samson et al., 2012). Since around half of autistic people do not have alexithymia, we conclude that alexithymia is not universally present in all autistic people. ...
... The mixture of higher arousal and lower executive function may together contribute to autistic people's tendency to prefer less cognitively demanding ER strategies, such as avoidance or distraction, which historically is deemed maladaptive in the general population. Finally, it is also possible that some autistic individuals may have difficulties changing their perspectives (needed for cognitive reappraisal), which often involves reinterpreting a situation in a different light (Samson et al., 2012). ...
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Difficulties regulating emotions have been coined as inherent to autism, possibly even presenting a core difficulty of autism. While several models of emotion regulation have been proposed in the past, in this targeted review article, we aim to map emotion regulation difficulties in autistic individuals within the framework of the extended process model of emotion regulation. This model can be considered the most comprehensive one currently incorporating not only different emotion regulation strategy groups but also different stages and processes involved in successful self-focused emotion regulation. Within this model, we will identify areas and domains as specifically impacted by autistic individuals. We will also outline gaps in the literature and provide suggestions for future research that can help deepen our understanding of the emotion regulation processes of autistic individuals. The ultimate goal is to develop specific support programs that address specific emotion regulation mechanisms, providing a much more individualized support approach. Lay abstract What do we already know about emotion regulation in autism? We know that many autistic children, youth, and adults experience difficulties regulating emotions. Existing research has focused mainly on the differences in emotion regulation capabilities between autistic and non-autistic individuals, the relationships between autistic traits and emotion regulation, and how emotion regulation relates to other outcomes, such as social skills and mental health. What does this paper add? We want to take a new approach to review the existing emotion regulation research through the lens of a specific theoretical model: the extended process model of emotion regulation. Professor James Gross developed this model. It consists of four emotion regulation phases: identification, selection, implementation, and monitoring. Our review revealed specific areas within these emotion regulation phases that could significantly impact the emotion regulation experiences of autistic individuals. We also outline the gaps in the research and propose avenues for future investigation. Implications for practice By deepening our understanding of emotion regulation in autistic individuals through the proposed future research, researchers and clinicians can pave the way for the development of tailored support programs. These programs will directly target specific emotion regulation mechanisms, offering a much-needed individualized support approach.
... Given the significant regulatory difficulties exhibited by many children with ASD and the functional impact of these challenges Jahromi et al., 2012;Mazefsky et al., 2014;Samson et al., 2012Samson et al., , 2015Ting & Weiss, 2017), identification of environmental support mechanisms is key. Findings from the current study replicate those of Fenning et al. (2018), which suggested that parental scaffolding may relate to the emotion regulation of children with ASD in the moment or in the presence of the parent, but this parenting behavior may not contribute significantly to children's independent regulation during the middle-to-late childhood period. ...
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Many children with ASD exhibit difficulties with emotion regulation that greatly impair functioning. Certain intrinsic correlates of dysregulation have been identified in this population, but the search for potential environmental influences has been less fruitful. The current study examined several aspects of parenting as correlates of observed regulation in Autistic children, as measured in both parent-child and independent regulatory contexts. A diverse sample of 76 children with ASD aged 6 to 10 years participated in frustrating laboratory tasks with and without their primary caregivers, and the caregivers completed a parenting questionnaire. Emotion regulation, parental scaffolding, and gentle guidance were coded from videotaped interaction, and scores of parental involvement, positive parenting, and inconsistent discipline were obtained through parent report. Differential relations were observed between parenting and children’s regulation when considered across contexts, with parental scaffolding associated with children’s dyadic regulation and parents’ reports of their involvement and discipline associated with children’s independent regulation. Findings support previous evidence identifying a potential delay in the internalization of parental co-regulatory support in Autistic children, and highlight parental involvement as a previously unidentified unique correlate of independent regulation in this population. Implications for conceptualizations of emotion regulation in autism are discussed as is the importance of extending findings through further longitudinal research.
... Irritability is the clinical manifestation of difficulty in emotion regulation and is associated with reactive aggression and anger (Leibenluft, 2011). Studies have shown a relationship between autism traits and difficulties in emotion regulation ( Jones Bartoli et al., 2009;Kotte et al., 2013;Pisula et al., 2015;Samson et al., 2012;Schoorl et al., 2016). ...
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This study aims to demonstrate that children and adolescents diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) who exhibit autism traits have a more severe clinical profile in terms of emotion regulation, clinical features related to ADHD, and functionality, compared to those diagnosed with ADHD without these traits. 50 patients with and 64 patients without autism traits between the ages of 8–16 were recruited for the study among the children and adolescents diagnosed with ADHD. The Schedule for Affective Disorders and Schizophrenia for School‐Age Children‐Present and Lifetime Version, DSM‐5‐2016‐Turkish Adaptation (K‐SADS‐PL‐DSM‐5‐T) was used to exclude the diagnosis of Autism Spectrum Disorder (ASD) and detect comorbid psychiatric diagnosis. The Social Reciprocity Scale (SRS) was completed by parents to determine groups based on autism traits. Children completed the Childhood Anxiety Sensitivity Index (CASI) and the Affective Reactivity Index (ARI). The Strengths and Difficulties Questionnaire (SDQ), Affective Reactivity Index‐Parent Report (ARI‐P) and Weiss Functional Impairment Rating Scale‐Parent Report (WFIRS‐P) were completed by the parents. We found that the group with autism traits had significantly more hyperactivity/inattention, conduct problems, emotional problems, and peer problems and significantly more irritability and frequent separation anxiety disorder. Although there was no significant impairment in functionality in either group, the level of impairment was significantly higher in the group with autism traits. Children diagnosed with Attention Deficit Hyperactivity Disorder who exhibit autism traits experience higher levels of irritability and separation anxiety disorder, as well as greater impairment in functionality, compared to those without these traits.
... Furthermore, conceptual and empirical evidence suggests that autistic individuals demonstrate delays in the development of ER strategies to regulate emotional responses (Cai et al., 2020(Cai et al., , 2021Cai, Richdale, Uljarevi c, et al., 2018;Conner et al., 2020;Mazefsky et al., 2013;Nuske et al., 2017;Rieffe et al., 2011;Samson et al., 2012Samson et al., , 2014Samson, Wells, et al., 2015). The process model of ER offers a framework for conceptualizing two classes of ER strategies, including antecedent-focused ER (situation selection, situation modification, attention deployment, or cognitive change) and response-focused ER (response modulation) that rely on attentional and cognitive capacities that are significantly impacted in moderate-profound ID (Gross, 1998(Gross, , 2015. ...
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Self‐injurious behaviors (SIB) commonly occur in autism spectrum disorder (ASD) and span diverse topographies of self‐inflicted behaviors ranging from head banging to hitting oneself against hard objects. Despite the high rates of SIB in autistic individuals, relatively little research has focused on psychological factors associated with the development and maintenance of SIB in individuals with autism and moderate‐profound intellectual disability (ID). This commentary synthesizes existing literature on SIB and highlights the need for more research focused on psychological correlates and mechanisms in autistic individuals with moderate‐profound ID. We highlight the key role of difficulties in emotion regulation (ER) and co‐occurring internalizing symptoms in the manifestation of self‐harm behaviors in clinical samples and autism. Furthermore, this commentary proposes a framework for understanding the interplay between poor ER and internalizing symptoms in the development and maintenance of SIB in autistic individuals with moderate‐profound ID. Specifically, we explore the emergence of SIB in the context of precipitating cues that trigger strong emotions, ER processes and strategy deployment, and co‐occurring internalizing symptoms. Future directions and implications for longitudinal research, measurement development, and clinical treatments are discussed.
... ED has been assessed by previous research through various scales: the Emotion Regulation Questionnaire (ERQ) [9][10][11], the Response to Stress Questionnaire (RSQ) [6,12], the Emotion Regulation Checklist (ERC) [13,14], and the Child Behavior Checklist (CBCL) [15,16]. The latter one, which is a questionnaire compiled by caregivers, has been widely applied, thanks to its availability and feasibility, and includes 113 items grouped into eight syndrome scales. ...
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Background/Objectives: Autism Spectrum Disorder (ASD) is a lifelong neurodevelop-mental condition characterized by social communication impairments and repetitive behaviors. Recent reports show that one in thirty-six 8-year-old children are autistic, signifying a considerable public health concern. According to previous studies, emotional dysregulation (ED) affects 50-60% of individuals with ASD and includes symptoms such as poor emotional control, heightened reactivity , and a low frustration tolerance. The main aims of the current study are to investigate the prevalence of ED among autistic preschoolers (below 6 years of age) and to assess the impacts of gender and intellectual disability on their emotional dysregulation profile. Methods: Data have been collected from three children's research hospitals in Italy (IRCCS Stella Maris Foundation, Stella Maris Mediterraneo Foundation, and IRCCS Bambino Gesù). Parents of 825 autistic pre-schooled children (mean age: 39.68 months, SD: 10.51 months) completed a general questionnaire and the Child Behaviour Checklist (CBCL), a reliable caregiver-reported assessment tool which provides a dysregulation profile. Results: A total of 30% of the children displayed a severe-to-moderate ED (emotional dysregulation) profile, with these children exhibiting significantly higher emotional-behavioral problems compared to those without ED. Males with ED exhibited greater emotional reactivity than females with ED. However, no significant relationships were found between ED and age, autism severity (ADOS-2), or intellectual disability. Conclusions: The results underline the importance of early, tailored interventions to face emotional challenges in young children with ASD, potentially improving long-term outcomes for this population.
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Research has found a gap between pro-environmental attitudes and behaviours that has not been understood yet. While studies have highlighted the important role of the cost/benefit evaluation, most of these studies did not consider emotional factors in this evaluation. We aimed to assess the role of emotional factors (i.e., empathy and emotional regulation) in the association between pro-environmental attitudes and behaviours. Specifically, we aimed to verify whether the non-acceptance of own negative emotions could moderate the relationship between pro-environmental attitudes and behaviours in a sample of corporate employees. We assessed pro-environmental attitudes and behaviours, empathy and emotional regulation in N = 1,432 Italian employees. Findings showed that the sample was divided into two clusters based on their levels of empathy and emotional dysregulation. Employees with high cognitive emotion functions showed more pro-environmental behaviours than employees with high affective emotion functions. Furthermore, results showed the partial moderation role of non-acceptance in the pro-environmental attitude–behaviour relationship. Important implications in implementing intervention programmes are discussed.
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Recently, a part of research in pragmatics has been focused on neuropragmatics. Is it a classic case of neuromania as the ones described by Legrenzi et al. (2014), or is it useful for understanding pragmatics? In this paper, we will try to answer this question. Since we believe Autism Spectrum Disorder (ASD) and schizophrenia represent the most vital core of neuropragmatics, neurolinguistics, and clinical pragmatics research (Bambini, Italian Journal of Linguistics 22:1, 2010; Cummings, Clinical pragmatics, Cambridge University Press, 2009; Cummings, Research in Clinical Pragmatics, Springer, 2017), we will review and discuss the neuropragmatic literature on these clinical cases. We will argue that the attempts of linking cerebral activations to pragmatics inferences can be equivocal: similar observations have been frequently raised about the neuroimaging studies (Pennisi, Il linguaggio dell’autismo, Il Mulino, 2016a; Uttal (2001). The new phrenology: the limits of localizing cognitive processes in the brain. The MIT Press.; Van Orden & Paap, 1997). Therefore, we will discuss the philosophical implications of the recent debate on the role of the temporo-parietal junction in the Theory of Mind (ToM). Some scholars in fact hypothesized that humans usually exercise a sort of mental state integration through inferential processes that are specific for mental phenomena (Saxe & Baron-Cohen, 2006) and that probably this ability is damaged in patients with ASD (Charman & Baron-Cohen, 1992; Leslie & Thaiss, 1992; Pennisi P (2016b). Inferential abilities and pragmatic deficits in subjects with Autism Spectrum Disorders. In Pragmemes and Theories of Language Use (pp. 749–768). Springer, Cham.) and schizophrenia (Lee et al., Social Neuroscience 6:569–581, 2011). This idea is much debated: the only way to clarify the problem would be to identify brain areas for mental state integrations (Stone & Gerrans, 2006); some researchers claim that these areas could be in temporo-parietal junction (Perner et al., Social Neuroscience 1:245–258, 2006). We will show that an approach to the neuropragmatics and/or neurolinguistics literature that also considers the philosophical-psychopathological perspective can allow the understanding of the speech of subjects with ASD and schizophrenia. Although the neuropragmatics studies frequently consider that schizophrenic subjects are unable to be ironic, sarcastic or have difficulties in figurative language, the cases of schizophrenic schizophasia, the letters written by the patients or their poetic productions, show that this is not always the case. Probably, in psychotic language cases, the problem is to consider schizophrenia without its delusional-hallucinatory context. So, it seems necessary to us that neuropragmatics and clinical pragmatics need to consider the schizophrenic context: therefore, also of delusion and hallucinations. Also considering the role of the Executive Functions (EF), of ToM or of so-called “domains of language,” if this does not happen there is the risk of losing the sense of schizophrenic speech, and more in general, the sense of the study of cognitive and linguistic context (Bucca, Capone et al. García-Carpintero et al. Falzone (eds), Indirect Reports and Pragmatics in the World Languages, Springer, 2018; Bucca, A. (2020). Il discorso schizofrenico. Verbigerazione, fraintendimenti, fallimenti comunicativi. Reti, saperi, linguaggi, 9(18), 2, 365–380). We recognize the efficacy of neurolinguistics, neuropragmatics, and clinical pragmatics studies, however, we think that these perspectives must be integrated with the philosophical and psychopathological perspective of the cognitive research on language.
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Background Parents have long held an important role in their autistic children’s lives. As autistic individuals enroll in higher education institutions at much higher rates, new issues emerge. In particular, autistic college students and their parents must reconcile the major transition with the extent to which parents must be involved and exert their influence. Purpose/Objective/Research Question/Focus of Study This phenomenological study set in a community college aimed to answer this question: How do autistic students, their parents, and college staff make meaning of parental involvement during autistic students’ transitions into postsecondary education? Parental involvement is of great relevance not only to autism-specific college support programs, such as the one featured in this study that helps students and parents negotiate these relationships, but also to colleges writ large. To disentangle the nuanced elements of parental involvement, I incorporated interdependence theory that explores the impacts of each stakeholder group’s outcomes on one another. Uncovering these dynamics may help in identifying realistic solutions that honor stakeholders’ various priorities and allow autistic students to leverage greater agency in their college journeys. Research Design This study was set in a community college boasting an autism-specific college support program featuring programming to support autistic learners in their college experiences, inclusive of issues around independence and advocacy. Employing a descriptive phenomenological approach allowed for deconstructing the nuanced interactions among parents, adult autistic children navigating college, and college staff. Here parental involvement served as the phenomenon of focus. Participants included 13 autistic college students, 5 mothers, and 15 college staff. Students engaged in surveys, interviews, observations, and written reflections, whereas mothers and college staff participated in interviews. Conclusions/Recommendations Parents and their children—autistic college students—must constantly re-evaluate and recalibrate their relationships as students gradually gain more independence. This study illuminates how institutional supports and stakeholders, including those associated with the autism-specific college support program, enable autistic college students to demonstrate growth in their agency. This study puts forward many recommendations for varied stakeholders, including, but not limited to, elevating self-advocacy training in forming students’ transition plans (high school personnel) and engaging in role-playing activities (parents and children). Regarding future research, takeaways call for longitudinal work to track autistic students’ distinct presentations of independence over time, as well as embedding journals or other reflective materials for parents to make sense of their communication patterns with their children.
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Background: Hardly any psychology research has been done specifically centered around chess, despite it being such a psychologically rich and interesting game. This study aims to understand the role of psychopathology in chess and its relationship to the ways in which individuals process emotions, specifically looking at Autism Spectrum Disorder. Results: Individuals with self-identified ASD represented the only group to report experiencing no anger throughout the tournament. Individuals with self-identified depression reported the lowest average happiness and the highest average sadistic feelings. Additionally, findings imply that feelings of competitiveness decrease with age and with increased skill level. Further research would need to be done to understand the prevalence of these findings, however, as statistical significance cannot be established due to the small sample size.
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Parents' perceptions of their children's emotional expressiveness, and possible bases for these perceptions, were investigated in a study comparing older, nonretarded autistic and normal children and in another study comparing young autistic, mentally retarded, and normal children. Both groups of autistic children were perceived as showing more negative emotion and less positive emotion than comparison children. In the younger sample, parental perceptions correlated with the children's attention and responsiveness to others' displays of emotion in 2 laboratory situations. Findings contradict the view that autism involves the "absence of emotional reaction" (American Psychiatric Association, 1987, p. 35).
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In recent studies of the structure of affect, positive and negative affect have consistently emerged as two dominant and relatively independent dimensions. A number of mood scales have been created to measure these factors; however, many existing measures are inadequate, showing low reliability or poor convergent or discriminant validity. To fill the need for reliable and valid Positive Affect and Negative Affect scales that are also brief and easy to administer, we developed two 10-item mood scales that comprise the Positive and Negative Affect Schedule (PANAS). The scales are shown to be highly internally consistent, largely uncorrelated, and stable at appropriate levels over a 2-month time period. Normative data and factorial and external evidence of convergent and discriminant validity for the scales are also presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)
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