Facial and Bodily Emotion Recognition in Autism: The Role of Alexithymia

Abstract

Background:

There is a general belief in the scientific community that autistic people have emotion recognition (ER) difficulties. Despite this, the research is inconclusive, with roughly half of the studies showing that autistic people have similar ER ability to non-autistic people. The alexithymia hypothesis posits that ER differences found in some autistic individuals might be due to concurrent alexithymia, with some incipient research backing this claim. One limitation of past literature is the focus on facial expressions, with ER from body language remaining understudied, especially in relation to autism and alexithymia.

Methods:

Adults (N = 364) completed a face and body ER task containing video expressions of all basic emotions, during which we measured their accuracy, confidence, and intensity ratings. Participants also completed Alexithymia (PAQ) and autism traits (AQ-10) questionnaires. After data cleaning, we split participants into an autistic group (n = 71) and non-autistic group (n = 279). We used alexithymia scores to further split the two autism groups into high and low alexithymia categories. We investigated the effects of autism and alexithymia on body and face ER accuracy (unbiased hit rates), confidence ratings, and intensity ratings.

Results:

Autistic individuals had slightly lower accuracy and confidence than non-autistic individuals. When alexithymia was modeled with autism, autistic people were no different than non-autistic people on accuracy and confidence. Alexithymia was a better predictor of confidence than autism and interacted with modality. Bodies were harder to recognize than faces, but we found no interaction between modality and autism or alexithymia. Our results did not find differences in intensity ratings.

Conclusion:

Alexithymia may account for differences in ER accuracy and confidence between autistic and non-autistic people. Our findings support the alexithymia hypothesis of autism. This is the first study comparing facial and bodily ER in autistic and non-autistic people and in low- and high-alexithymia-score individuals.

Community Brief

What was the purpose of this study?

Autistic people are often seen by the scientific community as having impairments in social abilities. When it comes to recognizing emotions, scientists believe that autistic people are worse. However, only half of the studies done so far found autistic people to be less accurate at recognizing emotions. The beliefs of the scientific community, especially when not entirely true, can be damaging to autistic people’s self-worth and the way other people treat them.

Why is this an important issue?

We tried to see if another trait, alexithymia, explains the mixed findings in emotion recognition (ER) studies with autistic people. Alexithymia is a personality trait, not a diagnosis. Alexithymic people describe themselves as having difficulties identifying their feelings, describing their feelings, and focus more on external happenings instead of internal experiences. We wanted to see if alexithymia explains ER difficulties that some people experience, instead of autism.

What did the researchers do?

We tested 364 people using an online test to see how accurate and confident they are in recognizing anger, disgust, fear, joy, sadness, and surprise. We also asked them to rate how intense they thought the emotion expressions were. They also completed alexithymia and autism self-report questionnaires. After cleaning the data, we split the people into two groups: autistic (71) and non-autistic (279). We compared the two groups on how they recognize emotions, how confident they are in their abilities, and how intense they perceive the emotions to be.

What were the results and conclusions of the study?

It seemed like autistic people did not have reduced ER accuracy and confidence when taking alexithymia into account, regardless of whether they looked at emotions expressed in the face or the body. In other words, alexithymia explained ER differences in autism. Alexithymia was a better predictor of confidence in ER than autism.

What is new or controversial about these findings?

This is the first study comparing facial and bodily ER in autistic people, showing that autistic people are not better or worse at body expression recognition. It also supports the alexithymia hypothesis of autism, which says that ER difficulties are due to alexithymia, not autism.

What are potential weaknesses in the study?

This study could not gender balance the autism groups, with more males and non-binary people in the autistic sample. In addition, most of the people in the study were young adults; more research needs to be conducted on older adults and children.

How will these findings help autistic adults now or in the future?

First, these findings cast doubt on the idea that autism is associated with ER problems, contrary to stereotypes that may harm autistic people. Second, it could inform non-verbal communication support practices, calling attention more toward alexithymic individuals. It points toward the existence of a high alexithymia subgroup on the autistic spectrum, a group of people that might benefit from understanding alexithymia better and from additional non-verbal communication support.