Poster #14 - Emotion Regulation to Faces as a Mechanism of Passing as Non-autistic in Adolescence

• In Event: Poster Session 08

Abstract

Background: Passing as non-autistic (PAN, sometimes called camouflaging) is a phenomenon in which an autistic person does not present as autistic in certain contexts (Libsack et al, 2021). While PAN is increasingly a focus of descriptive and theoretical research, little work has examined the neurocognitive processes that may facilitate it. Several conceptualizations of PAN suggest it is an emotionally exhausting process (Miller et al., 2021), involving substantial in vivo emotion regulation in the face of social stimuli (Santomauro et al., 2016); others suggest that PAN requires heightened responsivity (i.e., less emotion regulation) to social stimuli to facilitate reactivity (Lai et al., 2016). The Late Positive Potential (LPP) is an event-related potential elicited in response to arousing stimuli and is thought to index sustained attention and emotion regulation (Dennis & Hajcak, 2009), which may index such processes in response to facial emotion stimuli in autistic populations (Keifer et al., 2019). Thus, the LPP is a promising candidate for examining the emotion processing mechanisms that may underly PAN.
Methods: Forty-five autistic and non-autistic adolescents (rangeage=11.24–17.62 years; Table 1) completed a facial emotion recognition task during EEG recording (Lerner et al., 2013). To operationalize PAN, the discrepancy between teacher-report (SRS-2 T-Scores; Constantino et al., 2012) and research—reliable clinician-rated (ADOS-2 Comparison Score [CS]; Lord et al. 2012) ratings were calculated using interaction terms (Laird, 2020).
Results: An interaction was found between ADOS-2 CS and teacher-report SRS-2 scores in predicting LPP amplitude to subtle (β=0.031, p=0.046) but not overt (β=0.017; p=0.330) facial expressions. For participants with low and moderate SRS-2 scores, ADOS-2 CS predicted attenuated LPP amplitudes (Figure 1): low SRS-2 and high ADOS-2 CS (i.e., individuals who PAN) related to smaller LPP amplitudes.
Conclusion: These results point to the LPP as a potential neural index of PAN, suggesting that LPP response to subtle social stimuli is attenuated in autistic youth who PAN, as compared to non-autistic peers and autistic youth who do not PAN. Autistic adolescents who PAN may have an attenuated reactivity to social stimuli due to practice concealing their emotions in order to fit in with peers (Anderson et al., 2020). Alternatively, these adolescents may be predisposed to a low arousal response (i.e., greater in vivo emotion regulation) to social stimuli (Hubert et al., 2009); thus, their teachers’ perspectives may arise because they are not engaging in overt or disruptive behaviors that would call attention to themselves, even as their ADOS-2 reveals a clear autistic presentation. This study provides the first direct test of a potential neurocognitive mechanism of PAN, supporting emotion regulation-mediated PAN models. Future studies should further explore the role of the LPP in autism, as well as whether there are longer-term costs (e.g., burnout, depression) to emotion regulation to social stimuli in this population (Cage et al., 2017; Hull et al., 2021).

Authors

• Abigail P. Houck, Stony Brook Unviersity
  Presenting Author

• Jared Richards

• Talena Day, Stony Brook Unviersity

• Janelle Goodwill

• Matthew D Lerner, Stony Brook Unviersity