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Lay Abstract: Attitudes towards autism vary across countries. Some of this variation could reflect differences in cultural values across countries, or differences in how much people know about autism. Until now, most research on this topic has asked people directly about their attitudes towards interacting with autistic people. As a result, we understand little about why some people unconsciously hold negative attitudes towards autism, and whether these unconscious attitudes vary across countries. We studied explicit attitudes (willingness to interact), implicit attitudes (unconscious beliefs), knowledge about autism, and cultural values in university students from Hong Kong, the United Kingdom and the United States. We found that people were less willing to interact with autistic people if they knew less about autism, aligned with a competitive and hierarchical society ('vertical individualism'), did not see themselves as part of a collective whose members are equal (less 'horizontal collectivism'), and if they unconcsciously associated autism with negative attributes. Students in Hong Kong were less willing to interact with autistic people and had less understanding of autism compared to those in the United Kingdom and the United States. Unconscious biases did not differ across countries. Our findings highlight the need to combat misconceptions about autism to improve attitudes towards autistic people, especially in Hong Kong. Unfortunately, our results suggest that acquiring more accurate knowledge may not be sufficient to alter unconscious biases. Further research is needed to determine the factors underlying unconscious biases., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Recent findings suggest that stigma and camouflaging contribute to mental health difficulties for autistic individuals, however, this evidence is largely based on UK samples. While studies have shown cross-cultural differences in levels of autism-related stigma, it is unclear whether camouflaging and mental health difficulties vary across cultures. Hence, the current study had two aims: (1) to determine whether significant relationships between autism acceptance, camouflaging, and mental health difficulties replicate in a cross-cultural sample of autistic adults, and (2) to compare these variables across cultures. To fulfil these aims, 306 autistic adults from eight countries (Australia, Belgium, Canada, Japan, New Zealand, South Africa, the United Kingdom, and the United States) completed a series of online questionnaires. We found that external acceptance and personal acceptance were associated with lower levels of depression but not camouflaging or stress. Higher camouflaging was associated with elevated levels of depression, anxiety, and stress. Significant differences were found across countries in external acceptance, personal acceptance, depression, anxiety, and stress, even after controlling for relevant covariates. Levels of camouflaging also differed across countries however this effect became non-significant after controlling for the covariates. These findings have significant implications, identifying priority regions for anti-stigma interventions, and highlighting countries where greater support for mental health difficulties is needed., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Keating et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Some people are exceptional at reading emotional expressions, while others struggle. Here we ask whether the way we experience emotion "on the inside" influences the way we expect emotions to be expressed in the "outside world" and subsequently our ability to read others' emotional expressions. Across multiple experiments, incorporating discovery and replication samples, we develop EmoMap (N = 20; N = 271) and ExpressionMap (N = 98; replication N = 193) to map adults' experiences of emotions and visual representations of others' emotions. Some individuals have modular maps, wherein emotional experiences and visual representations are consistent and distinct-anger looks and feels different from happiness, which looks and feels different from sadness. In contrast, others have experiences and representations that are variable and overlapping-anger, happiness, and sadness look and feel similar and are easily confused for one another. Here we illustrate an association between these maps: those with consistent and distinct experiences of emotion also have consistent and distinct visual representations of emotion. Finally (N = 193), we construct the Inside Out Model of Emotion Recognition, which explains 60.8% of the variance in emotion recognition and illuminates multiple pathways to emotion recognition difficulties. These findings have important implications for understanding the emotion recognition difficulties documented in numerous clinical populations., (© 2023. The Author(s).)

Background: In recent years, there have been increasing discussions surrounding the appropriate terminology to talk about autism. Initially, this debate revolved around the use of person-first language (e.g., person with autism ) versus identity-first language (IFL; e.g., autistic person) but has recently expanded to other autism-related terms (e.g., deficits). However, to date, studies investigating autism-related language preferences have been limited to English-speaking countries, and little is known about preferences in other languages. This study addresses this gap by investigating the language preferences of French-speaking autistic adults., Methods: Five hundred and forty-one French-speaking autistic adults (formal diagnosis and self-identified) completed an online survey where they selected terms they preferred to use to talk about: (1) the nomenclature of autism; (2) an autistic person; (3) someone's autistic identity; (4) autism more broadly; (5) the abilities of autistic people; and (6) people without a diagnosis of autism. Participants also revealed more about their language preferences via an open-text response., Results: The most preferred terms were "Autisme," "Personne autiste," "Autiste," "Est Autiste," "Différence neurologique/cérébrale," "Différences," "Difficultés," "Personne neurotypique," "Neurotypique," and "Personne non-autiste." To better understand these preferences, participants' open comments were analyzed, revealing further support for IFL and the social model of disability, and a preference for simple, precise, and validated terms., Conclusions: These results are consistent with autism terminology preferences in English-speaking countries and provide additional insight into the reasons underlying these preferences. Such work has implications for informing the language of researchers, clinicians, and other professionals in the field, as well as the general public., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright 2023, Mary Ann Liebert, Inc., publishers.)

To date, studies have not yet established the mechanisms underpinning differences in autistic and non-autistic emotion recognition. The current study first investigated whether autistic and non-autistic adults differed in terms of the precision and/or differentiation of their visual emotion representations and their general matching abilities, and second, explored whether differences therein were related to challenges in accurately recognizing emotional expressions. To fulfil these aims, 45 autistic and 45 non-autistic individuals completed three tasks employing dynamic point light displays of emotional facial expressions. We identified that autistic individuals had more precise visual emotion representations than their non-autistic counterparts, however, this did not confer any benefit for their emotion recognition. Whilst for non-autistic people, non-verbal reasoning and the interaction between precision of emotion representations and matching ability predicted emotion recognition, no variables contributed to autistic emotion recognition. These findings raise the possibility that autistic individuals are less guided by their emotion representations, thus lending support to Bayesian accounts of autism., (© 2023. The Author(s).)

Over the past two decades, there have been increasing discussions around which terms should be used to talk about autism. Whilst these discussions have largely revolved around the suitability of identity-first language and person-first language, more recently this debate has broadened to encompass other autism-related terminology (e.g., 'high-functioning'). To date, academic studies have not investigated the language preferences of autistic individuals outside of the United Kingdom or Australia, nor have they compared levels of endorsement across countries. Hence, the current study adopted a mixed-methods approach, employing both quantitative and qualitative techniques, to explore the linguistic preferences of 654 English-speaking autistic adults across the globe. Despite variation in levels of endorsement between countries, we found that the most popular terms were similar-the terms 'Autism', 'Autistic person', 'Is autistic', 'Neurological/Brain Difference', 'Differences', 'Challenges', 'Difficulties', 'Neurotypical people', and 'Neurotypicals' were consistently favored across countries. Despite relative consensus across groups, both our quantitative and qualitative data demonstrate that there is no universally accepted way to talk about autism. Our thematic analysis revealed the reasons underlying participants' preferences, generating six core themes, and illuminated an important guiding principle-to respect personal preferences. These findings have significant implications for informing practice, research and language policy worldwide., (© 2022 The Authors. Autism Research published by International Society for Autism Research and Wiley Periodicals LLC.)

Alexithymia concerns a difficulty identifying and communicating one's own emotions, and a tendency towards externally-oriented thinking. Recent work argues that such alexithymic traits are due to altered arousal response and poor subjective awareness of "objective" arousal responses. Although there are individual differences within the general population in identifying and describing emotions, extant research has focused on highly alexithymic individuals. Here we investigated whether mean arousal and concordance between subjective and objective arousal underpin individual differences in alexithymic traits in a general population sample. Participants rated subjective arousal responses to 60 images from the International Affective Picture System whilst their skin conductance was recorded. The Autism Quotient was employed to control for autistic traits in the general population. Analysis using linear models demonstrated that mean arousal significantly predicted Toronto Alexithymia Scale scores above and beyond autistic traits, but concordance scores did not. This indicates that, whilst objective arousal is a useful predictor in populations that are both above and below the cut-off values for alexithymia, concordance scores between objective and subjective arousal do not predict variation in alexithymic traits in the general population.

To date, studies have not established whether autistic and non-autistic individuals differ in emotion recognition from facial motion cues when matched in terms of alexithymia. Here, autistic and non-autistic adults (N = 60) matched on age, gender, non-verbal reasoning ability and alexithymia, completed an emotion recognition task, which employed dynamic point light displays of emotional facial expressions manipulated in terms of speed and spatial exaggeration. Autistic participants exhibited significantly lower accuracy for angry, but not happy or sad, facial motion with unmanipulated speed and spatial exaggeration. Autistic, and not alexithymic, traits were predictive of accuracy for angry facial motion with unmanipulated speed and spatial exaggeration. Alexithymic traits, in contrast, were predictive of the magnitude of both correct and incorrect emotion ratings., (© 2021. The Author(s).)

Recent developments suggest that autistic individuals require dynamic angry expressions to have a higher speed in order for them to be successfully identified. Therefore, it is plausible that autistic individuals do not have a 'deficit' in angry expression recognition, but rather their internal representation of these expressions is characterised by very high-speed movement. In this study, matched groups of autistic and non-autistic adults completed a novel emotion-based task which employed dynamic displays of happy, angry and sad point light facial (PLF) expressions. On each trial, participants moved a slider to manipulate the speed of a PLF stimulus until it moved at a speed that, in their 'mind's eye', was typical of happy, angry or sad expressions. Participants were shown three different types of PLFs-those showing the full-face, only the eye region, and only the mouth region, wherein the latter two were included to test whether differences in facial information sampling underpinned any dissimilarities in speed attributions. Across both groups, participants attributed the highest speeds to angry, then happy, then sad, facial motion. Participants increased the speed of angry and happy expressions by 41% and 27% respectively and decreased the speed of sad expressions by 18%. This suggests that participants have 'caricatured' internal representations of emotion, wherein emotion-related kinematic cues are over-emphasised. There were no differences between autistic and non-autistic individuals in the speeds attributed to full-face and partial-face angry, happy and sad expressions respectively. Consequently, we find no evidence that autistic adults possess atypically fast internal representations of anger., (© 2021 The Authors. Autism Research published by International Society for Autism Research and Wiley Periodicals LLC.)

Competing Interests: The authors have declared that no competing interests exist.

Interoception, perception of one's bodily state, has been associated with mental health and socio-emotional processes. However, several interoception tasks are of questionable validity, meaning associations between interoception and other variables require confirmation with new measures. Here we describe the novel, smartphone-based Phase Adjustment Task (PAT). Tones are presented at the participant's heart rate, but out of phase with heartbeats. Participants adjust the phase relationship between tones and heartbeats until they are synchronous. Data from 124 participants indicates variance in performance across participants which is not affected by physiological or strategic confounds. Associations between interoception and anxiety, depression and stress were not significant. Weak associations between interoception and mental health variables may be a consequence of testing a non-clinical sample. A second study revealed PAT performance to be moderately stable over one week, consistent with state effects on interoception., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

The kinematics of peoples' body movements provide useful cues about emotional states: for example, angry movements are typically fast and sad movements slow. Unlike the body movement literature, studies of facial expressions have focused on spatial, rather than kinematic, cues. This series of experiments demonstrates that speed comprises an important facial emotion expression cue. In Experiments 1a-1c we developed ( N = 47) and validated ( N = 27) an emotion-induction procedure, and recorded ( N = 42) posed and spontaneous facial expressions of happy, angry, and sad emotional states. Our novel analysis pipeline quantified the speed of changes in distance between key facial landmarks. We observed that happy expressions were fastest, sad were slowest, and angry expressions were intermediate. In Experiment 2 ( N = 67) we replicated our results for posed expressions and introduced a novel paradigm to index communicative emotional expressions. Across Experiments 1 and 2, we demonstrate differences between posed, spontaneous, and communicative expression contexts. Whereas mouth and eyebrow movements reliably distinguished emotions for posed and communicative expressions, only eyebrow movements were reliable for spontaneous expressions. In Experiments 3 and 4 we manipulated facial expression speed and demonstrated a quantifiable change in emotion recognition accuracy. That is, in a discovery ( N = 29) and replication sample ( N = 41), we showed that speeding up facial expressions promotes anger and happiness judgments, and slowing down expressions encourages sad judgments. This influence of kinematics on emotion recognition is dissociable from the influence of spatial cues. These studies demonstrate that the kinematics of facial movements provide added value, and an independent contribution to emotion recognition. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Social "difficulties" associated with ASD may be a product of neurotypical-autistic differences in emotion expression and recognition. Research suggests that neurotypical and autistic individuals exhibit expressive differences, with autistic individuals displaying less frequent expressions that are rated lower in quality by non-autistic raters. Autistic individuals have difficulties recognizing neurotypical facial expressions; neurotypical individuals have difficulties recognizing autistic expressions. However, findings are mixed. Task-related factors (e.g., intensity of stimuli) and participant characteristics (e.g., age, IQ, comorbid diagnoses) may contribute to the mixed findings. The authors conclude by highlighting important areas for future research and the clinical implications of the discussed findings., Competing Interests: Disclosure The authors have nothing to disclose. This project was supported by the Medical Research Council (MRC, United Kingdom) MR/R015813/1 and the European Union’s Horizon 2020 Research and Innovation Programme under ERC-2017-STG Grant Agreement No 757583., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Social "difficulties" associated with ASD may be a product of neurotypical-autistic differences in emotion expression and recognition. Research suggests that neurotypical and autistic individuals exhibit expressive differences, with autistic individuals displaying less frequent expressions that are rated lower in quality by non-autistic raters. Autistic individuals have difficulties recognizing neurotypical facial expressions; neurotypical individuals have difficulties recognizing autistic expressions. However, findings are mixed. Task-related factors (e.g., intensity of stimuli) and participant characteristics (e.g., age, IQ, comorbid diagnoses) may contribute to the mixed findings. The authors conclude by highlighting important areas for future research and the clinical implications of the discussed findings., Competing Interests: Disclosure The authors have nothing to disclose. This project was supported by the Medical Research Council (MRC, United Kingdom) MR/R015813/1 and the European Union’s Horizon 2020 Research and Innovation Programme under ERC-2017-STG Grant Agreement No 757583., (Copyright © 2020 Elsevier Inc. All rights reserved.)