Category: Child / Adolescent - Anxiety
Keywords: Autism Spectrum Disorders | Anxiety
Presentation Type: Symposium
Background: A majority of studies on threat processing in autism (ASD) rely on tasks that require viewing faces (Tottenham, et al., 2014) or experimental contexts where the individual has relatively little control and the aversive stimulus is contrived (air-puff threat; Chamberlain et al., 2013; South, et al., 2011). Despite a substantial amount of evidence indicating elevated anxiety in ASD, no studies have unpacked a rapidly unfolding cascade of events involved in threat processing. We have designed a novel paradigm, the BOMB, that allows for the study of the threat-processing cascade, across vigilance, threat detection, reappraisal and escape. Our BOMB task is a dynamic paradigm presented as a virtual "hot potato" game with three other fictitious players. The BOMB task perturbs event related potentials (ERPs) during multiple stages of threat processing including ambiguous threat cues (where is the bomb going?), direct threats (the bomb is going to the participant), reappraisal events (the bomb is going to someone else, “not my problem”) and successful vs. unsuccessful avoidance. In the bomb a player passes a ball around that changes color from white (no threat) to yellow, orange, and then red (bomb = threat, will explode). If a red bomb does come to a player, it can be passed off before it explodes in the participant's glove, (exploding bombs lead to lost cherries).
Methods: 43 adolescents and young adults (22 female, age: M=15.00, SD=3.01) participated. 22 participants met DSM-IV-TR diagnostic criteria for Asperger’s syndrome, pervasive developmental disorder—not otherwise specified, or autistic disorder (ASD), diagnosed via the ADI-R and ADOS and 21 comparison participants had no previous or suspected diagnosis of ASD, schizophrenia, or other developmental/psychiatric disorder. All participants sat for an EEG with concurrent assessment of threat processing via the BOMB Threat Detection task.
Results: Ratings of anxiety on our bomb task are associated with self-reported anxiety (r = .32, p = .05). Across the sample, self-reported anxiety is associated with a P300 response to ambiguous threat cues (r = .39). While all participants show a P300 response to direct threats (bomb coming to the participant), only typical participants show a P600 response to bombs going to other players, t(37)=2.86, p=.008. The P600 is known to reflect an updating mechanism that we believe reflects automatic reappraisal.
Conclusion: Our data suggest intact threat detection, but impaired automatic reappraisal of threats in ASD. These reappraisal skills could be an important treatment target, possibly with emphasis on distinguishing threats from non-threats. Future work will consider the BOMB as an outcome of reappraisal skills in CBT for ASD.
Yale Child Study Center, Yale School of Medicine
Friday, November 17
12:00 PM – 1:30 PM
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