"Managing emotion": Open label trial and waitlist controlled trial of an emotion regulation program for university students.

Background: More than one-third of university students meet diagnostic criteria for a mental disorder, and three quarters experience role impairment in some aspect of their life. One determinant of whether young adults will experience mental health difficulties is their ability to regulate emotion. We conducted two pilot trials of a brief online program designed to teach emotion regulation skills to university students. Methods: In Study 1, we conducted an open-label trial (n = 104). In Study 2, we conducted a waitlist controlled trial (n = 167). In both studies, pre- and post-assessment of emotion regulation, psychological distress, and self-compassion were conducted. Results: In both trials, we observed improvements in emotion regulation, and reductions in symptoms of psychological distress. Acceptability and feasibility were also satisfactory. Conclusion: An online emotion regulation program may offer promise in improving emotion regulation and subsequent mental health concerns among university students. (ACTRN12620000390987; ACTRN12620000839909).

Featural vs. Holistic processing and visual sampling in the influence of social category cues on emotion recognition.

Past research demonstrates that emotion recognition is influenced by social category cues present on faces. However, little research has investigated whether holistic processing is required to observe these influences of social category information on emotion perception, and no studies have investigated whether different visual sampling strategies (i.e. differences in the allocation of attention to different regions of the face) contribute to the interaction between social cues and emotional expressions. The current study aimed to address this. Participants categorised happy and angry expressions on own- and other-race faces, and male and female faces. In Experiments 1 and 2, holistic processing was disrupted by presenting inverted faces (Experiment 1) or part faces (Experiment 2). In Experiments 3 and 4 participants' eye-gaze to eye and mouth regions was also tracked. Disrupting holistic processing did not alter the moderating influence of sex and race cues on emotion recognition (Experiments 1, 2, 4). Gaze patterns differed as a function of emotional expression, and social category cues, however, eye-gaze patterns did not reflect response time patterns (Experiments 3 and 4). Results indicate that the interaction between social category cues and emotion does not require holistic processing and is not driven by differences in visual sampling.

Selective attention to threat, anxiety and glycaemic management in adolescents with type 1 diabetes.

Objective: Previous research has established that adolescents with type 1 diabetes (T1D) experience more anxiety symptoms than their healthy peers and are also more likely to develop an anxiety disorder. Research in cognitive psychology has found that selective attention favouring the processing of threatening information causally contributes to elevated levels of anxiety; however, this process has not been investigated in the context of T1D. The current study examined whether selective attention for threatening information contributes to the association between anxiety and glycaemic management in adolescents with T1D. Methods: Participants completed a dot-probe task to assess selective attention for diabetes-related threatening information and general non-diabetes-related threatening information and we examined the associations between these measures and measures of HbA1c and anxiety. Results: Findings suggest that individual differences in anxiety vulnerability do not predict HbA1c alongside the attentional bias for threatening information. Conclusions: The attentional bias for threatening information makes a contribution to the relationship between anxiety and glycaemic management and may represent a target for therapeutic intervention to both reduce anxiety and improve glycaemic management.

Development and Feasibility of MindChip™: A Social Emotional Telehealth Intervention for Autistic Adults.

The study aims to develop and pilot a telehealth social emotional program, MindChip™ delivered with a computer based interventions (CBI) (Mind Reading©) for autistic adults. MindChip™ combined four theoretical perspectives and community feedback underpinning the essential mechanisms for targeting the social emotional understanding of autistic adults. A randomised pragmatic pilot trial (N = 25) was conducted to explore the feasibility of MindChip™ (n = 11) and to understand the preliminary efficacy of combining it with CBI compared to CBI only (n = 14). The use of MindChip™ and CBI combined demonstrated partial feasibility, with preliminary efficacy findings revealing increased emotion recognition generalisation outcomes compared to CBI only. Further research is required to improve the engagement and personalisation of the intervention for autistic adults.

What is attention bias variability? Examining the potential roles of attention control and response time variability in its relationship with anxiety.

The present study examined the underlying role of attention control and response time variability in explaining the relationship between anxiety and two commonly computed measures of attention bias variability: 'moving average' and 'trial-level bias score' measures. Participants (final n = 195) completed measures of anxiety symptomatology, antisaccade performance (attention control), a stand-alone measure of response-time variability, and a probe task measure of attention bias. Average bias and moving average bias variability measures both recorded significant, but low split-half reliability. Both attention bias variability measures and average attention bias were associated with anxiety, and attention control. Both attention bias variability measures correlated with response time variability. Neither attention bias variability measure correlated with average attention bias. Attention control was the single significant mediator of the relationship between anxiety and the trial-level bias score measure of attention bias variability. Neither response time variability nor attention control significantly mediated the relationship between anxiety and the moving average measure of attention bias variability. No evidence was found for the mediating role of response time variability. The present findings suggest that the relationships observed between anxiety and the trial-level bias score measure of attention bias variability in particular may be attributable to the over-arching role of attention control.

Cross-Cultural Adaptation to Australia of the KONTAKT© Social Skills Group Training Program for Youth with Autism Spectrum Disorder: A Feasibility Study.

This study investigated the feasibility and cultural validity of KONTAKT©, a manualised social skills group training, in improving the social functioning of adolescents with autism spectrum disorder (ASD). KONTAKT© was delivered to 17 adolescents (mage = 14.09, SDage = 1.43; 70% male) with ASD over sixteen 90 min sessions. A pre-test post-test design evaluated changes in personally meaningful social goals, symptom severity, quality of life, interpersonal efficacy, social anxiety, loneliness, and facial emotion recognition at pre, post and 3 months follow-up. Focus groups were conducted post intervention. Findings indicate that KONTAKT© may support Australian adolescents with ASD in achieving their personally meaningful social goals. This study resulted in finalisation of KONTAKT© in preparation for evaluation of its efficacy in a randomised controlled trial (Australian New Zealand Clinical Registry (ANZCTR): ACTRN12617001117303, ClinicalTrials.gov: NCT03294668).

The use of wearable technology to measure and support abilities, disabilities and functional skills in autistic youth: a scoping review.

BACKGROUND: Wearable technology (WT) to measure and support social and non-social functioning in Autism Spectrum Disorder (ASD) has been a growing interest of researchers over the past decade. There is however limited understanding of the WTs currently available for autistic individuals, and how they measure functioning in this population. OBJECTIVE: This scoping review explored the use of WTs for measuring and supporting abilities, disabilities and functional skills in autistic youth. METHOD: Four electronic databases were searched to identify literature investigating the use of WT in autistic youth, resulting in a total of 33 studies being reviewed. Descriptive and content analysis was conducted, with studies subsequently mapped to the ASD International Classification of Functioning, Disability and Health Core-sets and the ICF Child and Youth Version (ICF-CY). RESULTS: Studies were predominately pilot studies for novel devices. WTs measured a range of physiological and behavioural functions to objectively measure stereotypical motor movements, social function, communication, and emotion regulation in autistic youth in the context of a range of environments and activities. CONCLUSIONS: While this review raises promising prospects for the use of WTs for autistic youth, the current evidence is limited and requires further investigation.

"The big wide world of school": Supporting children on the autism spectrum to successfully transition to primary school: Perspectives from parents and early intervention professionals.

BACKGROUND: The transition to primary school is often a complex and uncertain time for autistic children and their families. Understanding how best to develop school readiness and support transition to primary school for autistic children is essential. School readiness and transition planning are influenced by a range of personal and contextual factors, and it is important to understand the perspectives of the various stakeholders involved in the transition process. METHODS: A qualitative exploration employing focus groups and interviews was undertaken with early intervention (EI) staff (n = 45) and parents (n = 18) across Australia to understand their perspectives on school readiness and the transition to primary school. RESULTS: Thematic analysis identified four emerging themes facilitating transition including: 1) building the child; 2) building the parents; 3) building the receiving school; and, 4) connecting the system. CONCLUSION: Findings highlight the need to consider school readiness and transition planning from a holistic perspective, ensuring clear, collaborative and ongoing communication between parents, teachers and EI staff, using a strength-based approach, and individualizing transition planning.

Complex facial emotion recognition and atypical gaze patterns in autistic adults.

While altered gaze behaviour during facial emotion recognition has been observed in autistic individuals, there remains marked inconsistency in findings, with the majority of previous research focused towards the processing of basic emotional expressions. There is a need to examine whether atypical gaze during facial emotion recognition extends to more complex emotional expressions, which are experienced as part of everyday social functioning. The eye gaze of 20 autistic and 20 IQ-matched neurotypical adults was examined during a facial emotion recognition task of complex, dynamic emotion displays. Autistic adults fixated longer on the mouth region when viewing complex emotions compared to neurotypical adults, indicating that altered prioritization of visual information may contribute to facial emotion recognition impairment. Results confirm the need for more ecologically valid stimuli for the elucidation of the mechanisms underlying facial emotion recognition difficulty in autistic individuals.

Can Proficiency Criteria Be Accurately Identified During Real-Time Fundamental Movement Skill Assessment?

Purpose: Fundamental movement skill (FMS) assessors in education environments rely upon real-time FMS assessment; however, the recognition of individual proficiency criteria during real-time process-oriented FMS assessment may be problematic. Few studies consider the accuracy of identifying individual proficiency criteria in process-oriented FMS assessment, even though criteria are relied upon for intervention planning. This study aimed to further understand assessors' ability to recognize proficiency criteria during real-time FMS assessment and the impact of assessor experience on assessment accuracy. Methods: 10 primary teachers, and 7 pediatric professionals assessed 10 performances of four FMSs (Jump, Hop, Kick, Throw) presented in videos and point-light displays using the Test of Gross Motor Development-2. Results: Accuracy in identifying proficiency criteria was moderate for both pediatric professionals (74.73%) and primary teachers (69.58%), with no differences between groups. In contrast, reliability of overall proficiency scores was good to excellent (ICC>0.8) in both groups. Some individual criteria may be more difficult to assess, evidenced by large average accuracy ranges within skills (e.g., 46% difference between Throw criteria 1 (34%) and 2 (80%)). Conclusions: The study reinforces the difficulty of observing proficiency criteria during real-time FMS assessment regardless of assessor experience. Results suggest that assessors can accurately score overall FMS proficiency, whilst accurate identification of proficiency criteria is problematic. Accurate criterion identification is crucial to understand skill deficiencies and inform subsequent intervention. Attentional demands during real-time assessment may be too great to allow accurate criterion identification, even by experienced assessors, which presents an important consideration for test administrators and developers.

KONTAKT© for Australian adolescents on the autism spectrum: protocol of a randomized control trial.

BACKGROUND: Individuals diagnosed with autism spectrum disorder (ASD) experience impairing challenges in social communication and interaction across multiple contexts. While social skills group training (SSGT) has shown moderate effects on various sociability outcomes in ASD, there is a need for (1) replication of effects in additional clinical and cultural contexts, (2) designs that employ active control groups, (3) calculation of health economic benefits, (4) identification of the optimal training duration, and (5) measurement of individual goals and quality of life outcomes. METHOD/DESIGN: With the aim of investigating the efficacy and cost-effectiveness of a SSGT, KONTAKT©, a two-armed randomized control trial with adolescents aged 12-17 years (N = 90) with ASD and an intelligence quotient (IQ) of over 70 will be undertaken. Following stratification for centre and gender, participants will be randomly assigned to either KONTAKT© or to an active control group, a group-based cooking programme. Participants will attend both programmes in groups of 6-8 adolescents, over 16 one-and-a-half-hour sessions. The primary outcome examined is adolescent self-rated achievement of personally meaningful social goals as assessed via the Goal Attainment Scaling during an interview with a blinded clinician. Secondary outcomes include adolescent self-reported interpersonal efficacy, quality of life, social anxiety, loneliness, face emotion recognition performance and associated gaze behaviour, and parent proxy reports of autistic traits, quality of life, social functioning, and emotion recognition and expression. Cost-effectiveness will be investigated in relation to direct and indirect societal and healthcare costs. DISCUSSION: The primary outcomes of this study will be evidenced in the anticipated achievement of adolescents' personally meaningful social goals following participation in KONTAKT© as compared to the active control group. This design will enable rigorous evaluation of the efficacy of KONTAKT©, exercising control over the possibly confounding effect of exposure to a social context of peers with a diagnosis of ASD. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12617001117303. Registered on 31 July 2017. anzctr.org.au ClinicalTrials.gov, NCT03294668. Registered on 22 September 2017. https://clinicaltrials.gov.

Atypical Visual Processing but Comparable Levels of Emotion Recognition in Adults with Autism During the Processing of Social Scenes.

Understanding the underlying visual scanning patterns of individuals with autism spectrum disorder (ASD) during the processing of complex emotional scenes remains limited. This study compared the complex emotion recognition performance of adults with ASD (n = 23) and matched neurotypical participants (n = 25) using the Reading the Mind in Films Task. Behaviourally, both groups exhibited similar emotion recognition accuracy. Visual fixation time towards key social regions of each stimuli was examined via eye tracking. Individuals with ASD demonstrated significantly longer fixation time towards the non-social areas. No group differences were evident for the facial and body regions of all characters in the social scenes. The findings provide evidence of the heterogeneity associated with complex emotion processing in individuals with ASD.

Brief social attention bias modification for children with autism spectrum disorder.

Reduced social attention is a hallmark feature in autism spectrum disorder (ASD), emerging as early as the first year of life. This difference represents a possible mechanism impacting upon the development of more complex social-communicative behaviors. The aim of this study was to develop and test the efficacy of a novel attention bias modification paradigm to alter social attention, specifically orienting to faces. Children with ASD (n = 66), aged between 5 and 12 years, were randomized to play either a social attention training or control game for 15 min. Children playing the training game were reinforced for attending to and engaging with social characters, whereas children in the control group were equally rewarded for attending to both social and non-social characters. Eye-tracking measures were obtained before and after gameplay. There was a significant increase in the percentage of first fixations to faces, relative to objects, after social attention training compared to a control group, associated with a medium effect size (partial η = 0.15). The degree of social attention change in the training group was inversely associated with restricted and repetitive behaviors and moderated by comorbid attention deficit hyperactivity disorder diagnoses, suggestive of differential training effects based on individual symptom profiles. By using the principles of attention bias modification, we demonstrated that social attention can be acutely modified in children with ASD, with an increased tendency to orient attention toward faces after brief social attention training. Modifying attentional biases may therefore represent a potential novel mechanism to alter the development of social communication trajectories. Autism Res 2019, 12: 527-535 © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Some children with autism spectrum disorder (ASD) do not look at faces or eyes as much as their non-ASD peers do. Using a game where players have to pay attention to characters with faces to score points, we found that children playing the game began to look more at faces, even outside of the game. Looking at faces is an important prerequisite to many social interactions, telling us about others' emotions and states of attention-things that become harder to understand when they are not seen. If children with ASD could use games to help train looking at faces in real life, then they may be in a better position to understand and participate in social exchanges.

Designing a Serious Game for Youth with ASD: Perspectives from End-Users and Professionals.

Recent years have seen an emergence of social emotional computer games for individuals with Autism Spectrum Disorder (ASD). These games are heterogeneous in design with few underpinned by theoretically informed approaches to computer-based interventions. Guided by the serious game framework outlined by Whyte et al. (Journal of Autism and Developmental Disorders 45(12):1-12, 2014), this study aimed to identify the key motivating and learning features for serious games targeting emotion recognition skills from the perspectives of 11 youth with ASD and 11 experienced professionals. Results demonstrated that youth emphasised the motivating aspects of game design, while the professionals stressed embedding elements facilitating the generalisation of acquired skills. Both complementary and differing views provide suggestions for the application of serious game principles in a potential serious game.

Emotion-in-Motion, a Novel Approach for the Modification of Attentional Bias: An Experimental Proof-of-Concept Study.

BACKGROUND: Individuals with heightened anxiety vulnerability tend to preferentially attend to emotionally negative information, with evidence suggesting that this attentional bias makes a causal contribution to anxiety vulnerability. Recent years have seen an increase in the use of attentional bias modification (ABM) procedures to modify patterns of attentional bias; however, often this change in bias is not successfully achieved. OBJECTIVE: This study presents a novel ABM procedure, Emotion-in-Motion, requiring individuals to engage in patterns of attentional scanning and tracking within a gamified, complex, and dynamic environment. We aimed to examine the capacity of this novel procedure, as compared with the traditional probe-based ABM procedure, to produce a change in attentional bias and result in a change in anxiety vulnerability. METHODS: We administered either an attend-positive or attend-negative version of our novel ABM task or the conventional probe-based ABM task to undergraduate students (N=110). Subsequently, participants underwent an anagram stressor task, with state anxiety assessed before and following this stressor. RESULTS: Although the conventional ABM task failed to induce differential patterns of attentional bias or affect anxiety vulnerability, the Emotion-in-Motion training did induce a greater attentional bias to negative faces in the attend-negative training condition than in the attend-positive training condition (P=.003, Cohen d=0.87) and led to a greater increase in stressor-induced state anxiety faces in the attend-negative training condition than in the attend-positive training condition (P=.03, Cohen d=0.60). CONCLUSIONS: Our novel, gamified Emotion-in-Motion ABM task appears more effective in modifying patterns of attentional bias and anxiety vulnerability. Candidate mechanisms contributing to these findings are discussed, including the increased stimulus complexity, dynamic nature of the stimulus presentation, and enriched performance feedback.

Visual Processing of Emotional Faces is Preserved in Mild Cognitive Impairment.

BACKGROUND: Research suggests that deficits in emotion recognition are evident in individuals with amnestic mild cognitive impairment (aMCI), a group 'at risk' of developing dementia. The mechanisms underlying this deficit, however, are unclear. OBJECTIVE: In this study, we sought to determine whether there are alterations in the way in which individuals with MCI visually explore emotional facial stimuli. METHODS: Eighteen healthy older controls (mean age = 64.6 years) and 32 individuals with MCI were recruited including 18 with the non-amnestic multiple domain (naMCI-md) subtype (mean age = 63.8 years) and 14 with the amnestic multiple domain (aMCI-md) subtype (mean age = 67.9 years). All participants were given a novel eye-tracking paradigm to investigate eye gaze while viewing images of emotional faces on a computer screen. RESULTS: Analyses of eye gaze revealed no significant difference in the percentage of time that groups spent fixating on facial and peripheral facial regions when viewing emotional faces. All participants showed a relative preference for the eye region of faces relative to all other regions. Individuals with aMCI-md were found to be less accurate than controls and naMCI-md on emotion recognition measures. For naMCI-md individuals, significant relationships were found between efficiencies in visual scanning and increased fixation time on the eye region. CONCLUSIONS: Visual processing strategies adopted by aMCI-md individuals when exploring emotional faces do not significantly differ from those of healthy controls or naMCI-md individuals. This suggests that impaired facial emotion recognition in aMCI-md is not likely accounted for by visual processing differences, but rather may reflect an eroded ability to extract meaningful cues from the eye region.

Inhibitory attentional control in anxiety: Manipulating cognitive load in an antisaccade task.

Theorists have proposed that heightened anxiety vulnerability is characterised by reduced attentional control performance and have made the prediction in turn that elevating cognitive load will adversely impact attentional control performance for high anxious individuals to a greater degree than low anxious individuals. Critically however, existing attempts to test this prediction have been limited in their methodology and have presented inconsistent findings. Using a methodology capable of overcoming the limitations of previous research, the present study sought to investigate the effect of manipulating cognitive load on inhibitory attentional control performance of high anxious and low anxious individuals. High and low trait anxious participants completed an antisaccade task, requiring the execution of prosaccades towards, or antisaccades away from, emotionally toned stimuli while eye movements were recorded. Participants completed the antisaccade task under conditions that concurrently imposed a lesser cognitive load, or greater cognitive load. Analysis of participants' saccade latencies revealed high trait anxious participants demonstrated generally poorer inhibitory attentional control performance as compared to low trait anxious participants. Furthermore, conditions imposing greater cognitive load, as compared to lesser cognitive load, resulted in enhanced inhibitory attentional control performance across participants generally. Crucially however, analyses did not reveal an effect of cognitive load condition on anxiety-linked differences in inhibitory attentional control performance, indicating that elevating cognitive load did not adversely impact attentional control performance for high anxious individuals to a greater degree than low anxious individuals. Hence, the present findings are inconsistent with predictions made by some theorists and are in contrast to the findings of earlier investigations. These findings further highlight the need for research into the relationship between anxiety, attentional control, and cognitive load.

Mechanisms of facial emotion recognition in autism spectrum disorders: Insights from eye tracking and electroencephalography.

While behavioural difficulties in facial emotion recognition (FER) have been observed in individuals with Autism Spectrum Disorder (ASD), behavioural studies alone are not suited to elucidate the specific nature of FER challenges in ASD. Eye tracking (ET) and electroencephalography (EEG) provide insights in to the attentional and neurological correlates of performance, and may therefore provide insight in to the mechanisms underpinning FER in ASD. Given that these processes develop over the course of the developmental trajectory, there is a need to synthesise findings in regard to the developmental stages to determine how the maturation of these systems may impact FER in ASD. We conducted a systematic review of fifty-four studies investigating ET or EEG meeting inclusion criteria. Findings indicate divergence of visual processing pathways in individuals with ASD. Altered function of the social brain in ASD impacts the processing of facial emotion across the developmental trajectory, resulting in observable differences in ET and EEG outcomes.

Gaze-Based Assessments of Vigilance and Avoidance in Social Anxiety: a Review.

PURPOSE OF REVIEW: A broad base of research has sought to identify the biases in selective attention which characterize social anxiety, with the emergent use of eye tracking-based methods. This article seeks to provide a review of eye tracking studies examining selective attention biases in social anxiety. RECENT FINDINGS: Across a number of contexts, social anxiety may be associated with a mix of both vigilant and avoidant patterns of attention with respect to the processing of emotional social stimuli. Socially anxious individuals may additionally avoid maintaining eye contact and may exhibit a generalized vigilance via hyperscanning of their environment. The findings highlight the utility of eye tracking methods for increasing understanding of the gaze-based biases which characterize social anxiety disorder, with promising avenues for future research.

Attentional bias mediates the effect of neurostimulation on emotional vulnerability.

Transcranial direct current stimulation (tDCS) is a neuromodulatory technique which has garnered recent interest in the potential treatment for emotion-based psychopathology. While accumulating evidence suggests that tDCS may attenuate emotional vulnerability, critically, little is known about underlying mechanisms of this effect. The present study sought to clarify this by examining the possibility that tDCS may affect emotional vulnerability via its capacity to modulate attentional bias towards threatening information. Fifty healthy participants were randomly assigned to receive either anodal tDCS (2 mA/min) stimulation to the left dorsolateral prefrontal cortex (DLPFC), or sham. Participants were then eye tracked during a dual-video stressor task designed to elicit emotional reactivity, while providing a concurrent in-vivo measure of attentional bias. Greater attentional bias towards threatening information was associated with greater emotional reactivity to the stressor task. Furthermore, the active tDCS group showed reduced attentional bias to threat, compared to the sham group. Importantly, attentional bias was found to statistically mediate the effect of tDCS on emotional reactivity, while no direct effect of tDCS on emotional reactivity was observed. The findings are consistent with the notion that the effect of tDCS on emotional vulnerability may be mediated by changes in attentional bias, holding implications for the application of tDCS in emotion-based psychopathology. The findings also highlight the utility of in-vivo eye tracking measures in the examination of the mechanisms associated with DLPFC neuromodulation in emotional vulnerability.