Peer-reviewed article
M33. ATTENTUATED POSITIVE SYMPOMS AND FACIAL AFFECT PROCESSING IN HIGH-RISK ADOLESCENTS WITH AND WITHOUT AUTISM
Maat A, Therman S, Swaab H, Ziermans T ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examines facial affect processing in adolescents aged 12-18 with attenuated positive symptoms (APS), comparing those with and without autism spectrum disorder to typically developing controls. The research found that adolescents with APS and autism showed slower reaction times to facial stimuli and had difficulty recognizing fearful expressions, but APS alone was not associated with emotion recognition deficits. The findings suggest that autistic-like traits rather than psychotic traits may be better indicated by slower processing of facial information.
Key points
- APS in adolescents was not associated with impairments in pattern, face, or emotion recognition overall
- Adolescents with both APS and autism spectrum disorder showed slower reaction times for face and emotional stimuli compared to other groups
- The APS with autism group was significantly worse at recognizing fearful expressions than APS without autism and controls
- No dimensional correlations were found between schizotypal traits and facial affect processing
- Slower reaction times to facial stimuli may be more characteristic of autistic phenotypes than psychotic phenotypes
Limitations
This is a descriptive study of associations between symptoms and cognitive processing with small sample sizes (particularly n=21 for the APS with autism group), which limits generalisability. The cross-sectional design cannot establish whether observed differences are causes or consequences of the developmental conditions being studied.
Abstract
Abstract Background Autism and schizophrenia spectrum disorders both represent severely disabling neurodevelopmental disorders with marked impairments in social functioning. Despite an increased incidence of psychosis in autism, and substantial overlap in symptoms and cognitive markers, it is unclear whether such phenotypes are specifically related to risk for psychosis or perhaps reflect more general, idiosyncratic autism traits. Attenuated positive symptoms (APS) currently constitute the best and most-replicated clinical predictors of schizophrenic psychosis, and are common in clinical youth with and without autism. The aims of this study were to test the hypothesis that facial affect processing is impaired in adolescents with APS and to explore whether such deficits are more indicative of psychotic or autistic phenotypes on a categorical and dimensional level. Methods Fifty-three adolescents with APS and 81 typically developing controls (aged 12–18) were included. The APS group consisted of adolescents with (n = 21) and without (n = 32) a diagnosis of autism spectrum disorder. Facial affect recognition and ‘lower-level’ cognitive skills, namely pattern and face recognition, were assessed with the Amsterdam Neuropsychological Tasks. For associations with schizotypal and autistic-like traits the Schizotypal Personality Questionnaire and Social Communication questionnaire were used and one-dimensional factor scores were generated with confirmatory factor analysis. Results Our preliminary findings suggest that APS in adolescents is not associated with impairments in pattern, face, or emotion recognition. However, the APS group with autism spectrum disorder generally showed slower reaction times for face/emotional stimuli and they were significantly worse in recognizing fearful expressions than APS participants without autism spectrum disorder and controls. There were no dimensional correlations with schizotypal traits and marginal correlations between autistic-like traits and speed of recognizing faces. Discussion Contrary to our expectations, APS demonstrated limited use in identifying cognitive deficits typical to schizophrenic psychosis. A more autistic-like profile may be characterized by slower reaction times to facial stimuli, suggesting that more complicated and dynamic social cognitive stimuli have a better chance of discerning between autistic and psychotic-like phenotypes.