Eye-Gaze Pattern Analysis as a Key to Understanding Co-occurring Social Anxiety within Autism Spectrum Disorder

Emerging research suggests that many adults with Autism Spectrum Disorder (ASD) experience impairing Social Anxiety Disorder (SAD) or social anxiety symptoms (e.g., Joshi et al., 2013; Kleinhans et al., 2010), yet there is little guidance or agreement about how to best assess social anxiety in this population. Direct examination of overt eye gaze patterns may help determine if the attentional biases often reported in people with SAD also operate in those with ASD and co-occurring social anxiety. This study sought to assess the influence of social anxiety on gaze patterns in adults with ASD. An exploratory aim was to better understand the phenomenology of SAD within ASD. Three groups of participants were included: adults with ASD (n = 25), adults with SAD (n = 25), and adults without ASD or SAD (n = 25). As hypothesized, a large subset (n = 11; 44%) of the participants with ASD met diagnostic criteria for SAD. Contrary to study hypotheses related to gaze patterns, however, there was no evidence for gaze vigilance followed by avoidance for socially threatening stimuli in either the ASD or SAD groups, and there was no relationship between fear of negative evaluation and gaze duration toward socially threatening stimuli within the ASD group. Possible reasons for these null findings are considered. Clinical implications and suggestions for future research are also discussed.