title: Emotional decision-making in autism spectrum disorder: the roles of interoception and alexithymia.
abstract: The way choices are framed influences decision-making. These "framing effects" emerge through the integration of emotional responses into decision-making under uncertainty. It was previously reported that susceptibility to the framing effect was reduced in individuals with autism spectrum disorder (ASD) due to a reduced tendency to incorporate emotional information into the decision-making process. However, recent research indicates that, where observed, emotional processing impairments in ASD may be due to co-occurring alexithymia. Alexithymia is thought to arise due to impaired interoception (the ability to perceive the internal state of one's body), raising the possibility that emotional signals are not perceived and thus not integrated into decision-making in those with alexithymia and that therefore reduced framing effects in ASD are a product of co-occurring alexithymia rather than ASD per se. Accordingly, the present study compared framing effects in autistic individuals with neurotypical controls matched for alexithymia. Results showed a marked deviation between groups. The framing effect was, in line with previous data, significantly smaller in autistic individuals, and there was no relationship between alexithymia or interoception and decision-making in the ASD group. In the neurotypical group, however, the size of the framing effect was associated with alexithymia and interoception, even after controlling for autistic traits. These results demonstrate that although framing effects are associated with interoception and alexithymia in the neurotypical population, emotional and interoceptive signals have less impact upon the decision-making process in ASD.
authors: Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, University of London, London, SE5 8AF UK.
authors: Punit
authors: 0000-0001-5497-4765
authors: P
authors: Shah
authors: Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, University of London, London, UK.
authors: Caroline
authors: C
authors: Catmur
authors: Institute of Cognitive Neuroscience, University College London, London, UK ; MRC SGDP Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, University of London, London, UK.
authors: Geoffrey
authors: G
authors: Bird
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000503:physiopathology / Q000523:psychology*; D000067877:Autism Spectrum Disorder / Q000503:physiopathology / Q000523:psychology*; D016022:Case-Control Studies; D003657:Decision Making; D005260:Female; D005639:Frustration; D006240:Happiness; D006801:Humans; D007361:Intelligence Tests; D065812:Interoception / Q000502:physiology*; D008297:Male
keywords: Alexithymia; Autism; Decision-making; Emotion; Framing effect; Insula; Interoception; Replication