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DOI 10.1007/s10803-013-1855-2
ORIGINAL PAPER
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112
GAD-7
SIAS
SCS
SCS private
SCS public
Total sample
Correlation coefficient
.602**
.647**
.622**
.434**
.257*
.088
.536**
p value
.000
.000
.000
.001
.047
.503
.000
AS
Correlation coefficient
.484**
.537**
.231
.320
.312
.319
.126
p value
.007
.002
.219
.085
.093
.085
.508
Control
Correlation coefficient
.304
.385*
.589**
.367*
.216
.196
.466**
p value
.102
.035
.001
.046
.251
.298
.010
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3.
113
4.
Methods
Participants
Participants with a diagnosis of AS (26 males: 4 females;
mean age 32.23, SD 9.43; mean IQ score 112, SD 11.77)
were recruited through voluntary organisations and completed two screening measures, the Autism Spectrum
Quotient (Baron-Cohen et al. 2001b) and the Wechsler
Abbreviated Scale of Intelligence (Wechsler 1999) to
ensure their suitability for the study. All of the participants
had verifiable diagnoses made on the basis of the current
DSM-IV/ICD-10 criteria for AS. The control group was
recruited through the University of Manchester as well as
local community resources and were matched group-wise
with the AS group for age (mean 31.63, SD 10.35), sex (26
males and 4 females) and estimated IQ scores (mean
107.67, SD 10.34).
Materials and Procedure
Wechsler Abbreviated Scale of Intelligence (WASI;
Wechsler 1999)
The two-subtest version of the WASI was used to estimate
IQ score using the vocabulary and matrix reasoning subtests, which are taken as measures of verbal and non-verbal
cognitive functioning. High internal consistency has been
reported for the two subscales (for both, a = 0.94) and
good testretest reliability (r = 0.90, 0.79).
The Autism Quotient (AQ) (Baron-Cohen et al. 2001b)
The AQ is a brief self-administered screening assessment
for measuring the degree to which an individual of normal
intelligence shows autistic traits. It consists of 50 statements in total, with 10 questions assessing each of 5 different domains (social skill, attention switching, attention
to detail, communication and imagination), with respondents indicate the degree to which they agree/disagree with
each statement on a four-point scale. The AQ has reasonable face validity, with moderate internal consistency for
the five domains (a = 0.630.77) and good testretest
reliability (r = 0.70). For the purpose of this study, a more
conservative threshold of 26/50 (compared to 32/50) was
used (Woodbury-Smith et al. 2005) to minimise false
negatives.
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from it and presented in the centre of the screen. Participants must decide from which jar the beads are coming
from based on the colours of beads that emerged. Participants are informed that they can ask to see as many beads
as they want until they felt certain. Previously drawn beads
stay at the bottom of the screen as a memory aid (Fig. 2).
In a second version of the Beads Task (Dudley et al.
1997a, b), the ratio of beads is 60:40 to increase task difficulty and the colours changed to red and blue. In both
versions, the task is stopped once participant make a
decision and the number of beads requested up to that point
recorded. In previous research, a JTC has been defined as
requesting only one or two beads (Garety et al. 2005). The
two versions of the task will hitherto be referred to as
Beads Task A and Beads Task B.
Eyes Test (Baron-Cohen et al. 2001a)
This is an advanced metallisation test examining the ability
to attribute a specific complex mental state based solely on
information from 36 photographs of pairs of eyes. The total
number of correct responses is recorded together with
speed of response (reaction time in ms). This assessment
has been previously used with people with AS (BaronCohen et al. 2001b).
Results
The two groups were matched group-wise for gender, age
and IQ scores. The male: female ratio was 26:4 in both
groups with no significant group differences for age (AS
group Mdn = 29.5, IQR = 16; control group Mdn = 33.5,
IQR = 18; U = 440, z = -.15, p = 0.88) or IQ scores (AS
group Mdn = 11, IQR = 10; control group Mdn = 11,
IQR = 10; U = 331, z = -1.77, p = 0.08). Social anxiety
scores were elevated in the AS group (Mdn = 46,
IQR = 22) than the control group (Mdn = 11, IQR = 21),
this difference being statistically significant (U = 78,
z = -5.5, p B .001; r = -0.71). On this basis, up to 80 %
of the AS group could be classified as socially phobic. No
difficulties were reported regarding the completion of any of
the measures by participants in either group.
The overall SCS scores were significantly higher in the
AS group (Mdn = 37.5, IQR = 14) than the control group
(Mdn = 27.5, IQR = 15) (U = 260.5, z = -2.8, p =
.005; r = -0.36). However, on examining individual
subscales score, social anxiety was the only one to demonstrate a statistically significant difference between
groups (U = 105.5, z = -5.107; p = .000) with a large
effect size (r = -0.66). Therefore, it is likely that the
social anxiety subscale score had the strongest influence on
the overall SCS score.
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The AS group were less accurate at identifying emotions with a median percentage accuracy of 69.44
(IQR = 23.61) compared with the control group
(Mdn = 80.56, IQR = 11.80), which difference was statistically significant (U = 182, z = -3.98, p B .001) with
a large effect size (r = -0.5). As predicted, the AS group
responded more quickly to stimuli (Mdn = 6,327.95,
IQR = 3,687.22) than the control group (Mdn = 7,981.6,
IQR = 10,771.60), which was again statistically significant
(U = 698, z = -3.21, p = .001) with a medium effect
size (r = -0.41).
Hypothesis 3 There will be higher levels of paranoia in
the AS group than the control group.
Paranoia scores were higher in the AS group
(Mdn = 58, IQR = 63) compared to the control group
(Mdn = 35.5, IQR = 6), with a notably wider range of
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Discussion
scores on the PTS in the AS group (see Fig. 4), and this
between-group difference was statistically significant
(U = 153, z = -4.39, p B .001) with a large effect size
(r = -0.57). It was noted that the responses of the AS
group on the PTS encompassed both ideas of persecution
and ideas of reference, with neither predominating or
characterising the paranoid ideation of the AS group.
Hypothesis 4 Performance on each of the experimental
tasks (Beads Task, Eyes Test) will be associated with levels
of paranoia.
For the sample as a whole, there was a statistically
significant negative relationship between paranoia scores
and both conditions of the Beads Task (A: q = -.596,
p B .001; B: q = -.603, p B .001), thus indicating that
higher scores on the paranoia scale were associated with
lower numbers of beads requested. There was also a statistically significant negative correlation between paranoia
scores and accuracy on the Eyes Test, indicating that
higher levels of reported paranoid thoughts were associated
with poorer performance on the latter task (q = -.400,
p = .002). No other significant relationships were observed
between paranoia and reaction time on the Eyes Test.
However, when the two groups were considered separately,
none of the above relationships remained significant for
either the AS group or the control group. On inspection of
scatter plots displaying both groups data, it appeared that
the original correlations observed for the whole sample
were probably art factual and represented group differences
rather than actual monotopic relationships.
Spearmans correlation coefficient was employed to
investigate possible associations between experimental
tasks scores. A medium-sized relationship was observed at
the 0.05 level between the Beads Task the Eyes Test in the
AS group.
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biases, with Young and Bentall (1995) noting that individuals with delusions were less likely than non-clinical
controls to systematically narrow down hypotheses in the
light of sequentially presented information on a rule discovery task. As it has been long established that people
with ASD perform poorly on tasks involving sequential
information processing (Allen et al. 1991; Heaton et al.
1993), the current findings may be a sequelae of this more
general problem in sequential information, a hypothesis
that could be examined in future studies. A related theory
suggests that deficits in information integration are related
to JTC biases, whereby abnormal salience is attributed to
stimuli resulting in excessive value being placed on current
evidence (Kapur 2003; Menon et al. 2006, 2005). In respect
of the Beads Task, this could be investigated by manipulating the number of trials to determine whether people
with ASD infer similar empirical rules rather than use a
priori probabilistic reasoning that is assumed to be central
to deriving the correct response. Finally, the current results
can also be considered in the context of studies that have
demonstrated working memory impairments in people with
ASD (e.g Steele et al. 2007) and thus the impaired reasoning abilities observed in the present study may relate to
a limited capacity for working memory rather than represent reasoning biases per se. Again, this could be examined
in future research studies.
The current findings could also be looked at in view of
the reported co-morbidity between ASD (including AS)
and ADHD and recent research suggesting that specific
forms of executive dysfunction differentially underpin
symptoms of ASD and ADHD (e.g. Corbett Constantine
et al. 2009). The JTC bias reported in the current study
could be interpreted in light of the observation that
response withholding and problems in inhibition appear to
characterise ADHD (Bramham et al. 2009).
In conclusion, further research is required to replicate
these findings and relate them to other differences and
deficits in information processing in people with ASD, to
examine possible causal factors and to explore the
implications of such data- gathering biases for social
experience and mental health difficulties. In this regard,
investigation of explanations for JTC biases in psychosis,
such as an elevated need for closure, over-extended
confirmatory reasoning style and difficulties with the use
of sequential information, may be useful. Similarly, the
potential contribution of factors such as facial expression
recognition and metallisation to data-gathering style could
be further tested, as well as associations with other factors, such as executive function, autobiographical memory, self-understanding and negative thinking and the
formation of negative assumptions about others beliefs
and intentions, which may impact upon the experience of
paranoia.
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Acknowledgment
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