Assessment & Research

Is a Negative Attentional Bias in Individuals with Autism Spectrum Disorder Explained by Comorbid Depression? An Eye-Tracking Study

MA et al. (2021) · 2021
★ The Verdict

Negative attention bias in autism is a depression signal, not an autism trait—screen mood first.

✓ Read this if BCBAs working with autistic teens or adults who show social withdrawal or negative fixations.
✗ Skip if Clinicians serving only non-verbal young children or clients with no mood concerns.

01Research in Context

01

What this study did

MShawler et al. (2021) used eye-tracking to watch where people looked.

They compared three groups: autistic adults with current depression, autistic adults whose depression had lifted, and autistic adults who had never been depressed.

Everyone viewed happy, angry, and sad faces while the camera logged gaze time.

02

What they found

Only the currently depressed autistic group stared longer at angry and sad faces.

The other two autistic groups looked at negative faces the same amount as happy ones.

The bias vanished when depression was gone, so it is a mood effect, not an autism trait.

03

How this fits with other research

Ganz et al. (2009) saw that emotional words did not grab attention in autism.

Their result looked like a core autism issue, but they did not check for depression.

MShawler et al. (2021) now shows the bias only appears if depression is also present.

Payne et al. (2020) found autistic teens were worse at naming negative faces.

That study blamed autism; MShawler et al. (2021) says the trouble may instead come from hidden low mood.

Together the papers warn: screen for depression before you label social-cognitive deficits as autism-only.

04

Why it matters

If you see a client locking onto angry faces or pictures, do not assume it is part of autism.

Run a quick mood checklist first.

When depression is treated, the attention bias may ease on its own, making social skills training easier.

Add a depression probe to your intake forms this week.

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Add a two-question depression screener before you start attention-shaping programs.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
180
Population
autism spectrum disorder, mixed clinical
Finding
positive

03Original abstract

Heightened attention towards negative information is characteristic of depression. Evidence is emerging for a negative attentional bias in Autism spectrum disorder (ASD), perhaps driven by the high comorbidity between ASD and depression. We investigated whether ASD is characterised by a negative attentional bias and whether this can be explained by comorbid (sub) clinical depression. Participants (n = 116) with current (CD) or remitted depression (RD) and/or ASD, and 64 controls viewed positively and negatively valenced (non-)social pictures. Groups were compared on three components of visual attention using linear mixed models. Both CD individuals with and without ASD, but not remitted depressed and never-depressed ASD individuals showed a negative bias, suggesting that negative attentional bias might be a depressive state-specific marker for depression in ASD.

, 2021 · doi:10.1007/s10803-021-04880-6