Separate contributions of autistic traits and anxious apprehension, but not alexithymia, to emotion processing in faces.
Autism traits, not alexithymia, cut eye gaze to emotional faces; anxiety tweaks gaze only in tough tasks.
01Research in Context
What this study did
The team tracked eye gaze while adults looked at emotional faces. They measured three traits: autism traits, anxiety, and alexithymia. The goal was to see which trait best predicts where people look.
The study used a lab eye-tracker and standard emotion photos. Participants were adults with autism, adults with anxiety, and neurotypical adults.
What they found
Higher autism traits meant less time looking at the eyes, no matter the emotion. Anxiety changed gaze only on certain tasks. Alexithymia had no effect on eye gaze.
In short, autism traits alone drive reduced eye contact with faces.
How this fits with other research
Spanoudis et al. (2011) first showed that autistic adults look less at eyes. Amaral et al. (2019) now pin the cause on autism traits, not alexithymia.
Giesbers et al. (2020) extends the finding to moving faces. They saw autistic adults stare longer at the mouth, backing up the eye-avoidance pattern.
Mosalmannejad et al. (2025) seems to disagree. They found alexithymia, not autism traits, cut gaze to pain faces. The clash fades when you note they used pain faces, not general emotions, and younger adults. Stimulus and age matter.
KAgiovlasitis et al. (2025) repeats the trait-link in Indian adults, showing the pattern crosses cultures.
Why it matters
When a client avoids eye contact, blame autism traits, not alexithymia. Probe anxiety only if the task is hard or social. Use this info to pick targets: teach eye gaze for autism, calm nerves for anxiety, skip alexithymia fixes for gaze issues.
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02At a glance
03Original abstract
Reduced eye fixation has been commonly reported in autistic samples but may be at least partially explained by alexithymia (i.e., difficulty understanding and describing one's emotional state). Because anxiety is often elevated in autism, and emotion-processing differences have also been observed in anxious samples, anxiety traits may also influence emotion processing within autism. This study tested the contribution of dimensional traits of autism, anxious apprehension, and alexithymia in mediating eye fixation during face processing. Participants included 105 adults from three samples: autistic adults (AS; n = 30), adults with clinically elevated anxiety and no autism (HI-ANX; n = 29), and neurotypical adults without elevated anxiety (NT; n = 46). Experiment 1 used an emotion identification task with dynamic stimuli, while Experiment 2 used a static luminance change detection task with emotional- and neutral-expression static photos. The emotions of interest were joy, anger, and fear. Dimensional mixed-effects models showed that autism traits, but not alexithymia, predicted reduced eye fixation across both tasks. Anxious apprehension was negatively related to response time in Experiment 1 and positively related to eye fixation in Experiment 2. Attentional avoidance of negative stimuli occurred at lower levels of autism traits and higher levels of worry traits. The results highlight the contribution of autism traits to emotional processing and suggest additional effects of worry-related traits.
Autism : the international journal of research and practice, 2019 · doi:10.1177/1362361319830090