Empathy-Stress Relation in Autistic Individuals: The Role of Prosopagnosia and Oxytocin

Abstract

Introduction

Social dysfunction is a core characteristic of Autism Spectrum Disorder (ASD), which manifests as deficits in interpreting facial expressions, face processing and emotion recognition impairments. Such challenges may lead to reduced empathic accuracy (EA) and heightened social stress [1]. Research shows that stressed participants show stronger activation in the empathy network, but what remains unclear is how individual’s different levels of empathy influence stress response during stressful social situation. Additionally, prosopagnosia which impairs face recognition and is prevalent in up to 36% among ASD population [1], may also influence the empathy-social stress relationship, but it’s impact remains underexplored.

A number of studies have suggested that the dysregulated neuropeptide oxytocin (OXT) might play a role in ASD [2]. OXT administration to healthy individuals has been shown to improve social cognition, such as enhancing EA and stress regulation [3], but it’s effect on empathy-social stress bond remains largely unexplored.

Our aim is to examine the relationship between EA and social stress reactivity in prosopagnosic autistic individuals (AUT-P), compared to non-prosopagnosic autistic individuals (AUT-NP). We will administrate exogenous OXT and explore how it may additionally moderate the relationship, compared to placebo.

Therefore, our main hypothesis is that OXT will improve EA and stress response in both groups, with a larger impact on AUT-P group.

Methods

Our study will include 68 participants with ASD diagnosis between the ages 18 and 60, divided into two groups; 50% with prosopagnosia and 50% without prosopagnosia.

All participants will be randomly assigned to receive either a dose of OXT (24 UI total or 6 puffs) or placebo. After that, participants will be assigned two tasks; Empathic Accuracy Task (EAT) and Trier Social Stress Test (TSST). During EAT, participants will watch ten video clips of narrators describing emotional (either positive or negative) autobiographical experiences. The second task, TSST, consists of a 5-minute preparation for a mock job interview followed by a 5-minute oral presentation. The presentation is deliberately set to give a neutral or subtly negative feedback. In addition, physiological measures, such as heart rate variability and salivary cortisol will be collected to assess physiological stress reactivity.

Expected Results

Overall, exogenous OXT administration is expected to enhance EA and physiological stress responses in both groups, with a larger effect in AUT-P group. Clarifying how oxytocin influences empathy-stress relationship could help support better social functioning in individuals with ASD.

References

[1] R. Fry, X. Li, T. C. Evans, M. Esterman, J. Tanaka, and J. DeGutis, “Investigating the Influence of Autism Spectrum Traits on Face Processing Mechanisms in Developmental Prosopagnosia,” Journal of Autism and Developmental Disorders, vol. 53, Sep. 2022. doi: 10.1007/s10803-022-05705-w.

[2] L. J. Young and C. E. Barrett, “Can oxytocin treat autism?,” Science, vol. 347, no. 6224, pp. 825–826, Feb. 2015. doi: 10.1126/science.aaa8120.

[3] J. A. Bartz, J. Zaki, N. Bolger, and K. N. Ochsner, “Social effects of oxytocin in humans: context and person matter,” Trends in Cognitive Sciences, vol. 15, Jun. 2011. doi: 10.1016/j.tics.2011.05.002.