Author: Ashley Lopez-Hernandez Adolescence is a period of emotional complexity, filled with social interactions that shape a young person's identity and relationships. For autistic adolescents, one of the core challenges during this time involves interpreting emotional cues, especially facial expressions. This difficulty in reading emotions doesn't just impact social understanding it can also intensify feelings of anxiety and isolation. How Emotion Interpretation Differs in Autism Autistic adolescents often experience differences in how they perceive facial expressions, particularly in identifying whether an emotion is genuine or safe to approach. A 2024 study published by Bothe et al. found that autistic traits are associated with "...difficulty in perceptual discrimination, labeling facial expressions, discriminating the genuineness of facial expressions, and differences in making social decisions relating to facial expressions" regardless of whether individuals also experienced Alexithymia -the difficulty in identifying and describing one’s own emotions- (Bothe et al., 2024, p. 1333). This means that even without difficulty in recognizing their own emotions, autistic individuals may still struggle to assess whether someone is sincere or emotionally approachable. In particular, the study highlights that many autistic individuals were less accurate in evaluating smiles. It was found that "autistic-like social skills predicted less typical approach judgements of genuine, but not posed, happy expressions, reflecting a reduced willingness to approach genuinely happy faces." (Bothe et al., 2024, p. 1331). This can be confusing in social interactions, increasing the risk of misunderstanding individuals' intentions and emotions. Why Misreading Emotions Contributes to Anxiety For most, facial expressions provide valuable feedback about social safety, inclusion, and rejection. However, when facial cues are difficult to decode, this lack of clarity can contribute to heightened anxiety. Social environments become unpredictable when one cannot determine if a peer is being kind, sarcastic, judgmental, or indifferent. This uncertainty may cause autistic teens to withdraw from social situations or avoid interactions all together. Over time, consistent avoidance behavior can lead to the development of social anxiety or exacerbate existing anxiety disorders. A comprehensive study by Hunsche et al. (2022) supports this connection, noting that poor theory of mind- which refers to the ability to infer the thoughts, emotions, and intentions of others- as well as similar social differences “may lead to greater peer rejection or to a sense of unpredictability and confusion in social interactions, which may then contribute to the development of social fears."(p. 199). This contribution to social fears can drastically impact anxiety levels for some Autistic adolescence. Therefore, it can be inferred that when Autistic adolescents repeatedly misinterpret social feedback, it not only impairs relationship-building but reinforces a sense of being “out of sync” with the social world around them. Addressing Emotional Misinterpretation in Therapy Given the role of misinterpreting emotions in autistic anxiety, treatment approaches need to address both social cognition and emotional regulation. Theory of Mind (ToM) and facial emotion recognition interventions, when adapted for autistic youth, has shown significant promise. The Hunsche et al. (2022) study found that providing social skills training opportunities to autistic adolescence " ...may reduce the uncertainty and confusion of social interactions and provide the option to exercise neurotypical social skills when needed, the pros (e.g., greater social acceptance.."(p. 205). Interventions integrating facial expression training, emotion labeling, and social scripts can help autistic adolescents feel more confident in social environments. Building this foundation of emotional literacy can reduce social misinterpretations and, in turn, lower social anxiety levels. Conclusion Understanding emotions is a key component of social functioning. For autistic adolescents, differences in emotional interpretation are not merely a communication barrier; they are tied to experiences of anxiety. As research from Bothe et al. (2024) and Hunsche et al. (2022) demonstrates, acknowledging and supporting these differences through targeted interventions can lead to more meaningful social engagement and improved mental health outcomes. By validating the emotional experiences of autistic youth and equipping them with tools to navigate the social world, we move closer to a more inclusive and supportive approach to adolescent development. Bothe, E., Jeffery, L., Dawel, A., Donatti-Liddelow, B., & Palermo, R. (2024). Autistic traits are associated with differences in the perception of genuineness and approachability in emotional facial expressions, independently of alexithymia. Emotion, 24(5), 1322–1337. https://doi.org/10.1037/emo0001350
Hunsche, M. C., Cervin, M., Storch, E. A., Kendall, P. C., Wood, J. J., & Kerns, C. M. (2022). Social functioning and the presentation of anxiety in children on the autism spectrum: A multimethod, multiinformant analysis. Journal of Psychopathology and Clinical Science, 131(2), 198-208. doi: https://doi.org/10.1037/abn0000724
0 Comments
By: Janae HerseyThis week's article discussed Camouflaging in autistic adult populations. This qualitative study included the experiences of both clinically and self-diagnosed individuals, providing insight into their thoughts, feelings and motivations behind camouflaging. This study helps shed light on this widely unknown behavior.
Camouflaging is described as the act of appearing more social or mirroring the social behaviors of other people to blend in in social settings. While anyone can camouflage, this is an article specifically focused on autistic individuals. The dangers reported in this article discussed how engaging in camouflage on a daily basis was exhausting and stressful, leaving individuals feeling cognitively overloaded. They described that they felt as though their brains were always working. Others reported that they felt like they couldn’t meet their basic needs because camouflaging was so draining. Some reported feeling better after resting but noted that there isn’t always much time to do so. These reports explain why many individuals related camouflaging to poor mental health outcomes. Depression, anxiety, suicidal thoughts, self-harm, and negative alcohol behaviors were reported in response to avoiding their awareness of social self. The third danger reported was that others often failed to accept the individuals when they were no longer camouflaging. Because of this, individuals reported feeling like they had to keep camouflaging to avoid being bullied, abused, or socially excluded. Not wishing to forfeit social acceptance, individuals continued even despite feeling inauthentic. As a result, many reported that the fear of losing social acceptance led them to isolate themselves completely. The last danger that was discussed was that camouflaging creates unreal perceptions of people with Autism. What the participants meant by this was that other people often do not believe that they are autistic, that they do not get enough recognition of their difficulties, or that people often get offended by them or think they are being fake when they are not camouflaging. Some even stated that camouflaging caused a delay in getting a formal diagnosis. They believe this would have been helpful when they were younger, potentially decreasing being hurt, by themselves or by others. The benefits the participants reported were that camouflaging helped them survive in society. They reported how there weren't many resources for them so camouflaging kept them out of bad places, alleviated bullying, or lessened the threat of being attacked. Some said it allowed them to better access the outside world, get jobs, meet people, make friends, and help with their partners and children. Others reported that they feel like it made them build resilience. They believe they built this resilience as a result of overcoming obstacles in society. When it came to the participants who do not camouflage, there were many different reasons for why they do not. Some reported stopping after they got their clinical diagnosis to preserve their mental health and also to educate others about Autism. Some believed that they were not that good at it and decided it was not worth it while others thought it only benefited the people around them, not themselves. Others reported only doing it around people who they do not know or do not understand, love, or feel supported by. It was also discussed that stopping the action of camouflaging was difficult, but some stated that it was rewarding as they reported feeling more positive, accepted, and confident. In our lab discussion, we brought up that not having to camouflage would be helpful for many people. We mentioned how camouflaging is different from code switching, which is usually only for a short period of time, at a specific event, and does not have the same risks as camouflaging. In general, it was our opinion that there were more negatives than positives to camouflaging. People generally have a lack of understanding about autism. A lack of awareness can cause camouflaging to happen for a long time, leading to the potential risks listed above. As a lab, we will continue working to reduce the need for camouflaging by fostering greater understanding and inclusivity for our participants with autism. Reference: Bradley, L., Shaw, R., Baron-Cohen, S., Cassidy, S. (2021, December 7). Autistic Adults’ Experiences of Camouflaging and Its Perceived Impact on Mental Health. Autism in Adulthood. Retrieved from https://www.liebertpub.com/doi/full/10.1089/aut.2020.0071 Author: Isabelle SutherlandThe impacts of poverty extend beyond having your power turned off and being unable to afford rent. It affects the body internally, particularly in early brain development and cognitive ability. The National Institutes of Health (NIH) has conducted numerous studies examining the development of the cerebral cortex in impoverished children, consistently finding a decrease in volume of gray matter compared to children from more financially secure households. Household eligibility for the federal poverty line is determined by family size and total income. In the United States, the average family typically has two children, with a mean federal poverty threshold of $21,250 per year for this family size (American Council on Aging, 2025). A cross-sectional study with 389 child participants found that those whose household’s income was 1.5 times above the federal poverty line had a 3-4% reduction in gray matter in the frontal cortex (related to higher level cognitive processes), temporal cortex (auditory and emotional processing), and the hippocampus (site of declarative and episodic memory). For children living at the federal poverty line, gray matter reductions were significantly greater, ranging from 8% to 9% (Hair et al., 2015). These results align with a study conducted by the NIH (Tomalski et al., 2013), which used electroencephalogram (EEG) technology to investigate baseline brain activity in the gamma frequency range (linked to higher-order executive functions) of 6- to 9-month-old infants from lower socioeconomic status families. The EEGs recorded lower high-frequency brain activity in the prefrontal cortex, suggesting potential disruptions in cognitive functions related to attention, decision-making, problem-solving, and emotional regulation as the infants mature (Tomalski et al., 2013).
Reduced cortical mass in the brain is an equifinal event that cannot be restricted to socioeconomic status. Restriction of resources extended to the child, such as food resulting in poor nutrition, inadequate housing, and lack of access to healthcare can occur due to many factors and are not exhaustive in contributing to poor brain development. Excessive exposure to loud noises, regular chaos, and conflict among family members can serve as chronic stressors to a child causing the release of the stress hormone cortisol. Elevated levels of this hormone are associated with changes in the volume of the amygdala (a brain region responsible for processing fear and anxiety), as well as atrophy of the hippocampus and dendrites of pyramidal neurons critical to communication between the prefrontal cortex and numerous regions throughout the brain (Liston et al., 2006). Consequently, stress responses that hinder problem-solving and planning could potentially develop heightened reactivity and difficulties with attention and social cognition. Poverty is a multifactorial issue, meaning there is not one solution to resolve it. However, there are actions that can counteract its negative effects. Positive parenting behaviors are attributed to lower cortisol levels in children and higher executive function. Despite the socioeconomic status of a child’s household, they are far more likely to be well-adjusted with a parent that offers warmth, affection, and emotional support. Screening children and their parents for mental health risks, followed with referrals to services is another way to reduce potential stress impact on a child. With the appropriate guidance, improvements in mental health and parenting styles can be achieved (Luby et al., 2018). Several studies have demonstrated that high-quality education can combat poor brain development (Luby et al., 2018) by significantly improving neurocognitive ability, regulation of attention, and the speed at which information is processed (Blair & Raver, 2015). One step in fighting poverty is to help parents build higher levels of human capital in order to increase their federal and state incomes so they can rise above the poverty line (Luby et al., 2018). America’s College Promise Act is a proposed bill that aims to drastically lower the cost of community, technical, and tribal colleges for lower-income adults (Granville, 2023). If passed through legislation, young parents could attend college and strengthen their earning potential to exit poverty and its associated stressors. By helping parents who are struggling financially to rise economically and deliver intentional parenting approaches, impoverished children can have greater opportunities for success, improving their developmental outcomes. References American Council on Aging. (2025). Federal poverty guidelines / levels for 2025 & their relevance to Medicaid eligibility. MedicaidPlanningAssistance.org. https://www.medicaidplanningassistance.org/federal-poverty-guidelines/. Blair, C., & Raver, C. C. (2015). Closing the achievement gap through modification of neurocognitive and neuroendocrine function: Results from a cluster randomized controlled trial of an innovative approach to the education of children in kindergarten. Proceedings of the National Academy of Sciences, 112(43), 13775–13780. https://doi.org/10.1073/pnas.1512276112. Granville, P. (2023, October 17). How America’s College Promise would reshape the free college landscape. The Century Foundation. https://tcf.org/content/report/how-americas-college-promise-would-reshape-the-free-college-landscape/ Hair, N. L., Hanson, J. L., Wolfe, B. L., & Pollak, S. D. (2015). Association of child poverty, brain development, and academic achievement. JAMA Pediatrics, 169(9), 822–829. https://doi.org/10.1001/jamapediatrics.2015.1475. Liston, C., Miller, M. M., Goldwater, D. S., & others. (2006). Stress-induced alterations in prefrontal cortical dendritic morphology predict selective impairments in perceptual attentional set-shifting. Journal of Neuroscience, 26(30), 7810–7818. https://doi.org/10.1523/JNEUROSCI.1245-06.2006 Luby, J., Belden, A., Harms, M. P., Tillman, R., & Barch, D. (2018). Poverty, stress, and brain development: New directions for prevention and intervention. JAMA Pediatrics, 172(9), 810–811. https://doi.org/10.1001/jamapediatrics.2018.1326. Tomalski, P., Moore, D. G., Ribeiro, H., & others. (2013). Socioeconomic status and functional brain development—Associations in early infancy. Developmental Science, 16(5), 676–687. https://doi.org/10.1111/desc.12079 Author: Ashley Lopez-Hernandez Thirteen-year-old AJ Peterman is one of many children benefiting from mobile EEG testing, a groundbreaking approach pioneered by psychologist Caitlin Hudac at the University of South Carolina. As part of her research in the Brain Research Across Development (B-RAD) lab, Dr. Hudac and her team bring their equipment directly into participants’ homes, making it easier for families—especially those in underserved areas—to participate in autism and neurodevelopmental research. According to Erskine (2025) in the article "USC Psychologist Uses Mobile EEG to Break Down Barriers," Hudac and her team share AJ’s experience as a participant in their study. AJ, who is autistic, first joined the research after his mother, Akira Peterman, sought resources for autistic children in their community. Living in Sumter, South Carolina, the Peterman family faces long commutes to access specialized services. To address this challenge, Hudac’s team set up their mobile EEG lab in the Petermans’ home, allowing AJ to comfortably undergo his eighth EEG test while engaging in familiar activities, such as watching videos and interacting with family members. A More Accessible Approach to ResearchThis mobile approach was born out of necessity during the COVID-19 pandemic when travel restrictions disrupted Hudac’s initial research plans. Rather than pause her research, she traveled across the country, testing more than 55 participants with rare genetic conditions such as GRIN2B, SCN2A, and SETBP1 in 90 days. This shift not only made participation easier for families but also improved the testing experience—children felt more at ease in their familiar surroundings, especially those with complex medical symptoms like epilepsy, motor delays, and autism. Now, with funding from the SETBP1 Society, the Orphan Disease Center, and a McCausland Faculty Fellowship, Hudac’steam continues to expand its reach. While studying rare genetic conditions linked to autism, they also rely on neurotypical and autistic participants like AJ to form comparison groups, helping researchers build a more complete picture of autism and neurodevelopmental differences. By comparing EEG measurements across different ages and diagnoses, they aim to understand how rare genetic conditions influence development and their connection to autistic symptoms. Hudac, S. (2025, March 14). "There's a lot of evidence to suggest that all autism is genetic. It's just a matter of have we discovered it or not," Hudac explains. "We currently know about a quarter of autism cases are linked to a known genetic etiology, which is important to emphasize." In Laura Erskine, USC psychologist uses mobile EEG to break down barriers to research. While Hudac’s team has traveled across the U.S. to test children with the SETBP1 gene variant, their long-term goal is to expand internationally to reach more families affected by rare disorders. Expanding and Representation in ScienceDr. Hudac's goal is to make mobile EEG testing accessible not only to participants with rare genetic disorders but also to individuals like AJ’s family in rural communities who face challenges traveling to USC’s lab. By bringing research directly to families, Hudac aims to broaden participation in neuroscience studies and ensure more inclusive representation in autism research. ReferenceErskine, L. (2025, March 14). USC psychologist uses mobile EEG to break down barriers to research. University of South Carolina. https://www.sc.edu/uofsc/posts/2025/03/hudac-mobile-eeg-research.php
Author: Veronica du PlessisOur recent discussion centered around an article titled “Depression Among Older Adults: A 20-Year Update on Five Common Myths and Misconception”. This article revisited a 1997 study that challenged five myths about depression in older adults, highlighting new insights on the subject. The findings of this article hold the potential to positively impact the mental health community as they challenge outdated assumptions that may have led to misdiagnosis, undertreatment, or ineffective interventions for older adults. If depression is better recognized and treated in this population, it could lead to improved quality of life, increased independence, and even longer life expectancy. On a broader scale, changing the conversation about mental health in aging populations can reduce stigma, ensuring that older individuals feel empowered to seek and receive the mental health care they need.
The article listed the first myth that depression is more common in older adults than in younger individuals. Earlier studies suggested that aging led to increased sadness and depressive symptoms. However, more recent research, such as Blazer (2003), has demonstrated that the prevalence of Major Depressive Disorder (MDD) is actually lower in older adults compared to middle-aged individuals. This shift in understanding is partly due to improved diagnostic tools and a better distinction between normal aging and clinical depression (Cole & Dendukuri, 2003). Another evolving perspective involves the causes of depression in older adults. Historically, psychological factors like grief and loneliness were considered the primary triggers. While these factors remain relevant, more recent studies emphasize biological and social determinants, including chronic illness, neurobiological changes, and social isolation, as key contributors (Fiske, Wetherell, & Gatz, 2009). This change in understanding has led to more comprehensive treatment approaches that incorporate medical, psychological, and social factors. Similarly, earlier beliefs suggested that depression manifests differently in older adults, primarily through physical symptoms rather than emotional distress. While some studies, such as Gallo et al. (1994), found a slight increase in bodily symptom complaints among older individuals, more recent research has shown that the overall symptom profile of depression remains consistent across age groups. This understanding has led to improved screening methods that ensure older adults receive appropriate diagnoses rather than attributing their symptoms solely to physical health conditions. The notion that depression in older adults is more chronic and treatment-resistant has also been reevaluated. While it is true that relapse rates are higher due to medical comorbidities and cognitive decline (Mitchell & Subramaniam, 2005), newer findings suggest that psychotherapy, particularly cognitive-behavioral therapy (CBT), is just as effective in older populations as in younger ones (Areán & Cook, 2002). Furthermore, while some earlier research indicated that antidepressant medications might be less effective in older adults, recent studies have focused on optimizing dosages and combining treatments for better outcomes (Nelson et al., 2008). The major findings of the article encompassed that Major Depressive Disorder in older adults is a complex issue influenced by many factors. The treatment, severity, and outcomes of depression depends on more variables such as health conditions than strictly age. The content of the article sparked exciting discussion, in which multiple implications of the article were brought to light. The increased awareness that depression in older adults is often linked to chronic health conditions and social isolation could place additional strain on healthcare systems. If depression is seen as part of a broader network of medical and social issues, treatment must extend beyond prescribing medication and include comprehensive care models- requiring more resources and coordination. Additionally, the research indicating that depression in older adults is more likely to relapse (Mitchell & Subramaniam, 2005) suggests that long-term treatment and follow-up care are crucial, potentially requiring sustained investment in geriatric mental health services. Furthermore, we discussed the social implications of such misconceptions, in particular stigma around mental health in aging. By challenging the myth that depression is a normal part of growing older, older adults may feel more encouraged to seek treatment. As a final note, we analyzed what factors could contribute to the establishment and continuation of misconceptions about mental health in the older age population, such as ageism, previous gaps in research, and the current focus on depression in younger age groups. Haigh, E. A. P., Bogucki, O. E., Sigmon, S. T., & Blazer, D. G. (2018). Depression Among Older Adults: A 20-Year Update on Five Common Myths and Misconceptions. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 26(1), 107–122. https://doi.org/10.1016/j.jagp.2017.06.011 |
AuthorB-RAD Lab Members all contribute to our articles. Archives
April 2025
Categories
All
|
|
Copyright: B-RAD Lab, Dr. Caitlin Hudac
|
Sitemap | Contact
|
Website updated: June 2024
|