Caratterizzazione Neuropsicologica del Disturbo dello Spettro Autistico senza Disabilità Intellettiva (CNeSA)

To date, research on executive functions in ASD has focused on “cool” aspects, identified as a salient characteristic of autism spectrum disorder (ASD). Little is known about the contribution of “hot” affective Executive Functions and their contribution on symptoms and autistic behaviour. Neuropsychologic characteristics (Set-shifting, Emotional Processing, Value-based Decision-Making, Social Cognition) and autonomic parameters (Stress Responsivity) were evaluated in 35 subjects with ASD with normal intelligence and 40 typically developmental controls aged 10 to 17 years and 10 months using a computer test battery. The tasks included Intra-Extra Dimensional Set-Shifting Task, Face Affective Go/noGO, New Cambridge Gambling Task, Prisoner’s Dilemma and Moral Judgment Tasks. Two sample of salivary cortisol were also collected before and after the tests’ administration. For each task, behavioural measures and cortisol response have been taken in account to explore the relation with autistic symptoms. Compared to controls, the participants with ASD showed: • Poorer risks taking behaviour to achieve a reward or to avoid a punishment compared to typical controls; • Reward-driven decision making to achieve a reward affected by guilt and stress (levels of salivary cortisol); • Biased emotional attention (sensitivity to emotionally irrelevant stimuli); sensitivity appears negatively interfering with decision making to avoid unpleasant consequences (fear); • Cooperative behaviours based on avatar’s strategy in comparison to control group on which is related to monetary contribution; • Less intensity of emotion of guilty where being an agent of an intentional harm and higher annoyance identifying themselves with the victim of an intentional and not unintentional harm; • Similar stress levels measured at baseline but highest stress responsivity after test administration. The results of the study indicate that, as expected, autistic subjects with normal IQ show difficulties on recognition of social situations and related moral emotions and their ability to predict intentions of others modulates their cooperative behaviour; moreover, they are more sensitive to stress conditions and conditions of uncertainty and stress impair risk-taking behaviour finalized to achieve a reward, while the attention on irrelevant stimuli impairs risk-taking behaviour to avoid a punishment. Taken together these results suggest that, in order to improve their decision making abilities and their understanding of social situations, educational programs for autistic subject with normal IQ must consider specific training activities finalized to manage their aversion toward the uncertainty and their attention on irrelevant stimuli.