Differential effects of anxiety and autism on social scene scanning in males with fragile X syndrome

Background: Existing literature draws links between social attention and socio-behavioural profiles in neurodevelopmental disorders. Research has identified atypically reduced social attention in autism spectrum disorder (ASD; behaviourally associated with social withdrawal), and atypically prolonged social attention in Williams syndrome (associated with hyper-sociability). The socio-behavioural profile of fragile X syndrome (FXS) includes social motivation alongside heightened anxieties and ASD symptomatology. However, studies investigating social attention to naturalistic scenes in FXS are scarce. Furthermore, insight into the role of anxiety and autistic features is important to understand the potential mechanisms underlying social attention, and to guide interventions. This study compares social attention in males with FXS to typically developing (TD) children, and investigates the relationships between social attention, anxiety and ASD symptomatology.
Methods: Eleven males with FXS (Mage = 26.29) and 11 TD children, matched on gender and receptive language ability (Mage = 6.28), participated in an eye-tracking task where 20 colour photographs of naturalistic social scenes were displayed. Dwell times to the background, body, and face regions of the stimuli were analysed. The relationships between social attention, anxiety and ASD symptomatology were investigated using the Spence Child Anxiety Scale and the Social Communication Questionnaire.
Results: There were no between-group differences for dwell time to the background, body or face regions of the stimuli. Increased looking at faces was associated with both heightened anxiety and fewer social communication impairments in the FXS group only.
Conclusion: These results suggest that whilst social attention to naturalistic social scenes may be developmentally ‘typical’ in males with FXS, anxiety and autism symptomatology are differentially related to social attention in this population. These results offer novel insights into the mechanisms associated with social attention in FXS, and paves the way for future investigations of the relationship between clinically-relevant, socio-behavioural phenotypes and social attention in neurodevelopmental disorders.