Emotional self-regulation in autism spectrum syndrome
Dysregulation of emotions is not a formal criterion for diagnosing autism spectrum disorder (ASD), however, parents and clinicians have long noted the importance of emotional problems in people with ASD.
Alice Covolan – OPEN SCHOOL Cognitive Psychotherapy and Research Mestre
In passato, su persone con disturbo dello spettro autistico, non vi sono stati molti studi che abbiano esaminato la regolazione delle emozioni, ma solo recentemente l’attenzione si è spostata verso questi orizzonti, riportando prove sufficienti che suggeriscono alti livelli di disturbo in questo dominio. La maggior parte degli studi tuttavia si sono concentrati sulla capacità delle persone con ASD di riconoscere emozioni negli altri, piuttosto che sull’esperienza e gestione delle proprie emozioni (Mazefsky et al., 2012). Altri studi hanno ampiamente effettuato osservazioni comportamentali e rapporti di indagine (Mazefsky et al., 2012) sul comportamento emotivo.
In diversi studi si sono frequentemente osservati comportamenti emotivi problematici inclusa irritabilità, scoppi d’ira, aggressività e / o comportamenti auto aggressivi. Lecavalier et al. (2006) ha recentemente suggerito che più del 60% dei giovani con ASD esibisce tali comportamenti. Inoltre, le persone con ASD hanno esperienza di alti livelli di ansia e aumento delle emozioni negative, che possono contribuire ad intensificare sentimenti di angoscia. Queste emozioni a livello elevato possono avere un impatto negativo sul funzionamento quotidiano e sulla qualità della vita. In particolare, gli studi hanno suggerito che gli individui con l’ASD usano strategie di regolazione delle emozioni adattive, come comportamenti diretti all’obiettivo o ricerca di supporto sociale, con meno efficacia rispetto al un gruppo di controllo con sviluppo tipico (Jahromi et al., 2012). Inoltre, le persone con ASD si affidano a strategie poco adattive o idiosincratiche, come l’evitamento e la ventilazione (Jahromi et al.,2012) o difesa e pianto (Konstantareas & Stewart, 2006). L’astensione dal contatto visivo in individui ASD è inteso come un meccanismo di coping usato per evitare una maggiore risposta emotiva associata al contatto oculare (Dalton et al., 2005). Questo è coerente con uno studio recente di Samson, Huber e Gross (2012) che suggerisce come gli adulti con ASD usino meno frequentemente la rivalutazione cognitiva rispetto alle persone con sviluppo tipico e usino di più la soppressione espressiva, che è considerata disadattativa a lungo termine se è l’unica strategia disponibile.
Quando gli individui regolano le loro emozioni influenzano il modo in cui vivono e / o esprimono le emozioni (Gross, 1998; Gross & Thompson, 2007). Le abilità di regolazione delle emozioni sono fondamentali perché ci permettono un ottimale funzionamento e adattamento, ci consentono risposte appropriate nelle interazioni sociali e facilitano la capacità di affrontare nuovi cambiamenti e situazioni (Gross, 1998, 2007; Seta, Steinberg, & Morris, 2003). Nell’ultimo decennio, i ricercatori hanno evidenziato un certo numero di strategie di regolazione delle emozioni, le quali si differenziano notevolmente le une dalle altre; ad esempio, alcune influenzano la risposta emotiva in corso agendo su ciò che avviene prima (l’azione è focalizzata sull’antecedente), altre influenzano l’azione a posteriori (l’azione è focalizzata sulla risposta).
Cognitive reassessment is a regulatory strategy focused on the antecedent and has been identified as particularly important for adaptive emotional functioning, involving thinking about an event that can elicit emotional impact. Previous studies suggest that cognitive re-evaluation is a highly effective strategy in self-regulation of negative emotions in typically developing subjects and predicts long-term positive results (Bower et al., 2005; Gross, 2002).
Recent research by Zantinge et al. (2017) studied arousal (emotional activation) and regulatory strategies in 29 children with ASD (ASD with reduced IQ and language skills) and 45 children with typical development, aged between 41 and 81 months. Since problematic emotional behavior was noted with outbursts of anger, irritability, aggression, self-harm, anxiety and impulsiveness reported by parents of children with autism, emotional activation was assessed in children with ASD in response to frustration, and like them address these emotions in terms of regulatory strategies.
The core of the study was physiological detection (heart rate measurements) in parallel with behavioral observations that indicate how children overcome the moment of frustration and what regulatory strategies they apply to return to a state of emotional balance.
Measurement of emotional arousal revealed that the emotional response pattern in children with ASD was similar to that of children with typical development. There was no difference in the emotional activation response between the groups. For both groups there was an increase in arousal in response to frustration, heart rate decreased during recovery and the decrease in frustration manifested similarly. If the emotional response to frustration did not differ between children with ASD and children with typical development, on the contrary, observations on behavioral strategies for regulating emotions, showed that children with ASD develop different maladaptive strategies, in particular there is greater use. ventilation and avoidance compared to children with typical development.
In this study, children with ASD also showed more self-control problems in daily school life, as reported by the teachers. Self-control plays an important role in regulating emotions. Other parallel studies would explain these results due to a reduced linguistic ability and would support the usefulness of interventions aimed at language with the aim of teaching an appropriate communicative model, in particular to be able to express one’s mood when a child shows excessive outbursts of anger. The authors of this study also speculated that inhibition and cognitive flexibility have not been used by children with ASD because they have probably not yet been developed as coping strategies in regulating emotion and,
The study of Samson et al. (2014) focused on the evaluation of emotional regulation in children and adolescents considering the strategy of cognitive re-evaluation, starting from a greater understanding of the situation. While the results of a previous study had provided evidence suggesting that adults with ASD used cognitive re-evaluation less frequently and less effectively than adults with typical development (Samson et al., 2012), little is known about use and effectiveness of cognitive re-evaluation in children and adolescents with ASD. Late childhood and adolescence are both critical phases for the development of emotion regulation. During these phases, individuals acquire a wide repertoire of emotion regulation strategies, including adaptive strategies such as problem solving and cognitive re-evaluation. The authors of this study used the ‘Reactivity and Regulation Situation’ tasks: in a nutshell, children and young people with ASD and typical development were invited in an initial phase to evaluate the situation recreated also live, which caused some degree of frustration , answering some questions that investigated emotions and thoughts. They were subsequently instructed to cognitive re-evaluation through suggestions such as ‘try to think differently’, ‘can you think about this situation in a different way so that it appears less worrying / fearful?’. Participants assessed their negativity by following their cognitive reinterpretations and not their initial reaction to the situation. From the study we have seen how,
Torrado and colleagues (2017), analyzed the needs of people with autism spectrum disorders (ASD) to achieve a form of pervasive, feasible and non-stigmatizing assistance of their emotional self-regulation, in order to alleviate some behavioral problems that undermine their health. mental throughout their lives. The research group would have devised a smartwatch system (regular watch) that supports the detection of the user’s internal state through models of relief from physiological signals (such as heart rate) and movement, and implements a wide range of self-regulation strategies , along with a smartphone authoring tool that must be used by caregivers or family members to create and modify these strategies in an adaptive way. Torrado and colleagues (2017) conducted a 9-day intensive experiment, with two people with ASD showing various behavioral responses representative of their emotional dysregulation. Both users were able to use effective and personalized emotional self-regulation strategies through system means, managing to manage most of the stressful episodes and outbursts experienced in their class.
Emotions are the result of cognitive evaluation of external circumstances, so the ways to deal with emotional issues, especially when it comes to people with cognitive disabilities, are truly varied. Because of this, it is even more problematic to define an intervention, because the strategies for regulating emotions must be adapted to each user, practically on a case by case basis. To design the data model behind the system, they followed the advice of Dr. Quintero-Lumbreras, expert of the Institute of Psycho-management, who suggests current strategies for regulating the emotions used with children. They then designed the model with the most used regulation strategies and subsequently implemented them in the system. The results of this study have shown that the use of the smartwatch avoids the use of printed images to support emotional regulation and saves time, its content creation is direct and visually attractive, customizable and pervasive (the user receives the intervention anywhere and anytime if he wears the smartwatch). The authors also noted that between the two participants and their classmates there are no differences in wearing smartwatches as a support (i.e., no stigma), and the system helped them control most of their stressful episodes. in a few minutes. Being able to handle a large number of outbursts is highly beneficial for people with ASD, and the accumulation of unpleasant and self-injurious exposure episodes in the long term increases future emotional regulation problems. This is the reason why this system could guarantee an important improvement in the quality of life of people with ASD and emotional dysregulation problems, since the intervention applied to daily life can prevent behavioral problems and guarantee correct emotional self-regulation.