Intact counterfactual emotion processing in autism spectrum disorder: Evidence from eye-tracking.

Counterfactual emotions, such as regret and relief, require an awareness of how things could have been different. We report a preregistered experiment that examines how adults with and without ASD process counterfactual emotions in real-time, based on research showing that the developmental trajectory of counterfactual thinking may be disrupted in people with ASD. Participants were eye-tracked as they read narratives in which a character made an explicit decision then subsequently experienced either a mildly negative or positive outcome. The final sentence in each story included an explicit remark about the character's mood that was either consistent or inconsistent with the character's expected feelings of regret or relief (e.g., "… she feels happy/annoyed about her decision."). Results showed that adults with ASD are unimpaired in processing emotions based on counterfactual reasoning, and in fact showed earlier sensitivity to inconsistencies within relief contexts compared to TD participants. This finding highlights a previously unknown strength in empathy and emotion processing in adults with ASD, which may have been masked in previous research that has typically relied on explicit, response-based measures to record emotional inferences, which are likely to be susceptible to demand characteristics and response biases. Therefore, this study highlights the value of employing implicit measures that provide insights on peoples' immediate responses to emotional content without disrupting ongoing processing. Autism Res 2019, 12: 422-444 © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Despite known difficulties with empathy and perspective-taking, we found that adults with autism are unimpaired at inferring complex emotions (regret and relief) in others. This finding extends existing evidence showing dysfunctional counterfactual thinking in children with autism. We highlight the value of using implicit measures to identify strengths and abilities in ASD that may be masked by explicit tasks that require participants to interact socially or report their own thoughts.