Autistic Adults Avoid Unpredictability in Decision-Making.

Macchia, Ana; Albantakis, Laura; Zebhauser, Paul Theo; Brandi, Marie-Luise; Schilbach, Leonhard; Brem, Anna- Katharine (2024). Autistic Adults Avoid Unpredictability in Decision-Making. (In Press). Journal of Autism and Developmental Disorders 10.1007/s10803-024-06503-2

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Decision-making under unpredictable conditions can cause discomfort in autistic persons due to their preference for predictability. Decision-making impairments might furthermore be associated with a dysregulation of sex and stress hormones. This prospective, cross-sectional study investigated decision-making in 32 autistic participants (AP, 14 female) and 31 non-autistic participants (NAP, 20 female) aged 18-64 years. The Iowa Gambling Task (IGT) and the Cambridge Risk Task (CRT) were used to assess decision-making under ambiguity and under risk with known outcome probabilities, respectively. Cortisol, estradiol, and testosterone serum levels were related to decision-making performance. Groups did not differ in overall IGT and CRT performance, but compared with NAP, AP preferred less profitable card decks with predictable outcomes while avoiding those with unpredictable outcomes. AP required more time to reach decisions compared to NAP. Additionally, AP without comorbid depression performed significantly worse than NAP in the IGT. Estradiol and cortisol concentrations were significant predictors of CRT scores in NAP, but not in AP. The study results imply that AP are 'risk-averse' in decision-making under ambiguity as they avoided choice options with unpredictable losses in comparison to NAP. Our findings highlight the intolerance for uncertainty, particularly in ambiguous situations. Thus, we recommend being as transparent and precise as possible when interacting with autistic individuals. Future research should explore decision-making in social situations among individuals with ASD, factoring in person-dependent variables such as depression.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > University Psychiatric Services > University Hospital of Geriatric Psychiatry and Psychotherapy

UniBE Contributor:

Brem, Anna- Katharine

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0162-3257

Language:

English

Submitter:

Pubmed Import

Date Deposited:

20 Aug 2024 08:56

Last Modified:

21 Aug 2024 04:22

Publisher DOI:

10.1007/s10803-024-06503-2

PubMed ID:

39158770

Uncontrolled Keywords:

Autism spectrum Cambridge risk task Decision-making Hormones Iowa gambling task Trail making test

BORIS DOI:

10.48350/199843

URI:

https://boris.unibe.ch/id/eprint/199843

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