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Finding the ‘Function’ in ‘Dysfunction’

Social cognition includes a host of mental processes that assist us in making sense of our social world. This article describes the psychophysiological technique of eye-tracking in reference to the visual processing of social cues in moral reasoning among neurotypical and neurodivergent persons. The review hints at the need to go beyond the diagnostic criteria and adopt a strength-based lens by focusing on empowering narratives of neurodivergence.

“Who art thou?”

Answering this question has been a challenge that most psychologists have taken upon themselves; study of the ‘self’ has occupied a significant part of psychology ever since its inception. The most fundamental roadblock to solving this mystery is untangling the myriad of influences on human lives - can we ever isolate the effect of each independent factor on our behavior? Indeed, this is what psychological research aims to get close to or, if lucky, find out. An exciting part of this ever-evolving self is social cognition: the cognitive processes operating in the context of other individuals and groups around us. Scientists have used multiple techniques to study social cognition in humans: functional neuroimaging, self-report measures, neuropsychological and lesion studies, and of course, the up-and-coming psychophysiological techniques such as eye-tracking.


Eye-tracking is a contemporary, cost-efficient, and user-friendly method for cognitive measurement in clinical and nonclinical populations (Bours et al., 2018). Although it is not a direct measure of brain function, it is non-invasive and gives rich information about the brain-behavior link for cognitive processes such as memory, reasoning, learning (Eckstein et al., 2017). Eye-tracking has high accuracy and temporal resolution with minimized testing time and discomfort to participants (Eckstein et al., 2017). It is based on the eye-mind assumption (Just & Carpenter, 1976) - certain oculomotor functions are reliable markers of cognitive processing, like saccades (rapid eye movements for repositioning gaze; denoting selective attention), fixations (voluntary emphasis on objects that indicates attention and acquisition of new information), pursuit (following a target stimulus), and pupillometry (involuntary response, indicator of cognitive engagement). Eye-tracking demands the head to be stable, and calibration is important for coinciding eye position with the point of regard (POR; Bueno et al., 2019).


In this respect, a confirmatory correlational study by Garon et al. (2018) used an ecological (close approximation to real life events) paradigm and eye-tracking mechanism to understand whether visual encoding of social cues contributed to moral reasoning in people with Autism Spectrum Disorder (ASD) as compared with control participants.


Moral reasoning is a higher-order social-cognitive function entailing our judgments and justifications regarding right and wrong, involving processes like attention, encoding of information, schematic processing, and evaluation of responses (Garrigan et al., 2018). It is an essential ingredient of our everyday social interactions. Because people with ASD show impairments in empathy, mentalizing, and Theory of Mind (ToM; Miranda et al., 2017), their capacity for intent-based moral reasoning is limited. Shulman et al. (2012) affirm that people with ASD make more utilitarian (outcome-oriented rather than intent-oriented) decisions with concrete explanations, less cognitive flexibility, and less abstract rules in moral reasoning than neurotypical individuals. Moral reasoning in people with ASD is considered less ‘mature’ in Kohlbergian tradition. However, this belief has been dismissed by Haidt (2001), who argued that the offered reasoning differs in quality rather than maturity.


Visual encoding is the initiator of social cognition and enables one to detect social-emotional cues (ventromedial prefrontal cortex, involved in emotional processing, is activated during moral reasoning; Fumagalli & Priori, 2012) used for adaptive moral reasoning. Subsequent processes are likely to be affected if information-encoding does not proceed smoothly. People with ASD exhibit differential patterns of visual encoding - making lesser and shorter fixations on faces, which limits the information available for sociomoral reasoning and leads to impaired social functioning (Dempsey et al., 2019).


Thus, these oculomotor functions in the context of this study are interpreted as follows: greater number of fixations on a moral stimulus is associated with choosing that option, lesser time to first fixation indicates accurate cognitive processing, and pupil dilation increases before decision-making. Analyses revealed that the understanding of moral dilemmas was significantly poor in participants with ASD. There also existed a significant difference in the moral decision-making capacities with neurotypical individuals producing more socially adaptive decisions. Lastly, participants with ASD gave greater universal and abstract justifications, whereas neurotypical participants gave greater interpersonally focused justifications, but the differences were insignificant.


People with ASD looked at ROIs later than neurotypical individuals, which can be attributed to delayed emotional processing and perspective-taking. People with ASD gave fewer socially adaptive responses and less moral justifications based on abstract rules (high moral maturity), signifying less preference for social information, cognitive rigidity, and a penchant for social order (D’Cruz et al., 2013) than a transactional mechanism of justification preferred by neurotypical individuals. Neurotypicals emphasize mutual favors and reputation management, while people with ASD appear more straightforward, albeit socially non-adaptive. Differences could also lie in the information-processing stage of moral reasoning that might be delayed in ASD. An fMRI study by Schneider et al. (2013) on people with ASD identified increased activation in brain areas linked with default-mode network and self-referential cognition - which hints at an altered mechanism of social information-processing than a frontal-lobe ‘dysfunction.’


Research should now understand the functional connectivity between various brain regions associated with moral functioning in ASD by taking a non-deficit, strengths-based approach, and to pinpoint alternative functioning mechanisms such as neuroplasticity. It might also be possible that the ‘deliberative’ brain in ASD is more sophisticated than the ‘intuitive-emotional’ brain.


People with ASD may feel out of place in a world that thrives on social communication. Academic discourse in psychopathology has erroneously emphasized the ‘deficit’ aspect - but not the differential strengths they might have. We often tend to look at issues with respect to certain ‘norms’, but forget that the issues might in fact be non-existent if the norms were to be replaced. What is ‘socially adaptive’ and ‘desirable’ for a set of people does not indicate that a ‘dysfunction’ has to be present in those who do not conform.


There is beauty and courage in non-conformity. We must not reduce people to diagnostic criteria and overlook what they have to individually offer - neurodivergence is an empowering construct. Let us not reduce neurodivergence to ‘brain deficits’, rather embrace the view that reality is more different than dysfunctional for them (Arnold, 2017).


(Disclaimer: Any views or opinions represented in this blog article are personal and belong solely to the author, and do not represent those of people, institutions or organizations that the author may be associated with in professional or personal capacity, unless explicitly stated.)


References

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