Page 221 - Demo

General Discussion2197While I have already discussed constraints linked to testing non-clinical samples earlier, it is additionally important to mention that individuals diagnosed with the same condition are not a coherent group. The %u201cspectrum%u201d in %u201cAutism Spectrum Conditions%u201d highlights this variability, as does the identification of different social anxiety subtypes (D%u2019Avanzato & Dalrymple, 2016). When it comes to facial emotion processing, only few studies have examined variability in autism. Here, observations of a worse emotion recognition performance have indeed only been driven by a subgroup within a sample of individuals on the autism spectrum (Meyer-Lindenberg et al., 2022), with those individuals also showing most social difficulties in real life (Loth et al., 2018). One personality trait that has specifically received attention in altered emotion processing in autism, but also other conditions, is alexithymia. Alexithymia is defined as an inability in expressing, describing, or distinguishing among one%u2019s emotions (first introduced by Nemiah et al., 1976) and is highly prevalent in autism (49.93%, Kinnaird et al., 2019). Even though the prevalence of alexithymia itself has not been as systematically investigated yet, individuals with social anxiety report difficulties in identifying and describing their emotions. The origin of reports of co-occurring alexithymia in both autism and social anxiety has recently been suggested to lie in altered interoceptive processing (Murphy et al., 2017; Palser et al., 2018). A vast amount of research support a prominent role of alexithymia in both emotion processing and interoception in autism (e.g., Bird & Cook, 2013; Ketelaars et al., 2016; D. Trevisan et al., 2019; D. A. Trevisan et al., 2016). Some studies have even concluded that mainly alexithymia, and not autism symptomology per se, would account for alterations in interoception (Shah et al., 2016), emotion recognition performance (Cook et al., 2013) or subjective and objective emotional arousal after emotion induction (Gaigg et al., 2018). In Chapter 6, I observed that both individuals on the autism spectrum and individuals with social anxiety report higher alexithymia. Although controlling for alexithymia did not change the results of my analysis, I believe that alexithymia may play an important role in processing emotions of others%u2019 in autism and social anxiety, especially in the integration of a bodily resonance of others%u2019 emotions. Lastly, research on physiological synchrony in clinical practice highlights both the relevance and the potential of considering interpersonal affective dynamics in the clinical context (Coutinho et al., 2014). Namely, therapists and patients who are more strongly linked on a physiological level do not only have more positive