Feelings of Regret and Disappointment in Adults with High-Functioning

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Available online at www.sciencedirect.com 65 66 1 ScienceDirect 67 2 68 3 69 www.elsevier.com/locate/cortex 4 Journal homepage: 70 5 71 6 72 7 73 8 74 9 Research report 75 10 76 11 Feelings of regret and disappointment in adults 77 12 78 13 with high-functioning autism 79 14 80 15 81 16 a,* b c d 82 17 Q14 Tiziana Zalla , Angela Sirigu , Suzanne Robic , Pauline Chaste , 83 d e,f 18 Marion Leboyer and Giorgio Coricelli 84 19 85 a ' 20 Institut Jean Nicod, Centre National de la Recherche Scientifique, Departement d Etudes Cognitives, 86 21 Ecole Normale Superieure, Paris, France 87 22 b Centre de Neuroscience Cognitive, CNRS, UMR 5229, Bron, France 88 23 c Lyon Neuroscience Research Center (Brain Dynamics and Cognition Team), INSERM U1028, CNRS UMR 5292, 89 24 Lyon 1 University, Lyon, France 90 25 d INSERM U 955, IMRB, University Paris Est Creteil, AP-HP, Henri Mondor-Albert Chenevier Hospitals, 91 26 Department of Psychiatry, Fondation FondaMental, French National Science Foundation, Creteil, France 92 27 93 e Laboratoire de Neurosciences Cognitives, INSERM U 960, Departement d'Etudes Cognitives, 28 94 Ecole Normale Superieure, Paris, France 29 95 f Department of Economics, University of Southern California, Los Angeles, USA 30 96 31 97 32 98 article info abstract 33 99 34 100 35 Article history: Impairments in emotional processing in Autism Spectrum Disorders (ASDs) can be char- 101 36 Received 11 October 2013 acterised by failure to generate and recognize self-reflective, cognitive-based emotions, 102 37 Reviewed 15 November 2013 such as pride, embarrassment and shame. Among this type of emotions, regret and 103 38 Revised 28 February 2014 disappointment, as well as their positive counterparts, result from a counterfactual com- 104 39 parison, that is the comparison between an actual value (“what is”) and a fictive value 105 40 Accepted 12 May 2014 Action editor Alan Sanfey (“what might have been”). However, while disappointment is experienced when the ob- 106 41 107 Published online xxx tained outcome is worse than the expected outcome that might have occurred from the 42 108 same choice, regret occurs when one experiences an outcome that is worse than the 43 109 44 Keywords: outcome of foregone choices. By manipulating a simple gambling task, we examined 110 45 Social cognition subjective reports on the intensity of negative and positive emotions in a group of adults 111 46 Emotions with High-Functioning Autism or Asperger syndrome (HFA/AS), and a control group 112 47 Alexithymia matched for age, gender and educational level. Participants were asked to choose between 113 48 Autism two lotteries with different levels of risk under two conditions of outcome feedback: (i) 114 49 Amygdala Partial, in which only the outcome of the chosen lottery was visible, (ii) Complete, in which 115 50 the outcomes of the two lotteries were simultaneously visible. By comparing partial and 116 51 complete conditions, we aimed to investigate the differential effect between disappoint- 117 52 118 ment and regret, as well as between their positive counterparts. Relative to the control 53 119 participants (CP), the group with HFA/AS reported reduced regret and no difference be- 54 120 tween regret and disappointment, along with a preserved ability to use counterfactual 55 121 56 thinking and similar choice behaviour. Difficulties to distinguish the feeling of regret in 122 57 123 58 124 59 125 60 126 61 * Corresponding author. Institut Jean Nicod-CNRS, Ecole Normale Superieure, 29 rue d'Ulm 75005, Paris, France. 127 62 E-mail addresses: [email protected], [email protected] (T. Zalla). 128 63 http://dx.doi.org/10.1016/j.cortex.2014.05.008 129 64 0010-9452/© 2014 Elsevier Ltd. All rights reserved.

Please cite this article in press as: Zalla, T., et al., Feelings of regret and disappointment in adults with high-functioning autism, Cortex (2014), http://dx.doi.org/10.1016/j.cortex.2014.05.008 CORTEX1208_proof ■ 18 June 2014 ■ 2/12

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1 participants with HFA/AS can be explained by diminished emotional awareness, likely 66 2 associated with an abnormal fronto-limbic connectivity. 67 3 © 2014 Elsevier Ltd. All rights reserved. 68 4 69 5 70 6 71 7 72 8 73 9 74 10 communication and to regulate interpersonal exchanges 75 Q1 1. Introduction 11 (Fitzgerald & Bellgrove, 2006; Hill, Berthoz, & Frith, 2004; Hill & 76 12 Berthoz, 2006). Precisely, it has been estimated that some- 77 Individuals with Autism Spectrum Disorders (ASDs) are 13 where between 40% and 50% of the ASD population is affected 78 characterized by qualitative impairments in the domains of 14 by alexithymia, (Fitzgerald & Bellgrove, 2006; Hill et al., 2004). 79 15 social interaction, communication, and stereotyped behav- 80 Remarkably, while high level of Alexithymia is associated 16 Q2 iour. Diagnostic criteria for ASDs, as defined by the DSM-IV-TR 81 with diminished mentalizing abilities in non-autistic in- 17 (American Psychiatric Association, 2000), the DSM 5 82 dividuals (Moriguchi et al., 2006), in ASD individuals, it may be 18 (American Psychiatric Association, 2013), the Autism Diag- 83 19 associated with abnormal empathic brain responses, poorer 84 nostic Interview-Revised (ADI-R) (Lord, Rutter, & Le Couteur, 20 facial emotion recognition and atypical gaze fixations, sug- 85 1994) or the Autism Diagnostic Observation Scale (Lord et al., 21 gesting that difficulties in introspecting on own emotions and 86 2000), all include difficulties in emotional processing. 22 aspects of the reciprocal social impairments in ASDs share a 87 Recently, there has been a considerable progress in the un- 23 common neuro-cognitive basis (Bird et al., 2010, Bird, Press, & 88 derstanding of the socio-emotional nature of impairments in 24 Richardson, 2011). Silani et al. (2008) reported that, differently Q3 89 ASDs and an increasing number of studies has acknowledged 25 from controls, individuals with HFA/AS showed reduced 90 26 the idea that individuals with ASDs exhibit both difficulties in 91 activation of the anterior insula, when they were asked to 27 mindreading and in processing self-related knowledge 92 introspect on their feelings. Interestingly, in this study, 28 (Lombardo et al., 2009; Millward, Powell, Messer, & Jordan, 93 behavioural measures of self-reported alexithymia and lack of 29 2000; Willians, 2010). Indeed, difficulties both in reporting 94 30 empathy were correlated, indicating a link between under- 95 own past thoughts and in keeping track of prior intentions ' ' 31 standing one s own and others emotions. 96 have also been reported in individuals with High-Functioning 32 These findings are mainly based on social emotions, but 97 ASDs (Hurlburt, Happe & Frith, 1994; Phillips, Baron-Cohen, & 33 little is known about emotional impairments of ASD in- 98 Rutter, 1998). Noteworthy, disturbances in understanding 34 dividuals in private settings. Our study aimed to fill this gap. In 99 others' affective states in ASDs often arise when the appreci- 35 the present study, we investigated whether the observed im- 100 ation of the emotion requires the representation of others' 36 pairments of ASD individuals in self-reflective emotional re- 101 beliefs, such as surprise or embarrassment (Zalla, Stopin, 37 sponses are present also in private contexts, where self- 102 38 Ahade, Sav, & Leboyer, 2009), but not when emotions are 103 reflection should be independent from any social interac- 39 generated by factual events (i.e., reality-based emotions) 104 tion. To do so, we measured self-reported affective responses 40 (Baron-Cohen, 1991; Baron-Cohen, Spitz, & Cross, 1993). 105 41 to (private) events that differ in terms of the level of subjective 106 Concerning self-related knowledge, children with autism ' 42 responsibility for the outcome of one s own choice. These 107 possess a less coherent representation of their own emotional 43 events can be associated with the emotions of disappoint- 108 experiences, and they may also be less able to generate and 44 ment and regret and their positive counterparts. 109 regulate emotionally laden situations introspectively or in 45 Disappointment and regret are common self conscious, 110 interaction with others (Rieffe, Meerum Terwogt, & 46 cognitive-based, unpleasant experiences arising when the 111 Kotronopoulou, 2007). Previous studies also revealed that 47 current state of affairs is worse than initially expected. Both 112 children with autism have difficulties with emotions related 48 emotions originate from a comparison processes in which the 113 49 to introspection and self-reflection, such as pride, guilt, or 114 outcome obtained is compared to the outcomes that might 50 shame (Capps, Sigman, & Yirmiya, 1995; Kasari, Chamberlain, 115 have occurred. However, despite these commonalities, these 51 & Bauminger, 2001) and suggested that failure to distinguish 116 counterfactual emotions differ on the basis of several charac- 52 emotional experiences would stem from a lack of reflective 117 teristics. While disappointment (and its positive counterpart, 53 appraisal of those experiences (Harris, Olthof, Meerum 118 54 joy) is experienced when the obtained outcome is worse than 119 Terwogt, & Hardman, 1987). Overall, these findings support 55 un-obtained outcomes from the chosen option, in a within- 120 the view that emotional responses are not normally inte- 56 option comparison; regret (and its positive counterpart, relief) 121 grated with cognitive processes in ASDs and that this might 57 results from a between-choice comparison, thus a comparison 122 result from a diminished introspective awareness about one's 58 between the outcome of a choice (“what is”) and “what could 123 own intentional and affective states, leading to serious con- 59 have been if I had chosen another option”. The experience of 124 sequences in the development of self-other relations. 60 regret is focused on the alternative choice rather than on the 125 61 Recent reports have underlined that there is a considerable 126 alternative outcome: we experience regret when realizing or 62 overlap in the clinical presentation of persons with a diag- 127 imagining that our present situation would have been better, 63 nosis of Asperger's Syndrome and alexithymia, a condition 128 had we decided differently (Zeelenberg, van Dijk, & Manstead, 64 characterized by difficulties in identifying ones' own emo- 129 65 1998). The difference between these two emotions is normally 130 tions, feelings and bodily sensations, and to use them in

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1 reflected in the amplification of the self-reported affective between the feelings of regret and disappointment, and to use 66 2 responses (e.g., regret is reported as more negative than anticipatory emotions to regulate choice behaviour. 67 3 68 disappointment) in individuals with typical development To elicit feelings of regret and disappointment e and their 4 69 (Camille et al., 2004; Coricelli et al., 2005; Zeelenberg, van Dijk, positive equivalents, relief and joy e we used a gambling task 5 70 & Manstead, 1998; Zeelenberg, van Dijk, Manstead, & van der in which a group of adults with HFA/AS and a control group 6 71 & 7 Pligt, 1998; Zeelenberg van Dijk, 2004). The lack of the abil- were presented with a choice between two risky gambles 72 8 ity to grasp the differences between regret and disappoint- associated with a monetary reward, and asked to report the 73 9 ment in individuals with ASD would reflect difficulties in self- valence and the intensity of their emotional responses to the 74 10 reflecting emotional processing in private settings. outcome of their choice by using a rating scale. 75 11 Neuropsychological and neuroimaging studies highlighted As previously shown (Camille et al., 2004), the same ob- 76 12 the role of the orbito-frontal cortex (OFC) (Camille et al., 2004; tained outcome will lead to different experienced emotions 77 13 Coricelli et al., 2005) and the amygdala in the affective re- depending on whether feedback about the outcome of the 78 14 sponses associated with regret e inducing events (Nicolle, unchosen gamble is provided. In the partial feedback condi- 79 15 80 Bach, Frith, & Dolan, 2011) and the experience of winning tion e in which only the outcome from the chosen gamble is 16 81 and losing (Zalla et al., 2000). In a previous study, Camille and provided e participants are supposed to experience disap- 17 82 18 collaborators (2004) showed that while patients with damage pointment, when the obtained value is lower than expected, 83 19 to the OFC were able to think counterfactually on the chosen and joy, when the obtained value is greater than expected. In 84 20 gamble and could experience disappointment, they did not contrast, in the complete condition in which outcomes from 85 21 experience regret. The authors concluded that since OFC in- the two gambles are available, knowledge of the unselected 86 22 tegrates the cognitive and the emotional components for the outcome would strongly modulate the effect of the selected 87 23 process of decision making, a dysfunction of this region gamble, eliciting the experiences of regret or relief. Because of 88 24 would affect the ability to generate and modulate specific the different types of counterfactual thinking involved under 89 25 cognitive-based emotions, such as regret. Furthermore, complete and partial feedback conditions (i.e., either across 90 26 91 Nicolle et al. (2011) showed that the subjective evaluation of alternative choices or alternative states of the world), we ex- 27 92 regretful events is not just a function of being the agent of a pected different emotional responses, which vary in valence 28 93 choice, but specifically depends upon level of subjective re- and intensity. Because the ability to engage in counterfactual 29 94 ' 30 sponsibility for the outcomes of one s own actions. The au- reasoning is a cognitive requirement for the experience of 95 31 thors reported that regret-related neuronal activity in the regret, we evaluate counterfactual thinking using the coun- 96 32 amygdala was enhanced by increased responsibility: the ef- terfactual inference test proposed by Roese and Olson (1995) to 97 33 fect was magnified in participants who displayed a greater discount the hypothesis that difficulties to introspect and self- 98 34 enhancement of their subjective ratings of regret by re- report on their feelings would be due to an impairment in 99 35 sponsibility, suggesting a critical role of this structure in self- inferential reasoning. 100 36 blame regret. 101 37 The amygdala is supposed to play a central role in the 102 38 103 etiopathology of ASDs and several theoretical explanations 2. Material and methods 39 104 compatible with the amygdala dysfunction have been pro- 40 105 41 posed to account for socio-emotional impairments, including 2.1. Participants 106 42 abnormal eye contact, poor recognition of fear and other 107 43 negative emotions, face processing, mental state under- Twelve adults with a clinical diagnosis of Asperger Syndrome Q4 108 44 standing and empathy (Amaral, Bauman, & Schumann, 2003; or High-Functioning Autism (HFA/AS) according to DSM-IV-TR 109 45 Ashwin, Chapman, Colle, & Baron-Cohen, 2006; Baron- (American Psychiatric Association, 2000) and Asperger Syn- 110 46 Cohen et al., 2000; Kim et al., 2010; Kliemann, Dziobek, Hatri, drome Diagnostic Interview (ASDI, Gillberg, Gillberg, Ra˚stam, 111 47 Baudewig, & Heekeren, 2012; Zalla & Sperduti, 2013). As posit & Wentz, 2001) and the ADOS (Lord et al., 2000) were 112 48 by the “Relevance Detection Theory” (Sander, Grafman, & recruited from Albert Chenevier Hospital in Creteil (Table 1). 113 49 114 Zalla, 2003), the human amygdala is a component of this The inclusion and exclusion criteria for the clinical group were 50 115 extended neural cortico-limbic system involved in detecting based on retrospective parental information about the early 51 116 stimuli by focussing attentional and physiological resources language development of their child. All diagnoses were made 52 117 53 on cues that have special relevance for the safety or success of by experienced clinicians and were based on clinical obser- 118 54 an organism within the broader context of its social life. Zalla vations of the participants. Semistructured interview with 119 55 and Sperduti (2013) suggested that several behavioural and parents or caregivers using the (ADI-R, Lord et al., 1994) yiel- 120 56 socialeemotional features of ASDs could be explained in ded scores in three content areas: [B] social interaction, [C] 121 57 terms of a disruption of a “Relevance Detector Network” communication, and [D] repetitive and stereotyped behav- 122 58 affecting the processing of stimuli that are relevant for the iours, allowing the separate quantification of severity of the 123 59 organism's self-regulating functions. symptomatology. The cut-off points for these domains are 10, 124 60 The present study investigated whether individuals with 8, and 3, respectively. All participants scored above the cut-off 125 61 126 HFA or AS may lack the ability to distinguish between the points. 62 127 experience of regret and disappointment. Because of the se- Twelve control participants (CP) with typical development 63 128 64 vere difficulties in emotional competences and, in particular, volunteered to match the clinical group with respect to age, 129 65 in recognizing self-relevant emotions in individuals with HFA/ educational level and gender (Table 1). Prior to their recruit- 130 AS, we expected them to encounter difficulties differentiating ment, the CP were screened to exclude any with a history of

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1 66 e 2 Table 1 Means (and standard deviations) of demographic 67 and clinical data for participants with HFA/AS and the CP. 3 68 4 HFA/AS Controls 69 5 70 N (male:female ratio) 11:1 9:3 6 71 Age in years 28.9 ± 9.5 29.3 ± 9.3 7 72 (mean, SD, range) 8 73 Education in years 14.4 ± 3.5 14.5 ± 3.4 9 (mean, SD) 74 10 ADI [B,C,D]a 18.6 (6.8); 11.6 (6.6); e 75 11 6.9 (3.2) 76 12 Full-scale IQ 103.3 (±23.2) 105.9 (±12.2) 77 13 Verbal IQ 108.3 (±25.7) 104.6 (±15.6) 78 14 Performance IQ 96.3 (±17.8) 106.3 (±11.6) 79 15 80 a [B] ¼ reciprocal social interaction, [C] ¼ communication, 16 81 [D] ¼ stereotyped behaviours. 17 82 18 83 psychiatric or neurological disorders. All participants were 19 84 20 native French speakers, and had normal/corrected to normal 85 21 vision. 86 22 They received basic neuropsychological screening, which 87 23 included Verbal and Performance IQs (WAIS-III) (Wechsler, 88 24 1997). All participants had an IQ above 70. The two groups 89 25 did not differ on gender (t-test: t(22) ¼ 1.1, p ¼ .29), chrono- 90 26 logical age (t-test: t(22) ¼ .11, p ¼ .91) and education (t-test: 91 27 t(22) ¼.19, p ¼ .84) and IQ level (Full-scale, Verbal and Per- 92 28 93 formance: t-test: t(22) ¼ .34, p ¼ .73; t(22) ¼.42, p ¼ .67; 29 94 t(22) ¼ 1.63, p ¼ .11). 30 95 31 The present research has been approved by the local 96 32 Ethical committee (Inserm, Institut Thematique Sante Pub- 97 33 lique; C07-33). All participants signed informed consent Fig. 1 e Timeline of a single trial (in complete feedback 98 agreements before volunteering for this study, and all inves- 34 condition). At the beginning of each trial, two lotteries were 99 35 tigation complied with APA ethical standards. 100 displayed. Participants were required to choose one of the 36 101 two wheels (CHOICE). A rectangular green box appeared 37 102 2.2. Procedure around the selected wheel (WAIT) and a rotating arrow 38 103 39 appeared in the centre of the gamble circle (SPINNING), 104 All participants were individually tested in a quiet room at the always stopping after 6 sec (simultaneously stopping for 40 105 41 Albert Chenevier Hospital in Creteil. Participants were sitting both the selected and the unselected wheel). The arrows 106 42 in front of a computer and were told that they had to play a indicated the outcomes of the selected and the unselected 107 43 Gambling task by choosing between two wheels associated gambles (OUTCOME). Participants were then asked to 108 44 with different amount of money (Fig. 1). We explained to the evaluate (EMOTIONAL RATING) the outcome of their choice 109 45 participants that earnings were hypothetical. on a scale ranging from ¡50 (extremely negative) to þ50 110 46 The experiment is 2 2 factorial design, with two levels of (extremely positive). Timeline of Partial feedback condition 111 47 e e 112 valence relative gains and relative losses and two feed- was identical to the one depicted here. In partial feedback 48 e 113 back conditions partial and complete. At the beginning of trials the spinning and feedback was restricted to the 49 114 each trial, two lotteries were displayed. Each wheel had two 50 chosen gamble only. 115 sectors (green and red) associated with different values or 51 116 outcome pairs. The two possible outcomes are formed by any 52 117 þ þ 53 pair of the following values: 50, 50, 200, 200 (units 6 sec. The outcome of the selected gamble was indicated by 118 54 correspond to cents of Euros), associated with different the resting position of the arrow (OUTCOME). Two types of 119 55 outcome probabilities (.8, .5, .2). The length of each sector is trials were performed. In the “partial feedback” condition (30 120 56 reﬂecting the associated probability. As shown in Fig. 1, in the trials), the outcome was presented only for the chosen 121 57 left lottery, the probabilities are: 1/2 of chance to gain 50 cents; gamble; in the “complete feedback” condition (30 trials), 122 58 1/2 of chance to lose 200 cents. In the right lottery the proba- outcome of both the selected and unselected gambles (and 123 59 bilities are: 1/5 of chance to gain 200 cents; 4/5 of chance to spinning arrow) were available. In complete feedback condi- 124 60 lose 200 cents. After the two lotteries appeared on the com- tion the arrows of the chosen and the unselected gamble 125 61 126 puter screen, participants were required to choose one of the stopped simultaneously, indicating respectively the obtained 62 127 two wheels by pressing one of two arrow keys of the keyboard outcome and the outcome of the foregone choice. At the end 63 128 64 (CHOICE). A rectangular green box appeared around the of each trial, participants were asked to give a subjective rat- 129 65 selected wheel (WAIT) and a rotating arrow appeared in the ing of their emotional response associated with the outcome 130 centre of the gamble circle (SPINNING), always stopping after of their choice (emotional scale ranging from 50, extremely

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1 negative, to þ50, extremely positive). The inter-trial delay was (1995). This test assumes that some aspects of the perceived 66 2 lasting 3 sec. Subjects played in total 60 trials. Each trial reality that are negative or unusual (e.g., a car accident or 67 3 68 duration depended on the choice time (self-paced) of the physical aggression) trigger the process of counterfactual 4 69 subject, and the time he took to give a subjective emotional thinking. Specifically, counterfactuals are more pronounced 5 70 rate on a scale (self-paced). The whole experiment lasted when the relationship between previous actions and outcome 6 71 7 around 45 min. is abnormal (normality), or when there is increased physical 72 8 Events were classified according to the relative losses or and temporal proximity (goal proximity) between the alter- 73 9 gains and the gambling context (see Fig. 2). Trials were cate- native situations. Participants were presented with pairs of 74 10 gorized as relative gain trials if the counterfactual comparison alternative scenarios that always described the experiences of 75 11 was advantageous and as loss trials if it was disadvantageous, two characters who are in similar situations and experienced 76 12 regardless of the sign of the obtained outcome. In partial identical outcomes. The stories always included one element 77 13 feedback condition, the participant could experience disap- in the antecedent that was different for the two characters 78 14 pointment in case of relative loss, that is when the obtained either for normality or goal proximity this event always 79 15 80 outcome is worse than the un-obtained outcome of the related to a factor known to be relevant to judgements of 16 81 selected gamble; or joy in case of relative gain, when the ob- regret and relief. In all cases, the participants were asked to 17 82 18 tained outcome is better than the un-obtained outcome of the judge whether one character would feel worse than the other 83 19 selected gamble (i.e., within-option comparison). In the character or whether the two characters would feel the same. 84 20 “complete feedback” condition, information about the The pictures did not depict the characters' emotional re- 85 21 outcome of the non-chosen lottery is available, and the sponses following the stories' outcomes. The ordering of the 86 22 participant could experience regret when the obtained stories was counterbalanced across participants. Examples of 87 23 outcome is worse than the outcome of the unselected gamble; scenarios are: (i) “Ann gets sick after eating at a restaurant she 88 24 or relief when the obtained outcome is better than the often visits/Sarah gets sick after eating at a restaurant she has 89 25 outcome of the unselected gamble (i.e., between-choice never visited before. Who is more upset about their choice of 90 26 91 comparison). In addition, in complete feedback condition the restaurant?” (ii) “Ed is attacked by a mugger only 10 feet from 27 92 comparison between the obtained outcome and the un- his house/James is attacked by a mugger a mile from his 28 93 obtained outcome from the chosen gamble is still possible house. Who is more upset by the mugging?” Normally, target 29 94 “ ” “ ” 30 (within-option comparison in complete feedback). The latter responses are: Sarah for the first item (normality), and Ed 95 31 event will be considered in the analysis. The two feedback for the second item (goal proximity). Participants were scored 96 32 conditions were presented in a block design. Participants were 1 for each target response achieved. The test also included the 97 33 informed in advance if they would have received a complete “I do not know” or “both characters” answers. The scale ranges 98 34 or partial feedback. Stimuli were delivered using Presentation from 0 (no counterfactual thinking) to 4 (perfect ability in 99 35 software (Neurobehavioral Systems, EU). counterfactual thinking). 100 36 101 37 2.2.1. Counterfactual inference test 2.3. Data collection and analyses 102 38 103 We measured counterfactual thinking using the four item 39 104 Counterfactual Inference Test developed by Roese and Olson The statistical analyses were conducted with the statistical 40 105 41 software package Stata (Stata Corp, College Station, TX, 106 42 Release 9/SE). Non-parametric tests were applied on the data 107 43 sets since the data violated several parametric assumptions, 108 44 particularly non-normal distribution. The significance of the 109 45 difference between behavioural variables, such as subjective 110 46 evaluations is estimated with the Wilcoxon signed rank test 111 47 (non-parametric test); the hypothesis tested is that the dis- 112 48 tribution of two random variables for matched pairs is the 113 49 114 same. Between groups (HFA/AS and CP) differences were 50 115 tested with ManneWhitney rank test. 51 116 52 117 53 2.3.1. Regression analyses 118 54 2.3.1.1. TESTING ANTICIPATED DISAPPOINTMENT AND REGRET. We 119 55 tested a model of choice that incorporates the effects of 120 56 Fig. 2 e Events of interest for the comparison of partial anticipated disappointment and regret in addition to the 121 57 (within-option comparison) and complete (between-choice maximization of expected values (Table 2). The panel data 122 58 comparison) feedback conditions. Relative loss and relative analysis takes each subject as the unit and the trial as time. 123 59 gain refer to counterfactual comparisons (e.g., loosing 50 The model estimated is the random effects model, and the 124 60 when they could have lost 200 was classified as relative parameters are estimated by maximum likelihood. 125 61 126 gain, and winning 50 when they could have won 200 was Given that Pr(g ) ¼ 1 Pr(g ), where Pr(g ) and Pr(g ) are the 62 1 2 1 2 127 classified as relative loss). Note that in complete feedback probabilities of choosing gamble 1 and gamble 2, respectively, 63 128 64 condition the comparison between the obtained outcome we defined the probability of choosing g1 in terms of three 129 65 and the un-obtained outcome from the chosen gamble is factors affecting the choice anticipated disappointment (d), 130 still possible (within-option in complete feedback). anticipated regret (r), and expected value (e).

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1 66 e only; (3) all participants with three interaction terms: d x group 2 Table 2 Regression analysis of choice behaviour for the 67 two groups of participants in complete feedback condition. indicated the interaction between groups and anticipated 3 68 Numbers indicate coefficients, and standard errors in disappointment; r x group indicated the interaction between 4 69 parentheses. *p < .05, **p < .0001. groups and anticipated regret; e x group indicated the inter- 5 70 action between groups and expected value. A positive coeffi- 6 Controls HFA/AS All participants 71 7 cient indicated that the variable of interest has a more 72 Constant .17 (.16) .38 (.17)* .27 (.11)* ' 8 important influence in HFA/AS subjects choices than in 73 e .029 (.004)** .024 (.004)** .029 (.004)** healthy controls' choices, whereas a negative coefficient 9 d .004 (.002)* .0017 (.0019) .0041 (.002)* 74 10 r .003 (.001)* .0029 (.001)* .0033 (.0013)* indicated that the variable of interest has a more important 75 11 e*group .0005 (.002) influence in CPs' choices than in HFA/AS subjects' choices. 76 12 d*group .006 (.003)* Additional regressions (one for CPs and one for HFA/AS) 77 13 r*group .0051 (.006) were run to test the effect of anticipated disappointment in 78 14 partial feedback condition. 79 15 80 16 81 Let us call outcomes x , y , and x , y the two possible 2.3.1.2. ANALYSIS OF THE EFFECT OF EXPERIENCED EMOTION ON SUBSE- 17 1 1 2 2 82 18 outcomes of the first (g1) and the second (g2) gambles, QUENT CHOICE BEHAVIOUR. We finally tested the effect of experi- 83 > > 19 respectively, with x1 y1, and x2 y2. enced regret and disappointment on subsequent choice 84 20 The probability of outcome x1 is p and the probability of behaviour. We tested the effect of experienced emotions to the 85 “ 21 outcome y1 is (1 p). The probability of outcome x2 is q and the choice of anticipating regret. The dependent variable choice 86 ¼ ” 22 probability of outcome y2 is (1 q). The model is Pr (g1it) F[dit, of anticipated regret took value 1 if the participant chose the 87

23 rit,eit], where i is individual and t is time. The function F [q] gamble that minimizes regret (at time t), and 0 otherwise. 88 24 denotes the function exp (q)/[1 þ exp (q)]. The dependent Anticipated regret is computed with the variable r. The inde- 89 25 “ ” “ ” ¼ 90 variable, choice of g1 , is 1 when the subject chooses g1 and pendent variables: experienced disappointment (un-ob- 26 91 0 when the subject chooses g . Independent variables are d, r, tained outcome of the chosen gamble e obtained outcome) at 27 2 92 e, where: time t 1; “experienced regret” ¼ (outcome of the unchosen 28 93 gamble e obtained outcome) at time t 1. 29 94 < 30 Anticipated disappointment choosing g1, 95 31 Â Ã Â Ã 96

32 d ¼ y2 x2 ð1 qÞ y1 x1 ð1 pÞ 3. Results 97 33 98 34 Anticipated disappointment is equal to the differences 3.1. Emotional evaluation 99 35 between the two outcomes of each gamble weighted by the 100 36 probability of the worst outcome, thus indicating an avoid- When asked to evaluate subjective emotional response 101 37 ance of possible sources of disappointment (Camille et al., following the choice's outcome, Wilcoxon Sign Rank Test 102 38 103 2004). revealed that the control group showed a pattern of emotional 39 104 ratings consistent with the presence of disappointment (in 40 < 105 Anticipated regret choosing g1, 41 partial feedback condition) and regret (in complete feedback 106 42 Â Ã condition). CP evaluated as more negative a loss of 50 (or a 107 ¼ 43 r y2 x1 y1 x2 win of þ50) when the un-obtained outcome of the chosen 108 gamble was þ200 compared with an un-obtained outcome of 44 Anticipated regret is based on considering choosing an 109 45 200 (z ¼3.058, p ¼ .002, for both 50 and þ50 obtained) in 110 alternative and simultaneously rejecting other alternatives. r 46 the partial feedback condition (i.e., disappointment effect, 111 represents the difference between the highest outcome of the 47 within-option comparison). As shown in Fig. 3, this effect was 112 first wheel and the lowest outcome of the second, that is the 48 greater in the complete feedback condition when the com- 113 49 comparison between the value of choice and the value of a 114 parison is made between the obtained outcome and the 50 rejected alternative (Camille et al., 2004). 115 outcome of the unselected gamble (i.e., regret effect, between- 51 116 < choice comparison), thus the between-choice comparison 52 Expected value choosing g1, 117 53 induced greater responses than the within-option comparison 118 À Á À Á Â Ã Â Ã ¼ ¼ 54 ¼ ¼ þð Þ þð Þ (z 2.35, p .01). Like the control group, when asked to 119 e EV g1 EV g2 px1 1 p y1 qx2 1 q y2 55 evaluate their emotional responses, participants with HFA/AS 120 56 Expected value is the probability-weighted sum of the experienced a loss of 50 (or a win of þ50) as more negative 121 57 possible values (Camille et al., 2004). A significant positive e when the un-obtained outcome was þ200 as compared to 122 58 coefficient indicates that subjects consistently choose the those circumstance in which un-obtained outcome was 200 123 59 gamble with highest expected value. Similarly significant (z ¼2.787, p ¼ .005, for 50 obtained; and z ¼3.059, p ¼ .002, 124 60 positive d or r coefficients indicate that subjects anticipated for þ50) in the partial feedback condition. However, emotional 125 61 126 (minimized) disappointment or regret, respectively (Camille ratings associated with the complete feedback condition 62 127 et al., 2004). (regret effect, between-choice comparison) and the partial 63 128 64 To analyse the interaction between groups (HFA/AS and feedback condition (disappointment effect, within-option 129 65 CP) and choice behaviour we run three logistic regressions comparison) were similar in kind and intensity in partici- 130 (reported in Table 2): (1) with data of the CP only; (2) HFA/AS pants with HFA/AS (z ¼.549, p ¼ .58) (Fig. 3).

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1 66 2 67 3 68 4 69 5 70 6 71 7 72 8 73 9 74 10 75 11 76 12 77 13 78 14 79 15 80 16 81 17 82 18 83 19 84 20 85 21 86 22 87 23 88 24 89 25 90 26 91 27 92 28 93 29 94 30 Fig. 3 e Mean emotional ratings for the two obtained outcome (¡50 and þ50) as a function of the foregone outcomes of ¡200 95 31 (blue) and þ200 (red), for the control group, in partial (A) and complete (B) feedback conditions, and for the group with HFA/ 96 32 AS in partial (C) and complete (D) feedback conditions, respectively. The foregone outcome in partial feedback condition 97 33 refers to the un-obtained outcome of the chosen wheel (within-option comparison), while the foregone outcome for the 98 34 99 complete feedback condition is the outcome of the unchosen wheel (between-choice comparison). Wilcoxon sign rank test 35 100 between the emotional ratings of the two unselected outcomes (¡200 vs þ200) for each obtained outcome (¡50 or þ50): 36 101 p < p < Q12 Q15 37 * .05, ** .001. 102 38 103 39 104 When we compared emotional rating across the four 40 105 different conditions, each eliciting a distinct emotional 41 106 e 42 response, Mann Whitney test yielded signiﬁcant group dif- 107 43 ference only for emotional ratings associated with the com- 108 44 plete feedback condition (regret effect, between-choice 109 45 comparison) (U ¼ 32; z ¼2.31; p ¼ .02; mean diff. ¼16.8), 110 46 while the two groups of participants reported comparable 111 47 emotional rating for the partial feedback condition (disap- 112 48 pointment effect, within-option comparison) (U ¼ 47; 113 49 z ¼1.44; p ¼ .14; mean diff. ¼6.23), joy (U ¼ 65; z ¼.4; 114 50 115 p ¼ .68; mean diff. ¼3.29) and emotional ratings associated 51 116 with the complete feedback condition (relief effect, between- 52 117 ¼ ¼ ¼ 53 choice comparison) (U 53; z 1.1; p .27; mean 118 ¼ 54 diff. 2.6) (Fig. 4). Participants with HFA/AS reported higher 119 55 score in emotional rating for the partial feedback condition 120 56 (joy effect, within-option comparison), as compared to the 121 57 complete feedback condition (relief effect, between-choice 122 58 comparison) (Wilcoxon sign rank test: z ¼2.22; p ¼ .026; Fig. 4 e Mean subjective emotional rating for the four 123 59 mean diff. ¼ 5.73), unlike CP who reported equal level of in- different events (note: disappointment and joy refer to the 124 60 tensity for these two events (z ¼.16; p ¼ .87; mean within-option comparison in the partial feedback 125 61 126 diff. ¼.17). condition, while regret and relief refer to the between- 62 127 Notably, the analysis of the effect of the un-obtained choice comparison in the complete feedback condition) for 63 128 outcome of the selected gamble (within-option) in the com- p ¼ 64 the two groups of participants. * .03. The emotional 129 ¡ þ 65 plete feedback condition shows that for CP the between- scale ranged from 50, extremely negative, to 50, 130 choice comparison (i.e., regret effect) was more negative extremely positive.

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1 (z ¼ 2.74, p ¼ .006, mean diff. ¼4.46) than the within-option consisted of two conditions in which the information about 66 2 comparisons (i.e., the comparison between the obtained the outcome of the non-chosen lottery was either omitted 67 3 68 outcome and the un-obtained outcome of the chosen gamble (partial feedback) or available (complete feedback). Crucially, 4 69 in feedback condition, mean ¼13.34, SD ¼ 9.79). Moreover, the type and the intensity of the self-reported affective re- 5 70 there were no differences between the within-option com- sponses depend both on the values of the obtained outcome 6 71 ¼ ¼ e 7 parisons in the partial or complete condition (z .078, p .93). and the foregone outcome. In the partial feedback condition 72 8 While patients reported identical effects for the between- in which only the outcome from the chosen gamble is pro- 73 9 choice comparison and the within-option comparison vided e participants are expected to experience disappoint- 74 10 (mean ¼3.51, SD ¼ 16.08) in the complete feedback condition ment, when the obtained value is a relative loss, and joy, when 75 11 (z ¼ .31, p ¼ .75, mean diff ¼.13) and also an identical effect of the obtained value is a relative gain. In contrast, since com- 76 12 the within-option comparison in the two conditions (z ¼ 1.41, plete feedback trials enabled the participants to judge not only 77 13 p ¼ .15). the financial consequence of the chosen gamble, but also the 78 14 outcome that would occur if they had selected the other op- 79 15 80 3.2. Choice behaviour tion, unfavourable comparison between the obtained 16 81 outcome and a more favourable outcome of the unselected 17 82 18 Results based on regression analysis with data from the gamble could generate the regret experience, or the experi- 83 19 complete feedback condition revealed that CPs chose antici- ence of relief if the obtained outcome is more favourable than 84 20 pating regret and maximizing the expected values. Results the unselected one (Camille et al., 2004). 85 21 from the panel logit procedure with individual random effects As expected, all participants reported experiencing more 86 22 are shown in Table 2. Participants with HFA/AS showed a positive emotions following a favourable obtained outcome 87 23 pattern of behaviour similar to that of the CPs, since they and more negative emotions following an unfavourable ob- 88 24 chose maximizing expected values and anticipating regret tained one. However, whereas CP experienced the affective 89 25 (the coefficients of r and e were significant, both p < .05). The response to a regret-inducing event as more intense than the 90 26 91 coefficient of the variable d is not significant for the HFA/AS affective response to a disappointment-inducing event, par- 27 92 group (p ¼ .13) and negative for the CPs (p ¼ .002) in the ticipants with HFA/AS did not exhibit any increase in the 28 93 complete feedback condition (Table 2). We observe similar emotion intensity associated with regretful events. In addi- 29 94 ' 30 results with data from the partial feedback condition (HFA/AS tion, when we compared participants subjective evaluation 95 ¼ ¼ ¼ 31 group coefficient of d .002, p .14; CPs group, d 2.99, for all types of emotional experiences generated during the 96 32 p ¼ .003). As shown in the regression analysis with all the gambling task, the two groups only differed in the evaluation 97 33 participant with data from complete feedback (Table 2), only of the regret experience, that is participants with HFA/AS 98 34 d*group is significant; thus there were no differences in choice experienced the affective response to a regret-inducing 99 35 behaviour between the two groups in terms of anticipated outcome as being significantly less intense than CP. In 100 36 regret and maximization of expected values. contrast, the two groups did not differ in the evaluation of the 101 37 Additionally, both CPs and HFA/AS choices of anticipated affective responses associated with disappointment, joy and 102 38 103 regret were influenced by experienced regret. We regressed relief outcomes. The analysis of the effect of the un-obtained 39 104 the choice of anticipating regret (at trial t) as a function of outcome (within-option comparison) in complete feedback 40 105 41 experienced regret at trial t 1. Both CPs and HFA/AS condition corroborates the fact that only CP differentiated the 106 42 increased the probabilities of anticipating regret after the between-choice comparison (regret) from the within-option 107 43 experience of regret. The coefficient of experienced regret in comparison. Thus, HFS/AS evaluation of the obtained 108 44 the complete feedback condition is positive and significant for outcome is not affected by the outcome of the unselected 109 45 the HFA/AS group (coefficient of experienced regret ¼ .0009, gamble (i.e., they do not show an amplification effect). 110 46 SE ¼ .0008, p ¼ .03) and marginally significant for the CP We suggest that the reduced experience of regret observed 111 47 (experienced regret ¼ .002, SE ¼ .0009, p ¼ .063). in our sample of participants with HFA/AS would reflect a 112 48 diminished self-report emotional awareness that might 113 49 114 3.3. Counterfactual inference test compromise their ability to distinguish self-relevant emotional 50 115 states, such as the experience of regret, from other similar in- 51 116 ternal bodily states. As pointed out by Zeelenberg and collabo- 52 No difference was observed between participants with HFA/ 117 ¼ ¼ & & 53 AS (mean counterfactual score 1.9, SD 1.3) and CP (mean rators (Zeelenberg van Dijk, 2004; Zeelenberg Pieters, 2007), 118 54 counterfactual score ¼ 2, SD ¼ 1.13; ManneWhitney test, regret is a self-relevant negative emotion, differing from other 119 55 z ¼ .137, p ¼ .8914). general negative emotions such as disappointment, anger, 120 56 sadness, envy, guilt and shame on the basis of its specific 121 57 antecedent counterfactual conditions, appraisal patterns, 122 58 4. Discussion experiential content and behavioural consequences. Different 123 59 from disappointment, regret arises in situations where one is, 124 60 In the present study, we used a gambling task to investigate or feels responsible for the occurrence of the negative event and 125 61 126 the ability of a group of adults with HFA/AS to experience its experience is associated with a tendency to blame oneself for 62 127 regret and disappointment. Participants were asked to make a having made the wrong decision. The emphasis on between- 63 128 64 choice between two risky gambles associated with a monetary option counterfactuals invokes the notion that regret depends 129 65 reward, and to report the quality and the intensity of their upon the personal sense of blame or feeling responsible for bad 130 emotional responses following winning or losing. The task decisions, and that the sense of responsibility, induced from

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1 such specific counterfactual thinking, amplifies the feelings self-relevant emotion, which is characterized by a higher level 66 2 associated with a regretful event (Frijda, Kuipers, & ter Schure, of physiological arousal and a strong behavioural impact. It is 67 3 68 1989; Zeelenberg, van Dijk, & Manstead, 1998; Zeelenberg, van possible that whereas the level of physiological arousal, 4 69 Dijk, Manstead, & van der Pligt, 1998, Zeelenberg, van Dijk, associate with regretful events, is sufficient to orient subse- 5 70 Manstead, & van der Pligt, 2000). quent behavioural choices, a much higher threshold is needed 6 71 7 In the present study, the two groups showed similar per- for generating emotional awareness and a specific emotional 72 8 formance on counterfactual reasoning task, in accordance content. This could explain why in participants with HFA/AS 73 9 with previous research showing intact reasoning abilities in who did not exhibit the amplified regret effect, they never- 74 10 individuals with HFA (Begeer, Terwogt, Lunenburg, & Stegge, theless manifest regret avoidance behaviour. 75 11 2009; Leevers & Harris, 2000; Scott, Baron-Cohen, & Leslie, This explanation is in accordance with research in social 76 12 1999). This finding is of particular importance because it al- cognition showing the existence of unconscious guidance 77 13 lows us to discount the hypothesis that impaired inferential systems, composed by a variety of automatic process detecting 78 14 reasoning would account for group difference in emotional relevant stimuli and information in the social and physical 79 15 80 awareness. Hence, the lack of the amplification effect for the environments. The automatic effects of environmental stimuli 16 81 experience of regret in participants with HFA/AS might reflect are directly connected to behavioural tendencies, in the 17 82 18 the failure to overtly integrate self-relevant emotional infor- absence of any involvement by conscious or intentional pro- 83 & 19 mation with inferential reasoning processes. cesses (Bargh Morsella, 2009). Emotional states can thus 84 20 It is noteworthy that the two participant groups reported trigger goals and motivational states of which the individual is 85 21 similar emotional evaluation for disappointment, joy and re- not aware and does not consciously intend. Unconscious pro- 86 22 lief inducing events. Although, like regret, relief depends upon cessing was found to drive a large variety of cognitive pro- 87 23 between-choice counterfactual inference, that is the favour- cessing, including stereotyping judgements, social behaviour 88 24 able comparison between the obtained and the unselected and motivated goal pursuit (Bargh & Morsella, 2008; Bargh, 89 25 outcome on complete feedback conditions, different from Schwader, Hailey, Dyer, & Boothby, 2012). Hence, it is likely 90 26 91 regret-inducing events, relief and joy-inducing events were that these unconscious guidance systems are partly preserved 27 92 experienced as equally intense by CP. In contrast, participants in ASD population, but only covertly affect subject's behaviour. 28 93 with HFA/AS reported higher emotional rating for joy- The present findings are consistent with evidence showing 29 94 30 inducing events, as compared to relief inducing-events. This that alexithymia, which is characterized by difficulties in the 95 31 finding suggests that while individuals with HFA/AS are sen- appraisal and expression of emotion and in overtly use feel- 96 32 sitive to positive feedback, they exhibit some atypicalities in ings to guide behaviour, considerably overlaps with ASDs 97 33 the subjective experience of emotions and possibly differ from (Fitzgerald & Bellgrove, 2006). Recently, Gaigg (2012) has pro- 98 34 typically developed individuals with respect to the conscious posed that ASDs may be better understood in terms of a 99 35 representation of physiological arousal states. Unfortunately, disruption in the domain-general interplay between emotion 100 36 as we adopted an operational notion of ‘regret’, the present and cognition. The present results are in accordance with this 101 37 study does not provide a more direct measure of the experi- theoretical account and further reveal that difficulties in 102 38 103 ential and evaluative contents of those emotions, which reflective appraisal of self-relevant emotional experience in 39 104 might help explaining group and potentially individual dif- individuals with HFA/AS also arise in private settings. 40 105 ' 41 ferences in subjective self-reports. Using a gambling task, Nicolle et al. (2011) s study showed 106 42 In addition, although the experience of regret elicited a less that in typically developed participants increased subjective 107 43 intense emotional response in participants with HFA/AS, they responsibility amplified the tendency to report high feelings of 108 44 showed a choice behaviour similar to the one of the CP. Both regret and, neuronal activity in the amygdala was enhanced 109 45 groups maximized expected values, anticipated regret, and by increased responsibility associated with this “self-blame 110 46 also avoided regret more after a regret event, suggesting that regret” experience. These findings suggest that the experience 111 47 the HFA/AS are able to anticipate and avoid regrettable out- of regret crucially depends on the level of subjective re- 112 48 comes. We also found that CP reported a negative coefficient sponsibility and on the personal sense of blame induced by 113 49 114 of anticipated disappointment. This might be due to the the individual's own choice. According to this view, the 50 115 overwhelming effect of experience of anticipated regret in inability to differentiate the affective responses associated 51 116 their choice behaviour. with regret and disappointment-inducing events in our par- 52 117 53 Overall, the present results seem to suggest that, despite ticipants with ASDs might result from an impairment in 118 54 group differences in the subjective self-reports, emotional attributing responsibility to internal causes and in processing 119 55 information, associated with a specific neurophysiological the self-blame component of regret, rather than reflecting a 120 56 arousal, elicited by regretful events, is unconsciously pro- disrupted system for conscious emotional appraisal. Never- 121 57 cessed and affect choice behaviour covertly. Feeling of regret theless, the fact that both groups manifested regret avoidance 122 58 plays an important role in the evaluation of behavioural al- behaviour suggests that participants made attributions of 123 59 ternatives and promotes learning from one's mistakes by regretful events to internal factors, at least in a cover manner. 124 60 providing critical feedback in the form of anticipatory self- 125 61 126 blame feelings. Since behavioural choices are often made to 62 127 avoid highly unpleasant events, people anticipate emotional 5. Conclusion 63 128 64 reactions (e.g., regret vs relief/self-approval) and engage in the 129 65 more advantageous and reparative actions (Zeelenberg, van The present findings suggest that the reduced feeling of regret 130 Dijk, Manstead, & van der Pligt, 2000). As such, regret is a in individuals with ASDs would reflect an impaired appraisal

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1 system affecting the ability to make self-relevant affective in- Ashwin, C., Chapman, E., Colle, L., & Baron-Cohen, S. (2006). 66 2 formation available for conscious evaluation and cognitive Impaired recognition of negative basic emotions in autism: a 67 3 e 68 reasoning. In accordance with the model of alexithymia pro- test of the amygdala theory. The Society of Neuroscience, 1(3 4), 4 349e363. Q7 69 posed by Lane and Schwartz (1987), we distinguish the level of 5 Bargh, J. A., & Morsella, E. (2008). The unconscious mind. 70 physiological arousal from the level of conscious representa- 6 Perspectives on Psychological Science, 3,73e79. 71 7 tion of that arousal state. Impairments of the second-order Bargh, J. A., & Morsella, E. (2009). Unconscious behavioral 72 8 awareness of bodily states, associated with emotions or guidance systems. In C. Agnew, et al. (Eds.), Then a miracle 73 9 interoceptive awareness, can explain alexithymic symptoms occurs: Focusing on Behavior in Social Psychological Theory and 74 10 Q5 in individuals with ASDs. Research. New York: Oxford University Press. 75 11 The ability to incorporate affective values with reasoning Bargh, J. A., Schwader, K. L., Hailey, S. E., Dyer, R. L., & 76 12 Boothby, E. J. (2012). Automaticity in social-cognitive 77 processes, such as counterfactual thinking, critically relies on e 13 processes. Trends in Cognitive Sciences, 16(12), 593 605. 78 the OFC and on its functional connectivity with the amygdala Baron-Cohen, S., Ring, H. A., Bullmore, E. T., Wheelwright, S., 14 79 (Coricelli et al., 2005). Since this structure has been found to be Ashwin, C., & Williams, S. C. (2000). The amygdala theory of 15 80 crucially involved in the ASD pathophysiology, it is likely that autism. 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Personality & 94 e 30 Further research is needed to investigate the impact of a Individual Differences, 26, 477 485. 95 31 diminished emotional awareness on conscious decision- Camille, N., Coricelli, G., Sallet, J., Pradat-Diehl, P., Duhamel, J. R., 96 32 making and reasoning, and the neural structures involved in & Sirigu, A. (2004). The involvement of the orbitofrontal cortex 97 e 33 this impairment in ASDs. Finally, it would be important to in the experience of regret. Science, 304, 1167 1170. 98 Capps, L., Sigman, M., & Yirmiya, N. (1995). Self-competence and 34 corroborate the present behavioural findings by using both 99 emotional understanding in high-functioning children with 35 100 implicit psychophysiological measures of emotions (i.e., autism. Development and Psychopathology, 1, 137e149. 36 101 electrodermal activity and heart rate), an explicit appreciation Chua, F. C., Gonzalez, R., Taylor, S. F., Welsh, R. 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Please cite this article in press as: Zalla, T., et al., Feelings of regret and disappointment in adults with high-functioning autism, Cortex (2014), http://dx.doi.org/10.1016/j.cortex.2014.05.008