Research and Publications - Department of Psychology

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Emotionality and Perceptual Defense
(American Psychological Association, 1949-08-31) McGinnies, Elliott
Estimating the reproducibility of psychological science
(American Association for the Advancement of Science, 2015) Group Author: Open Science Collaboration; Gable, Philip; Mechin, Nicole
Reproducibility is a defining feature of science, but the extent to which it characterizes science is unknown. Following a structured protocol, we conducted 100 replications of studies published in three psychology journals. Replication effects (M = .198, SD = .255) were half the magnitude of original effects (M = .396, SD = .193) representing a substantial decline effect. Ninety-seven percent of original studies had significant results (p < .05). Thirty-six percent of replications had significant results; 47% of original effect sizes were in the 95% confidence interval of the replication effect size; 38% of effects were subjectively rated to have replicated the original result; and, if no bias in original results is assumed, 70% of the meta-analytic combinations were significant effects. Correlational tests suggest that replication success is better predicted by the strength of original evidence than by characteristics of the original and replication teams. In sum, a large portion of replications did not reproduce evidence supporting the original results despite using high-powered designs and original materials when available. The open dataset provides a basis for hypothesis generation on the causes of irreproducibility.
Experiences of Students with Autism in Online Postsecondary Education: A Consensus Building Investigation Using the Nominal Group Technique
(2023) Nelson, Cailee M.; White, Susan W.; Stoppelbein, Laura; Paul, Margaret L.; Armstrong, Madelyn L.; Morett, Laura M.
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is often characterized in existing literature by deficits in social skills and communication. Due to COVID-19, a new issue has presented itself for many students—learning effectively in online education. Despite evidence suggesting many college students with autism prefer online courses, research specifically investigating the challenges these students face in emergency remote instruction is limited. Using a virtually adapted nominal group technique (NGT), this project examined the challenges students with and without autism face in emergency remote and hybrid postsecondary education and inquired about resources available to them. Themes such as struggling to form relationships, poor communication, and a need for increased accessibility emerged from the participants with (n ¼ 8) and without (n ¼ 11) autism. Ultimately, these findings highlight challenges that postsecondary students with and without autism are facing in emergency remote instruction and supports that would be helpful in these educational experiences.
The Role of Emotion Regulation and Core Autism Symptoms in the Experience of Anxiety in Autism
(Sage, 2020) Conner, Caitlin M.; White, Susan W.; Scahill, Lawrence; Mazefsky, Carla A.
Youth with autism spectrum disorder (ASD) are at elevated risk for impaired emotion regulation (ER) and clinically impairing anxiety. A prior developmental framework posited that impaired ER leads to co-occurring psychiatric conditions such as anxiety, with outcome determined in part by ASD-specific moderating factors. Using measures developed and validated in ASD, this study evaluated: 1) the association between ER and anxiety in a large, community-based sample of youth with ASD and a wide range of intellectual and verbal abilities; and 2) whether greater core ASD symptoms strengthened the association between impaired ER and anxiety. Parents of 1,107 children with a community diagnosis of ASD (881 boys; age 6–17 years) participated in an online survey assessing their child’s ER, anxiety, and ASD symptoms. ER impairment significantly predicted whether participants had elevated levels of anxiety, after controlling for demographic variables and ASD symptoms; however, there was no interaction of ER and ASD symptoms. This study is the first to support the anxiety-ER association with measures developed and validated specifically for ASD, in a large sample with co-occurring ID and minimally verbal youth with ASD.
Considering equifinality in treatment planning for social impairment: Divergent paths in neurodevelopmental disorders
(Guilford Press, 2019) Simmons, Grace Lee; Hilton, Dane C.; Jarrett, Matthew A.; Tomeny, Theodore S.; White, Susan W.
Youth with autism spectrum disorder (ASD) present with deficits in both social cognition and executive functioning (EF), which contribute to social impairment. Autistic youth are also frequently diagnosed with comorbid attention-deficit/hyperactivity disorder (ADHD), a disorder that, like ASD, includes impaired EF and social functioning. The comorbidity of ASD and ADHD may result in compounded social impairment, but prior research has not sufficiently evaluated the extent to which this comorbidity profile responds to evidence-based intervention targeting social deficits. It is conceivable that dually targeting EF and social cognition impairment will be more impactful than direct social skills training alone. The authors present an integrative model for intervention programming that examines pathways to social impairment in order to more effectively improve social skills and thereby impact both proximal (e.g., emotion expression, current peer relationships) and more distal outcomes (e.g., depression, self-esteem) in youth with ASD and other neurodevelopmental disorders. (B
Pathways to Psychopathology Among Autistic Adults
(Springer, 2023) White, Susan W.; Siegle, Greg J.; Kana, Rajesh; Rothman, Emily F.
Autistic adults frequently utilize mental healthcare services, and experience heightened risk for chronic impairment as a result of mental health problems. Understanding causal and developmental risk processes in autism should inform personalized treatment. We synthesize extant research on these processes and offer suggestions for addressing them therapeutically and societally.
Quantitative EEG Changes in Youth With ASD Following Brief Mindfulness Meditation Exercise
(IEEE, 2022) Susam, Busra T.; Riek, Nathan T.; Beck, Kelly; Eldeeb. Safaa; Hudac, Caitlin M.; Gable, Philip A.; Conner, Caitlin; Akcakaya, Murat; White, Susan W.; Mazefsky, Carla
Mindfulness has growing empirical support for improving emotion regulation in individuals with Autism Spectrum Disorder (ASD). Mindfulness is cultivated through meditation practices. Assessing the role of mindfulness in improving emotion regulation is challenging given the reliance on self-report tools. Electroencephalography (EEG) has successfully quantified neural responses to emotional arousal and meditation in other populations, making it ideal to objectively measure neural responses before and after mindfulness (MF) practice among individuals with ASD. We performed an EEG-based analysis during a resting state paradigm in 35 youth with ASD. Specifically, we developed a machine learning classifier and a feature and channel selection approach that separates resting states preceding (Pre-MF) and following (Post-MF) a mindfulness meditation exercise within participants. Across individuals, frontal and temporal channels were most informative. Total power in the beta band (16–30 Hz), Total power (4–30 Hz), relative power in alpha band (8–12 Hz) were the most informative EEG features. A classifier using a non-linear combination of selected EEG features from selected channel locations separated Pre-MF and Post-MF resting states with an average accuracy, sensitivity, and specificity of 80.76%, 78.24%, and 82.14% respectively. Finally, we validated that separation between Pre-MF and Post-MF is due to the MF prime rather than linear-temporal drift. This work underscores machine learning as a critical tool for separating distinct resting states within youth with ASD and will enable better classification of underlying neural responses following brief MF meditation.
University-Community Mental Health Training Collaboration: Teaching Criminal Legal Stakeholders About Autism
(American Psychiatric Association, 2023) Kois, Lauren E.; Cox, Jennifer; Simmons, Grace Lee; White, Susan W.; Scott-Adams, Virginia
Individuals with autism spectrum disorder (ASD) are disproportionately represented in the criminal legal system, yet ASD-speciﬁc training is rarely provided to frontline clinical staff or legal professionals. This column describes a collab-oration between university researchers and a state mental health department to promote ASD awareness, knowledge, and intervention skills among clinical and legal professionals working with autistic individuals with criminal legal involvement. Descriptions of how speciﬁc needs were identiﬁed, how tailored educational workshops were developed, and how workshop efﬁcacy was assessed are provided. Les-sons learned and recommendations for researchers and health care systems interested in similar collaborations are offered.
Change in Gaze-Based Attention Bias in Adolescents with Social Anxiety Disorder
(Taylor & Francis, 2019) White, Susan W.; Capriola-Hall, Nicole N.; Wieckowski, Andrea Trubanova; Ollendick, Thomas H.
Although attention bias (AB) toward threat has been associated with Social Anxiety Disorder (SAD), concerns regarding the ability of current measures to detect change in AB following treatment exist. We sought to examine change in bias, as measured via eye-tracking, in adolescents with SAD receiving either attention-bias modification training (ABMT) or attention-control training (ACT). Gaze-based AB was associated (r = −0.361) with symptoms of social anxiety prior to treatment, whereas there was no association between bias as measured via dot probe and social anxiety. Moreover, gaze-based bias to same-age face stimuli showed change following treatment. Large effects are seen for condition (ABMT or ACT) and for time, independent of treatment condition, in gaze-based AB to same-age stimuli. Findings suggest that further research on gaze-based bias, to assess stability over time outside of treatment and sensitivity to change following intervention, is warranted.
The Influence of Social Communication Impairments on Gaze in Adolescents with Social Anxiety Disorder
(Springer, 2018) Capriola-Hall, Nicole N.; Wieckowski, Andrea Trubanova; Ollendick, Thomas H.; White, Susan W.
Adolescents with social anxiety disorder (SAD) often present distorted beliefs related to expected social rejection, coupled with avoidance of social stimuli including interpersonal interactions and others' gaze. Social communication (SC) deficits, often seen in SAD, may play a role in avoidance of social stimuli. The present study evaluated whether SC impairment uniquely contributes to diminished or heightened attention to social stimuli. Gaze patterns to social stimuli were examined in a sample of 41 adolescents with SAD (12-16 years of age; 68% female). Unexpectedly, no significant relationship was observed between SC impairment and fixation duration to angry or neutral faces. However, SC impairment did predict greater fixation duration to happy faces, after controlling for social anxiety severity [adjusted R2 = .201, F (2, 38) = 4.536, p = .018]. Clinical implications are discussed, focusing on the potential utility of targeting SC impairments directly in light of the role of SC difficulties in youth with SAD.
Task Dependency when Evaluating Association between Facial Emotion Recognition and Facial Emotion Expression in Children with ASD
(Springer, 2019) Wieckowski, Andrea Trubanova; Swain, Deanna M.; Abbott, A. Lynn; White, Susan W.
The impact of facial emotion recognition (FER) deficits on facial emotion expression (FEE) during interaction with a novel computerized system was investigated in children with ASD (n = 20), in comparison to typically developing (TD) peers (n = 20). Although there was not clear evidence of impaired FEE, children with ASD showed more atypical FEE. In children with ASD, better FER predicted better FEE when the participants were asked to express a labeled emotion (t(18) = − 2.75, p = .01, d = 1.24). The stronger relationship between FER and FEE in children with ASD, relative to controls, suggests that intervention targeting social communication deficits might have maximal effect when both processes are considered.
Promoting Quality of Life: Suggestions for Mental Health Care Providers Working with Young Autistic Adults
(Mary Ann Liebert, Inc., 2023) White, Susan W.; Schall, Carol; Santos, Jin Delos; Maddox, Brenna B.; Hillier, Ashleigh; Klinger, Laura; Pugliese, Cara
There is a growing population of autistic adults in need of supports from a service delivery system that, at present, fails to accommodate their needs adequately and equitably. Unfortunately, there is a shortage of trained behavioral health service providers to meet the needs of young autistic adults. Quality of life (QoL), or one's perception of, and satisfaction with, life in relation to held goals and expectations, has been identified as a key outcome of interest by autistic self-advocates. By supporting autistic clients to hone their strengths and interests, integrate various aspects of their identity, identify goals, and connect to appropriate resources, providers can promote clients' self-knowledge and self-determination, in the service of improving QoL. In this Perspectives article, we offer concrete recommendations to mental health providers, including those who do not specialize in autism, with the goal of supporting implementation of evidence-based strategies that improve QoL and promote self-determination among young autistic clients.
Bridging Gaps and Enhancing Support: Stakeholder Perspectives on Optimizing a Transition Program for Autistic Youth and Young Adults
(Association for Behavioral and Cognitive Therapies, 2024) McClain, Amaya B.; Guyotte, Kelly W.; Powell, Nicole; White, Susan W.
Autistic adolescents and young adults face lower employment, education, and quality of life outcomes as compared to their nonautistic peers (Lawson et al., 2020; Nord et al., 2016). To address these issues, the Stepped Transition to Employment and Postsecondary Education Success (STEPS; White et al., 2017) program was developed to help students successfully transition into adulthood. Given the established effectiveness of STEPS (e.g., White et al., 2021), we sought input from community partners to reduce the gap between mental health and developmental disability support (Laxman et al., 2019; White et al., 2023) and to maximize the program's scalability and accessibility through the use of a community engagement framework. This study examined the perspectives of community stakeholders on different aspects of the program’s development, such as the barriers and facilitators to implementing STEPS and how to make the program more scalable and accessible for families, clinicians, and educators.
Characterizing the Relationship Among the Social Competence Elements in Autistic Adolescents
(Wiley, 2025) Key, Alexandra P.; McGonigle, Trey; Liu, Jinyuan; Muscatello, Rachael; Gable, Philip; White, Susan W.; Lerner, Matthew; Corbett, Blythe A.
Individuals with autism spectrum disorder have significant difficulties in social competence. This study provided empirical evaluation of the theoretical model by Kennedy and Adolphs (2012) positing that social competence relies on an interconnected network of four components: social brain, cognition, behavior and functioning. Data from 243 youth (69 female, 174 male), age 10–17 years, were used to test the hypothesized mediation effect of social cognition (Theory of Mind) from social brain (event-related potential markers of face perception and memory) to social behavior (Contextual Assessment of Social Skills) and functioning (Child Behavior Checklist). An additional analysis evaluated whether the structure of the social competence model varied based on the biological sex of the autistic participants. The findings support the conceptual model of social competence where the social brain’s contributions to social behavior and functioning are mediated by social cognition, with an additional direct path between the brain and behavior. The relationship among the four components of social competence is not significantly different for autistic males and females. Social competence is best represented as a network of direct and indirect connections among the neural, cognitive, and behavioral components. Thus, focusing on any single element is not sufficient for effective design of novel assessment and treatment approaches in autism. The findings also highlight the importance of self-initiated active engagement with social cues as a contributor to successful social behavior and functioning in autism.
Peers, Play, and Performance to Build Social Salience in Autistic Youth: A Multisite Randomized Clinical Trial
(American Psychological Association, 2023) Corbett, Blythe A.; White, Susan W.; Lerner, Matthew; Preacher, Kristopher J.; Klemencic, Mark E.; Simmons, Grace Lee; Pilkington, Jennifer; Gable, Philip; Gioia, Ayla; Key, Alexandra P.
Objective: Individuals with autism spectrum disorder (ASD) have significant impairment in social competence and reduced social salience. SENSE Theatre, a peer-mediated, theater-based intervention has demonstrated posttreatment gains in face memory and social communication. The multisite randomized clinical trial compared the Experimental (EXP; SENSE Theatre) to an Active Control Condition (ACC; Tackling Teenage Training, TTT) at pretest, posttest, and follow-up. It was hypothesized that the EXP group would demonstrate greater incidental face memory (IFM) and better social behavior (interaction with novel peers) and social functioning (social engagement in daily life) than the ACC group, and posttest IFM would mediate the treatment effect on follow-up social behavior and functioning. Method: Two hundred ninety participants were randomized to EXP (N = 144) or ACC (N = 146). Per protocol sample (≥7/10 sessions) resulted in 207 autistic children 10–16 years. Event-related potentials measured IFM. Naive examiners measured social behavior (Vocal Expressiveness, Quality of Rapport, Social Anxiety) and functioning (Social Communication). Structural equation modeling was used to assess treatment effects. Results: SENSE Theatre participants showed significantly better IFM (b = .874, p = .039) at posttest, and significant indirect effects on follow-up Vocal Expressiveness a × b = .064, with 90% CI [.014, .118] and Quality of Rapport a × b = .032, with 90% CI [.002, .087] through posttest IFM. Conclusions: SENSE Theatre increases social salience as reflected by IFM, which in turn affected Vocal Expressiveness and Quality of Rapport. Results indicate that a neural mechanism supporting social cognition and driven by social salience is engaged by the treatment and has a generalized, indirect effect on clinically meaningful functional outcomes related to core symptoms of autism.
Brief Report: The Influence of Autism Severity and Depression on Self-Determination Among Young Adults with Autism Spectrum Disorder
(Springer, 2022) White, Susan W.; Smith, Isaac; Brewe, Alexis M.
Self-determination (SD) is linked to autonomy and better adult outcomes. Adults with autism spectrum disorder (ASD) are often less independent than cognitively matched peers. Given the frequency with which depression co-occurs in ASD and the established association between depression and SD, we sought to evaluate the influence of both ASD severity and depression on SD among cognitively able emerging adults with ASD. Emerging adults (n = 59) with ASD completed measures of SD, ASD severity, and depression. Both ASD severity and depression were moderately correlated with SD (r = − 0.473; − 0.423, respectively) and with each other (r = 0.625). After controlling for ASD severity, depression did not significantly predict SD. Strengthening SD should be considered in programming to promote independence.
Psychometric Properties of the Dutch Contextual Assessment of Social Skills (CASS): An Independent Observational Outcome Measure of Social Skills in Autistic Adolescents
(Springer, 2023) Idris, Sakinah; ten Hoeve, Femke H. F.; Ratto, Allison B.; White, Susan W.; van Haren, Neeltje; Greaves-Lord, Kirsten
The goal of this study was to translate and adapt the original 9-item of the Contextual Assessment of Social Skills (CASS) to a Dutch version and assess its psychometric qualities. Autistic adolescents aged 12 to 18 years (n = 99) took part in a randomized controlled trial. In this study, pre-intervention data were utilized. The original CASS was adapted to ensure cultural relevance and the content validity was assessed. Data was used to assess reliability and structural validity, using confirmatory factor analysis. 4-item were added to the CASS during the adaptation to better align with the objectives of the experimental intervention. The original 9-item had inter-item correlations between .01 and .70. The Cronbach’s alpha for the original 4-item total score was moderate (α = .69), while for a 7-item total score, it was high (α = .86). This 7-item total score had a sufficient model fit (Comparative Fit Index = .90). This total score had a significant correlation with the Assertion subscale of the Social Skills Improvement System-Adolescent (SSIS-A) (r = 0.26, p < .01), and the Social Responsiveness Scale-2 (SRS-2) total score (r = − .21, p = .04) indicating sufficient convergent validity. The CASS total score was not correlated with the Repetitive and Restricted Behavior scale of the SRS-2 (r = − .08, p = .43), indicating sufficient divergent validity. The Dutch CASS can be considered a conceptually sound and reliable observational instrument for assessing social conversational skills in Dutch autistic youth. Further evaluation of its feasibility when implemented in practice, outside of clinical research, is needed. Trial registration: Dutch trail register NTR6255 (NL6117) 08/02/2017 https://www.trialregister.nl/trial/6117
Efficacy of the Emotion Awareness and Skills Enhancement (EASE) Program in Autism: A Randomized Controlled Trial
(Elsevier, 2025) White, Susan W.; Conner, Caitlin M.; Beck, Kelly; Mazefsky, Carla A.
Autistic adolescents and adults often struggle with emotion dysregulation, and advocates consistently encourage more research on mental health. This study aimed to establish efficacy for psychotherapeutic intervention for emotion dysregulation for autistic adolescents and young adults. In this multisite randomized controlled trial, a primarily mindfulness-based intervention called the Emotion Awareness and Skills Enhancement (EASE) Program, developed to improve emotion dysregulation in autistic adolescents and young adults, was compared to a rigorous active control condition (ACC) that allowed for personalized and evidence-based intervention as long as it did not include EASE core elements. It was hypothesized that the EASE group would demonstrate a steeper decline in emotion dysregulation, as well as decreased mental health problems, compared to those in ACC. A total of 109 participants were randomized, 102 began treatment, 89 participants completed all treatment sessions. intent-to-treat (ITT; n = 109) analyses were conducted, with supplemental per protocol analyses (PP; n = 76). Primary outcomes included emotion dysregulation severity and its interference with daily functioning, whereas secondary outcomes assessed mental health symptoms. Condition-naive interviews, which gauged impairment related to dysregulation, showed that the EASE group had more treatment responders (63%) compared to ACC (44%) (p = .052, odds ratio = 2.85), but this difference was not statistically significant. EASE participants demonstrated greater declines in emotion dysregulation than those in ACC (Reactivity, b = − 0.168, p = .017; Dysphoria, b = − 0.182, p = .010) at endpoint. EASE participants demonstrated improvement in internalizing and externalizing symptoms, relative to baseline, based on self and caregiver-report, whereas ACC participants showed improvement only in caregiver-reported externalizing symptoms. All effects were stronger in PP analyses, suggesting the possible importance of treatment dosage. Findings suggest that EASE improves emotion dysregulation for autistic adolescents and young adults.
Gender Matters: The Relationship between Social Anxiety and Alcohol-Related Consequences
(PLoS, 2014) Schry, Amie R.; Norberg, Melissa M.; Maddox, Brenna B.; White, Susan W.
Background and Objectives: Identification of risk factors for alcohol-related consequences is an important public health concern. Both gender and social anxiety have been associated with alcohol-related consequences broadly, but it is unknown whether these variables are differentially related to specific types of alcohol-related consequences for American college students. Methods: In the present study, 573 undergraduate students (Mage519.86 years, SD51.40; range 18 to 25; 68.9% female) completed an on-line assessment of social anxiety, alcohol use, and four types of alcohol-related consequences (personal, social, physical, and role). Poisson regressions were run to examine social anxiety, gender, and the interaction between social anxiety and gender as predictors of each type of alcohol-related consequences. Results: After controlling for alcohol use, social anxiety was positively associated with all four types of consequences, and females endorsed higher rates of physical, personal, and role consequences. The interaction between social anxiety and gender was statistically significant only for physical consequences, with social anxiety having a stronger effect for males. Discussion and Conclusions: These findings, which diverge somewhat from those of a prior study with Australian college students, are discussed in the context of a biopsychosocial model of social anxiety and substance use problems. Scientific Significance: This study highlights the importance of further investigating cultural differences in the relationships among social anxiety, gender, and alcohol-related consequences.
Understanding the experiences of self-injurious behavior in autism spectrum disorder: Implications for monitoring technology design
(Oxford University Press, 2021) Cantin-Garside, Kristine D.; Nussbaum, Maury A.; White, Susan W.; Kim, Sunwook; Kim, Chung Do; Fortes, Diogo M.G.; Valdez, Rupa S.
Monitoring technology may assist in managing self-injurious behavior (SIB), a pervasive concern in autism spectrum disorder (ASD). Affiliated stakeholder perspectives should be considered to design effective and accepted SIB monitoring methods. We examined caregiver experiences to generate design guidance for SIB monitoring technology. Twenty-three educators and 16 parents of individuals with ASD and SIB completed interviews or focus groups to discuss needs related to monitoring SIB and associated technology use. Qualitative content analysis of participant responses revealed 7 main themes associated with SIB and technology: triggers, emotional responses, SIB characteristics, management approaches, caregiver impact, child/student impact, and sensory/technology preferences. The derived themes indicated areas of emphasis for design at the intersection of monitoring and SIB. Systems design at this intersection should consider the range of manifestations of and management approaches for SIB. It should also attend to interactions among children with SIB, their caregivers, and the technology. Design should prioritize the transferability of physical technology and behavioral data as well as the safety, durability, and sensory implications of technology. The collected stakeholder perspectives provide preliminary groundwork for an SIB monitoring system responsive to needs as articulated by caregivers. Technology design based on this groundwork should follow an iterative process that meaningfully engages caregivers and individuals with SIB in naturalistic settings.

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