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This paper describes the rationale, design, and methods of the Treatment for Anxiety in Autism Spectrum Disorders study, a three-site randomized controlled trial investigating the relative efficacy of a modular CBT protocol for anxiety in ASD (Behavioral Interventions for Anxiety in Children with Autism) versus standard CBT for pediatric anxiety (the Coping Cat program) and a treatment-as-usual control. The trial is distinct in its scope, its direct comparison of active treatments for anxiety in ASD, and its comprehensive approach to assessing anxiety difficulties in youth with ASD. The trial will evaluate the relative benefits of CBT for children with ASD and investigate potential moderators (ASD severity, anxiety presentation, comorbidity) and mediators of treatment response, essential steps for future dissemination and implementation.

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Individuals are consistently better at recognizing own-race faces compared to other-race faces (other-race effect, ORE). One popular hypothesis is that this recognition memory ORE is caused by differential own- and other-race holistic processing, the simultaneous integration of part and configural face information into a coherent whole. Holistic processing may create a more rich, detailed memory representation of own-race faces compared to other-race faces. Despite several studies showing that own-race faces are processed more holistically than other-race faces, studies have yet to link the holistic processing ORE and the recognition memory ORE. In the current study, we sought to use a more valid method of analyzing individual differences in holistic processing by using regression to statistically remove the influence of the control condition (part trials in the part-whole task) from the condition of interest (whole trials in the part-whole task). We also employed regression to separately examine the two components of the ORE: own-race advantage (regressing other-race from own-race performance) and other-race decrement (regressing own-race from other-race performance). First, we demonstrated that own-race faces were processed more holistically than other-race faces, particularly the eye region. Notably, using regression, we showed a significant association between the own-race advantage in recognition memory and the own-race advantage in holistic processing and that these associations were weaker when examining the other-race decrement. We also demonstrated that performance on own- and other-race faces across all of our tasks was highly correlated, suggesting that the differences we found between own- and other-race faces are quantitative rather than qualitative. Together, this suggests that own- and other-race faces recruit largely similar mechanisms, that own-race faces more thoroughly engage holistic processing, and that this greater engagement of holistic processing is significantly associated with the own-race advantage in recognition memory.

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Although holistic processing is thought to underlie normal face recognition ability, widely discrepant reports have recently emerged about this link in an individual differences context. Progress in this domain may have been impeded by the widespread use of subtraction scores, which lack validity due to their contamination with control condition variance. Regressing, rather than subtracting, a control condition from a condition of interest corrects this validity problem by statistically removing all control condition variance, thereby producing a specific measure that is uncorrelated with the control measure. Using 43 participants, we measured the relationships amongst the Cambridge Face Memory Test (CFMT) and two holistic processing measures, the composite task (CT) and the part-whole task (PW). For the holistic processing measures (CT and PW), we contrasted the results for regressing vs. subtracting the control conditions (parts for PW; misaligned congruency effect for CT) from the conditions of interest (wholes for PW; aligned congruency effect for CT). The regression-based holistic processing measures correlated with each other and with CFMT, supporting the idea of a unitary holistic processing mechanism that is involved in skilled face recognition. Subtraction scores yielded weaker correlations, especially for the PW. Together, the regression-based holistic processing measures predicted more than twice the amount of variance in CFMT (R(2)=.21) than their respective subtraction measures (R(2)=.10). We conclude that holistic processing is robustly linked to skilled face recognition. In addition to confirming this theoretically significant link, these results provide a case in point for the inappropriateness of subtraction scores when requiring a specific individual differences measure that removes the variance of a control task.

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Because holistic processing is a hallmark of normal face recognition, we ask whether such processing is reduced in developmental prosopagnosia (DP), and, if so, what the sources are of this deficit. Existing literature provides a mixed picture, with face inversion effects showing consistent holistic processing deficits but unable to locate their source and with some composite face studies showing reduced holistic processing and some not. We addressed this issue more thoroughly with a very large sample of DPs (N = 38) performing the part-whole task, a well-accepted measure of holistic processing that allows for the separate evaluation of individual face parts. Contrary to an expected overall reduction in holistic processing, we found an intact holistic advantage for the mouth and a complete absence of a holistic advantage for the eye region. Less severely impaired prosopagnosics showed significantly more holistic processing of the mouth, suggesting that holistic processing can aid them in recognizing faces.

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