Caetextia

Caetextia (from the Latin word caecus, meaning "blind" and contextus, meaning "context") is a term and concept first coined by psychologists Joe Griffin and Ivan Tyrrell to describe a chronic disorder that manifests as a context blindness in people on the autism spectrum. It was specifically used to designate the most dominant manifestation of autistic behaviour in higher-functioning individuals. Griffin and Tyrell also suggested that caetextia "is a more accurate and descriptive term for this inability to see how one variable influences another, particularly at the higher end of the spectrum, than the label of 'Asperger's syndrome.

Caetextia presents itself as the inability to adjust behaviour appropriately to deal with interacting variables. People with caetextia may fail to consider the context surrounding the behaviour. This can result in people with caetextia experiencing elevated levels of frustration, anger, and anxiety when faced with a situation that requires giving attention to more than one interacting variable or factor at a time. This can be attributed to the inability to unconsciously draw upon the contextual information presented in a given situation as well as evaluate the significance of change with regards to the surrounding environment.

Caetextia can also exist in a temporary form prompted by stress, anxiety, or depression.

In autism spectrum disorder (ASD)
Many of the symptoms observed in patients with Asperger's can be attributed to caetextia. In order for someone to be considered contextually aware, they must be able to attach attention to and detach it from the interacting variables in a given situation. This implies active integration of sensory information gathered from the situation. It has been found that patients differ in their ability to perform these functions based on the dominant hemisphere of their brain.

Some areas that are affected by ASD are the ability to understand and use non-verbal and verbal communication, behave in socially appropriate ways, flexible thinking, and under or over sensitivity to sensory stimuli.

Context blindness has been speculated as having a relationship with other prominent neurocognitive theories of autism spectrum disorder (ASD) such as theory of mind, empathizing–systemizing, social coherence and executive function.

Example
A person with caetextia may look into a mirror to brush their hair but they never brush the back of their hair. This is because the image they saw in the mirror does not show the back of their head and they have not related this image to the bigger picture, or the context. Here, there is a difficulty viewing the situation from a different point of view or in a different context.

Evolutionary importance
Occurring through the whole spectrum is the inability to read context. Through evolutionary psychology, the importance of context when making decisions and performing behaviours can be seen in mammals. Mammals had to develop the ability to store memories of previous information and use this information to influence future encounters more efficiently. This enabled them to perform a risk analysis of different events. They had to make decisions based on the specific circumstances or context that they found themselves in as their survival may depend on it.

To see context, we need to be able to see events from different viewpoints. It was previously believed that mammals simply responded mechanically to stimuli, however, research has concluded that there is a cognitive component involved in their response which involves prior experience. Mammals formed a mechanism capable of gauging risk by processing multiple streams of information whilst at the same time, unconsciously comparing similar, previous experiences. This is called ‘parallel processing’.

The ability to effortlessly switch between separate streams of information can only be achieved when the brain can dissociate. This enables the individual to review what they know about something from previous experience whilst also paying attention to the present.

Alternative theories
The theory of social coherence suggests that, when carrying out tasks, autistic people fail to process information for context dependent meaning. This is prevalent in story telling tasks. If you ask an autistic person to retell a story, they are likely to focus on the small details but will miss the overarching idea, meaning or metaphor. They fail to recognise the main themes as they are not recognising context. If you ask someone not on the autism spectrum to recall a story, they can give you an overview or the central meaning on the story.

Another theory to explain ASD is the lack of ‘theory of mind’ introduced by Baron-Cohen. Some researchers propose that in ASD there is a reduced ability to read other people’s minds and use this to predict other people’s behaviour. Baron-Cohen suggests that thinking about what others are thinking is essential for engaging in social activity as it underpins our ability to learn from each other and cooperate. Research suggests that theory of mind is either absent or delayed in ASD individuals and this can explain their difficulty with social interaction.

However, some 21st century studies have shown that the results of some studies of theory of mind tests on autistic people may be misinterpreted based on the double empathy problem, which proposes that rather than autistic people specifically having trouble with theory of mind, autistic people and non-autistic people have equal difficulty understanding one-another due to their neurological differences. Studies have shown that autistic adults perform better in theory of mind tests when paired with other autistic adults as well as possibly autistic close family members. Academics who acknowledge the double empathy problem also propose that it is likely autistic people understand non-autistic people to a higher degree than vice-versa, due to the necessity of functioning in a non-autistic society.

The link between ASD and psychosis
It has been proposed that caetextia may account for both psychosis and ASD. For example, where an autistic person may be preoccupied with objects and systems and have little sense of self, those with psychosis are preoccupied with relationships and over sensitive to the responses of others.

The underlying mechanism that explains the development of them both could be the REM state, entered during dreaming and daydreaming. Research has shown that instinctive patterns for responding to the environment such as emotions, appetite and urges are programmed during REM sleep in the foetus and new-born. REM sleep, which normally accounts for 80 percent of foetal sleep, is greatly reduced in autistic children.

REM sleep is also key to understanding caetextia. Mammals needed to develop the ability to control impulses that would result in a waste of energy such as pursuing every sound or movement. The development of the ability to suppress impulses that were not in the mammal’s survival interests also bought another requirement: the need to devise a mechanism enabling discharge of the emotional arousal caused by unexpressed impulses. This would allow them to restore an emotional equilibrium and prevent these impulses from being permanently inhibited. This led to REM state of dreaming, to discharge emotional arousal not acted upon. This leads to the overarching theme: that mammals had to learn to make decisions based on context. The REM state in dreaming is caetextic as we have no context in dreams.

Physiological evidence for parallel processing
As the human brain became more sophisticated, the hemispheres of the brain developed specialisations. Language and structured thought primarily uses the left hemisphere and imaginative thinking uses the right hemisphere. People who cannot parallel process tend to rely on one type of thinking – thinking by random association or logical thinking. Left brain caetextia relies on logical thinking. Right brain caetextia relies on random association.

There is physiological evidence for the existence of parallel processing using neuro-imaging techniques of the brain’s default network. When the brain is not engaged with specific outward activity, it uses 30 percent more calories than when it focused inwards, this includes daydreaming, thinking about the past or future and perspective taking. This energy usage has been tracked to the default network. It has been shown that the default network is used in inwards thinking but is switched off in outwards thinking. The default system does not switch on in those with ASD and fails to switch off in psychosis.

The terms left- and right-brain caetextia are oversimplifications. It is now more accurate to see this in terms of default systems. A person with right-brain caetextia is excessively in the default system. Conversely, people with left-brained caetextia are ‘locked out’ of the default system and so unable to relate their current reality to the deeper context in which they exist.