Research in Autism Spectrum Disorders 67 (2019) 101421

Contents lists available at ScienceDirect

Research in Autism Spectrum Disorders

journal homepage: [Link]/locate/rasd

Spanish validation of the “Reading the Mind in the Voice” task: A

T
study of complex emotion recognition in adults with autism
spectrum conditions
Sergio Sánchez-Realesa,b, Carmen Caballero-Peláeza, Javier Prado-Abrilc,
Félix Inchaustid,e, María Lado-Codesidof,g, Alejandro García-Caballeroh,
⁎
Guillermo Laherai,
a
Hospital Virgen del Castillo, Servicio Murciano de Salud, Avda. de la Feria, s/n, 30510 Yecla, Murcia, Spain
b
Universidad Internacional de La Rioja, Avenida de la Paz, 137, C.P. 26006 Logroño, Spain
c
Centro Sanitario Bajo Cinca, Servicio Aragonés de Salud, C/ de la Hermana Andresa, 2, 22520 Fraga, Huesca, Spain
d
CSMIJ Espartero, Servicio Riojano de Salud, Av. Pío XII, 12 Bis, 26003 Logroño, La Rioja, Spain
e
Departamento de Psicología, Universidad de Navarra, Campus Universitario, 31009 Pamplona, Navarra, Spain
f
Hospital Universitario de Donostia, Paseo Dr. Begiristain, s/n, 20014, Donostia-San Sebastian, Guipúzcoa, Spain
g
Universidad de Santiago de Compostela, Praza do Obradoiro, 0, 15705 Santiago de Compostela, A Coruña, Spain
h
Instituto Biomédico Galicia Sur, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Complexo Hospitalario Universitario de
Ourense, C/ Ramon Puga Noguerol, 54, 32005 Orense, Spain
i
Universidad de Alcalá, CIBERSAM, Plaza de San Diego, s/n, 28801 Alcalá de Henares, Madrid, Spain

A R T IC LE I N F O ABS TRA CT

Keywords: Background: Social cognition includes a range of cognitive processes that help individuals un-
Autism spectrum derstand how others think and feel. Recent proposals outline the relevance of this cognitive
Asperger syndrome domain in a broad set of clinical pictures, as well as its diagnostic and prognostic value. In this
Complex emotions study, we present the Spanish validation of the Reading the Mind in the Voice (RMV-SV) task,
Emotion recognition
(Rutherford et al., 2002), an instrument for the recognition of mental states and complex emo-
Emotional prosody
Theory of mind
tions through prosody.
Method: A group of adults diagnosed with autism spectrum disorders (ASD, n = 45) were com-
pared to a control group from the general population (n = 51) in several emotion-recognition
tasks.
Results: The ASD group performed worse than controls overall on complex emotion and mental
state recognition from voices (ŋ2 = .322; p < .01), statistically significant differences were
found on 18/33 specific emotions. A positive correlation was found between verbal and non-
verbal IQ and emotion recognition task scores. Using RMV-SV scores, 87.5% of the participants
were correctly allocated to their original condition group.
Conclusions: The results confirmed the alteration of the recognition of mental states and complex
emotions by prosody among adults diagnosed with ASD. The RMV-SV showed suitable validity

⁎
Corresponding author at: Faculty of Medicine, University of Alcalá, Ctra. Madrid-Barcelona, km. 33, 600 28805 Alcalá de Henares, Madrid,
Spain.
E-mail addresses: [Link]@[Link] (S. Sánchez-Reales), carmencaballeropelaez@[Link] (C. Caballero-Peláez),
jpradoabril@[Link] (J. Prado-Abril), felixinchausti@[Link] (F. Inchausti), [Link]@[Link] (M. Lado-Codesido),
[Link]@[Link] (A. García-Caballero), [Link]@[Link] (G. Lahera).

[Link]
Received 12 April 2019; Received in revised form 12 July 2019; Accepted 15 July 2019
Available online 21 August 2019
1750-9467/ © 2019 Elsevier Ltd. All rights reserved.
S. Sánchez-Reales, et al. Research in Autism Spectrum Disorders 67 (2019) 101421

and reliability indexes, so the adapted task could facilitate the evaluation of complex emotion
recognition through prosody in Spanish.

1. Introduction

Skills development aimed at understanding one’s own or somebody else’s emotional state is an essential aspect by which to cope
with the environmental demands required for personal and social adaptation (Hudepohl, Robins, King, & Henrich, 2015; Olsson &
Ochsner, 2008). Social cognition is central to this field of study. It provides an in-depth view into the mental operations that underlie
social interactions, including perception, interpretation and responses to the intentions, dispositions and behaviours of others (Green
et al., 2008).
Traditionally, research on emotion recognition has been focused on the identification of basic emotions (surprise, disgust, fear,
happiness, sadness and anger) in discrete forms of social communication (facial expression, emotional prosody or body movement),
based on their transcultural relevance (Ekman, 1993) and the correlations between findings from neuroimaging studies with specific
emotions (Kassam, Markey, Cherkassky, Loewenstein, & Just, 2013; Saarimäki et al., 2015). Recent theoretical and methodological
contributions (Feldman Barrett, 2013) suggest that the assessment in this field of tasks of recognition of complex emotions (e.g.,
confusion, disappointment) is more frequent in daily life and depends on the integration of contextual information, based on cog-
nitive assessment and beliefs (Griffiths, 1997; Harris, 1989; Izard, 2007; Zinck & Newen, 2008). Performance of these tasks includes
two classic concepts in the field of social cognition, namely, the theory of mind (ToM) and emotion recognition (ER). According to
recognised definitions, ER refers to the individual’s ability to identify and discriminate emotional states from the observation of signs
in the behaviour of others (Cotter et al., 2018; Spunt & Adolphs, 2019). ToM incorporates the capacity to attribute mental states and
infer intentions, dispositions or beliefs and, on the basis of all this, describe, explain and predict behaviour (Baron-Cohen,
Wheelwright, Hill, Raste, & Plumb, 2001; Frith, 1992; Mathersul, McDonald, & Rushby, 2013).
Pioneering descriptions of autistic spectrum disorders (ASD) define the condition as an “affective contact disorder” (Kanner,
1943). This impression was based on studies that related ASD symptoms with difficulties in processing and interpreting information
of a socioemotional nature (Kuusikko et al., 2009). It has been hypothesised that these difficulties could be the consequence of an
inadequate development of ToM, which organises both the personal emotional world and the interpersonal sphere (Baron-Cohen,
Leslie, & Frith, 1985; Frith, 2003; Hobson & Hobson, 2013).
Nonetheless, literature has shown inconsistencies in the recognition of basic emotions presented within a single form of social
communication that could be preserved (Castelli, 2005; Grossman, 2010; Murphy, Brady, Fitzgerald, & Troje, 2009; Tracy, Robins,
Schriber, & Solomon, 2011) or compensated for (Chevallier, Noveck, Happé, & Wilson, 2011) in a percentage of the population
diagnosed with ASD, whereas at the same time there are clear alterations in an extensive set of ER studies through facial expression
(Harms, Martin, & Wallace, 2010; Uljarevic & Hamilton, 2013), prosody (McCann, Peppé, Gibbon, O’Hare, & Rutherford, 2007) or
body movement (Centelles, Assaiante, Etchegoyhen, Bouvard, & Schmitz, 2013). This empirical disparity may be attributed to
methodological nuances intrinsic to the use of basic emotion tasks in the assessment, such as ceiling effects, the use of multimodal
methodology (face–voice stimuli) or the use of verbal mediation as a compensatory strategy, which may mask their deficits under
certain circumstances. The optimisation of the ecological validity of the measures by using tests based on complex emotions (Baron-
Cohen, Wheelwright, Hill et al., 2001; Baron-Cohen, Wheelwright, Skinner, Martin, & Clubley, 2001; Golan, Baron-Cohen, Hill, &
Rutherford, 2007; Happé, 1994; Rutherford, Baron-Cohen, & Wheelwright, 2002) has been proposed as an alternative to solve the
instability of the results (Dziobek et al., 2006; Golan, Baron-Cohen, & Hill, 2006; Golan, Baron-Cohen, Hill, & Golan, 2006; Stewart,
Mcadam, Ota, Peppé, & Cleland, 2013).
This work focuses on the Spanish version of the Reading the Mind in the Voice task (Rutherford et al., 2002), a task of recognition
of both mental states and complex emotions through prosody. The original instrument included 40 voice segments with a certain
emotional intonation, lasting 2–3 s. The number of correct answers obtained discriminated between a sample of patients with ASD
and a control group. The performance was not conditioned by variables such as intelligence or age. A later review (Golan et al., 2007)
included methodological improvements that optimised their discriminative capacity and exceeded the ceiling effect, in addition to
showing satisfactory psychometric indicators. This study replicates the validation of the task, comparing the performance of a group
of people diagnosed with ASD to a neurotypical control group. We hypothesised an altered performance in the ER tests in the ASD
group versus the control group based on previous research (Golan et al., 2007; Rutherford et al., 2002). Measures for recognition of
complex emotions, and for ASD spectrum symptoms, were included in the design. We also studied the influence of relevant variables
within autistic symptomatology which could effect performance scores on emotion recognition tasks. These variables included verbal
and nonverbal intelligence (Fridenson-Hayo et al., 2016; Rosenblau, Kliemann, Dziobek, & Heekeren, 2017) as well as affective states
(Capps, Kasari, Yirmiya, & Sigman, 1993; Samson, Huber, & Gross, 2012).

2. Materials and methods

2.1. Participants

The clinical group consisted of 45 adults (six female, 39 male) diagnosed with ASD according to DSM-5 criteria (American

2
S. Sánchez-Reales, et al. Research in Autism Spectrum Disorders 67 (2019) 101421

Psychiatric Association, 2013). The age range was between 18 and 40 (M = 23.20, SD = 5.99). Participants were recruited from
several associations, specialised clinics or mental health units in Spain. All patients were diagnosed by mental health professionals,
(clinical psychologists and psychiatrists) with at least two years of sustained diagnosis. All participants completed the Kaufman
Intelligence Brief Test (K-BIT) (Kaufman & Kaufman, 2000), obtaining scores above 80. The average group scores on the intelligence
test were 104.96 (SD = 8.75) for verbal IQ, 106.58 (SD = 9.91) for nonverbal IQ and 104.64 (SD = 10.53) for combined IQ.
The control group consisted of 51 people (23 female, 28 male) aged 18–45 (M = 21.45, SD = 6.45) and neurotypical develop-
ment, recruited from the Medicine and Health Science School of the University of Alcalá through voluntary practice. The Spanish
version of the Autism Spectrum Quotient test (Baron-Cohen, 2005; Baron-Cohen, Wheelwright, Skinner et al., 2001) was used as a
screening test for autistic traits. None of the participants was excluded from this group. Control group participants completed tests
similar to those of the ASD group, with an average group score in the K-BIT of 108.58 (SD = 9.42) in verbal IQ, 106.75 (SD = 8, 22)
in nonverbal IQ, and 107.06 (SD = 8.08) in combined IQ.
Table 1 shows sociodemographic data. Both groups were paired by means of age; education; and verbal, nonverbal and combined
IQ variables. Gender differences between groups were statistically controlled.

2.2. Instruments

2.2.1. Reading the Mind in the Voice task: Spanish version

The original test was developed by Rutherford et al. (2002), later revised by Golan et al. (2007), and assesses the recognition of
complex emotions and mental states through prosody. Participants have to decide what a character is feeling or thinking as they are
exposed to an interpreted text. The subjects had to choose one of four answers, of which only one was correct. Simultaneously, a
consultation sheet with the definition of each of the emotional states was given. Golan´s review showed test–retest reliability in-
dicators of .8 and discriminant capacity higher than 85% in ASD and controls.

2.2.2. Adaptation of the task to the Spanish population

Golan’s methodology was followed in the Spanish adaptation (Rutherford et al., 2002). Two translators were used to develop the
Spanish version, following the methodological standard (Brislin, 1970). Eight professional actors (four female, four male) interpreted
the items in a neutral Spanish accent. Each of them recorded the interpretation of one half of the questionnaire according to the
emotional tone of the items. Five expert clinical psychologists (two female, three male) rated the representativeness of each of the
four interpretations of each item to the emotional state they intended to transmit, scoring them on a Likert scale from 1 to 4 (1 = “It
does not fit the emotion”; 4 = “It fits the emotion perfectly”). The interpretation with the highest score was selected for each item.
Items that did not reach the score of 2 were excluded; thus, a first version of the 39-item instrument emerged. This version was
ultimately administered to a group of 19 people from the general population (nine female, 10 male, age M = 32.7, SD = 5.34), using
similar conditions to those proposed in the research design. The final version included only those items whose target answer was
chosen by at least half of the participants (nine or more), and if the incorrect options were not selected by more than a third of the
participants (five or fewer).The final version of the instrument contained 33 items (see Electronic Supplementary Material 1 and 2).

[Link]. Reading the mind in the eyes test: Spanish version (RME-SV; Fernández-Abascal, Cabello, Fernández-Berrocal, & Baron-Cohen,
2013). The Reading the Mind in the Eyes test assesses recognition of complex emotions and mental states from 36 photographs of
people’s gaze (Baron-Cohen, Wheelwright, Hill et al., 2001; Baron-Cohen, Wheelwright, Skinner et al., 2001), administered as a
multiple-choice test with four adjectives that describe emotional states. It was provided together with an auxiliary sheet with the
definitions of the adjectives listed, which could be consulted. The Spanish translation showed good psychometric indicators and one-
year test–retest stability, with an interclass correlation coefficient (ICC) = .63.

[Link]. Autism spectrum quotient: Spanish translation (AQ) (Baron-Cohen, 2005). This is a 50-item self-report that assesses the degree
to which an adult with normal IQ has traits associated with the autistic spectrum (Baron-Cohen, Wheelwright, Hill et al., 2001; Baron-
Cohen, Wheelwright, Skinner et al., 2001). Scores ranged from 0 to 50. According to Baron-Cohen´s Spanish version, scores higher
than 36 were considered an indication of autism. It has shown good discriminant validity (Woodbury-Smith, Robinson, Wheelwright,

Table 1
Means, standard deviations and ranges of chronological age and IQ scores.
ASD (n = 45) Control group (n = 51)

M SD Range % M SD Range % t(94) χ² p

Age 23.20 5.99 18–40 21.45 6.24 18–45 2.29 .13

Verbal IQ 104.64 10.53 124–79 107.06 8.08 127–72 1.03 .30
Non Verbal IQ 106.58 9.91 121–88 106.75 8.22 123–86 1.33 .18
Total IQ 104.36 8.75 121–87 108.58 9.42 118–85 1.71 .09

Female 20.7 45.1 11.44 < .01

Higher Secondary Education 97.8 100 1.14 .28

Bold text indicates a statistically significant difference with a p-value less than 0.05.

3
S. Sánchez-Reales, et al. Research in Autism Spectrum Disorders 67 (2019) 101421

& Baron-Cohen, 2005) and a test–retest validity of .7. The Spanish validation of this instrument is currently being developed. The
scores showed a Cronbach’s α of .92 in this study.

[Link]. Positive and negative affect schedule: Spanish adaptation (PANAS; López-Gómez, Hervás, & Vázquez, 2015). This is a 20-item
self-report questionnaire (Watson, Clark, & Tellegen, 1988). In scientific literature, it is one of the most frequently used measures to
assess emotions. It has shown excellent psychometric properties in the Spanish population, with a bi-factorial structure (Positive
Affect and Negative Affect). This assessment measure was only used in the ASD group.

[Link]. Kaufman brief intelligence test (K-BIT) (Kaufman & Kaufman, 2000). This is a brief intelligence test used in samples
comprising participants between 4 and 90 years old. It is divided into two subtests: Vocabulary and Matrices. It provides two IQ
indicators (verbal and nonverbal) and a combined IQ. The internal consistency and test–retest stability coefficients are higher than
.85 in both subtests.

2.3. Procedure

This research was approved by the Clinical Research Ethics Committee of the General University Hospital of Elche. All procedures
performed in this study were conducted in accordance with the ethical standards of the institutional research committees and the
Declaration of Helsinki as revised in 2000. Informed consent was obtained from all individual participants included in the study.
The administration of the aforesaid instruments was carried out by qualified staff in each of the centres the participants attended.
The first individual 60-minute assessment session included the collection of sociodemographic information, AQ, K-BIT, RME-SV and
PANAS results (the latter only for the ASD group), questionnaires in pencil and paper format, together with the RMV-SV, presented on
Microsoft PowerPoint 2007©. Half of the participants from the ASD group repeated the RMV-SV 15 days after the first assessment, in
a 20-minute session.

2.4. Statistical analysis

Group scores were compared in the different measures used, following the strategy of data analysis of the original validation
studies. The distribution of all dependent variables, except K-BIT scores, failed to fulfil the assumption of homoscedasticity, so the
intergroup differences were analysed by means of an ANOVA based on the Welch test (Moder, 2010). Given the gender differences
between groups, an additional intra-group comparison of performance in each task was carried out by applying the Student’s t-test.
The correlation between measures, test–retest reliability and discriminative capacity of the instrument were analysed on the basis of
discriminant analysis. Calculations were made with the SPSS 19 (IBM Corp., 2010) statistical package. The statistical power of the test
(1-β) was calculated from the G*Power program, version [Link] (Faul, Erdfelder, Lang, & Buchner, 2007).

3. Results

All participants from the control group and the ASD group, except two, exceeded the correct answers expected by chance in the
RMV-SV (12 points, p < .05, binomial test). Only one of the participants from the ASD group scored below the RME-SV chance result
(13 points, p < .05, binomial test). Table 2 includes score descriptions and comparisons in each test or questionnaire used in the
design.

Table 2
Mean scores of males and females.
ASD (n = 45) Control group (n = 51)

M SD Range M SD Range F p η2

RMV-SV 21.73 4.92 7–28 26.78 1.88 22–30 41.96 < .01 .32
Female 20.16 6.40 8–25 27.04 1.77 25–30
Male 21.97 4.72 7–28 26.57 1.97 22–30
RME-SV 22.05 4.49 11–32 27.51 3.10 13–34 46.208 < .01 .34
Female 22.67 3.50 19–29 27.74 3.16 21–32
Male 21.95 4.65 11–32 27.32 3.09 22–34
AQ 30.25 7.92 15–48 13.92 6.10 4–33 123.53 < .01 .57
Female 30.67 10.67 15–48 12.35 4.60 4–20
Male 30.18 7.59 15–42 15.21 6.91 4–33

Notes: RMV-SV = “Reading the Mind in the Voice” Task–Spanish version; RME-SV = “Reading the mind in the eyes”- Test-Spanish Version; AQ = Autism
Spectrum Quotient-Spanish Version.
Bold text indicates a statistically significant difference with a p-value less than 0.05.

4
S. Sánchez-Reales, et al. Research in Autism Spectrum Disorders 67 (2019) 101421

3.1. Reading the Mind in the Voice task: Spanish version

The control group participants attained significantly higher scores in 18 out of 33 items, plus three items that showed marginal
differences (p = .06). The overall score was higher in the ASD group than in the control group in items 9 (Surprise), 12 (Fury) and 28
(Resignation), without reaching statistical significance (see Table 3).
Comparison between groups showed significant differences in the performance of the test (F[1,55,23]) = 41.96, p < .01,
η2 = .32) for the control group. The comparison of performance according to gender did not show differences in the control group (t
[49] = .89, p = .38) or in the ASD group (t[43] = −.83, p = .41).

3.2. Reading the mind in the eyes test: Spanish version

The results showed statistically significant inter-group differences (F[1,74,80] = 46.21, p < .01, η2 = .34), with higher scores for
the control group. Gender differences were not significant in either the control group (t[49] = .47, p = .64) or the clinical group (t
[43] = .37, p = .72).

3.3. Autism spectrum quotient: Spanish version

ANOVA analysis showed significantly higher scores in the ASD group (F[1,80,18] = 123.53, p < .01, η2 = .57). There were no
intra-group differences according to gender in either the control group (t[49] = −.70, p = .09) or the clinical group (t[43] = .14,
p = .89).

3.4. Correlations between RMV-SV and other relevant variables

The pattern of bivariate correlations between scores in the different emotion recognition tasks and other relevant variables is

Table 3
Frequency of correct responses to the “Reading the Mind in the Voice” Task-Spanish version items.
Control (n = 51) ASD (n = 45)

Item f f Dif % χ²(p)

1 16 8 13.6 2.36 (.12)

2 51 42 7 3.51 (.06)
3 46 27 30.2 11.96 (< .01)
4 51 36 20 11.25 (< .01)
5 38 32 3.4 .14 (.71)
6 39 23 25.4 6.71 (.01)
7 51 40 7 3.51 (.06)
8 46 33 16.9 4.66 (.03)
9 16 18 −8.6 .78 (.38)
10 42 27 22.4 5.91 (.01)
11 50 41 6.9 2.34 (.13)
12 31 32 −10.3 1.96 (.29)
13 50 38 13.6 5.78 (.01)
14 41 28 18.2 3.90 (.04)
15 44 31 17.4 4.28 (.04)
16 30 16 23.24 5.19 (.23)
17 46 36 10.2 1.96 (.15)
18 41 28 18.2 3.90 (.04)
19 43 36 2.1 .75 (.78)
20 44 27 26.3 8.57 (< .01)
21 48 32 23 9.11 (< .01)
22 41 22 31.5 10.52 (< .01)
23 31 27 .8 .01 (.93)
24 48 30 23 11.82 (< .01)
25 49 34 31.5 7.32 (.07)
26 32 13 33.81 11.00 (< .01)
27 49 33 22.8 9.92 (< .01)
28 28 27 −5.1 .25 (.61)
29 50 40 9.1 3.42 (.06)
30 48 39 7.4 1.56 (.211)
31 37 25 16.9 3.02 (.08)
32 50 36 18 8.34 (< .01)
33 39 17 38.7 14.72 (< .01)

Note: Dif % = Difference between percentage of correct responses in the control and ASD groups.
Bold text indicates a statistically significant difference with a p-value less than 0.05.

5
S. Sánchez-Reales, et al. Research in Autism Spectrum Disorders 67 (2019) 101421

presented in Table 4. RMV-SV scores correlated positively with RME-SV scores (r = .593, p < .01), verbal IQ (r = .439, p < .01)
and nonverbal IQ (r = .275, p < .01). However, the AQ score showed a negative correlation (r = −.434, p < .01). The RME-SV task
was directly associated with verbal IQ variables (r = .378, p < .01) and nonverbal IQ (r = .308, p < .01), and correlated inversely
with the score in AQ (r = −.450, p < .01) and negative affect (r = −.339, p < .01). The correlations between RME-SV and the
PANAS dimensions were inverse and significant both for positive affect (r = −.325, p = .03) and for negative affect (r = −.31,
p = .03).

3.5. Power, reliability and validity

The ER task is usually limited by the ceiling effect; thus, the calculation of the power of the RMV-SV task (bilateral, α = .01)
offered a 1-β indicator = .999. Furthermore, an item-by-item descriptive analysis showed that only three out of 33 items reported
100% correct answers in the control group, and up to 12 correct answers reached 90%. No items reached 100% success and only three
exceeded 90% in the ASD group, so the ceiling effect risk was dismissed in the Spanish version of the instrument (see Electronic
Supplementary Material 3 for percentages of correct response by item).
Item scores in the RMV-SV were used in a discriminant analysis, showing a statistically significant discriminant function
(χ²(33) = 60.358; p < .01). It correctly classified 87.5% of the total sample; 90.19% of the sample was correctly classified in the
control group compared to 84.44% of the ASD group. Test–retest validity was calculated in a subgroup of clinical participants
(n = 24), and a significant correlation, r = .801 (p < .01), was obtained.

4. Discussion and implications

The general objective of this research work was the translation, adaptation and validation of the Reading the Mind in the Voice
task and its review. After translation and the interpretation of the items by professional actors, we strictly replicated the procedure
described by Golan et al. (2007) based on the original instrument proposed by Rutherford et al. (2002) and obtained a final 33-item
Spanish version. So far, this is the first known evaluation test on recognition of complex emotions and mental states through prosody
in Spanish.
The ASD group participants had a lower overall score than the control group, showing worse performance, similar to the results in
Anglo-Saxon samples. Reliability and discriminative capacity indicators were satisfactory. The reliability of the Spanish version was
similar to the English version. The discriminative function of the translated instrument significantly improved the discriminative
function of the control group participants compared to previous works. Ceiling or floor effects could be ruled out due to the score
range obtained. This is usually one of the main methodological difficulties found in this type of measure.
The hypothesis made about better performance in the identification of emotion or mental states by the control group was con-
firmed by the analysis of the RMV-SV item-to-item scores. Significant differences were found in 19 of the 33 items. Unexpectedly, the
ASD group showed a higher percentage of right answers in three of these items than the control group did. These items included the
emotions of surprise, anger and resignation. Although this finding has been reported in both Anglo-Saxon versions, authors such as
Doi et al. (2013) have reported an optimised performance in ER tasks for the items with the lowest emotional intensity in the ASD
sample. In addition, two of these are considered basic emotions (surprise and anger). These emotions are less difficult to recognise for
this population (Chevallier et al., 2011).
Research on the identification of emotional states presented through prosody in individuals diagnosed with ASD has traditionally
offered inconsistent results and has included both impaired performance (Globerson, Amir, Kishon-Rabin, & Golan, 2015; Loveland
et al., 1995; McCann et al., 2007) and execution similar to normal groups (Loveland, 1997, Chevallier et al., 2011; Grossman, 2010;
Mazefsky & Oswald, 2007). Certain methodological issues could explain this variation (McCann & Peppé, 2003; Zinck & Newen,
2008). This study indicates that using measures with higher ecological validity do indeed elicit the difficulties in processing social

Table 4
Correlations of “Reading the Mind in the Voice” Task- Spanish Version (RMV-SV) and
“Reading the Mind in the Eyes” Test- Spanish version (RME-SV) with AQ, age and IQ
scores.
RMV-SV RME-SV

RME-SV .593**
AQ −.434** −.450**
Verbal IQ .439** .378**
Non Verbal IQ .275** .325
Positive affecta −.134 −.325*
Negative affecta −.219 −.318*
Age .207 −.257

Note: AQ = Autism Spectrum Quotient-Spanish Version.

Bold text indicates a statistically significant difference with a p-value less than 0.05.
a
Only in the ASD group.
* Correlation is significant at the .05 level (2-tailed).
** Correlation is significant at the .01 level (2-tailed).

6
S. Sánchez-Reales, et al. Research in Autism Spectrum Disorders 67 (2019) 101421

information faced by adults diagnosed with ASD (Rosenblau et al., 2017). While basic emotions elicit distinctive responses with
remarkable haste, little cognitive participation, characteristic facial expressions and body movements or tone of voice that are easily
identified, in everyday life these basic emotions are seldom found in isolation. On the other hand, complex emotions require the
attribution of an additional cognitive state to the recognition of an emotion, largely dependent on context and culture (Golan, Baron-
Cohen, Hill et al., 2006). Therefore, alterations in the recognition of emotional prosody in ASD patients could contribute to a more
difficult adaptation to social interactions.
The correlation pattern between RMV-SV scores and measures of emotional recognition or autistic symptomatology confirms the
concurrent validity of the measure. Similar to previous studies (Golan et al., 2007), RMV-SV scores directly correlated with RME-SV, a
similar test of emotion recognition through the eyes. Inverse correlation was highlighted with respect to the score in the AQ test, an
instrument for autistic spectrum traits assessment. Literature frequently shows negative affects in people with ASD (Samson et al.,
2012), but neither the negative nor the positive affect correlated with the RMV-SV scores. Both variables correlated inversely with
respect to the RME-SV. This result was unexpected, and perhaps it points to the effect of affective activation on ER performance.
Several studies, including transcultural ones (Fridenson-Hayo et al., 2016), have shown the relationship between verbal in-
telligence measures and ER, particularly for complex emotions (Golan et al., 2007; Rosenblau et al., 2017). This association has been
interpreted as secondary to the capacity for content integration and verbal input intonation, though it could also reflect compensatory
strategies, based on verbal content analysis during test performance (Globerson et al., 2015). An unexpected result between non-
verbal intelligence and performance in emotion recognition tests by prosody was found. This finding suggests that other skills might
be involved, different to those associated with verbal intelligence. Further research is required.
There are several limitations to this study. The clinical sample selection criteria were carried out by specialist physicians, ac-
cording to diagnostic criteria from international classifications, without using diagnostic assessment measures such as the Autism
Diagnostic Interview-Revised (ADI-R) (Lord, Rutter, & Lecouteur, 1994) or the Autism Diagnostic Observation Schedule (ADOS)
(Lord, Luyster, Gotham, & Guthrie, 2012). This would have allowed a more detailed study of particular aspects that are part of the
diagnosis and its interaction with emotional prosody recognition skills. Furthermore, ecological validity of ER measures is limited by
the static nature of the stimuli included in the RMV-SV, far away from daily interactions. Recently, some ER batteries have been
proposed for dynamic stimuli (Golan, Baron-Cohen, Hill, 2006; Lassalle et al., 2019). Although validated in other European countries,
these are yet to be translated into Spanish. An important limitation is that people in the autistic spectrum show heterogeneous clinical
characteristics (Pelphrey, Shultz, Hudac, & Vander Wyk, 2011). Gender distribution of the diagnosis in the population is three to four
times more frequent among males (Loomes, Hull, & Mandy, 2017), so analysis with statistical power is hindered. A final limitation is
that the conclusions considered only the average-upper range of the IQ continuum. Future studies should take into account the
inclusion of a wider IQ range sample to verify the relation between variables.
The RMV-SV is a reasonable measure for assessment of adults’ recognition of complex emotions and mental states through
prosody in Spanish. It has shown construct validity, reliability and discriminative capacity, making it suitable for use in both clinical
and research contexts. We do not know of any similar measure in Spanish, so its use will complement the study of clinical syndromes
that show this altered capacity, such as ASD, neurocognitive disorders, mood disorders or the schizophrenia spectrum disorders
(Frühholz & Staib, 2017). Other uses of this instrument include research on aspects related to these diagnoses, such as the expanded
autistic phenotype (Oerlemans et al., 2014) or the longitudinal evaluation of therapeutic interventions on one’s emotion recognition
skills (Berggren et al., 2017).

Data statement

Due to privacy policies of the associations and mental health units that collaborated in the study, the participants were assured
that raw data would remain confidential and would not be shared.

Declaration of Competing Interest

There were no conflicts of interest for any of the authors when conducting this research.

Acknowledgments

The authors would like to thank the participants who made this research possible, and the personnel of the associations that
participated in this study out of kindness: Asociación Asperger Alicante (ASPALI), Asociación Asperger y TGD de Aragón (Zaragoza),
Asociación de familiares y personas con Autismo (ADANSI, Gijón), Asociación Sevillana de Síndrome de Asperger and Fundació
Friends (Barcelona). We also acknowledge the excellent work of the actors of the Espacio Labruc (Madrid) who collaborated in an
altruistic way. Special thanks to Jose Antonio Aldaz Armendariz for his assistance in revising the final manuscript.

References

American Psychiatric Association (2013). Manual Diagnóstico y Estadístico de los Trastornos Mentales (5a ed.). Madrid: Editorial Médica Panamericana.
Baron-Cohen, S. (2005). La gran diferencia: cómo son realmente los cerebros de hombres y mujeres. Barcelona: Amat Editorial.
Baron-Cohen, S., Leslie, A., & Frith, U. (1985). The autistic child have a “theory of mind”? Cognitive Development, 21, 37–46.
Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., & Plumb, I. (2001). The “reading the mind in the eyes” Test revised version: a study with normal adults, and adults

7
S. Sánchez-Reales, et al. Research in Autism Spectrum Disorders 67 (2019) 101421

with Asperger syndrome or high-functioning autism. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 42(2), 241–251.
Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The Autism-Spectrum Quotient (AQ): Evidence from Asperger syndrome/high-
functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31(1), 5–17.
Berggren, S., Fletcher-Watson, S., Milenkovic, N., Marschik, P. B., Bölte, S., & Jonsson, U. (2017). Emotion recognition training in autism spectrum disorder: A
systematic review of challenges related to generalizability. Developmental Neurorehabilitation, 21(3), 141–154.
Brislin, R. W. (1970). Back-translation for cross-cultural research. Journal of Cross-Cultural Psychology, 1(3), 185–216.
Capps, L., Kasari, C., Yirmiya, N., & Sigman, M. (1993). Parental perception of emotional expressiveness in children with autism. Journal of Consulting and Clinical
Psychology, 61(3), 475–484. [Link]
Castelli, F. (2005). Understanding emotions from standardized facial expressions in autism and normal development. Autism, 9(4), 428–449.
Centelles, L., Assaiante, C., Etchegoyhen, K., Bouvard, M., & Schmitz, C. (2013). From action to interaction: Exploring the contribution of body motion cues to social
understanding in typical development and in autism spectrum disorders. Journal of Autism and Developmental Disorders, 43(5), 1140–1150.
Chevallier, C., Noveck, I., Happé, F., & Wilson, D. (2011). What’s in a voice? Prosody as a test case for the theory of mind account of autism. Neuropsychologia, 49(3),
507–517.
Cotter, J., Granger, K., Backx, R., Hobbs, M., Looi, C. Y., & Barnett, J. H. (2018). Social cognitive dysfunction as a clinical marker: A systematic review of meta-analyses
across 30 clinical conditions. Neuroscience & Biobehavioral Reviews, 84, 92–99.
Doi, H., Fujisawa, T. X., Kanai, C., Ohta, H., Yokoi, H., Iwanami, A., ... Shinohara, K. (2013). Recognition of facial expressions and prosodic cues with graded emotional
intensities in adults with Asperger syndrome. Journal of Autism and Developmental Disorders, 43(9), 2099–2113.
Dziobek, I., Fleck, S., Kalbe, E., Rogers, K., Hassenstab, J., Brand, M., ... Convit, A. (2006). Introducing MASC: A movie for the assessment of social cognition. Journal of
Autism and Developmental Disorders, 36(5), 623–636.
Ekman, P. (1993). Facial expression and emotion. American Psychologist, 48, 384–392.
Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G*Power: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences.
Behavior Research Methods, 39(2), 175–191.
Feldman Barrett, L. (2013). Psychological construction: The darwinian approach to the science of emotion. Emotion Review, 5(4), 379–389.
Fernández-Abascal, E. G., Cabello, R., Fernández-Berrocal, P., & Baron-Cohen, S. (2013). Test-retest reliability of the “Reading the Mind in the Eyes” test: A one-year
follow-up study. Molecular Autism, 4(1), 33.
Fridenson-Hayo, S., Berggren, S., Lassalle, A., Tal, S., Pigat, D., Bölte, S., ... Golan, O. (2016). Basic and complex emotion recognition in children with autism: Cross-
cultural finding. Molecular Autism, 7(1).
Frith, C. D. (1992). The cognitive neuropsychology of schizophrenia. Hove, UK: Lawrence Erlbaum Associates.
Frith, U. (2003). Autismo: Hacia una explicación del enigma. Madrid: Alianza Editorial.
Frühholz, S., & Staib, M. (2017). Neurocircuitry of impaired affective sound processing: A clinical disorders perspective. Neuroscience and Biobehavioral Reviews, 83,
516–524.
Globerson, E., Amir, N., Kishon-Rabin, L., & Golan, O. (2015). Prosody recognition in adults with high-functioning autism spectrum disorders: From psychoacoustics to
cognition. Autism Research, 8(2), 153–163.
Golan, O., Baron-Cohen, S., & Hill, J. (2006). The Cambridge Mindreading (CAM) face-voice battery: Testing complex emotion recognition in adults with and without
Asperger syndrome. Journal of Autism and Developmental Disorders, 36(2), 169–183.
Golan, O., Baron-Cohen, S., Hill, J. J., & Golan, Y. (2006). The ‘“reading the mind in films”’ task: Complex emotion recognition in adults with and without autism
spectrum conditions. Social Neuroscience, 1(2), 111–123.
Golan, O., Baron-Cohen, S., Hill, J. J., & Rutherford, M. D. (2007). The “Reading the Mind in the Voice” test-revised: A study of complex emotion recognition in adults
with and without autism spectrum conditions. Journal of Autism and Developmental Disorders, 37(6), 1096–1106.
Green, M. F., Penn, D. L., Bentall, R., Carpenter, W. T., Gaebel, W., Gur, R. C., ... Heinssen, R. (2008). Social cognition in schizophrenia: An NIMH workshop on
definitions, assessment, and research opportunities. Schizophrenia Bulletin, 34(6), 1211–1220.
Griffiths, P. (1997). What emotions really are: The problem of psychological categories. Chicago: University of Chicago Press.
Grossman (2010). Lexical and affective prosody in children with high functioning autism. Journal of Speech Language and Hearing Research, 53(3), 778–793.
Happé, F. (1994). An advanced test of theory of mind: Understanding of story characters’ thoughts and feelings by able autistic, mentally handicapped, and normal
children and adults. Journal of Autism and Developmental Disorders, 24(2), 129–154.
Harms, M. B., Martin, A., & Wallace, G. L. (2010). Facial emotion recognition in autism spectrum disorders: A review of behavioral and neuroimaging studies.
Neuropsychology Review, 20(3), 290–322.
Harris, P. (1989). Children and emotion: The development of psychological understanding. Cambridge, MA, US: Basil Blackwell.
Hobson, P. R., & Hobson, J. A. (2013). Autism: Self and others. In S. Baron-Cohen, H. Tager-Flusberg, & M. Lombardo (Eds.). Understanding other minds: Perspectives
from developmental social neuroscience(3a ed). Oxford, UK: Oxford University Press.
Hudepohl, M. B., Robins, D. L., King, T. Z., & Henrich, C. C. (2015). The role of emotion perception in adaptive functioning of people with autism spectrum disorders.
Autism, 19(1), 107–112.
IBM Corp. Released 2010. IBM SPSS Statistics for Windows, Version 19.0. Armonk, NY: IBM Corp.
Izard, C. E. (2007). Basic emotions, natural kinds, emotion schemas, and a new paradigm. Perspectives on Psychological Science, 2(3), 260–280.
Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217–250.
Kassam, K. S., Markey, A. R., Cherkassky, V. L., Loewenstein, G., & Just, A. (2013). Identifying emotions on the basis of neural activation. PLoS One, 8(June (6)),
[Link]
Kaufman, A. S., & Kaufman, N. L. (2000). Test Breve de inteligencia de Kaufman. Madrid: TEA Editores.
Kuusikko, S., Haapsamo, H., Jansson-Verkasalo, E., Hurtig, T., Mattila, M.-L., Ebeling, H., ... Moilanen, I. (2009). Emotion recognition in children and adolescents with
autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(6), 938–945.
Lassalle, A., Pigat, D., O’Reilly, H., Berggen, S., Fridenson-Hayo, S., Tal, S., ... Lundqvist, D. (2019). The EU-emotion voice database. Behavior Research Methods, 51(2),
493–506. [Link]
Loomes, R., Hull, L., & Mandy, W. P. L. (2017). What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. Journal of the
American Academy of Child and Adolescent Psychiatry, 56(6), 466–474.
López-Gómez, I., Hervás, G., & Vázquez, C. (2015). Adaptación de la “Escalas de afecto positivo y negativo” (PANAS) en una muestra general española. Behavioral
Psychology/ Psicologia Conductual, 23(3), 529–548.
Lord, C., Luyster, R., Gotham, K., & Guthrie, W. (2012). Autism diagnostic observation schedule (2a). Torrence, CA: Western Psychological Services.
Lord, C., Rutter, M., & Lecouteur, A. (1994). Autism diagnostic interview - revised: A revised version of a diagnostic interview for carers of individuals with possible
pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24(5), 659–685.
Loveland, K. (1997). Emotion recognition in autism: Verbal and nonverbal information. Development and Psychopathology, 9(3), 579–593.
Loveland, K. A., Tunali-Kotoski, B., Chen, R., Brelsford, K. A., Ortegon, J., & Pearson, D. A. (1995). Intermodal perception of affect in persons with autism or Down
syndrome. Development and Psychopathology, 7(3), 409–418.
Mathersul, D., McDonald, S., & Rushby, J. A. (2013). Understanding advanced theory of mind and empathy in high-functioning adults with autism spectrum disorder.
Journal of Clinical and Experimental Neuropsychology, 35(6), 655–668.
Mazefsky, C. A., & Oswald, D. P. (2007). Emotion perception in Asperger’s syndrome and high-functioning autism: The importance of diagnostic criteria and cue
intensity. Journal of Autism and Developmental Disorders, 37(6), 1086–1095.
McCann, J., & Peppé, S. (2003). Prosody in autism spectrum disorders: A critical review. International Journal of Language and Communication Disorders, 38(4), 325–350.
McCann, J., Peppé, S., Gibbon, F. E., O’Hare, A., & Rutherford, M. (2007). Prosody and its relationship to language in school-aged children with high-functioning
autism. International Journal of Language and Communication Disorders, 42(6), 682–702.

8
S. Sánchez-Reales, et al. Research in Autism Spectrum Disorders 67 (2019) 101421

Moder, K. (2010). Alternatives to F-test in one way ANOVA in case of heterogeneity of variances (a simulation study). Psychological Test and Assessment Modeling, 52(4),
343–353.
Murphy, P., Brady, N., Fitzgerald, M., & Troje, N. F. (2009). No evidence for impaired perception of biological motion in adults with autistic spectrum disorders.
Neuropsychologia, 47(14), 3225–3235.
Oerlemans, A. M., Van Der Meer, J. M. J., Van Steijn, D. J., De Ruiter, S. W., De Bruijn, Y. G. E., De Sonneville, L. M. J., ... Rommelse, N. N. J. (2014). Recognition of
facial emotion and affective prosody in children with ASD (+ADHD) and their unaffected siblings. European Child and Adolescent Psychiatry, 23(5), 257–271.
Olsson, A., & Ochsner, K. N. (2008). The role of social cognition in emotion. Trends in Cognitive Sciences, 12(2), 65–71.
Pelphrey, K. A., Shultz, S., Hudac, C. M., & Vander Wyk, B. C. (2011). Research Review: Constraining heterogeneity: The social brain and its development in autism
spectrum disorder. Journal of Child Psychology and Psychiatry, 52(6), 631–644.
Rosenblau, G., Kliemann, D., Dziobek, I., & Heekeren, H. R. (2017). Emotional prosody processing in autism spectrum disorder. Social Cognitive and Affective
Neuroscience, 12(2), 224–239.
Rutherford, M. D., Baron-Cohen, S., & Wheelwright, S. (2002). Reading the mind in the voice: A study with normal adults and adults with Asperger syndrome and high
functioning autism. Journal of Autism and Developmental Disorders, 32(3), 189–194.
Saarimäki, H., Gotsopoulos, A., Jääskeläinen, I. P., Lampinen, J., Vuilleumier, P., Hari, R., ... Nummenmaa, L. (2015). Discrete neural signatures of basic emotions.
Cerebral Cortex, 26(June (6)), 2563–2573. [Link]
Samson, A. C., Huber, O., & Gross, J. J. (2012). Emotion regulation in Asperger’s syndrome and high-functioning autism. Emotion, 12(4), 659–665.
Spunt, R. P., & Adolphs, R. (2019). The neuroscience of understanding the emotions of others. Neuroscience Letters, 693, 44–48. [Link]
06.018.
Stewart, M. E., Mcadam, C., Ota, M., Peppé, S., & Cleland, J. (2013). Emotional recognition in autism spectrum conditions from voices and faces. Autism, 17(1), 6–14.
Tracy, J. L., Robins, R. W., Schriber, R. A., & Solomon, M. (2011). Is emotion recognition impaired in individuals with autism spectrum disorders? Journal of Autism and
Developmental Disorders, 41(1), 102–109.
Uljarevic, M., & Hamilton, A. (2013). Recognition of emotions in autism: A formal meta-analysis. Journal of Autism and Developmental Disorders, 43(7), 1517–1526.
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality
and Social Psychology, 54(6), 1063–1070.
Woodbury-Smith, M. R., Robinson, J., Wheelwright, S., & Baron-Cohen, S. (2005). Screening adults for Asperger syndrome using the AQ: A preliminary study of its
diagnostic validity in clinical practice. Journal of Autism and Developmental Disorders, 35(3).
Zinck, A., & Newen, A. (2008). Classifying emotion: A developmental account. Synthese, 161(1), 1–25.