Drawing on sociocultural theories and Bayesian accounts of brain function, in this article we construe psychiatric conditions as disorders of social interaction to fully account for their complexity and dynamicity across levels of description and temporal scales. After an introduction of the theoretical underpinnings of our integrative approach, we take autism spectrum conditions (ASC) as a paradigm example and discuss how neurocognitive hypotheses can be translated into a Bayesian formulation, i.e., in terms of predictive processing and active inference. We then argue that consideration of individuals (even within a Bayesian framework) will not be enough for a comprehensive understanding of psychiatric conditions and consequently put forward the dialectical misattunement hypothesis, which views psychopathology not merely as disordered function within single brains but also as a dynamic interpersonal mismatch that encompasses various levels of description. Moving from a mere comparison of groups, i.e., “healthy” persons versus “patients,” to a fine-grained analysis of social interactions within dyads and groups of individuals will open new avenues and may allow to avoid an overly neurocentric scope in psychiatric research as well as help to reduce social exclusion.

In this article, moving from being to becoming, we construe the 'self' as a dynamic process rather than as a static entity. To this end we draw on dialectics and Bayesian accounts of cognition. The former allows us to holistically consider the 'self' as the interplay between internalization and externalization and the latter to operationalize our suggestion formally. Internalization is considered here as the co-construction of bodily hierarchical models of the (social) world and the organism, while externalization is taken as the collective transformation of the world. We do not consider these processes as sequentially linked, but rather as a dialectic between the collective and the individual. This leads us to the suggestion of the self as a historical product of dialectical attunement across multiple time scales, from species evolution and culture to individual development and everyday learning. Subsequently, we describe concrete means for empirically testing our proposal in the form of two-person psychophysiology and multi-level analyses of intersubjectivity. Taken together, we suggest that a finegrained analysis of social interaction might allow us to reconsider the 'self' beyond the static individual, i.e. how it emerges and manifests itself in social relations. Such an approach, we believe, could be relevant in multiple fields, from ethics and psychiatry to pedagogy and artificial intelligence.

In healthy individuals the anterior cingulate gyrus signals social prediction errors: discrepancies between an actual outcome and the perceived expectations of another person. Balsters et al. demonstrate that this crucial social signal is altered in individuals with autism, and that variability in social prediction error signalling indexes social symptom severity.

Autism is a developmental condition, characterized by difficulties of social interaction and communication, as well as restricted interests and repetitive behaviors. Although several important conceptions have shed light on specific facets, there is still no consensus about a universal yet specific theory in terms of its underlying mechanisms. While some theories have exclusively focused on sensory aspects, others have emphasized social difficulties. However, sensory and social processes in autism might be interconnected to a higher degree than what has been traditionally thought. We propose that a mismatch in sensory abilities across individuals can lead to difficulties on a social, i.e. interpersonal level and vice versa. In this article, we, therefore, selectively review evidence indicating an interrelationship between perceptual and social difficulties in autism. Additionally, we link this body of research with studies, which investigate the mechanisms of action control in social contexts. By doing so, we highlight that autistic traits are also crucially related to differences in integration, anticipation and automatic responding to social cues, rather than a mere inability to register and learn from social cues. Importantly, such differences may only manifest themselves in sufficiently complex situations, such as real-life social interactions, where such processes are inextricably linked.

Psychiatric disorders are ubiquitously characterized by debilitating social impairments. These difficulties are thought to emerge from aberrant social inference. In order to elucidate the underlying computational mechanisms, patients diagnosed with major depressive disorder (N = 29), schizophrenia (N = 31), and borderline personality disorder (N = 31) as well as healthy controls (N = 34) performed a probabilistic reward learning task in which participants could learn from social and non-social information. Patients with schizophrenia and borderline personality disorder performed more poorly on the task than healthy controls and patients with major depressive disorder. Broken down by domain, borderline personality disorder patients performed better in the social compared to the non-social domain. In contrast, controls and major depressive disorder patients showed the opposite pattern and schizophrenia patients showed no difference between domains. In effect, borderline personality disorder patients gave up a possible overall performance advantage by concentrating their learning in the social at the expense of the non-social domain. We used computational modeling to assess learning and decision-making parameters estimated for each participant from their behavior. This enabled additional insights into the underlying learning and decision-making mechanisms. Patients with borderline personality disorder showed slower learning from social and non-social information and an exaggerated sensitivity to changes in environmental volatility, both in the non-social and the social domain, but more so in the latter. Regarding decision-making the modeling revealed that compared to controls and major depression patients, patients with borderline personality disorder and schizophrenia showed a stronger reliance on social relative to non-social information when making choices. Depressed patients did not differ significantly from controls in this respect. Overall, our results are consistent with the notion of a general interpersonal hypersensitivity in borderline personality disorder and schizophrenia based on a shared computational mechanism characterized by an over-reliance on beliefs about others in making decisions and by an exaggerated need to make sense of others during learning specifically in borderline personality disorder.

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Autistic traits are known to be associated with social interaction difficulties. Yet, somewhat paradoxically, relevant research has been typically restricted to studying individuals. In line with the ‘dialectical misattunement hypothesis’ and clinical insights of intact social interactions amongst autistic individuals, we hypothesized that friendship quality varies as a function of interpersonal similarity and more concretely the difference value of autistic traits in a dyad, above and beyond autistic traits per se. Therefore, in this study, we used self-report questionnaires to investigate these measures in a sample of 67 neurotypical dyads across a broad range of autistic traits. Our results demonstrate that the more similar two persons are in autistic traits, the higher is the perceived quality of their friendship, irrespective of friendship duration, age, sex and importantly, the (average of) autistic traits in a given dyad. More specifically, higher interpersonal similarity of autistic traits was associated with higher measures of closeness, acceptance and help. These results, therefore, lend support to the idea of an interactive turn in the study of social abilities across the autism spectrum and pave the way for future studies on the multiscale dynamics of social interactions.

The sense of agency is a core element of self-experiences and is defined as the feeling of oneself being the ‘initiator’ of an action. It is thought to depend on an implicit coupling of action-outcome predictions and the sensory perception of the action. This concept is well-studied in the motor-domain, but less is known about agency during social interactions. It is clear that a sense of agency also occurs when we perform a social action (e. g. looking at someone’s eyes) and receiving feedback by another person (e. g. returning eye-contact). Here, we will refer to the experience of agency within a social interaction as the sense of social agency. The main aim of this article is to first, describe the concept of social agency and second review how virtual reality can help to simulate social interactions in order to systematically study self-experiences and social agency. Gaze-contingent eye-tracking paradigms represent a powerful tool in this endeavour, while we emphasise the importance of implementing ecologically valid, interactive stimuli. We furthermore propose a computational approach that can be useful to analyse such data based on the concept of predictive processing. Finally, we highlight the clinical relevance of this account and suggest how this approach can be helpful in providing a mechanistic description of social impairments across various psychiatric disorders. With this article, we attempt to review previous experimental work, suggest new methodological procedures and encourage future empirical research in the field.