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BackgroundConcrete thinking is one of the common clinical features of patients with schizophrenia, especially chronic and symptomatically severe patients. Until now, neuropsychological tests or proverb tests have been used to measure the difficulty of abstract thinking in patients with schizophrenia, but these methods have been difficult to know how concrete thinking patterns affect daily living of schizophrenia patients. In this study, we constructed a task that supposes the purchase of clothes in order to realize a situation close to the decision making of everyday life and tried to visualize the thinking process through eye-tracking method.MethodsEach twenty of healthy controls and schizophrenia patients performed the task of purchasing clothes. In serial, subjects are asked whether the clothes are fancy, suitable for themselves, affordable and whether they would buy the clothes. The eye gaze information was obtained by using the eye tracking system of the SensoMotoric Instrument, and the fixation time in the face and the clothes areas was measured. The changes of the fixation time ratio of the face to the clothes between the matching and the purchasing decision blocks for each group were compaired using repeated-measure ANOVA and the change of the ratio in patients with schizophrenia was analyzed with the PANSS concrete thinking score using generalized estimating equations. To investigate the relationship between the fixation time ratio and the answer of the purchasing block, two-way ANOVA with post hoc independent T-test was used.ResultsThere was a significant interaction effect between the groups on the change of the fixation time ratio(p<0.001). In the patient group, the fixation time ratio decreased (matching:0.474 ± 0.044, purchasing:0.206 ± 0.069) while the fixation time ratio increased in the control group (preference:0.233 ± 0.041, purchase decision:0.463 ± 0.064). To investigate whether the change of the fixation time ratio is affected by the degree of concrete thinking, the odds ratio of the concrete thinking score to the fixation time ratio was calculated as 0.825(95% CI; 0.684–0.992). The higher the concrete thinking score, the greater the decrease in the fixation time ratio was. Comparing the relationship between the answers in the purchasing block and the fixation time ratio, the interaction of fixation time ratios for each group was significant(p=0.031). In the post-hoc independent t-test, the fixation time ratio was significantly different for the control group(p<0.001); 0.167 ± 0.124 with purchase and 0.566 ± 0.073 without the purchase. For the patient group, there was no significant difference in the fixation time ratios by the answer.DiscussionThe patients with schizophrenia relatively concentrated more on the face in the matching block, where the question included both “you” referring to the self and the clothes. In the purchasing block, where question did not contain “you”, they focused less on the face. The concrete thinking scores had a significant influence on the change of the...

High aggression is common and costly for mental health problems in young adults. Because communication is a universal part of social relationships, including conflicts with others, it could be a possible target for mediating aggression. This study aimed to evaluate whether the virtual reality (VR)-based communication modification program can be utilized for aggression management. Fifty-eight individuals with high aggression (n = 30) and with low aggression (n = 28) completed psychological assessments associated with aggression and functional communication, and they participated in the program, consisting of the three tasks: exploring the communication style, practicing functional communication, and expressing empathy. The participants’ selections and their visual analog scale scores, in response to questions in the tasks, were collected as behavioral data. Results indicated that the high aggression group selected blaming dysfunctional communication style more frequently than the low aggression group. VR-based parameters, expected to reflect dysfunctional communication-related characteristics, showed significantly different correlations with aggression-related traits between the two groups. These findings show that our program may accurately represent an individual’s aggressive traits and elicit the appropriate reaction.