Is Nonverbal Communication Disrupted in Interactions Involving Patients With Schizophrenia?

Abstract

Background: Nonverbal communication is a critical feature of successful social interaction and interpersonal rapport. Social exclusion is a feature of schizophrenia. This experimental study investigated if the undisclosed presence of a patient with schizophrenia in interaction changes nonverbal communication (ie, speaker gesture and listener nodding). Method: 3D motion-capture techniques recorded 20 patient (1 patient, 2 healthy participants) and 20 control (3 healthy participants) interactions. Participants rated their experience of rapport with each interacting partner. Patients’ symptoms, social cognition, and executive functioning were assessed. Four hypotheses were tested: (1) Compared to controls, patients display less speaking gestures and listener nods. (2) Patients’ increased symptom severity and poorer social cognition are associated with patients’ reduced gesture and nods. (3) Patients’ partners compensate for patients’ reduced nonverbal behavior by gesturing more when speaking and nodding more when listening. (4) Patients’ reduced nonverbal behavior, increased symptom severity, and poorer social cognition are associated with others experiencing poorer rapport with the patient. Results: Patients gestured less when speaking. Patients with more negative symptoms nodded less as listeners, while their partners appeared to compensate by gesturing more as speakers. Patients with more negative symptoms also gestured more when speaking, which, alongside increased negative symptoms and poorer social cognition, was associated with others experiencing poorer patient rapport. Conclusions: Patients’ symptoms are associated with the nonverbal behavior of patients and their partners. Patients’ increased negative symptoms and gesture use are associated with poorer interpersonal rapport. This study provides specific evidence about how negative symptoms impact patients’ social interactions.

Towards a second-person neuropsychiatry

“…[82][83][84][85]). Most interestingly, it has been shown that in interaction with a schizophrenic patient, it is the behaviour of the 'normal' interaction partner that changes to compensate for the behaviour of the patient [86].…”

Systems Neuroscience of Psychosis: Mapping Schizophrenia Symptoms onto Brain Systems

“…Patients with schizophrenia frequently suffer from impaired hand gesture performance [126, 127] and they tend to use gestures less frequently [128]. Two studies noted an association of impaired gesture performance with frontal lobe dysfunction and motor abnormalities in schizophrenia [25, 126].…”

Negative Symptoms and Avoidance of Social Interaction: A Study of Non-Verbal Behaviour

“…As such, the assessment of negative symptoms has been advanced through the use of the CAINS MAP subscale, which focuses solely on the experience-related deficits relating to negative symptoms. Different and potentially more specifically developed instruments, as well as computerised analyses with 3D mo- tion capture techniques, may be used in the future [13,34]. The use of motion energy analysis, which has previously looked at the non-verbal synchrony of individuals during social interactions, may provide a more objective and continuous measure of non-verbal behaviour [35].…”

“…In other studies, different symptom domains have been associated with differing symptom severities. For example, increased negative symptoms have been associated with decreases in prosocial behaviour [9,13,14], and a higher general severity of symptoms has been linked with increased flight behaviour [9,11]. By contrast, Brüne et al [4] found that reduced symptoms were associated with an increase in flight behaviour.…”