Responding to joint attention bids in schizophrenia: An interactive eye-tracking study

Abstract

This study investigated social cognition in schizophrenia using a virtual reality paradigm to capture the dynamic processes of evaluating and responding to eye gaze as an intentional communicative cue. A total of 21 patients with schizophrenia and 21 age-, gender-, and IQ-matched healthy controls completed an interactive computer game with an on-screen avatar that participants believed was controlled by an off-screen partner. On social trials, participants were required to achieve joint attention by correctly interpreting and responding to gaze cues. Participants also completed non-social trials in which they responded to an arrow cue within the same task context. While patients and controls took equivalent time to process communicative intent from gaze shifts, patients made significantly more errors than controls when responding to the directional information conveyed by gaze, but not arrow, cues. Despite no differences in response times to gaze cues between groups, patients were significantly slower than controls when responding to arrow cues. This is the opposite pattern of results previously observed in autistic adults using the same task and suggests that, despite general impairments in attention orienting or oculomotor control, patients with schizophrenia demonstrate a facilitation effect when responding to communicative gaze cues. Findings indicate a hyper-responsivity to gaze cues of communicative intent in schizophrenia. The possible effects of self-referential biases when evaluating gaze direction are discussed, as are clinical implications.

The Factor Structure of Social Cognition in Schizophrenia: A Focus on Replication With Confirmatory Factor Analysis and Machine Learning

“…Alternatively, tasks developed for other clinical populations, such as autism spectrum and neurological disorders (Caruana et al, 2018;Henry, Von Hippel, Molenberghs, Lee, & Sachdev, 2016;Kandalaft, Didehbani, Krawczyk, Allen, & Chapman, 2013), might be fruitfully adapted to schizophrenia research. There are also interesting new paradigms using emerging technologies, such as virtual reality, that show promise for use in schizophrenia research (Caruana, Seymour, Brock, & Langdon, 2019;Oker et al, 2015).…”

The effect of non-communicative eye movements on joint attention

“…This is particularly relevant to studies attempting to explain why responsive joint attention may diverge in certain populations. Indeed, this study raises new possibilities for the interpretation of our previous findings with people on the autism spectrum ( Caruana et al, 2018 ) and those diagnosed with schizophrenia ( Caruana et al, 2019 ). In these studies, group differences in the social Random Search condition were believed to reflect differences associated with evaluating the communicative intent of gaze, given that the same differences were not observed in a non-social arrow condition.…”

“…In five previous studies ( Caruana et al, 2015 , 2018 , 2019 ; Caruana, McArthur, Woolgar, & Brock, 2017 ; Caruana, Spirou & Brock, 2017 ), we found that participants’ saccadic reaction times (SRTs) were significantly slower to Alan’s gaze cues than to arrows. By contrast, non-interactive studies that present only a single, and thus, unambiguous gaze cue report more rapid cueing for social gaze compared with non-social cues (see Frischen et al, 2007 , for review).…”

“…In line with our previous analyses (see Caruana et al, 2019 ), we compared a series of mixed random-effects models using chi-square likelihood ratios to quantify the variance explained by each of our fixed effect and interactions parameters. These analyses were conducted in lieu of traditional effect-size measures, which are unable to account for the variance explained by each fixed effect, over and above variance already explained by the defined random effects.…”

“…This suggests that the non-communicative cues in our gaze condition may have slowed our participants down. Indeed, when we directly compared trials that did and did not include non-communicative gaze cues (see Caruana et al, 2017a , 2019 ), participants were slower in the presence of non-predictive cues. We have suggested that slower responses may be due to the additional processing time required to evaluate and selectively respond to the avatar’s communicative eye movements.…”