Attention to gaze and emotion in schizophrenia

Individuals with schizophrenia have difficulty interpreting social and emotional cues such as facial expression, gaze direction, body position, and voice intonation. Nonverbal cues are powerful social signals but are often processed implicitly, outside the focus of attention. The aim of this research was to assess implicit processing of social cues in individuals with schizophrenia.

Patients with schizophrenia or schizoaffective disorder and matched controls performed a primary task of word classification with social cues in the background. Participants were asked to classify target words (LEFT/RIGHT) by pressing a key that corresponded to the word, in the context of facial expressions with eye gaze averted to the left or right.

Although facial expression and gaze direction were irrelevant to the task, these facial cues influenced word classification performance. Participants were slower to classify target words (e.g., LEFT) that were incongruent to gaze direction (e.g., eyes averted to the right) compared to target words (e.g., LEFT) that were congruent to gaze direction (e.g., eyes averted to the left), but this only occurred for expressions of fear. This pattern did not differ for patients and controls.

The results showed that threat-related signals capture the attention of individuals with schizophrenia. These data suggest that implicit processing of eye gaze and fearful expressions is intact in schizophrenia.