Participation during first social encounters in schizophrenia

Patients with a diagnosis of schizophrenia are socially excluded. The aim of this study was to investigate how patients participate in first encounters with unfamiliar healthy participants, who are unaware of their diagnosis.

Patterns of participation were investigated during interactions involving three-people. Three conversation roles were analysed: (i) speaker, (ii) primary recipient- focus of the speaker's attention and (iii) secondary recipient- unaddressed individual. Twenty patient interactions (1 patient, 2 healthy controls) and 20 control interactions (3 healthy participants) were recorded and motion captured in 3D. The participation of patients and their partners, in each conversation role, was compared with controls at the start, middle and end of the interaction. The relationship between patients' participation, their symptoms and the rapport others experienced with them was also explored.

At the start of the interaction patients spoke less (ß = -.639, p = .02) and spent more time as secondary recipient (ß = .349, p = .02). Patients' participation at the middle and end of the interaction did not differ from controls. Patients' partners experienced poorer rapport with patients who spent more time as a primary recipient at the start of the interaction (Rho(11) = -.755, p<.01). Patients' participation was not associated with symptoms.

Despite their increased participation over time, patients' initial participation appears to be associated with others' experience of rapport with them. Thus, the opening moments of patients' first encounters appear to be interpersonally significant. Further investigation of patient and others' behaviour during these critical moments is warranted in order to understand, and possibly develop interventions to address, the difficulties schizophrenia patients experience here.