Gender differences in attentive bias during social information processing in schizophrenia: An eye-tracking study

Interpersonal communication is a specific scenario in which patients with psychiatric symptoms may manifest different behavioral patterns due to psychopathology. This was a pilot study by eye-tracking technology to investigate attentive bias during social information processing in schizophrenia. We enrolled 39 patients with schizophrenia from Shanghai Mental Health Center and 42 age-, gender- and education-matched healthy controls. The experiment was a free-viewing task, in which pictures with three types of degree of interpersonal communication were shown. We used two measures: 1) initial fixation duration, 2) total gaze duration. The Positive and Negative Syndrome Scale (PANSS) was used to determine symptom severity. The ratio of first fixation duration for pictures of communicating vs. non-communicating persons was significantly lower in patients than in controls (Mann-Whitney U = 512, p = 0.004). We found that male patients showed a significantly lower ratio of first fixation duration than male controls (Mann-Whitney U = 190, p = 0.028), while it was marginally lower in female patients than female controls (Mann-Whitney U = 77, p = 0.057). The ratio of first fixation duration for pictures of communicating persons vs. no persons was negatively correlated with PANSS negative symptoms in male patients (rho = -0.458, p = 0.024). In contrast, it was negatively correlated with PANSS positive symptoms in female patients (-0.701, p = 0.004). These findings suggest altered attentive bias during social information processing with a pattern of avoidance at first sight towards pictures of communicating persons in schizophrenia. It is worthwhile to note that social functioning impairment is associated with the severity of symptoms.