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Related Experiment Video

Updated: May 5, 2026

Comparing Eye-tracking Data of Children with High-functioning ASD, Comorbid ADHD, and of a Control Watching Social Videos
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Eye Movement Abnormalities During the Gaze Perception Task in Individuals With Clinical High Risk for Psychosis: A

Harry Kam Hung Tsui1, Yingqi Liao1, Janet Hui-Wen Hsiao2

  • 1Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.

Schizophrenia Bulletin
|August 21, 2025
PubMed
Summary

Individuals at clinical high risk for psychosis (CHR) show distinct eye movement patterns during gaze perception. Combining these patterns with behavioral data improves classification accuracy, suggesting potential diagnostic and therapeutic applications.

Keywords:
classificationclinical high risk for psychosiseye-trackergaze perceptionmachine learningself-referential biassocial cognition

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Cognitive Science

Background:

  • Social cognitive impairments are prominent in schizophrenia and individuals at clinical high risk for psychosis (CHR).
  • Eye movement abnormalities are documented in schizophrenia, but less understood in CHR individuals.
  • Gaze perception is crucial for social interaction and is often impaired in psychosis spectrum disorders.

Purpose of the Study:

  • To investigate eye movement patterns during gaze perception in CHR individuals compared to healthy controls (HC).
  • To assess the diagnostic utility of eye movement variables and self-referential gaze perception (SRGP) rates in differentiating CHR from HC.
  • To explore associations between visual attention patterns and clinical symptoms/social functioning in CHR.

Main Methods:

  • Recruited 36 CHR individuals and 50 HC for a gaze perception task.
  • Utilized eye-tracking technology analyzed with hidden Markov models for pattern recognition.
  • Compared eye movement metrics and SRGP rates between groups; employed discriminant analyses to assess classification accuracy.

Main Results:

  • CHR individuals exhibited nose-focused and erratic eye movements compared to HC.
  • A combined model of behavioral and eye movement variables achieved an AUC of 0.893 for CHR/HC classification, outperforming models using either alone.
  • Eyes-nose scale, fixation duration, and ambiguous SRGP rate were key discriminative features; specific patterns correlated with symptom dimensions and social functioning.

Conclusions:

  • Eye movement patterns during gaze perception differ significantly between CHR individuals and HC.
  • Combined behavioral and eye movement analysis offers a promising approach for identifying CHR.
  • Visual attention patterns hold potential as diagnostic biomarkers and therapeutic targets for CHR.