Neural correlates of conversational turn-taking perception in individuals at clinical high-risk for psychosis

Impaired social functioning is a core feature of individuals at clinical high-risk (CHR) for psychosis and strongly predicts poor outcomes. One essential component of everyday communication that may be disrupted in this population is conversational turn-taking. While atypical turn-taking has been documented in CHR behaviorally, the neural mechanisms underlying these disruptions in CHR remain underexplored.

Using electroencephalogram (EEG), participants passively listened to brief, recorded conversations in which one speaker made a request and the other responded following a short (200 ms) or long (700 ms) inter-speaker gap. The final sample included 24 CHR individuals (M = 20.6 years, 62.5 % male) and 32 healthy controls (HC; M = 21.7 years, 40.6 % male).

ERP amplitudes during the long inter-speaker gap did not significantly differ between groups, t(50) = -1.49, p = .14, g = -0.40. However, HCs exhibited significantly negative amplitudes relative to zero, t(31) = -4.12, p < .001, g = -0.71, whereas CHR individuals did not, t(23) = -1.63, p = .12, g = -0.32. Following the speaker's response, a main effect of gap length was observed, F(1, 54) = 15.73, p < .001, ges = 0.12, such that P2/P3 amplitudes were larger following long gaps relative to short gaps, with no significant interaction or main effect of group. Weaker modulation of P2/P3 amplitude was associated with greater social anhedonia, r(54) = -0.28, p = .040.

Disrupted perception of turn-taking in CHR may reflect impairments in social communication, providing insight into social anhedonia and potential neural markers of psychosis risk.