Gaze aversion and emotional mimicry deficits in individuals with schizophrenia during naturalistic interaction

Individuals with schizophrenia exhibit a range of verbal and nonverbal impairments during social interaction, which contribute to reduced interaction quality and broader social dysfunction. To optimize clinical interventions, it is essential to identify the mechanisms underlying these deficits. Building on previous findings demonstrating reduced emotional mimicry in schizophrenia, the present study examined whether gaze aversion is associated with instances of failed mimicry during naturalistic conversation. In a within-partner design, interacting partners (n = 20) each engaged in one conversation with an individual with schizophrenia (n = 20) and one with a matched healthy control (n = 20). Prior analyses using OpenFace-based video coding revealed diminished emotional mimicry in the schizophrenia group. In the present study, the same video recordings were reanalyzed using FaceReader to extract gaze direction. We specifically examined gaze aversion during the interaction and, more critically, during episodes of failed mimicry, defined as instances in which participants did not reciprocate their partner's smile. Results indicated that although individuals with schizophrenia did not display significantly greater overall gaze aversion across the entire interaction, they exhibited significantly greater gaze aversion when their partner was smiling. This pattern was associated with a higher proportion of failed mimicry accompanied by gaze aversion in the schizophrenia group compared to controls. These findings suggest that reduced visual attention may represent one mechanism contributing to emotional mimicry deficits in schizophrenia. Clinical implications are discussed, along with the potential role of stigma in exacerbating these processes.