Associations between smooth pursuit, predictive pursuit, anomalous self-experiences, and psychotic-like experiences

Oculomotor dysfunction is well-documented in the psychosis spectrum, particularly deficits in smooth pursuit eye movements. These disruptions are thought to serve as endophenotypic markers of psychosis vulnerability and more recent work has linked oculomotor dysfunction with alterations in agency, a core feature of the psychosis spectrum. Understanding this link between oculomotor impairment, agency, and psychosis can provide insight into key mechanisms of psychosis vulnerability. To address this gap, we utilized an eye tracking paradigm to examine smooth and predictive pursuit in 100 young-adults, recruited with an enriched sampling strategy to represent a range of severity of distress associated with psychotic-like experiences. Relationships with positive psychotic-like experiences, agentic symptoms, depression, anxiety, and cognitive symptoms were investigated. There was a significant relationship between distress associated with overall positive psychotic-like experiences and bizarre experiences with frequency of catch-up saccades on both smooth pursuit (r = 0.25, p = 0.012; r = 0.27, p_adj=0.036) and predictive pursuit (r = 0.29, p = 0.004; r = 0.36, p_adj=0.002) trials, and distress from positive psychotic-like experiences with phase difference on predictive pursuit trials (r=-0.23, p = 0.023). There were no significant relationships between anomalous self-experiences and performance on either task. Performance on the predictive pursuit task was related to cognitive performance (r = 0.22, p = 0.039), but relationships between psychotic-like experiences and predictive pursuit remained significant after controlling for cognitive performance. No other secondary clinical symptoms were related to performance on either task. The current study supports theory suggesting smooth pursuit as an endophenotypic marker of psychosis risk and presents predictive pursuit as a promising paradigm for assessment in psychosis vulnerability populations.