Visual attention in schizophrenia: Eye contact and gaze aversion during clinical interactions

Many of the essential clues to the psychiatric condition of an individual lie within the nonverbal and communicative behavior patterns they express during social interactions. Unfortunately, these behaviors are particularly difficult to assess subjectively in a time-constrained environment, to which clinicians are often limited in realistic settings. The present analysis examines quantified patterns of gaze aversion across a set of persons recently admitted to an inpatient psychotic disorder unit at a major psychiatric hospital. These patterns are used to inform the development of discriminative models with the task of predicting schizophrenic symptom severity from both a typological and a dimensional assessment perspective. The results expose a novel set of gaze aversion behaviors distinguishing between positive subtype schizophrenia, characterized by excessive behaviors such as hallucinations and grandiosity, and negative subtype schizophrenia, characterized by diminished behaviors such as blunted affect and emotional withdrawal. The predictive models constitute a significant step toward the development of automated tools to aid medical professionals in the diagnosis of psychotic disorders.