Examining the joint and unique contributions of early- and mid-stage visual processes to altered eye gaze perception in schizophrenia

Background. Eye gaze perception—a building block of social cognition—is altered in schizophrenia (SZ), manifesting as both reduced perceptual precision and stronger self-referential bias. Yet, the visual processing mechanisms influencing gaze precision and bias are unclear. This study examined the unique and joint contributions of early- and mid-stage visual processing to altered eye gaze perception in SZ.Methods. A sample of 62 participants with SZ and 63 healthy controls completed a psychophysical gaze-perception task, which was used to measure perceptual precision and self-referential bias. Early- and mid-stage visual processes were indexed using measures of visual integration and visuospatial memory, respectively. Hierarchical linear regressions were used to determine the unique contributions of these visual processes to perceptual precision and self-referential bias.Results. Visual integration, but not visuospatial memory, explained unique variance in perceptual precision during eye gaze perception across groups. Conversely, visual integration did not explain unique variance in self-referential bias of eye gaze perception; however, visuospatial memory was a significant predictor of self-referential bias even after accounting for the effect of visual integration.Conclusions. Results indicate that perceptual precision and self-referential bias of eye gaze perception may be differentially influenced by early- and mid-stage visual processes in SZ as well as HC. These findings can inform the development of more precise interventions for social cognition in SZ.