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. 2025 Oct 16:286:1-8.
doi: 10.1016/j.schres.2025.10.010. Online ahead of print.

Aberrant visual attention is associated with social judgements of attractiveness and negative symptoms in schizophrenia

Lauren Luther  1 , Rebecca F Mathis  2 , William R Keller  3 , Robert W Buchanan  4 , James M Gold  4 , James I Koeing  5 , Gregory P Strauss  6
Affiliations
Free article

Aberrant visual attention is associated with social judgements of attractiveness and negative symptoms in schizophrenia

Lauren Luther et al. Schizophr Res. .
Free article

Abstract

Background: Accurate perception of facial attractiveness supports normative social motivation and approach behaviors, in part via its association with endogenous oxytocin levels. Individuals with schizophrenia (SZ) display impaired social functioning that is associated with endogenous oxytocin levels. However, it is unclear whether judgements of facial attractiveness and the attentional processes that support them contribute to social abnormalities in SZ. The current study examined whether judgements of facial attractiveness and gaze behavior were associated with negative symptoms, social functioning, and oxytocin.

Method: Forty-one individuals with SZ and 23 healthy controls (CN) rated male and female facial stimuli for levels of attractiveness while gaze behavior was recorded via eye-tracking. Fixation count and gaze duration in facial regions of interest were used to evaluate facial scanning behavior. Plasma oxytocin concentrations were derived via radioimmunoassay.

Results: CN and SZ did not significantly differ on perceptions of facial attractiveness; however, SZ displayed an aberrant visual scan pattern characterized by reduced attention to salient facial features on both male and female faces. Further, this aberrant scanning pattern was associated with greater negative symptoms and reduced social functioning in SZ. Oxytocin was not associated with attractiveness perceptions or gaze behavior.

Conclusions: Findings suggest that negative symptoms and social functioning are associated with diminished judgements of facial attractiveness and corresponding patterns of aberrant gaze behavior. Attention training programs focused on increasing gaze to salient facial features may support better social functioning and lower negative symptoms in SZ.

Keywords: Attractiveness; Eye tracking; Gaze behavior; Negative symptoms; Schizophrenia; Visual scan path.

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Conflict of interest statement

Declaration of competing interest Dr. Gregory Strauss is one of the original developers of the Brief Negative Symptom Scale (BNSS) and receives royalties and consultation fees from Medavante-ProPhase LLC in connection with commercial use of the BNSS and other professional activities; these fees are donated to the Brain and Behavior Research Foundation. Dr. Strauss has received honoraria and travel support from Medavante-ProPhase LLC for training pharmaceutical company raters on the BNSS. In the past 2 years, Dr. Strauss has consulted for and/or been on the speaker bureau for Minerva Neurosciences, Acadia, Lundbeck, Sunovion, Boehringer Ingelheim, and Otsuka pharmaceutical companies. Dr. Luther has also consulted for Boehringer-Ingelheim in the last two years. Dr. Buchanan has consulted for Boehringer-Ingelheim; serves on the Data Safety and Monitoring Boards of Roche, Merck and Newron; and has served on the Advisory Boards of Merck, Acadia, Karuna, and Neurocrine. All other authors have no relevant disclosures to report.

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