Converging evidence of social avoidant behavior in schizophrenia from two approach-avoidance tasks.
Many people with schizophrenia suffer from social impairments characterized by active social avoidance, which is related to social phobia common in schizophrenia, while motivational impairments can also result in passive social withdrawal. Although social avoidance is frequently reported in this population, this is the first study to directly compare approach-avoidance tendencies in schizophrenia patients (N = 37) and healthy controls (N = 29). Participants performed two tasks: a computerized approach-avoidance task (AAT) to assess response tendencies toward images of happy and angry faces with direct or averted gaze and a one-to-one personal space test (PST) to gauge more naturalistic approach-avoidance behaviors toward a real person bearing a neutral expression. The AAT results showed that both groups showed faster avoidance responses to angry faces and faster approach responses to happy faces with a direct gaze. Happy faces with averted gaze, however, resulted in faster avoidance responses in the patient group only. On the PST, the patients approached the experimenter less than healthy controls did. This measure of interpersonal distance was positively related to positive symptom severity. Delusions of reference and increased sensitivity to social rejection may explain the patients' avoidance tendencies in response to pictures of happy faces with averted gaze and in the presence of an actual person. The current findings demonstrate the importance of others adopting positive and unambiguous attitudes when interacting with schizophrenia patients to minimize behavioral avoidance patterns, which is particularly relevant for relatives and clinicians whose interactions with the patients are crucial to facilitating treatment and promoting healthy social relationships.
Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium. Electronic address: F.Javier83@Gmail.com.
Javier
J
de la Asuncion
Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; Psychiatric Center Brothers Alexians, Provinciesteenweg 408, 2530 Boechout, Belgium.
Lise
L
Docx
Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; University Psychiatric Center St Norbertushuis, Stationstraat 22c, 2570 Duffel, Belgium.
Bernard
B
Sabbe
Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; Psychiatric Center Brothers Alexians, Provinciesteenweg 408, 2530 Boechout, Belgium.
Manuel
M
Morrens
Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; Department of Clinical Psychology, Leiden Institute for Brain and Cognition (LIBC), Leiden University, Wassenaarseweg 52, 2333 AK Leiden, Netherlands.
Ellen R A
ER
de Bruijn
D000786:Anger; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001362:Avoidance Learning; D003201:Computers; D005149:Facial Expression; D000066499:Facial Recognition; D005260:Female; D006240:Happiness; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests; D011930:Reaction Time; D012559:Schizophrenia / Q000188:drug therapy; D012565:Schizophrenic Psychology; D012919:Social Behavior; D013037:Spatial Behavior
D014150:Antipsychotic Agents
Approach-avoidance; Personal space; Schizophrenia; Social