Association of Abnormal Eye Gaze Pattern with Magical Ideation during Reality Evaluation in Patients with Schizophrenia

Jung Suk Lee; Min-Woo Kim; Yeon-Ju Hong; Jae-Jin Kim

doi:10.16946/kjsr.2018.21.2.37

Journal List > Korean J Schizophr Res > v.21(2) > 1105660

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Lee, Kim, Hong, and Kim: Association of Abnormal Eye Gaze Pattern with Magical Ideation during Reality Evaluation in Patients with Schizophrenia

Original Article

Korean Journal of Schizophrenia Research 2018; 21(2): 37-42.

Published online: 25 October 2018

DOI: https://doi.org/10.16946/kjsr.2018.21.2.37

Association of Abnormal Eye Gaze Pattern with Magical Ideation during Reality Evaluation in Patients with Schizophrenia

Jung Suk Lee, MD, PhD^1,², Min-Woo Kim¹, Yeon-Ju Hong, MA¹, Jae-Jin Kim, MD, PhD^1,³

¹Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea.

²Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, Korea.

³Department of Psychiatry, Yonsei University Gangnam Severance Hospital, Seoul, Korea.

Address for correspondence: Jae-Jin Kim, Department of Psychiatry, Yonsei University Gangnam Severance Hospital, 211 Eonju-ro, Gangnamgu, Seoul 06273, Korea. Tel: 02-2019-3341, Fax: 02-3462-4304. jaejkim@yonsei.ac.kr

Received 22 July 2018 Revised 5 October 2018 Accepted 5 October 2018

Korean Society for Schizophrenia Research

Abstract

Objectives

Magical ideation refers to belief in forms of causation that by conventional standards are invalid, and is considered to be one of prodromal psychotic symptoms in schizophrenia. This study aimed to investigate the relationship between magical ideation and eye gaze pattern in patients with schizophrenia.

Methods

Eye gaze data were recorded in 23 patients with schizophrenia and 23 healthy controls while performing the reality evaluation task, in which participants should judge the realness of real or unreal pictures.

Results

Compared to healthy controls, patients with schizophrenia showed decreased fixation, saccade and area of interest (AOI) fixation counts, and reduced scanpath length. Magical Ideation Scale score in patients with schizophrenia showed negative correlation with the scanpath length in the real condition and the AOI fixation count in the unreal condition.

Conclusion

These findings suggest that patients with schizophrenia show restricted visual scanning during reality evaluation, and their restricted visual scanning may play an important role in the magical ideation.

Keywords: Eye gaze, Magical ideation, Reality evaluation, Schizophrenia, Visual scanning

Figures and Tables

Fig. 1

Examples of stimuli and analysis in the reality evaluation task. Real pictures were composed of objects (e.g., human, animal, house, furniture) with appropriate backgrounds, while unreal pictures were composed of distorted objects with appropriate backgrounds or of intact objects with inappropriate backgrounds (A). The area of interest (AOI) was defined as the main object in the real or unreal pictures (B). Examples of gaze distribution in the patient and control group were displayed in the heat map (C), which shows fixation counts related to the color scale between blue (less counts) and red (most counts).

Fig. 2

Results of the correlational analyses. The Magical Ideation Scale score was significantly correlated with the scanpath length in the real condition and the AOI fixation count in the unreal condition in the patient group, while it did not correlate with eye gaze data in the control group. * : p<0.05.

Table 1

Demographic and clinical characteristics of participants

* : p<0.05, †: Pearson's chi square test. RCFT : Rey Complex Figure Test, MIS : Magical Ideation Scale, PS : Paranoia Scale, PANSS : Positive and Negative Syndrome Scale

Table 2

Behavioral responses of reality evaluation task

Table 3

Eye gaze results

AOI : Area of interest

References

1. Lee JS, Chun JW, Lee SH, Kang DI, Kim JJ. Association of impaired reality processing with psychotic symptoms in schizophrenia. Psychiatry Res. 2013; 210:721–728.

2. van Os J, Hanssen M, Bijl RV, Ravelli A. Strauss (1969) revisited: a psychosis continuum in the general population? Schizophr Res. 2000; 45:11–20.

3. Poulton R, Caspi A, Moffitt TE, Cannon M, Murray R, Harrington H. Children's self-reported psychotic symptoms and adult schizophreniform disorder: a 15-year longitudinal study. Arch Gen Psychiatry. 2000; 57:1053–1058.

4. Eckblad M, Chapman LJ. Magical ideation as an indicator of schizotypy. J Consult Clin Psychol. 1983; 51:215–225.

5. Tandon N, Montrose D, Shah J, Rajarethinam RP, Diwadkar VA, Keshavan MS. Early prodromal symptoms can predict future psychosis in familial high-risk youth. J Psychiatr Res. 2012; 46:105–110.

6. Gaudiano BA, Zimmerman M. Prevalence of attenuated psychotic symptoms and their relationship with DSM-IV diagnoses in a general psychiatric outpatient clinic. J Clin Psychiatry. 2013; 74:149–155.

7. Wilcox J, Briones D, Quadri S, Tsuang M. Prognostic implications of paranoia and thought disorder in new onset psychosis. Compr Psychiatry. 2014; 55:813–817.

8. Drusch K, Stroth S, Kamp D, Frommann N, Wolwer W. Effects of training of affect recognition on the recognition and visual exploration of emotional faces in schizophrenia. Schizophr Res. 2014; 159:485–490.

9. Han K, Shin J, Yoon SY, Jang DP, Kim JJ. Deficient gaze pattern during virtual multiparty conversation in patients with schizophrenia. Comput Biol Med. 2014; 49:60–66.

10. Kojima T, Matsushima E, Ohta K, Toru M, Han YH, Shen YC, et al. Stability of exploratory eye movements as a marker of schizophreniaa WHO multi-center study. World Health Organization. Schizophr Res. 2001; 52:203–213.

11. Morita K, Miura K, Fujimoto M, Yamamori H, Yasuda Y, Iwase M, et al. Eye movement as a biomarker of schizophrenia: Using an integrated eye movement score. Psychiatry Clin Neurosci. 2017; 71:104–114.

12. Suzuki M, Takahashi S, Matsushima E, Tsunoda M, Kurachi M, Okada T, et al. Relationships between exploratory eye movement dysfunction and clinical symptoms in schizophrenia. Psychiatry Clin Neurosci. 2012; 66:187–194.

13. Bestelmeyer PE, Tatler BW, Phillips LH, Fraser G, Benson PJ, St Clair D. Global visual scanning abnormalities in schizophrenia and bipolar disorder. Schizophr Res. 2006; 87:212–222.

14. Minassian A, Granholm E, Verney S, Perry W. Visual scanning deficits in schizophrenia and their relationship to executive functioning impairment. Schizophr Res. 2005; 74:69–79.

15. Hori Y, Fukuzako H, Sugimoto Y, Takigawa M. Eye movements during the Rorschach test in schizophrenia. Psychiatry Clin Neurosci. 2002; 56:409–418.

16. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association;2000.

17. Raven J, Court J, Raven J. Manual for Raven's progressive matrices and vocabulary scales: Section 3 Standard progressive matrices. London: Lewis;1988.

18. Meyers JE, Meyers KR. Rey Complex Figure Test and Recognition Trial: Professional Manual. Lutz, FL: Psychological Assessment Resources;1995.

19. Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987; 13:261–276.

20. Fenigstein A, Vanable PA. Paranoia and self-consciousness. J Pers Soc Psychol. 1992; 62:129–138.

21. Lee JS, Chun JW, Lee SH, Kim E, Lee SK, Kim JJ. Altered neural basis of the reality processing and its relation to cognitive insight in schizophrenia. PLoS One. 2015; 10:e0120478.

22. Oh J, Chun JW, Lee JS, Kim JJ. Relationship between abstract thinking and eye gaze pattern in patients with schizophrenia. Behav Brain Funct. 2014; 10:13.

23. Roux P, Forgeot d'Arc B, Passerieux C, Ramus F. Is the Theory of Mind deficit observed in visual paradigms in schizophrenia explained by an impaired attention toward gaze orientation? Schizophr Res. 2014; 157:78–83.

24. Langdon R, Ward PB, Coltheart M. Reasoning anomalies associated with delusions in schizophrenia. Schizophr Bull. 2010; 36:321–330.

25. Moritz S, Woodward TS, Hausmann D. Incautious reasoning as a pathogenetic factor for the development of psychotic symptoms in schizophrenia. Schizophr Bull. 2006; 32:327–331.

26. Gooding DC, Matts CW, Rollmann EA. Sustained attention deficits in relation to psychometrically identified schizotypy: Evaluating a potential endophenotypic marker. Schizophr Res. 2006; 82:27–37.

TOOLS

Similar articles