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You looking at me?: Interpreting social cues in schizophrenia

Published online by Cambridge University Press:  04 September 2015

T. P. White
Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
F. Borgan
Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK
O. Ralley
Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK
S. S. Shergill*
Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, UK
*Address for correspondence: Professor S. S. Shergill, Cognition, Schizophrenia and Imaging Laboratory, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK. (Email:



Deficits in the perception of social cues are common in schizophrenia and predict functional outcome. While effective communication depends on deciphering both verbal and non-verbal features, work on non-verbal communication in the disorder is scarce.


This behavioural study of 29 individuals with schizophrenia and 25 demographically matched controls used silent video-clips to examine gestural identification, its contextual modulation and related metacognitive representations.


In accord with our principal hypothesis, we observed that individuals with schizophrenia exhibited a preserved ability to identify archetypal gestures and did not differentially infer communicative intent from incidental movements. However, patients were more likely than controls to perceive gestures as self-referential when confirmatory evidence was ambiguous. Furthermore, the severity of their current hallucinatory experience inversely predicted their confidence ratings associated with these self-referential judgements.


These findings suggest a deficit in the contextual refinement of social-cue processing in schizophrenia that is potentially attributable to impaired monitoring of a mirror mechanism underlying intentional judgements, or to an incomplete semantic representation of gestural actions. Non-verbal communication may be improved in patients through psychotherapeutic interventions that include performance and perception of gestures in group interactions.

Original Articles
Copyright © Cambridge University Press 2015 

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