Adults with higher social anxiety show avoidant gaze behaviour in a real-world social setting: A mobile eye tracking study

The effect of social anxiety on social attention in naturalistic situations

BACKGROUND AND OBJECTIVES

This multimodal two-phase study investigated the impact of trait social anxiety on exploration, social attention, and autonomic responses in a naturalistic setting. We expected higher avoidance of potentially crowded spaces, reduced visual attention on other people, and heightened physiological arousal in social situations for participants with higher social anxiety levels.

DESIGN AND METHODS

Eighty-seven participants, pre-screened for high variance in trait social anxiety, first completed a half-hour walk on a freely chosen route and subsequently had a staged social interaction with a confederate consisting of a non-interactive waiting phase and a short conversation.

RESULTS

While social anxiety did not modulate the choice of route during the walk phase, socially anxious participants avoided gazing at other individuals in non-interactive situations, i.e., during the walk and the waiting phase. In contrast, during actual interaction, they showed increased visual attention towards the confederate's face. Across all experimental phases, highly socially anxious individuals showed elevated heart rates, but this effect was independent of the social context.

CONCLUSIONS

This study showed that social anxiety affects social exploration behavior not in a way of general avoidance, but rather in nuanced adaptations depending on the concrete situation, likelihood of interaction and associated socio-evaluative threat.

Attention mechanisms of social anxiety in daily life: Unique effects of negative self-focused attention on post-event processing

Social anxiety disorder (SAD) is characterized by biased patterns of attention that are theorized to play a key role in maintaining symptoms. SAD has been linked to externally oriented attentional biases (i.e., towards social-evaluative threats) and internally oriented attentional biases (i.e., towards anxiety-laden thoughts and sensations), both of which might increase proneness for post-event processing (PEP), a form of rumination about the negative aspects of past social events. However, prior research examining attentional biases in SAD has primarily been conducted in laboratory settings, leaving unanswered questions about the naturalistic patterns of attention and cognition that most strongly characterize and maintain social anxiety. The present study applied ecological momentary assessment (EMA) to examine attentional biases during real-world social interactions and their effects on subsequent PEP in a sample of adults with high (n = 108) and low (n = 94) levels of social anxiety. Three times per day for one week, participants reported their attention orientation (i.e., internal versus external), the valence of their attentional foci (i.e., negative versus positive), and their degree of PEP following salient social events. Results revealed that high (vs. low) levels of social anxiety were associated with relatively more internally oriented and negatively valenced attention during social interactions, which in turn predicted increases in subsequent PEP. Findings highlight the salience of negative self-focused attention and ruminative thinking as maintenance factors in social anxiety, and suggest that interventions targeting these mechanisms could show promise in future research.

Early hypervigilance and sustained attention for the eye region in adolescents with social anxiety disorder

Social anxiety disorder (SAD) is a highly prevalent and debilitating affliction that typically manifests during childhood and adolescence. While theoretical models of adult SAD emphasize the role of attentional biases, little is known about maintaining factors during childhood and adolescence. The objective of our eye-tracking study was to determine whether youth with SAD exhibit a hypervigilance-avoidance pattern of visual attention for faces. To this end, we used a free-viewing paradigm to present angry, happy, and neutral faces, and non-social object stimuli to three groups of adolescents aged 10-15 years: SAD (n = 57), specific phobia (SP; n = 41), and healthy controls (HC; n = 65). A screen-based eye tracker recorded gaze behavior and pupil dilation. Among participants, only older adolescents with SAD exhibited shorter latencies of first fixation to the eye region compared to HC. Contrary to our expectations, there were no differences in duration of first fixation to the eye region among the groups. Instead, compared to HC, older adolescents with SAD showed longer dwell times on the eye region during the first 1000 - 3000 ms of stimulus presentation. No significant differences among the groups were found regarding scanpath length or pupillary reactivity. Taken together, our findings suggest early hypervigilance followed by sustained attention to the eye region in older adolescents with SAD, which may indicate difficulties in disengaging attention. We discuss the theoretical and practical implications in detail.

Personality traits prediction based on eye movements while reading manga

Background

Previous studies utilizing machine learning methods have demonstrated that personal traits can be predicted from eye movement data recorded in real-world situations, such as navigating a university campus or browsing one's Facebook news feed. The objective of this study was to conceptually replicate and extend these findings in a different type of visual engagement. Specifically, we aimed to predict individuals' personal traits using eye movements that reflect gaze behaviors while reading manga (Japanese comics).

Methods

We recorded the eye movements of 51 participants as they read manga and trained several machine learning classifiers to predict the levels of each of the self-reported Big Five personality traits from the eye movement features extracted from their reading behavior. The models' performance was evaluated using cross-validation, and the SHapley Additive exPlanation (SHAP) approach was employed to elucidate the classification model by identifying important features and their impacts on the model output.

Results

Among the Big Five personality traits, only extraversion was predictable. The evaluation results demonstrated that the best model achieved comparable performance with previous literature, with a macro F1 score of 0.49. Analysis of the SHAP value plots showed that a high fixation rate, pupillary response, and blink rate were informative indicators.

Conclusion

The results partially replicated the previously noted associations between eye movement and personality traits. We found that gaze behaviors observed during reading manga are informative of an individual's extraversion personality trait. We also point out several potential advantages of using manga for gaze-based personality detection.

Mutual eye gaze and vocal pitch in relation to social anxiety and depression: A virtual interaction task

BACKGROUND

Individuals with high social interaction anxiety (SIA) and depression often behave submissively in social settings. Few studies have simultaneously examined the associations between objectively assessed submissive behaviors and SIA or depression, despite their high comorbidity and unknown mechanisms regarding submissiveness.

METHODS

A sample of 45 young adults self-reported trait SIA and depression, state positive/negative affect (PA/NA) before and after a virtual social interaction. Participants engaged in a four-minute conversation with a confederate who was trained to behave neutrally. Mutual eye gaze, via eye-tracking, and vocal pitch were assessed throughout the interaction.

RESULTS

Depression and SIA were positively correlated with NA, poorer self-rated performance, and vocal pitch. Highly socially anxious women engaged in less mutual eye gaze than highly socially anxious men. Also, vocal pitch was inversely associated with mutual eye gaze and positively related to NA and (nonsignificantly) to self-ratings of poor performance. Finally, our data partially replicated past research on the use of vocal pitch during social stress to detect social anxiety disorder.

LIMITATIONS

The current sample is relatively homogenous in educational attainment, age, and race. All research confederates were women. Future research should examine whether these archival data replicate with the latest telecommunication technologies.

CONCLUSION

Our findings highlight nuanced relationships among SIA, depression, emotions, self-perceptions, and biobehavioral indicators of submissive behavior-in response to an ambiguously negative/positive social interaction. Sex/gender may interact with these effects, emphasizing considerations for research method designs.

Synchrony within, synchrony without: establishing the link between interpersonal behavioural and brain-to-brain synchrony during role-play

Interpersonal synchrony is a crucial construct in understanding social interactions, which has been used in clinical studies to measure the quality of the therapeutic alliance. However, there is a lack of studies investigating the correlation between synchrony expressed on different levels: behavioural and neurophysiological. Furthermore, there are no studies that examine how the implementation of psychodramatic role-playing techniques, when individuals adopt the persona of a different character, may influence intrinsic biobehavioural synchrony between two parties. The present study, therefore, aims to uncover the relationship between behavioural and brain-to-brain synchrony across different role-playing techniques and elucidate the impact of these synchronies on participants' levels of anxiety and empathy. By using functional near-infrared imaging and behavioural coding in a dyadic role-playing paradigm (n = 41 dyads), the study found correlations between behavioural and brain-to-brain synchrony during naturalistic conversations, but not during role-play, implying a qualitative change in interpersonal synchrony when implementing role-playing techniques. Additionally, the study noted significant contributions of both behavioural and brain-to-brain synchrony as well as peripheral factors such as dyadic sex make-up and role immersion in predicting dyadic anxiety and empathy changes. Findings call for future studies to consider role-playing scenarios as a qualitatively different form of social interaction.

Taking another look at intelligence and personality using an eye-tracking approach

Intelligence and personality are both key drivers of learning. This study extends prior research on intelligence and personality by adopting a behavioral-process-related eye-tracking approach. We tested 182 adults on fluid intelligence and the Big Five personality traits. Eye-tracking information (gaze patterns) was recorded while participants completed the intelligence test. Machine learning models showed that personality explained 3.18% of the variance in intelligence test scores, with Openness and, surprisingly, Agreeableness most meaningfully contributing to the prediction. Facet-level measures of personality explained a larger amount of variance (7.67%) in intelligence test scores than the trait-level measures, with the largest coefficients obtained for Ideas and Values (Openness) and Compliance and Trust (Agreeableness). Gaze patterns explained a substantial amount of variance in intelligence test performance (35.91%). Gaze patterns were unrelated to the Big Five personality traits, but some of the facets (especially Self-Consciousness from Neuroticism and Assertiveness from Extraversion) were related to gaze. Gaze patterns reflected the test-solving strategies described in the literature (constructive matching, response elimination) to some extent. A combined feature vector consisting of gaze-based predictions and personality traits explained 37.50% of the variance in intelligence test performance, with significant unique contributions from both personality and gaze patterns. A model that included personality facets and gaze explained 38.02% of the variance in intelligence test performance. Although behavioral data thus clearly outperformed "traditional" psychological measures (Big Five personality) in predicting intelligence test performance, our results also underscore the independent contributions of personality and gaze patterns in predicting intelligence test performance.

Social attention patterns of autistic and non-autistic adults when viewing real versus reel people

LAY ABSTRACT

Early research shows that autistic adults do not attend to faces as much as non-autistic adults. However, some recent studies where autistic people are placed in scenarios with real people reveal that they attend to faces as much as non-autistic people. This study compares attention to faces in two situations. In one, autistic and non-autistic adults watched a pre-recorded video. In the other, they watched what they thought were two people in a room in the same building, via a life webcam, when in fact exactly the same video in two situations. We report the results of 32 autistic adults and 33 non-autistic adults. The results showed that autistic adults do not differ in any way from non-autistic adults when they watched what they believed was people interacting in real time. However, when they thought they were watching a video, non-autistic participants showed higher levels of attention to faces than non-autistic participants. We conclude that attention to social stimuli is the result of a combination of two processes. One innate, which seems to be different in autism, and one that is influenced by social norms, which works in the same way in autistic adults without learning disabilities. The results suggest that social attention is not as different in autism as first thought. Specifically, the study contributes to dispel long-standing deficit models regarding social attention in autism as it points to subtle differences in the use of social norms rather than impairments.

AI for Psychometrics: Validating Machine Learning Models in Measuring Emotional Intelligence with Eye-Tracking Techniques

AI, or artificial intelligence, is a technology of creating algorithms and computer systems that mimic human cognitive abilities to perform tasks. Many industries are undergoing revolutions due to the advances and applications of AI technology. The current study explored a burgeoning field-Psychometric AI, which integrates AI methodologies and psychological measurement to not only improve measurement accuracy, efficiency, and effectiveness but also help reduce human bias and increase objectivity in measurement. Specifically, by leveraging unobtrusive eye-tracking sensing techniques and performing 1470 runs with seven different machine-learning classifiers, the current study systematically examined the efficacy of various (ML) models in measuring different facets and measures of the emotional intelligence (EI) construct. Our results revealed an average accuracy ranging from 50-90%, largely depending on the percentile to dichotomize the EI scores. More importantly, our study found that AI algorithms were powerful enough to achieve high accuracy with as little as 5 or 2 s of eye-tracking data. The research also explored the effects of EI facets/measures on ML measurement accuracy and identified many eye-tracking features most predictive of EI scores. Both theoretical and practical implications are discussed.

Social anxiety is related to reduced face gaze during a naturalistic social interaction

BACKGROUND

Social anxiety has long been related to reduced eye contact, and this feature is seen as a causal and a maintaining factor of social anxiety disorder. The present research adds to the literature by investigating the relationship between social anxiety and visual avoidance of faces in a reciprocal face-to-face conversation, while taking into account two aspects of conversations as potential moderating factors: conversational role and level of intimacy.

METHOD

Eighty-five female students (17-25 years) completed the Leibowitz Social Anxiety Scale and had a face-to-face getting-acquainted conversation with a female confederate. We alternated conversational role (talking versus listening) and manipulated intimacy of the topics (low versus high). Participants' gaze behavior was registered with Tobii eye-tracking glasses. Three dependent measures were extracted regarding fixations on the face of the confederate: total duration, proportion of fixations, and mean duration.

RESULTS

The results revealed that higher levels of social anxiety were associated with reduced face gaze on all three measures. The relation with total fixation duration was stronger for low intimate topics. The relation with mean fixation duration was stronger during listening than during speaking.

CONCLUSION

The results highlight the importance of studying gaze behavior in a naturalistic social interaction.

Level of Attention to Motherese Speech as an Early Marker of Autism Spectrum Disorder

Importance

Caregivers have long captured the attention of their infants by speaking in motherese, a playful speech style characterized by heightened affect. Reduced attention to motherese in toddlers with autism spectrum disorder (ASD) may be a contributor to downstream language and social challenges and could be diagnostically revealing.

Objective

To investigate whether attention toward motherese speech can be used as a diagnostic classifier of ASD and is associated with language and social ability.

Design, Setting, and Participants

This diagnostic study included toddlers aged 12 to 48 months, spanning ASD and non-ASD diagnostic groups, at a research center. Data were collected from February 2018 to April 2021 and analyzed from April 2021 to March 2022.

Exposures

Gaze-contingent eye-tracking test.

Main Outcomes and Measures

Using gaze-contingent eye tracking wherein the location of a toddler's fixation triggered a specific movie file, toddlers participated in 1 or more 1-minute eye-tracking tests designed to quantify attention to motherese speech, including motherese vs traffic (ie, noisy vehicles on a highway) and motherese vs techno (ie, abstract shapes with music). Toddlers were also diagnostically and psychometrically evaluated by psychologists. Levels of fixation within motherese and nonmotherese movies and mean number of saccades per second were calculated. Receiver operating characteristic (ROC) curves were used to evaluate optimal fixation cutoff values and associated sensitivity, specificity, positive predictive value (PPV), and negative predictive value. Within the ASD group, toddlers were stratified based on low, middle, or high levels of interest in motherese speech, and associations with social and language abilities were examined.

Results

A total of 653 toddlers were included (mean [SD] age, 26.45 [8.37] months; 480 males [73.51%]). Unlike toddlers without ASD, who almost uniformly attended to motherese speech with a median level of 82.25% and 80.75% across the 2 tests, among toddlers with ASD, there was a wide range, spanning 0% to 100%. Both the traffic and techno paradigms were effective diagnostic classifiers, with large between-group effect sizes (eg, ASD vs typical development: Cohen d, 1.0 in the techno paradigm). Across both paradigms, a cutoff value of 30% or less fixation on motherese resulted in an area under the ROC curve (AUC) of 0.733 (95% CI, 0.693-0.773) and 0.761 (95% CI, 0.717-0.804), respectively; specificity of 98% (95% CI, 95%-99%) and 96% (95% CI, 92%-98%), respectively; and PPV of 94% (95% CI, 86%-98%). Reflective of heterogeneity and expected subtypes in ASD, sensitivity was lower at 18% (95% CI, 14%-22%) and 29% (95% CI, 24%-34%), respectively. Combining metrics increased the AUC to 0.841 (95% CI, 0.805-0.877). Toddlers with ASD who showed the lowest levels of attention to motherese speech had weaker social and language abilities.

Conclusions and Relevance

In this diagnostic study, a subset of toddlers showed low levels of attention toward motherese speech. When a cutoff level of 30% or less fixation on motherese speech was used, toddlers in this range were diagnostically classified as having ASD with high accuracy. Insight into which toddlers show unusually low levels of attention to motherese may be beneficial not only for early ASD diagnosis and prognosis but also as a possible therapeutic target.

Clear Aligners and Smart Eye Tracking Technology as a New Communication Strategy between Ethical and Legal Issues

Smart eye-tracking technology (SEET) that determines visual attention using smartphones can be used to determine the aesthetic perception of different types of clear aligners. Its value as a communication and comprehension tool, in addition to the ethical and legal concerns which it entails, can be assessed. One hundred subjects (50 F, 50 M; age range 15-70) were equally distributed in non-orthodontic (A) and orthodontic (B) groups. A smartphone-based SEET app assessed their knowledge of and opinions on aligners. Subjects evaluated images of smiles not wearing aligners, with/without attachments and with straight/scalloped gingival margins, as a guided calibration step which formed the image control group. Subsequently, the subjects rated the same smiles, this time wearing aligners (experimental images group). Questionnaire data and average values for each group of patients, and images relating to fixation times and overall star scores, were analyzed using these tests: chi-square, t-test, Mann-Whitney U, Spearman's rho, and Wilcoxon (p < 0.05). One-way ANOVA and related post-hoc tests were also applied. Orthodontic patients were found to be better informed than non-orthodontic patients. Aesthetic perception could be swayed by several factors. Attachments scored lower in aesthetic evaluation. Lips distracted attention from attachments and improved evaluations. Attachment-free aligners were better rated overall. A more thorough understanding as to the opinions, expectations and aesthetic perception of aligners can improve communication with patients. Mobile SEET is remarkably promising, although it does require a careful medicolegal risk-benefit assessments for responsible and professional use.

No evidence that gaze anxiety predicts gaze avoidance behavior during face-to-face social interaction

Eye contact is an indispensable social signal, yet for some individuals it is also a source of discomfort they fear and avoid. However, it is still unknown whether gaze anxiety actually produces avoidant gaze behavior in naturalistic, face-to-face interactions. Here, we relied on a novel dual eye-tracking setup that allows us to assess interactive gaze behavior. To investigate the effect of gaze anxiety on gaze behavior, we a priori created groups of participants reporting high or low levels of gaze anxiety. These participants (n = 51) then performed a semi-standardized interaction with a previously unknown individual reporting a medium level of gaze anxiety. The gaze behavior of both groups did not differ in either classical one-way, eye-tracking parameters (e.g. unilateral eye gaze), or interactive, two-way ones (e.g. mutual gaze). Furthermore, the subjective ratings of both participants' interaction did not differ between groups. Gaze anxious individuals seem to exhibit normal gaze behavior which does not hamper the perceived quality of interactions in a naturalistic face-to-face setup. Our findings point to the existence of cognitive distortions in gaze anxious individuals whose exterior behavior might be less affected than feared by their interior anxiety.

The Good, the Bad, and the Ugly-Chances, Challenges, and Clinical Implications of Avoidance Research in Psychosomatic Medicine

Avoidance behaviors are shaped by associative learning processes in response to fear of impending threats, particularly physical harm. As part of a defensive repertoire, avoidance is highly adaptive in case of acute danger, serving a potent protective function. However, persistent or excessive fear and maladaptive avoidance are considered key factors in the etiology and pathophysiology of anxiety- and stress-related psychosomatic disorders. In these overlapping conditions, avoidance can increase the risk of mental comorbidities and interfere with the efficacy of cognitive behavioral treatment approaches built on fear extinction. Despite resurging interest in avoidance research also in the context of psychosomatic medicine, especially in conditions associated with pain, disturbed interoception, and disorders of the gut-brain axis, current study designs and their translation into the clinical context face significant challenges limiting both, the investigation of mechanisms involved in avoidance and the development of novel targeted treatment options. We herein selectively review the conceptual framework of learning and memory processes, emphasizing how classical and operant conditioning, fear extinction, and return of fear shape avoidance behaviors. We further discuss pathological avoidance and safety behaviors as hallmark features in psychosomatic diseases, with a focus on anxiety- and stress-related disorders. Aiming to emphasize chances of improved translational knowledge across clinical conditions, we further point out limitations in current experimental avoidance research. Based on these considerations, we propose means to improve existing avoidance paradigms to broaden our understanding of underlying mechanisms, moderators and mediators of avoidance, and to inspire tailored treatments for patients suffering from psychosomatic disorders.