Eye contact elicits bodily self-awareness in human adults

The impact of facial expression and communicative gaze of a humanoid robot on individual Sense of Agency

Sense of Agency (SoA) is the feeling of control over one's actions and their outcomes. A well-established implicit measure of SoA is the temporal interval estimation paradigm, in which participants estimate the time interval between a voluntary action and its sensory consequence. In the present study, we aimed to investigate whether the valence of action outcome modulated implicit SoA. The valence was manipulated through interaction partner's (i) positive/negative facial expression, or (ii) type of gaze (gaze contact or averted gaze). The interaction partner was the humanoid robot iCub. In Experiment 1, participants estimated the time interval between the onset of their action (head movement towards the robot), and the robot's facial expression (happy vs. sad face). Experiment 2 was identical, but the outcome of participants' action was the type of robot's gaze (gaze contact vs. averted). In Experiment 3, we assessed-in a within-subject design-the combined effect of robot's type of facial expression and type of gaze. Results showed that, while the robot's facial expression did not affect participants' SoA (Experiment 1), the type of gaze affected SoA in both Experiment 2 and Experiment 3. Overall, our findings showed that the robot's gaze is a more potent factor than facial expression in modulating participants' implicit SoA.

Changes in self-other boundaries modulate children's body image attitudes

One's own face is a key distinctive feature of our physical appearance, yet multisensory visuo-tactile stimulation can alter self-other boundaries, eliciting changes in adult's self-face representation and social cognition processes. This study tested whether changing self-face representation by altering self-other boundaries with the enfacement illusion modulates body image attitudes toward others in 6-11-year-old children (N = 51; 31 girls; predominantly White). Across all ages, congruent multisensory information led to stronger enfacement (η²_p = 0.06). Participants who experienced a stronger enfacement illusion showed preference for larger body size, suggesting increased positive body size attitudes. This effect was stronger in 6-7-year-olds compared to 8-9-year-olds. Thus, blurring self-other boundaries successfully modulates self-face representation and body image attitudes toward others in children. Our results suggest that increased self-resemblance through self-other blurring resulting from the enfacement illusion may reduce social comparisons between self and other and result in positive body size attitudes.

How vergence influences the perception of being looked at

Perceiving other people's direct gaze is important for many areas of everyday activity. For horizontal and vertical eye movements, the area of being looked at, known as the cone of gaze, has been well explored. Previous research has shown a range of eye rotations (up to eccentricities of 4°-9°) that people accept as direct gaze. Vergence is an important cue for perceiving the depth of fixation. This study examines the range of vergence angles that support the perception of being looked at. In two experiments, observers adjusted the degree of vergence of the lookers' eyes until they felt just (not) looked at. The first experiment also asked to adjust the point of being exactly looked at, which was 0° (parallel eyes). The thresholds of being just (not) looked at were around 4.5° of convergence and 2.5° divergence, which results in a depth of 7° of vergence. This depth was replicated in Experiment 2, while the thresholds of convergence (3.5°) and divergence (3.5°) slightly differ from Experiment 1. The results indicate a consistent area of vergences being accepted as direct gaze, yielding first-time evidence for a third dimension-the depth dimension-of direct gaze.

Social signalling as a framework for second-person neuroscience

Despite the recent increase in second-person neuroscience research, it is still hard to understand which neurocognitive mechanisms underlie real-time social behaviours. Here, we propose that social signalling can help us understand social interactions both at the single- and two-brain level in terms of social signal exchanges between senders and receivers. First, we show how subtle manipulations of being watched provide an important tool to dissect meaningful social signals. We then focus on how social signalling can help us build testable hypotheses for second-person neuroscience with the example of imitation and gaze behaviour. Finally, we suggest that linking neural activity to specific social signals will be key to fully understand the neurocognitive systems engaged during face-to-face interactions.

The Influence of Face Gaze by Physicians on Patient Trust: an Observational Study

BACKGROUND

Physicians' gaze towards their patients may affect patients' trust in them. This is especially relevant considering recent developments, including the increasing use of Electronic Health Records, which affect physicians' gaze behavior. Moreover, socially anxious patients' trust in particular may be affected by the gaze of the physician.

OBJECTIVE

We aimed to evaluate if physicians' gaze towards the face of their patient influenced patient trust and to assess if this relation was stronger for socially anxious patients. We furthermore explored the relation between physicians' gaze and patients' perception of physician empathy and patients' distress.

DESIGN

This was an observational study using eye-tracking glasses and questionnaires.

PARTICIPANTS

One hundred patients and 16 residents, who had not met before, participated at an internal medicine out-patient clinic.

MEASURES

Physicians wore eye-tracking glasses during medical consultations to assess their gaze towards patients' faces. Questionnaires were used to assess patient outcomes. Multilevel analyses were conducted to assess the relation between physicians' relative face gaze time and trust, while correcting for patient background characteristics, and including social anxiety as a moderator. Analyses were then repeated with perceived empathy and distress as outcomes.

RESULTS

More face gaze towards patients was associated with lower trust, after correction for gender, age, education level, presence of caregivers, and social anxiety (β=-0.17, P=0.048). There was no moderation effect of social anxiety nor a relation between face gaze and perceived empathy or distress.

CONCLUSIONS

These results challenge the notion that more physician gaze is by definition beneficial for the physician-patient relationship. For example, the extent of conversation about emotional issues might explain our findings, where more emotional talk could be associated with more intense gazing and feelings of discomfort in the patient. To better understand the relation between physician gaze and patient outcomes, future studies should assess bidirectional face gaze during consultations.

Pupil dilation predicts modulation of direct gaze on action value calculations

Perceiving direct gaze facilitates social cognition and behaviour. We hypothesized that direct gaze modulates decision-making, particularly calculations of action values. To test our hypothesis, we used the reinforcement learning paradigm in situations with or without direct gaze. Forty adults were recruited and participated in pupil size measurements and a two-armed bandit task. The task was conducted with 70% and 30% reward probabilities for each option. During the task, a female showing the Direct Gaze (DG) or Closed Eyes (CE) condition was presented from the start of each trial. The results showed that behavioural bias to choices with 70% reward probability increased more in the DG condition than in the CE condition and the expected reward value. This bias to choices with 70% reward in the DG condition was predicted by pupil dilation to DG. These results suggest that participants over-evaluated the expected reward value in the DG condition, and this DG effect may be related to subjective expectations of rewarding events indexed by pupil dilations. It is considered that perceiving direct gaze is a driver of reward expectations that modulate action value calculations and then cognitive processing and behaviours are facilitated.

When eyes beat lips: speaker gaze affects audiovisual integration in the McGurk illusion

Eye contact is a dynamic social signal that captures attention and plays a critical role in human communication. In particular, direct gaze often accompanies communicative acts in an ostensive function: a speaker directs her gaze towards the addressee to highlight the fact that this message is being intentionally communicated to her. The addressee, in turn, integrates the speaker’s auditory and visual speech signals (i.e., her vocal sounds and lip movements) into a unitary percept. It is an open question whether the speaker’s gaze affects how the addressee integrates the speaker’s multisensory speech signals. We investigated this question using the classic McGurk illusion, an illusory percept created by presenting mismatching auditory (vocal sounds) and visual information (speaker’s lip movements). Specifically, we manipulated whether the speaker (a) moved his eyelids up/down (i.e., open/closed his eyes) prior to speaking or did not show any eye motion, and (b) spoke with open or closed eyes. When the speaker’s eyes moved (i.e., opened or closed) before an utterance, and when the speaker spoke with closed eyes, the McGurk illusion was weakened (i.e., addressees reported significantly fewer illusory percepts). In line with previous research, this suggests that motion (opening or closing), as well as the closed state of the speaker’s eyes, captured addressees’ attention, thereby reducing the influence of the speaker’s lip movements on the addressees’ audiovisual integration process. Our findings reaffirm the power of speaker gaze to guide attention, showing that its dynamics can modulate low-level processes such as the integration of multisensory speech signals.

Neural correlates of interoceptive accuracy: Beyond cardioception

Interoceptive accuracy (IAc), the precision with which one assesses the signals arising from one's own body, is receiving increasing attention in the literature. IAc has mainly been approached as an individual trait and has been investigated through the cardiac modality using mostly non-ecological methods. Such studies consensually designate the anterior insular cortex as the main brain correlate of IAc. However, there is a lack of brain imaging studies investigating IAc in a broader and more ecological way. Here, we used a novel ecological task in which participants monitored their general bodily reactions to external events and investigated brain regions subtending intraindividual (i.e. trial-by-trial) variations of IAc. At each trial, participants had to rate the intensity of their bodily reactions to an emotional picture. We recorded participants' skin conductance response (SCR) to the picture as an indicator of actual physiological response intensity. We fitted a functional magnetic resonance imaging (fMRI) model using, as regressors, the SCR value, the rating and the product of the two (as a proxy of participants' IAc) obtained trial per trial. We observed that activity in the dorsomedial prefrontal cortex (dmPFC) increased when individuals' IAc decreased. This result reveals general mechanism of error processing in intraindividual variations of IAc, which are unspecific to interoception. Our result has a practical impact in the clinical domain. Namely, it supports the predictive coding framework whereby IAc deficits may reflect impairments in processing a mismatch between actual interoceptive signals and predictions.

I can see it in your eyes: Perceived gaze direction impacts ERP and behavioural measures of affective theory of mind

Looking at someone's eyes is thought to be important for affective theory of mind (aTOM), our ability to infer their emotional state. However, it is unknown whether an individual's gaze direction influences our aTOM judgements and what the time course of this influence might be. We presented participants with sentences describing individuals in positive, negative or neutral scenarios, followed by direct or averted gaze neutral face pictures of those individuals. Participants made aTOM judgements about each person's mental state, including their affective valence and arousal, and we investigated whether the face gaze direction impacted those judgements. Participants rated that gazers were feeling more positive when they displayed direct gaze as opposed to averted gaze, and that they were feeling more aroused during negative contexts when gaze was averted as opposed to direct. Event-related potentials associated with face perception and affective processing were examined using mass-univariate analyses to track the time-course of this eye-gaze and affective processing interaction at a neural level. Both positive and negative trials were differentiated from neutral trials at many stages of processing. This included the early N200 and EPN components, believed to reflect automatic emotion areas activation and attentional selection respectively. This also included the later P300 and LPP components, thought to reflect elaborative cognitive appraisal of emotional content. Critically, sentence valence and gaze direction interacted over these later components, which may reflect the incorporation of eye-gaze in the cognitive evaluation of another's emotional state. The results suggest that gaze perception directly impacts aTOM processes, and that altered eye-gaze processing in clinical populations may contribute to associated aTOM impairments.

Meeting another's gaze shortens subjective time by capturing attention

Gaze directed at the observer (direct gaze) is an important and highly salient social signal with multiple effects on cognitive processes and behavior. It is disputed whether the effect of direct gaze is caused by attentional capture or increased arousal. Time estimation may provide an answer because attentional capture predicts an underestimation of time whereas arousal predicts an overestimation. In a temporal bisection task, observers were required to classify the duration of a stimulus as short or long. Stimulus duration was selected randomly between 988 and 1479 ms. When gaze was directed at the observer, participants underestimated stimulus duration, suggesting that effects of direct gaze are caused by attentional capture, not increased arousal. Critically, this effect was limited to dynamic stimuli where gaze appeared to move toward the participant. The underestimation was present with stimuli showing a full face, but also with stimuli showing only the eye region, inverted faces and high-contrast eye-like stimuli. However, it was absent with static pictures of full faces and dynamic nonfigurative stimuli. Because the effect of direct gaze depended on motion, which is common in naturalistic scenes, more consideration needs to be given to the ecological validity of stimuli in the study of social attention.

Social Agency as a continuum

Sense of Agency, the phenomenology associated with causing one's own actions and corresponding effects, is a cornerstone of human experience. Social Agency can be defined as the Sense of Agency experienced in any situation in which the effects of our actions are related to a conspecific. This can be implemented as the other's reactions being caused by our action, joint action modulating our Sense of Agency, or the other's mere social presence influencing our Sense of Agency. It is currently an open question how such Social Agency can be conceptualized and how it relates to its nonsocial variant. This is because, compared with nonsocial Sense of Agency, the concept of Social Agency has remained oversimplified and underresearched, with disparate empirical paradigms yielding divergent results. Reviewing the empirical evidence and the commonalities and differences between different instantiations of Social Agency, we propose that Social Agency can be conceptualized as a continuum, in which the degree of cooperation is the key dimension that determines our Sense of Agency, and how it relates to nonsocial Sense of Agency. Taking this perspective, we review how the different factors that typically influence Sense of Agency affect Social Agency, and in the process highlight outstanding empirical questions within the field. Finally, concepts from wider research areas are discussed in relation to the ecological validity of Social Agency paradigms, and we provide recommendations for future methodology.

Feeling through another's eyes: Perceived gaze direction impacts ERP and behavioural measures of positive and negative affective empathy

Looking at the eyes informs us about the thoughts and emotions of those around us, and impacts our own emotional state. However, it is unknown how perceiving direct and averted gaze impacts our ability to share the gazer's positive and negative emotions, abilities referred to as positive and negative affective empathy. We presented 44 participants with contextual sentences describing positive, negative and neutral events happening to other people (e.g. "Her newborn was saved/killed/fed yesterday afternoon."). These were designed to elicit positive, negative, or little to no empathy, and were followed by direct or averted gaze images of the individuals described. Participants rated their affective empathy for the individual and their own emotional valence on each trial. Event-related potentials time-locked to face-onset and associated with empathy and emotional processing were recorded to investigate whether they were modulated by gaze direction. Relative to averted gaze, direct gaze was associated with increased positive valence in the positive and neutral conditions and with increased positive empathy ratings. A similar pattern was found at the neural level, using robust mass-univariate statistics. The N100, thought to reflect an automatic activation of emotion areas, was modulated by gaze in the affective empathy conditions, with opposite effect directions in positive and negative conditions.. The P200, an ERP component sensitive to positive stimuli, was modulated by gaze direction only in the positive empathy condition. Positive and negative trials were processed similarly at the early N200 processing stage, but later diverged, with only negative trials modulating the EPN, P300 and LPP components. These results suggest that positive and negative affective empathy are associated with distinct time-courses, and that perceived gaze direction uniquely modulates positive empathy, highlighting the importance of studying empathy with face stimuli.

No preference for direct versus averted gaze in autistic adults: a reinforced preferential looking paradigm

Background

With the overarching objective to gain better insights into social attention in autistic adults, the present study addresses three outstanding issues about face processing in autism. First, do autistic adults display a preference for mouths over eyes; second, do they avoid direct gaze; third, is atypical visual exploration of faces in autism mediated by gender, social anxiety or alexithymia?

Methods

We used a novel reinforced preferential looking paradigm with a group of autistic adults (n = 43, 23 women) pairwise matched on age with neurotypical participants (n = 43, 21 women). Participants watched 28 different pairs of 5 s video recordings of a speaking person: the two videos, simultaneously displayed on the screen, were identical except that gaze was directed at the camera in one video and averted in the other. After a 680 ms transition phase, a short reinforcement animation appeared on the side that had displayed the direct gaze.

Results

None of the groups showed a preference for mouths over eyes. However, neurotypical participants fixated significantly more the stimuli with direct gaze, while no such preference emerged in autistic participants. As the experiment progressed, neurotypical participants also increasingly anticipated the appearance of the reinforcement, based on the location of the stimulus with the direct gaze, while no such anticipation emerged in autistic participants.

Limitations

Our autistic participants scored higher on the social anxiety and alexithymia questionnaires than neurotypicals. Future studies should match neurotypical and autistic participants on social anxiety and alexithymia and complement questionnaires with physiological measures of anxiety.

Conclusions

The absence of preference for direct versus averted gaze in the autistic group is probably due to difficulties in distinguishing eye gaze direction, potentially linked to a reduced spontaneous exploration or avoidance of the eye region. Social attention and preference for direct versus averted gaze correlated with alexithymia and social anxiety scores, but not gender.

The effect of non-communicative eye movements on joint attention

Eye movements provide important signals for joint attention. However, those eye movements that indicate bids for joint attention often occur among non-communicative eye movements. This study investigated the influence of these non-communicative eye movements on subsequent joint attention responsivity. Participants played an interactive game with an avatar which required both players to search for a visual target on a screen. The player who discovered the target used their eyes to initiate joint attention. We compared participants' saccadic reaction times (SRTs) to the avatar's joint attention bids when they were preceded by non-communicative eye movements that predicted the location of the target (Predictive Search), did not predict the location of the target (Random Search), and when there were no non-communicative eye gaze movements prior to joint attention (No Search). We also included a control condition in which participants completed the same task, but responded to a dynamic arrow stimulus instead of the avatar's eye movements. For both eye and arrow conditions, participants had slower SRTs in Random Search trials than No Search and Predictive Search trials. However, these effects were smaller for eyes than for arrows. These data suggest that joint attention responsivity for eyes is relatively stable to the presence and predictability of spatial information conveyed by non-communicative gaze. Contrastingly, random sequences of dynamic arrows had a much more disruptive impact on subsequent responsivity compared with predictive arrow sequences. This may reflect specialised social mechanisms and expertise for selectively responding to communicative eye gaze cues during dynamic interactions, which is likely facilitated by the integration of ostensive eye contact cues.

Temporal error monitoring with directional error magnitude judgements: a robust phenomenon with no effect of being watched

A key aspect of metacognition is the ability to monitor performance. A recent line of work has shown that error-monitoring ability captures both the magnitude and direction of timing errors, thereby pointing at the metric composition of error monitoring [e.g., Akdoğan and Balcı (J Exp Psychol https://dx.doi.org/10.1037/xge0000265 , 2017)]. These studies, however, primarily used a composite variable that combined isolated measures of ordinal confidence ratings (as a proxy for error magnitude judgement) and "shorter/longer than the target" judgements. In two experiments we tested temporal error monitoring (TEM) performance with a more direct measure of directional error magnitude rating on a continuum. The second aim of this study is to test if TEM performance is modulated by the feeling of being watched that was previously shown to influence metacognitive-like monitoring processes. We predicted that being watched would improve TEM performance, particularly in participants with high timing precision (a proxy for high task mastery), and disrupt TEM performance in participants with low timing precision (a proxy for low task mastery). In both experiments, we found strong evidence for TEM ability. However, we did not find any reliable effect of the social stimulus on TEM performance. In short, our results demonstrate that metric error monitoring is a robust metacognitive phenomenon, which is not sensitive to social influence.

Direct gaze enhances interoceptive accuracy

Direct-gaze signals are known to modulate human cognition, including self-awareness. In the present study, we specifically focused on 'bodily' self-awareness and examined whether direct gaze would modulate one's interoceptive accuracy (IAcc)-the ability to accurately monitor internal bodily sensations. While viewing a photograph of a frontal face with a direct gaze, an averted face or a mere white cross as a baseline, participants were required to count their heartbeats without taking their pulse. The results showed higher IAcc in the direct-gaze condition than in the averted-face or baseline condition. This was particularly the case in participants with low IAcc at baseline, indicating that direct gaze enhanced the participants' IAcc. Importantly, their heart rate was not different while viewing the direct gaze and averted face, suggesting that sensitivity to interoceptive signals, rather than physiological arousal, is heightened by direct gaze. These findings demonstrate the role of social signals in our bodily interoceptive processing and support the notion of the social nature of self-awareness.

Effects of being watched on self-referential processing, self-awareness and prosocial behaviour

Reputation management theory suggests that our behaviour changes in the presence of others to signal good reputation (audience effect). However, the specific cognitive mechanisms by which being watched triggers these changes are poorly understood. Here we test the hypothesis that these changes happen because the belief in being watched increases self-referential processing. We used a novel deceptive video-conference paradigm, where participants believe a video-clip is (or is not) a live feed of a confederate watching them. Participants completed four tasks measuring self-referential processing, prosocial behaviour and self-awareness under these two belief settings. Although the belief manipulation and self-referential effect task were effective, there were no changes on self-referential processing between the two settings, nor on prosocial behaviour and self-awareness. Based on previous evidence and these findings, we propose that further research on the role of the self, social context and personality traits will help elucidating the mechanisms underlying audience effects.

Working With the Predictable Life of Patients: The Importance of "Mentalizing Interoception" to Meaningful Change in Psychotherapy

To understand our patients and optimize their treatment, psychotherapists of all theoretical orientations may benefit from considering current scientific evidence alongside psychodynamic constructs. There is recent neuroscientific evidence that subjective awareness, feelings and emotions depend upon "interoception," defined as the neural signaling to the brain from all tissues of the body. Interoception is the obvious basis of homeostasis (in the brainstem) but some interoceptive signals rise above this level and contribute to inferential processes that substantiate intrapersonal and interpersonal experience. The focus of this paper is on the essential role that their "interoception" plays in our patients' emotional experience and subjective awareness, and how the process referred to as "mentalizing interoception" may be harnessed in therapy. This can best be understood in terms of "predictive processing," which describes how subjective states, and particularly emotion, are inferred from sensory inputs - both interoceptive and exteroceptive. Predictive processing assumes that the brain infers (probabilistically) the likely cause of sensation experienced through the sense organs, by testing this sensory data against its innate and learned "priors." This implies that any effort at changing heavily over-learned prior beliefs will require action upon the system that has generated that set of prior beliefs. This involves, quite literally, acting upon the world to alter inferential processes, or in the case of interoceptive priors, acting on the patient's body to alter habitual autonomic nervous system (ANS) reflexes. Focused attention to bodily sensations/reactions, in the safety of the therapeutic relationship, provides a route to "mentalizing interoception," by means of the bodily cues that may be the only conscious element of deeply hidden priors and thus the clearest way to access them. This can: update patients' characteristic, dysfunctional responses to emotion and feelings; increase emotional insight; decrease cognitive distortions; and engender a more acute awareness of the present moment. These important ideas are outlined below from the perspective of psychodynamic psychotherapeutic practice, in order to discuss how relevant information from neuroscientific theory and current research can best be applied in clinical treatment. A clinical case will be presented to illustrate how this argument or treatment relates directly to clinical practice.

Eye contact effects on social preference and face recognition in normal ageing and in Alzheimer's disease

Perceiving a direct gaze (i.e. another individual's gaze directed to the observer leading to eye contact) influences positively a wide range of cognitive processes. In particular, direct gaze perception is known to stimulate memory for other's faces and to increase their likeability. Alzheimer's disease (AD) results in social withdrawal and cognitive decline. However, patients show preserved eye contact behaviours until the middle stage of the disease. The eye contact effects could be preserved in AD and be used to compensate for cognitive and social deficits. Yet, it is unknown whether these effects are preserved in normal ageing. The aim of this study was to address whether the positive effects of eye contact on memory for faces and likeability of others are preserved in healthy older adults and in patients with early to mild AD. Nineteen AD patients, 20 older adults and 20 young adults participated in our study. Participants were first presented with faces displaying either direct or averted gaze and rated each face's degree of likeability. They were then asked to identify the faces they had previously seen during a surprise recognition test. Results showed that the effect of eye contact on other's likeability was preserved in normal ageing and in AD. By contrast, an effect of eye contact on memory for faces seems to emerge only in young participants, suggesting that this effect declines with ageing. Interestingly, however, AD patients show a positive correlation between ratings of likeability and recognition scores, suggesting that they implicitly allocated their encoding resources to most likeable faces. These results open a new way for a "compensating" therapy in AD.

The impact of eye contact on the sense of agency

Recent research suggests that eye contact can lead to enhanced self-awareness. A related phenomenon, the sense of agency deals with the notion of the self as the origin of our actions. Possible links between eye contact and agency have been so far neglected. Here, we investigated whether an implicit sense of agency could be modulated by eye gaze. We asked participants to respond (button press) to a face stimulus: looking or not at the participant (experiment 1); or displaying distinct eye gaze before or after a mask (experiment 2). After each trial, participants estimated the time between their key press and the ensuing effects. We found enhanced intentional binding for conditions that involved direct compared to averted gaze. This study supports the idea that eye contact is an important cue that affects complex cognitive processes and suggests that modulating self-processing can impact the sense of agency.

Socially Communicative Eye Contact and Gender Affect Memory

Because of their value as a socially communicative cue, researchers have strived to understand how the gaze of other people influences a variety of cognitive processes. Recent work in social attention suggests that the use of images of people in laboratory studies, as a substitute for real people, may not effectively test socially communicative aspects of eye gaze. As attention affects many other cognitive processes, it is likely that social attention between real individuals could also affect other cognitive processes, such as memory. However, from previous work alone, it is unclear whether, and if so how, socially communicative eye gaze affects memory. The present studies test the assumption that socially communicative aspects of eye gaze may impact memory by manipulating the eye gaze of a live speaker in the context of a traditional recognition paradigm used frequently in the laboratory. A female (Experiment 1) or male (Experiment 2) investigator read words aloud and varied whether eye contact was, or was not, made with a participant. With both female and male investigators, eye contact improved word recognition only for female participants and hindered word recognition in male participants. When a female investigator prolonged their eye contact (Experiment 3) to provide a longer opportunity to both observe and process the investigator’s eye gaze, the results replicated the findings from Experiments 1 and 2. The findings from Experiments 1–3 suggest that females interpret and use the investigator’s eye gaze differently than males. When key aspects from the previous experiments were replicated in a noncommunicative situation (i.e., when a video of a speaker is used instead of a live speaker; Experiment 4), the memory effects observed previously in response to eye gaze were eliminated. Together, these studies suggest that it is the socially communicative aspects of eye gaze from a real person that influence memory. The findings reveal the importance of using social cues that are communicative in nature (e.g., real people) when studying the relationship between social attention and memory.

Perceived Gaze Direction Differentially Affects Discrimination of Facial Emotion, Attention, and Gender - An ERP Study

The perception of eye-gaze is thought to be a key component of our everyday social interactions. While the neural correlates of direct and averted gaze processing have been investigated, there is little consensus about how these gaze directions may be processed differently as a function of the task being performed. In a within-subject design, we examined how perception of direct and averted gaze affected performance on tasks requiring participants to use directly available facial cues to infer the individuals' emotional state (emotion discrimination), direction of attention (attention discrimination) and gender (gender discrimination). Neural activity was recorded throughout the three tasks using EEG, and ERPs time-locked to face onset were analyzed. Participants were most accurate at discriminating emotions with direct gaze faces, but most accurate at discriminating attention with averted gaze faces, while gender discrimination was not affected by gaze direction. At the neural level, direct and averted gaze elicited different patterns of activation depending on the task over frontal sites, from approximately 220-290 ms. More positive amplitudes were seen for direct than averted gaze in the emotion discrimination task. In contrast, more positive amplitudes were seen for averted gaze than for direct gaze in the gender discrimination task. These findings are among the first direct evidence that perceived gaze direction modulates neural activity differently depending on task demands, and that at the behavioral level, specific gaze directions functionally overlap with emotion and attention discrimination, precursors to more elaborated theory of mind processes.

The Role of Eye Gaze During Natural Social Interactions in Typical and Autistic People

Social interactions involve complex exchanges of a variety of social signals, such as gaze, facial expressions, speech and gestures. Focusing on the dual function of eye gaze, this review explores how the presence of an audience, communicative purpose and temporal dynamics of gaze allow interacting partners to achieve successful communication. First, we focus on how being watched modulates social cognition and behavior. We then show that the study of interpersonal gaze processing, particularly gaze temporal dynamics, can provide valuable understanding of social behavior in real interactions. We propose that the Interpersonal Gaze Processing model, which combines both sensing and signaling functions of eye gaze, provides a framework to make sense of gaze patterns in live interactions. Finally, we discuss how autistic individuals process the belief in being watched and interpersonal dynamics of gaze, and suggest that systematic manipulation of factors modulating gaze signaling can reveal which aspects of social eye gaze are challenging in autism.

Differential impact of trait, social, and attachment anxiety on the stare-in-the-crowd effect

Eye gaze conveys crucial information for social interactions, with straight versus averted gaze triggering distinct emotional and cognitive processes. The "stare-in-the-crowd" effect exemplifies such differential visual processing of gaze direction, in more recent reports also in interaction with head orientation. Besides aiming at replicating the "stare-in-the-crowd" effect by means of an eye gaze by head orientation interaction, the present study intended to for the first time testing its susceptibility to inter-individual differences in trait, social, and attachment anxiety. Our findings reveal a significant relation between the "stare-in-the-crowd" effect and social and attachment, but not trait anxiety, and therefore provide preliminary cues for personality influences on visual processing of eye gaze and head orientation.

Interoception and Its Interaction with Self, Other, and Emotion Processing: Implications for the Understanding of Psychosocial Deficits in Borderline Personality Disorder

PURPOSE OF REVIEW

We review evidence for the potential importance of interoception, i.e., the processing of signals arising from inside the body, for deficient psychosocial functioning in borderline personality disorder (BPD).

RECENT FINDINGS

Evidence suggests that variability in interoception interacts with higher-order psychological functions such as self, other, and emotion processing. These domains are characteristically impaired in BPD, suggesting a likely causal role of disturbed interoception in the etiology of the disorder. The inability to identify and describe one's own emotional states represents a proxy of impaired interoception which might further mediate between the perception of inner physiological conditions and psychosocial functioning in BPD. There is preliminary evidence explaining how early life stress might adversely affect central interoceptive representation and psychosocial functioning in BPD. Based on these findings and the specific pattern of disturbances in BPD, we propose the crucial role of interoception in an integrated biobehavioral model for BPD.

Social Contact Enhances Bodily Self-Awareness

Human self-awareness is arguably the most important and revealing question of modern sciences. Converging theoretical perspectives link self-awareness and social abilities in human beings. In particular, mutual engagement during social interactions-or social contact-would boost self-awareness. Yet, empirical evidence for this effect is scarce. We recently showed that the perception of eye contact induces enhanced bodily self-awareness. Here, we aimed at extending these findings by testing the influence of social contact in auditory and tactile modalities, in order to demonstrate that social contact enhances bodily self-awareness irrespective of sensory modality. In a first experiment, participants were exposed to hearing their own first name (as compared to another unfamiliar name and noise). In a second experiment, human touch (as compared to brush touch and no-touch) was used as the social contact cue. In both experiments, participants demonstrated more accurate rating of their bodily reactions in response to emotional pictures following the social contact condition-a proxy of bodily self-awareness. Further analyses indicated that the effect of social contact was comparable across tactile, auditory and visual modalities. These results provide the first direct empirical evidence in support of the essential social nature of human self-awareness.

Increasing Our Insular World View: Interoception and Psychopathology for Psychotherapists

Interoception has been determined to be an elemental aspect of the neural foundations of physiological homeostasis, subjective experience, and motivated behavior. This paper reviews current neuroscience research regarding interoception and forms of interoceptive dysfunction that may result in psychopathology, focusing on depression, and anxiety, in a manner conducive to psychotherapists engaging with it to consider clinical applications. Pertinent aspects of interoceptive system processes in relation to psychopathology are addressed: Functional interoceptive ability and the forms of its expression, the difficulty of accurate measurement of such within an individual or group, interoceptive inference processes and perturbations. Predictive coding, considered in this context as interoceptive inference, a process that integrates bottom-up and top down lines of neural information emerging from the multitude of bidirectional, anatomically hierarchical connections the insular cortex makes with other cortical, and subcortical structures, will be addressed regarding its place in psychopathological formulations. Clinical vignettes will elucidate how interoceptive disturbances might present in the therapeutic relationship, supporting the evaluation and application of scientific theory, and research findings by psychotherapists. The clinical implications of this neuroscientific research have received little attention in the psychotherapeutic setting. Increasing the knowledge base of psychotherapists and furthering awareness of the functional interactions of body and brain toward the creation of healthy and psychopathological experience benefits the patient. There is immediate need for the translational expression of scientific findings into the psychological evaluation of patients, therapeutic process, and treatment. While it may seem distant and unrelated to the affective processes that occur within the psychotherapeutic exchange, neuroscience adds a unique perspective from which to observe and live such experience for the therapist and patient. With the therapeutic relationship as the backdrop, a scientific perspective will support psychotherapists' comprehension of their patients' experience and the process of change, either through direct information, or the development of different perspectives from which to observe and interact with their patients. This paper will serve not only as a guide for psychotherapists concerning this expanding knowledge base, but also a source for neuroscience researchers intent on formulating research protocols that could produce clinical benefit.

Genuine eye contact elicits self-referential processing

The effect of eye contact on self-awareness was investigated with implicit measures based on the use of first-person singular pronouns in sentences. The measures were proposed to tap into self-referential processing, that is, information processing associated with self-awareness. In addition, participants filled in a questionnaire measuring explicit self-awareness. In Experiment 1, the stimulus was a video clip showing another person and, in Experiment 2, the stimulus was a live person. In both experiments, participants were divided into two groups and presented with the stimulus person either making eye contact or gazing downward, depending on the group assignment. During the task, the gaze stimulus was presented before each trial of the pronoun-selection task. Eye contact was found to increase the use of first-person pronouns, but only when participants were facing a real person, not when they were looking at a video of a person. No difference in self-reported self-awareness was found between the two gaze direction groups in either experiment. The results indicate that eye contact elicits self-referential processing, but the effect may be stronger, or possibly limited to, live interaction.

Gazing at me: the importance of social meaning in understanding direct-gaze cues

Direct gaze is an engaging and important social cue, but the meaning of direct gaze depends heavily on the surrounding context. This paper reviews some recent studies of direct gaze, to understand more about what neural and cognitive systems are engaged by this social cue and why. The data show that gaze can act as an arousal cue and can modulate actions, and can activate brain regions linked to theory of mind and self-related processing. However, all these results are strongly modulated by the social meaning of a gaze cue and by whether participants believe that another person is really watching them. The implications of these contextual effects and audience effects for our theories of gaze are considered.

[Eye contact effects: A therapeutic issue?]

INTRODUCTION

The perception of a direct gaze - that is, of another individual's gaze directed at the observer that leads to eye contact - is known to influence a wide range of cognitive processes and behaviors. We stress that these effects mainly reflect positive impacts on human cognition and may thus be used as relevant tools for therapeutic purposes.

OBJECTIVES

In this review, we aim (1) to provide an exhaustive review of eye contact effects while discussing the limits of the dominant models used to explain these effects, (2) to illustrate the therapeutic potential of eye contact by targeting those pathologies that show both preserved gaze processing and deficits in one or several functions that are targeted by the eye contact effects, and (3) to propose concrete ways in which eye contact could be employed as a therapeutic tool.

DISCUSSION

(1) We regroup the variety of eye contact effects into four categories, including memory effects, activation of prosocial behavior, positive appraisals of self and others and the enhancement of self-awareness. We emphasize that the models proposed to account for these effects have a poor predictive value and that further descriptions of these effects is needed. (2) We then emphasize that people with pathologies that affect memory, social behavior, and self and/or other appraisal, and self-awareness could benefit from eye contact effects. We focus on depression, autism and Alzheimer's disease to illustrate our proposal. To our knowledge, no anomaly of eye contact has been reported in depression. Patients suffering from Alzheimer disease, at the early and moderate stage, have been shown to maintain a normal amount of eye contact with their interlocutor. We take into account that autism is controversial regarding whether gaze processing is preserved or altered. In the first view, individuals are thought to elude or omit gazing at another's eyes while in the second, individuals are considered to not be able to process the gaze of others. We adopt the first stance following the view that people with autism are not interested in processing social signals such as gaze but could do so efficiently if properly motivated. For each pathology we emphasize that eye contact could be used, for example, to enhance sensitivity to bodily states, thus improving emotional decision making (in autism); to lead to more positive appraisal of the self and others (in depression); to improve memory performances (in Alzheimer disease) and, more generally, to motivate the recipient to engage in the therapeutic process. (3) Finally we propose two concrete ways to employ eye contact effects as a therapeutic tool. The first is to develop cognitive-behavioral tools to learn and/or motivate the recipient to create frequent and prolonged eye contact periods. The second is to raise awareness among caregivers of the beneficial effects of eye contact and to teach them the way to use eye contact to reach its optimum effects. Future investigations are however needed to explore the ways in which eye contact effects can be efficiently integrated in therapeutic strategies, as well as to identify the clinical populations that can benefit from such therapeutic interventions.

Being watched by others eliminates the effect of emotional arousal on inhibitory control

The psychological effect of being watched by others has been proven a powerful tool in modulating social behaviors (e.g., charitable giving) and altering cognitive performance (e.g., visual search). Here we tested whether such awareness would affect one of the core elements of human cognition: emotional processing and impulse control. Using an emotion stop-signal paradigm, we found that viewing emotionally-arousing erotic images before attempting to inhibit a motor response impaired participants’ inhibition ability, but such an impairing effect was completely eliminated when participants were led to believe that their facial expressions were monitored by a webcam. Furthermore, there was no post-error slowing in any of the conditions, thus these results cannot be explained by a deliberate speed-accuracy tradeoff or other types of conscious shift in strategy. Together, these findings demonstrate that the interaction between emotional arousal and impulse control can be dependent on one’s state of self-consciousness. Furthermore, this study also highlights the effect that the mere presence of the experimenter may have on participants’ cognitive performance, even if it’s only a webcam.

Visual attention in mixed-gender groups

A basic principle of objectification theory is that a mere glance from a stranger represents the potential to be sexualized, triggering women to take on the perspective of others and become vigilant to their appearance. However, research has yet to document gendered gaze patterns in social groups. The present study examined visual attention in groups of varying gender composition to understand how gender and minority status influence gaze behavior. One hundred undergraduates enrolled in psychology courses were photographed, and an additional 76 participants viewed groupings of these photographs while their point of gaze was recorded using a remote eye-tracking device. Participants were not told that their gaze was being recorded. Women were viewed more frequently and for longer periods of time than men in mixed-gender groups. Women were also more likely to be looked at first and last by observers. Men spent more time attending to pictures of women when fewer women were in the group. The opposite effect was found for pictures of men, such that male pictures were viewed less when fewer pictures of men were in the group. Female observers spent more time looking at men compared to male observers, and male observers spent more time looking at women than female observers, though both female and male observers looked at women more than men overall. Consistent with objectification theory, women's appearance garners more attention and interest in mixed-gender social groups.