The link between basic visual processing and higher-level social cognition: Eye gaze perception as a bridge in a transdiagnostic sample enriched with social dysfunction

Psychol Med. 2026 May 14;56:e152. doi: 10.1017/S0033291726104589.

ABSTRACT

BACKGROUND: Social cognitive deficits are common across many psychiatric conditions and contribute to broader social dysfunction. One hypothesized mechanism involves altered basic visual processing, which may disrupt the perception of low-level social cues and, in turn, compromise broader social cognitive processes. Here, we examined relations between basic visual processing and different levels of social cognition in a transdiagnostic youth sample.

METHODS: A sample of 148 youth, ranging from healthy individuals to individuals with neuropsychiatric diagnoses and significant social dysfunction, completed two measures of basic visual processing (contrast sensitivity and visual integration) and a battery of social cognition tasks spanning lower-level (gaze perception) to mid-level (emotion recognition) to higher-level (theory of mind) social cognition. We used a four-level path model to test whether basic visual processing predicts gaze perception, which in turn predicts emotion recognition, which predicts theory of mind.

RESULTS: Poorer contrast sensitivity and visual integration were associated with less precise gaze perception, which was, in turn, associated with worse emotion recognition, which was associated with worse theory of mind. This four-level path model demonstrated good fit and showed superior fit compared to alternative models.

CONCLUSIONS: These findings suggest that basic visual processing influences the perception of basic social cues (e.g. gaze direction), which subsequently impairs more complex social perception and inference. Notably, this study extends prior observations from individuals with chronic schizophrenia to a transdiagnostic youth sample, indicating that altered basic visual processing may be a shared mechanism contributing to social cognitive deficits across psychiatric disorders and illness stages.

PMID:42132002 | DOI:10.1017/S0033291726104589