Exploring interaction with environmental affordances in schizophrenia spectrum disorders using virtual reality

AI Summary

Patients with schizophrenia exhibited reduced visual exploration, indicated by fewer gaze shifts per minute, especially in urban 360° video environments.
Basic object interaction remained preserved in the interactive VR game, though patients showed longer latencies initiating social interaction with a virtual character.
Findings are preliminary given limited sample size, but immersive VR may probe altered subject-world relations and interact with sense-making of psychotic experiences.

Schizophrenia (Heidelb). 2026 Jun 25. doi: 10.1038/s41537-026-00774-7. Online ahead of print.

ABSTRACT

Schizophrenia has been associated with disturbances in perceiving affordances, i.e. action possibilities offered by the environment. However, empirical research has largely relied on static laboratory tasks that poorly capture the dynamic perception-action loops of everyday environments. In this exploratory study, we used immersive virtual reality (VR) to examine environmental exploration and interaction in patients with schizophrenia and healthy controls (n = 19 each). Participants completed baseline questionnaires including self-report measures of anomalous world experience and were exposed to natural and urban 360° video environments and an interactive VR game. Their field of view was recorded and manually coded using a predefined coding scheme. Subjective affect, stress, and presence were assessed before and after VR exposure. Patients with schizophrenia showed reduced visual exploration of the environments, reflected by fewer gaze shifts per minute compared with controls, particularly in urban scenes. In the interactive VR game, overall object interaction patterns were comparable, although patients showed a tendency toward longer latencies before initiating social interaction with a virtual non-player character. Reduced fixation of the character’s face was strongly associated with domains of anomalous world experience related to other persons, language, and atmosphere. Qualitative observations further suggested that immersive environments could interact with the sense-making of psychotic experiences in a few participants. Although preliminary given the limited sample size, these findings indicate subtle alterations in how patients with schizophrenia explore their surroundings, while basic object interaction remains preserved. Immersive VR paradigms may provide a promising experimental platform to investigate altered subject-world relations in psychosis.

PMID:42350489 | DOI:10.1038/s41537-026-00774-7

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