Background: Social interactions require rapid, real-time information integration and performative application of dynamic social information, and can be especially difficult for patients with schizophrenia. Their difficulty processing social information could lie in challenges extracting the information or in updating their actions to accommodate the new information, resulting in behaviors that may appear rigid or inappropriate. Disruptions may emerge in the underlying, requisite behavioral or neural processes. Methods: Seventeen matched healthy controls and seventeen patients with schizophrenia participated in an fMRI study, which included a social interaction priming procedure wherein they met a friendly stranger who held opposite social values from their own. They answered self-judgement questions about their social values two days before the priming experiment and again during the fMRI scan. Results: Controls suppress social values when interacting with the stranger whereas patients with schizophrenia augment the opposite values, simultaneously holding two sets of social values. Compared to controls, patients display hyperactivity in dorsomedial prefrontal cortex and atypical activity in caudate, posterior cingulate and precuneus. Discussion: Patients appear to correctly extract social information but apply the information atypically. They display evidence of atypical social flexibility on both performative and neural measures, resulting in confusion between self and other.
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