From Subjective Impression to Objective Measure: The Nonverbal Foundations of the Praecox Feeling.

Abstract

Introduction: The praecox feeling (PF) refers to clinicians' immediate sense of disturbed interpersonal contact when encountering individuals with schizophrenia. Although considered subjective, this experience persists in clinical practice through the PANSS poor rapport item, used as an indirect operational proxy. The behavioral substrates underlying this judgment remain insufficiently specified. We examined whether objectively quantified gestural behavior during first contact relates to clinician-rated poor rapport and whether interaction partners (IPs) adapt their nonverbal behavior accordingly.

Methods: Naïve IPs engaged in two first contact interactions, one with an individual with schizophrenia (ISZ) and one with a matched control (MAT), in an ecological setting. Gestural expansiveness was quantified using automatic motion tracking. Poor rapport was assessed independently during a subsequent standardized PANSS interview conducted by a trained psychiatrist not involved in the interaction.

Results: Within the schizophrenia group, reduced gestural expansiveness during first contact was associated with higher clinician-rated poor rapport. No significant group difference in gestural expansiveness was observed between ISZ and MAT. However, IPs showed reduced gestural expansiveness when interacting with ISZ.

Conclusions: Ecologically measured gesture kinematics were associated with independently assessed clinician-rated interpersonal disturbance. These findings suggest that praecox feeling may reflect clinicians' sensitivity to subtle, measurable alterations in embodied interpersonal dynamics that generalize across interactional settings. Disturbed social contact appears to emerge within a dyadic system rather than from individual behavior alone. Objective movement markers may contribute to operationalizing early interpersonal disturbance and may contribute to refining the phenomenological construct of praecox feeling.