“The second I laid eyes on him I knew”: First impressions predict willingness to interact with individuals with schizophrenia

Individuals diagnosed with schizophrenia often experience social interaction deficits, and these difficulties may arise as early as the first encounter. First impressions, formed during initial interactions, are crucial in shaping relationship outcomes. This study explored how first impressions formed during initial encounters influence the quality of social interactions between healthy individuals and those with schizophrenia. We recruited 60 participants, including 20 healthy individuals to serve as interacting partners, 20 individuals diagnosed with schizophrenia, and 20 age and sex-matched healthy controls. Each interacting partner interacted once with an individual diagnosed with schizophrenia and once with a sex- and age-matched healthy control, without knowledge of any diagnosis. Upon arrival at the experiment location, participants were briefly introduced to each other and then asked to rate their first impressions independently. Then, they engaged in four conversational tasks, after which they assessed their willingness to continue interacting—a measure of social interaction quality. Results showed that interacting partners rated individuals with schizophrenia more negatively than healthy controls in both first impressions and willingness to continue interacting. While first impression ratings across all participants significantly predicted willingness to continue interacting, they did not mediate the group differences in willingness scores, suggesting the involvement of additional underlying factors. This study is the first to assess first impressions of individuals with schizophrenia in ecological settings, marking an important step toward understanding the factors contributing to altered first impressions of individuals diagnosed with schizophrenia.