The effect of avatar identity on level-2 visual perspective taking in individuals with schizophrenia

This study investigated whether individuals with schizophrenia (SZ) exhibit impairments in Level-2 visual perspective-taking (VPT)—the ability to understand how a scene appears from another’s viewpoint—and if using a self-represented avatar could mitigate these deficits. Two experiments were conducted. Experiment 1 ( N = 63) used a digit inversion task to assess Level-2 VPT based on object appearance. Experiment 2 ( N = 62) used a round-table task to assess it based on spatial location. Participants with SZ and healthy controls (HC) performed both tasks under two conditions: using a ‘self-avatar’ and an ‘other-avatar’. Individuals with SZ demonstrated significant Level-2 VPT impairments in both experiments. Compared to HC, the SZ group showed significantly lower accuracy and a stronger egocentric bias, particularly in perspective-incongruent conditions. Critically, the self-avatar identity did not produce a selective performance benefit in the SZ group. The findings confirm pervasive Level-2 VPT deficits in schizophrenia across different task domains. The absence of a schizophrenia-specific self-avatar benefit suggests that an instruction-based self-avatar manipulation alone may be insufficient to selectively improve Level-2 VPT performance in schizophrenia. The cognitive mechanisms underlying this pattern remain to be established. Not applicable.