Identifying in-the-moment alterations in socioemotional connection in youth at clinical high risk for psychosis and their caregivers via positivity resonance.

Moments of shared positive emotions, or positivity resonance, can strengthen relationships while promoting well-being and health. However, positivity resonance's potential clinical relevance - including among youth at clinical high risk (CHR) and their caregivers - has yet to be investigated. The present laboratory-based dyadic interaction study examined positivity resonance behavior in 66 dyads across 126 participants (30 CHR youth-caregiver dyads; 36 typically developing youth-caregiver dyads) who engaged in 10-min conflict and pleasant videorecorded conversations. We used automated facial expressions analysis through FaceReader, paired with Hidden Markov models, to determine the probability that dyads entered and exited latent states of positivity resonance behavior (i.e., states when dyad members were more likely to simultaneously show positive facial expressions). Results showed that CHR dyads displayed a significantly lower probability of entering (but no difference in staying in) states positivity resonance behavior compared to typically developing dyads. These findings document alterations in in-the-moment positive connections in CHR dyads, manifesting as a reduced likelihood of entering states of positivity resonance behavior during conversations. They highlight the potential of automated facial expression analysis and Hidden Markov models to measure positivity resonance behavior in dyads and provide early insights into altered positivity resonance in psychopathology.