Is everyone looking at me? The perception of direct gaze as a potential cognitive marker in social anxiety and its moderation by emotional expression.

The "Cone of Gaze" (CoG), a measure of the range of gaze angles that one perceives to be looking at them, has been proposed as a biobehavioural marker of psychiatric disorders characterised by symptoms in the social domain, such as social anxiety disorder. However, the evidence remains inconsistent and its mechanisms unclear. Here, we combine meta-analysis and well-powered experimental replications to investigate: 1) individual differences in the CoG between those with and without social anxiety; 2) within-subjects differences in the CoG in response to faces with angry versus neutral expressions; and 3) the interaction between these factors. The meta-analyses revealed significantly wider CoG for socially anxious versus non-anxious individuals (representing 10 studies and 403 participants), and wider CoG for angry versus neutral expressions (9 studies, 523 participants). However, the existing evidence was sparse, highly heterogeneous and often involved small samples. Our experiments (N = 514) did not replicate the effect of social anxiety or emotional expression on CoG. Our integrated approach, combining meta-analyses with experimental replications and extensions, provides a rigorous framework for assessing the robustness and clinical relevance of gaze perception effects. We highlight the need for larger, more transparent datasets to accurately estimate CoG effects and other putative markers to assess their translational potential.