Looking beyond the laboratory: Exploring behavioral and eye-fixation patterns in individuals with severe mental illness during a real-life supermarket task

Individuals with severe mental illnesses (SMI) often have difficulty performing daily activities that require intact executive functions, such as grocery shopping. Performance-based evaluations are valuable but lack the subjects' viewpoints during task performance. This study aims to combine performance-based observation and cognitive science methods to provide insights regarding real-life behavior and problem-solving in populations with SMI. In this correlational-research study, 42 participants (10 in the SMI group and 32 in the control group) performed the Test of Grocery Shopping Skills (TOGSS) while wearing an eye-tracking device. We hypothesized that patterns in task planning, task-time use, and attention allocation to written information relevant to the task would differ between the groups during the task. The results showed between-group differences in both TOGSS efficiency outcomes (time and redundancy), duration, and number of fixations. An eye-tracking pattern analysis determined between-group differences in scanning patterns of the grocery list but similarities in task planning. The selection process was found to be significantly more accurate and efficient for the control group than for the SMI group. Our findings suggest that a combination of perspectives allows us to better understand the behavior of SMI individuals in a regular daily task.