Investigating Prosodic Accommodation in Clinical Interviews with Depressed Patients

Six in-depth clinical interviews, involving six elderly female patients (aged 60+) and one female psychiatrist, were recorded and analysed for a number of prosodic accommodation variables. Our analysis focused on pitch, speaking time, and vowel-space ratio. Findings indicate that there is a dynamic manifestation of prosodic accommodation over the course of the interactions. There is clear adaptation on the part of the psychiatrist, even going so far as to have a reduced vowel-space ratio, mirroring a reduced vowel-space ratio in the depressed patients. Previous research has found a reduced vowel-space ratio to be associated with psychological distress; however, we suggest that it indicates a high level of adaptation on the part of the psychiatrist and needs to be considered when analysing psychiatric clinical interactions

Computerized Identification of Mental State for Mental Health Care

Introduction Sebastian, a 30-year-old man, was just diagnosed with depression and is undergoing cognitive-behavioral therapy (CBT) sessions on a weekly basis. As he goes about his daily routine, he wears a gadget that measures his physiological activity. His therapist enters his physiological data for the week into a computer software at the start of each CBT session. The computer compiles Sebastian's levels of happy and negative affect and pinpoints the times when these reactions peaked. The therapist utilizes this information to track Sebastian's development and dynamically customize the therapy, for as by asking Sebastian to recollect experiences that correlate to some of the emotion peaks

Mental Health Outcomes for Adolescents with a History of Developmental Language Disorder: An Exploration of Risk Factors

This research investigated mental health outcomes for adolescents with and without a history of Developmental Language Disorder (DLD), which affects approximately seven percent of the population, and is characterised by persistent difficulties in understanding and expressing language. The findings indicated that language difficulties and bullying victimisation worked together to increase emotional problems. These findings reinforce the importance of monitoring psychosocial wellbeing and vulnerability to bullying victimisation for adolescents with DLD

Voice treatment in Parkinson’s disease: Patient perspectives

Speech and voice changes are a central feature of the symptom complex of people with Parkinson’s disease (pwPD). Speaking is a social activity involving the pwPD, family, and the wider communicative context. Sensory-motor, cognitive-linguistic, and affective changes in Parkinson’s disease (PD) combine to alter communication, impacting on psycho-social quality-of-life, leading to risks of social withdrawal and increased depression and anxiety. The underlying pathophysiology of speech, voice, and communication difficulties in pwPD is multi-factorial and complex. Sensory-motor changes in the respiratory, phonatory, and articulatory subsystems, underscaling of effort, and central processing problems are further affected by broader cognitive-linguistic difficulties, and non-speech motor deficits. Many studies show that, when pwPD are asked to rate their own voice and how it functions in everyday situations, they show increased voice-related disability and negative impact relative to healthy controls. Voice treatment is integral to improving communication in pwPD. Studies show positive benefits from the perspective of pwPD and carers. Treatment approaches vary from one-to-one to group interventions, a singular focus on increasing loudness to more general voice exercises, and choral singing. The nature and underlying pathophysiology of speech, voice, and communication changes in pwPD are reviewed before exploring the effects of voice treatment programs and pwPD and carer perceptions of their effect. Larger scale, better powered, controlled trials of intervention for voice and speech that measure clinically and socially relevant outcomes are finally underway. Future research should also focus on issues of treatment compliance, practicality (for service delivery and use), and long-term follow-up outcomes. The role of carers in longer-term maintenance represents a further important area of exploration

Emotional Prosody Processing in the Schizophrenia Spectrum.

THESIS ABSTRACT Emotional prosody processing impairment is proposed to be a main contributing factor for the formation of auditory verbal hallucinations in patients with schizophrenia. In order to evaluate such assumption, five experiments in healthy, highly schizotypal and schizophrenia populations are presented. The first part of the thesis seeks to reveal the neural underpinnings of emotional prosody comprehension (EPC) in a non-clinical population as well as the modulation of prosodic abilities by hallucination traits. By revealing the brain representation of EPC, an overlap at the neural level between EPC and auditory verbal hallucinations (AVH) was strongly suggested. By assessing the influence of hallucinatory traits on EPC abilities, a continuum in the schizophrenia spectrum in which high schizotypal population mirrors the neurocognitive profile of schizophrenia patients was established. Moreover, by studying the relation between AVH and EPC in non-clinical population, potential confounding effects of medication influencing the findings were minimized. The second part of the thesis assessed two EPC related abilities in schizophrenia patients with and without hallucinations. Firstly, voice identity recognition, a skill which relies on the analysis of some of the same acoustical features as EPC, has been evaluated in patients and controls. Finally, the last study presented in the current thesis, assessed the influence that implicit processing of emotional prosody has on selective attention in patients and controls. Both patients studies demonstrate that voice identity recognition deficits as well as abnormal modulation of selective attention by implicit emotion prosody are related to hallucinations exclusively and not to schizophrenia in general. In the final discussion, a model in which EPC deficits are a crucial factor in the formation of AVH is evaluated. Experimental findings presented in the previous chapters strongly suggests that the perception of prosodic features is impaired in patients with AVH, resulting in aberrant perception of irrelevant auditory objects with emotional prosody salience which captures the attention of the hearer and which sources (speaker identity) cannot be recognized. Such impairments may be due to structural and functional abnormalities in a network which comprises the superior temporal gyrus as a central element

Neurocognitive Implications of Tangential Speech in Patients with Focal Brain Damage

There are no studies on the neurocognitive implications of tangential speech (TS). This research aims to take a step forward in the study of narrative processing, by evaluating TS in a sample that helps to detect this deficit when it is neurogenic and recently manifested. The relationship between TS, secondary to focal brain injury, and neuropsychological and neuroanatomical variables was explored. A comprehensive neuropsychological battery was administered to 175 volunteers: 95 alert inpatients, without aphasia, without psychiatric history and without TS history, and 80 healthy participants, without TS. Results: TS (prevalence 16%) was independent of type or site of injury. An adverse effect of TS on global neuropsychological performance was observed. This effect was significantly related to attentional errors along with prolonged processing times but not to correct responses. Reliability and validity indices for the present TS screening scale were provided. Conclusion: Present results support the hypothesis that this neurogenic inability to spontaneously find, organize and communicate verbal information, beyond single words, depends on extended brain networks involving processes such as sustained attention, complex-syntax comprehension, the (implicit) interpretation and spontaneous recall of a narrative, and emotional and behavioral alterations. Early TS detection is advisable for prevention and treatment at any age

Automatic Detection of Apathy using Acoustic Markers extracted from Free Emotional Speech

International audienceApathy is a frequent neuropsychiatric syndrome in people with dementia. It leads to diminished motivation for physical, cognitive and emotional activity. Apathy is highly underdiagnosed since its criteria have been only recently established and rely heavily on the subjective evaluation of human observers. In this paper we analyse speech samples from demented people with and without apathy. Speech was provoked by asking patients two emotional questions. Acoustic features were extracted and used in a classification task. The resulting models show performances of AUC = 0:71 and AUC = 0:63. This is a decent first step into the direction of automatic detection of apathy from speech. Usefulness of stimuli to elicit free speech is found to depend on patients gender

Discovering affect-laden requirements to achieve system acceptance

Novel envisioned systems face the risk of rejection by their target user community and the requirements engineer must be sensitive to the factors that will determine acceptance or rejection. Conventionally, technology acceptance is determined by perceived usefulness and ease-of-use, but in some domains other factors play an important role. In healthcare systems, particularly, ethical and emotional factors can be crucial. In this paper we describe an approach to requirements discovery that we developed for such systems. We describe how we have applied our approach to a novel system to passively monitor users for signs of cognitive decline consistent with the onset of dementia. A key challenge was eliciting users’ reactions to emotionally charged events never before experienced by them at first hand. Our goal was to understand the range of users’ emotional responses and their values and motivations, and from these formulate requirements that would maximise the likelihood of acceptance of the system. The problem was heightened by the fact that the key stakeholders were elderly people who represent a poorly studied user constituency. We discuss the elicitation and analysis methodologies used, and our experience with tool support. We conclude by reflecting on the affect issues for RE and for technology acceptance