Association between acoustic speech features and non-severe levels of anxiety and depression symptoms across lifespan

Background Several studies have investigated the acoustic effects of diagnosed anxiety and depression. Anxiety and depression are not characteristics of the typical aging process, but minimal or mild symptoms can appear and evolve with age. However, the knowledge about the association between speech and anxiety or depression is scarce for minimal/mild symptoms, typical of healthy aging. As longevity and aging are still a new phenomenon worldwide, posing also several clinical challenges, it is important to improve our understanding of non-severe mood symptoms’ impact on acoustic features across lifetime. The purpose of this study was to determine if variations in acoustic measures of voice are associated with non-severe anxiety or depression symptoms in adult population across lifetime. Methods Two different speech tasks (reading vowels in disyllabic words and describing a picture) were produced by 112 individuals aged 35-97. To assess anxiety and depression symptoms, the Hospital Anxiety Depression Scale (HADS) was used. The association between the segmental and suprasegmental acoustic parameters and HADS scores were analyzed using the linear multiple regression technique. Results The number of participants with presence of anxiety or depression symptoms is low (>7: 26.8% and 10.7%, respectively) and non-severe (HADS-A: 5.4 ± 2.9 and HADS-D: 4.2 ± 2.7, respectively). Adults with higher anxiety symptoms did not present significant relationships associated with the acoustic parameters studied. Adults with increased depressive symptoms presented higher vowel duration, longer total pause duration and short total speech duration. Finally, age presented a positive and significant effect only for depressive symptoms, showing that older participants tend to have more depressive symptoms. Conclusions Non-severe depression symptoms can be related to some acoustic parameters and age. Depression symptoms can be explained by acoustic parameters even among individuals without severe symptom levels.publishe

Affective Computing for Late-Life Mood and Cognitive Disorders

Affective computing (also referred to as artificial emotion intelligence or emotion AI) is the study and development of systems and devices that can recognize, interpret, process, and simulate emotion or other affective phenomena. With the rapid growth in the aging population around the world, affective computing has immense potential to benefit the treatment and care of late-life mood and cognitive disorders. For late-life depression, affective computing ranging from vocal biomarkers to facial expressions to social media behavioral analysis can be used to address inadequacies of current screening and diagnostic approaches, mitigate loneliness and isolation, provide more personalized treatment approaches, and detect risk of suicide. Similarly, for Alzheimer\u27s disease, eye movement analysis, vocal biomarkers, and driving and behavior can provide objective biomarkers for early identification and monitoring, allow more comprehensive understanding of daily life and disease fluctuations, and facilitate an understanding of behavioral and psychological symptoms such as agitation. To optimize the utility of affective computing while mitigating potential risks and ensure responsible development, ethical development of affective computing applications for late-life mood and cognitive disorders is needed

주요 우울 장애의 음성 기반 분석: 연속적인 발화의 음향적 변화를 중심으로

학위논문(박사) -- 서울대학교대학원 : 융합과학기술대학원 융합과학부(디지털정보융합전공), 2023. 2. 이교구.Major depressive disorder (commonly referred to as depression) is a common disorder that affects 3.8% of the world's population. Depression stems from various causes, such as genetics, aging, social factors, and abnormalities in the neurotransmitter system; thus, early detection and monitoring are essential. The human voice is considered a representative biomarker for observing depression; accordingly, several studies have developed an automatic depression diagnosis system based on speech. However, constructing a speech corpus is a challenge, studies focus on adults under 60 years of age, and there are insufficient medical hypotheses based on the clinical findings of psychiatrists, limiting the evolution of the medical diagnostic tool. Moreover, the effect of taking antipsychotic drugs on speech characteristics during the treatment phase is overlooked. Thus, this thesis studies a speech-based automatic depression diagnosis system at the semantic level (sentence). First, to analyze depression among the elderly whose emotional changes do not adequately reflect speech characteristics, it developed the mood-induced sentence to build the elderly depression speech corpus and designed an automatic depression diagnosis system for the elderly. Second, it constructed an extrapyramidal symptom speech corpus to investigate the extrapyramidal symptoms, a typical side effect that can appear from an antipsychotic drug overdose. Accordingly, there is a strong correlation between the antipsychotic dose and speech characteristics. The study paved the way for a comprehensive examination of the automatic diagnosis system for depression.주요 우울 장애 즉 흔히 우울증이라고 일컬어지는 기분 장애는 전 세계인 중 3.8%에 달하는 사람들이 겪은바 있는 매우 흔한 질병이다. 유전, 노화, 사회적 요인, 신경전달물질 체계의 이상등 다양한 원인으로 발생하는 우울증은 조기 발견 및 일상 생활에서의 관리가 매우 중요하다고 할 수 있다. 인간의 음성은 우울증을 관찰하기에 대표적인 바이오마커로 여겨져 왔으며, 음성 데이터를 기반으로한 자동 우울증 진단 시스템 개발을 위한 여러 연구들이 진행되어 왔다. 그러나 음성 말뭉치 구축의 어려움과 60세 이하의 성인들에게 초점이 맞추어진 연구, 정신과 의사들의 임상 소견을 바탕으로한 의학적 가설 설정의 미흡등의 한계점을 가지고 있으며, 이는 의료 진단 기구로 발전하는데 한계점이라고 할 수 있다. 또한, 항정신성 약물의 복용이 음성 특징에 미칠 수 있는 영향 또한 간과되고 있다. 본 논문에서는 위의 한계점들을 보완하기 위한 의미론적 수준 (문장 단위)에서의 음성 기반 자동 우울증 진단에 대한 연구를 시행하고자 한다. 우선적으로 감정의 변화가 음성 특징을 잘 반영되지 않는 노인층의 우울증 분석을 위해 감정 발화 문장을 개발하여 노인 우울증 음성 말뭉치를 구축하고, 문장 단위에서의 관찰을 통해 노인 우울증 군에서 감정 문장 발화가 미치는 영향과 감정 전이를 확인할 수 있었으며, 노인층의 자동 우울증 진단 시스템을 설계하였다. 최종적으로 항정신병 약물의 과복용으로 나타날 수 있는 대표적인 부작용인 추체외로 증상을 조사하기 위해 추체외로 증상 음성 말뭉치를 구축하였고, 항정신병 약물의 복용량과 음성 특징간의 상관관계를 분석하여 우울증의 치료 과정에서 항정신병 약물이 음성에 미칠 수 있는 영향에 대해서 조사하였다. 이를 통해 주요 우울 장애의 영역에 대한 포괄적인 연구를 진행하였다.Chapter 1 Introduction 1 1.1 Research Motivations 3 1.1.1 Bridging the Gap Between Clinical View and Engineering 3 1.1.2 Limitations of Conventional Depressed Speech Corpora 4 1.1.3 Lack of Studies on Depression Among the Elderly 4 1.1.4 Depression Analysis on Semantic Level 6 1.1.5 How Antipsychotic Drug Affects the Human Voice? 7 1.2 Thesis objectives 9 1.3 Outline of the thesis 10 Chapter 2 Theoretical Background 13 2.1 Clinical View of Major Depressive Disorder 13 2.1.1 Types of Depression 14 2.1.2 Major Causes of Depression 15 2.1.3 Symptoms of Depression 17 2.1.4 Diagnosis of Depression 17 2.2 Objective Diagnostic Markers of Depression 19 2.3 Speech in Mental Disorder 19 2.4 Speech Production and Depression 21 2.5 Automatic Depression Diagnostic System 23 2.5.1 Acoustic Feature Representation 24 2.5.2 Classification / Prediction 27 Chapter 3 Developing Sentences for New Depressed Speech Corpus 31 3.1 Introduction 31 3.2 Building Depressed Speech Corpus 32 3.2.1 Elements of Speech Corpus Production 32 3.2.2 Conventional Depressed Speech Corpora 35 3.2.3 Factors Affecting Depressed Speech Characteristics 39 3.3 Motivations 40 3.3.1 Limitations of Conventional Depressed Speech Corpora 40 3.3.2 Attitude of Subjects to Depression: Masked Depression 43 3.3.3 Emotions in Reading 45 3.3.4 Objectives of this Chapter 45 3.4 Proposed Methods 46 3.4.1 Selection of Words 46 3.4.2 Structure of Sentence 47 3.5 Results 49 3.5.1 Mood-Inducing Sentences (MIS) 49 3.5.2 Neutral Sentences for Extrapyramidal Symptom Analysis 49 3.6 Summary 51 Chapter 4 Screening Depression in The Elderly 52 4.1 Introduction 52 4.2 Korean Elderly Depressive Speech Corpus 55 4.2.1 Participants 55 4.2.2 Recording Procedure 57 4.2.3 Recording Specification 58 4.3 Proposed Methods 59 4.3.1 Voice-based Screening Algorithm for Depression 59 4.3.2 Extraction of Acoustic Features 59 4.3.3 Feature Selection System and Distance Computation 62 4.3.4 Classification and Statistical Analyses 63 4.4 Results 65 4.5 Discussion 69 4.6 Summary 74 Chapter 5 Correlation Analysis of Antipsychotic Dose and Speech Characteristics 75 5.1 Introduction 75 5.2 Korean Extrapyramidal Symptoms Speech Corpus 78 5.2.1 Participants 78 5.2.2 Recording Process 79 5.2.3 Extrapyramidal Symptoms Annotation and Equivalent Dose Calculations 80 5.3 Proposed Methods 81 5.3.1 Acoustic Feature Extraction 81 5.3.2 Speech Characteristics Analysis recording to Eq.dose 83 5.4 Results 83 5.5 Discussion 87 5.6 Summary 90 Chapter 6 Conclusions and Future Work 91 6.1 Conclusions 91 6.2 Future work 95 Bibliography 97 초 록 121박

VOCAL BIOMARKERS OF CLINICAL DEPRESSION: WORKING TOWARDS AN INTEGRATED MODEL OF DEPRESSION AND SPEECH

Speech output has long been considered a sensitive marker of a person’s mental state. It has been previously examined as a possible biomarker for diagnosis and treatment response for certain mental health conditions, including clinical depression. To date, it has been difficult to draw robust conclusions from past results due to diversity in samples, speech material, investigated parameters, and analytical methods. Within this exploratory study of speech in clinically depressed individuals, articulatory and phonatory behaviours are examined in relation to psychomotor symptom profiles and overall symptom severity. A systematic review provided context from the existing body of knowledge on the effects of depression on speech, and provided context for experimental setup within this body of work. Examinations of vowel space, monophthong, and diphthong productions as well as a multivariate acoustic analysis of other speech parameters (e.g., F0 range, perturbation measures, composite measures, etc.) are undertaken with the goal of creating a working model of the effects of depression on speech. Initial results demonstrate that overall vowel space area was not different between depressed and healthy speakers, but on closer inspection, this was due to more specific deficits seen in depressed patients along the first formant (F1) axis. Speakers with depression were more likely to produce centralised vowels along F1, as compared to F2—and this was more pronounced for low-front vowels, which are more complex given the degree of tongue-jaw coupling required for production. This pattern was seen in both monophthong and diphthong productions. Other articulatory and phonatory measures were inspected in a factor analysis as well, suggesting additional vocal biomarkers for consideration in diagnosis and treatment assessment of depression—including aperiodicity measures (e.g., higher shimmer and jitter), changes in spectral slope and tilt, and additive noise measures such as increased harmonics-to-noise ratio. Intonation was also affected by diagnostic status, but only for specific speech tasks. These results suggest that laryngeal and articulatory control is reduced by depression. Findings support the clinical utility of combining Ellgring and Scherer’s (1996) psychomotor retardation and social-emotional hypotheses to explain the effects of depression on speech, which suggest observed changes are due to a combination of cognitive, psycho-physiological and motoric mechanisms. Ultimately, depressive speech is able to be modelled along a continuum of hypo- to hyper-speech, where depressed individuals are able to assess communicative situations, assess speech requirements, and then engage in the minimum amount of motoric output necessary to convey their message. As speakers fluctuate with depressive symptoms throughout the course of their disorder, they move along the hypo-hyper-speech continuum and their speech is impacted accordingly. Recommendations for future clinical investigations of the effects of depression on speech are also presented, including suggestions for recording and reporting standards. Results contribute towards cross-disciplinary research into speech analysis between the fields of psychiatry, computer science, and speech science

Secure account-based data capture with smartphones – preliminary results from a study of articulatory precision in clinical depression

Schaeffler, Felix - ORCID 0000-0002-2764-7635 https://orcid.org/0000-0002-2764-7635Jannetts, Stephen - ORCID 0000-0003-1084-8745 https://orcid.org/0000-0003-1084-8745Smartphone technology is continuously being updated through software and hardware changes. At present, a limited number of studies have been undertaken to assess the impact of these changes on data collection for linguistic research. This paper discusses the potential of smartphones to gather reliable recordings, along with ethical considerations for storing additional personal information when working in other contexts (i.e. healthcare settings). A pilot study was undertaken using the FitvoiceTM account-based application to analyse articulatory proficiency in depressed and healthy participants. Results suggest that phonetic differences exist between these groups in terms of plosive production, and that smartphones are capable of adequately recording these minute aspects of the speech signal for analysis.https://doi.org/10.1515/lingvan-2019-00157pubpubs

Remote data collection speech analysis and prediction of the identification of Alzheimer’s disease biomarkers in people at risk for Alzheimer’s disease dementia: the Speech on the Phone Assessment (SPeAk) prospective observational study protocol

International audienceIntroduction Identifying cost-effective, non-invasive biomarkers of Alzheimer's disease (AD) is a clinical and research priority. Speech data are easy to collect, and studies suggest it can identify those with AD. We do not know if speech features can predict AD biomarkers in a preclinical population. Methods and analysis The Speech on the Phone Assessment (SPeAk) study is a prospective observational study. SPeAk recruits participants aged 50 years and over who have previously completed studies with AD biomarker collection. Participants complete a baseline telephone assessment, including spontaneous speech and cognitive tests. A 3-month visit will repeat the cognitive tests with a conversational artificial intelligence bot. Participants complete acceptability questionnaires after each visit. Participants are randomised to receive their cognitive test results either after each visit or only after they have completed the study. We will combine SPeAK data with AD biomarker data collected in a previous study and analyse for correlations between extracted speech features and AD biomarkers. The outcome of this analysis will inform the development of an algorithm for prediction of AD risk based on speech features. Ethics and dissemination This study has been approved by the Edinburgh Medical School Research Ethics Committee (REC reference 20-EMREC-007). All participants will provide informed consent before completing any study-related procedures, participants must have capacity to consent to participate in this study. Participants may find the tests, or receiving their scores, causes anxiety or stress. Previous exposure to similar tests may make this more familiar and reduce this anxiety. The study information will include signposting in case of distress. Study results will be disseminated to study participants, presented at conferences and published in a peer reviewed journal. No study participants will be identifiable in the study results

Detection of Verbal and Nonverbal speech features as markers of Depression: results of manual analysis and automatic classification

The present PhD project was the result of a multidisciplinary work involving psychiatrists, computing scientists, social signal processing experts and psychology students with the aim to analyse verbal and nonverbal behaviour in patients affected by Depression. Collaborations with several Clinical Health Centers were established for the collection of a group of patients suffering from depressive disorders. Moreover, a group of healthy controls was collected as well. A collaboration with the School of Computing Science of Glasgow University was established with the aim to analysed the collected data. Depression was selected for this study because is one of the most common mental disorder in the world (World Health Organization, 2017) associated with half of all suicides (Lecrubier, 2000). It requires prolonged and expensive medical treatments resulting into a significant burden for both patients and society (Olesen et al., 2012). The use of objective and reliable measurements of depressive symptoms can support the clinicians during the diagnosis reducing the risk of subjective biases and disorder misclassification (see discussion in Chapter 1) and doing the diagnosis in a quick and non-invasive way. Given this, the present PhD project proposes the investigation of verbal (i.e. speech content) and nonverbal (i.e. paralingiuistic features) behaviour in depressed patients to find several speech parameters that can be objective markers of depressive symptoms. The verbal and nonverbal behaviour are investigated through two kind of speech tasks: reading and spontaneous speech. Both manual features extraction and automatic classification approaches are used for this purpose. Differences between acute and remitted patients for prosodic and verbal features have been investigated as well. In addition, unlike other literature studies, in this project differences between subjects with and without Early Maladaptive Schema (EMS: Young et al., 2003) independently from the depressive symptoms, have been investigated with respect to both verbal and nonverbal behaviour. The proposed analysis shows that patients differ from healthy subjects for several verbal and nonverbal features. Moreover, using both reading and spontaneous speech, it is possible to automatically detect Depression with a good accuracy level (from 68 to 76%). These results demonstrate that the investigation of speech features can be a useful instrument, in addition to the current self-reports and clinical interviews, for helping the diagnosis of depressive disorders. Contrary to what was expected, patients in acute and remitted phase do not report differences regarding the nonverbal features and only few differences emerges for the verbal behaviour. At the same way, the automatic classification using paralinguistic features does not work well for the discrimination of subjects with and without EMS and only few differences between them have been found for the verbal behaviour. Possible explanations and limitations of these results will be discussed

Exploring Language Learning as a Potential Tool against Cognitive Impairment in Late-Life Depression:Two Meta-Analyses and Suggestions for Future Research

Late-life depression (LLD) affects about an eighth of community-dwelling seniors. LLD impacts well-being, with loneliness and small social networks being typical. It has also been linked to cognitive dysfunction and an increased risk of developing dementia. Safety and efficacy of pharmacological treatments for LLD have been debated, and cognitive dysfunction often persists even after remission. Various cognitive interventions have been proposed for LLD. Among these, one has received special attention: foreign language learning could serve as a social intervention that simultaneously targets brain structures affected in LLD. Lifelong bilingualism may significantly delay the onset of cognitive impairment symptoms by boosting cognitive reserve. Even late-life foreign language learning without lifelong bilingualism can train cognitive flexibility. It is then counterintuitive that the effects of language learning on LLD have never been examined. In order to create a theoretical basis for further interdisciplinary research, this paper presents a status quo of current work through two meta-analyses investigating cognitive functioning in LLD on the one hand and in senior bilinguals or seniors following a language course on the other hand. While LLD was consistently associated with cognitive dysfunction, inconsistent results were found for bilingualism and language learners. Possible reasons for this and suggestions for future research are subsequently discussed