Movement Synchrony in the Psychotherapy of Adolescents With Borderline Personality Pathology – A Dyadic Trait Marker for Resilience?

Abstract

Movement synchrony describes the coordination of body movements. In psychotherapy, higher movement synchrony between therapist and patient has been associated with higher levels of empathy, therapeutic alliance, better therapy outcome, and fewer drop-outs. The current study investigated movement synchrony during the psychotherapeutic treatment of female adolescents with borderline personality disorder. It was hypothesized that there are higher levels of movement synchrony in the analyzed therapy sessions compared to pseudo-interactions. Further, we tested whether higher levels of movement synchrony correlate with stronger patients’ symptom reduction and whether higher movement synchrony predicts higher post-session ratings. A total of 356 sessions from 16 completed psychotherapies of adolescent patients with BPD were analyzed. Movement synchrony was assessed with motion energy analysis and an index of synchrony was calculated by lagged cross-correlation analysis. As hypothesized, the findings support higher levels of movement synchrony in therapy sessions compared to pseudo-interactions (Cohen’s d = 0.85). Additionally, a correlation of movement synchrony with better therapy outcome was found (standardized beta = −0.43 indicating stronger personality functioning impairment reduction). The post-session ratings were negatively associated with higher levels of movement synchrony (standardized beta = −0.1). The relevance of movement synchrony and potential implications for clinical practice are discussed.

Instructor-learner body coupling reflects instruction and learning

“…Consequently, both positive and negative cross-correlation coefficients contributed positively to BtBC. In line with previous work 9 , 44 , 45 , we derived an index of overall BtBC, i.e., cross-correlation coefficients averaged over all time lags. To control for spurious BtBC, we created a surrogate dataset ( n = 100 out of each genuine time series) by segment-wise (60-s segments) shuffling of the original data 9 , 19 .…”

“…Finally, future research is needed to combine BtBC and instructor-learner interactions to study e.g., learning difficulties. Recent years have witnessed fruitful applications of BtBC in clinical areas; for example, coordinated body movements reflected relationship quality and outcome in psychotherapy 9 , and were closely related to symptom profiles of patients with Schizophrenia 44 and Borderline Personality Pathology 45 . The degree of BtBC may be indicative of core deficits underlying interpersonal communication and social functioning (including learning interactions).…”

Withdrawal ruptures in adolescents with borderline personality disorder psychotherapy are marked by increased speech pauses–can minimal responses be automatically detected?

“…The current study points towards the predictive importance of speaker switching patterns as well as the time dynamic of the features. Additionally, video-based features such as facial emotion recognition [ 29 ] or motion energy analysis [ 30 ] have the potential to improve the predictive performance beyond what can be achieved with audio features alone. Finally, predictive features can be engineered to represent the interaction of the patient and the therapist (e.g., synchrony measures) [ 66 – 68 ] which might potentially enable the detection of confrontation and withdrawal ruptures or other significant episodes e.g., moments of psychotherapeutic change [ 69 ].…”

“…Additionally, the translation of the model into clinical practice, where resources are even scarcer, is highly problematic, if not impossible. With this in mind, while not part of our initial research protocols [21,26], our research group has gained interest in automated evaluations of psychotherapy sessions based on audio and video recordings (e.g., dyadic speech pattern analysis or facial emotion recognition) and used these techniques in the sample that will be investigated in the current study [27][28][29][30]. These techniques allow for the standardised processing of entire psychotherapies within hours, minutes or even in real time.…”

Nonverbal synchrony in subjects with hearing impairment and their significant others

“…In the domain of psychotherapy, nonverbal synchrony provided valuable information regarding the patient-therapist relationship and their alliance in sessions (Ramseyer and Tschacher, 2011 ; Altmann et al, 2020 ; Cohen et al, 2021 ). Furthermore, it predicted the outcome of psychotherapy and showed relevant associations with relationship and alliance (Ramseyer and Tschacher, 2011 , 2014 ; Prinz et al, 2021 ; Zimmermann et al, 2021 ). Whether it is also beneficial for the individual themselves, has recently been questioned (Galbusera et al, 2019 ).…”