Non‐verbal communication in meetings of psychiatrists and patients with schizophrenia

Abstract

Lavelle M, Dimic S, Wildgrube C, McCabe R, Priebe S. Non-verbal communication in meetings of psychiatrists and patients with schizophrenia.Objective: Recent evidence found that patients with schizophrenia display non-verbal behaviour designed to avoid social engagement during the opening moments of their meetings with psychiatrists. This study aimed to replicate, and build on, this finding, assessing the nonverbal behaviour of patients and psychiatrists during meetings, exploring changes over time and its association with patients' symptoms and the quality of the therapeutic relationship. Method: 40-videotaped routine out-patient consultations, involving patients with schizophrenia, were analysed. Non-verbal behaviour of patients and psychiatrists was assessed during three fixed, 2-min intervals using a modified Ethological Coding System for Interviews. Symptoms, satisfaction with communication and the quality of the therapeutic relationship were also measured. Results: Over time, patients' non-verbal behaviour remained stable, whilst psychiatrists' flight behaviour decreased. Patients formed two groups based on their non-verbal profiles, one group (n = 25) displaying pro-social behaviour, inviting interaction and a second (n = 15) displaying flight behaviour, avoiding interaction. Psychiatrists interacting with pro-social patients displayed more pro-social behaviours (P < 0.001). Patients' pro-social profile was associated reduced symptom severity (P < 0.05), greater satisfaction with communication (P < 0.001) and positive therapeutic relationships (P < 0.05). Conclusion: Patients' non-verbal behaviour during routine psychiatric consultations remains unchanged, and is linked to both their psychiatrist's non-verbal behaviour and the quality of the therapeutic relationship. • Patients with schizophrenia can be classified into two groups based on their non-verbal behaviour; one group displaying non-verbal behaviour designed to avoid social interaction, and a second displaying non-verbal behaviour inviting social interaction.• Patients' non-verbal behaviour is associated both with the behaviour of their psychiatrist and the quality of the therapeutic relationship.

Negative Symptoms and Avoidance of Social Interaction: A Study of Non-Verbal Behaviour

“…The results support past findings on the importance of prosocial and flight behaviours with strengthened methodology [9,11,28]. However, in contrast to some past findings, associations with non-verbal behaviour were only found with negative symptoms and not with other symptom domains.…”

“…In total, six 30-s sections were analysed for each patient, totalling 3 min. The end of each 30-s section was marked with a beep, and raters recorded the frequency of the behaviours using a 3-point scoring system, as previously used in two studies [11,28] (0 = behaviour not present, 1 = behaviour present at least once, and 2 = behaviour present more than once). A 3-point scoring system was used to capture a greater variance of behaviours, in contrast to the onezero sampling method applied in previous studies.…”

Fusing Multilabel Deep Networks for Facial Action Unit Detection

“…Subsequently, building an automatic and reliable AUs detection system will offer a powerful tool for different fields (e.g. Psychological field [6], [16]), that use manual annotation for studying facial behaviour. Moreover, it will have a great impact on the current challenging facial-based applications (e.g.…”

The assessment of nonverbal behavior in schizophrenia through the Formal Psychological Assessment

“…Third, different studies report a correlation, albeit sometimes negative, between NVB and classical measures of negative symptoms. It has been observed that patients with a predominance of these symptoms also express an overall reduction of NVB (Brüne, Abdel‐Hamid, Sonntag, Lehmkämper, & Langdon, ; Brüne et al, ; Troisi, Spalletta, & Pasini, ); this profile tends to remain stable for short periods of time, for instance during clinical consultations (Lavelle, Dimic, Wildgrube, McCabe, & Priebe, ). Assuming these evidences, several items of the assessment tool referring to specific subdomains of negative symptoms, such as blunted affect and alogia, could be analyzed within the frame of NVB.…”