What is the nonverbal communication of depression? Assessing expressive differences between depressive patients and healthy volunteers during clinical interviews

Fiquer, Juliana Teixeira; Moreno, Ricardo Alberto; Brunoni, André R.; Barros, Vivian Boschesi; Fernandes, Fernando; Gorenstein, Clarice

doi:10.1016/j.jad.2018.05.071

Cited by 17 publications

(11 citation statements)

References 53 publications

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“…Moreover, decrease of negative facial and head indicators and increase of eye contact and yes nodding accompanied clinical improvement, whereas illustrative gestures did not [ 35 ]. In another study, Fiquer et al [ 37 ] compared nonverbal behavior in patients with depression versus controls. They showed that patients with depression displayed higher levels of negative nonverbal behaviors (shrug, head and lips down, adaptative hand gesture, frown, and cry) and lower levels of positive nonverbal behaviors (eye contact and smile).…”

Section: Resultsmentioning

confidence: 99%

Digital Phenotyping for Differential Diagnosis of Major Depressive Episode: Narrative Review

Ettore¹,

Müller²,

Hinze³

et al. 2023

JMIR Ment Health

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Background Major depressive episode (MDE) is a common clinical syndrome. It can be found in different pathologies such as major depressive disorder (MDD), bipolar disorder (BD), posttraumatic stress disorder (PTSD), or even occur in the context of psychological trauma. However, only 1 syndrome is described in international classifications (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5]/International Classification of Diseases 11th Revision [ICD-11]), which do not take into account the underlying pathology at the origin of the MDE. Clinical interviews are currently the best source of information to obtain the etiological diagnosis of MDE. Nevertheless, it does not allow an early diagnosis and there are no objective measures of extracted clinical information. To remedy this, the use of digital tools and their correlation with clinical symptomatology could be useful. Objective We aimed to review the current application of digital tools for MDE diagnosis while highlighting shortcomings for further research. In addition, our work was focused on digital devices easy to use during clinical interview and mental health issues where depression is common. Methods We conducted a narrative review of the use of digital tools during clinical interviews for MDE by searching papers published in PubMed/MEDLINE, Web of Science, and Google Scholar databases since February 2010. The search was conducted from June to September 2021. Potentially relevant papers were then compared against a checklist for relevance and reviewed independently for inclusion, with focus on 4 allocated topics of (1) automated voice analysis, behavior analysis by (2) video and physiological measures, (3) heart rate variability (HRV), and (4) electrodermal activity (EDA). For this purpose, we were interested in 4 frequently found clinical conditions in which MDE can occur: (1) MDD, (2) BD, (3) PTSD, and (4) psychological trauma. Results A total of 74 relevant papers on the subject were qualitatively analyzed and the information was synthesized. Thus, a digital phenotype of MDE seems to emerge consisting of modifications in speech features (namely, temporal, prosodic, spectral, source, and formants) and in speech content, modifications in nonverbal behavior (head, hand, body and eyes movement, facial expressivity, and gaze), and a decrease in physiological measurements (HRV and EDA). We not only found similarities but also differences when MDE occurs in MDD, BD, PTSD, or psychological trauma. However, comparative studies were rare in BD or PTSD conditions, which does not allow us to identify clear and distinct digital phenotypes. Conclusions Our search identified markers from several modalities that hold promise for helping with a more objective diagnosis of MDE. To validate their potential, further longitudinal and prospective studies are needed.

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Section: Resultsmentioning

confidence: 99%

Digital Phenotyping for Differential Diagnosis of Major Depressive Episode: Narrative Review

Ettore¹,

Müller²,

Hinze³

et al. 2023

JMIR Ment Health

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“…Monkeys who were euthanized due to being severely ill spent significantly less time in normal stationary positions and more time displaying clinical signs, including a hunched posture, compared to monkeys who were ill yet survived [62]. As mentioned earlier, withdrawn behaviour has also been suggested to indicate a depressive-like state [19], which is corroborated by human evidence: hunched postures are more likely to be seen in clinically depressed individuals than controls [63][64][65].…”

Section: Being 'Withdrawn'mentioning

confidence: 88%

Recommendations for Abnormal Behaviour Ethograms in Monkey Research

Polanco

McCowan

Niel

et al. 2021

Animals

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Laboratory monkey ethograms currently include subcategories of abnormal behaviours that are based on superficial morphological similarity. Yet, such ethograms may be misclassifying behaviour, with potential welfare implications as different abnormal behaviours are likely to have distinct risk factors and treatments. We therefore investigated the convergent validity of four hypothesized subcategories of abnormal behaviours (‘motor’, e.g., pacing; ‘self-stimulation’, e.g., self-sucking; ‘postural’, e.g., hanging; and ‘self-abuse’, e.g., self-biting). This hypothesis predicts positive relationships between the behaviours within each subcategory. Rhesus macaque (Macaca mulatta) data on 19 abnormal behaviours were obtained from indoor-housed animals (n = 1183). Logistic regression models, controlling for sex, age, and the number of observations, revealed that only 1/6 ‘motor’ behaviours positively predicted pacing, while 2/3 ‘self-abuse’ behaviours positively predicted self-biting (one-tailed p-value < 0.05). Furthermore, ‘self-stimulation’ behaviours did not predict self-sucking, and none of the ‘postural’ behaviours predicted hanging. Thus, none of the subcategories fully met convergent validity. Subsequently, we created four new valid subcategories formed of comorbid behaviours. The first consisted of self-biting, self-hitting, self-injurious behaviour, floating limb, leg-lifting, and self-clasping. The second comprised twirling, bouncing, rocking, swinging, and hanging. The third comprised pacing and head-twisting, while the final subcategory consisted of flipping and eye-poking. Self-sucking, hair-plucking, threat-biting, and withdrawn remained as individual behaviours. We encourage laboratories to replicate the validation of these subcategories first, and for scientists working with other species to validate their ethograms before using them in welfare assessments.

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“…Results of eye-tracking studies reveal that, compared to non-depressed controls, individuals with depression spend more time viewing negative images (e.g., sad faces) and less time with positive or neutral images (Kellough et al, 2008;Sanchez et al, 2013;Isaac, et al, 2014). Furthermore, research on clinical interviews has shown that patients with depression display less eye contact with mental health professionals than the patients with other psychiatric conditions such as schizophrenia (Jones and Pansa, 1979) and non-depressed controls (Hinchliffe et al, 1970;Sobin and Sackeim, 1997;Fiquer, et al, 2018). Interestingly, the avoidance of eye contact has been observed to emerge regardless of the severity of depression and to persist relatively long after treatment (Fiquer et al, 2018).…”

Section: Depression and Social Interactionmentioning

confidence: 99%

“…Furthermore, research on clinical interviews has shown that patients with depression display less eye contact with mental health professionals than the patients with other psychiatric conditions such as schizophrenia (Jones and Pansa, 1979) and non-depressed controls (Hinchliffe et al, 1970;Sobin and Sackeim, 1997;Fiquer, et al, 2018). Interestingly, the avoidance of eye contact has been observed to emerge regardless of the severity of depression and to persist relatively long after treatment (Fiquer et al, 2018). In the context of social interaction, the gaze behavior of individuals with depression has been interpreted as withdrawal from social contacts and as avoidance of intimacy (Hinchliffe et al, 1970).…”

Section: Depression and Social Interactionmentioning

confidence: 99%

The Psychophysiological Experience of Solving Moral Dilemmas Together: An Interdisciplinary Comparison Between Participants With and Without Depression

et al. 2021

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Dyads with a depressed and a non-depressed participant (N = 15) and two non-depressed participants (N = 15) discussed a moral dilemma, during which the participants’ gaze direction and skin conductance (SC) were measured. Partner gazing occurred most frequently when a speaker took a strong stance toward saving a person in the dilemma, depressed participants however looking at their co-participants less often than non-depressed participants. The participants’ SC response rates were higher during responsive utterances expressing disagreement (vs. agreement) with co-participant ideas or suggesting that a person be sacrificed (vs. saved). We argue that a better understanding of the affective corollaries of human social interaction necessitates a balanced consideration of both contents of talk and behavioral patterns.

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What is the nonverbal communication of depression? Assessing expressive differences between depressive patients and healthy volunteers during clinical interviews

Cited by 17 publications

References 53 publications

Digital Phenotyping for Differential Diagnosis of Major Depressive Episode: Narrative Review

Digital Phenotyping for Differential Diagnosis of Major Depressive Episode: Narrative Review

Recommendations for Abnormal Behaviour Ethograms in Monkey Research

The Psychophysiological Experience of Solving Moral Dilemmas Together: An Interdisciplinary Comparison Between Participants With and Without Depression

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