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Konrad K, Gerloff C, Kohl SH, Mehler DMA, Mehlem L, Volbert EL, Komorek M, Henn AT, Boecker M, Weiss E, Reindl V. Interpersonal neural synchrony and mental disorders: unlocking potential pathways for clinical interventions. Front Neurosci 2024; 18:1286130. [PMID: 38529267 PMCID: PMC10962391 DOI: 10.3389/fnins.2024.1286130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/30/2024] [Indexed: 03/27/2024] Open
Abstract
Introduction Interpersonal synchronization involves the alignment of behavioral, affective, physiological, and brain states during social interactions. It facilitates empathy, emotion regulation, and prosocial commitment. Mental disorders characterized by social interaction dysfunction, such as Autism Spectrum Disorder (ASD), Reactive Attachment Disorder (RAD), and Social Anxiety Disorder (SAD), often exhibit atypical synchronization with others across multiple levels. With the introduction of the "second-person" neuroscience perspective, our understanding of interpersonal neural synchronization (INS) has improved, however, so far, it has hardly impacted the development of novel therapeutic interventions. Methods To evaluate the potential of INS-based treatments for mental disorders, we performed two systematic literature searches identifying studies that directly target INS through neurofeedback (12 publications; 9 independent studies) or brain stimulation techniques (7 studies), following PRISMA guidelines. In addition, we narratively review indirect INS manipulations through behavioral, biofeedback, or hormonal interventions. We discuss the potential of such treatments for ASD, RAD, and SAD and using a systematic database search assess the acceptability of neurofeedback (4 studies) and neurostimulation (4 studies) in patients with social dysfunction. Results Although behavioral approaches, such as engaging in eye contact or cooperative actions, have been shown to be associated with increased INS, little is known about potential long-term consequences of such interventions. Few proof-of-concept studies have utilized brain stimulation techniques, like transcranial direct current stimulation or INS-based neurofeedback, showing feasibility and preliminary evidence that such interventions can boost behavioral synchrony and social connectedness. Yet, optimal brain stimulation protocols and neurofeedback parameters are still undefined. For ASD, RAD, or SAD, so far no randomized controlled trial has proven the efficacy of direct INS-based intervention techniques, although in general brain stimulation and neurofeedback methods seem to be well accepted in these patient groups. Discussion Significant work remains to translate INS-based manipulations into effective treatments for social interaction disorders. Future research should focus on mechanistic insights into INS, technological advancements, and rigorous design standards. Furthermore, it will be key to compare interventions directly targeting INS to those targeting other modalities of synchrony as well as to define optimal target dyads and target synchrony states in clinical interventions.
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Affiliation(s)
- Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany
- JARA Brain Institute II, Molecular Neuroscience and Neuroimaging (INM-11), Jülich Research Centre, Jülich, Germany
| | - Christian Gerloff
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany
- JARA Brain Institute II, Molecular Neuroscience and Neuroimaging (INM-11), Jülich Research Centre, Jülich, Germany
- Department of Applied Mathematics and Theoretical Physics, Cambridge Centre for Data-Driven Discovery, University of Cambridge, Cambridge, United Kingdom
| | - Simon H. Kohl
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany
- JARA Brain Institute II, Molecular Neuroscience and Neuroimaging (INM-11), Jülich Research Centre, Jülich, Germany
| | - David M. A. Mehler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
- School of Psychology, Cardiff University Brain Research Imaging Center (CUBRIC), Cardiff University, Cardiff, United Kingdom
| | - Lena Mehlem
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany
| | - Emily L. Volbert
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany
| | - Maike Komorek
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany
| | - Alina T. Henn
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany
| | - Maren Boecker
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany
- Institute of Medical Psychology and Medical Sociology, University Hospital RWTH, Aachen, Germany
| | - Eileen Weiss
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany
- Institute of Medical Psychology and Medical Sociology, University Hospital RWTH, Aachen, Germany
| | - Vanessa Reindl
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital RWTH, Aachen, Germany
- Department of Psychology, School of Social Sciences, Nanyang Technological University, Singapore, Singapore
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Shatz H, Asher M, Aderka IM. Catching a (sine) wave: Temporal dynamics of nonverbal synchrony in social anxiety disorder. J Anxiety Disord 2024; 102:102828. [PMID: 38245962 DOI: 10.1016/j.janxdis.2024.102828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/24/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
Individuals with social anxiety disorder (SAD) experience a range of interpersonal problems and studies have found that nonverbal synchrony (the coordination between interaction partners' movements) may be impaired in dyads in which one individual has SAD (Asher et al., 2020). In the present study, we examined the temporal dynamics of nonverbal synchrony during "getting aquatinted" conversations of individuals with and without SAD. Specifically, participants (n = 146) formed either SAD dyads (dyads in which one individual had SAD and the other did not; n = 37 dyads), or control dyads (dyads in which both individuals did not have SAD; n = 36 dyads). Dyads were randomized to either small talk or closeness-generating (i.e., intimate) conversations. We found that during conversations, nonverbal synchrony followed a repeating pattern of increases and decreases that was best modeled by a sinusoidal wave (explained variance = 63.74 %). We found significant Diagnosis × Social Context interactions in the temporal dynamics of nonverbal synchrony (i.e., in the parameters of sine waves). Specifically, we found that for SAD dyads (but not control dyads), the average sine wave amplitude which indicates increases and decreases in nonverbal synchrony was greater during small talk conversations compared to closeness-generating conversations. In addition, we found that among control dyads (but not SAD dyads), the average vertical offset of sine waves (i.e., the average level of nonverbal synchrony) during closeness-generating conversations was greater compared to small talk conversations. The findings are interpreted within the context of the social anxiety literature as capturing two distinct social-anxiety related processes, and suggest that when examined temporally (rather than averaged), nonverbal synchrony may be an important implicit biomarker of SAD.
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Affiliation(s)
- Hallel Shatz
- School of Psychological Sciences, University of Haifa, Israel
| | - Maya Asher
- School of Psychological Sciences, University of Haifa, Israel
| | - Idan M Aderka
- School of Psychological Sciences, University of Haifa, Israel.
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Zilcha-Mano S. Individual-Specific Animated Profiles of Mental Health. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2024:17456916231226308. [PMID: 38377015 DOI: 10.1177/17456916231226308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
How important is the timing of the pretreatment evaluation? If we consider mental health to be a relatively fixed condition, the specific timing (e.g., day, hour) of the evaluation is immaterial and often determined on the basis of technical considerations. Indeed, the fundamental assumption underlying the vast majority of psychotherapy research and practice is that mental health is a state that can be captured in a one-dimensional snapshot. If this fundamental assumption, underlying 80 years of empirical research and practice, is incorrect, it may help explain why for decades psychotherapy failed to rise above the 50% efficacy rate in the treatment of mental-health disorders, especially depression, a heterogeneous disorder and the leading cause of disability worldwide. Based on recent studies suggesting within-individual dynamics, this article proposes that mental health and its underlying therapeutic mechanisms have underlying intrinsic dynamics that manifest across dimensions. Computational psychotherapy is needed to develop individual-specific pretreatment animated profiles of mental health. Such individual-specific animated profiles are expected to improve the ability to select the optimal treatment for each patient, devise adequate treatment plans, and adjust them on the basis of ongoing evaluations of mental-health dynamics, creating a new understanding of therapeutic change as a transition toward a more adaptive animated profile.
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Wessler J, Gebhard P, Zilcha-Mano S. Investigating movement synchrony in therapeutic settings using socially interactive agents: an experimental toolkit. Front Psychiatry 2024; 15:1330158. [PMID: 38380119 PMCID: PMC10877720 DOI: 10.3389/fpsyt.2024.1330158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/16/2024] [Indexed: 02/22/2024] Open
Affiliation(s)
- Janet Wessler
- Affective Computing Group, Cognitive Assistants, German Research Center for Artificial Intelligence, Saarbruecken, Germany
| | - Patrick Gebhard
- Affective Computing Group, Cognitive Assistants, German Research Center for Artificial Intelligence, Saarbruecken, Germany
| | - Sigal Zilcha-Mano
- Psychotherapy Research Lab, Department of Psychology, University of Haifa, Haifa, Israel
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Moffat R, Caruana N, Cross ES. Inhibiting responses under the watch of a recently synchronized peer increases self-monitoring: evidence from functional near-infrared spectroscopy. Open Biol 2024; 14:230382. [PMID: 38378138 PMCID: PMC10878812 DOI: 10.1098/rsob.230382] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/30/2024] [Indexed: 02/22/2024] Open
Abstract
Developing motor synchrony with a peer (through interventions such as the mirror game) can yield collaborative, cognitive and social benefits. However, it is also well established that observation by an audience can improve cognition. The combined and relative advantages offered by motor synchronization and audience effects are not yet understood. It is important to address this gap to determine the extent to which synchronizing activities might interact with the positive effects of an audience. In this preregistered study, we investigate the extent to which response inhibition may be improved when observed by a peer after motor synchronization with this peer. We compare behavioural and cortical (functional near-infrared spectroscopy; fNIRS) measures of inhibition between synchronized and non-synchronized dyads and find that the presence of a synchronized peer-audience introduces a speed-accuracy trade-off, consisting of slower reaction times and improved accuracy. This co-occurs with cortical activation in bilateral inferior frontal and middle prefrontal cortices, which are implicated in monitoring and maintenance of social alignment. Our findings have implications for carers and support people, who may benefit from synchronizing activities for rehabilitating inhibition and social skills in clinical settings.
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Affiliation(s)
- R. Moffat
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales 2109, Australia
- Professorship for Social Brain Sciences, ETH Zurich, Zurich 8092, Switzerland
| | - N. Caruana
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales 2109, Australia
- College of Education, Psychology and Social Work, Flinders University, Bedford Park, South Australia, Australia
| | - E. S. Cross
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales 2109, Australia
- MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead Innovation Quarter Building U, Westmead New South Wales 2145, Australia
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow G12 8QB, UK
- Professorship for Social Brain Sciences, ETH Zurich, Zurich 8092, Switzerland
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Høgenhaug SS, Kongerslev MT, Kjaersdam Telléus G. The role of interpersonal coordination dynamics in alliance rupture and repair processes in psychotherapy-A systematic review. Front Psychol 2024; 14:1291155. [PMID: 38239459 PMCID: PMC10794593 DOI: 10.3389/fpsyg.2023.1291155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/27/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction The purpose of this systematic review is to expand our knowledge of the underlying mechanisms of the alliance in psychotherapy. This is done by examining the association between alliance rupture and repair processes and interpersonal coordination dynamics. Method A systematic review based on PRISMA guidelines was conducted, aimed at papers investigating the association between alliance rupture and repair episodes and different behavioral modalities (i.e., physiology, movement) in the psychotherapeutic interaction. Seventeen studies were included for full text-analysis. Results The results indicate that rupture and repair episodes were associated with interpersonal coordination dynamics. Different modalities (movement, heart rate, and vocalization) were found to serve as markers for alliance rupture and repair events. Facial expressions, physiological arousal, vocalization, and behavior were found to play important roles in the therapeutic interaction in relation to mutual emotion regulation, empathic response, safety, trust, and meaning-making. Discussion Limitations of this review are discussed, including the great methodological variation and selection bias observed in the reviewed studies. Recommendations for future research in this area are presented. Overall, interpersonal coordination dynamics was found to have the potential to help identify and manage alliance ruptures and foster repairs in the therapeutic interaction, which has high potential for future clinical work and training.
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Affiliation(s)
- S. S. Høgenhaug
- Clinic North, Psychiatric Hospital, Bronderslev, Denmark
- Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - M. T. Kongerslev
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Mental Health Services West, Region Zealand, Slagelse, Denmark
| | - G. Kjaersdam Telléus
- Psychiatry, Aalborg University Hospital, Aalborg, Denmark
- Psychology, Department of Communication and Psychology, Aalborg University, Aalborg, Denmark
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Shatz H, Oren-Yagoda R, Aderka IM. Nonverbal synchrony in diagnostic interviews of individuals with social anxiety disorder. J Anxiety Disord 2024; 101:102803. [PMID: 38101251 DOI: 10.1016/j.janxdis.2023.102803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 11/15/2023] [Accepted: 12/01/2023] [Indexed: 12/17/2023]
Abstract
The present study examined nonverbal synchrony (i.e., synchrony between individuals' movement) during diagnostic interviews of individuals with and without social anxiety disorder (SAD). Specifically, 42 individuals with SAD and 42 individuals without SAD underwent a structured clinical interview, and videos of clinical interviews were analysed using Motion Energy Analysis (an objective machine-based video analysis) to quantify each individuals' movement as well as dyadic synchrony. Results indicated that interviews of individuals with SAD had significantly lower levels of nonverbal synchrony compared to interviews of individuals without SAD. In addition, interviews of individuals with SAD had lower levels of pacing compared to interviews of individuals without SAD (pacing refers to synchrony in which the interviewer initiates movement to which the participant responds). Analyses with social anxiety represented as a continuum of severity (vs. a diagnostic dichotomy) resulted in similar findings. Thus, individuals with SAD synchronized with interviewers' movement to a lesser extent compared to individuals without SAD, and social anxiety was associated with diminished synchrony. Implications for psychopathology and diagnosis of SAD are discussed.
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Affiliation(s)
- Hallel Shatz
- School of Psychological Sciences, University of Haifa, Israel
| | | | - Idan M Aderka
- School of Psychological Sciences, University of Haifa, Israel.
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Dai X, Li X, Xia N, Xi J, Zhang Y. Client-counselor behavioral and inter-brain synchronization among dismissing and secure clients and its association with alliance quality and outcome. Psychother Res 2023:1-14. [PMID: 37643580 DOI: 10.1080/10503307.2023.2249587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 07/19/2023] [Accepted: 07/28/2023] [Indexed: 08/31/2023] Open
Abstract
Objective This study aimed to explore whether behavioral synchrony (BS) and inter-brain synchrony (IBS) could serve as potential biomarkers for alliance quality or outcomes among clients with different adult attachment styles. Method: We assessed the clients' self-report working alliance and clinical outcomes as well as simultaneously measured BS using motion energy analysis (MEA) and IBS with functional near-infrared spectroscopy (fNIRS) among 37 secure (N = 21) or dismissing (N = 16) clients with their counselors during the first psychological counseling meeting. Results: Dismissing dyads manifested significantly higher late-stage counselor-led and client-led IBS (p = .018) than secure dyads. Adult attachment style served as the moderators in the correlation of both whole-stage client-led BS with bond dimension of alliance (p = .015) as well as in the correlation of both whole-stage no-lag IBS with CORE-10 score changes (p = .022). Moreover, increases in the whole-stage client-led BS were significantly associated with decreases in early-stage, late-stage and whole-stage no-lag IBS (all ps ≤ 0.01). Conclusion: These findings revealed the potentially impeding role of interpersonal synchrony in alliance quality for dismissing clients, at least during the first psychological counseling meetings. They also might partially validate the relationship between different modalities of interpersonal synchrony.
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Affiliation(s)
- Xiaoyan Dai
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Centre (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
| | - Xueying Li
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Centre (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
| | - Na Xia
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Centre (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
| | - Juzhe Xi
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Centre (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
| | - Ya Zhang
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Centre (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, People's Republic of China
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Atzil-Slonim D, Soma CS, Zhang X, Paz A, Imel ZE. Facilitating dyadic synchrony in psychotherapy sessions: Systematic review and meta-analysis. Psychother Res 2023:1-20. [PMID: 37001119 DOI: 10.1080/10503307.2023.2191803] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Objective: This paper highlights the facilitation of dyadic synchrony as a core psychotherapist skill that occurs at the non-verbal level and underlies many other therapeutic methods. We define dyadic synchrony, differentiate it from similar constructs, and provide an excerpt illustrating dyadic synchrony in a psychotherapy session. Method: We then present a systematic review of 17 studies that have examined the associations between dyadic synchrony and psychotherapy outcomes. We also conduct a meta-analysis of 8 studies that examined whether there is more synchrony between clients and therapists than would be expected by chance. Results: Weighted box score analysis revealed that the overall association of synchrony and proximal as well as distal outcomes was neutral to mildly positive. The results of the meta-analysis indicated that real client-therapist dyad pairs exhibited synchronized behavioral patterns to a much greater extent than a sample of randomly paired people who did not actually speak. Conclusion: Our discussion revolves around how synchrony can be facilitated in a beneficial way, as well as situations in which it may not be beneficial. We conclude with training implications and therapeutic practices.
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Andreas S, Gablonski TC, Tschacher W, Gebhardt A, Rabung S, Schulz H, Kadur J. Long-term psychodynamic psychotherapy in a face-to-face versus videoconferencing setting: A single case study. J Clin Psychol 2023; 79:277-295. [PMID: 35819447 PMCID: PMC10084227 DOI: 10.1002/jclp.23411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 06/07/2022] [Accepted: 06/26/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Due to the coronavirus pandemic and crisis, psychotherapists around the world were forced to switch to video- or tele-based treatments overnight. To date, only a few studies on the effectiveness of video-based psychodynamic psychotherapy via the Internet exist. Therefore, the goal of the present study was to examine symptom improvement, therapeutic relationship, nonverbal synchrony processes, and intersession processes within a systematic single case design and compare face-to-face to video-based approaches in long-term psychodynamic-oriented psychotherapy. METHODS We examined 85 sessions of a client with major depression whose psychodynamic psychotherapy changed from a face-to-face setting to a video-based setting. Video recordings were analyzed using motion energy analysis, and nonverbal synchrony was computed using a surrogate synchrony approach. Time series analyses were performed to analyze changes in symptom severity, therapeutic relationship, and intersession processes. RESULTS The results showed that symptom severity improved descriptively, but not significantly, across the entire course of psychotherapy. There were significant differences, however, in the therapeutic relationship, intersession experiences, and synchronous behavior between the face-to-face and video-based settings. CONCLUSION The results indicate that the presented methodology is well situated to investigate the question whether psychodynamic psychotherapy in video-based setting works in the sameway as in a face-to-face setting.
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Affiliation(s)
- Sylke Andreas
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Thorsten-Christian Gablonski
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Wolfgang Tschacher
- University Hospital of Psychiatry and Psychotherapy, Experimental Psychology Division, University of Bern, Bern, Switzerland
| | - Albrecht Gebhardt
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Sven Rabung
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Holger Schulz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jennifer Kadur
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
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Hudson D, Wiltshire TJ, Atzmueller M. multiSyncPy: A Python package for assessing multivariate coordination dynamics. Behav Res Methods 2023; 55:932-962. [PMID: 35513768 PMCID: PMC10027834 DOI: 10.3758/s13428-022-01855-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
In order to support the burgeoning field of research into intra- and interpersonal synchrony, we present an open-source software package: multiSyncPy. Multivariate synchrony goes beyond the bivariate case and can be useful for quantifying how groups, teams, and families coordinate their behaviors, or estimating the degree to which multiple modalities from an individual become synchronized. Our package includes state-of-the-art multivariate methods including symbolic entropy, multidimensional recurrence quantification analysis, coherence (with an additional sum-normalized modification), the cluster-phase 'Rho' metric, and a statistical test based on the Kuramoto order parameter. We also include functions for two surrogation techniques to compare the observed coordination dynamics with chance levels and a windowing function to examine time-varying coordination for most of the measures. Taken together, our collation and presentation of these methods make the study of interpersonal synchronization and coordination dynamics applicable to larger, more complex and often more ecologically valid study designs. In this work, we summarize the relevant theoretical background and present illustrative practical examples, lessons learned, as well as guidance for the usage of our package - using synthetic as well as empirical data. Furthermore, we provide a discussion of our work and software and outline interesting further directions and perspectives. multiSyncPy is freely available under the LGPL license at: https://github.com/cslab-hub/multiSyncPy , and also available at the Python package index.
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Affiliation(s)
- Dan Hudson
- Semantic Information Systems Group, Institute of Computer Science, Osnabrück University, P.O. Box 4469, 49069, Osnabrueck, Germany.
- Department of Cognitive Science and Artificial Intelligence, Tilburg University, Tilburg, The Netherlands.
| | - Travis J Wiltshire
- Department of Cognitive Science and Artificial Intelligence, Tilburg University, Tilburg, The Netherlands
| | - Martin Atzmueller
- Semantic Information Systems Group, Institute of Computer Science, Osnabrück University, P.O. Box 4469, 49069, Osnabrueck, Germany
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Altmann U, Strauss B, Tschacher W. Cross-Correlation- and Entropy-Based Measures of Movement Synchrony: Non-Convergence of Measures Leads to Different Associations with Depressive Symptoms. ENTROPY (BASEL, SWITZERLAND) 2022; 24:e24091307. [PMID: 36141194 PMCID: PMC9497848 DOI: 10.3390/e24091307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 05/29/2023]
Abstract
BACKGROUND Several algorithms have been proposed to quantify synchronization. However, little is known about their convergent and predictive validity. METHODS The sample included 30 persons who completed a manualized interview focusing on psychosomatic symptoms. The intensity of body motions was measured using motion-energy analysis. We computed several measures of movement synchrony based on the time series of the interviewer and participant: mutual information, windowed cross-recurrence analysis, cross-correlation, rMEA, SUSY, SUCO, WCLC-PP and WCLR-PP. Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ9). RESULTS According to the explorative factor analyses, all the variants of cross-correlation and all the measures of SUSY, SUCO and rMEA-WCC led to similar synchrony measures and could be assigned to the same factor. All the mutual-information measures, rMEA-WCLC, WCLC-PP-F, WCLC-PP-R2, WCLR-PP-F, and WinCRQA-DET loaded on the second factor. Depressive symptoms correlated negatively with WCLC-PP-F and WCLR-PP-F and positively with rMEA-WCC, SUCO-ES-CO, and MI-Z. CONCLUSION More standardization efforts are needed because different synchrony measures have little convergent validity, which can lead to contradictory conclusions concerning associations between depressive symptoms and movement synchrony using the same dataset.
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Affiliation(s)
- Uwe Altmann
- Institute of Psychosocial Medicine, Psychotherapy and Psycho-Oncology, Jena University Hospital, D-07743 Jena, Germany
| | - Bernhard Strauss
- Institute of Psychosocial Medicine, Psychotherapy and Psycho-Oncology, Jena University Hospital, D-07743 Jena, Germany
| | - Wolfgang Tschacher
- Department of Experimental Psychology, University Hospital of Psychiatry and Psychotherapy, CH-3060 Bern, Switzerland
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Yap SS, Ramseyer FT, Fachner J, Maidhof C, Tschacher W, Tucek G. Dyadic nonverbal synchrony during pre and post music therapy interventions and its relationship to self-reported therapy readiness. Front Hum Neurosci 2022; 16:912729. [PMID: 36147296 PMCID: PMC9485672 DOI: 10.3389/fnhum.2022.912729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/26/2022] [Indexed: 12/05/2022] Open
Abstract
Nonverbal interpersonal synchronization has been established as an important factor in therapeutic relationships, and the differentiation of who leads the interaction appears to provide further important information. We investigated nonverbal synchrony - quantified as the coordination of body movement between patient and therapist. This was observed in music therapy dyads, while engaged in verbal interaction before and after a music intervention in the session. We further examined associations with patients' self-reported therapy readiness at the beginning of the session. Eleven neurological in-patients participated in this study. Our results showed an increase in both nonverbal synchrony and patient leading after the music intervention. A significant negative correlation was found between self-reported therapy readiness and nonverbal synchrony after the music intervention. These findings point to the empathic ability of the music therapist to sense patients' therapy readiness. Higher patient leading in nonverbal synchrony after the music intervention may thus indicate that the music intervention may have allowed dyadic entrainment to take place, potentially increasing self-regulation and thus empowering patients.
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Affiliation(s)
- Sun Sun Yap
- Department of Health Sciences, Institute of Health Sciences and Midwifery, IMC University of Applied Sciences Krems, Krems an der Donau, Austria
- Josef Ressel Centre for Horizons of Personalised Music Therapy, IMC University of Applied Sciences Krems, Krems an der Donau, Austria
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, United Kingdom
| | - Fabian T. Ramseyer
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Bern, Bern, Switzerland
| | - Jörg Fachner
- Josef Ressel Centre for Horizons of Personalised Music Therapy, IMC University of Applied Sciences Krems, Krems an der Donau, Austria
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, United Kingdom
| | - Clemens Maidhof
- Josef Ressel Centre for Horizons of Personalised Music Therapy, IMC University of Applied Sciences Krems, Krems an der Donau, Austria
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, United Kingdom
| | - Wolfgang Tschacher
- Department of Experimental Psychology, University Hospital of Psychiatry and Psychotherapy, Bern, Switzerland
| | - Gerhard Tucek
- Department of Health Sciences, Institute of Health Sciences and Midwifery, IMC University of Applied Sciences Krems, Krems an der Donau, Austria
- Josef Ressel Centre for Horizons of Personalised Music Therapy, IMC University of Applied Sciences Krems, Krems an der Donau, Austria
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14
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Sened H, Zilcha-Mano S, Shamay-Tsoory S. Inter-brain plasticity as a biological mechanism of change in psychotherapy: A review and integrative model. Front Hum Neurosci 2022; 16:955238. [PMID: 36092652 PMCID: PMC9458846 DOI: 10.3389/fnhum.2022.955238] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 08/04/2022] [Indexed: 11/26/2022] Open
Abstract
Recent models of psychopathology and psychotherapy highlight the importance of interpersonal factors. The current review offers a biological perspective on these interpersonal processes by examining inter-brain synchrony—the coupling of brain activity between people interacting with one another. High inter-brain synchrony is associated with better relationships in therapy and in daily life, while deficits in the ability to achieve inter-brain synchrony are associated with a variety of psychological and developmental disorders. The review suggests that therapy improves patients’ ability to achieve such synchrony through inter-brain plasticity—a process by which recurring exposure to high inter-brain synchrony leads to lasting change in a person’s overall ability to synchronize. Therapeutic sessions provide repeated situations with high inter-brain synchrony. This can lead to a long-term increase in the ability to synchronize, first with the therapist, then generalized to other interpersonal relationships, ultimately leading to symptom reduction. The proposed inter-brain plasticity model offers a novel biological framework for understanding relational change in psychotherapy and its links to various forms of psychopathology and provides testable hypotheses for future research. Understanding this mechanism may help improve existing psychotherapy methods and develop new ones.
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15
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Völter C, Oberländer K, Mertens S, Ramseyer FT. Nonverbal synchrony in subjects with hearing impairment and their significant others. Front Psychol 2022; 13:964547. [PMID: 36059730 PMCID: PMC9434370 DOI: 10.3389/fpsyg.2022.964547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/21/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Hearing loss has a great impact on the people affected, their close partner and the interaction between both, as oral communication is restricted. Nonverbal communication, which expresses emotions and includes implicit information on interpersonal relationship, has rarely been studied in people with hearing impairment (PHI). In psychological settings, non-verbal synchrony of body movements in dyads is a reliable method to study interpersonal relationship. Material and methods A 10-min social interaction was videorecorded in 39 PHI (29 spouses and 10 parent-child dyads) and their significant others (SOs). Nonverbal synchrony, which means the nonverbal behaviors of two interacting persons (referring to both general synchrony and the role of leading) and verbal interaction (percentage of speech, frequency of repetitions, and queries) were analyzed by computer algorithms and observer ratings. Hearing-related quality of life, coping mechanisms, general psychopathology, quality of relationship, and burden of hearing loss experienced by SOs were assessed using questionnaires. Results In the 39 dyads, true nonverbal synchrony differed from pseudosynchrony [t(43.4) = 2.41; p = 0.02] with a medium effect size (d = 0.42). Gender of PHI had a significant effect on general synchrony (p = 0.025) and on leading by SOs (p = 0.017). Age gap correlated with synchronic movements (p = 0.047). Very short duration of hearing impairment was associated with lower nonverbal synchrony in the role of leading by SOs (p = 0.031). Feeling of closeness by PHI correlated negatively with the role of leading by SOs (p > 0.001) and feeling of closeness by SOs was positively associated with leading by PHI (p = 0.015). No correlation was detected between nonverbal synchrony and other questionnaires. Burden experienced by the SOs was higher in SOs who reported less closeness (p = 0.014). Discussion A longer hearing impairment leads to more nonverbal leading by SOs compared to PHI with very short duration of hearing loss, possibly because of the long-lasting imbalance in communication. If PHI felt more closeness, SOs led less and vice versa. Burden experienced by SOs negatively correlated with closeness reported by SOs. Use of nonverbal signals and communication might help to improve benefits of auditory rehabilitation for PHI and decrease burden experienced by SOs.
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Affiliation(s)
- Christiane Völter
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Bochum, Germany
- *Correspondence: Christiane Völter
| | - Kirsten Oberländer
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Bochum, Germany
| | - Sophie Mertens
- Department of Otorhinolaryngology, Head and Neck Surgery, Catholic Hospital Bochum, Bochum, Germany
| | - Fabian T. Ramseyer
- Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
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16
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Erwin SR, Liu PJ, Datta N, Nicholas J, Rivera-Cancel A, Leary M, Chartrand TL, Zucker NL. Experiences of mimicry in eating disorders. J Eat Disord 2022; 10:103. [PMID: 35841035 PMCID: PMC9288029 DOI: 10.1186/s40337-022-00607-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 06/13/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND People unknowingly mimic the behaviors of others, a process that results in feelings of affiliation. However, some individuals with eating disorders describe feeling "triggered" when mimicked. This study explores the effects of implicit non-verbal mimicry on individuals with a history of an eating disorder (ED-His) compared to healthy controls (HCs). METHOD Women (N = 118, nED-His = 31; Mage = 21 years) participated in a laboratory task with a confederate trained to either discreetly mimic (Mimicry condition) or not mimic (No-Mimicry condition) the mannerisms of the participant. Participants rated the likability of the confederate and the smoothness of the interaction. RESULTS Participants in the No-Mimicry condition rated the confederate as significantly more likable than in the Mimicry condition, and ED-His rated the confederate as more likable than HCs. ED-His in the Mimicry condition rated the interaction as less smooth than HCs, whereas this pattern was not found in the No-Mimicry condition. Among ED-His, longer disorder duration (≥ 3.87 years) was associated with less liking of a confederate who mimicked and more liking of a confederate who did not mimic. CONCLUSIONS We discuss the implications of these findings for interpersonal therapeutic processes and group treatment settings for eating disorders. Our study on subtle, nonverbal mimicry revealed differences in social behavior for women with a history of an eating disorder compared to healthy women. For participants with an eating disorder history, a longer duration of illness was associated with a worse pattern of affiliation, reflected in lower liking of a mimicker. Further research on how diverging processes of affiliation may function to perpetuate the chronicity of eating disorders and implications for treatment is needed.
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Affiliation(s)
- Savannah R Erwin
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA.
| | - Peggy J Liu
- Fuqua School of Business, Duke University, Durham, NC, USA.,Katz Graduate School of Business, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nandini Datta
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA.,Department of Psychiatry and Behavioral Sciences, Stanford Medicine, Stanford, CA, USA
| | - Julia Nicholas
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.,Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Alannah Rivera-Cancel
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Mark Leary
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA
| | | | - Nancy L Zucker
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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Tourunen A, Nyman-Salonen P, Muotka J, Penttonen M, Seikkula J, Kykyri VL. Associations Between Sympathetic Nervous System Synchrony, Movement Synchrony, and Speech in Couple Therapy. Front Psychol 2022; 13:818356. [PMID: 35360617 PMCID: PMC8961511 DOI: 10.3389/fpsyg.2022.818356] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background Research on interpersonal synchrony has mostly focused on a single modality, and hence little is known about the connections between different types of social attunement. In this study, the relationship between sympathetic nervous system synchrony, movement synchrony, and the amount of speech were studied in couple therapy. Methods Data comprised 12 couple therapy cases (24 clients and 10 therapists working in pairs as co-therapists). Synchrony in electrodermal activity, head and body movement, and the amount of speech and simultaneous speech during the sessions were analyzed in 12 sessions at the start of couple therapy (all 72 dyads) and eight sessions at the end of therapy (48 dyads). Synchrony was calculated from cross-correlations using time lags and compared to segment-shuffled pseudo synchrony. The associations between the synchrony modalities and speech were analyzed using complex modeling (Mplus). Findings Couple therapy participants' synchrony mostly occurred in-phase (positive synchrony). Anti-phase (negative) synchrony was more common in movement than in sympathetic nervous system activity. Synchrony in sympathetic nervous system activity only correlated with movement synchrony between the client-therapist dyads (r = 0.66 body synchrony, r = 0.59 head synchrony). Movement synchrony and the amount of speech correlated negatively between spouses (r = -0.62 body synchrony, r = -0.47 head synchrony) and co-therapists (r = -0.39 body synchrony, r = -0.28 head synchrony), meaning that the more time the dyad members talked during the session, the less bodily synchrony they exhibited. Conclusion The different roles and relationships in couple therapy were associated with the extent to which synchrony modalities were linked with each other. In the relationship between clients and therapists, synchrony in arousal levels and movement "walked hand in hand", whereas in the other relationships (spouse or colleague) they were not linked. Generally, more talk time by the therapy participants was associated with anti-phase movement synchrony. If, as suggested, emotions prepare us for motor action, an important finding of this study is that sympathetic nervous system activity can also synchronize with that of others independently of motor action.
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Affiliation(s)
- Anu Tourunen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Petra Nyman-Salonen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
- Department of Social Sciences and Philosophy, Faculty of Humanities and Social Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Joona Muotka
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Markku Penttonen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Jaakko Seikkula
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Virpi-Liisa Kykyri
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
- Faculty of Social Sciences, Tampere University, Tampere, Finland
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18
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Schwartz B, Rubel JA, Deisenhofer AK, Lutz W. Movement-based patient-therapist attunement in psychological therapy and its association with early change. Digit Health 2022; 8:20552076221129098. [PMID: 36185387 PMCID: PMC9520162 DOI: 10.1177/20552076221129098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 09/11/2022] [Indexed: 11/15/2022] Open
Abstract
Objective Attunement is a novel measure of nonverbal synchrony reflecting the duration of the present moment shared by two interaction partners. This study examined its association with early change in outpatient psychotherapy. Methods Automated video analysis based on motion energy analysis (MEA) and cross-correlation of the movement time-series of patient and therapist was conducted to calculate movement synchrony for N = 161 outpatients. Movement-based attunement was defined as the range of connected time lags with significant synchrony. Latent change classes in the HSCL-11 were identified with growth mixture modeling (GMM) and predicted by pre-treatment covariates and attunement using multilevel multinomial regression. Results GMM identified four latent classes: high impairment, no change (Class 1); high impairment, early response (Class 2); moderate impairment (Class 3); and low impairment (Class 4). Class 2 showed the strongest attunement, the largest early response, and the best outcome. Stronger attunement was associated with a higher likelihood of membership in Class 2 (b = 0.313, p = .007), Class 3 (b = 0.251, p = .033), and Class 4 (b = 0.275, p = .043) compared to Class 1. For highly impaired patients, the probability of no early change (Class 1) decreased and the probability of early response (Class 2) increased as a function of attunement. Conclusions Among patients with high impairment, stronger patient-therapist attunement was associated with early response, which predicted a better treatment outcome. Video-based assessment of attunement might provide new information for therapists not available from self-report questionnaires and support therapists in their clinical decision-making.
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Affiliation(s)
- Brian Schwartz
- Department of Psychology, University of Trier, Trier, Germany
| | - Julian A. Rubel
- Department of Psychology, Justus-Liebig-University Gießen, Giessen, Germany
| | | | - Wolfgang Lutz
- Department of Psychology, University of Trier, Trier, Germany
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19
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Terhürne P, Schwartz B, Baur T, Schiller D, Eberhardt ST, André E, Lutz W. Validation and application of the Non-Verbal Behavior Analyzer: An automated tool to assess non-verbal emotional expressions in psychotherapy. Front Psychiatry 2022; 13:1026015. [PMID: 36386975 PMCID: PMC9650367 DOI: 10.3389/fpsyt.2022.1026015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/12/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Emotions play a key role in psychotherapy. However, a problem with examining emotional states via self-report questionnaires is that the assessment usually takes place after the actual emotion has been experienced which might lead to biases and continuous human ratings are time and cost intensive. Using the AI-based software package Non-Verbal Behavior Analyzer (NOVA), video-based emotion recognition of arousal and valence can be applied in naturalistic psychotherapeutic settings. In this study, four emotion recognition models (ERM) each based on specific feature sets (facial: OpenFace, OpenFace-Aureg; body: OpenPose-Activation, OpenPose-Energy) were developed and compared in their ability to predict arousal and valence scores correlated to PANAS emotion scores and processes of change (interpersonal experience, coping experience, affective experience) as well as symptoms (depression and anxiety in HSCL-11). MATERIALS AND METHODS A total of 183 patient therapy videos were divided into a training sample (55 patients), a test sample (50 patients), and a holdout sample (78 patients). The best ERM was selected for further analyses. Then, ERM based arousal and valence scores were correlated with patient and therapist estimates of emotions and processes of change. Furthermore, using regression models arousal and valence were examined as predictors of symptom severity in depression and anxiety. RESULTS The ERM based on OpenFace produced the best agreement to the human coder rating. Arousal and valence correlated significantly with therapists' ratings of sadness, shame, anxiety, and relaxation, but not with the patient ratings of their own emotions. Furthermore, a significant negative correlation indicates that negative valence was associated with higher affective experience. Negative valence was found to significantly predict higher anxiety but not depression scores. CONCLUSION This study shows that emotion recognition with NOVA can be used to generate ERMs associated with patient emotions, affective experiences and symptoms. Nevertheless, limitations were obvious. It seems necessary to improve the ERMs using larger databases of sessions and the validity of ERMs needs to be further investigated in different samples and different applications. Furthermore, future research should take ERMs to identify emotional synchrony between patient and therapists into account.
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Affiliation(s)
- Patrick Terhürne
- Clinical Psychology and Psychotherapy, University of Trier, Trier, Germany
| | - Brian Schwartz
- Clinical Psychology and Psychotherapy, University of Trier, Trier, Germany
| | - Tobias Baur
- Chair for Human Centered Artificial Intelligence, Augsburg University, Augsburg, Germany
| | - Dominik Schiller
- Chair for Human Centered Artificial Intelligence, Augsburg University, Augsburg, Germany
| | | | - Elisabeth André
- Chair for Human Centered Artificial Intelligence, Augsburg University, Augsburg, Germany
| | - Wolfgang Lutz
- Clinical Psychology and Psychotherapy, University of Trier, Trier, Germany
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20
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Nyman-Salonen P, Kykyri VL, Penttonen M. Challenges and added value of measuring embodied variables in psychotherapy. Front Psychiatry 2022; 13:1058507. [PMID: 36590641 PMCID: PMC9800897 DOI: 10.3389/fpsyt.2022.1058507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 11/07/2022] [Indexed: 12/23/2022] Open
Abstract
Research on embodied aspects of clinical encounters is growing, but discussion on the premises of including embodied variables in empirical research is scarce. Studies have repeatedly demonstrated that embodied aspects of psychotherapy interaction are vital in developing a therapeutic alliance, and these should be considered to better understand the change process in psychotherapy. However, the field is still debating which methods should be used and which features of the embodied aspects are relevant in the clinical context. The field lacks methodological consistency as well as a theoretical model. In the Relational Mind research project, we have studied the embodied aspects of interaction in the context of couple therapy for almost a decade and have gained experience with the positive and negative aspects of studying embodied variables in quantitative and qualitative studies. We have set out to develop the methodology (or procedures) for studying embodied variables in a multiperson setting, concentrating on interpersonal synchrony of sympathetic nervous system responses and movements, and we have strived to create methods for integrating information from different embodied modalities. In this narrative review, we share our experiences of the challenges and added value of studying embodied aspects in psychotherapy. The research field urgently needs an ongoing discussion of what researchers should take into consideration when studying the embodied aspects of interaction. We urge researchers to collaborate between research groups to jointly decide on the basic parameters of studies on the different embodied modalities of the research so that the individual researcher can become more aware of the impact the methodological choices have on their studies, results, and interpretations. We also see the use of embodied variables as having added value in the clinical work of psychotherapists, since it not only deepens our understanding about what is helpful in psychotherapy but will enable fine-tuning therapy processes to better suit clients who are verbally less fluent.
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Affiliation(s)
- Petra Nyman-Salonen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland.,Department of Social Sciences and Philosophy, Faculty of Humanities and Social Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Virpi-Liisa Kykyri
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Markku Penttonen
- Department of Psychology, Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
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21
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Nyman-Salonen P, Kykyri VL, Tschacher W, Muotka J, Tourunen A, Penttonen M, Seikkula J. Nonverbal Synchrony in Couple Therapy Linked to Clients' Well-Being and the Therapeutic Alliance. Front Psychol 2021; 12:718353. [PMID: 34858258 PMCID: PMC8631962 DOI: 10.3389/fpsyg.2021.718353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
Nonverbal synchrony between individuals has a robust relation to the positive aspects of relationships. In psychotherapy, where talking is the cure, nonverbal synchrony has been related to a positive outcome of therapy and to a stronger therapeutic alliance between therapist and client in dyadic settings. Only a few studies have focused on nonverbal synchrony in multi-actor therapy conversations. Here, we studied the synchrony of head and body movements in couple therapy, with four participants present (spouses and two therapists). We analyzed more than 2000min of couple therapy videos from 11 couple therapy cases using Motion Energy Analysis and a Surrogate Synchrony (SUSY), a procedure used earlier in dyadic psychotherapy settings. SUSY was calculated for all six dyads per session, leading to synchrony computations for 66 different dyads. Significant synchrony occurred in all 29 analyzed sessions and between the majority of dyads. Complex models were used to determine the relations between nonverbal synchrony and the clients’ well-being and all participants’ evaluations of the therapeutic alliance. The clients’ well-being was related to body synchronies in the sessions. Differences were found between the clients’ and therapists’ alliance evaluations: the clients’ alliance evaluations were related to synchrony between both dyads of opposite gender, whereas the therapists’ alliance evaluations were related to synchrony between dyads of the same gender, but opposite to themselves. With four participants present, our study introduces a new aspect of nonverbal synchrony, since as a dyad synchronizes, the other two participants are observing it. Nonverbal synchrony seems to be as important in couple therapy as in individual psychotherapy, but the presence of multiple participants makes the patterns more complex.
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Affiliation(s)
- Petra Nyman-Salonen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland.,Faculty of Humanities and Social Sciences, Department of Social Sciences and Philosophy, University of Jyväskylä, Jyväskylä, Finland
| | - Virpi-Liisa Kykyri
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland.,Faculty of Social Sciences/Psychology, University of Tampere, Tampere, Finland
| | - Wolfgang Tschacher
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Joona Muotka
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Anu Tourunen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Markku Penttonen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Jaakko Seikkula
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland.,Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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22
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Scheidt CE, Pfänder S, Ballati A, Schmidt S, Lahmann C. Language and Movement Synchronization in Dyadic Psychotherapeutic Interaction - A Qualitative Review and a Proposal for a Classification. Front Psychol 2021; 12:696448. [PMID: 34744862 PMCID: PMC8569105 DOI: 10.3389/fpsyg.2021.696448] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 08/31/2021] [Indexed: 11/30/2022] Open
Abstract
In individual psychotherapy verbal communication and movement synchronization are closely interrelated. The microanalysis of timing, rhythm and gestalt of movement has established dynamic movement coordination as a systemic property of the dyadic interaction. Movement synchronization supports and enhances the unfolding of linguistic meaning. In order to substantiate the importance of the concept of synchrony for adult psychotherapy we review evidence from developmental psychology and discuss approaches to measure synchrony with particular reference to the naturalistic setting of dyadic psychotherapy. As the concept of synchrony is still ambiguous, and the respective interactional phenomena are ephemeral and fluid, in the current paper we suggest a set of five criteria for the description of synchronization in general terms and eight additional criteria which specifically enable the description of phenomena of movement synchronization. The five general dimensions are: (1) context, (2) modality, (3) resources, (4) entrainment, and (5) time-lag. The eight categories for the description of movement synchrony are: (1) spatial direction, (2) amplitude, (3) sinuosity, (4) duration, (5) event structure, (6) phase, (7) frequency, and (8) content. To understand the process of participatory sense-making and the emergence of meaning in psychotherapy, synchrony research has to cope with the multimodality of the embodied interaction. This requires an integrated perspective of movement and language. A system for the classification of synchrony phenomena may contribute to the linking of variations and patterns of movement with language and linguistic utterances.
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Affiliation(s)
- Carl Eduard Scheidt
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Albert-Ludwigs-University Freiburg, Freiburg, Germany.,Freiburg Institute for Advanced Studies (FRIAS), Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Stefan Pfänder
- Freiburg Institute for Advanced Studies (FRIAS), Albert-Ludwigs-University Freiburg, Freiburg, Germany.,Romanisches Seminar, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Arianna Ballati
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Stefan Schmidt
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Claas Lahmann
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Albert-Ludwigs-University Freiburg, Freiburg, Germany.,Freiburg Institute for Advanced Studies (FRIAS), Albert-Ludwigs-University Freiburg, Freiburg, Germany
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23
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Meier D, Tschacher W. Beyond Dyadic Coupling: The Method of Multivariate Surrogate Synchrony (mv-SUSY). ENTROPY 2021; 23:e23111385. [PMID: 34828083 PMCID: PMC8623376 DOI: 10.3390/e23111385] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/12/2021] [Accepted: 10/19/2021] [Indexed: 11/25/2022]
Abstract
Measuring interpersonal synchrony is a promising approach to assess the complexity of social interaction, which however has been mostly limited to dyads. In this study, we introduce multivariate Surrogate Synchrony (mv-SUSY) to extend the current set of computational methods. Methods: mv-SUSY was applied to eight datasets consisting of 10 time series each, all with n = 9600 observations. Datasets 1 to 5 consist of simulated time series with the following characteristics: white noise (dataset 1), non-stationarity with linear time trends (dataset 2), autocorrelation (dataset 3), oscillation (dataset 4), and multivariate correlation (dataset 5). Datasets 6 to 8 comprise empirical multivariate movement data of two individuals (datasets 6 and 7) and between members of a group discussion (dataset 8.) Results: As hypothesized, findings of mv-SUSY revealed absence of synchrony in datasets 1 to 4 and presence of synchrony in dataset 5. In the empirical datasets, mv-SUSY indicated significant movement synchrony. These results were predominantly replicated by two well-established dyadic synchrony approaches, Surrogate Synchrony (SUSY) and Surrogate Concordance (SUCO). Conclusions: The study applied and evaluated a novel synchrony approach, mv-SUSY. We demonstrated the feasibility and validity of estimating multivariate nonverbal synchrony within and between individuals by mv-SUSY.
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Deres-Cohen K, Lipsitz-Odess I, Fisher H, Ramseyer FT, Lutz W, Zilcha-Mano S. Shedding light on the effects of supportive techniques on nonverbal synchrony and their moderators in psychotherapy for depression. Psychother Res 2021; 32:470-483. [PMID: 34445938 DOI: 10.1080/10503307.2021.1966542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Objective: Accumulating research demonstrates the importance of utilizing supportive techniques in psychotherapy; however, little is known about therapeutic processes that are set in motion following the use of supportive techniques. The present study examined the effects of supportive techniques on nonverbal synchrony, both at the sample level and at the individual differences level.Method: The sample consisted of 86 patients from a randomized controlled trial for treatment of depression. Supportive techniques were rated by patients and therapists after every session, and nonverbal synchrony was quantified by motion energy analysis (MEA) for each session. The ability of supportive techniques to predict subsequent nonverbal synchrony was examined using polynomial regression and response surface analysis.Results: The findings suggest that, at the sample level, greater use of supportive techniques was a significant predictor of subsequent higher levels of nonverbal synchrony. At the individual differences level, this effect was significant for patients with low levels of depression severity and personality disorders, yet not significant for patients with high levels.Conclusion: The present study demonstrates that greater use of supportive techniques in treatment may facilitate a process that manifests as higher levels of synchrony, especially for patients with lower levels of personality disorders and depression.
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Affiliation(s)
| | | | - Hadar Fisher
- The Department of Psychology, University of Haifa, Haifa, Israel
| | - Fabian T Ramseyer
- The Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Wolfgang Lutz
- The Department of Clinical Psychology and Psychotherapy, University of Trier, Trier, Germany
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Interpersonal Patterns in Social Anxiety Disorder: Predictors and Outcomes of Cognitive-Behavioral Therapy. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-020-10192-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Zimmermann R, Fürer L, Kleinbub JR, Ramseyer FT, Hütten R, Steppan M, Schmeck K. Movement Synchrony in the Psychotherapy of Adolescents With Borderline Personality Pathology - A Dyadic Trait Marker for Resilience? Front Psychol 2021; 12:660516. [PMID: 34276484 PMCID: PMC8277930 DOI: 10.3389/fpsyg.2021.660516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/14/2021] [Indexed: 11/13/2022] Open
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.
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Affiliation(s)
- Ronan Zimmermann
- Child and Adolescent Psychiatric Research Department, Psychiatric University Hospitals, University of Basel, Basel, Switzerland.,Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Lukas Fürer
- Child and Adolescent Psychiatric Research Department, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Johann R Kleinbub
- Department of Philosophy, Sociology, Education and Applied Psychology, University of Padova, Padova, Italy
| | - Fabian T Ramseyer
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Bern, Bern, Switzerland
| | - Rahel Hütten
- Child and Adolescent Psychiatric Research Department, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Martin Steppan
- Child and Adolescent Psychiatric Research Department, Psychiatric University Hospitals, University of Basel, Basel, Switzerland.,Division of Personality and Developmental Psychology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Klaus Schmeck
- Child and Adolescent Psychiatric Research Department, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
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Erdös T, Ramseyer FT. Change Process in Coaching: Interplay of Nonverbal Synchrony, Working Alliance, Self-Regulation, and Goal Attainment. Front Psychol 2021; 12:580351. [PMID: 34248727 PMCID: PMC8260835 DOI: 10.3389/fpsyg.2021.580351] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 05/11/2021] [Indexed: 01/19/2023] Open
Abstract
Background: Psychological literature emphasizes that self-regulation is important as goal intentions, goal setting, or implementation intention does not automatically result in effective results in coaching. The question which coaching strategies to apply to strengthening clients' self-regulatory capacities as prerequisites of effective change outcomes remains a black box in coaching. Method: This quantitative study explored clients' self-regulatory mechanisms by addressing how nonverbal synchrony influences clients' cognitive and emotional self-regulation across sessions. One hundred eighty-four coach–client pairs and their evolving change process were observed over 8 months. Video-recorded sessions were assessed with motion energy analysis to automatically capture coach and client nonverbal behavior and quantify nonverbal synchrony at the level of the dyad. Results: Synchrony was differentially associated with clients' post-session questionnaires on result-oriented problem-reflection and self-reflection, affect balance, and working alliance. Network analyses suggested that the association between synchrony and other process variables did not correspond to the previously found positive association between synchrony and positive aspects of alliance or outcome. Instead, this association depended on the level of perceived outcome. Discussion: Coaching success may be predicted by process variables assessed after each session: goal reflection, alliance, and mood all predict successful coaching. The assessment of nonverbal synchrony suggests a state-dependent effect of embodied processes on a coaching outcome that warrants further inspection.
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Affiliation(s)
- Tünde Erdös
- Department of Management and Organization, Amsterdam Business Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Fabian T Ramseyer
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Bern, Bern, Switzerland
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Reinecke KCH, Joraschky P, Lausberg H. Hand movements that change during psychotherapy and their relation to therapeutic outcome: An analysis of individual and simultaneous movements. Psychother Res 2021; 32:117-127. [PMID: 33975526 DOI: 10.1080/10503307.2021.1925989] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Hands are, compared to other body parts, the body parts that display the most gestural movements during an interaction and their movement is sensitive to reveal anxiety states. However, psychotherapy research focuses on movement synchrony of different body parts to be an indicator of improved symptoms. The present study investigates symptoms in social anxiety disorder and considers both, individual and simultaneous hand movements. 56 video recordings of 28 patient-therapist dyads with patients with social anxiety at the beginning and in the end of psychotherapy were analyzed. Two independent blind certified raters analyzed the hand movement behavior using the NEUROGES® analysis system for nonverbal behavior concerning individual movement units and the simultaneous overlaps between the patients' and therapists' movement units. Simultaneous overlap change negatively correlated with symptoms (LSAS week eight-measurement, r = -.52; and week 15-measurement, r = -.52; BDI pre-measurement, r = -.54). The patients' right hand movement at the end of the psychotherapy correlated significantly with therapeutic alliance (HAQ post-measurement; r = .55). Hand movement behavior analysis should be considered in psychotherapy research in combination with movement synchrony as a measurement parameter related to therapeutic process and outcome. Enriching previous findings, this study indicates that simultaneous movement change is related to symptoms and therefore a process-sensitive parameter in psychotherapy.
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Affiliation(s)
- Katharina C H Reinecke
- Department of Neurology, Psychosomatic Medicine and Psychiatry, Institute of Health Promotion and Clinical Movement Science, German Sport University (GSU) Cologne, Cologne, Germany
| | - Peter Joraschky
- Clinic for Psychotherapy and Psychosomatics, University Hospital, Carl Gustav Carus University, Dresden, Germany
| | - Hedda Lausberg
- Department of Neurology, Psychosomatic Medicine and Psychiatry, Institute of Health Promotion and Clinical Movement Science, German Sport University (GSU) Cologne, Cologne, Germany
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Inoue M, Irino T, Furuyama N, Hanada R. Observational and Accelerometer Analysis of Head Movement Patterns in Psychotherapeutic Dialogue. SENSORS (BASEL, SWITZERLAND) 2021; 21:3162. [PMID: 34063286 PMCID: PMC8124818 DOI: 10.3390/s21093162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/10/2021] [Accepted: 04/28/2021] [Indexed: 12/30/2022]
Abstract
Psychotherapists, who use their communicative skills to assist people, review their dialogue practices and improve their skills from their experiences. However, technology has not been fully exploited for this purpose. In this study, we analyze the use of head movements during actual psychotherapeutic dialogues between two participants-therapist and client-using video recordings and head-mounted accelerometers. Accelerometers have been utilized in the mental health domain but not for analyzing mental health related communications. We examined the relationship between the state of the interaction and temporally varying head nod and movement patterns in psychological counseling sessions. Head nods were manually annotated and the head movements were measured using accelerometers. Head nod counts were analyzed based on annotations taken from video data. We conducted cross-correlation analysis of the head movements of the two participants using the accelerometer data. The results of two case studies suggest that upward and downward head nod count patterns may reflect stage transitions in counseling dialogues and that peaks of head movement synchrony may be related to emphasis in the interaction.
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Affiliation(s)
- Masashi Inoue
- Department of Information and Communication Engineering, Tohoku Institute of Technology, 35-1 Yagiyama Kasumicho, Taihaku-ku, Sendai 982-8577, Japan
| | - Toshio Irino
- Faculty of Systems Engineering, Wakayama University, Sakaedani 930, Wakayama City 640-8510, Japan;
| | - Nobuhiro Furuyama
- Faculty of Human Sciences, Waseda University, 2-579-15 Mikajima, Saitama, Tokorozawa City 359-1192, Japan;
| | - Ryoko Hanada
- Department of Psychology, Tokyo Woman’s Christian University, 2-6-1 Zempukuji, Suginami-ku, Tokyo 167-8585, Japan;
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Altmann U, Friemann C, Frank TS, Sittler MC, Schoenherr D, Singh S, Schurig S, Strauss B, Petrowski K. Movement and Emotional Facial Expressions during the Adult Attachment Interview: Interaction Effects of Attachment and Anxiety Disorder. Psychopathology 2021; 54:1-12. [PMID: 33626527 DOI: 10.1159/000512127] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 10/04/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Adult attachment is commonly associated with emotion regulation. Less is known about the nonverbal embodiment of adult attachment. OBJECTIVE We hypothesized that dismissing attachment is related to less movement and fewer facial expressions of emotions, whereas preoccupied attachment is associated with more negative emotional facial expressions. Moreover, the interaction of attachment and the presence of an anxiety disorder (AD) was explored. METHODS The sample included 95 individuals, 21 with AD without comorbidity, 21 with AD and comorbid major depression (AD-CD), and 53 healthy controls. We analyzed nonverbal behavior during a part of the Adult Attachment Interview (AAI) asking about the family and parental figures. The movements of the interviewees were captured via Motion Energy Analysis. Facial expressions were coded according to the Facial Action Coding System using the OpenFace software. We compared individuals with secure, dismissing, and preoccupied states of mind (assessed with the AAI) with regard to the frequency and complexity of movements and the frequency of the facial expressions such as happy, sad, and contemptuous. RESULTS As expected, dismissingly attached individuals moved less often and with lower complexity than securely attached. For emotional facial expressions, a main effect of the disorder group and interaction effects of attachment by disorder were found. In the AD-CD group, dismissingly attached patients showed comparatively fewer happy facial expressions than securely attached individuals. CONCLUSIONS Reduced movement specifically seems to be related to dismissing attachment when interviewees talk about significant parental figures. Facial expressions of emotions related to attachment occurred when maladaptive emotion regulation strategies were intensified by a psychological disorder.
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Affiliation(s)
- Uwe Altmann
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Friedrich-Schiller-Universität, Jena, Germany,
| | - Catharina Friemann
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Friedrich-Schiller-Universität, Jena, Germany
| | - Theresa S Frank
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Friedrich-Schiller-Universität, Jena, Germany
| | - Mareike C Sittler
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Friedrich-Schiller-Universität, Jena, Germany
- Department of Counseling and Clinical Intervention, Institute of Psychology, Friedrich-Schiller-University Jena, Jena, Germany
| | - Désirée Schoenherr
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Friedrich-Schiller-Universität, Jena, Germany
| | - Sashi Singh
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Friedrich-Schiller-Universität, Jena, Germany
| | - Susan Schurig
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Dresden, Germany
| | - Bernhard Strauss
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Friedrich-Schiller-Universität, Jena, Germany
| | - Katja Petrowski
- Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Altmann U, Brümmel M, Meier J, Strauss B. Movement Synchrony and Facial Synchrony as Diagnostic Features of Depression: A Pilot Study. J Nerv Ment Dis 2021; 209:128-136. [PMID: 33214386 DOI: 10.1097/nmd.0000000000001268] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
ABSTRACT The pilot study investigated with a matched-subjects design whether nonverbal synchrony is a diagnostic feature for depression and whether it mediates between depression and postsession ratings of the interviewer behavior. The sample includes n = 15 patients with major depression and n = 15 healthy controls (aged 20-30 years, 40% female). We conducted structured diagnostic interviews for somatic complaints to standardize the recording setting, issue, and course of conversation. Body movements and facial expressions were coded automatically frame by frame using computer vision methods. Ratings of the interviewers' professional behavior and positive affect were assessed using questionnaires. Patients with depression showed less movement synchrony and less synchronous positive facial expressions. Only synchronous positive expressions mediated between depression and less perceived positive affect. We conclude that the applied methodology is well suited to examine nonverbal processes under naturalistic but widely standardized conditions and that depression affects the nonverbal communication in medical conversations.
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Affiliation(s)
- Uwe Altmann
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Jena, Germany
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Abstract
Zusammenfassung
Hintergrund
Die Studie untersuchte Therapeuteneffekte bei der Psychotherapie der sozialen Angststörung unter Verwendung von 3 methodischen Ansätzen: 1. Varianzen zufälliger Effekte, 2. Effekte soziodemografischer Variablen und 3. eine Disaggregation von therapeutischer Beziehung und nonverbaler Synchronisation in einen „Between“- und einen „Within“-Anteil der Therapeutenvarianz sowie deren Vorhersage des Outcome.
Material und Methoden
Die Patienten wurden mit manualisierter supportiver-expressiver Therapie (n = 54), manualisierter kognitiver Verhaltenstherapie (n = 102) oder naturalistischer kognitiver Verhaltenstherapie (n = 111) behandelt (insgesamt n = 267). Es wurden Patientenbeurteilungen interpersonaler Probleme (Inventar zur Erfassung interpersonaler Probleme, IIP-32), von Depressionssymptomen (Beck-Depressions-Inventar, BDI) und der therapeutischen Beziehung (Helping Alliance Questionnaire, HAQ) erfasst. Die nonverbale Synchronisation wurde mithilfe der Motion Energy Analysis und zeitreihenanalytischer Verfahren quantifiziert. Die Zusammenhangsanalysen erfolgten mit Mehrebenenmodellen.
Ergebnisse
Alter und Geschlecht des Therapeuten waren nicht prädiktiv für die zum Therapieende gemessenen IIP-32- und BDI-Werte. Therapeuteneffekte in Form zufälliger Effekte (Intra-Klassen-Korrelation [ICC] = 23,4 % bzw. 30,1 %) erklärten ein Vielfaches mehr an Outcome-Varianz als das Therapieverfahren (ICC = 6 % bzw. ICC = 1,6 %). Bei der nonverbalen Synchronisation waren Between-therapist- und Within-therapist-Anteil mit der Reduktion des IIP-32 assoziiert. Der Between-therapist-Anteil des HAQ sagte eine Reduktion des BDI vorher.
Schlussfolgerung
Bei der Behandlung sozialer Ängste sind Therapeuteneffekte bedeutsamer als das Therapieverfahren. Desgleichen waren die Therapeutenanteile bei den prozessrelevanten Variablen therapeutische Beziehung und nonverbale Synchronisation bedeutsamer als die patienten- bzw. dyadenspezifischen Anteile.
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Prior NH. What's in a Moment: What Can Be Learned About Pair Bonding From Studying Moment-To-Moment Behavioral Synchrony Between Partners? Front Psychol 2020; 11:1370. [PMID: 32848962 PMCID: PMC7417665 DOI: 10.3389/fpsyg.2020.01370] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 05/22/2020] [Indexed: 12/24/2022] Open
Abstract
Our understanding of the behavioral and physiological mechanisms of monogamy largely comes from studies of behavioral interactions unique to pair-bonded individuals. By focusing on these highly marked behaviors, a remarkable conservation in the mechanisms underlying pair bonding has been revealed; however, we continue to know very little about the range of behavioral and neurobiological mechanisms that could explain the great diversity of pair-bonding phenotypes that exists both within and across species. In order to capture the dynamic nature of bonds over time and across contexts, we need specific, operationally-defined behavioral variables relevant across such a diversity of scenarios. Additionally, we need to be able to situate these behavioral variables within broader frameworks that allow us to interpret and compare patterns seen across species. Here I review what is known about behavioral synchrony with respect to pair bonding and discuss using synchrony as such a variable as well as a framework to expand on our understanding of pair bonding across timescales, contexts and species. First, I discuss the importance of behavioral synchrony and parental coordination for reproductive success in monogamous biparental bird species. Second, I highlight research documenting the critical importance of interpersonal coordination for human social relationships. Finally, I present recent work that experimentally bridges these lines of research by quantifying moment-to-moment behavioral synchrony during brief social interactions in zebra finch dyads. All together, these distinct perspectives support the notion that synchrony (1) is a shared premise for sociality across species, (2) is deeply shaped by social experiences, and (3) exists across timescales, behaviors, and levels of physiology. Conceptualizing pair bonding through the framework of behavioral synchrony is likely to facilitate a deeper understanding of the nuances of how social experiences and interactions impact the brain and behavior.
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Affiliation(s)
- Nora H. Prior
- Department of Psychology, University of Maryland, College Park, MD, United States
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Pan Y, Cheng X. Two-Person Approaches to Studying Social Interaction in Psychiatry: Uses and Clinical Relevance. Front Psychiatry 2020; 11:301. [PMID: 32390881 PMCID: PMC7193689 DOI: 10.3389/fpsyt.2020.00301] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/26/2020] [Indexed: 12/20/2022] Open
Abstract
Social interaction is ubiquitous in human society. The two-person approach-a new, powerful tool to study information exchange and social behaviors-aims to characterize the behavioral dynamics and neural mechanisms of real-time social interactions. In this review, we discuss the benefits of two-person approaches compared to those for conventional, single-person approaches. We describe measures and paradigms that model social interaction in three dimensions (3-D), including eye-to-eye, body-to-body, and brain-to-brain relationships. We then discuss how these two-person measures and paradigms are used in psychiatric conditions (e.g., autism, mood disorders, schizophrenia, borderline personality disorder, and psychotherapy). Furthermore, the advantages of a two-person approach (e.g., dual brain stimulation, multi-person neurofeedback) in clinical interventions are described. Finally, we discuss the methodological and translational challenges surrounding the application of two-person approaches in psychiatry, as well as prospects for future two-/multi-person studies. We conclude that two-person approaches serve as useful additions to the range of behavioral and neuroscientific methods available to assess social interaction in psychiatric settings, for both diagnostic techniques and complementary interventions.
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Affiliation(s)
- Yafeng Pan
- School of Psychology, Shenzhen University, Shenzhen, China.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Xiaojun Cheng
- School of Psychology, Shenzhen University, Shenzhen, China
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Ramseyer FT. Exploring the evolution of nonverbal synchrony in psychotherapy: The idiographic perspective provides a different picture. Psychother Res 2019; 30:622-634. [PMID: 31603387 DOI: 10.1080/10503307.2019.1676932] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Objectives: A methodological obstacle for the assessment of psychotherapy process concerns the compatibility between nomothetic versus idiographic approaches. Using quantitative methodology at an idiographic level, we seek to narrow this gap for the special case of nonverbal synchrony in psychotherapy dyads.Methods: Using quantitative idiographic process analysis (QUIPA), we combined the assessments of nonverbal synchrony-the coordination of patient's and therapist's body-movement-quantified with motion energy analysis (MEA), patient- and therapist session-reports, and patient's self-reports of symptomatology into multivariate time-series of psychotherapy process across the course of N = 12 dyadic psychotherapies with a total of N = 150 sessions. Adopting both mixed models as well as vector auto regressive models (VAR) to time-series, we aimed to extend previous results assessed in a randomized sample by exploring the evolution of nonverbal synchrony in psychotherapy dyads across time.Results: Aggregated idiographic data revealed that nonverbal synchrony was different from findings based on a previously reported nomothetic account: Associations with session-level outcome were weaker and did not replicate cross-sectional analyses.Conclusions: The application of idiographic assessments may help broadening our conception of synchrony in psychotherapy and also reminds us that ergodicity is not necessarily the usual case, but one of many possibilities.
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Affiliation(s)
- Fabian T Ramseyer
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
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Atzil-Slonim D, Tschacher W. Dynamic dyadic processes in psychotherapy: Introduction to a special section. Psychother Res 2019; 30:555-557. [DOI: 10.1080/10503307.2019.1662509] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
| | - Wolfgang Tschacher
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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