Movement Synchrony and Facial Synchrony as Diagnostic Features of Depression: A Pilot Study

"Vulnerability can breed strength": The role of borderline personality disorder severity in movement synchrony among patients with major depressive disorder

Objective: Patients with Major depressive disorder (MDD) and a comorbid Borderline personality disorder (BPD) show a poorer prognosis for MDD compared to patients without BPD. Little is known about the therapeutic processes underlying this prognosis. The goal of the present study was to investigate whether patients with more severe BPD symptoms experience less strengthening in patient-therapist movement synchrony (MS) throughout treatment, and whether less strengthening in MS is associated with less effective sessions. Method: Ninety-five patients participating in a randomized control trial were assessed for BPD (N = 9) using the Structured Interview for DSM-IV Personality. 1367 video-taped sessions were analyzed for MS using Motion Energy Analysis. Session effectiveness was evaluated following each session using a one-item scale taken from the Helping Skills Measure. Multilevel models were used to assess whether BPD severity predicted MS throughout treatment, and whether MS predicted session effectiveness. Results: Patients with more severe BPD symptoms experienced greater strengthening in MS throughout treatment. Less MS strengthening was associated with less session effectiveness. Conclusion: These findings indicate unique therapeutic processes that characterize individuals with more severe BPD symptoms. Shedding light on these unique processes has the potential to contribute to the personalization of MDD treatment for patients with BPD.

Association between nonverbal synchrony, alliance, and outcome in psychotherapy: Systematic review and meta-analysis

OBJECTIVE

Research on nonverbal synchrony (NVS) as a core element in the therapeutic relationship has substantially increased and suggests that NVS influences therapeutic alliance and outcomes.

METHOD

Studies on NVS regarding body movements, vocal pitch, peripheral physiological measures, and hormonal states were included. A random-effects multilevel meta-analysis was performed on 23 publications from 13 trials.

RESULTS

There was no significant overall association between NVS and alliance/outcome (r = .03, p = .644). Across modalities, there was a marginally significant association between higher NVS and smaller interpersonal problems (r = .10, p = .084) and a nonsignificant effect for the association between NVS and alliance (r = .06, p = .316), symptomatic outcome (r = -.06, p = .320), and other outcomes (r = .07, p = .255). There was significant heterogeneity between studies (I2 = 56.47). Moderator analyses revealed that vocal pitch synchrony was negatively associated with alliance/outcome (r = -.20, p = .011), while NVS of peripheral physiological parameters was positively correlated with alliance/outcome (r = .32, p = .006).

CONCLUSION

Findings suggest that specific modalities of NVS show specific associations with outcomes. More research is needed to investigate whether NVS across modalities reflects a unified underlying construct.

Digital assessment of nonverbal behaviors forecasts first onset of depression

BACKGROUND

Adolescence is marked by a sharp increase in the incidence of depression, especially in females. Identification of risk for depressive disorders (DD) in this key developmental stage can help prevention efforts, mitigating the clinical and public burden of DD. While frequently used in diagnosis, nonverbal behaviors are relatively understudied as risk markers for DD. Digital technology, such as facial recognition, may provide objective, fast, efficient, and cost-effective means of measuring nonverbal behavior.

METHOD

Here, we analyzed video-recorded clinical interviews of 359 never-depressed adolescents females via commercially available facial emotion recognition software.

RESULTS

We found that average head and facial movements forecast future first onset of depression (AUC = 0.70) beyond the effects of other established self-report and physiological markers of DD risk.

CONCLUSIONS

Overall, these findings suggest that digital assessment of nonverbal behaviors may provide a promising risk marker for DD, which could aid in early identification and intervention efforts.

Dynamics of following and leading: association of movement synchrony and depression severity

Objective

Depression negatively affects interpersonal functioning and influences nonverbal behavior. Interpersonal theories of depression suggest that depressed individuals engage in behaviors that initially provoke others' support and reassurance, but eventually lead to rejection that may also be expressed nonverbally.

Methods

This study investigated movement synchrony as a nonverbal indicator of support and rejection and its association with depression severity in a sample of depressed and healthy individuals. Semi-standardized diagnostic interview segments with N = 114 dyads were video recorded. Body movement was analyzed using Motion Energy Analysis, synchrony intervals were identified by computing windowed cross-lagged correlation and a peak-picking-algorithm. Depression severity was assessed via both self-rating (BDI-II) and clinician rating (HAMD).

Results

Both self-rated and clinician-rated depression severity were negatively correlated with patient-led, but not clinician-led movement synchrony measures. The more depressed patients were, the less they initiated movement synchrony with their clinicians. These correlations remained significant after controlling for gender, age, gross body movement, and psychopharmacological medication.

Conclusion

Findings suggest that depression may negatively affect patients' active initiative in interaction situations. Automatized methods as used in this study can add valuable information in the diagnosis of depression and the assessment of associated social impairments.

Cortisol Synchrony in Psychotherapy for Major Depressive Disorder

INTRODUCTION

Accumulating research emphasizes the role of interpersonal coordination in arousal levels, which may manifest as cortisol synchrony, in interpersonal interactions. While the role of cortisol has been investigated in psychotherapy, cortisol synchrony and its characteristics and effect on treatment progress remain a relatively unexplored area. This study aims to explore the existence of distinct patterns of cortisol coordination throughout psychotherapy and test the associations of different coordination patterns with patients' pre-treatment characteristics and treatment progress measures.

METHODS

Fifty patient-therapist dyads participated in 16 weeks of psychodynamic treatment for major depressive disorder. Salivary cortisol samples were collected before and after each session at four time points. Self-report questionnaires and treatment session video-coding were used to characterize and differentiate between patterns of cortisol coordination.

RESULTS

Three patterns of cortisol coordination were identified: synchronized, unsynchronized and stable-therapist. These patterns differed in patient characteristics and treatment progress measures in that patients exhibiting a synchronized pattern tended to be more anxious and dominant in their relationships and were more prone to withdrawal ruptures.

CONCLUSIONS

Results provide novel evidence regarding variability in patient-therapist cortisol patterns and its putative associations with treatment progress.

Individual-Specific Animated Profiles of Mental Health

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.

The role of interpersonal coordination dynamics in alliance rupture and repair processes in psychotherapy-A systematic review

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.

Facilitating dyadic synchrony in psychotherapy sessions: Systematic review and meta-analysis

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.

Multimodal Approach for Characterizing the Quality of Parent-Child Interaction: A Single Synchronization Source May Not Tell the Whole Story

The interaction between the parent and child is essential for the child's cognitive and emotional development and sets the path for future well-being. These interactions, starting from birth, are necessary for providing the sensory stimulation the child needs in the critical time window of brain development. The characterization of parent-child interactions is traditionally performed by human decoding. This approach is considered the leading and most accurate way of characterizing the quality of these interactions. However, the development of computational tools and especially the concept of parent-child synchronization opened up an additional source of data characterizing these interactions in an objective, less human-labor manner. Such sources include brain-to-brain, voice/speech, eye contact, motor, and heart-rate synchronization. However, can a single source synchronization dataset accurately represent parent-child interaction? Will attending to the same stimulation, often resulting in a higher brain-to-brain synchronization, be considered an interactive condition? In this perspective, we will try to convey a new concept of the child-parent interaction synchronization (CHIPS) matrix, which includes the different sources of signals generated during an interaction. Such a model may assist in explaining the source of interaction alterations in the case of child/parent developmental/emotional or sensory deficits and may open up new ways of assessing interventions and changes in parent-child interactions along development. We will discuss this interaction during one of the parent-child joint activities providing opportunities for interaction, i.e., storytelling.

Cross-Correlation- and Entropy-Based Measures of Movement Synchrony: Non-Convergence of Measures Leads to Different Associations with Depressive Symptoms

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.

Inter-brain plasticity as a biological mechanism of change in psychotherapy: A review and integrative model

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.

Associations Between Sympathetic Nervous System Synchrony, Movement Synchrony, and Speech in Couple Therapy

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.

Klang der Depression

Hintergrund

Die Depression ist neben kognitiven, emotionalen, sozialen und psychomotorischen Beeinträchtigungen durch spezifische stimmliche Merkmale gekennzeichnet. Bisher existieren erst wenige Studien, die diese in klinischen Kontexten und in Abgrenzung zu Gesunden untersuchten.

Fragestellung

Untersucht wurde der Zusammenhang zwischen Depressivität und paraverbalen Merkmalen bei depressiven Patient_innen und gesunden Probanden.

Methode

In einem mehrschrittigen Verfahren wurden die Audioinhalte von Anamneseinterviews mit Depressiven (n = 15) und Gesunden (n = 15) mit einer Software annotiert und transkribiert. Die paraverbalen Merkmale Grundfrequenz der Stimme, Spannweite der Stimme, Sprechgeschwindigkeit und Pausenlänge wurden automatisiert bestimmt. Mithilfe hierarchisch linearer Modelle wurde der Einfluss der Gruppenzugehörigkeit, Depressivität, Ängstlichkeit sowie psychischer und körperlicher Gesundheit auf die paraverbalen Merkmale analysiert.

Ergebnisse

Es zeigte sich ein Zusammenhang zwischen Depressivität und der Sprechgeschwindigkeit. Zwischen der Spannweite der Grundfrequenz, der Pausenlänge und Depressivität konnten tendenzielle Zusammenhänge gefunden werden. Depressive Patient_innen sind im Vergleich zu Gesunden durch eine monotone Sprache, eine geringe Sprechgeschwindigkeit und längere Pausen gekennzeichnet. Sprechgeschwindigkeit und Pausenlänge waren ebenfalls mit Ängstlichkeit assoziiert.

Diskussion

Sprechgeschwindigkeit, Pausenlänge und Spannweite der Grundfrequenz scheinen relevante Indikatoren für Depressivität/ggf. Ängstlichkeit zu sein. Die Spannweite der Grundfrequenz ist eher depressionsspezifisch, während Pausenlänge und Sprechgeschwindigkeit mit Depressivität und Ängstlichkeit assoziiert sind. Zukünftige Studien sollten die Zusammenhänge in größeren Stichproben verschiedener klinischer Störungsbilder untersuchen.

Nonverbal Synchrony in Couple Therapy Linked to Clients' Well-Being and the Therapeutic Alliance

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.

Language and Movement Synchronization in Dyadic Psychotherapeutic Interaction - A Qualitative Review and a Proposal for a Classification

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.

Impaired recognition of nonverbal expressions of emotions in depressed individuals

INTRODUCTION

Depressive individuals are impaired in the recognition of emotions in others'. Recent research suggests that the recognition of nonverbal expressions of emotions in other people may depend on the analysis of bodily rather than facial expressions. Therefore, we investigated if an impaired recognition of emotions by depressed individuals is body part specific.

METHODS

Clinically diagnosed depressed and healthy matched controls were instructed to identify nonverbal expressions of positive (happiness), neutral, and negative emotions (sadness) via the face, the body, or the body and face.

RESULTS

Depressed participants responded significantly less correctly overall when compared to non-depressed individuals. The recognition of nonverbal expressions of happiness by the body negatively predicted the Beck Depression Inventory II (BDI-II) score.

DISCUSSION

The data revealed that the impaired recognition of nonverbal expressions of emotions in others by depressed individuals is not body part specific. Nevertheless, depressive symptoms seem to be related to the recognition of bodily expressions of happiness. Future studies must address whether impairments of depressive individuals are related to nonverbal expressions of the whole body.

Change Process in Coaching: Interplay of Nonverbal Synchrony, Working Alliance, Self-Regulation, and Goal Attainment

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.

Hand movements that change during psychotherapy and their relation to therapeutic outcome: An analysis of individual and simultaneous movements

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.

Movement and Emotional Facial Expressions during the Adult Attachment Interview: Interaction Effects of Attachment and Anxiety Disorder

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.

Depression Severity Is Related to Less Gross Body Movement: A Motion Energy Analysis

Psychomotor retardation is a well-known clinical phenomenon in depressed patients that can be measured in various ways. This study aimed to investigate objectively measured gross body movement (GBM) during a semi-structured clinical interview in patients with a depressive disorder and its relation with depression severity. A total of 41 patients with a diagnosis of depressive disorder were assessed both with a clinician-rated interview (Hamilton Depression Rating Scale) and a self-rating questionnaire (Beck Depression Inventory-II) for depression severity. Motion energy analysis (MEA) was applied on videos of additional semi-structured clinical interviews. We considered (partial) correlations between patients' GBM and depression scales. There was a significant, moderate negative correlation between both measures for depression severity (total scores) and GBM during the diagnostic interview. However, there was no significant correlation between the respective items assessing motor symptoms in the clinician-rated and the patient-rated depression severity scale and GBM. Findings imply that neither clinician ratings nor self-ratings of psychomotor symptoms in depressed patients are correlated with objectively measured GBM. MEA thus offers a unique insight into the embodied symptoms of depression that are not available via patients' self-ratings or clinician ratings.

Nonverbale Korrelate depressiver Störungen

Zusammenfassung. Theoretischer Hintergrund: Psychische Störungen gehen mit Veränderungen des nonverbalen Verhaltens einher. Fragestellung: Die Pilotstudie untersuchte, inwiefern Charakteristika von Mimik, Körper- und Kopfbewegungen als diagnostische Kriterien depressiver Störungen geeignet sind und testete dabei computerbasierte Messungen des nonverbalen Verhaltens. Methode: Die Stichprobe umfasste N = 15 Patient_innen mit depressiver Störung und N = 15 gesunde Kontrollpersonen. Mit Fragebögen wurden Depressivität (PHQ-9), Ängstlichkeit (GAD-7) und Schmerzbeeinträchtigung (PDI) erfasst. Strukturierte Anamneseinterviews zu körperlichen Beschwerden wurden mit Video aufgezeichnet. Mimik und Bewegungen wurden automatisch mit OpenFace und Motion Energy Analysis kodiert. Ergebnisse: Hypothesenkonform lächelten depressive Personen seltener (Hedges g = 1.56) und bewegten ihren Kopf weniger ( g = 0.79) als Gesunde. Expressionen von Trauer sowie Häufigkeit, Dauer und Geschwindigkeit von Körperbewegungen waren nicht für die Gruppenzugehörigkeit prädiktiv. Schlussfolgerungen: Es lässt sich schlussfolgern, dass computerbasierte Messungen des nonverbalen Verhaltens zur Untersuchung nonverbaler Korrelate depressiver Störungen geeignet sind und dass psychomotorische Hemmung und emotionale Eintrübung nicht bei allen nonverbalen Charakteristika zu Tage treten.