Non-verbal Adaptation to the Interlocutors' Inner Characteristics: Relevance, Challenges, and Future Directions

Automated analysis of clinical interviews indicates altered head movements during social interactions in youth at clinical high-risk for psychosis

Alterations in social functioning are commonly observed in youth at clinical high risk (CHR) for psychosis. Previous research has focused on perception and interpretation of social stimuli. Assessments of social behavior have been limited and have typically been conducted using time-consuming, manual, and not always reliable methods. The current study aimed to characterize patterns of head movements, a critical feature of nonverbal social behavior, to determine alterations among CHR individuals, using novel automated tools. A total of 87 CHR and 90 healthy control youth completed video-recorded clinical interviews. Segments when participants were responding to questions were processed using an open-access machine learning-based head tracking program. This program extracted target variables such as total head movement, amplitude, and speed in each direction (x, y, and z). Relationships between head movement patterns and symptoms were then examined. Findings indicated that the CHR group exhibited the same amount of head movements as the control group, establishing that results did not reflect a more global deficit. Notably, the CHR group executed spontaneous head turns in side-to-side movements (such as the "no" gesture) at a significantly slower speed when compared to controls (U = 2860, p = 0019, d = -0.41). Slower side-to-side head movement was also associated with elevated clinician-rated scores of "disorganized communication" (r = -0.23), but not with other symptoms in the positive domain nor negative or depressive phenomenology. These findings provide new insights into alterations in social processes in individuals at CHR and highlight the promise of using automated tools to capture spontaneous head movements, thereby expanding the assessment of social behavior, communication, and applied social cognition.

The Musical Semiotics of Voice in Distance: Some Reflections on the Question of Teleanalysis

Within the context of the debate over teleanalysis, I wish to reintroduce the discussion of voice as the primary link between analyst and patient, a link present in analysis on the phone. Far from questioning the importance of the in-person analysis, I aim to emphasize the voice, the musical semiotics of emotions, as a critical, if not the most vital, aspect of psychoanalysis as a "talking cure" and an art of listening. Insofar as the speaking is instituted in the body, the body is present through voice, even in the virtual analytic room in teleanalysis. I argue that the need for the presence of the material bodies in the session is one aspect of the analytic rituals that, along with the room, the couch, and other power objects, set the stage for the continuous projection of the role identities of the analytic couple. In teleanalysis, the seductive nature of the analytic situation and the status differential are more salient in the analyst's office turf than in the patient's room.

Study protocol for the ETMED-L project: longitudinal study of mental health and interpersonal competence of medical students in a Swiss university using a comprehensive framework of empathy

INTRODUCTION

Physician interpersonal competence is crucial for patient care. How interpersonal competence develops during undergraduate medical education is thus a key issue. Literature on the topic consists predominantly of studies on empathy showing a trend of decline over the course of medical school. However, most existing studies have focused on narrow measures of empathy. The first aim of this project is to study medical students' interpersonal competence with a comprehensive framework of empathy that includes self-reported cognitive and affective empathy, performance-based assessments of emotion recognition accuracy, and a behavioural dimension of empathy. The second aim of the present project is to investigate the evolution of mental health during medical school and its putative link to the studied components of interpersonal competence. Indeed, studies documented a high prevalence of mental health issues among medical students that could potentially impact their interpersonal competence. Finally, this project will enable to test the impact of mental health and interpersonal competence on clinical skills as evaluated by experts and simulated patients.

METHODS AND ANALYSIS

This project consists of an observational longitudinal study with an open cohort design. Each year during the four consecutive years of the project, every medical student (curriculum years 1-6) of the University of Lausanne in Switzerland will be asked to complete an online questionnaire including several interpersonal competence and mental health measures. Clinical skills assessments from examinations and training courses with simulated patients will also be included. Linear mixed models will be used to explore the longitudinal evolutions of the studied components of interpersonal competence and mental health as well as their reciprocal relationship and their link to clinical skills.

ETHICS AND DISSEMINATION

The project has received ethical approval from the competent authorities. Findings will be disseminated through internal, regional, national and international conferences, news and peer-reviewed journals.