Sounds like a fight: listeners can infer behavioural contexts from spontaneous nonverbal vocalisations

When we hear another person laugh or scream, can we tell the kind of situation they are in - for example, whether they are playing or fighting? Nonverbal expressions are theorised to vary systematically across behavioural contexts. Perceivers might be sensitive to these putative systematic mappings and thereby correctly infer contexts from others' vocalisations. Here, in two pre-registered experiments, we test the prediction that listeners can accurately deduce production contexts (e.g. being tickled, discovering threat) from spontaneous nonverbal vocalisations, like sighs and grunts. In Experiment 1, listeners (total n = 3120) matched 200 nonverbal vocalisations to one of 10 contexts using yes/no response options. Using signal detection analysis, we show that listeners were accurate at matching vocalisations to nine of the contexts. In Experiment 2, listeners (n = 337) categorised the production contexts by selecting from 10 response options in a forced-choice task. By analysing unbiased hit rates, we show that participants categorised all 10 contexts at better-than-chance levels. Together, these results demonstrate that perceivers can infer contexts from nonverbal vocalisations at rates that exceed that of random selection, suggesting that listeners are sensitive to systematic mappings between acoustic structures in vocalisations and behavioural contexts.

Four Misconceptions About Nonverbal Communication

Research and theory in nonverbal communication have made great advances toward understanding the patterns and functions of nonverbal behavior in social settings. Progress has been hindered, we argue, by presumptions about nonverbal behavior that follow from both received wisdom and faulty evidence. In this article, we document four persistent misconceptions about nonverbal communication-namely, that people communicate using decodable body language; that they have a stable personal space by which they regulate contact with others; that they express emotion using universal, evolved, iconic, categorical facial expressions; and that they can deceive and detect deception, using dependable telltale clues. We show how these misconceptions permeate research as well as the practices of popular behavior experts, with consequences that extend from intimate relationships to the boardroom and courtroom and even to the arena of international security. Notwithstanding these misconceptions, existing frameworks of nonverbal communication are being challenged by more comprehensive systems approaches and by virtual technologies that ambiguate the roles and identities of interactants and the contexts of interaction.

Aging and working memory modulate the ability to benefit from visible speech and iconic gestures during speech-in-noise comprehension

When comprehending speech-in-noise (SiN), younger and older adults benefit from seeing the speaker's mouth, i.e. visible speech. Younger adults additionally benefit from manual iconic co-speech gestures. Here, we investigate to what extent younger and older adults benefit from perceiving both visual articulators while comprehending SiN, and whether this is modulated by working memory and inhibitory control. Twenty-eight younger and 28 older adults performed a word recognition task in three visual contexts: mouth blurred (speech-only), visible speech, or visible speech + iconic gesture. The speech signal was either clear or embedded in multitalker babble. Additionally, there were two visual-only conditions (visible speech, visible speech + gesture). Accuracy levels for both age groups were higher when both visual articulators were present compared to either one or none. However, older adults received a significantly smaller benefit than younger adults, although they performed equally well in speech-only and visual-only word recognition. Individual differences in verbal working memory and inhibitory control partly accounted for age-related performance differences. To conclude, perceiving iconic gestures in addition to visible speech improves younger and older adults' comprehension of SiN. Yet, the ability to benefit from this additional visual information is modulated by age and verbal working memory. Future research will have to show whether these findings extend beyond the single word level.

Investigating contributors to performance evaluations in small groups: Task competence, speaking time, physical expressiveness, and likability

This study compared the impacts of actual individual task competence, speaking time and physical expressiveness as indicators of verbal and nonverbal communication behavior, and likability on performance evaluations in a group task. 164 participants who were assigned to 41 groups first solved a problem individually and later solved it as a team. After the group interaction, participants' performance was evaluated by both their team members and qualified external observers. We found that these performance evaluations were significantly affected not only by task competence but even more by speaking time and nonverbal physical expressiveness. Likability also explained additional variance in performance evaluations. The implications of these findings are discussed for both the people being evaluated and the people doing the evaluating.

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

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.

Crossmodal Phase Reset and Evoked Responses Provide Complementary Mechanisms for the Influence of Visual Speech in Auditory Cortex

Natural conversation is multisensory: when we can see the speaker's face, visual speech cues improve our comprehension. The neuronal mechanisms underlying this phenomenon remain unclear. The two main alternatives are visually mediated phase modulation of neuronal oscillations (excitability fluctuations) in auditory neurons and visual input-evoked responses in auditory neurons. Investigating this question using naturalistic audiovisual speech with intracranial recordings in humans of both sexes, we find evidence for both mechanisms. Remarkably, auditory cortical neurons track the temporal dynamics of purely visual speech using the phase of their slow oscillations and phase-related modulations in broadband high-frequency activity. Consistent with known perceptual enhancement effects, the visual phase reset amplifies the cortical representation of concomitant auditory speech. In contrast to this, and in line with earlier reports, visual input reduces the amplitude of evoked responses to concomitant auditory input. We interpret the combination of improved phase tracking and reduced response amplitude as evidence for more efficient and reliable stimulus processing in the presence of congruent auditory and visual speech inputs.SIGNIFICANCE STATEMENT Watching the speaker can facilitate our understanding of what is being said. The mechanisms responsible for this influence of visual cues on the processing of speech remain incompletely understood. We studied these mechanisms by recording the electrical activity of the human brain through electrodes implanted surgically inside the brain. We found that visual inputs can operate by directly activating auditory cortical areas, and also indirectly by modulating the strength of cortical responses to auditory input. Our results help to understand the mechanisms by which the brain merges auditory and visual speech into a unitary perception.

Patterns of early change in interpersonal problems and their relationship to nonverbal synchrony and multidimensional outcome

Early change is an increasing area of investigation in psychotherapy research. In this study, we analyzed patterns of early change in interpersonal problems and their relationship to nonverbal synchrony and multiple outcome measures for the first time. We used growth mixture modeling to identify different latent classes of early change in interpersonal problems with 212 patients who underwent cognitive-behavioral treatment including interpersonal and emotion-focused elements. Furthermore, videotaped sessions were analyzed using motion energy analysis, providing values for the calculation of nonverbal synchrony to predict early change in interpersonal problems. The relationship between early change patterns and symptoms as well as overall change in interpersonal problems was also investigated. Three latent subgroups were identified: 1 class with slow improvement (n = 145), 1 class with fast improvement (n = 12), and 1 early deterioration class (n = 55). Lower levels of early nonverbal synchrony were significantly related to fast improvement in interpersonal change patterns. Furthermore, such patterns predicted treatment outcome in symptoms and interpersonal problems. The results suggest that nonverbal synchrony is associated with early change patterns in interpersonal problems, which are also predictive of treatment outcome. Limitations of the applied methods as well as possible applications in routine care are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Social Interaction Skill Intervention for Autistic Adults with Intellectual Disability and Limited Language: A Pilot of the SKILL Program

There is a dearth of research that focuses on social intervention efforts for adults on the autism spectrum with intellectual disability and limited conversational language. Using a multiple baseline experimental design, this pilot investigation of the Socialization Knowledge for Individuals with Limited Language (SKILL) program evaluated a novel peer-facilitated group program specifically designed to target social interaction skills for this population. Findings from five pilot participants yielded evidence of social improvements across specific verbal skills (on-topic conversational contributions and responses) and nonverbal behaviors (eye-contact, active listening), as evidenced by coded social conversation probes and parent-report measures. These findings demonstrate the promise of a socialization intervention for a population that has historically been neglected in the social intervention research literature.

Emojis influence autobiographical memory retrieval from reading words: An fMRI-based study

Advances in computer and communications technology have deeply affected the way we communicate. Social media have emerged as a major means of human communication. However, a major limitation in such media is the lack of non-verbal stimuli, which sometimes hinders the understanding of the message, and in particular the associated emotional content. In an effort to compensate for this, people started to use emoticons, which are combinations of keyboard characters that resemble facial expressions, and more recently their evolution: emojis, namely, small colorful images that resemble faces, actions and daily life objects. This paper presents evidence of the effect of emojis on memory retrieval through a functional Magnetic Resonance Imaging (fMRI) study. A total number of fifteen healthy volunteers were recruited for the experiment, during which successive stimuli were presented, containing words with intense emotional content combined with emojis, either with congruent or incongruent emotional content. Volunteers were asked to recall a memory related to the stimulus. The study of the reaction times showed that emotional incongruity among word+emoji combinations led to longer reaction times in memory retrieval compared to congruent combinations. General Linear Model (GLM) and Blind Source Separation (BSS) methods have been tested in assessing the influence of the emojis on the process of memory retrieval. The analysis of the fMRI data showed that emotional incongruity among word+emoji combinations activated the Broca's area (BA44 and BA45) in both hemispheres, the Supplementary Motor Area (SMA) and the inferior prefrontal cortex (BA47), compared to congruent combinations. Furthermore, compared to pseudowords, word+emoji combinations activated the left Broca's area (BA44 and BA45), the amygdala, the right temporal pole (BA48) and several frontal regions including the SMA and the inferior prefrontal cortex.

Emoji can facilitate recognition of conveyed indirect meaning

In face-to-face communication there are multiple paralinguistic and gestural features that facilitate recognition of a speaker’s intended meaning, features that are lacking when people communicate digitally (e.g., texting). As a result, substitutes have emerged (expressive punctuation, capitalization, etc.) to facilitate communication in these situations. However, little is known about the comprehension processes involved in digital communication. In this research we examined the role of emoji in the comprehension of face-threatening, indirect replies. Participants in two experiments read question–reply sequences and then judged the accuracy of interpretations of the replies. On critical trials the reply violated the relation maxim and conveyed a negative, face-threatening response. On one-third of the trials the reply contained only text, on one-third of the trials the reply contained text and an emoji, and on one-third of the trials the reply contained only an emoji. When the question requested potentially negative information about one of the interactants (disclosures and opinions), participants were more likely to endorse the indirect meaning of the reply, and did so faster, when the reply contained an emoji than when it did not. This effect did not occur when the question was a request for action, a more conventional type of indirect reply. Overall, then, this research demonstrates that emoji can sometimes facilitate the comprehension of meaning. Future research is needed to examine the boundary conditions for this effect.

Are there non-verbal signals of guilt?

Guilt is a complex emotion with a potentially important social function of stimulating cooperative behaviours towards and from others, but whether the feeling of guilt is associated with a recognisable pattern of nonverbal behaviour is unknown. We examined the production and perception of guilt in two different studies, with a total of 238 participants with various places of origin. Guilt was induced experimentally, eliciting patterns of movement that were associated with both the participants' self-reported feelings of guilt and judges' impressions of their guilt. Guilt was most closely associated with frowning and neck touching. While there were differences between self-reported guilt and perception of guilt the findings suggest that there are consistent patterns that could be considered a non-verbal signal of guilt in humans.

Do Infants With Down Syndrome Show an Early Receptive Language Advantage?

Purpose The study explored longitudinally the course of vocabulary and general language development in a group of infants with Down syndrome (DS) compared to a group of typically developing (TD) infants matched on nonverbal mental ability (NVMA). Method We compared the vocabulary and general language trajectories of the two groups in two ways: (a) at three time points during a 12-month period and (b) at two time points when the groups had made equal progress in NVMA (a period of 6 months for the TD infants vs. 12 months for the infants with DS). Results The TD group had overtaken the DS group on all general language and vocabulary measures by the end of the 12-month period. However, expressive communication and expressive vocabulary were developing at the same rate and level in the two groups when examined over a period in which the two groups were matched in gains in NVMA. Furthermore, the infants with DS showed a receptive language advantage over the TD group; this group's auditory comprehension and receptive vocabulary scores were superior to those of the TD group at both time points when NVMA was accounted for. Conclusion The results shed light on the widely reported discrepancy between expressive and receptive language in individuals with DS. Although infants with DS appear to be developing language skills more slowly than chronological age TD peers, when NVMA is taken into account, infants with DS do not have expressive language delays, and they seem to show a receptive language advantage.

The Nonverbal Processing of Actions Is an Area of Relative Strength in the Semantic Variant of Primary Progressive Aphasia

Purpose Better performance for actions compared to objects has been reported in the semantic variant of primary progressive aphasia (svPPA). This study investigated the influence of the assessment task (naming, semantic picture matching) over the dissociation between objects and actions. Method Ten individuals with svPPA and 17 matched controls completed object and action naming tests, and object and action semantic picture matching tests. Performance was compared between the svPPA and control groups, within the svPPA group, and for each participant with svPPA versus the control group individually. Results Compared to controls, participants with svPPA were impaired on object and action naming, and object and action semantic picture matching. As a group, participants with svPPA had an advantage for actions over objects and for semantic picture matching tests over naming tests. Eight participants had a better performance for actions compared to objects in naming, with three showing a significant difference. Nine participants had a better performance for actions compared to objects in semantic picture matching, with six showing a significant difference. For objects, semantic picture matching was better than naming in nine participants, with five showing a significant difference. For actions, semantic picture matching was better than naming in all 10 participants, with nine showing a significant difference. Conclusion The nonverbal processing of actions, as assessed with a semantic picture matching test, is an area of relative strength in svPPA. Clinical implications for assessment planning and interpretation and theoretical implications for current models of semantic cognition are discussed.

A Moan of Pleasure Should Be Breathy: The Effect of Voice Quality on the Meaning of Human Nonverbal Vocalizations

Prosodic features, such as intonation and voice intensity, have a well-documented role in communicating emotion, but less is known about the role of laryngeal voice quality in speech and particularly in nonverbal vocalizations such as laughs and moans. Potentially, however, variations in voice quality between tense and breathy may convey rich information about the speaker's physiological and affective state. In this study breathiness was manipulated in synthetic human nonverbal vocalizations by adjusting the relative strength of upper harmonics and aspiration noise. In experiment 1 (28 prototypes × 3 manipulations = 84 sounds), otherwise identical vocalizations with tense versus breathy voice quality were associated with higher arousal (general alertness), higher dominance, and lower valence (unpleasant states). Ratings on discrete emotions in experiment 2 (56 × 3 = 168 sounds) confirmed that breathiness was reliably associated with positive emotions, particularly in ambiguous vocalizations (gasps and moans). The spectral centroid did not fully account for the effect of manipulation, confirming that the perceived change in voice quality was more specific than a general shift in timbral brightness. Breathiness is thus involved in communicating emotion with nonverbal vocalizations, possibly due to changes in low-level auditory salience and perceived vocal effort.

Children's reliance on the non-verbal cues of a robot versus a human

Robots are used for language tutoring increasingly often, and commonly programmed to display non-verbal communicative cues such as eye gaze and pointing during robot-child interactions. With a human speaker, children rely more strongly on non-verbal cues (pointing) than on verbal cues (labeling) if these cues are in conflict. However, we do not know how children weigh the non-verbal cues of a robot. Here, we assessed whether four- to six-year-old children (i) differed in their weighing of non-verbal cues (pointing, eye gaze) and verbal cues provided by a robot versus a human; (ii) weighed non-verbal cues differently depending on whether these contrasted with a novel or familiar label; and (iii) relied differently on a robot's non-verbal cues depending on the degree to which they attributed human-like properties to the robot. The results showed that children generally followed pointing over labeling, in line with earlier research. Children did not rely more strongly on the non-verbal cues of a robot versus those of a human. Regarding pointing, children who perceived the robot as more human-like relied on pointing more strongly when it contrasted with a novel label versus a familiar label, but children who perceived the robot as less human-like did not show this difference. Regarding eye gaze, children relied more strongly on the gaze cue when it contrasted with a novel versus a familiar label, and no effect of anthropomorphism was found. Taken together, these results show no difference in the degree to which children rely on non-verbal cues of a robot versus those of a human and provide preliminary evidence that differences in anthropomorphism may interact with children's reliance on a robot's non-verbal behaviors.

Nonverbal synchrony in virtual reality

How might nonverbal synchrony naturally evolve in a social virtual reality environment? And how can avatar embodiment affect how participants coordinate nonverbally with each other? In the following pre-registered between-subjects experiment, we tracked the movements of pairs of users during a collaborative or competitive task in immersive virtual reality. Each conversational partner controlled either a customized avatar body or an abstract cube that responded to their movements. We compared the movements of the actual user pairs between the two conditions, and to an artificial "pseudosynchrony" dataset composed of the movements of randomly combined participant pairs who did not actually interact. We found stronger positive and negative correlations between real pairs compared to pseudosynchronous pairs, providing evidence for naturally occurring nonverbal synchrony between pairs in virtual reality. We discuss this in the context of the relationships between avatar appearance, task success, social closeness and social presence.

Handshaking promotes deal-making by signaling cooperative intent

We examine how a simple handshake-a gesture that often occurs at the outset of social interactions-can influence deal-making. Because handshakes are social rituals, they are imbued with meaning beyond their physical features. We propose that during mixed-motive interactions, a handshake is viewed as a signal of cooperative intent, increasing people's cooperative behavior and affecting deal-making outcomes. In Studies 1a and 1b, pairs who chose to shake hands at the onset of integrative negotiations obtained better joint outcomes. Study 2 demonstrates the causal impact of handshaking using experimental methodology. Study 3 suggests a driver of the cooperative consequence of handshaking: negotiators expected partners who shook hands to behave more cooperatively than partners who avoided shaking hands or partners whose nonverbal behavior was unknown; these expectations of cooperative intent increased negotiators' own cooperation. Study 4 uses an economic game to demonstrate that handshaking increased cooperation even when handshakes were uninstructed (vs. instructed). Further demonstrating the primacy of signaling cooperative intent, handshaking actually reduced cooperation when the action signaled ill intent (e.g., when the hand-shaker was sick; Study 5). Finally, in Study 6, executives assigned to shake hands before a more antagonistic, distributive negotiation were less likely to lie about self-benefiting information, increasing cooperation even to their own detriment. Together, these studies provide evidence that handshakes, ritualistic behaviors imbued with meaning beyond mere physical contact, signal cooperative intent and promote deal-making. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Associations Between Anxious and Depressive Symptoms and the Recognition of Vocal Socioemotional Expressions in Youth

The current study examined the associations between internalizing symptoms and adolescents' recognition of vocal socioemotional expressions produced by youth. Fifty-seven youth (8-17 years old, M = 12.62, SD = 2.66; 29 anxious, 28 nonanxious; 32 female, 25 male) were asked to identify the intended expression in auditory recordings of youth's portrayals of basic emotions and social attitudes. Recognition accuracy increased with age, suggesting that the ability to recognize vocal affect continues to develop into adolescence. Anxiety symptoms were not associated with recognition ability, but youth's depressive symptoms were related to poorer identification of anger and happiness. Youth experiencing symptoms of depression may be likely to misinterpret vocal expressions of happiness and anger.

Evidence for gesture-speech mismatch detection impairments in schizophrenia

Patients with schizophrenia suffer from impairments in the perception and production of gestures. The extent to which patients can access the semantic association between speech and co-verbal gestures in concrete or abstract/metaphorical meaning contexts is unknown. We investigated 1) how patients differ from controls in gesture matching performance, 2) how performance differs in the context of abstract versus concrete meaning, and 3) whether formal thought disorder (FTD) symptom severity predicts task impairment. Forty-five patients with schizophrenia spectrum disorders (two subgroups, "mild" and "severe") took part in this study. Participants were presented with video clips, each showing an actor saying a sentence while producing a gesture. Sentences contained either concrete or abstract/metaphorical information, and the accompanying gesture was either semantically related or unrelated to the sentence. Participants indicated via button press whether the gesture matched the content of the verbal utterance. Both patient subgroups demonstrated reduced performance in all comparisons. A significant interaction was found between patient subgroup and sentence abstractness. Task performance was worst for patients with severe positive FTD symptomatology in the abstract condition, while there were no patient subgroup differences in the concrete condition. These data shed new light on gesture-speech mismatch detection impairments in schizophrenia.

Inferring power and dominance from dyadic nonverbal interactions in autism spectrum disorder

Research studies to date have revealed conflicting results with respect to the processing of nonverbal cues from social interactions in autism spectrum disorder (ASD). Therefore, the aim of the present study was to investigate the contribution of two important factors for the perception of dyadic social interactions, namely (a) the movement contingency and (b) the spatial context. To this end, 26 adult participants with ASD and 26 age-, sex-, and IQ-matched typically developed control participants observed animations presenting nonverbal interactions between two human virtual characters enacting power relationships. We manipulated (a) movement contingency by exchanging one of the two original agents with an agent from another dyad and (b) spatial context by changing agents' spatial orientation to a back-to-back position. Participants were asked to rate dominance and submissiveness of these agents. Results showed that the movement contingency manipulation affected accuracy and consistency of power perception and that the spatial context manipulation slowed down reaction times comparably in both groups. With regard to group differences, individuals with ASD were found to judge power relationships slower compared to control participants, potentially suggesting a more explicit processing style in ASD. Furthermore, the spatial context manipulation slowed down the reaction times more in the contingent compared to the non-contingent conditions only in the ASD group. These findings contribute to the ongoing debate whether individuals with ASD have difficulties in understanding nonverbal cues in a dyadic context by suggesting that they do so in more subtle ways than previously investigated. Autism Res 2019, 12: 505-516 © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This study shows that the ability and speed of judging who is dominant in a social interaction depends on two factors: (a) whether their movements are matched and (b) whether they are facing each other or not. This is similarly the case for participants with and without autism. Interestingly, however, individuals with autism seem to judge generally slower, suggesting a more explicit processing style. The two factors seem to interact, suggesting that nonverbal processing difficulties are subtler than previously thought.

Nonverbal synchrony as a behavioural marker of patient and physician race-related attitudes and a predictor of outcomes in oncology interactions: protocol for a secondary analysis of video-recorded cancer treatment discussions

INTRODUCTION

Racial disparities in cancer treatment contribute to racial disparities in mortality rates. The quality of patient-physician communication during clinical interactions with black patients and non-black physicians (racially discordant) is poorer than communication quality with white patients (racially concordant). Patient and physician race-related attitudes affect the quality of this communication. These attitudes are likely expressed through subtle non-verbal behaviours, but prior research has not examined these behaviours. Nonverbal synchrony, the coordination of physical movement, reflects the preinteraction attitudes of participants in interactions and predicts their postinteraction perceptions of and affect towards one another. In this study, peer reviewed and funded by the National Institute of Minority Health and Health Disparities (R21MD011766), we will investigate non-verbal synchrony in racially concordant and discordant interactions to better understand racial disparities in clinical communication.

METHODS AND ANALYSIS

This secondary analysis includes racially concordant (n=163) and racially discordant (n=68) video-recorded oncology interactions, patient and oncologist self-reported race-related attitudes, perceptions of the interaction and observer ratings of physician patient-centred communication and patient and physician affect and rapport. In aim 1, we will assess and compare non-verbal synchrony between physicians and patients in racially concordant and discordant interactions. In aim 2, we will determine the influence of non-verbal synchrony on patient and physician affect and communication. In aim 3, we will examine possible causes (ie, race-related attitudes) and consequences (ie, negative perceptions) of non-verbal synchrony in racially discordant interactions. In aim 4, we will develop and test a mediational model linking physician and patient race-related attitudes to non-verbal synchrony and, in turn, interaction outcomes.

ETHICS AND DISSEMINATION

The parent and current studies were approved by the Wayne State University Institutional Review Board. Since only archival data will be used, ethical or safety risks are low. We will disseminate our findings to relevant conferences and journals.

Parents and Physiotherapists Recognition of Non-Verbal Communication of Pain in Individuals with Cerebral Palsy

Pain assessment is difficult in individuals with cerebral palsy (CP). This is of particular relevance in children with communication difficulties, when non-verbal pain behaviors could be essential for appropriate pain recognition. Parents are considered good proxies in the recognition of pain in their children; however, health professionals also need a good understanding of their patients' pain experience. This study aims at analyzing the agreement between parents' and physiotherapists' assessments of verbal and non-verbal pain behaviors in individuals with CP. A written survey about pain characteristics and non-verbal pain expression of 96 persons with CP (45 classified as communicative, and 51 as non-communicative individuals) was performed. Parents and physiotherapists displayed a high agreement in their estimations of the presence of chronic pain, healthcare seeking, pain intensity and pain interference, as well as in non-verbal pain behaviors. Physiotherapists and parents can recognize pain behaviors in individuals with CP regardless of communication disabilities.

Typical vs. atypical: Combining auditory Gestalt perception and acoustic analysis of early vocalisations in Rett syndrome

BACKGROUND

Early speech-language development of individuals with Rett syndrome (RTT) has been repeatedly characterised by a co-occurrence of apparently typical and atypical vocalisations.

AIMS

To describe specific features of this intermittent character of typical versus atypical early RTT-associated vocalisations by combining auditory Gestalt perception and acoustic vocalisation analysis.

METHODS AND PROCEDURES

We extracted N = 363 (pre-)linguistic vocalisations from home video recordings of an infant later diagnosed with RTT. In a listening experiment, all vocalisations were assessed for (a)typicality by five experts on early human development. Listeners' auditory concepts of (a)typicality were investigated in context of a comprehensive set of acoustic time-, spectral- and/or energy-related higher-order features extracted from the vocalisations.

OUTCOMES AND RESULTS

More than half of the vocalisations were rated as 'atypical' by at least one listener. Atypicality was mainly related to the auditory attribute 'timbre', and to prosodic, spectral, and voice quality features in the acoustic domain.

CONCLUSIONS AND IMPLICATIONS

Knowledge gained in our study shall contribute to the generation of an objective model of early vocalisation atypicality. Such a model might be used for increasing caregivers' and healthcare professionals' sensitivity to identify atypical vocalisation patterns, or even for a probabilistic approach to automatically detect RTT based on early vocalisations.

Attenuated impression of irony created by the mismatch of verbal and nonverbal cues in patients with autism spectrum disorder

Perception of irony has been observed to be impaired in adults with autism spectrum disorder. In typically developed adults, the mismatch of verbal and nonverbal emotional cues can be perceived as an expression of irony even in the absence of any further contextual information. In this study, we evaluate to what extent high functioning autists perceive this incongruence as expressing irony. Our results show that incongruent verbal and nonverbal signals create an impression of irony significantly less often in participants with high-functioning autism than in typically developed control subjects. The extent of overall autistic symptomatology as measured with the autism-spectrum questionnaire (AQ), however, does not correlate with the reduced tendency to attribute incongruent stimuli as expressing irony. Therefore, the attenuation in irony attribution might rather be related to specific subdomains of autistic traits, such as a reduced tendency to interpret communicative signals in terms of complex intentional mental states. The observed differences in irony attribution support the assumption that a less pronounced tendency to engage in higher order mentalization processes might underlie the impairment of pragmatic language understanding in high functioning autism.

Is overconfidence a social liability? The effect of verbal versus nonverbal expressions of confidence

[Correction Notice: An Erratum for this article was reported in Vol 116(3) of Journal of Personality and Social Psychology (see record 2019-08943-002). In the article "Is Overconfidence a Social Liability? The Effect of Verbal Versus Nonverbal Expressions of Confidence" by Elizabeth R. Tenney, Nathan L. Meikle, David Hunsaker, Don A. Moore, and Cameron Anderson (Journal of Personality and Social Psychology. Advance online publication. October 11, 2018. http://dx.doi.org/10.1037/pspi0000150), the Editor' Note acknowledging David Dunning as the action editor for this article was omitted. All versions of this article have been corrected.] What are the reputational consequences of being overconfident? We propose that the channel of confidence expression is one key moderator-that is, whether confidence is expressed verbally or nonverbally. In a series of experiments, participants assessed target individuals (potential collaborators or advisors) who were either overconfident or cautious. Targets expressed confidence, or a lack thereof, verbally or nonverbally. Participants then learned targets' actual performance. Across studies, overconfidence was advantageous initially-regardless of whether targets expressed confidence verbally or nonverbally. After performance was revealed, overconfident targets who had expressed confidence verbally were viewed more negatively than cautious targets; however, overconfident targets who had expressed confidence nonverbally were still viewed more positively than cautious ones. The one condition wherein nonverbal overconfidence was detrimental was when confidence was clearly tied to a falsifiable claim. Results suggest that, compared with verbal statements, nonverbal overconfidence reaps reputational benefits because of its plausible deniability. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Warm Communication Style Strengthens Expectations and Increases Perceived Improvement

Communication, both verbal and nonverbal, between healthcare providers and patients has been shown to affect treatment outcomes in clinical settings. Separately, accumulating research suggests a role for response expectations in altering treatment outcomes, especially in the context of inert or placebo treatment. However, few studies have examined which aspects of patient-provider communication strengthen expectations, leading to better treatment outcomes. The goal of this study is to test the effect of both verbal and nonverbal aspects of communication on response expectations and treatment outcomes in the context of a placebo exercise program. In a 2 × 2 between-subjects analogue study design, 89 healthy adults were randomly assigned to interact with a trainer with either a warm or a neutral communication style. Each group also received from their trainer either basic or enhanced information about the placebo training program. Participants performed coordination and balance tests before and after the placebo training program, and expectations were assessed after the training but prior to the second series of tests. Participants in the warm condition had significantly higher expectations of treatment effects and reported more improvement in their performance. No such differences were found between the enhanced and basic information conditions. There were no significant effects of communication style or information on actual balance and coordination performance. These results shed light on the importance of nonverbal communication, especially facial expression and tone of voice, in strengthening expectations and increasing subjective improvement.

Trust and Perceptions of Physicians' Nonverbal Behavior Among Women with Immigrant Backgrounds

Previous findings suggest immigrant patients have lower trust in their physicians, and perceive nonverbal communication differently compared to non-immigrant patients. We tested discrepancies in trust and the impact of non-verbal behavior between immigrants and non-immigrants in The Netherlands. Nonverbal communication of an oncologist was systematically varied in an experimental video vignettes design. Breast cancer patients (n = 34) and healthy women (n = 34) viewed one of eight video versions and evaluated trust and perceived friendliness of the oncologist. In a matched control design, women with immigrant and non-immigrant backgrounds were paired. Immigrant women reported stronger trust. Nonverbal communication by the oncologist did not influence trust differently for immigrants compared to for non-immigrants. However, smiling strongly enhanced perceived friendliness for non-immigrants, but not for immigrants. Immigrant patients' strong trust levels may be formed a priori, instead of based on physicians' communication. Physicians may need to make extra efforts to optimize their communication.

Patient-Centeredness as Physician Behavioral Adaptability to Patient Preferences

A physician who communicates in a patient-centered way is a physician who adapts his or her communication style to what each patient needs. In order to do so, the physician has to (1) accurately assess each patient's states and traits (interpersonal accuracy) and (2) possess a behavioral repertoire to choose from in order to actually adapt his or her behavior to different patients (behavioral adaptability). Physician behavioral adaptability describes the change in verbal or nonverbal behavior a physician shows when interacting with patients who have different preferences in terms of how the physician should interact with them. We hypothesized that physician behavioral adaptability to their patients' preferences would lead to better patient outcomes and that physician interpersonal accuracy was positively related to behavioral adaptability. To test these hypotheses, we recruited 61 physicians who completed an interpersonal accuracy test before being videotaped during four consultations with different patients. The 244 participating patients indicated their preferences for their physician's interaction style prior to the consultation and filled in a consultation outcomes questionnaire directly after the consultation. We coded the physician's verbal and nonverbal behavior for each of the consultations and compared it to the patients' preferences to obtain a measure of physician behavioral adaptability. Results partially confirmed our hypotheses in that female physicians who adapted their nonverbal (but not their verbal) behavior had patients who reported more positive consultation outcomes. Moreover, the more female physicians were accurate interpersonally, the more they showed verbal and nonverbal behavioral adaptability. For male physicians, more interpersonal accuracy was linked to less nonverbal adaptability.

Integration of speech and gesture in aphasia

BACKGROUND

Information from speech and gesture is often integrated to comprehend a message. This integration process requires the appropriate allocation of cognitive resources to both the gesture and speech modalities. People with aphasia are likely to find integration of gesture and speech difficult. This is due to a reduction in cognitive resources, a difficulty with resource allocation or a combination of the two. Despite it being likely that people who have aphasia will have difficulty with integration, empirical evidence describing this difficulty is limited. Such a difficulty was found in a single case study by Cocks et al. in 2009, and is replicated here with a greater number of participants.

AIMS

To determine whether individuals with aphasia have difficulties understanding messages in which they have to integrate speech and gesture.

METHODS & PROCEDURES

Thirty-one participants with aphasia (PWA) and 30 control participants watched videos of an actor communicating a message in three different conditions: verbal only, gesture only, and verbal and gesture message combined. The message related to an action in which the name of the action (e.g., 'eat') was provided verbally and the manner of the action (e.g., hands in a position as though eating a burger) was provided gesturally. Participants then selected a picture that 'best matched' the message conveyed from a choice of four pictures which represented a gesture match only (G match), a verbal match only (V match), an integrated verbal-gesture match (Target) and an unrelated foil (UR). To determine the gain that participants obtained from integrating gesture and speech, a measure of multimodal gain (MMG) was calculated.

OUTCOMES & RESULTS

The PWA were less able to integrate gesture and speech than the control participants and had significantly lower MMG scores. When the PWA had difficulty integrating, they more frequently selected the verbal match.

CONCLUSIONS & IMPLICATIONS

The findings suggest that people with aphasia can have difficulty integrating speech and gesture in order to obtain meaning. Therefore, when encouraging communication partners to use gesture alongside language when communicating with people with aphasia, education regarding the types of gestures that would facilitate understanding is recommended.

Thin Slices of Athletes' Nonverbal Behavior Give Away Game Location: Testing the Territoriality Hypothesis of the Home Game Advantage

The present research investigated whether perceivers could detect who is playing at home or away in soccer matches based on thin slices of professional (Experiment 1) and amateur (Experiment 3) athletes' nonverbal behavior prior to the match and whether perceivers rated athletes playing at home relatively higher on behavioral dimensions (Experiments 2 and 3) linked to territoriality. In Experiment 1 ( N = 80), participants watched short videos depicting soccer players prior to a UEFA Champions League match and rated whether athletes were more likely to be playing at home or away. In Experiment 2 (two groups N = 102 and N = 101), perceivers rated these videos in terms of assertiveness, dominance, and aggression. In Experiment 3, we replicated the procedure of Experiments 1 and 2 with different stimulus material from amateur soccer ( N = 112). Participants could significantly differentiate between home playing and away playing athletes (Experiment 1: d = 0.44 and Experiment 3: d = 1.07). Experiments 2 and 3 showed that perceivers rated professional and amateur soccer players higher on assertiveness ( d = 0.34-0.63), dominance ( d = 0.20-0.55), and aggression ( d = 0.16-0.49) when playing at home compared to playing away. Findings are supportive of evolutionary accounts of nonverbal behavior, ecological approaches to person perception, and the thin slices of behavior hypothesis by demonstrating that humans change their nonverbal behavior depending on game location. We discuss the relevance of the present findings for the home advantage in sports.

The soothing function of touch: affective touch reduces feelings of social exclusion

The mammalian need for social proximity, attachment and belonging may have an adaptive and evolutionary value in terms of survival and reproductive success. Consequently, ostracism may induce strong negative feelings of social exclusion. Recent studies suggest that slow, affective touch, which is mediated by a separate, specific C tactile neurophysiological system than faster, neutral touch, modulates the perception of physical pain. However, it remains unknown whether slow, affective touch, can also reduce feelings of social exclusion, a form of social pain. Here, we employed a social exclusion paradigm, namely the Cyberball task (N = 84), to examine whether the administration of slow, affective touch may reduce the negative feelings of ostracism induced by the social exclusion manipulations of the Cyberball task. As predicted, the provision of slow-affective, as compared to fast-neutral, touch led to a specific decrease in feelings of social exclusion, beyond general mood effects. These findings point to the soothing function of slow, affective touch, particularly in the context of social separation or rejection, and suggest a specific relation between affective touch and social bonding.

The teacher's body elements that influence the teaching-learning process of university nursing students

OBJECTIVES

To identify the body elements of the teacher that influence the teaching-learning process and to analyze their effects on university nursing students.

METHODS

Qualitative research with descriptive approach implemented through a dramatic play dynamics. In the second half of 2015, sixteen students from a private university center located in Rio de Janeiro (Brazil) participated in the study. The data processing was carried out by using Bardin's theoretical and analytical framework.

RESULTS

Four decoding units were created. They verse about the teacher's positioning, body movements, eyes, facial expressions as well as the clothes used to teach nursing.

CONCLUSIONS

The teacher's elements are capable of generating effects that influence the process of learning nursing. This leads us to believe that the body should continue to be an object of study and discussion in the higher education of nurses.

Nonverbal Communication as a Pain Reliever: The Impact of Physician Supportive Nonverbal Behavior on Experimentally Induced Pain

Despite the evidence for the potential of supportive communication to alleviate physical pain, no study to date has assessed the impact of supportive nonverbal behavior on the objective and subjective experience of pain. This analogue study examined the impact of an actor-physician's supportive nonverbal behavior on experimentally induced pain. Participants (N = 205) were randomly assigned to interact with a videotaped physician conveying high or low supportive nonverbal behaviors. Participant pain was assessed with subjective and objective measures. Participants interacting with the high nonverbal support physicians showed increased pain tolerance and a reduction in the amount of pain expressed compared to those interacting with the low nonverbal support physicians. For subjectively rated pain, a gender difference existed such that for men, high physician nonverbal support decreased pain ratings and memory of pain, but for women, high physician nonverbal support increased pain ratings and memory of pain. These results highlight the importance of nonverbal communication in altering pain with broad implications for clinical care.

Communicating with people living with dementia who are nonverbal: The creation of Adaptive Interaction

Loss of verbal language production makes people with dementia appear unreachable. We previously presented a case study applying nonverbal communication techniques with a lady with dementia who could no longer speak, which we termed Adaptive Interaction. The current small-n study examines the applicability of Adaptive Interaction as a general tool for uncovering the communication repertoires of non-verbal individuals living with dementia. Communicative responses of 30 interaction sessions were coded and analysed in two conditions: Standard (Baseline) and Adaptive Interaction (Intervention). All participants retained the ability to interact plus a unique communication repertoire comprising a variety of nonverbal components, spanning eye gaze, emotion expression, and movement. In comparison to Baseline sessions, Intervention sessions were characterised by more smiling, looking at ME and imitation behaviour from the people with dementia. These findings allude to the potential of Adaptive Interaction as the basis for interacting with people living with dementia who can no longer speak.

You and me: The structural basis for the interaction of people with severe and profound intellectual disability and others

Interaction between two people may be construed as a continuous process of perception and action within the dyad. A theoretical framework is proposed in this article that explains the concepts and processes which comprise the interaction process. The article explores the transactional nature of interaction, through analysis of narrative data from two dyads, each comprising a person with severe or profound intellectual and multiple disability and a service worker. The novel application of grounded theory to analyse video data of non-verbal communication data in order to develop the theoretical framework is reviewed. Previously, attuning has been identified as the key process that drives interaction. This article explores the other concepts of the theory proposed, namely, setting, being, stimulus, action, attention and engagement. The article concludes by contrasting this theory of the interaction process with other related concepts and suggests how application of the proposed framework may enhance practice.

Patients' Expectations as to Doctors' Behaviors During Appointed Visits

Numerous guidelines for students and medical professionals provide the instructions of proper behavior during encounters with patients in a doctor's office. However, they quite often do not consider cultural differences that may affect the doctor-patient relationship. In our study we analyzed Polish patients' expectations (N = 976) for their physicians' actual behavior. We compared our results with analogue studies performed in the United States. We determined that patient expectations concerning a desirable form of verbal and nonverbal communication with a physician vary to a considerable degree. Relatively universal, however, is the wish that the doctors introduce themselves and apply personalized forms of contact.

The Role of Nonverbal Communication Behaviors in Clinical Trial and Research Study Recruitment

Few studies have examined the communication behaviors of those who recruit for clinical trials and research studies, particularly of nonmedical professionals who often do the bulk of recruiting. This focus-group study of 63 recruiters analyzes the ways in which nonverbal communication behaviors support the process of recruitment, using the lens of communication accommodation theory. Results indicate that recruiters first "read" potential study participants' nonverbal communication for clues about their state of mind, then use nonverbal communication to achieve a sense of convergence. Specific nonverbal communication behaviors were discussed by recruiters, including smiling, variations in the use of voice, adjusting body position, the appropriate use of physical touch, the management of eye contact, and the effect of clothing and physical appearance. Implications for recruitment practice are discussed.

Assessing a Microswitch-Based Stimulation Procedure for Eye-Blinking Responses in a Young Woman with Profound Multiple Disabilities

We applied a new microswitch-based stimulation procedure for eye-blinking responses with a young woman with profound multiple disabilities, and compared effects of this procedure on the eye-blinking responses and smiling with the effects of a caregiver-based stimulation condition. Analysis showed that the microswitch-based stimulation procedure, with stimulation occurring contingent on eye-blinking responses, increased the frequencies of these responses significantly above the levels recorded in baseline and caregiver-based stimulation conditions. No changes in smiling frequencies occurred. Implications of the findings in terms of alertness, learning, and quality of life are discussed.

Nonverbal Communication of Confidence in Soccer Referees: An Experimental Test of Darwin's Leakage Hypothesis

The goal of the present paper was to investigate whether soccer referees' nonverbal behavior (NVB) differed based on the difficulty of their decisions and whether perceivers could detect these systematic variations. On the one hand, communicating confidence via NVB is emphasized in referee training. On the other hand, it seems feasible from a theoretical point of view that particularly following relatively difficult decisions referees have problems controlling their NVB. We conducted three experiments to investigate this question. Experiment 1 (N = 40) and Experiment 2 (N = 60) provided evidence that perceivers regard referees' NVB as less confident following ambiguous decisions as compared with following unambiguous decisions. Experiment 3 (N = 58) suggested that perceivers were more likely to debate with the referee when referees nonverbally communicated less confidence. We discuss consequences for referee training.

Effects of Emotional Intelligence on the Impression of Irony Created by the Mismatch between Verbal and Nonverbal Cues

Emotional information is conveyed through verbal and nonverbal signals, with nonverbal cues often being considered the decisive factor in the judgment of others' emotional states. The aim of the present study was to examine how verbal and nonverbal cues are integrated by perceivers. More specifically, we tested whether the mismatch between verbal and nonverbal information was perceived as an expression of irony. Moreover, we investigated the effects of emotional intelligence on the impression of irony. The findings revealed that the mismatch between verbal and nonverbal information created the impression of irony. Furthermore, participants higher in emotional intelligence were faster at rating such stimuli as ironic expressions.

Faces on Her and His Mind: Female and Likable

Faces are a valuable source of non-verbal information for daily life social interaction. Mounting evidence points to gender specificity in face perception. Here we search for the factors that can potentially trigger gender differences in tuning to faces. By using a set of Face-n-Food images slightly bordering on the Giuseppe Arcimboldo style, we examine: (i) whether face resemblance is linked to gender specific face impression, and, if so, whether this association is perceiver gender specific; and (ii) whether images most resembling a face are also most likable for female and male perceivers. First, in a spontaneous recognition task, participants were shown a set of Face-n-Food images in a predetermined order from the least to most resembling a face. Then in a two-alternative forced-choice (2AFC) task, participants judged whether each face appeared for them (i) either female or male (Exp. 1); or (ii) either likable or unlikable (Exp. 2). Remarkably, face resemblance is closely connected to gender specific impressions: images more resembling a face elicit also more female-face responses. This link is not perceiver gender specific as it occurs for both females and males. Moreover, face resemblance is positively linked to face likability, but this holds true only for female perceivers. The findings shed light on gender specificity in tuning to faces, and help to clarify abnormalities of the social brain in neurodevelopmental, psychiatric and psychosomatic disorders.

Non-verbal Communication Method Based on a Biochemical Marker for People with Severe Motor and Intellectual Disabilities

This study evaluated a novel non-verbal communication method for people with severe motor and intellectual disabilities (SMID) based on a biochemical marker, salivary amylase. The physical and psychological status of 10 people with SMID was quantitatively evaluated using a hand-held salivary amylase activity monitor. Each patient needed daily gastric and/or bronchial tube exchanges and these medical procedures were thought to cause severe distress and pain. Salivary amylase activity and heart rate were simultaneously measured during 32 medical procedures. The medical procedures resulted in a significant mean increase for individuals of 70% in salivary amylase activity. The increase in salivary amylase activity was more than four-fold that observed for heart rate. The structural equation modelling analysis also demonstrated a significant correlation between pain and salivary amylase activity. Our data indicate that salivary amylase activity might be used as a non-verbal method of assessing pain in people with SMID.

Thinking While Talking

This experiment tested the ability of 81 adult subjects to make a decision on a simple nonverbal false-belief reasoning task while concurrently either shadowing prerecorded spoken dialogue or tapping along with a rhythmic shadowing track. Our results showed that the verbal task, but not tapping, significantly disrupted false-belief reasoning, suggesting that language plays a key role in working theory of mind in adults, even when the false-belief reasoning is nonverbal.

Impaired non-verbal emotion processing in Pathological Gamblers

Impaired perception of emotion in others has been described and confirmed in addictions with substances, but no such data exists regarding addictions without substances. As it has been hypothesized that toxic effect of substances on the brain was responsible for the impairments described, studying addictions without substances could be of interest to confirm this hypothesis. Twenty-two male pathological gamblers were compared to 22 male healthy controls matched for age and education level on non-verbal emotion perception tasks including faces, voices, and musical excerpts. Depression and anxiety levels were controlled for. Pathological gamblers significantly underestimated the intensity of peacefulness in music, and overall they were less accurate when reading emotion in voices and faces. They also overestimated emotional intensity in neutral voices and faces. Although anxiety levels did account for accuracy problems when detecting fear in voices and for overestimating emotions in neutral faces, anxiety levels did not explain the range of deficits observed. This is the first study showing non-verbal perception deficits in a purely behavioural addiction. These findings show that deficits in decoding non-verbal signals are associated with addictive behaviours per se, and are not due solely to toxic effects of substances on the brain.

Clients' psychosocial communication and midwives' verbal and nonverbal communication during prenatal counseling for anomaly screening

OBJECTIVES

This study focuses on facilitation of clients' psychosocial communication during prenatal counseling for fetal anomaly screening. We assessed how psychosocial communication by clients is related to midwives' psychosocial and affective communication, client-directed gaze and counseling duration.

METHODS

During 184 videotaped prenatal counseling consultations with 20 Dutch midwives, verbal psychosocial and affective behavior was measured by the Roter Interaction Analysis System (RIAS). We rated the duration of client-directed gaze. We performed multilevel analyses to assess the relation between clients' psychosocial communication and midwives' psychosocial and affective communication, client-directed gaze and counseling duration.

RESULTS

Clients' psychosocial communication was higher if midwives' asked more psychosocial questions and showed more affective behavior (β=0.90; CI: 0.45-1.35; p<0.00 and β=1.32; CI: 0.18-2.47; p=0.025, respectively). Clients "psychosocial communication was not related to midwives" client-directed gaze. Additionally, psychosocial communication by clients was directly, positively related to the counseling duration (β=0.59; CI: 0.20-099; p=0.004).

CONCLUSIONS

In contrast with our expectations, midwives' client-directed gaze was not related with psychosocial communication of clients.

PRACTICE IMPLICATIONS

In addition to asking psychosocial questions, our study shows that midwives' affective behavior and counseling duration is likely to encourage client's psychosocial communication, known to be especially important for facilitating decision-making.

Differences in Physicians' Verbal and Nonverbal Communication With Black and White Patients at the End of Life

CONTEXT

Black patients are more likely than white patients to die in the intensive care unit with life-sustaining treatments. Differences in patient- and/or surrogate-provider communication may contribute to this phenomenon.

OBJECTIVES

To test whether hospital-based physicians use different verbal and/or nonverbal communication with black and white simulated patients and their surrogates.

METHODS

We conducted a randomized factorial trial of the relationship between patient race and physician communication using high-fidelity simulation. Using a combination of probabilistic and convenience sampling, we recruited 33 hospital-based physicians in western Pennsylvania who completed two encounters with prognostically similar, critically and terminally ill black and white elders with identical treatment preferences. We then conducted detailed content analysis of audio and video recordings of the encounters, coding verbal emotion-handling and shared decision-making behaviors, and nonverbal behaviors (time interacting with the patient and/or surrogate, with open vs. closed posture, and touching the patient and physical proximity). We used a paired t-test to compare each subjects' summed verbal and nonverbal communication scores with the black patient compared to the white patient.

RESULTS

Subject physicians' verbal communication scores did not differ by patient race (black vs. white: 8.4 vs. 8.4, P-value = 0.958). However, their nonverbal communication scores were significantly lower with the black patient than with the white patient (black vs. white: 2.7 vs. 2.9, P-value 0.014).

CONCLUSION

In this small regional sample, hospital-based physicians have similar verbal communication behaviors when discussing end-of-life care for otherwise similar black and white patients but exhibit significantly fewer positive, rapport-building nonverbal cues with black patients.

Gaze Synchrony between Mothers with Mood Disorders and Their Infants: Maternal Emotion Dysregulation Matters

A lowered and heightened synchrony between the mother's and infant's nonverbal behavior predicts adverse infant development. We know that maternal depressive symptoms predict lowered and heightened mother-infant gaze synchrony, but it is unclear whether maternal emotion dysregulation is related to mother-infant gaze synchrony. This cross-sectional study examined whether maternal emotion dysregulation in mothers with mood disorders is significantly related to mother-infant gaze synchrony. We also tested whether maternal emotion dysregulation is relatively more important than maternal depressive symptoms in predicting mother-infant gaze synchrony, and whether maternal emotion dysregulation mediates the relation between maternal depressive symptoms and mother-infant gaze synchrony. We observed 68 mothers and their 4- to 9-month-old infants in the Still-Face paradigm during two play interactions, before and after social stress was induced. The mothers' and infants' gaze behaviors were coded using microanalysis with the Maternal Regulatory Scoring System and Infant Regulatory Scoring System, respectively. The degree of mother-infant gaze synchrony was computed using time-series analysis. Maternal emotion dysregulation was measured by the Difficulties in Emotion Regulation Scale; depressive symptoms were assessed using the Beck Depression Inventory. Greater maternal emotion dysregulation was significantly related to heightened mother-infant gaze synchrony. The overall effect of maternal emotion dysregulation on mother-infant gaze synchrony was relatively more important than the effect of maternal depressive symptoms in the five tested models. Maternal emotion dysregulation fully mediated the relation between maternal depressive symptoms and mother-infant gaze synchrony. Our findings suggest that the effect of the mother's depressive symptoms on the mother-infant gaze synchrony may be mediated by the mother's emotion dysregulation.