Nonverbal behavior during standardized interviews in patients with schizophrenia spectrum disorders
ABSTRACT Several studies have consistently shown that patients with schizophrenia or schizophrenia spectrum disorders (SSD) can be distinguished from normal controls on the basis of their nonverbal behavior during standardized interviews, with considerable interactions between negative symptoms and poor facial expressivity. However, most studies have examined unmedicated patients, and gender of both interviewer and interviewee has not been taken into account. In this study we assessed the nonverbal behavior of male and female patients with SSD who were receiving second-generation antipsychotic medication (SGA) using the Ethological Coding System for Interviews (Troisi, 1998). In addition, we used a novel 5-factor model of the Positive and Negative Symptom Scale (PANSS, van der Gaag et al., 2006) to correlate nonverbal behavior with standard psychopathology ratings. Our findings strongly resembled results of previous studies into nonverbal behavior of patients with SSD, despite differences in cultural backgrounds and gender of the interviewer. Negative symptoms were inversely correlated with several of the nonverbal behavioral dimensions. Medication dose did not correlate with any one of the behavioral or psychopathological measures. Patients with SSD make less use of their nonverbal behavioral repertoire compared with controls, independent of antipsychotic treatment. Culture-specific nonverbal expressivity seems to play an additional (minor) role in distinguishing patients from healthy controls.
- SourceAvailable from: PubMed Central[Show abstract] [Hide abstract]
ABSTRACT: Background In 1963, Nicolaas Tinbergen published an article on ¿the aims and methods of ethology¿ in which he identified a fundamental framework for the scientific inquiry into the understanding of biological phenomena. In particular, he emphasized to not only study what he called the ¿proximate¿ causes, that is, mechanism and ontogeny of a given trait, but to include evolutionary explanations, i.e., the phylogeny and adaptive properties of that trait.DiscussionWhile influential in the field of biology and to some degree medicine, psychiatry has fallen short of adopting Tinbergen¿s approach. This article aims at discussing why Tinbergen¿s précis has lost nothing of its attractiveness to psychiatry as a medical discipline. Examples will be given for the analysis of emotions, attachment and psychotherapy.SummaryTinbergen has bequeathed to us a scientific framework that can greatly advance our understanding of psychiatric conditions and improve diagnosis and treatment of mental disorders, with similar potential for medicine in general.BMC Psychiatry 12/2014; 14(1):364. DOI:10.1186/PREACCEPT-2113036343145163 · 2.24 Impact Factor
- Acta Psychiatrica Scandinavica 08/2014; · 5.55 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Objective Recent evidence found that patients with schizophrenia display non-verbal behaviour designed to avoid social engagement during the opening moments of their meetings with psychiatrists. This study aimed to replicate, and build on, this finding, assessing the non-verbal behaviour of patients and psychiatrists during meetings, exploring changes over time and its association with patients' symptoms and the quality of the therapeutic relationship.Method40-videotaped routine out-patient consultations, involving patients with schizophrenia, were analysed. Non-verbal behaviour of patients and psychiatrists was assessed during three fixed, 2-min intervals using a modified Ethological Coding System for Interviews. Symptoms, satisfaction with communication and the quality of the therapeutic relationship were also measured.ResultsOver time, patients' non-verbal behaviour remained stable, whilst psychiatrists' flight behaviour decreased. Patients formed two groups based on their non-verbal profiles, one group (n = 25) displaying pro-social behaviour, inviting interaction and a second (n = 15) displaying flight behaviour, avoiding interaction. Psychiatrists interacting with pro-social patients displayed more pro-social behaviours (P < 0.001). Patients' pro-social profile was associated reduced symptom severity (P < 0.05), greater satisfaction with communication (P < 0.001) and positive therapeutic relationships (P < 0.05).Conclusion Patients' non-verbal behaviour during routine psychiatric consultations remains unchanged, and is linked to both their psychiatrist's non-verbal behaviour and the quality of the therapeutic relationship.Acta Psychiatrica Scandinavica 08/2014; DOI:10.1111/acps.12319 · 4.86 Impact Factor