Using Nonverbal Behaviour To Assess Depression Severity
Christopher Philip
Certainly, some areas of research is lagging behind. This is particularly so with respect to the use and application of nonverbal communication. Body language is an effective way to measure an array of emotion and recently, research has focused on assessing depression severity with the help of nonverbal language.
One such study led by Brazilian researcher Juliana Teixeira Fiquer Department of Psychiatry, University of SãoPaulo used empirical study to look at how patients revealed their relative level of depression using various nonverbal cues.
Normally, depression is assessed with questionnaires and reports filled out by patients or their relatives during various interviews. While these can be useful in collecting information regarding symptoms they do little to reveal subconscious emotions and feelings which the patient himself is unaware.
Additionally, self reports may be purposefully distorted due to the perception of social stigma or motivated by a desire to withdraw from treatment. This can lead to under, or at times, over-reporting of symptoms.
By using nonverbal displays, one can, in theory, catalogue more autonomic and authentic displays exhibited by patients’ suffering.
We know that prosocial behaviour is a marker for health. Smiling and making eye contact are two cues we look for in others in a positive interaction. Lowering of the head, eye contact avoidance, slouching, or even outright crying mark symptoms worthy of care. Lack of gesticulation, yes-nodding, and an overall of lack of reciprocity while engaging in conversation have also been pointed out as cues to be watched in depression.
While some studies have pointed out that general trends occur in depression such as social withdraw, few have studied them empirically.
The Current Study
Forty patients suffering from depression where recruited for the study. Over the course of the experiment, subjects received treatment with cortical direct current stimulation.
As part of the experimental protocol, the subjects were initially assessed with various questionnaires and assessments.
As well, the subjects were video recorded as they described their mood and symptoms which lasted 15 minutes.
The video was encoded for 57 behaviours related to body and shoulder inclination, head inclination and movement, arm posture, hand gestures, facial movements, and vocalizations or lack thereof. The researchers settled on 21 behaviors they deemed relevant.
Of the nonverbal cues, 10 were considered high energy and hence favourable which included social interaction (eye-contact, illustrative gestures, symmetric smile, raised eyebrows, yes/no nodding, head up, head to side, verbal- backchannel, body posture towards the interlocutor). Another 10 were indicative of low energy and negative feelings which indicated social disinterest (folded arms, head down, shrug, asymmetric smile, adaptive gestures, crying, frown, tight lips, lips down, silence). Verbal behavior was also recorded and formed another category.
The Results
Several behaviours were associated with depression including asymmetric smile and crying. Use of illustrative gestures, raised eyebrows, and lack of nodding on the other hand was disassociated with depression.
After patients received treatment, their negative cues declined and positive cues increased. For example, after treatment, head down, lips down, frown, crying diminished whereas yes-nodding and eye contact increased.
Overall, a reduction in frowning and crying and an increase in yes-nodding was associated with a decrease in depression severity.
Drawing Conclusions
Overall, symptom severity was predicted by nonverbal cues. Specifically, low energy and social disinterest diminished with treatment. On the other hand, pro-social behaviour increased after treatment.
Overall facial and head movements stood out the most. Crying, asymmetrical smile, and motionless head and eyebrows was associated with more sever depression. On the other hand, a decrease in negative head and facial indicators and an increase of eye-contact and yes-nodding accompanied clinical improvement.
The results fall in line with other studies showing more eyebrow movement and eye contact with reduction in depression.
Energy expressed, or lack thereof, in the face and head, are relevant cues in assessing depression severity in patients suffering from depression.
Resources
Teixeira Fiquer, Juliana; Paulo Sérgio Boggio and Clarice Gorenstein. Talking Bodies: Nonverbal Behavior in the Assessment of Depression Severity. Journal of Affective Disorders. 2019. 150: 1114-1119.