Nonverbal Behavior During Clinical Interviews

Abstract

Research has shown that patients with schizophrenia and depression differ from nonclinical subjects in nonverbal behavior. In contrast, there is a paucity of studies addressing differences in nonverbal communication between diagnostic groups and as to what extent nonverbal communication feeds into standard ratings of psychopathology. Twenty-six patients with schizophrenia were compared with 24 patients with affective disorders (13 depressed, 11 manic) regarding their nonverbal behavior using the Ethological Coding System for Interviews. Symptom severity was rated using the Brief Psychiatric Rating Scale. Patients with mania displayed more illustrative gestures than did patients with schizophrenia or depression. Subtler behavioral differences between the groups occurred regarding assertive behaviors and displacement activities suggestive of hostility and motivational conflict, respectively. Distinct correlations between nonverbal communication and psychopathology ratings emerged in all three groups. Patients with schizophrenia, depression, and mania differ in nonverbal behavior. Nonverbal communication seems to be a significant contributor to clinicians' intuitive ratings.

Negative Symptoms and Avoidance of Social Interaction: A Study of Non-Verbal Behaviour

“…The results support past findings on the importance of prosocial and flight behaviours with strengthened methodology [9,11,28]. However, in contrast to some past findings, associations with non-verbal behaviour were only found with negative symptoms and not with other symptom domains.…”

“…Partial correlation analyses and Mann-Whitney U tests were used to assess whether associations could be explained by medication or gender as potential confounders. Antipsychotic medication was adjusted for, similarly to previous analyses [8,31], as medication has been found to correlate with certain non-verbal behaviours in the past [9,32]. Gender was assessed as a possible confounder, as previous studies have found differences in nonverbal behaviour between males and females [2,33].…”

“…In other studies, different symptom domains have been associated with differing symptom severities. For example, increased negative symptoms have been associated with decreases in prosocial behaviour [9,13,14], and a higher general severity of symptoms has been linked with increased flight behaviour [9,11]. By contrast, Brüne et al [4] found that reduced symptoms were associated with an increase in flight behaviour.…”

“…Results: Patients with a higher level of negative symptoms displayed significantly fewer prosocial (e.g., nodding and smiling), gesture, and displacement behaviours (e.g., fumbling), but significantly more flight behav-schizophrenia display less non-verbal behaviour [3][4][5][6] and, in turn, these reductions in expressivity have been linked with poorer social functioning and social competence [7,8]. Patients with schizophrenia have also been shown to have non-verbal profiles that differ from those with different psychiatric diagnoses [6,7,[9][10][11][12].…”

Realising stratified psychiatry using multidimensional signatures and trajectories

“…Diagnostic categories may exhibit marked differences in neurodevelopment [33–35] but also overlap in terms of shared symptoms: psychotic features are seen in borderline personality disorder [36–39], and bipolar disorder and schizophrenia both exhibit similarities in non-verbal communication [40], affective symptoms [41], cognitive deficits [42, 43], genetic risk factors [44–46] and a broader trans-diagnostic ‘psychosis’ phenotype [47]. The observation that signs or symptoms are rarely exclusive is an inevitable stumbling block for categorical classification in psychiatry, because they are a distinct manifestation of neurobiological dysfunction whose idiosyncratic expression in an individual patient is shaped by complex environmental factors in the history of that individual’s illness.…”