Ruminative minds, wandering minds: Effects of rumination and mind wandering on lexical associations, pitch imitation and eye behaviour.

This study demonstrates that rumination is reflected in two behavioural signals that both play an important role in face-to-face interactions and provides evidence for the negative impact of rumination on social cognition. Sixty-one students were randomly assigned either to a condition in which rumination was induced or to a control condition. Their task was to play a speech-based word association game with an Embodied Conversational Agent during which their word associations, pitch imitation and eye movements were measured. Two questionnaires assessed their ruminative tendencies and mind wandering thoughts, respectively. Rumination predicted differences in task-related mind wandering, polarity of lexical associations, pitch imitation, and blinks while mind wandering predicted differences in saccades. This outcome may show that rumination has a negative impact on certain aspects of social interactions.

A case study of vocal features associated with galvanic skin response to stressors in a clinical interaction.

OBJECTIVE: We investigated vocal characteristics associated with physiologically determined stressful episodes by means of post-hoc acoustic analyses of speech recorded in a clinical setting. Our research addressed the understudied question of which vocal features may serve as cues naturally occurring stress and is the first to explore this issue in a pitch accent language. METHODS: The vocal profile of a single female patient interacting with a physician was analyzed with standard speech analysis software for acoustic indicators of stress-related arousal determined by galvanic skin response measurements. RESULTS: Vocal jitter, representing an aspect of voice quality perceived as hoarseness, appeared to increase during and immediately after skin conductance response intervals. Skin conductance levels during the response intervals were negatively correlated with acoustic features used to approximate the perception of voice unsteadiness (slope and standard deviation of fundamental frequency). CONCLUSION: An acoustic analysis of vocal properties of speech uttered during independently detected skin conductance response intervals revealed individual patterns for some acoustic features linked to stress in earlier studies. PRACTICE IMPLICATIONS: Non-invasive methods of arousal detection in physician-patient communication based on acoustic analyses of vocal profiles may, in combination with other analyses, help identify stressful events and thus improve the process of medical information gathering and decision-making.

The link between perception of clinical empathy and nonverbal behavior: The effect of a doctor's gaze and body orientation.

OBJECTIVES: Clinical empathy is considered to be one of the most important skills for medical professionals. It is primarily conveyed by nonverbal behavior; however, little is known about the importance of different types of cues and their relation to engagement and sincerity as possible correlates of perceived clinical empathy (PCE). In this study, we explored the effect of doctor's gaze and body orientation on PCE with the help of 32 video vignettes. METHODS: Actors impersonating medical interns displayed different combinations of gaze and body orientation while uttering an empathetic verbal statement. The video vignettes were evaluated in terms of the perceived clinical and general empathy, engagement and sincerity. RESULTS: A principal component analysis revealed a possible single-factor solution for the scales measuring the two types of empathy, engagement and sincerity; therefore, they were subsumed under general perceived empathy (GPE). An analysis of variance showed a main effect of gaze and body orientation, with a stronger effect of gaze, on GPE. We subsequently performed a linear random effects analysis, which indicated possible gender-related differences in the perception of gaze. CONCLUSIONS: The outcomes of our experiment confirm that both gaze and body orientation have an influence on the GPE. The effect of gaze, however, appears to be gender-dependent: in the experiment, males were perceived as slightly more empathetic with patient-centered gaze, while for females averted gaze resulted in higher GPE scores. PRACTICE IMPLICATIONS: The findings are directly relevant in the context of medical communication training. Perception of clinical empathy supports medical information transfer, diagnosis quality and other patient outcomes.

Automatic detection of confusion in elderly users of a web-based health instruction video.

BACKGROUND: Because of cognitive limitations and lower health literacy, many elderly patients have difficulty understanding verbal medical instructions. Automatic detection of facial movements provides a nonintrusive basis for building technological tools supporting confusion detection in healthcare delivery applications on the Internet. MATERIALS AND METHODS: Twenty-four elderly participants (70-90 years old) were recorded while watching Web-based health instruction videos involving easy and complex medical terminology. Relevant fragments of the participants' facial expressions were rated by 40 medical students for perceived level of confusion and analyzed with automatic software for facial movement recognition. RESULTS: A computer classification of the automatically detected facial features performed more accurately and with a higher sensitivity than the human observers (automatic detection and classification, 64% accuracy, 0.64 sensitivity; human observers, 41% accuracy, 0.43 sensitivity). A drill-down analysis of cues to confusion indicated the importance of the eye and eyebrow region. CONCLUSIONS: Confusion caused by misunderstanding of medical terminology is signaled by facial cues that can be automatically detected with currently available facial expression detection technology. The findings are relevant for the development of Web-based services for healthcare consumers.

Auditory perception bias in speech imitation.

In an experimental study, we explored the role of auditory perception bias in vocal pitch imitation. Psychoacoustic tasks involving a missing fundamental indicate that some listeners are attuned to the relationship between all the higher harmonics present in the signal, which supports their perception of the fundamental frequency (the primary acoustic correlate of pitch). Other listeners focus on the lowest harmonic constituents of the complex sound signal which may hamper the perception of the fundamental. These two listener types are referred to as fundamental and spectral listeners, respectively. We hypothesized that the individual differences in speakers' capacity to imitate F 0 found in earlier studies, may at least partly be due to the capacity to extract information about F 0 from the speech signal. Participants' auditory perception bias was determined with a standard missing fundamental perceptual test. Subsequently, speech data were collected in a shadowing task with two conditions, one with a full speech signal and one with high-pass filtered speech above 300 Hz. The results showed that perception bias toward fundamental frequency was related to the degree of F 0 imitation. The effect was stronger in the condition with high-pass filtered speech. The experimental outcomes suggest advantages for fundamental listeners in communicative situations where F 0 imitation is used as a behavioral cue. Future research needs to determine to what extent auditory perception bias may be related to other individual properties known to improve imitation, such as phonetic talent.