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An Analysis of the Organization of Looking and Speech-Pause Behaviour of Depressive Patients

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Several theories of the origin of depression are based on how depressive patients interact with their environment. The aim of the current study is to explore rules for interpersonal behaviour via direct observation and to relate these rules to aspects of depression, as assessed by means of clinical judgement. Because looking and speaking are the most important elements of a dyadic interaction, the timing of looking in relation to speech-pause behaviour was studied during a psychiatric interview. Looking and speaking were recorded for 29 endogenously severely depressed in-patients and for the interviewing psychiatrist. Methods of analysis are presented extensively. Four types of pauses, i.e., pauses within the speech of the patient and of the psychiatrist and switching pauses between the psychiatrist and the patient and vice versa, were distinguished. The analysis focusses on these 4 types of pauses and their preceding and following speech fragments. All speech-pause behaviour occurring during an interview was subdivided into these 4 types of speech-pause-speech sequences. The temporal distribution of looking was then described in relation to each of the 4 types of sequences. Two methods were used to deal with differences in duration of speech and pause fragments. One method describes the timing of looking with absolute time units; the other method uses relative time units. Further, the methods enable us to study whether differences in the duration of speaking or pausing coincide with different patterns of looking. Analysis of the data revealed that such relationships exist. Moreover, within a group of depressives different degrees of retardation (a measure for psychomotor functioning) coincide with different patterns of looking. The lesser amount of looking in retarded patients is discussed in relation to functions of looking and possible consequences for interpersonal behaviour.

Affiliations: 1: Psychiatric University Clinic, Dept. of Biological Psychiatry, Groningen, The Netherlands; 2: Lab. of Experimental Clinical Psychology, University of Groningen, The Netherlands

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