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  1. Article ; Online: Leveraging natural language processing to study emotional coherence in psychotherapy.

    Atzil-Slonim, Dana / Eliassaf, Amir / Warikoo, Neha / Paz, Adar / Haimovitz, Shira / Mayer, Tobias / Gurevych, Iryna

    Psychotherapy (Chicago, Ill.)

    2024  Volume 61, Issue 1, Page(s) 82–92

    Abstract: The association between emotional experience and expression, known as emotional coherence, is considered important for individual functioning. Recent advances in natural language processing (NLP) make it possible to automatically recognize verbally ... ...

    Abstract The association between emotional experience and expression, known as emotional coherence, is considered important for individual functioning. Recent advances in natural language processing (NLP) make it possible to automatically recognize verbally expressed emotions in psychotherapy dialogues and to explore emotional coherence with larger samples and finer granularity than previously. The present study used state-of-the-art emotion recognition models to automatically label clients' emotions at the utterance level, employed these labeled data to examine the coherence between verbally expressed emotions and self-reported emotions, and examined the associations between emotional coherence and clients' improvement in functioning throughout treatment. The data comprised 872 transcribed sessions from 68 clients. Clients self-reported their functioning before each session and their emotions after each. A subsample of 196 sessions were manually coded. A transformer-based approach was used to automatically label the remaining data for a total of 139,061 utterances. Multilevel modeling was used to assess emotional coherence and determine whether it was associated with changes in clients' functioning throughout treatment. The emotion recognition model demonstrated moderate performance. The findings indicated a significant association between verbally expressed emotions and self-reported emotions. Coherence in clients' negative emotions was associated with improvement in functioning. The results suggest an association between clients' subjective experience and their verbal expression of emotions and underscore the importance of this coherence to functioning. NLP may uncover crucial emotional processes in psychotherapy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
    MeSH term(s) Humans ; Natural Language Processing ; Professional-Patient Relations ; Psychotherapy/methods ; Emotions ; Expressed Emotion
    Language English
    Publishing date 2024-01-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 281564-3
    ISSN 1939-1536 ; 0033-3204
    ISSN (online) 1939-1536
    ISSN 0033-3204
    DOI 10.1037/pst0000517
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Facilitating dyadic synchrony in psychotherapy sessions: Systematic review and meta-analysis.

    Atzil-Slonim, Dana / Soma, Christina S / Zhang, Xinyao / Paz, Adar / Imel, Zac E

    Psychotherapy research : journal of the Society for Psychotherapy Research

    2023  Volume 33, Issue 7, Page(s) 898–917

    Abstract: Objective: ...

    Abstract Objective:
    MeSH term(s) Humans ; Professional-Patient Relations ; Psychotherapy/methods ; Treatment Outcome
    Language English
    Publishing date 2023-03-31
    Publishing country England
    Document type Meta-Analysis ; Systematic Review ; Journal Article
    ZDB-ID 1080323-3
    ISSN 1468-4381 ; 1050-3307
    ISSN (online) 1468-4381
    ISSN 1050-3307
    DOI 10.1080/10503307.2023.2191803
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Transdiagnostic effects of therapist self-disclosure on diverse emotional experiences of clients with emotional disorders and schizophrenia.

    Alfi-Yogev, Tal / Kivity, Yogev / Atzil-Slonim, Dana / Paz, Adar / Igra, Libby / Lavi-Rotenberg, Adi / Hasson-Ohayon, Ilanit

    Journal of clinical psychology

    2024  Volume 80, Issue 3, Page(s) 678–691

    Abstract: Objective: Despite the clinical significance of emotional diversity, also known as emodiversity, there has been limited investigation into the therapeutic interventions that influence this construct. In the current study we examined the association ... ...

    Abstract Objective: Despite the clinical significance of emotional diversity, also known as emodiversity, there has been limited investigation into the therapeutic interventions that influence this construct. In the current study we examined the association between immediate therapist self-disclosure (TSD) and emodiversity among two diagnostic groups who tend to experience emotional difficulties: people with schizophrenia and people with emotional disorders (i.e., depression and/or anxiety).
    Method: The sample comprised 74 clients (37 diagnosed with schizophrenia and 37 with emotional disorders) treated by 45 therapists in a university clinic setting. Following each session, clients self-reported their emotions, and therapists completed a measure of frequency and centrality of their immediate TSD during the session.
    Results: Longitudinal multilevel models indicated that immediate TSD was positively associated with clients' global emodiversity, both at the within- and the between-client levels, as well as with clients' negative emodiversity at the between-client level. Moreover, clients with emotional disorders and clients with schizophrenia did not differ in the association between immediate TSD and emodiversity. In addition, across groups, clients treated by therapists who used more immediate TSD on average showed greater increases in global emodiversity during treatment.
    Conclusions: immediate TSD is associated with clients' ability to experience rich and diverse emotional experiences across different disorders. The theoretical and clinical implications of these findings are discussed.
    MeSH term(s) Humans ; Schizophrenia/therapy ; Disclosure ; Professional-Patient Relations ; Emotions ; Mood Disorders ; Psychotherapy
    Language English
    Publishing date 2024-01-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 219160-x
    ISSN 1097-4679 ; 0021-9762
    ISSN (online) 1097-4679
    ISSN 0021-9762
    DOI 10.1002/jclp.23648
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Facing Change: Using Automated Facial Expression Analysis to Examine Emotional Flexibility in the Treatment of Depression.

    Slonim, Dana Atzil / Yehezkel, Ido / Paz, Adar / Bar-Kalifa, Eran / Wolff, Maya / Dar, Avinoam / Gilboa-Schechtman, Eva

    Administration and policy in mental health

    2023  

    Abstract: Objective: Depression involves deficits in emotional flexibility. To date, the varied and dynamic nature of emotional processes during therapy has mostly been measured at discrete time intervals using clients' subjective reports. Because emotions tend ... ...

    Abstract Objective: Depression involves deficits in emotional flexibility. To date, the varied and dynamic nature of emotional processes during therapy has mostly been measured at discrete time intervals using clients' subjective reports. Because emotions tend to fluctuate and change from moment to moment, the understanding of emotional processes in the treatment of depression depends to a great extent on the existence of sensitive, continuous, and objectively codified measures of emotional expression. In this observational study, we used computerized measures to analyze high-resolution time-series facial expression data as well as self-reports to examine the association between emotional flexibility and depressive symptoms at the client as well as at the session levels.
    Method: Video recordings from 283 therapy sessions of 58 clients who underwent 16 sessions of manualized psychodynamic psychotherapy for depression were analyzed. Data was collected as part of routine practice in a university clinic that provides treatments to the community. Emotional flexibility was measured in each session using an automated facial expression emotion recognition system. The clients' depression level was assessed at the beginning of each session using the Beck Depression Inventory-II (Beck et al., 1996).
    Results: Higher emotional flexibility was associated with lower depressive symptoms at the treatment as well as at the session levels.
    Conclusion: These findings highlight the centrality of emotional flexibility both as a trait-like as well as a state-like characteristic of depression. The results also demonstrate the usefulness of computerized measures to capture key emotional processes in the treatment of depression at a high scale and specificity.
    Language English
    Publishing date 2023-10-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1025319-1
    ISSN 1573-3289 ; 0894-587X
    ISSN (online) 1573-3289
    ISSN 0894-587X
    DOI 10.1007/s10488-023-01310-w
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  5. Article: Gaze Control During Simulator Driving in Adolescents With and Without Attention Deficit Hyperactivity Disorder.

    Yuval-Greenberg, Shlomit / Keren, Anat / Hilo, Rinat / Paz, Adar / Ratzon, Navah

    The American journal of occupational therapy : official publication of the American Occupational Therapy Association

    2019  Volume 73, Issue 3, Page(s) 7303345030p1–7303345030p8

    Abstract: Importance: Attention deficit hyperactivity disorder (ADHD) is associated with driving deficits. Visual standards for driving define minimum qualifications for safe driving, including acuity and field of vision, but they do not consider the ability to ... ...

    Abstract Importance: Attention deficit hyperactivity disorder (ADHD) is associated with driving deficits. Visual standards for driving define minimum qualifications for safe driving, including acuity and field of vision, but they do not consider the ability to explore the environment efficiently by shifting the gaze, which is a critical element of safe driving.
    Objective: To examine visual exploration during simulated driving in adolescents with and without ADHD.
    Design: Adolescents with and without ADHD drove a driving simulator for approximately 10 min while their gaze was monitored. They then completed a battery of questionnaires.
    Setting: University lab.
    Participants: Participants with (n = 16) and without (n = 15) ADHD were included. Participants had a history of neurological disorders other than ADHD and normal or corrected-to-normal vision. Control participants reported not having a diagnosis of ADHD. Participants with ADHD had been previously diagnosed by a qualified professional.
    Outcomes and measures: We compared the following measures between ADHD and non-ADHD groups: dashboard dwell times, fixation variance, entropy, and fixation duration.
    Results: Findings showed that participants with ADHD were more restricted in their patterns of exploration than control group participants. They spent considerably more time gazing at the dashboard and had longer periods of fixation with lower variability and randomness.
    Conclusions and relevance: The results support the hypothesis that adolescents with ADHD engage in less active exploration during simulated driving.
    What this article adds: This study raises concerns regarding the driving competence of people with ADHD and opens up new directions for potential training programs that focus on exploratory gaze control.
    MeSH term(s) Adolescent ; Attention Deficit Disorder with Hyperactivity/diagnosis ; Automobile Driving ; Case-Control Studies ; Fixation, Ocular ; Humans ; Surveys and Questionnaires
    Language English
    Publishing date 2019-05-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 219403-x
    ISSN 1943-7676 ; 0272-9490 ; 0161-326X
    ISSN (online) 1943-7676
    ISSN 0272-9490 ; 0161-326X
    DOI 10.5014/ajot.2019.031500
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Oxytocin reactivity to the therapeutic encounter as a biomarker of change in the treatment of depression.

    Atzil-Slonim, Dana / Stolowicz-Melman, Dana / Bar-Kalifa, Eran / Gilboa-Schechtman, Eva / Paz, Adar / Wolff, Maya / Rotter, Inbal / Zagoory, Orna / Feldman, Ruth

    Journal of counseling psychology

    2022  Volume 69, Issue 5, Page(s) 755–760

    Abstract: Depression affects millions worldwide, thus underscoring the urgent need to optimize health care practices. To better understand the processes involved in psychotherapy gains, studies have emphasized the need to complement subjective reports with ... ...

    Abstract Depression affects millions worldwide, thus underscoring the urgent need to optimize health care practices. To better understand the processes involved in psychotherapy gains, studies have emphasized the need to complement subjective reports with objective measures, in particular biological markers. Oxytocin (OT) has been proposed as a potential biomarker in the treatment of depression given its involvement in depression-related psychological and physiological functions and the formation of close relationships. Here, we assessed whether OT reactivity to therapeutic encounters (absolute and/or directional reactivity) is linked to improvements in depressive symptoms from session to session during psychotherapy. A total of 284 saliva samples were collected from 30 adult clients who underwent 16 sessions of manualized psychodynamic psychotherapy for depression in a university setting. Salivary OT was measured before and after five preselected sessions distributed evenly throughout the therapy. The Beck Depression Inventory-II (BDI-II) was administered at the beginning of each session. Multilevel growth models indicated that clients exhibiting greater absolute OT reactivity showed greater improvement in depressive symptoms throughout treatment. Directional reactivity was not associated with depressive symptom change. In addition, clients with higher baseline OT levels displayed less change in depressive symptoms. These findings highlight reactivity of the OT system, in either direction, as an important feature of the treatment response. Consistent with recent models of the neurobiology of resilience, OT reactivity appears to serve as an important biomarker of psychotherapy gain in the treatment of depression. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
    MeSH term(s) Adult ; Biomarkers ; Depression/therapy ; Humans ; Oxytocin/therapeutic use ; Psychotherapy, Psychodynamic
    Chemical Substances Biomarkers ; Oxytocin (50-56-6)
    Language English
    Publishing date 2022-04-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2066555-6
    ISSN 1939-2168 ; 0022-0167
    ISSN (online) 1939-2168
    ISSN 0022-0167
    DOI 10.1037/cou0000617
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Intrapersonal and interpersonal vocal affect dynamics during psychotherapy.

    Paz, Adar / Rafaeli, Eshkol / Bar-Kalifa, Eran / Gilboa-Schectman, Eva / Gannot, Sharon / Laufer-Goldshtein, Bracha / Narayanan, Shrikanth / Keshet, Joseph / Atzil-Slonim, Dana

    Journal of consulting and clinical psychology

    2021  Volume 89, Issue 3, Page(s) 227–239

    Abstract: Objective: The present study implements an automatic method of assessing arousal in vocal data as well as dynamic system models to explore intrapersonal and interpersonal affect dynamics within psychotherapy and to determine whether these dynamics are ... ...

    Abstract Objective: The present study implements an automatic method of assessing arousal in vocal data as well as dynamic system models to explore intrapersonal and interpersonal affect dynamics within psychotherapy and to determine whether these dynamics are associated with treatment outcomes.
    Method: The data of 21,133 mean vocal arousal observations were extracted from 279 therapy sessions in a sample of 30 clients treated by 24 therapists. Before and after each session, clients self-reported their well-being level, using the Outcome Rating Scale.
    Results: Both clients' and therapists' vocal arousal showed intrapersonal dampening. Specifically, although both therapists and clients departed from their baseline, their vocal arousal levels were "pulled" back to these baselines. In addition, both clients and therapists exhibited interpersonal dampening. Specifically, both the clients' and the therapists' levels of arousal were "pulled" toward the other party's arousal level, and clients were "pulled" by their therapists' vocal arousal toward their own baseline. These dynamics exhibited a linear change over the course of treatment: whereas interpersonal dampening decreased over time, there was an increase in intrapersonal dampening over time. In addition, higher levels of interpersonal dampening were associated with better session outcomes.
    Conclusions: These findings demonstrate the advantages of using automatic vocal measures to capture nuanced intrapersonal and interpersonal affect dynamics in psychotherapy and demonstrate how these dynamics are associated with treatment gains. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
    MeSH term(s) Adult ; Affect/physiology ; Arousal ; Databases, Factual ; Female ; Humans ; Male ; Mental Disorders/therapy ; Professional-Patient Relations ; Psychotherapy/methods ; Self Report ; Treatment Outcome ; Verbal Behavior/physiology
    Language English
    Publishing date 2021-04-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 121321-0
    ISSN 1939-2117 ; 0022-006X
    ISSN (online) 1939-2117
    ISSN 0022-006X
    DOI 10.1037/ccp0000623
    Database MEDical Literature Analysis and Retrieval System OnLINE

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