A comparison of communication modes in adult psychiatry.

The process and outcome of clinical tasks in an acute psychiatric unit were compared using four different communication modes: face to face, telephone, hands-free telephone, and a low-cost videoconferencing system. Six doctors and six patients took part in the study. Four assessment measures were used. The videoconferencing system was positively received by both patients and doctors. Both doctors and patients preferred communication modes with visual cues. However, there were few significant differences between communication modes when using single measures; only multiple levels of analysis can adequately assess the differences between such modes of communication.

An evaluation of the use of interactive television in an acute psychiatric service.

This study reports the results of the use of a low-cost videoconferencing system (LCVC) for communication in an acute psychiatric service. Qualitative research methodology was used to examine the use of the LCVC in interactions between psychiatrists, patients and nursing staff, including information on refusals. One hundred and five clinical interactions were studied over four months. The LCVC proved technically reliable and compatible with the performance of a wide range of clinical tasks. However, the results suggest the need for better understanding of the nature and origins of the attitudes that users bring to the use of such communications technology. A framework is presented for the classification of user responses in terms of preexisting attitudes of the users, technological limitations of the system and the mental state of the users. The study demonstrated the potential for interactive television to support many of the communication tasks necessary in a dispersed psychiatric service and for telepsychiatry to become a major method of service provision.

Effects of communication content on speech behavior of depressives.

Depressed patients were interviewed at two different severity levels in the course of their illness about both problematic and neutral topics, and their speech behavior was analyzed in terms of speech activity and silences. Lowered speech activity and increased silences occurred at higher severity levels and also during problematic communication content, suggesting the mediation of cognitive factors as postulated by Beck's cognitive model of depression.

Preliminary evaluation of a low cost videoconferencing system for teaching in clinical psychiatry.

The use of a digitized low cost videoconferencing system (LCVC) for the teaching of clinical medical students on clinical attachment to a psychiatric ward is described. This work was performed as part of the Telemed project which is evaluating the use of the LCVC in a range of tasks in clinical psychiatry. Any move towards greater reliance on communications technology in psychiatry should take account of the requirements of clinical teaching. The case presentation was used as a teaching paradigm in a controlled study comparing teaching face-to-face with teaching mediated via the LCVC. A questionnaire was developed for student evaluation of the case presentation. General user responses to the LCVC are reported. No significant differences were found between the conditions. User responses were favourable, suggesting that remote interactive teaching via the LCVC warrants further investigation.

Cultural differences in interpersonal responses to depressives' nonverbal behaviour.

The Social Impression and Interpersonal Attraction of British depressed patients was rated by British and German subjects on the basis of the patients' video-recorded nonverbal behaviour. Depressives were rated negatively by all subjects. Males in both cultural groups agreed in their ratings of depressives but German females expressed a more negative attitude than British females. This is attributed to cultural differences in sex-appropriate interactive behaviour. The importance of studying the expression of depression and its meaning within a particular cultural context is indicated and the role of cultural differences in interactive behaviour is discussed with respect to intercultural assessment and treatment of depression.

Variable-image videoconfrontation as a method of assessing body image: a technical report and comparison with similar techniques.

In this study a new modified videosystem, designed for measuring body-image, was evaluated alongside the major size-estimation measure, namely, the visual size-estimation apparatus. The advantages afforded by a videosystem which allows independent adjustment of size and height/width proportions were highlighted, and its validity and reliability were examined, based on estimates made by obese, normal weight, and pregnant groups.

The influence of alcohol on judgement of facial expression of emotion.

Despite considerable research into the effects of alcohol on behaviour, there appears to be little information available about the influence of alcohol on interpersonal judgement. An experiment was carried out to test the hypothesis that alcohol would affect subjects' ability to judge facial expressions of emotion. Thirty male and 30 female normal social drinkers were allocated at random to high alcohol, low alcohol or placebo conditions and were shown photographs of faces displaying basic emotions. As predicted, subjects in the high alcohol condition made more errors and subjects in the low alcohol condition fewer errors than subjects in the placebo condition. Accuracy of judgement also varied significantly according to the sex of the subject and the category of emotion being judged. In particular, alcohol was associated with greater impairment of judgements of anger than of other emotions. The clinical implications of the findings are discussed in relation to the association between alcohol and violence, and the use of social skills training with problem drinkers.

Body image: a selective review of existing measurement techniques.

A selective review of studies concerning body image is presented to illustrate the diversity of approaches which have been adopted. Equivocal definitions of the concept of body image and the difficulties inherent in its measurement are examined and the most popular measurement techniques are described and criticized.

Video-feedback and personal attribution in anorexic, depressed and normal viewers.

Video-feedback has been shown to be particularly influential in changing bodily awareness and causal attribution by confronting participants with a concrete 'public' self-image. Body-image disturbance and denial are major aspects of patients suffering with anorexia nervosa. It was predicted that video-feedback should alter these attitudes in this group and result in a more realistic self-appraisal. Anorexics respond to video-feedback with a reduction in self-esteem whereas normal controls displayed an increase in self-esteem and depressed patients perceived themselves negatively both before and after video-feedback. It is concluded that video-feedback may prove to be a useful technique in the treatment of body-image disturbance in anorexic patients.

Orality and smoking.

This study was designed to investigate the relation of orality and smoking, smoking motivation and anticipatory pleasure in smoking. Ninety-seven male and female subjects completed questionnaires designed to elicit information about their motivation and behaviour. Results indicated that difficulty in stopping smoking was positively related to three non-nutriment oral preoccupations. Smoking for psychological as opposed to social reasons was positively related to two-nutriment oral preoccupations. Anticipation of pleasure in smoking before becoming a smoker was negatively related to nutriment orality, positively related to smoking because of a craving, and, for females only, positively to one type of non-nutriment orality. The results are discussed in relation to the role of oral ingestion and the reaction of the central nervous system to the drug.

Errors in decoding tone of voice during dyadic interaction.

Predictions derived from evidence on projection, behavioural assimilation and attribution theory suggest differing ways in which one individual may perceive another's tone of voice in dyadic interaction. Pairs of male subjects undertook a competitive or cooperative counting task. One member of each pair was instructed that he could best influence the dyad's performance by the use of an angry or pleased tone of voice. The results indicate that while subjects in the cooperative condition tended to attribute their own tone of voice to their (neutral) partner, competitive subjects attributed a discrepant or neutral tone. The findings are interpreted in terms of attribution theory. Implications for studies of non-verbal communication are discussed.