Papers by Christine Howes
The British journal of psychiatry : the journal of mental science, Jan 19, 2015
BackgroundPsychiatrists' questions are the mechanism for achieving clinical objectives and ma... more BackgroundPsychiatrists' questions are the mechanism for achieving clinical objectives and managing the formation of a therapeutic alliance - consistently associated with patient adherence. No research has examined the nature of this relationship and the different practices used in psychiatry. Questions are typically defined in binary terms (e.g. 'open' v. 'closed') that may have limited application in practice.AimsTo undertake a detailed examination of the types of questions psychiatrists ask patients and explore their association with the therapeutic alliance and patient adherence.MethodA coding protocol was developed to classify questions from 134 out-patient consultations, predominantly by syntactic form. Bivariate correlations with measures of patient adherence and the therapeutic alliance (psychiatrist-rated) were examined and assessed using generalised estimating equations, adjusting for patient symptoms, psychiatrist identity and amount of speech.ResultsP...
Biomedical Informatics Insights, 2013
Previous research shows that aspects of doctor-patient communication in therapy can predict patie... more Previous research shows that aspects of doctor-patient communication in therapy can predict patient symptoms, satisfaction and future adherence to treatment (a significant problem with conditions such as schizophrenia). However, automatic prediction has so far shown success only when based on low-level lexical features, and it is unclear how well these can generalize to new data, or whether their effectiveness is due to their capturing aspects of style, structure or content. Here, we examine the use of topic as a higher-level measure of content, more likely to generalize and to have more explanatory power. Investigations show that while topics predict some important factors such as patient satisfaction and ratings of therapy quality, they lack the full predictive power of lower-level features. For some factors, unsupervised methods produce models comparable to manual annotation.
Behavioral and Brain Sciences, 2016
Mental illnesses such as depression and anxiety are highly prevalent, and therapy is increasingly... more Mental illnesses such as depression and anxiety are highly prevalent, and therapy is increasingly being offered online. This new setting is a departure from face-toface therapy, and offers both a challenge and an opportunity -it is not yet known what features or approaches are likely to lead to successful outcomes in such a different medium, but online text-based therapy provides large amounts of data for linguistic analysis. We present an initial investigation into the application of computational linguistic techniques, such as topic and sentiment modelling, to online therapy for depression and anxiety. We find that important measures such as symptom severity can be predicted with comparable accuracy to face-to-face data, using general features such as discussion topic and sentiment; however, measures of patient progress are captured only by finergrained lexical features, suggesting that aspects of style or dialogue structure may also be important. Professional communication varies widely (McCabe et al., 2013b) and aspects of doctorpatient interaction and language are known to influence outcomes such as patient satisfaction, treatment adherence and health status (Ong et al., 1995; McCabe et al., 2013a). For therapists, automated methods to analyse therapist-client communication are of interest as there is little known about how the quality of communication influences patient outcome. Identifying patterns of effective communication -both in terms of what is spoken about and how it is spoken about -would help guide training of therapists.
A distinguishing feature of dialogue is that contributions can be fragmentary or incomplete. Such... more A distinguishing feature of dialogue is that contributions can be fragmentary or incomplete. Such incomplete utterances may be later completed by another interlocutor. These cross-person compound contributions (CCs) have been hypothesised to be more likely in predictable contexts but the contributions of different sources of predictability has not been systematically investigated. In this paper we present an experiment which artificially truncates genuine contributions in ongoing text-based dialogues, to investigate the effects of lexical, syntactic and pragmatic predictability of the truncation point on the likelihood of one's interlocutor supplying a continuation. We show that what is critical is the actual and presumed accessibility of common ground, and that while people are sensitive to syntactic predictability, this alone is insufficient to prompt a completion.
In ordinary conversation, a Clarification Request (CR) can be posed before a turn is complete:
ABSTRACT Similarities between language and music have tantalised theorists over many years. The p... more ABSTRACT Similarities between language and music have tantalised theorists over many years. The papers of this book explore the case for leaving behind static views of language and music in which they are formally describable independently of their practice, turning instead to the view that both are intrinsically mechanisms for interaction. This is a stance which enables parallelisms between the two to be drawn commensurate with emergent cognitive neuroscience research for music of all types and from all cultures. The papers, written by leading figures in linguistics, music, psycholinguistics, include discussions of how to approach the challenge of modelling structural growth and content for language and music, how to develop and evaluate experimental methodologies for such models, in-depth studies of Indian raga performer-accompanist-audience interactions, Somali sung poetry recitations, and ethnographic studies of language and music interactions.
Previous research shows that aspects of doctor-patient communication in therapy can predict patie... more Previous research shows that aspects of doctor-patient communication in therapy can predict patient symptoms, satisfaction and future adherence to treatment (a significant problem with conditions such as schizophrenia). However, automatic prediction has so far shown success only when based on low-level lexical features, and it is unclear how well these can generalise to new data, or whether their effectiveness is due to their capturing aspects of style, structure or content. Here, we examine the use of topic as a higher-level measure of content, more likely to generalise and to have more explanatory power. Investigations show that while topics predict some important factors such as patient satisfaction and ratings of therapy quality, they lack the full predictive power of lower-level features. For some factors, unsupervised methods produce models comparable to manual annotation.
In this paper we examine how people negotiate, interpret and repair the frame of reference (FoR) ... more In this paper we examine how people negotiate, interpret and repair the frame of reference (FoR) in free dialogues discussing spatial scenes. We describe a pilot study in which participants are given different perspectives of the same scene and asked to locate several objects that are only shown on one of their pictures. This task requires participants to coordinate on FoR in order to identify the missing objects. Preliminary results indicate that conversational participants align locally on FoR but do not converge on a global frame of reference. Misunderstandings lead to clarification sequences in which participants shift the FoR. These findings have implications for situated dialogue systems.
Advances in Interaction Studies, 2013
As much empirical work attests, people have a reliable tendency to match their conversational par... more As much empirical work attests, people have a reliable tendency to match their conversational partner's body movements, speech style, and patterns of language use -amongst other things. A specific version of this tendency, Structural priming, which occurs when prior exposure to a particular linguistic structure facilitates one's subsequent processing of the same structure, has gained widespread acceptance. propose that cross-person structural priming is a basic mechanism of conversational coordination -part of an automatic, resource-free alignment mechanism that is the basis for all successful human interaction. We present evidence to the contrary from two analyses of a corpus of ordinary conversation. The first suggests that the level of structural (syntactic) matching is no different from chance, and the second that the observed statistical correlation between prime form and target form may be entirely associated with repetition of lexical form.
A distinguishing feature of dialogue is that more that one person can contribute to the productio... more A distinguishing feature of dialogue is that more that one person can contribute to the production of an utterance. However, until recently these 'split' utterances have received relatively little attention in models of dialogue processing or of dialogue structure. Here we report an experiment that tests the effects of artificially introduced speaker switches on groups of people engaged in a task-oriented dialogue. The results show that splits have reliable effects on response time and on the number of edits involved in formulating subsequent turns. In particular we show that if the second half of an utterance is 'misattributed' people take longer to respond to it. We also show that responses to utterances that are split across speakers involve fewer deletes. We argue that these effects provide evidence that: a) speaker switches affect processing where they interfere with expectations about who will speak next and b) that the pragmatic effect of a split is to suggest to other participants the formation of a coalition or sub-'party'.
Research on co-speech gestures has primarily focussed on speakers. However, in conversation non-s... more Research on co-speech gestures has primarily focussed on speakers. However, in conversation non-speaking addressees can also gesture. Often this is to provide concurrent feedback such as backchannels but sometimes it involves gestures that relate to the specific content of the speaker's turn. We hypothesise that non-speakers should contribute most actively during clarification sequences i.e. at the moments when mutual-understanding is threatened. We test this hypothesis using a corpus of story-telling dialogues, captured using video and motion capture. The results show that during clarification sequences speaker and non-speaker behaviours tend to merge. Non-speakers in particular move their hands faster and produce more than twice as many content-specific specific gestures in overlap with speaker turns. These results underline the collaborative nature of conversation, the strategic importance of non-verbal resources for sustaining mutual-understanding and the critical role of cl...
In conversation, interlocutors routinely indicate whether something said or done has been process... more In conversation, interlocutors routinely indicate whether something said or done has been processed and integrated. Such feedback includes backchannels such as 'okay' or 'mhm', the production of a next relevant turn, and repair initiation via clarification requests. Importantly, such feedback can be produced not only at sentence/turn boundaries, but also sub-sententially. In this paper, we extend an existing model of incremental semantic processing in dialogue, based around the Dynamic Syntax (DS) grammar framework, to provide a low-level, integrated account of these phenomena, demonstrating that they can be accounted for as part of the semantic processing mechanisms rather than as higher level pragmatic phenomena or as an " unofficial " part of the conversation. Specifically, we show how backchannels, clarification requests and their responses can be parsed and generated incrementally in context, using only the core semantic structure-building mechanisms o...
Similarities between language and music have tantalised theorists over many years. The papers of ... more Similarities between language and music have tantalised theorists over many years. The papers of this book explore the case for leaving behind static views of language and music in which they are formally describable independently of their practice, turning instead to the view that both are intrinsically mechanisms for interaction. This is a stance which enables parallelisms between the two to be drawn commensurate with emergent cognitive neuroscience research for music of all types and from all cultures. The papers, written by leading figures in linguistics, music, psycholinguistics, include discussions of how to approach the challenge of modelling structural growth and content for language and music, how to develop and evaluate experimental methodologies for such models, in-depth studies of Indian raga performer-accompanist-audience interactions, Somali sung poetry recitations, and ethnographic studies of language and music interactions.
Patients with schizophrenia have difficulties interacting with others, but the nature of this def... more Patients with schizophrenia have difficulties interacting with others, but the nature of this deficit is unclear. A critical feature of successful social interaction is coordination between speech and movement. The current study employed 3-D motion capture techniques to assess coordination between patients' hand movements and speech during live interaction. Compared to controls, patients displayed reduced coordination between their own speech and hand movement. Healthy participants interacting with the patient also appear to adopt this pattern but to a lesser extent. Patients' coordination deficits may underlie their social difficulties and contribute to their social exclusion.
In natural conversation people sometimes build larger grammatical, semantic and pragmatic units o... more In natural conversation people sometimes build larger grammatical, semantic and pragmatic units out of multiple turns or installments. The incremental and collaborative character of these 'compound contributions' presents challenges for theories of natural language processing. Compounds produced over successive turns by one person have often been analysed in essentially the same way as compounds produced by multiple people. In some recent accounts this putative equivalence has been taken as evidence for the claim that within-and cross-person language processing are fundamentally interchangeable. However, in this paper we present an analysis of compound contributions in a corpus of ordinary dialogues which shows that same-and crossperson compound contributions are constructed in different ways and have different semantic and pragmatic effects on the organisation of dialogue. In particular, we show that they differ in the pragmatic environments in which they occur and that they have different consequences for subsequent turn-taking and interpretation. This asymmetry highlights the need for models of dialogue that account for not just the inherent incrementality of dialogue, but the different status of each contributor towards a turn-in-progress.
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Papers by Christine Howes