Toward Objective, Multifaceted Characterization of Psychotic Disorders: Lexical, Structural, and Disfluency Markers of Spoken Language

Abstract

Psychotic disorders are forms of severe mental illness characterized by abnormal social function and a general sense of disconnect with reality. The evaluation of such disorders is often complex, as their multifaceted nature is often difficult to quantify. Multimodal behavior analysis technologies have the potential to help address this need and supply timelier and more objective decision support tools in clinical settings. While written language and nonverbal behaviors have been previously studied, the present analysis takes the novel approach of examining the rarely-studied modality of spoken language of individuals with psychosis as naturally used in social, face-to-face interactions. Our analyses expose a series of language markers associated with psychotic symptom severity, as well as interesting interactions between them. In particular, we examine three facets of spoken language: (1) lexical markers, through a study of the function of words; (2) structural markers, through a study of grammatical fluency; and (3) disfluency markers, through a study of dialogue self-repair. Additionally, we develop predictive models of psychotic symptom severity, which achieve significant predictive power on both positive and negative psychotic symptom scales. These results constitute a significant step toward the design of future multimodal clinical decision support tools for computational phenotyping of mental illness.