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Biomedical subjects

M Alpert

Publications and source records attributed to M Alpert.

At least 19 recordsLinked to original sources
PubMed2001

Reflections of depression in acoustic measures of the patient's speech.

BACKGROUND: The literature on acoustic measures of voice in depression is reviewed. Authors have separated results derived from studies of automatic speech, such as counting or reading, from free speech. Free speech requires cognitive activity such as word finding and discourse planning in addition to the motor activity of automatic speech. Also, results have been less ambiguous if homogeneous groups of agitated or retarded depressed patients were examined. METHODS: These distinctions are applied to the results of a 12-week double-blind treatment trial that compared response to nortriptyline (25-100 mg/day) with sertraline (50-150 mg/day). Twelve male and ten female elderly depressed patients and an age-matched normal control group (n=19) were studied. Patients were divided into retarded or agitated groups on the basis of ratings. Results from measures of fluency (speech productivity and pausing) and prosody (emphasis and inflection) are described. RESULTS: Depressed patients showed less prosody than the normal subjects. Improvement in the retarded group was reflected in briefer pauses but not longer utterances. There was a trend in the agitated group for improvement to be reflected in the utterance but not the pause measure. CONCLUSIONS: Clinical impressions are substantially related to acoustic parameters. Temporal changes associated with depression appear to reflect the depressed state whereas prosodic features seem to reflect a depressed trait. Acoustic measures of the patient's speech may provide objective procedures to aid in the evaluation of depression. Limitations of the study are discussed.

Aged↗
PubMed2001

Kibbles and bytes.

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Play and Playthings↗
PubMed2000

Prosody and lexical accuracy in flat affect schizophrenia.

To test the hypothesis that flat affect in schizophrenia involves a motor-expressive deficiency, but not an emotional deficiency, we compared the acoustic properties of speech that are used to express emotion with the emotional content of the words. DSM-III-R schizophrenic patients were divided into flat (N=20) and non-flat affect (N=26) groups on the basis of rating-scale scores. Twenty normal subjects also were included. Subjects were recorded on audio tape as they described a happy and a sad experience for about 10 min. The recordings were analyzed acoustically for fluency and for two types of prosody: inflection and emphasis. Words from transcriptions of the recordings were sorted by content analysis software into psychologically meaningful categories; we compared 'pleasure' and 'distress' word categories. Patients with flat affect spoke with less inflection, and were less fluent. However, they were similar to the other groups in the rate at which they used 'pleasure' words to describe happy experiences and 'distress' words to describe sad experiences. The behavioral deficiency in flat affect appears to be restricted to reduced activity in communicative motor channels. Other aspects of emotion processing seem intact.

Adult↗
PubMed2000

How to go to Mars.

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Geological Phenomena↗
PubMed2000

Fire in the sky

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Journal Article↗
PubMed2000

Comparison of sertraline and nortriptyline in the treatment of major depressive disorder in late life.

OBJECTIVE: This study was designed to evaluate the comparative efficacy and safety of sertraline and nortriptyline for the treatment of major depressive disorder in older adults. METHOD: A double-blind, parallel group design was used to compare 210 outpatients, 60 years of age and older, who met DSM-III-R criteria for major depressive episode and had a minimum Hamilton Depression Rating Scale score of 18. The patients were randomly assigned to 12 weeks of treatment with either sertraline (50-150 mg/day) or nortriptyline (25-100 mg/day). RESULTS: The safety profiles of the two treatments were similar except that nortriptyline treatment was associated with a significant increase in pulse rate, whereas sertraline was associated with a nonsignificant decrease. Efficacy of both drugs was similar for both treatments at all time points, with 71.6% (N=53 of 74) of the sertraline-treated patients and 61.4% (N=43 of 70) of the nortriptyline-treated patients achieving responder status by week 12. Time to response was also similar, with more than 75% of the improvement in scores on the Hamilton depression scale having occurred by week 6. Secondary efficacy measures (posttreatment measures of cognitive function, memory, and quality of life) revealed a significant advantage for sertraline treatment. CONCLUSIONS: Primary efficacy measures showed sertraline and nortriptyline to be similarly effective. With secondary outcome measures there was consistent evidence of an advantage for the sertraline-treated group. The clinical impact of these measures on the long-term well-being of elderly depressed patients should be examined in a study of maintenance treatment.

Age Factors↗
PubMed2000

Stress and vulnerability to posttraumatic stress disorder in children and adolescents.

OBJECTIVE: This study examined the experiential factors and interacting vulnerabilities that contribute to the development of posttraumatic stress disorder (PTSD) in children and adolescents. METHOD: Of 100 consecutive referrals to an inner-city child and adolescent psychiatry clinic, 59 had experienced a trauma that qualified as a precipitant of PTSD. For those with trauma, ages ranged from 3 to 18 years (mean=9.9, SD=4.10); 39 (66%) were males. The authors used a series of multiple regression analyses to examine the contribution of demographic characteristics, the nature of the stressor(s), and the role of preexisting clinical signs in the development of PTSD. RESULTS: Twenty-two percent of the 59 children who had been traumatized met full criteria for PTSD, 32% had some symptoms of PTSD but did not meet full criteria, and 46% had no symptoms of PTSD. Witnessing domestic violence or being physically abused predicted severity of PTSD. Children with preexisting aggressive behavior were more likely to be victims of physical abuse. CONCLUSIONS: Traumatic experience interacts with factors in the child and family to contribute to the development of PTSD. Trauma that threatens family integrity appears to make a strong contribution to the development of PTSD. Increased understanding of the factors contributing to PTSD may provide additional opportunities for developing effective interventions.

Adolescent↗
PubMed1999

The relationship between affect expression and affect recognition in schizophrenia.

To examine the relationship between affect expression and affect recognition, we assessed 30 clinically stable, medicated schizophrenic inpatients. Affect expression was assessed using both a standard clinical rating scale (SANS) and a computerized acoustic voice analysis (VOXCOM). Affect recognition was assessed using the Florida Affect Battery (FAB). The schizophrenics' performance on the FAB was impaired, indicating broad deficits in affect recognition (p<0.05). There were no significant correlations between measures of affect expression and affect recognition, suggesting that the expressive impairment in schizophrenia is not related to their ability to discern emotions in others. SANS Inappropriate Affect, however, was negatively correlated with facial affect recognition (p = 0.001), suggesting that raters' impression of inappropriate affect may indicate a failure in the process of affect attunement.

Adult↗
PubMed1999

Emotion in speech: the acoustic attributes of fear, anger, sadness, and joy.

Decoders can detect emotion in voice with much greater accuracy than can be achieved by objective acoustic analysis. Studies that have established this advantage, however, used methods that may have favored decoders and disadvantaged acoustic analysis. In this study, we applied several methodologic modifications for the analysis of the acoustic differentiation of fear, anger, sadness, and joy. Thirty-one female subjects between the ages of 18 and 35 (encoders) were audio-recorded during an emotion-induction procedure and produced a total of 620 emotion-laden sentences. Twelve female judges (decoders), three for each of the four emotions, were assigned to rate the intensity of one emotion each. Their combined ratings were used to select 38 prototype samples per emotion. Past acoustic findings were replicated, and increased acoustic differentiation among the emotions was achieved. Multiple regression analysis suggested that some, although not all, of the acoustic variables were associated with decoders' ratings. Signal detection analysis gave some insight into this disparity. However, the analysis of the classic constellation of acoustic variables may not completely capture the acoustic features that influence decoders' ratings. Future analyses would likely benefit from the parallel assessment of respiration, phonation, and articulation.

Adolescent↗