Fidgeting Behavior During Psychotherapy: Hand Movement Structure Contains Information About Depressive Symptoms

Katharina C H Reinecke,Daniela Dvoretska,Hedda Lausberg,Peter Joraschky

doi:10.1007/s10879-020-09465-5

Abstract

Fidgeting may be a motor sign reflecting self-regulation processes in patients with social anxiety disorder (SAD) and depressive patients. Since SAD co-occurs with comorbid depression, the question arises whether fidgeting is a disorder-unspecific phenomenon or a specific and therefore diagnostically relevant sign of depression. 33 SAD patients with (n = 12) and without (n = 21) depression from the Social Phobia Psychotherapy Research Network project were compared regarding their nonverbal behavior. Four video sequences of a psychotherapy session with each patient were analyzed using a standardized system for the analysis of nonverbal behavior by two independent, certified, blind raters. SAD patients with comorbid depression exhibited significantly more (number/minute) irregular movements, but fewer (number/minute) repetitive movements than SAD patients without depression. Irregular movements, which reflect less structured motor behavior, are associated with comorbid depression in SAD. In contrast, in SAD without depression, more structured repetitive movements were prominent. Thus, irregular movements represent a diagnostically relevant behavior for comorbid depression among SAD patients.

Highlights

In outpatient psychotherapy, adopting a new perspective and seeing oneself from the observer’s point of view by employing self-observation (Koffert et al 2019) can be helpful
We calculated a MANOVA for the frequency of hand movements for the Structure category due to the interdependent nature of the dependent variable, the between-subjects factor “group” and the within-subjects factor “hand”
social anxiety disorder (SAD) patients with comorbid depressive symptoms did not differ in overall movement activity from SAD patients without comorbid depressive symptoms

Summary

Introduction

In outpatient psychotherapy, adopting a new perspective and seeing oneself from the observer’s point of view by employing self-observation (Koffert et al 2019) can be helpful. Therapists take on the observer’s point of view by focusing their attention on their patients. Therapists focus on the verbal content and on their patients’ nonverbal behavior. Fidgeting is a prominent observable movement behavior in patients with social anxiety disorder (SAD) and persons with subclinical social anxiety and arousal. Fidgeting has been linked to stress and arousal in healthy persons (Densing et al 2018). Heerey and Kring (2007) identified a socially anxious group and a non-socially anxious group in a student sample. During an interview situation with a stranger, individuals in the socially anxious group displayed increased fidgeting

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Conclusion