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Computer methods for the study of psychiatric interviews
C o m p u t e r M e d m d s for the Study o f l:%ychiatric |nl.erviews B!f .]oIlx A. S'I°AllK'~,VF'.ATIH!;I'I
C O M P U T E I I h a s a l r e a d y s h o w n itself to be, a p o w e r f u l a n d v e r s a t i l e , a s s i s t a n t to m a n y k i n d s of r e s e a r c h cfforts w h i c h focus on i n t e r v i e w s . S o m e i n v e s t i g a t o r s h a v e u s e d t h e c o m p u t e r as a s t a t i s t i c a l a s s i s t a n t for t h e n n a t y s i s of d a t a d e r i v e d f r o m h i m } a n juclgm~enl a b o u t i n t e r v i e w i n t e r a c t i o n . O t h e r s h a v e u s e d its logical b u t n o n - n u m e r i c a l capacitic;s for l a r g e s c a l e clerical tasks p r e l i m i n a r y to s u c h mmlysis. An e x a m p l e of this is t h e c o u n t i n g of w o r d s or p h r a s e s from v e r b a t i m t r a n s c r i p t s , a procx~,ss w h i c h m a y d e m a n d m a p y m i l l i o n s of s y m b o ] i c c o m p a r i s o n s . 13y d e v e l o p i n g i n c r e a s i n g l y c o m p l e x m e t h o d s for t h e h a n d l i n g of l a n g u a g e c o n t e n t , s o m e investigat(~rs h a v e b e g u n to s i m u l a t e eith(,r one or botli sides of t h e psyc-hia t t i c intervi,:w. T h e y h a v e d e v e l o p e d m o d e l s w i t h o b s e r v a b l e o u t p u t w h i c h c a n be f u r t h e r s t u d i e d for r e s e m b l a n c e to a c t u a l interviews, a n d to t h t ~ r e t i c a ] e x p e c t a t i o n s . T h e incre!tsing atfilitv of c o m p u t e r s to i n t e r a c t w i t h t r u m a n u s e , s in a c o n v e r s i o n a l f a s h i o n h a s p r o m p t e d use of t h e c o m p u t e r as a c o n v e r s a tional p a r t n e r i~ an a c t i v e m o d e l i n g process. All t h e s e m e t h o d s u s e t h e c o m p u t e r to s t u d y t h e v e r b a l c o n t e n t of w h a t t r a n s p i r e s in c o n v e r s a t i o n a l i n t e r a c t i o n . \ V e k n o w t h a t t h e r e is also a cons i d o r a b l c a m o u n t of i n f o r m a t i o n t r a n s f e r a e c o m p ] i s l m d in a f a c e - t o - f a c e i n t e r view t h r o u g h g e s t u r a l a c t i v i t y , facial e x p r e s s i o n , a n d vocal c h a n g e s in voice (tualit.v. T h e s e eSn sigmal i n d i c a t i o n s of t h e e m o t i o n a l s t a t e of t h e s p e a k e r and i n f l u e n c e the. i n t e r p r e t a t i o n of tim r e l a t e d v e r b a l c o n t e n t . S t u d i e s w h i c h a t t e n a p t a q u u n t i t a t i v e v i e w of t h e s e o t h e r c h a n n e l s of c o m m u n i c a t i o n h a v e a ] s o f o u n d a nc~
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R a t h e r t h a n deal w i t h all of t h e v a r i a b l e s ' e x i s t i n g ha a ] i r e s i t u a t i o n , many" i n v e s t i g a t o r s h a v e r e c o r d e d t h e v e r b a l p r o d u c t i o n s of a n mtermx" a n d t a k e n t h e f u r t h e r .,;tel) of p r e p a r i n g v e r b a t i m trm~seripts of s u c h r e c o r d i n g s . T h e t a p e r e c o r d i n g e l i m i n a t e s t h e visual cues r e l a t e d to g e s t u r e a n d facial c,xpression w h i l e t h e t y p e d t r a n s c r i p t f u r t h e r e l i m i n a t e s cues f r o m vocal t ' x p r e s s i o n wtfich m a y c a r r y a c o n s i d e r a b l e p a r t of t h e m e a n i n g . C o n t e n t JoHx A. S'r.~t~KWt-:.-xTHV:m l'H.l).: Protc,s'sor o! Medical l'.s.~chohyat3; Unicc.r.s'ittt of C a l f /or,Ha .qchr,tff of ~lcdici,~e, and Coorditmtor o/ lnfl,rmation St.l.vtcms, gnit'cr.vit!l o / C a l i [ o r n i a 3lcdical Center, San Francisco, Cali[ornia. l'rcparation o] thi.s" paper teas SUl~por&'d in par! b!t Grant FR-O0122. U.SI Public [T¢;alth Scr~rice; a m l C o . t r a c t s :\'0NR-3656(28). O]!ice o[ Nat:al Research, I)A--19-193-MD2711. U.S. Arm!l 31cdical Rcscarch and ])ct:trlolln,cnt Comtnand, and U S I ) I I E I V - O E - 6 ,-*o~. U.S. O~/ce oj t'2ducation. Palwr prte.scnted at th," .\'alional Con[crg'nce on Contc,,t Analusis, T h e Anncnhertz School ~,/ Comrn,micati(m.v, Uniccr.s'it9 of Pcnn.w.lh'ania, Phih,dcltd*ia, Wot'ember, 1967. 509
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analysis, t h e r e f o r e , implies a r e s t r i c t i o n of i n | o r m a t i o n :available to t h e a n a l y s t , Even at this p o i n t , h o w e v e r , s t u d i e s differ w i d e l y in the d e g r e e to whic}t m e t h o d s a r e ol)jec/ive a n d q u a n t i t a t i v e . \V|~ilc a t r a i n e d ana~lvs! can be, i n t u i t i v e a n d i n s i g h t f u l , q u a n t i t a t i v e m e t h o d s mtLv m i n i m i z e his 1)ias a n d l e a d to s t u d i e s w h o s e c o n c l u s i o n s m a y 1)e mort- r e a d i l y r e p e a t e d by others. S u c h m e t h o d s a r e also m o r e likely to a l l o w t h e use of c o m p u t e r p r o g n u n s a n d the p o s s i b i l i t y of i n c r e a s i n g l h e a s s i s t a n c e froni c o m p u t e r m e t h o d s . A v a r i e t y of a p p r o a c h e s to c o n t e n t a n a l y s i s m a y b e f o u n d d i s c u s s e d in a c o l h , c t i o n ()t: p a p e r s e d i t e d b v Pool in 1959, A r e v i e w of these p a p e r s to(lay is l i k e l y to s u g g e s t m a n y Ol)t)ortuniti(~s f o r the a p p l i c a t i o n of c o m p u t e r m e t h ~ d s . \ V h i l e m o s t c o n t e n t a n a l y s i s s t u d i e s h a v e f o c u s e d on w h a t is l)eing comn m n i e a t e d , s o m e h a v e b e e n c o n c e r n e d w i t h i d e n t i f i c a t i o n of a s p e a k e r or it writer. Kxtensive w(~rk w h i c h uses a v a r i e t y ot: c o m p u t e r meth(~ds .l~as |)emi d o n e in c e r t a i n cases of d i s p u t e d a u t h o r s h i p (.Xlostelcr, 196,1). \ V h e n kn(~wn d o c u m e n t s a r e availal)le from t w o p o t e n t i a l writers, i n d i c e s o|" w o r d visage m a y be p o s s i b l e to d e f i n e w h i c h will h e l p to classify u n k n o w n w r i t i n g s as m o r e likely: p r ( ~ l u c e d b y o n e o r t h e o t h e r a u t h o r . Nlore o{ten, in ~luantitative a p p r o a c h e s to c o n t e n t analysis, a u n i t of w r i t i n g or oi" s p e e c h , u s u a l l y w o r d s or s e n t e n c e s , is j u d g e d ~cs f a l l i n g i n t o speei[ie c a t e g o r i e s such as w o r d s w h i c h s ~ g g e s t hapl)iness, worcls w h i c h s u g g e s t a c'onccrn a b o u t | m a l t h , clc. It is a s s u m e d t h a t | w s t u d y i n g t h e r e l a t i v e fr('(luency of o c c u r r e n c e of suc]~ t y p e s of units, a n e w a n d lls(,t'ul d e s c r i p t i o n of a d()clm~ent m a y t)e f o r m e d . A c o m p u t e r p r o g r a m w h i c h has p r o v e n us~,ful to at n u m l ) e r of i n v c s t i g a t ~ r s wi.',h c o n t e n t a n a l y s i s p r o b l e m s is th(, ( ; e n e r a l I n ( / ~ i r e r (SlolJc r t al.. 198-): S!one, 19GG). T h e progn-am e x p e c t s text a r r a n g e d as seuten('es, a n d e x a m i n e s this text w i t h leflre'' • ,vlct', to a d i c t i o n a r y of w o r d stems, a d i c t i o n a r y w l d e h has b e e n d e v e l o p e d to m a k e useful classifications in a p a r t i c u l a r urea of stlltly. P h i l l i p Stone. the o r i g i n a t o r of t h e ( ; e n e r a l I n q u i r e r , e a r l y d e v e l o p e c ' a dietionaD" for p s y c h i a t r i c m a t e r i a l . I n p u t to t h e G, n t r a l I n q u i r e r is u s u a l l y p r e - e d i t e d b y c o d i n g for s y n t a x posititm of e a c h w o r d w i t h i n t h e s:mtenee. I n t h e ea.,~e of v e r b a l i m t r a n s c r i p t s , the unit of a s e n t e n c e is not a l w a y s well d e t i n e d a n d q u a n t i t a t i v e m e t h o d s for t h e s t u d y of t r a n s c r i p t s of s p o k e n m a t e r i a l h a v e t e n d e d to focus u p o n w o r d usage, p a r t l y in o r d e r to a v o i d t h e p r o b l e m s of s e r a m l ) l e d syntax. "l'xxt~ a p p r o a c h e s to this t y p e w e r e r r p o r t e d in 1964 ( H a n v a v & l k e r . 1964: S t a r k w e a t h e r & I)t'ck(-r, 1,964). T h e a p p r o a c h deseril)pd l)v S t a r k w e a t h e r a n d 1)eeker ,,,,'ill 1)e d i s c u s s e d l)rietly here. T h e c o m p u t e r is v i e w e d as m! accurat(" a n d Tmtiring clerk assisting in the d e v e l o p m e n t o | a special d i e t i ( m a r v w h i c h a p p l i e s (rely to tim wor(1 tlsagc of an i n d i v i d u a l p a t i e n t . T h e i n p u t to this lmJsaram is n a t u r a l l a n g u a g e p u n c h e d o n t a b u l a t i n g c a r d s a n d t h e b a s i c otltpllt is ,t v o c a b u l a r y listing w h i c h is o r g a n i z e d 1)v d e c r e a s i n g w o r d ltsage a n d is a l p h a l m t i z e t l w i t h cac'|~ levpl ~Jr usage. It has b e e n useful, in w o r k i n g w i t h rcx.orded inter,~iews, to i n c l u d e c e r t a i n s o u n d s - - s u c h as a c o u g h - - a s s p e c i a l w o r d s w h i c h will not be conf, lsed w i t h t h e l a n g u a g e of t h e p a t i e n t . VChcn the pro.at,ram operatt,s ,tin a l a r g e amo~mt of a t)atient's l a n g u a g e it pr(~duecs an ~ r g a n i z e d suture;an" whicl! rcl)rt.s~nts ])is Iota| v o c a h u l a r y u s a g e in ,ha_ i n l r r v i e w situatiov~. Such at sun~-
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~narv m a y i n d i c a t e q u i t o a d i f f e r e t t t level of c'(mll)etenc'e frown a m e a s u r e of v o o a l ) u l n r v kl~oxvledgt, as o b t a i t m d f r o m a test. A n e x a m p l e p r t - s c ~ t e d 1W Starku'ei~tl~el" and D e c k e r r e s u l t e d f r o m 1:2 h o u r s (~f i n t e r v i e w s , a n d s h o w s t h a t l h e p a t i ( ' n t u s e d a i ) l ) r o x i l n a t e l y 2,000 d i f f e r e n t w o r d s in t h e e o l l r s e of s p e a k i n g ".~0,000 t o t a l w o r d s . I'n o r d e r to a n a l y ' z e t h c s ~ illtt,rviews, h u m m i c l i l d e a l j u d g m e n t w a s lised to d e v e l o p w o r d lists w h i c h s e e m e d a p p r o p r i a t e to g r o u p [ r o m t h e l a n g u a g e of t h e s p e c i f i c p a t i e n t . A l t h o u g h this d e v e l o p m e n t of lists w a s a n o n - p r o g r a m m e d s t e p i~l t h e prt~ceduro, w e c a n lncz~tion s e v e r a l u s e f u l r a t i o n a l e s w h i c h w e r e I~ept in mil~d. T h e r e a r e diff,,:rent ~ r a m m a t i e a l f o r m s of tile s a m e w o r d whic, h w e r e groul~t.d w h e n t h e ~ll'e~l lit" ll]('alllill~.~r s ( ' e l l l e d al)pr()priatc'. A p p a r e n t synotLvms w e r e g r t m p o d in o r d e r to e t n m t w()rds as a l t e r n a t i v e e x p r e s s i o n s w h i c h s e e m to i n d i ( : a l e s i t n i l a r m e a n i n g . In a d d i t i o n t h e r e a r e w o r d s w h i c h m a y a p p e a r it~ m o r e t h a n ~)ne c o n t e x t a n d l~e u s e d w i t h m o r e t h a n o n e m e a n i n g , If w e a r e i l l t e r e s t e d in jlist One of t h e s e n l e a n i n g s , it is p o s s i b l e to f o r m a list" w h i c h il~cllzmlt's w o r d s w h i c h t e n d to a p p e a r \ v i t h it w h e n t h a t m e a n i n g is l)rest'nl. T h e t o t a l ( ' o t t n t t ~ r sllel~ a list w i l l t h e n e m p h a s i z e t h i s m e a n i n g m o r e t h : a l o t h e r s . T h e o r g a n i z o ( l t a l l y of \'oeal~daD" a c t u a l l y u s e d is a c o n ,,,ideral~le a i d in p r o d u c i n g s u c h lists. It e m p h a s i z e s w o r d s v c l l i d l a r e h e a v i l y usctl so t h a t t h e ¢ x m s t r t m t i o n of a s p e c i a l i z e d dictionary" w i l l m a x i m i z e u s e ~t' tltt, avaih~l)h, d a t a . T h e next s t e p i~ this a t m l y s i s w a s to d e c i d e u p o n a size o f v e r b a l s a m p l e t~ ust" as a s i n g l e o b s e r v a t i o n . T h e c h o i c e of s a m p l e s i z e s h o u l d s t r i k e a t m l a n c t , 1)t'tween a n a l ) p r o p r i a t e t o t a l n u m t ~ c r o~" Se¢luential o b s e r v a t i o n s a n d a s u t l i c i e n t sizt, [or e a c h s a m p l e w i t h i n w h i c h xx'¢, w o u l d o b t a i n u s e f u l c m m t s ~t" t h e O C C l l l ' r e l l { ' l , o f v e e r ( I s ill t h e lists. By nsit~g s u c c e s s i v e s a m p l e s of °O0 ,a'ords e a c h , t h e a n a l y s i s prodt~c.ed t-rein 1{} to 25 s a m p l e s f r o m e a c h i n t e r v i e w h o u r . T h e cornets [~)r w o r d oeetn'l'enct" ovt t,ach lint w e r e r e c o r d e d in a form a P l ) r o p r i a t t - a s i n p u t to s t a t i s t i c a l p r o g r a m s . T h e m e t h o d of f a c t o r att,alvsis w a s t h e n a p p l i e d to t h e r a t e of o c c u r r e n c e .~,t w o r d s in t h e lists of r e l a t e d w o r d s . S p e c u l a t i v e l a b e l s sucla as " d e n i a l " a n d " s e l f - a g g r e s s i o n ' " w o r e a p p l i e d to f a c t o r s p r ~ d u c o d f r o m s u c h a n a l y s i s , a n d it p r o v e d i n t e r e s t i n g t¢~ g r a p h t h e x-aria!ion of f a c t o r s c o r e s so p r o d u c e d o n s u c c e s s i v e s m n p h . s of t h e o r i g i n a l x'erlml m a t e r i a l . T i m o v e r a l l p r o c e d u r e sh,,~ws s o m e p o t e n t i a l in a l l o w i n g us to folloxv s h i f t s in t o p i c s a n d c o n c e r n s t h r o u g h tht, c o m ' s c of l ) s y c h o t h e r a p y . It c a n p r o v i d e a n o t h e r m e a n s to t r a c k c h a n g e s in the t , n m t i o n a l s t a t e of at p a t i e n t as t h e s e c h a n g e s a r e expre.ssed in w o r d u s a g e . A r e v i e w ot s p e c i f i c v e r b a l s a m p l e s w h i c h r e s u l t e d in e s l ) e e i a l l y h i g h f a c t o r s c o r e s ~,n f a c t o r s l i k e "'st-lf-a~gression" s h o w a h i g h f a c e v a l i d i t y r e l a t e d to t h e c o n c e p t . T h a t is. p a s s a g e s s e l e c t e d tLv t h e f a c t o r a n a l y s i s d o i n d e e d r e a d as thou~l~ t h e f a c t o r is especially" rt,levant. C a s e s t u d i e s w h i c h h a r t , c,oml~int'd t h i s a n a l y s i s a p p r o a c h w i t h a s t u d y of o t h e r c . o m m t m i e a t i o n c h a n n e l s sugges~ t h a t tim ~ t t m n t i t a t i v e a p p r o a e l i to v e r b a l e ( m t e n t a n a l v s i s is o f t e ~ e o m p l e ~ n c ~ t a r y t¢~ ~ t l m r i n f o r m a t i o n a n d it m a y l)t, l ) a r t i e ~ d a r l y t~st.ful w i t h i t M i v i d u a l p a t i m f l s w h o ( h ' m o t ~ s t r a t e ¢.motit~ml c h a n g e p r i m a r i l y in t h e i r l a l | Z u a ~ o ¢'~mt~'tlt.
5 1 -°. -
J O I I N A. STAltKV~'EA'rltl,.'I! ANALYSIS OF I:[ECOIIDED V O C A L AND N O N V E R B A L [N'FERVIEXV BEHAVIOIi
As m e t h o d s h a v e d e v e l o p e d w h i c h a r e m o r e q u a n t i t a t i v e a n d w h i c h rely less u p o n clinical j u d g a n e n t or r a t i n g s for the i n t e r p r e t a t i o n of v e r b a l eonterlt~ similar d e v e l o p m e n t s h a v e t a k e n p l a c e in the analysis of vocal a n d nonv e r b a l i n f o r m a t i o n . T h e r e are s o m e w h o feel t h a t l a n g u a g e c o n t e n t is m o r e r e a d i l y a v a i l a b l e for s t u d y a n d t h a t p a r a l a n g u a g e f e a t u r e s a r e usually" r e d u n d a n t in t h e i n f o r m a t i o n w h i c h t h e y c a r r y a b o u t e m o t i o n a l state. Situations can b e p o i n t e d out, h o w e v e r , ira w h i c h m e s s a g e s c a r r i e d b y vocal vs. v e r b a l or b y g e s t u r e s vs. Verbal c h a n n e l s a r e c l e a r l y d i s c r e p a n t . In a d d i t i o n . t h e r e is the possibility t h a t clever logical naach,.'nery; of w h i c h the c o m p u t e r is t h e p r i m e e x a m p l e , can m o r e easily a n a l y z e c h a r a c t e r i s t i c s of vocal expression a n d its relations to e m o t i o n a l s t a t e t h a n it cam c a n t o u t the c o m p l e x linguistic analysis of v e r b a l content. R e v i e w s a r e a v a i l a b l e w h i c h s u m m a r i z e a n d c o m m e n t on i n v e s t i g a t i o n s of vocal } r a n s f e r of i n f o r m a t i o n ( K r a m c r . t963. S l a r k w e a t h e r ; 1961; S t a r k w e a t h e r , 1964). X,lany- of the studies r e v i e w e d are j u d g m e n t a l in n a t u r e . It is c l e a r t h a t j u d g e s w h o a r e a b l e to reeog.q~ize e m o tional s t a t e of a s p e a k e r f r o m vocal cues d e p e n d u p o n c h a n g e s in pitch, rate, v o h n n e a n d o t h e r p h y s i c a l eh.taracteristies of t h e voice, b u t t h e y lack a consistent way- to d e s c r i b e t h e s e qualities. T h e d e v e l o p m e n t of c o m p u t e r m e t h o d s will r e q u i r e objective m e a s u r e s in this a r e a . V a r i o u s c o m b i n a t i o n s of o b j e c t i v e m e a s u r e s , i n c l u d i n g s p e e c h timing, rate. pitch, a n d m e a s u r e m e n t s of t h e f r e q u e n c y s p e c t r u m , h a v e a p p e a r e d to bo r e l a t e d to t h e s p e a k e r ' s p e r s o n a l i t y a n d e m o t i o n a l s t a t e in i n d i v i d u a l studies. I n v e s t i g a t o r s h a v e u s e d a v a r i e t y of m a c h i n e s a n d t e c h n i q u ( ~ to m e a s u r e a e o u s t i e a l dim~:,~sitms of the voice a n d h a v e e x p l o r e d the r e l a t i o n s h i p of t h e s e m e a s u r e s to s p e a k e r attribl~tes. It is dittqcult to r e l a t e the r e s u l t s of t h e s e studies to a d e s c r i p t i o n of e o m m m t i e a t i o n b e t w e e n a s p e a k e r a n d a h u m m a listener. h o w e v e r , b e c a u s e s u c h a c o u s t i c a l m e a s u r e s h a v e not i m i t a t e d t h e p r o c e s s i n g of vocal i n f o r m a t i o n b y h u m a n s . T i m e - a v e r a g e d sp.eetra of voice, for e x a m p l e , a r e p r o b a b l y u n l i k e a n y d a t a p r o c e s s e d b y a listener, since a p e r s o n is m o r e likely to a t t e n d to m o m e n t a r y , shifts in i n t o n a t i o n . S u c h d a t a . n e v e r t h e l e s s , h a v e b e e n s h o w n sensitive to t h e i d e n t i t y of d i f f e r e n t s p e a k e r s , to clinie~dly p e r c e p t ible v a r i a t i o n s in a s p e a k e r ' s m o d e of talking, to d a i l y c h a n g e s i n m o o d indic a t e d b y self r e p o r t or b y observers" ratings, a n d to v a r i a t i o n s in voice w h i e h a c c o m p a n y o b v i o u s e m o t i o n a l events. S u c h d a t a a r e p r o d u c e d b y p a s s i n g at voice signal t h r o u g h a set of d i s c r i m i n a t i n g b a n d - p a s s filters. O n e m a y then m e a s u r e t h e s o u n d e n e r g y for e a c h p o r t i o n of the a u d i b l e f r e q u e n c y s p e c t r u m a n d aw.'rage s u c h e n e r g y o v e r successive p e r i o d s of time, w i t h e a c h p e r i o d sufficiently long to eonta/a~"an i n t e g r a t e d s a m p l i n g of v e r b a l content. O n e can thus a t t e m p t t h e analysis of s p o n t a n e o u s s p e e c h ( w h e r e t h e r e is n o c h a n c e to c o n t r o l t h e v e r b a l c o n t e n t or m a k e it identical f r o m o n e s a m p l e to t h e next. ) A n indivqdual s p e a k e r m a y h a v e a c h a r a c t e r i s t i c use of t h e f r e ( t u e n e y s p e e t n l m as i n d i c a t e d b y s u c h a v e r a g e d d a t a , h u t s u c h d a t a m a y b e q u i t e d i t f e r e n t f r o m those a v a i l a b l e to a listener w h o h e a r s e v e r y v a r i a t i o n in p i k ' h as it occttrs. C h a n g e in tim f r e q u e n c y distril)ution of ,,'()ice e n e r g y can b e v i e w e d as a pot e n t i a l l y usefld m e a s u r e to i n d i c a t e c h a n g i n g m o o d for p s y c h i a t r i c p a t i e n t s ,
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p a r t i c l d a r l y those w i t h a n affective d i s t u r b a n c e . T h e o u t p u t of s o u n d e n e r g y f r o m it m a t c h e d set of a c o u s t i c filter.~ can b e r a p i d l y s a m p l e d 1)y a h i g h s p e e d m u l t i p l e x e r a n d a n a l o g - d i g i t a l c o n v e r t e r c o n n e c t e d to a d i g i t a l 9 o m p u t e r . T h i s p r o v i d e s p r o b a b l y the m o s t v e r s a t i l e a r r a n g e m e n t for t h e f u r t h e r analysis of such spectrum information. A t t e m p t s to a n a l y z e g e s t u r e a n d facial e x p r e s s i o n h a v e f a c e d h ) r m i d a b l e lmrriers in m o v i n g t o w a r d o b j e c t i v e m e a s u r e m e n t . S o m e success h a s a p p e a r e d in the u s e of m a c h i n e s to aid in t h e efficient p r e s e n t a t i o n o f p h o t o g r a p h i c inf o r m a t i o n to j u d g e s for r a t i n g a n d for the c o m p a r i s o n of one s a m p l e w i t h a n o t h e r . E q u i p m e n t is e n r r e n t l y u n d e r d e v e l o p m e n t to control t h e logic of s u c h p r e s e n t a t i o n b y digital c o m p u t e r , a n d to tlse t h e c a p a b i l i t i e s of v i d e o t a p e for p l a y b a c k of h o t h s o u n d a n d m o t i o n ( E k m a n , 1967). ~[ODELIN(; OF
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T h e c o m p u t e r h a s a p p e a l e d to s o m e i n v e s t i g a t o r s as a p o w e r f u l d e v i c e f o r s i m u l a t i n g t h e i n f o r m a t i o n p r o c e s s i n g w h i c h ties b e h i n d o b s e r v a b l e a s p e c t s of t h e clinical i n t e r v i e w . \ V e e x p e c t a c o m p u t e r s i m u l a t i o n to m a k e explicit in s y m b o l i c form s o m e o p e r a t i o n a l a s p e c t s of a t h e o r y , a n d the p r o g r m n s l m u ] d c o n t a i n v a r i a b l e s a n d m e c h a n i s m s w h i c h e x e m p l i f y t h e theory,. A n e a r l y att e m p t to b u i l d this k i n d of a p r o g r a m is d e s c r i b e d t)y Colt)}, ( i n T o m l l k i n s mid 51¢~sick. 19(~3). T h e s a m e v o h l m e c o n t a i n s o t h e r e x a m p l e s of c o m p u t e r use w h i c h a r e of interest in this c o n n e c t i o n . C o l b y set h i m s e l f t h e t a s k of w r i t ing p r o g r a m s to s i m u l a t e the t r e a t m e n t of n e u r o s e s b y p s y c h o t h e r a p y , in s u c c e e d i n g p a p e r s (1964a, 1964b. 1965) he d e s c r i b e d t h e e l a b o r a t i o n of t h e s e a t t e m p t s to d e v e l o p a p r o g r a m m e d m o d e l w h i c h w o u l d r e p e a t cycles of conflict, anxiety, a n d t h o u g h t distortions a n a l o g o u s to a n e u r o t i c process. T h e p r o g r a m c o n t a i n s v a r i a b l e s c a l l e d "'beliefs," e a c h of w h i c h has a t t r i b u t e s w h i c h m a y conflict w i t h o t h e r beliefs. T h e progTam p r o v i d e s f o r c o m p a r i s o n s betaveen beliefs. As a result of s u c h c o m p a r i s o n s , an o u t p u t sentence, is p r o d u c e d w h e n ~,. belief h a s b e e n s e l e c t e d b y a r a n d o m p r o c e s s a n d h a s a v o i d e d conflict in c o m p a r i s o n s w i t h o t h e r beliefs. W h e n conflict occurs, o t h e r m e c h a n i s m s c o m e into play-, a n d t h e s e t r a n s f o n n t h e p o t e n t i a l o u t p u t a n d c r e a t e s n e w beliefs in t h e d a t a pool. T h i s b r i e f d e s c r i p t i o n does an injt,stice to t h e i n g e n u i t y a n d complexity" of t h e p r o g r a m a n d t h e r e a d e r is r e f e r e d to C o l b y , 19641) for a c o m p l e t e d e s c r i p t i o n . T h e g e n e r a l a p p r o a c h to c o m p u t e r s i n m l a t i o n , h o w e v e r , s h o u l d b e e v i d e n t f r o m t h e d e s c r i p t i o n . A c o m p u t e r p r o g r a m p r o v i d e s an a n a l o g of a p r o c e s s in w h i c h entitic.*s or v a r i a b l e s a r e p r o v i d e d w i t h specific a t t r i b u t e s , a r e set into m o t i o n f r o m p a r t i c u l a r initial s t a t e s w i t h t h e a p p l i c a t i o n of i n t e n m l m e c h a n i s m s , a n d t h e m e c h a n i s n l s s e r v e to r e l a t e the v a r i a b l e s a c c o r d i n g to a specific theory. As t h e p r o g r a m o p e r a t e s , r e p o r t s a r e g e n e r a t e d at i m p o r t a n t t)oints in t h e process. In t h e ease of a p r o g r a m w h i c h s i m u l a t e s inter~,iew activity, at l e a s t a p o r t i o n of the r e p o r t s a r e t h e v e r b a l c o n t e n t w h i c h m a t c h t h e i n t e r a c t i o n of p e r s o n s , T h e o r e t i c a l i d e a s a r e t e s t e d l)y r u n n i n g t h e c o m p u t e r p r o g r a m w h i c h e x e m p l i ~ e s t h e m . I n i t i a l states, a t t r i b u t e s , a n d m e c h a n i s m s can all b e c h a n g e d a n d the p r o g r a m n m a g a i n to see the c h a n g e ill r e s u l t s .
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B e l h n a n , F r i e n d , a n d K u r l a n d ( 1 9 6 3 ) h a v e e m p h a s i z e d tim s e q u e n t i a l n a t u r e of t h e c l i n i c a l i n t e r v i e w b y a p p l y i n g a t h e o r y of m u l t i - s t a g e d e c i s i o n processes. T h i s has b e e n a p p l i e d to a s i m u l a t i o n of t h e initial p s y c h i a t r i c int e r v i e w w i t h a b r a i m h i n g s y s t e m of p o t e n t i a l q u e s t i o n s a n d replies. T h e questions a n d r e p l i e s h a v e b e e n d e s i g n e d to be e i t h e r c o n v e r g e n t or d i v e r g e n t to tim task at h a n d , t h e task of initial d i a g n o s i s a n d s e t t i n g of goals. In o r d e r to a r r i v e at a m e a s u r e o f p r o g r e s s of t h e i n t e r v i e w , t h e s e i n v e s t i g a t o r s c a t e g o r i z e d e a c h s e q u e n t i a l i t e m of v e r b a l b e h a v i o r for b o t h t h e r a p i s t a n d p a t i e n t i n t o t h e classes of c o n v e r g e n t , a m l ) i g u o u s , a n d ctivergent. On the p a r t of a p a t i e n t , a r e s p o n s e w h i c h p r o v i d e s i n f o r m a t i o n a n d i n d i c a t e s a g r e a t e r d e g r e e of recogn i t i o n , u n d e r s t a n d i n g a n d s e l f - a w a r e n e s s was c a l l e d c o n v e r g e n t . An a m b i g u o u s r e s p o n s e b y the p a t i e n t was likely to d e m o n s t n l t e circling, stalling, or misd i r e c t i o n . A d i v e r g e n t r e s p o n s e was o n e t h a t s u g g e s t e d a r e f u s a l to comm u n i c a t e a n d a v o i d a n c e of s e l f - a w a r e n e s s . O n t h e p a r t of t h e t h e r a p i s t , a c o n v e r g e n t r e s p o n s e w a s o n e t h a t f a c i l i t a t e d the p a t i e n t ' s s e l f - a w a r e n e s s w i t h a largely" e n c o u r a g i n g tone. An a m b i g u o u s r e s p o n s e s u g g e s t e d a t t e m p t s to control, p l a c a t e , or o u t w i t t h e p a t i e n t , w h i l e a t h e r a p i s t d i v e r g e n t r e s p o n s e was o n e t h a t was r e j e c t i n g or p u n i s h i n g to the p a t i e n t . A s s o c i a t e d w i t h e a c h ques| i o n vcas a set of a n s w e r s a n d e a c h was a s s i g n e d a p r o b a b i l i t y of occ.tH-rc11ee. VVhen tile p r o g r a m runs, t h e c o m p u t e r m a k e s aecess to a c h a n c e m e c h a n i s m in a c c o r d a n c e w i t h t h e s e p r o b a b i l i t i e s to d e t e r m i n e the next r e s p o n s e in the simulation. B u i l d i n g on the b a s e of a t r a n s c r i p t of an initial i n t e r v i e w first p u l ) l i s h e d by Gill et al. (197>4), a c o m p l e t e set of q t w s t i o n s a n d a n s w e r s w e r e c o n s t r u c t e d in w h i c h all t h r e e c a t e g o r i e s of c o n v e r g e n t , a m b i g u o u s , a n d d i v e r g e n t w e r e u s e d f o r t h e first t w o sdts of q u e s t i o n s a n d a n s w e r s a n d t h e r e a f t e r w e r e r e s t r i c t e d t o tile e x t r e m e s of c o n v e r g e n t a n d d i v e r g e n t t h r o u g h 16 levels of o p e r a t i o n . S t o r a g e r e q u i r e m e n t s of t h e p r o g r a m w e r e also r e d u c e d b y a l l o w i n g w h a t w e r e e o n s i d e r e d u n p r o f i t a b l e lines of d i a l o g u e to l o o p b a c k to p r e v i o u s stages io t h e interx, iew a n d in a d d i t i o n to use t h e s a m e q u e s t i o n s a n d a n s w e r s at v a r i o u s stages. A r e p o r t p u b l i s h e d in D e c e m b e r , 1966 gives a cx)ml)lete listing o f t h e ' q u e s t i o n s a n d a n s w e r s , s o m e s a m p l e d i a l o g u e s u n d e r various p r o l m l f i l i t y settings, as well a s a l i s t i n g o f t h e c o m p u t e r p r o g r a m itself. MAX-NIAcmxE ] N'rl::IIACrlON S i m u l a t i o n a t t e m p t s can becx)me p a r t i c u l a r l y i n t e r e s t i n g w h e n e i t h e r b y use of a small c ~ m p u t e r or b y a m o r e c o m p l e x l i m e - s h a r i n g system, t h e c o m p u t e r p r o g r a m c a n i n t e r a c t w i t h a h u m a n u s e r in t h e c o u r s e of o p e r a t i o n , q'he p r o g T a m m a y t h e n 1)e a r r a n g e d to p l a y t h e role of e i t h e r a l)atient or the rol~.~ o f an i n t e r v i e w e r . In t h e initial i n t e r v i e w s i m u k t t i o n d e s c r i b e d a b o v e , the investigators were i n t e r e s t e d in p r o v i d i n g an aid for the clinical t r a i n i n g o f i n i t i a l i n t e r v i e w i n g skill, w i t h a n a b i l i t y to v i e w t h e results of c h a n g i n g t h e q u e s t i o n i n g policy. A t r a i n e e a s s u m e s the role of t h e r a p i s t a n d the c o m p u t e r replies as t h o u g h it w e r e a p a r t i c u l a r p a t i e n t : T h e t r a i n e e is told to p r o c e e d as t h o u g h h e w e r e i n v o l v e d in an a c t u a l i n t e r v i e w e x c e p t t h a t q u e s t i o n s a n d a n s w e r s will l)e l ) r o u g h t to a n d f r o m t h e p a t i e n t 1)y i n t e r m e d i a r i e s . An inter'view b e g i n s w i t h t h e t r a i n e e r e v i e w i n g s o m e initial i n | o r m a t i o n a n d t h e n
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Fig. 1.--The I n t e r v i e w as a .Multi-stage Decision Process. b e i n g g i v e n a c h o i c e o t a n u m b e r of i n i t i a l q u e s t i o n s . \ V h e n h e s e l e c t s a p a r t i c u l a r q u e s t i o n t h e c o m p u t e r p r o g r a m , o p e r a t i n g veith tile p r o b a b i l i t y strtteture which has been provided, then choosea one of the possible answers a n d sets u p a s e c o n d c h o i c e of p o s s i b l e q u e s t i o n s for t h e t r a i n e e ( s e e Fig. 1 ). B e l h n a n e t al. ( 1 9 6 6 ) h a v e d i s c u s s e d t h e d e s i r a b i l i t y of a l l o w i n g a t r a i n e e to f r n m e his o w n q u e s t i o n s r a t h e r t h a n s i m p l y to c h o o s e f r o m t h e p r e a r r a n g e d set. T h e y s u g g e s t a n " ' u m p i r e " w h o w o u l d m a t c h t h e t r a i n e e ' s q u e s t i o n l o o n e o f t h e q u e s t i o n s a l r e a d y e x i s t i n g in t h e p r o g ' r a m , O t h e r w o r k e r s h a v e att e m p t e d t o d e v e h ~ p c o m p u t e r m e e h n n i s m s to w o r k d i r e c t l y w i t h f r e e r e s p o n s e from the subject. C o l b y ' s w o r k h a s r e c e n t l y m o v e d in this d i r e c t i o n b y t h e u s e o f a c o m p u t e r t i m e - s h a r i n g s y s t e m ( C o l b y , 1966, 1 9 6 7 ) . T h e p r o g r a m a t t e m p t s to m o d e l t h e b e l i e f s y s t e m of a p e r s o n w h o is e n g a g e d in r e p e a t e d d i a l o g u e s w i t h t h e p r o g r a m . A q u o t a t i o n ,,,,-ill g i v e s o m e flavor o f this w o r k ( C o l b y , 1 9 6 7 ) . Throu,~h self-ol)servation one can ol~serve moments called reflective when we en~dage in ;in i,ternal diaio~zue designed to chan~e at helief or helle[ structure. \Ve 1)ril~t" into platy" a personal lo~zic in attemptinlz to dislodge or renounce a belief. A belief can l:e ehan~zed by changing its sematie content, its degree of credibility, or its degree of import. We are currently trying to simulate these processes by nn on-line dialo,mm with the
516
. J O I t N A. S'rAIIK~,VEA'rI1EII
p r o g r a m w h i c h firs't a t t e m p t s to l e s s e n t h e c r e d e n c e o f a b e l i e f b y w e i g h i n g e v i d e n c e f o r a n d a g a i n s t it. T h i s is a c h i e v e d b y c o n s u l t i n g all t h e r e l e w m t b e l i e f s i n t h e s y s t e m to w e i g h e v i d e n c e f o r t h e c o n t r a s t o f a b e l i e f . I f m o r e e v i d e n c e is f o u n d f o r t h e c o n t r a s t t h a n t h e o r i g i n a l , t h e o r i g i n a l b e l i e f ' s c r e d e n c e is l e s s e n e d . T h i s in t u r n m a y e f f e c t t h e c r e d e n c e o f a b e l i e f f o r w h i c h it c a n s e r v e as a s n p p o r t i n g r e a s o n . I f t h e " m a i n b e l i e f s e r v e s a r e a s o n m s0n-Je o t h e r b e l i e f ' s r e a s o n s t r u c t u r e , a n t i s o ( m , t h e r e s u l t is a s e r i e s o f s m a l l b u t f a r r e a c h i n g c h a i n r e a c t i o n s in t h e d e g r e e to w h i c h s o m e b e l i e f s a r e n o w a c c e p t e d ~ks t n , e .
S i m u l a t i o n w h i e h iaavolves m a n - m a c h i n e c o m m u n i c a t i o n will v e r y likely differ in t h e deg-ree t o w h i c h a s u b j e c t c o n s i d e r s t h e s i t u a t i o n to b e a c r e d i b l e one. ~ V e i z e n b a u m (1966, 1967) h a s b e e n p a r t i e u l m ' l y i n t e r e s t e d in this problem. I h a v e b e e n p a r t i c u l a r l y c o n c e r n e d w i t h the d e v e l o p m e n t of a p r o g r a m m i n g l a n g u a g e w h i c h tries to p r o v i d e m e c h a n i s m s n e c e s s a r y f o r this k i n d of intera c t i v e p r o g r a m m i n g b u t p r o t e c t s t h e u s e r as n m c h as p o s s i b l e f r o m die'ne~qd to c o n s i d e r or e v e n u n d e r s t a n d t h e details of c o m p u t e r o p e r a t i o n , q ~ e d e s i g n of m e c h a n i s m s w h i c h a r e sufficiently explicit for c o m p u t e r o p e r a t i o n b u t w h i c h a l l o w t h e a p p r o p r i a t e h a n d l i n g of f r e e eom,'ersation is a c h a l l e n g i n g task; U n d e r s t a n d i n g of a r e s p o n s e a n d recogaaition of its m e a n i n g m u s t b e b a s e d on "loaowledge of t h e s u b j e c t m a t t e r at h a n d a n d t h e b o u n d s of t h e c u r r e n t c o n t e x t of o p e r a t i o n . T h i s r e q u i r e s a s h : t r i n g of v o c a b u l a r y b e t w e e n t h e c o m p u t e r p r o g r a m a n d t h e p e r s o n i n t e r a c t i n g w i t h it. A n d this implie\s a s h a r i n g of beliefs a n d a t t i t u d e s b e t w e e n t h e r e s p o n d e n t a n d t h e c o m p u t e r p r o g r a m m e r , for t h e p r o g r a m m e r h a s h a d to a n t i c i p a t e a n d p r e p a r e a p p r o p r i a t e h a n d l i n g f o r a variety, of r e s p o n s e s . T o i l l u s t r a t e w h a t is m e a n t here, T a b l e 1 s h o w s tlm results of a p r o g r a m m e d inter~-iewer in c o n v e r s a t i o n w i t h a h u m a n sub.iect. T h e m a t e r i a l t y p e d b y t h e c o m p u t e r a n d t h e s e d i f f e r e n t r e s p o n s e s h a v e c a u s e d in t u r n a d i f f e r e n t q u e s t i o n eases at a p o i n t w h e r e t h e c o m p u t e r p r e s e n t s t h e q u e s t i o n , " \ V h a t b r o u g h t y o u in to s~_~e m e t o d a y . " T w o d i f f e r e n t p e o p l e h a v e r e s p o n d e d d i f f e r e n t l y to t h e c o m p n t e r a n d t h e s e d i f f e r e n t r e s p o n s e s h a v e c a u s e d i n tuna a d i f f e r e n t q u e s t i o n to b e a s k e d next. T h e e x a m p l e i m p l i e s a r e c o ~ l i t i o n of d i f f e r e n c e on t h e p a r t of t h e c o m p u t e r p r o g r a m . It is e n o u g h h e r e to r e c o g n i z e a n imlx~rtant w o r d in e a c h case. I n t h e first e x a m p l e , t h e w o r d is "'disc~unaged" a n d in t h e s e c o n d e x a m p l e t h e w o r d is "'jittery" o r p e r h a p s "'jumpy.'" T h i s e x a m p l e is p r i m i t i v e in its a t t e m p t to s i m u l a t e i n t e r v i e w i n g a n d o t h e r k i n d s of f r e e c o n v e r s a t i o n b y u s i n g t h e r e c o g n i t i o n of i n d i v i d u a l w o r d s b u t a s y s t e m of u s i n g t h e c o m p u t e r a l l o w s e x t e n s i o n s to t h e logic i n v o l v e d a n d an i n c r e a s e d abili b" to h a n d l e complex material. Programming languages called COMPUTEST and P1LOT are particularly s u i t e d to this k i n d of p r o b l e m . T h e y a r e n o t a b l e in h a v i n g a n e a s y e n t r y p o i n t into p r o g r a m m i n g c o n v e r s a t i o n a l m a t e r i a l . In T a b l e 2, w e see t h e c o d i n g of a s i m p l e q u e s t i o n , "'Are y o u r e a d y to b e g i n , p l e a s e a n s w e r yes o r no." T h e q u e s t i o n w h i c h is to b e p r e s e n t e d b y t h e c o m p u t e r m u s t h a v e t h e l e t t e r T ( f o r t y p e ) as die first l e t t e r of e a c h line. T h e "'right a n s w e r " is t h e w o r d "'yes" a n d this is indicatexl b y t h e l e t t e r R in t h e first c h a r a c t e r position. T h e letters G and B stand for "Good" and "Bad" comments which a p p e a r d e p e n d i n g upon
.CO,~II'UTER
~IETItODS
FOR
STUDY
OF
INTERV1E%VS
517
Table 1.~A programmed interview in conversation with a human subject (computer typing is indented) Case 1. %VHAT BROUGItT YOU H E R E T O S E E ME TODAY, MISS JONES? In general I'm just terribly discouraged. HO\V BAD IIAS IT B EEN ? Case 2. W H A T B R O U G t I T Y O U H E R E TO SEE ME TODAY, MR. SMITH? I'm sort of jittery and ~urnpy most of the time. IT SOUNDS L I K E YOU HAVE S O M E T H I N G L I K E NERVOUSNESS OR T E N S I O N . IS T H A T RIGHT? Table 2.--PILOT coding of a simple question. T: -k : R: G: t3:
ARE YOU READY TO BEGIN; PLEASE ANSV~ZER YES OR NO.; YES; COOD, H E R E W E GO; PEHIIAPS SOME O T H E R TIME; Table 3.--PILOT coding of an intelligence test question
T:
"F/qlS IS A Q U E S T I O N OF T H E SIMILARITY OF T W O T H ING S. 1tO\%: ARE A ~VATCI[ A N D A CLOCK ALIKE?;
A:
;
11: TIME, ltOUR, M I N U T E , SECOND, HOROLOGIC; G: F I N E , H E R E IS A N O T H E R FOR YOU TO TRY; C: J U M P TO NEXT; R: T I C K , IIANDS, FACE, W I N D , DIAL; G: RIGHT, BUT ]T W O U L D BE BETTER TO SAY "FIIAT T I I E Y T E L L TIME.; B: T H A T ANSWER IS A PUZZLE TO ~tE.; T: NEXT: q l l E NEXT Q U E S T I O N ; w h e t h e r t h e w o r d "'ye~s'" ix f o u n d o r n o t f o u n d . T h e r e m a i n i n g l i n e c o n t a i n s t h e l e t t e r A w h i c h i n s t r u c t s t h e c o m p u t e r to a c c e p t t h e a n s w e r f r o m t h e s u b j e c t . T a b l e 3 s h o w s t h e c o d i n g of a m o r e c o m p l e x q u e s t i o n s u c h as m i g h t b e f o t m d i n a n i n d i v i d u a l i n t e l l i g e n c e t est. q t a e q u e s t i o n p r e s e n t e d f r o m l i n e s m a r k e d b y d i e l e t t e r T is " h o w a r e a w a t c h a n d a c l o c k alike.'" C e r t a i n w o r d s s u c h as "'time, h o u r , m i n u t e , s e c o n d " h a v e b e e n f o u n d to i n d i c a t e r e l i a b l y t h a t a n a p p r o p r i a t e c o n c e p t has b e e n d e s c r i b e d in t h e r e s p o n s e . T h e f i n d i n g of o n e of t h e s e w o r d s r e s u l t s i n t h e " ' g o o d c o m m e n t " w h i c h is "'fine h e r e is a n o t h e r f o r y o u t o try.'" O t h e r w o r d s , s u c h as " t i c k , h a n d s , f a c e , w i n d , d i a l " h a v e b e e n f o u n d to i n d i c a t e a m o r e c o n c r e t e (less a b s t r a c t ) c o n c e p t vehich s h o u l d r e c e i v e d i f f e r e n t t r e a t m e n t . A n a b i l i t y t o r e - s c a n t h e s a m e a n s w e r w i t h d i f f e r e n t lists o f w o r d s a l l o w this k i n d o f p r o b l e m to b e h a n d l e d . T a b l e 4 s h o w s a n e x a m p l e o f t h e k i n d o f i n t e r a c t i o n w h i c h w e f o r e s e e as b e i n g u s e f u l i n c l i n i c a l i n s t n l e t i o n . T h e c o m p u t e r p l a y s t h e r o l e o f a Specific
51~
JOHN
A. S l b ~ , R K ~ , V E A T f t E I 1
T a b l e 4.--A p r o g r a m m e d p a t i e n t in c o n v e r s a t i o n w i t h a h u m a n interviewer. COMPUTER-SIMULaTED INITIAL INTERVIEW ~VItAT F O L L O W S IS A N E X P E R 1 N I E N T 1N C O M P U T E R S I M U L A T I O N O F AN I N I T I A L I N T E R V I E V ¢ \ V I T I t A 1L-XTIENT. TO BEGIN \VITII, PLEASE TYPE YOUR LAST NAME, TIIEN RETURN TttE CARRIAGE. Dr. S m i t h GOOD, YOU H A V E T I l E IDEA. T H E ONLY O ' I l I E R TILING YOU \VILI, N E E D T O KNO'~V IS T t t A T T O R E S P O N D W I T H S I L E N C E , YOU M E R E L Y S T R I K E S, T t t E N REal'URN T H E C A R R I A G E . N O W T I l E I N T E R V I E W B E G I N S : T H E P A T I E N T E N T E R S Y O U R O F F I C E . H E IS A S L E N D E R , C O N V E N T I O N A L L Y D R E S S E D A l A N A P P E A R I N G A B O U T T H I R T Y YEARS O L D . HIS N A M E 1S J O I I N S A N D E R S . Y O U S E A T Y O U R S E L F , A N D ASK t l I M T O B E S E A T E D . H E SITS D O W N A N D SAYS-T t t A N K YOU. W h a t brings y o u in to see m e today? W E L L , MY W I F E W A N T E D M E T O C O M E . Go on
I T ' S N O T MY I D E A , T H A T ' S F O I l S U R E . S I t E l U S T T O L D M E 1 0 U G I I T T O S E E A PSYCHIATRIST.. SHE SAiD ..... SHE SAID SHE WAS GOING TO LEAVE I F I D I D N ' T GO. D o yon h a v e a n y reason yourself for c o m i n g ? t l E L L , I D O N ' T K N O W W H A T T O T E L L YOU. ASK M E S O M E Q U E S T I O N S - T t i E N M A Y B E YOU C A N F I G U R E O U T \ V I I A T ' S T H E _MATTER. W h a t has b e e n h a p p e n i n g ? (SILENCE) S HO'~V~COME YOU N E V E R SAY A N ) ~ I t I I N G , A N Y W A Y ? A S K YOU A Q U E S T I O N A N D YOU J U S T S I T T H E R E . T t l A T ' S '~VttAT i H E A R A B O U T YOU (,UYS. ANYV~\-\Y. YOU J U S T S I T T H E R E A N D N E V E R D O A N Y T H I N ( ; . D o you feel you h a v e a p r o b l e m to see m e al~out? TELL YOU kLL ABOUT MYSELF, ttUIl? W h a t e v e r y o u feel is i m p o r t a n t "~VELL, I ' M A P A I N T E R N O T O N E O F T H E M A R T I S T S , YOU KNO'~V A t t O U S E P A I N T E R . M-kKE P R E T T Y G O O D M O N E Y A F I T T t t R E E T'~VENTYF I V E AN t t O U R , A N D B E E N W O R K I N G P R E T I ~ " S T E A D Y , T O O . patient ,and different subjects can act as interviewer and gather information from the simulated patient. It will be a form of laboratory- exercise for those le,~nfing clinical skills and also a practice device for the retention of skills. This approach can of course be a means to further study of the psychiatric inter-' view, with different insights obtained depending on which side of the inter~qew is s i m u l a t e d ( S t a r k ' w e a t h e r , 1967a, 1967b). O u r f i r s t a t t e m p t t o d e v e l o p a s y s t e m t o h a n d l e thcxse c o n v e r s a t i o n a l needs resulted in a programming language called COMPUTEST, ol×~.rational on the I B N I 16:20 c x ) m p u t e r a n d l i m i t e d t o u s e o n t h a t m a c h i n e ( S t a r k w e a t h e r , 1965). Experience with COMPUTEST has led to an improved language for the cont r o l o f r e m o t e D'pe~,~witers h a v i n g a c c e s s t o a l a r g e c o m p u t e r . This language is c a l l e d P I L O T (Programmed Inquiry., Learning Or Teaching). Like COMPUTEST, PILOT builds conversations around the following form:
CO,"~[PUTI~;II
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NTUD~t"
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1. 2. 3.
I n f o r m a t i o n or a q u e s t i o n is p r e s e n t e d t)y t h e c o m p u t e r . T h e u s e r re-spends. T h e m a c h i n e e o m p ~ r e s t h e r e s p o n s e to a n u m b e r of p o s s i b l e e l e m e n t s of r e s p o n s e s . P r e v i o u s r e s p o n s e s of t h e u s e r c a n affect this e o m p a r k s o n in a v a r i e t y of w a y s . -1. T h e c o m p u t e r m a y m a k e o n e of s e v e r a l c o m m e n t s , or a s k a n o t h e r q u e s tion, b a s e d o n its p r e v i o u s d e c i s i o n s . P I L O T a l l o w s t h e a u t h o r of a p r o g r m n to w r i t e e a s i l y t h e q u e s t i o n s , d e c i s i o n s , a n d c o m m e n t s t h e m a c h i n e uses. T h e s y s t e m c a n a l s o k e e p a r e c o r d of res p o n s e s mad score t h e m as r e q u i r e d . P I L O T h a s m a n y o p t i o n a l feattcres u s e f u l to a n a d v a n c e d user, b u t m a i n t a i n s a s i m p l e level of b a s i c o p e r a t i o n w h i e h lets a n e w a u t h o r g e t s t a r t e d r a p i d l y w i t h u s e f u l w o r k . ~Vo e x p e c t tlmt p r o g n u n s w r i t t e n in P I L O T w i l l b e c o m e c a p a b l e of t e a c h i n g at n o v i c e u s e r of t h e c o m p u t e r h o w to b e n e f i t f r o m its services. T h u s , it is l i k e l y t h a t a s y s t e m w h i c h uses r u d i n a e n t a r y m e t l a o d s of c o n t e n t a n a l y s i s to c o n v e r s e w i t h users of t h e c o m p u t e r will in tuna h e l p t h e m to s t u d y psyehi,-itrie conv e r s a t i o n s m o r e c o m p l e t e l y . As m o r e i n v e s t i g a t o r s m a k e u s e of t h e c o m p u t e r b y this m e a n s , w e b e l i e v e t h e s y s t e m will a d a p t to theii" n e e d s a n d b e c o m e an increasingly valuable assistant. REFERENCES
I. Belhnan, R., Friend. M. B.. & Kurland. L. Psychiatric interviewing a n d multista,ze decision processes and a d a p tive ty"pe. Santa Moniea: T h e R A N D Corporation. RM-3732-NIII, .rune. 196¢3. 2. Be.lhnan, R., Friend, M. B., & Kurland. L. A simulation of the initial psychiatric inten'iew. Santa Monica: T h e R A N D Corporation, R-449-RC, Dee. 1966. 3. Colby, K. M. Experimental t r e a t m e n t of neurot;c c o m p u t e r programs. Arch. ~zen. Psychiat., 1964, 10:220-227. -I. Colby, K..XI. & Gilbert, J. P., P r o g r a m ruing a c-ompnter m o d e l of neurosis. l- Math. INychol., 196-t, 1:405-417. 25. Colby, K. NI. C o m p u t e r simulation of neurotic processes. In R. ~,V. S t a c y & B. 13. ~Vaxman, ( E d s . ) C o m p u t e r s in biomedical research. N e w York: A c a d e m i c Press, 1965. 6. Colby, K. M., Watt, J., & Gilbert, J. P. A c o m p u t e r model of p s y c h o t h e r a p y . J. nerv. ment. Dis,, 1966, 142:148152. 7. Colby, K. M. C o m p u t e r simulation of c h a n g e in personal belief systems. Behavioral Sci., 1967, 12:248-253. ,g. E k m a n , P. V I D - R (Visual Information
Display and ltetrievei) and SCAN ( S y s t e m a t i c Classification a n d Analysis of Nonverbal B e h a v i o r ) : t l a r d w a r e and m e t h o d s in tlae s t u d y of visual records of behavior. -¢). (:ill, M. I)., N e w m a n . R., Redlich, F. C., & Sommers, M. Tile initial interview in psychiatric practice. N e w York: International Universities Press, 195-1. 10. I t a n v a y , N. I. & Iker, I1. P. C o m p u t e r analysis of c o n t e n t in p s y c h o t h e r a p y . Psychol. Rep., 1964, 14:720-722. I1. Kramer, E. J , l d g m e n t o f personal charaeteristic.~; a n d emotions from nonverbal properties of speech. Psyehol. Bul., 1963, 60:408-420. 1:2. Mosteller, F., & Wallace, D. L. Infere n e e a n d d i s p u t e d authorship: T h e Federalist. Reading, ~lass.: AddisonWesley, 1964. 13. Pool, I. de S e l l ( e d . ) T r e n d s in c o n t e n t analysis. Urbana: Univer. of Illinois Press, 1959. 1-1. Stone, P. J., Balers, 1t. F., N a m e n w i r t h , J. Z., a n d O~ilvie, D. M. T h e general inquirer: A c o m p u t e r system for c o n t e n t analysis a n d retrieval based tm the s e n t e n c e as a u n i t of inform't-
JottN
tion. Behavioral Sci., 1962, 7:484498. 15: Stone, P. J., Dunphy, D. C., Smith, M. S., & Ogilvie, D. M. The general inquirer: A computer approach to content anal)sis in the behavioral sciences. Cambridge, Mass.: MtT Press, 1966. 16. Starkweather, J. A. Vocal communication of personality and human feelings. J. Communication, 196!, 11:6372. 27. Starkweather, J. A. Variations i1~ vocal behavior. In D. MeK. Rioeh (ed.) Disorders of Communication. Proceedings of ARNMD, vol. 42, 1964. Baltimore: Williams & Wilkins Co. 18. Starkv,'eather, J. A., & Decker, J. B. Computer Analysis of Inte~'ie,a," conte,t. Psychol. Rep., 1964, 15:875882. 19. Starkweather, J. A. COMPUTEST: A computer lan~mge for individual
-k. STARKWEATIIEI!
testing, instruction, and interviewing. Psychol. Reports, 1965, 17:227-237. 20. Slarkweather, J. A., Computer-assisted learning in medical education. Canad. Med. Assoc. J., 1967, 97: 733-738. 21. Starkwe~ther, J. A., Kamp, M. and Monto, 2(. Psychiatric interview simulation by computer. Methods of Information iI"~ Psychiatry, 1967, 6: 15-23.
22. Tompkins, S. S. & Messick, S. (eds.) Computer simldation: Frontier of persomdit3' theo~'., New York: Wiley, 1963. 23. \Veizenbaum, J., ELIZA-A computer program for the study of natural ]anguage communi~ation between man and machine. Commun. Assoc. Computer Machinery, 1966, 9:36-45. 2,1. Weizenbaum, 3- Contextual understanding by computers, Commun. Assoc. Computer Machinery, 1967, 10:47,1-480.
C O M P U T E I I h a s a l r e a d y s h o w n itself to be, a p o w e r f u l a n d v e r s a t i l e , a s s i s t a n t to m a n y k i n d s of r e s e a r c h cfforts w h i c h focus on i n t e r v i e w s . S o m e i n v e s t i g a t o r s h a v e u s e d t h e c o m p u t e r as a s t a t i s t i c a l a s s i s t a n t for t h e n n a t y s i s of d a t a d e r i v e d f r o m h i m } a n juclgm~enl a b o u t i n t e r v i e w i n t e r a c t i o n . O t h e r s h a v e u s e d its logical b u t n o n - n u m e r i c a l capacitic;s for l a r g e s c a l e clerical tasks p r e l i m i n a r y to s u c h mmlysis. An e x a m p l e of this is t h e c o u n t i n g of w o r d s or p h r a s e s from v e r b a t i m t r a n s c r i p t s , a procx~,ss w h i c h m a y d e m a n d m a p y m i l l i o n s of s y m b o ] i c c o m p a r i s o n s . 13y d e v e l o p i n g i n c r e a s i n g l y c o m p l e x m e t h o d s for t h e h a n d l i n g of l a n g u a g e c o n t e n t , s o m e investigat(~rs h a v e b e g u n to s i m u l a t e eith(,r one or botli sides of t h e psyc-hia t t i c intervi,:w. T h e y h a v e d e v e l o p e d m o d e l s w i t h o b s e r v a b l e o u t p u t w h i c h c a n be f u r t h e r s t u d i e d for r e s e m b l a n c e to a c t u a l interviews, a n d to t h t ~ r e t i c a ] e x p e c t a t i o n s . T h e incre!tsing atfilitv of c o m p u t e r s to i n t e r a c t w i t h t r u m a n u s e , s in a c o n v e r s i o n a l f a s h i o n h a s p r o m p t e d use of t h e c o m p u t e r as a c o n v e r s a tional p a r t n e r i~ an a c t i v e m o d e l i n g process. All t h e s e m e t h o d s u s e t h e c o m p u t e r to s t u d y t h e v e r b a l c o n t e n t of w h a t t r a n s p i r e s in c o n v e r s a t i o n a l i n t e r a c t i o n . \ V e k n o w t h a t t h e r e is also a cons i d o r a b l c a m o u n t of i n f o r m a t i o n t r a n s f e r a e c o m p ] i s l m d in a f a c e - t o - f a c e i n t e r view t h r o u g h g e s t u r a l a c t i v i t y , facial e x p r e s s i o n , a n d vocal c h a n g e s in voice (tualit.v. T h e s e eSn sigmal i n d i c a t i o n s of t h e e m o t i o n a l s t a t e of t h e s p e a k e r and i n f l u e n c e the. i n t e r p r e t a t i o n of tim r e l a t e d v e r b a l c o n t e n t . S t u d i e s w h i c h a t t e n a p t a q u u n t i t a t i v e v i e w of t h e s e o t h e r c h a n n e l s of c o m m u n i c a t i o n h a v e a ] s o f o u n d a nc~
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R a t h e r t h a n deal w i t h all of t h e v a r i a b l e s ' e x i s t i n g ha a ] i r e s i t u a t i o n , many" i n v e s t i g a t o r s h a v e r e c o r d e d t h e v e r b a l p r o d u c t i o n s of a n mtermx" a n d t a k e n t h e f u r t h e r .,;tel) of p r e p a r i n g v e r b a t i m trm~seripts of s u c h r e c o r d i n g s . T h e t a p e r e c o r d i n g e l i m i n a t e s t h e visual cues r e l a t e d to g e s t u r e a n d facial c,xpression w h i l e t h e t y p e d t r a n s c r i p t f u r t h e r e l i m i n a t e s cues f r o m vocal t ' x p r e s s i o n wtfich m a y c a r r y a c o n s i d e r a b l e p a r t of t h e m e a n i n g . C o n t e n t JoHx A. S'r.~t~KWt-:.-xTHV:m l'H.l).: Protc,s'sor o! Medical l'.s.~chohyat3; Unicc.r.s'ittt of C a l f /or,Ha .qchr,tff of ~lcdici,~e, and Coorditmtor o/ lnfl,rmation St.l.vtcms, gnit'cr.vit!l o / C a l i [ o r n i a 3lcdical Center, San Francisco, Cali[ornia. l'rcparation o] thi.s" paper teas SUl~por&'d in par! b!t Grant FR-O0122. U.SI Public [T¢;alth Scr~rice; a m l C o . t r a c t s :\'0NR-3656(28). O]!ice o[ Nat:al Research, I)A--19-193-MD2711. U.S. Arm!l 31cdical Rcscarch and ])ct:trlolln,cnt Comtnand, and U S I ) I I E I V - O E - 6 ,-*o~. U.S. O~/ce oj t'2ducation. Palwr prte.scnted at th," .\'alional Con[crg'nce on Contc,,t Analusis, T h e Anncnhertz School ~,/ Comrn,micati(m.v, Uniccr.s'it9 of Pcnn.w.lh'ania, Phih,dcltd*ia, Wot'ember, 1967. 509
C.o.xtpmc,ir:xswv Ps'~'Cm.XTI~V.VoL. S. No. 6 ( l)~'t:,.:xH~r.'~), 1.9t37
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analysis, t h e r e f o r e , implies a r e s t r i c t i o n of i n | o r m a t i o n :available to t h e a n a l y s t , Even at this p o i n t , h o w e v e r , s t u d i e s differ w i d e l y in the d e g r e e to whic}t m e t h o d s a r e ol)jec/ive a n d q u a n t i t a t i v e . \V|~ilc a t r a i n e d ana~lvs! can be, i n t u i t i v e a n d i n s i g h t f u l , q u a n t i t a t i v e m e t h o d s mtLv m i n i m i z e his 1)ias a n d l e a d to s t u d i e s w h o s e c o n c l u s i o n s m a y 1)e mort- r e a d i l y r e p e a t e d by others. S u c h m e t h o d s a r e also m o r e likely to a l l o w t h e use of c o m p u t e r p r o g n u n s a n d the p o s s i b i l i t y of i n c r e a s i n g l h e a s s i s t a n c e froni c o m p u t e r m e t h o d s . A v a r i e t y of a p p r o a c h e s to c o n t e n t a n a l y s i s m a y b e f o u n d d i s c u s s e d in a c o l h , c t i o n ()t: p a p e r s e d i t e d b v Pool in 1959, A r e v i e w of these p a p e r s to(lay is l i k e l y to s u g g e s t m a n y Ol)t)ortuniti(~s f o r the a p p l i c a t i o n of c o m p u t e r m e t h ~ d s . \ V h i l e m o s t c o n t e n t a n a l y s i s s t u d i e s h a v e f o c u s e d on w h a t is l)eing comn m n i e a t e d , s o m e h a v e b e e n c o n c e r n e d w i t h i d e n t i f i c a t i o n of a s p e a k e r or it writer. Kxtensive w(~rk w h i c h uses a v a r i e t y ot: c o m p u t e r meth(~ds .l~as |)emi d o n e in c e r t a i n cases of d i s p u t e d a u t h o r s h i p (.Xlostelcr, 196,1). \ V h e n kn(~wn d o c u m e n t s a r e availal)le from t w o p o t e n t i a l writers, i n d i c e s o|" w o r d visage m a y be p o s s i b l e to d e f i n e w h i c h will h e l p to classify u n k n o w n w r i t i n g s as m o r e likely: p r ( ~ l u c e d b y o n e o r t h e o t h e r a u t h o r . Nlore o{ten, in ~luantitative a p p r o a c h e s to c o n t e n t analysis, a u n i t of w r i t i n g or oi" s p e e c h , u s u a l l y w o r d s or s e n t e n c e s , is j u d g e d ~cs f a l l i n g i n t o speei[ie c a t e g o r i e s such as w o r d s w h i c h s ~ g g e s t hapl)iness, worcls w h i c h s u g g e s t a c'onccrn a b o u t | m a l t h , clc. It is a s s u m e d t h a t | w s t u d y i n g t h e r e l a t i v e fr('(luency of o c c u r r e n c e of suc]~ t y p e s of units, a n e w a n d lls(,t'ul d e s c r i p t i o n of a d()clm~ent m a y t)e f o r m e d . A c o m p u t e r p r o g r a m w h i c h has p r o v e n us~,ful to at n u m l ) e r of i n v c s t i g a t ~ r s wi.',h c o n t e n t a n a l y s i s p r o b l e m s is th(, ( ; e n e r a l I n ( / ~ i r e r (SlolJc r t al.. 198-): S!one, 19GG). T h e progn-am e x p e c t s text a r r a n g e d as seuten('es, a n d e x a m i n e s this text w i t h leflre'' • ,vlct', to a d i c t i o n a r y of w o r d stems, a d i c t i o n a r y w l d e h has b e e n d e v e l o p e d to m a k e useful classifications in a p a r t i c u l a r urea of stlltly. P h i l l i p Stone. the o r i g i n a t o r of t h e ( ; e n e r a l I n q u i r e r , e a r l y d e v e l o p e c ' a dietionaD" for p s y c h i a t r i c m a t e r i a l . I n p u t to t h e G, n t r a l I n q u i r e r is u s u a l l y p r e - e d i t e d b y c o d i n g for s y n t a x posititm of e a c h w o r d w i t h i n t h e s:mtenee. I n t h e ea.,~e of v e r b a l i m t r a n s c r i p t s , the unit of a s e n t e n c e is not a l w a y s well d e t i n e d a n d q u a n t i t a t i v e m e t h o d s for t h e s t u d y of t r a n s c r i p t s of s p o k e n m a t e r i a l h a v e t e n d e d to focus u p o n w o r d usage, p a r t l y in o r d e r to a v o i d t h e p r o b l e m s of s e r a m l ) l e d syntax. "l'xxt~ a p p r o a c h e s to this t y p e w e r e r r p o r t e d in 1964 ( H a n v a v & l k e r . 1964: S t a r k w e a t h e r & I)t'ck(-r, 1,964). T h e a p p r o a c h deseril)pd l)v S t a r k w e a t h e r a n d 1)eeker ,,,,'ill 1)e d i s c u s s e d l)rietly here. T h e c o m p u t e r is v i e w e d as m! accurat(" a n d Tmtiring clerk assisting in the d e v e l o p m e n t o | a special d i e t i ( m a r v w h i c h a p p l i e s (rely to tim wor(1 tlsagc of an i n d i v i d u a l p a t i e n t . T h e i n p u t to this lmJsaram is n a t u r a l l a n g u a g e p u n c h e d o n t a b u l a t i n g c a r d s a n d t h e b a s i c otltpllt is ,t v o c a b u l a r y listing w h i c h is o r g a n i z e d 1)v d e c r e a s i n g w o r d ltsage a n d is a l p h a l m t i z e t l w i t h cac'|~ levpl ~Jr usage. It has b e e n useful, in w o r k i n g w i t h rcx.orded inter,~iews, to i n c l u d e c e r t a i n s o u n d s - - s u c h as a c o u g h - - a s s p e c i a l w o r d s w h i c h will not be conf, lsed w i t h t h e l a n g u a g e of t h e p a t i e n t . VChcn the pro.at,ram operatt,s ,tin a l a r g e amo~mt of a t)atient's l a n g u a g e it pr(~duecs an ~ r g a n i z e d suture;an" whicl! rcl)rt.s~nts ])is Iota| v o c a h u l a r y u s a g e in ,ha_ i n l r r v i e w situatiov~. Such at sun~-
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~narv m a y i n d i c a t e q u i t o a d i f f e r e t t t level of c'(mll)etenc'e frown a m e a s u r e of v o o a l ) u l n r v kl~oxvledgt, as o b t a i t m d f r o m a test. A n e x a m p l e p r t - s c ~ t e d 1W Starku'ei~tl~el" and D e c k e r r e s u l t e d f r o m 1:2 h o u r s (~f i n t e r v i e w s , a n d s h o w s t h a t l h e p a t i ( ' n t u s e d a i ) l ) r o x i l n a t e l y 2,000 d i f f e r e n t w o r d s in t h e e o l l r s e of s p e a k i n g ".~0,000 t o t a l w o r d s . I'n o r d e r to a n a l y ' z e t h c s ~ illtt,rviews, h u m m i c l i l d e a l j u d g m e n t w a s lised to d e v e l o p w o r d lists w h i c h s e e m e d a p p r o p r i a t e to g r o u p [ r o m t h e l a n g u a g e of t h e s p e c i f i c p a t i e n t . A l t h o u g h this d e v e l o p m e n t of lists w a s a n o n - p r o g r a m m e d s t e p i~l t h e prt~ceduro, w e c a n lncz~tion s e v e r a l u s e f u l r a t i o n a l e s w h i c h w e r e I~ept in mil~d. T h e r e a r e diff,,:rent ~ r a m m a t i e a l f o r m s of tile s a m e w o r d whic, h w e r e groul~t.d w h e n t h e ~ll'e~l lit" ll]('alllill~.~r s ( ' e l l l e d al)pr()priatc'. A p p a r e n t synotLvms w e r e g r t m p o d in o r d e r to e t n m t w()rds as a l t e r n a t i v e e x p r e s s i o n s w h i c h s e e m to i n d i ( : a l e s i t n i l a r m e a n i n g . In a d d i t i o n t h e r e a r e w o r d s w h i c h m a y a p p e a r it~ m o r e t h a n ~)ne c o n t e x t a n d l~e u s e d w i t h m o r e t h a n o n e m e a n i n g , If w e a r e i l l t e r e s t e d in jlist One of t h e s e n l e a n i n g s , it is p o s s i b l e to f o r m a list" w h i c h il~cllzmlt's w o r d s w h i c h t e n d to a p p e a r \ v i t h it w h e n t h a t m e a n i n g is l)rest'nl. T h e t o t a l ( ' o t t n t t ~ r sllel~ a list w i l l t h e n e m p h a s i z e t h i s m e a n i n g m o r e t h : a l o t h e r s . T h e o r g a n i z o ( l t a l l y of \'oeal~daD" a c t u a l l y u s e d is a c o n ,,,ideral~le a i d in p r o d u c i n g s u c h lists. It e m p h a s i z e s w o r d s v c l l i d l a r e h e a v i l y usctl so t h a t t h e ¢ x m s t r t m t i o n of a s p e c i a l i z e d dictionary" w i l l m a x i m i z e u s e ~t' tltt, avaih~l)h, d a t a . T h e next s t e p i~ this a t m l y s i s w a s to d e c i d e u p o n a size o f v e r b a l s a m p l e t~ ust" as a s i n g l e o b s e r v a t i o n . T h e c h o i c e of s a m p l e s i z e s h o u l d s t r i k e a t m l a n c t , 1)t'tween a n a l ) p r o p r i a t e t o t a l n u m t ~ c r o~" Se¢luential o b s e r v a t i o n s a n d a s u t l i c i e n t sizt, [or e a c h s a m p l e w i t h i n w h i c h xx'¢, w o u l d o b t a i n u s e f u l c m m t s ~t" t h e O C C l l l ' r e l l { ' l , o f v e e r ( I s ill t h e lists. By nsit~g s u c c e s s i v e s a m p l e s of °O0 ,a'ords e a c h , t h e a n a l y s i s prodt~c.ed t-rein 1{} to 25 s a m p l e s f r o m e a c h i n t e r v i e w h o u r . T h e cornets [~)r w o r d oeetn'l'enct" ovt t,ach lint w e r e r e c o r d e d in a form a P l ) r o p r i a t t - a s i n p u t to s t a t i s t i c a l p r o g r a m s . T h e m e t h o d of f a c t o r att,alvsis w a s t h e n a p p l i e d to t h e r a t e of o c c u r r e n c e .~,t w o r d s in t h e lists of r e l a t e d w o r d s . S p e c u l a t i v e l a b e l s sucla as " d e n i a l " a n d " s e l f - a g g r e s s i o n ' " w o r e a p p l i e d to f a c t o r s p r ~ d u c o d f r o m s u c h a n a l y s i s , a n d it p r o v e d i n t e r e s t i n g t¢~ g r a p h t h e x-aria!ion of f a c t o r s c o r e s so p r o d u c e d o n s u c c e s s i v e s m n p h . s of t h e o r i g i n a l x'erlml m a t e r i a l . T i m o v e r a l l p r o c e d u r e sh,,~ws s o m e p o t e n t i a l in a l l o w i n g us to folloxv s h i f t s in t o p i c s a n d c o n c e r n s t h r o u g h tht, c o m ' s c of l ) s y c h o t h e r a p y . It c a n p r o v i d e a n o t h e r m e a n s to t r a c k c h a n g e s in the t , n m t i o n a l s t a t e of at p a t i e n t as t h e s e c h a n g e s a r e expre.ssed in w o r d u s a g e . A r e v i e w ot s p e c i f i c v e r b a l s a m p l e s w h i c h r e s u l t e d in e s l ) e e i a l l y h i g h f a c t o r s c o r e s ~,n f a c t o r s l i k e "'st-lf-a~gression" s h o w a h i g h f a c e v a l i d i t y r e l a t e d to t h e c o n c e p t . T h a t is. p a s s a g e s s e l e c t e d tLv t h e f a c t o r a n a l y s i s d o i n d e e d r e a d as thou~l~ t h e f a c t o r is especially" rt,levant. C a s e s t u d i e s w h i c h h a r t , c,oml~int'd t h i s a n a l y s i s a p p r o a c h w i t h a s t u d y of o t h e r c . o m m t m i e a t i o n c h a n n e l s sugges~ t h a t tim ~ t t m n t i t a t i v e a p p r o a e l i to v e r b a l e ( m t e n t a n a l v s i s is o f t e ~ e o m p l e ~ n c ~ t a r y t¢~ ~ t l m r i n f o r m a t i o n a n d it m a y l)t, l ) a r t i e ~ d a r l y t~st.ful w i t h i t M i v i d u a l p a t i m f l s w h o ( h ' m o t ~ s t r a t e ¢.motit~ml c h a n g e p r i m a r i l y in t h e i r l a l | Z u a ~ o ¢'~mt~'tlt.
5 1 -°. -
J O I I N A. STAltKV~'EA'rltl,.'I! ANALYSIS OF I:[ECOIIDED V O C A L AND N O N V E R B A L [N'FERVIEXV BEHAVIOIi
As m e t h o d s h a v e d e v e l o p e d w h i c h a r e m o r e q u a n t i t a t i v e a n d w h i c h rely less u p o n clinical j u d g a n e n t or r a t i n g s for the i n t e r p r e t a t i o n of v e r b a l eonterlt~ similar d e v e l o p m e n t s h a v e t a k e n p l a c e in the analysis of vocal a n d nonv e r b a l i n f o r m a t i o n . T h e r e are s o m e w h o feel t h a t l a n g u a g e c o n t e n t is m o r e r e a d i l y a v a i l a b l e for s t u d y a n d t h a t p a r a l a n g u a g e f e a t u r e s a r e usually" r e d u n d a n t in t h e i n f o r m a t i o n w h i c h t h e y c a r r y a b o u t e m o t i o n a l state. Situations can b e p o i n t e d out, h o w e v e r , ira w h i c h m e s s a g e s c a r r i e d b y vocal vs. v e r b a l or b y g e s t u r e s vs. Verbal c h a n n e l s a r e c l e a r l y d i s c r e p a n t . In a d d i t i o n . t h e r e is the possibility t h a t clever logical naach,.'nery; of w h i c h the c o m p u t e r is t h e p r i m e e x a m p l e , can m o r e easily a n a l y z e c h a r a c t e r i s t i c s of vocal expression a n d its relations to e m o t i o n a l s t a t e t h a n it cam c a n t o u t the c o m p l e x linguistic analysis of v e r b a l content. R e v i e w s a r e a v a i l a b l e w h i c h s u m m a r i z e a n d c o m m e n t on i n v e s t i g a t i o n s of vocal } r a n s f e r of i n f o r m a t i o n ( K r a m c r . t963. S l a r k w e a t h e r ; 1961; S t a r k w e a t h e r , 1964). X,lany- of the studies r e v i e w e d are j u d g m e n t a l in n a t u r e . It is c l e a r t h a t j u d g e s w h o a r e a b l e to reeog.q~ize e m o tional s t a t e of a s p e a k e r f r o m vocal cues d e p e n d u p o n c h a n g e s in pitch, rate, v o h n n e a n d o t h e r p h y s i c a l eh.taracteristies of t h e voice, b u t t h e y lack a consistent way- to d e s c r i b e t h e s e qualities. T h e d e v e l o p m e n t of c o m p u t e r m e t h o d s will r e q u i r e objective m e a s u r e s in this a r e a . V a r i o u s c o m b i n a t i o n s of o b j e c t i v e m e a s u r e s , i n c l u d i n g s p e e c h timing, rate. pitch, a n d m e a s u r e m e n t s of t h e f r e q u e n c y s p e c t r u m , h a v e a p p e a r e d to bo r e l a t e d to t h e s p e a k e r ' s p e r s o n a l i t y a n d e m o t i o n a l s t a t e in i n d i v i d u a l studies. I n v e s t i g a t o r s h a v e u s e d a v a r i e t y of m a c h i n e s a n d t e c h n i q u ( ~ to m e a s u r e a e o u s t i e a l dim~:,~sitms of the voice a n d h a v e e x p l o r e d the r e l a t i o n s h i p of t h e s e m e a s u r e s to s p e a k e r attribl~tes. It is dittqcult to r e l a t e the r e s u l t s of t h e s e studies to a d e s c r i p t i o n of e o m m m t i e a t i o n b e t w e e n a s p e a k e r a n d a h u m m a listener. h o w e v e r , b e c a u s e s u c h a c o u s t i c a l m e a s u r e s h a v e not i m i t a t e d t h e p r o c e s s i n g of vocal i n f o r m a t i o n b y h u m a n s . T i m e - a v e r a g e d sp.eetra of voice, for e x a m p l e , a r e p r o b a b l y u n l i k e a n y d a t a p r o c e s s e d b y a listener, since a p e r s o n is m o r e likely to a t t e n d to m o m e n t a r y , shifts in i n t o n a t i o n . S u c h d a t a . n e v e r t h e l e s s , h a v e b e e n s h o w n sensitive to t h e i d e n t i t y of d i f f e r e n t s p e a k e r s , to clinie~dly p e r c e p t ible v a r i a t i o n s in a s p e a k e r ' s m o d e of talking, to d a i l y c h a n g e s i n m o o d indic a t e d b y self r e p o r t or b y observers" ratings, a n d to v a r i a t i o n s in voice w h i e h a c c o m p a n y o b v i o u s e m o t i o n a l events. S u c h d a t a a r e p r o d u c e d b y p a s s i n g at voice signal t h r o u g h a set of d i s c r i m i n a t i n g b a n d - p a s s filters. O n e m a y then m e a s u r e t h e s o u n d e n e r g y for e a c h p o r t i o n of the a u d i b l e f r e q u e n c y s p e c t r u m a n d aw.'rage s u c h e n e r g y o v e r successive p e r i o d s of time, w i t h e a c h p e r i o d sufficiently long to eonta/a~"an i n t e g r a t e d s a m p l i n g of v e r b a l content. O n e can thus a t t e m p t t h e analysis of s p o n t a n e o u s s p e e c h ( w h e r e t h e r e is n o c h a n c e to c o n t r o l t h e v e r b a l c o n t e n t or m a k e it identical f r o m o n e s a m p l e to t h e next. ) A n indivqdual s p e a k e r m a y h a v e a c h a r a c t e r i s t i c use of t h e f r e ( t u e n e y s p e e t n l m as i n d i c a t e d b y s u c h a v e r a g e d d a t a , h u t s u c h d a t a m a y b e q u i t e d i t f e r e n t f r o m those a v a i l a b l e to a listener w h o h e a r s e v e r y v a r i a t i o n in p i k ' h as it occttrs. C h a n g e in tim f r e q u e n c y distril)ution of ,,'()ice e n e r g y can b e v i e w e d as a pot e n t i a l l y usefld m e a s u r e to i n d i c a t e c h a n g i n g m o o d for p s y c h i a t r i c p a t i e n t s ,
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p a r t i c l d a r l y those w i t h a n affective d i s t u r b a n c e . T h e o u t p u t of s o u n d e n e r g y f r o m it m a t c h e d set of a c o u s t i c filter.~ can b e r a p i d l y s a m p l e d 1)y a h i g h s p e e d m u l t i p l e x e r a n d a n a l o g - d i g i t a l c o n v e r t e r c o n n e c t e d to a d i g i t a l 9 o m p u t e r . T h i s p r o v i d e s p r o b a b l y the m o s t v e r s a t i l e a r r a n g e m e n t for t h e f u r t h e r analysis of such spectrum information. A t t e m p t s to a n a l y z e g e s t u r e a n d facial e x p r e s s i o n h a v e f a c e d h ) r m i d a b l e lmrriers in m o v i n g t o w a r d o b j e c t i v e m e a s u r e m e n t . S o m e success h a s a p p e a r e d in the u s e of m a c h i n e s to aid in t h e efficient p r e s e n t a t i o n o f p h o t o g r a p h i c inf o r m a t i o n to j u d g e s for r a t i n g a n d for the c o m p a r i s o n of one s a m p l e w i t h a n o t h e r . E q u i p m e n t is e n r r e n t l y u n d e r d e v e l o p m e n t to control t h e logic of s u c h p r e s e n t a t i o n b y digital c o m p u t e r , a n d to tlse t h e c a p a b i l i t i e s of v i d e o t a p e for p l a y b a c k of h o t h s o u n d a n d m o t i o n ( E k m a n , 1967). ~[ODELIN(; OF
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T h e c o m p u t e r h a s a p p e a l e d to s o m e i n v e s t i g a t o r s as a p o w e r f u l d e v i c e f o r s i m u l a t i n g t h e i n f o r m a t i o n p r o c e s s i n g w h i c h ties b e h i n d o b s e r v a b l e a s p e c t s of t h e clinical i n t e r v i e w . \ V e e x p e c t a c o m p u t e r s i m u l a t i o n to m a k e explicit in s y m b o l i c form s o m e o p e r a t i o n a l a s p e c t s of a t h e o r y , a n d the p r o g r m n s l m u ] d c o n t a i n v a r i a b l e s a n d m e c h a n i s m s w h i c h e x e m p l i f y t h e theory,. A n e a r l y att e m p t to b u i l d this k i n d of a p r o g r a m is d e s c r i b e d t)y Colt)}, ( i n T o m l l k i n s mid 51¢~sick. 19(~3). T h e s a m e v o h l m e c o n t a i n s o t h e r e x a m p l e s of c o m p u t e r use w h i c h a r e of interest in this c o n n e c t i o n . C o l b y set h i m s e l f t h e t a s k of w r i t ing p r o g r a m s to s i m u l a t e the t r e a t m e n t of n e u r o s e s b y p s y c h o t h e r a p y , in s u c c e e d i n g p a p e r s (1964a, 1964b. 1965) he d e s c r i b e d t h e e l a b o r a t i o n of t h e s e a t t e m p t s to d e v e l o p a p r o g r a m m e d m o d e l w h i c h w o u l d r e p e a t cycles of conflict, anxiety, a n d t h o u g h t distortions a n a l o g o u s to a n e u r o t i c process. T h e p r o g r a m c o n t a i n s v a r i a b l e s c a l l e d "'beliefs," e a c h of w h i c h has a t t r i b u t e s w h i c h m a y conflict w i t h o t h e r beliefs. T h e progTam p r o v i d e s f o r c o m p a r i s o n s betaveen beliefs. As a result of s u c h c o m p a r i s o n s , an o u t p u t sentence, is p r o d u c e d w h e n ~,. belief h a s b e e n s e l e c t e d b y a r a n d o m p r o c e s s a n d h a s a v o i d e d conflict in c o m p a r i s o n s w i t h o t h e r beliefs. W h e n conflict occurs, o t h e r m e c h a n i s m s c o m e into play-, a n d t h e s e t r a n s f o n n t h e p o t e n t i a l o u t p u t a n d c r e a t e s n e w beliefs in t h e d a t a pool. T h i s b r i e f d e s c r i p t i o n does an injt,stice to t h e i n g e n u i t y a n d complexity" of t h e p r o g r a m a n d t h e r e a d e r is r e f e r e d to C o l b y , 19641) for a c o m p l e t e d e s c r i p t i o n . T h e g e n e r a l a p p r o a c h to c o m p u t e r s i n m l a t i o n , h o w e v e r , s h o u l d b e e v i d e n t f r o m t h e d e s c r i p t i o n . A c o m p u t e r p r o g r a m p r o v i d e s an a n a l o g of a p r o c e s s in w h i c h entitic.*s or v a r i a b l e s a r e p r o v i d e d w i t h specific a t t r i b u t e s , a r e set into m o t i o n f r o m p a r t i c u l a r initial s t a t e s w i t h t h e a p p l i c a t i o n of i n t e n m l m e c h a n i s m s , a n d t h e m e c h a n i s n l s s e r v e to r e l a t e the v a r i a b l e s a c c o r d i n g to a specific theory. As t h e p r o g r a m o p e r a t e s , r e p o r t s a r e g e n e r a t e d at i m p o r t a n t t)oints in t h e process. In t h e ease of a p r o g r a m w h i c h s i m u l a t e s inter~,iew activity, at l e a s t a p o r t i o n of the r e p o r t s a r e t h e v e r b a l c o n t e n t w h i c h m a t c h t h e i n t e r a c t i o n of p e r s o n s , T h e o r e t i c a l i d e a s a r e t e s t e d l)y r u n n i n g t h e c o m p u t e r p r o g r a m w h i c h e x e m p l i ~ e s t h e m . I n i t i a l states, a t t r i b u t e s , a n d m e c h a n i s m s can all b e c h a n g e d a n d the p r o g r a m n m a g a i n to see the c h a n g e ill r e s u l t s .
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B e l h n a n , F r i e n d , a n d K u r l a n d ( 1 9 6 3 ) h a v e e m p h a s i z e d tim s e q u e n t i a l n a t u r e of t h e c l i n i c a l i n t e r v i e w b y a p p l y i n g a t h e o r y of m u l t i - s t a g e d e c i s i o n processes. T h i s has b e e n a p p l i e d to a s i m u l a t i o n of t h e initial p s y c h i a t r i c int e r v i e w w i t h a b r a i m h i n g s y s t e m of p o t e n t i a l q u e s t i o n s a n d replies. T h e questions a n d r e p l i e s h a v e b e e n d e s i g n e d to be e i t h e r c o n v e r g e n t or d i v e r g e n t to tim task at h a n d , t h e task of initial d i a g n o s i s a n d s e t t i n g of goals. In o r d e r to a r r i v e at a m e a s u r e o f p r o g r e s s of t h e i n t e r v i e w , t h e s e i n v e s t i g a t o r s c a t e g o r i z e d e a c h s e q u e n t i a l i t e m of v e r b a l b e h a v i o r for b o t h t h e r a p i s t a n d p a t i e n t i n t o t h e classes of c o n v e r g e n t , a m l ) i g u o u s , a n d ctivergent. On the p a r t of a p a t i e n t , a r e s p o n s e w h i c h p r o v i d e s i n f o r m a t i o n a n d i n d i c a t e s a g r e a t e r d e g r e e of recogn i t i o n , u n d e r s t a n d i n g a n d s e l f - a w a r e n e s s was c a l l e d c o n v e r g e n t . An a m b i g u o u s r e s p o n s e b y the p a t i e n t was likely to d e m o n s t n l t e circling, stalling, or misd i r e c t i o n . A d i v e r g e n t r e s p o n s e was o n e t h a t s u g g e s t e d a r e f u s a l to comm u n i c a t e a n d a v o i d a n c e of s e l f - a w a r e n e s s . O n t h e p a r t of t h e t h e r a p i s t , a c o n v e r g e n t r e s p o n s e w a s o n e t h a t f a c i l i t a t e d the p a t i e n t ' s s e l f - a w a r e n e s s w i t h a largely" e n c o u r a g i n g tone. An a m b i g u o u s r e s p o n s e s u g g e s t e d a t t e m p t s to control, p l a c a t e , or o u t w i t t h e p a t i e n t , w h i l e a t h e r a p i s t d i v e r g e n t r e s p o n s e was o n e t h a t was r e j e c t i n g or p u n i s h i n g to the p a t i e n t . A s s o c i a t e d w i t h e a c h ques| i o n vcas a set of a n s w e r s a n d e a c h was a s s i g n e d a p r o b a b i l i t y of occ.tH-rc11ee. VVhen tile p r o g r a m runs, t h e c o m p u t e r m a k e s aecess to a c h a n c e m e c h a n i s m in a c c o r d a n c e w i t h t h e s e p r o b a b i l i t i e s to d e t e r m i n e the next r e s p o n s e in the simulation. B u i l d i n g on the b a s e of a t r a n s c r i p t of an initial i n t e r v i e w first p u l ) l i s h e d by Gill et al. (197>4), a c o m p l e t e set of q t w s t i o n s a n d a n s w e r s w e r e c o n s t r u c t e d in w h i c h all t h r e e c a t e g o r i e s of c o n v e r g e n t , a m b i g u o u s , a n d d i v e r g e n t w e r e u s e d f o r t h e first t w o sdts of q u e s t i o n s a n d a n s w e r s a n d t h e r e a f t e r w e r e r e s t r i c t e d t o tile e x t r e m e s of c o n v e r g e n t a n d d i v e r g e n t t h r o u g h 16 levels of o p e r a t i o n . S t o r a g e r e q u i r e m e n t s of t h e p r o g r a m w e r e also r e d u c e d b y a l l o w i n g w h a t w e r e e o n s i d e r e d u n p r o f i t a b l e lines of d i a l o g u e to l o o p b a c k to p r e v i o u s stages io t h e interx, iew a n d in a d d i t i o n to use t h e s a m e q u e s t i o n s a n d a n s w e r s at v a r i o u s stages. A r e p o r t p u b l i s h e d in D e c e m b e r , 1966 gives a cx)ml)lete listing o f t h e ' q u e s t i o n s a n d a n s w e r s , s o m e s a m p l e d i a l o g u e s u n d e r various p r o l m l f i l i t y settings, as well a s a l i s t i n g o f t h e c o m p u t e r p r o g r a m itself. MAX-NIAcmxE ] N'rl::IIACrlON S i m u l a t i o n a t t e m p t s can becx)me p a r t i c u l a r l y i n t e r e s t i n g w h e n e i t h e r b y use of a small c ~ m p u t e r or b y a m o r e c o m p l e x l i m e - s h a r i n g system, t h e c o m p u t e r p r o g r a m c a n i n t e r a c t w i t h a h u m a n u s e r in t h e c o u r s e of o p e r a t i o n , q'he p r o g T a m m a y t h e n 1)e a r r a n g e d to p l a y t h e role of e i t h e r a l)atient or the rol~.~ o f an i n t e r v i e w e r . In t h e initial i n t e r v i e w s i m u k t t i o n d e s c r i b e d a b o v e , the investigators were i n t e r e s t e d in p r o v i d i n g an aid for the clinical t r a i n i n g o f i n i t i a l i n t e r v i e w i n g skill, w i t h a n a b i l i t y to v i e w t h e results of c h a n g i n g t h e q u e s t i o n i n g policy. A t r a i n e e a s s u m e s the role of t h e r a p i s t a n d the c o m p u t e r replies as t h o u g h it w e r e a p a r t i c u l a r p a t i e n t : T h e t r a i n e e is told to p r o c e e d as t h o u g h h e w e r e i n v o l v e d in an a c t u a l i n t e r v i e w e x c e p t t h a t q u e s t i o n s a n d a n s w e r s will l)e l ) r o u g h t to a n d f r o m t h e p a t i e n t 1)y i n t e r m e d i a r i e s . An inter'view b e g i n s w i t h t h e t r a i n e e r e v i e w i n g s o m e initial i n | o r m a t i o n a n d t h e n
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Fig. 1.--The I n t e r v i e w as a .Multi-stage Decision Process. b e i n g g i v e n a c h o i c e o t a n u m b e r of i n i t i a l q u e s t i o n s . \ V h e n h e s e l e c t s a p a r t i c u l a r q u e s t i o n t h e c o m p u t e r p r o g r a m , o p e r a t i n g veith tile p r o b a b i l i t y strtteture which has been provided, then choosea one of the possible answers a n d sets u p a s e c o n d c h o i c e of p o s s i b l e q u e s t i o n s for t h e t r a i n e e ( s e e Fig. 1 ). B e l h n a n e t al. ( 1 9 6 6 ) h a v e d i s c u s s e d t h e d e s i r a b i l i t y of a l l o w i n g a t r a i n e e to f r n m e his o w n q u e s t i o n s r a t h e r t h a n s i m p l y to c h o o s e f r o m t h e p r e a r r a n g e d set. T h e y s u g g e s t a n " ' u m p i r e " w h o w o u l d m a t c h t h e t r a i n e e ' s q u e s t i o n l o o n e o f t h e q u e s t i o n s a l r e a d y e x i s t i n g in t h e p r o g ' r a m , O t h e r w o r k e r s h a v e att e m p t e d t o d e v e h ~ p c o m p u t e r m e e h n n i s m s to w o r k d i r e c t l y w i t h f r e e r e s p o n s e from the subject. C o l b y ' s w o r k h a s r e c e n t l y m o v e d in this d i r e c t i o n b y t h e u s e o f a c o m p u t e r t i m e - s h a r i n g s y s t e m ( C o l b y , 1966, 1 9 6 7 ) . T h e p r o g r a m a t t e m p t s to m o d e l t h e b e l i e f s y s t e m of a p e r s o n w h o is e n g a g e d in r e p e a t e d d i a l o g u e s w i t h t h e p r o g r a m . A q u o t a t i o n ,,,,-ill g i v e s o m e flavor o f this w o r k ( C o l b y , 1 9 6 7 ) . Throu,~h self-ol)servation one can ol~serve moments called reflective when we en~dage in ;in i,ternal diaio~zue designed to chan~e at helief or helle[ structure. \Ve 1)ril~t" into platy" a personal lo~zic in attemptinlz to dislodge or renounce a belief. A belief can l:e ehan~zed by changing its sematie content, its degree of credibility, or its degree of import. We are currently trying to simulate these processes by nn on-line dialo,mm with the
516
. J O I t N A. S'rAIIK~,VEA'rI1EII
p r o g r a m w h i c h firs't a t t e m p t s to l e s s e n t h e c r e d e n c e o f a b e l i e f b y w e i g h i n g e v i d e n c e f o r a n d a g a i n s t it. T h i s is a c h i e v e d b y c o n s u l t i n g all t h e r e l e w m t b e l i e f s i n t h e s y s t e m to w e i g h e v i d e n c e f o r t h e c o n t r a s t o f a b e l i e f . I f m o r e e v i d e n c e is f o u n d f o r t h e c o n t r a s t t h a n t h e o r i g i n a l , t h e o r i g i n a l b e l i e f ' s c r e d e n c e is l e s s e n e d . T h i s in t u r n m a y e f f e c t t h e c r e d e n c e o f a b e l i e f f o r w h i c h it c a n s e r v e as a s n p p o r t i n g r e a s o n . I f t h e " m a i n b e l i e f s e r v e s a r e a s o n m s0n-Je o t h e r b e l i e f ' s r e a s o n s t r u c t u r e , a n t i s o ( m , t h e r e s u l t is a s e r i e s o f s m a l l b u t f a r r e a c h i n g c h a i n r e a c t i o n s in t h e d e g r e e to w h i c h s o m e b e l i e f s a r e n o w a c c e p t e d ~ks t n , e .
S i m u l a t i o n w h i e h iaavolves m a n - m a c h i n e c o m m u n i c a t i o n will v e r y likely differ in t h e deg-ree t o w h i c h a s u b j e c t c o n s i d e r s t h e s i t u a t i o n to b e a c r e d i b l e one. ~ V e i z e n b a u m (1966, 1967) h a s b e e n p a r t i e u l m ' l y i n t e r e s t e d in this problem. I h a v e b e e n p a r t i c u l a r l y c o n c e r n e d w i t h the d e v e l o p m e n t of a p r o g r a m m i n g l a n g u a g e w h i c h tries to p r o v i d e m e c h a n i s m s n e c e s s a r y f o r this k i n d of intera c t i v e p r o g r a m m i n g b u t p r o t e c t s t h e u s e r as n m c h as p o s s i b l e f r o m die'ne~qd to c o n s i d e r or e v e n u n d e r s t a n d t h e details of c o m p u t e r o p e r a t i o n , q ~ e d e s i g n of m e c h a n i s m s w h i c h a r e sufficiently explicit for c o m p u t e r o p e r a t i o n b u t w h i c h a l l o w t h e a p p r o p r i a t e h a n d l i n g of f r e e eom,'ersation is a c h a l l e n g i n g task; U n d e r s t a n d i n g of a r e s p o n s e a n d recogaaition of its m e a n i n g m u s t b e b a s e d on "loaowledge of t h e s u b j e c t m a t t e r at h a n d a n d t h e b o u n d s of t h e c u r r e n t c o n t e x t of o p e r a t i o n . T h i s r e q u i r e s a s h : t r i n g of v o c a b u l a r y b e t w e e n t h e c o m p u t e r p r o g r a m a n d t h e p e r s o n i n t e r a c t i n g w i t h it. A n d this implie\s a s h a r i n g of beliefs a n d a t t i t u d e s b e t w e e n t h e r e s p o n d e n t a n d t h e c o m p u t e r p r o g r a m m e r , for t h e p r o g r a m m e r h a s h a d to a n t i c i p a t e a n d p r e p a r e a p p r o p r i a t e h a n d l i n g f o r a variety, of r e s p o n s e s . T o i l l u s t r a t e w h a t is m e a n t here, T a b l e 1 s h o w s tlm results of a p r o g r a m m e d inter~-iewer in c o n v e r s a t i o n w i t h a h u m a n sub.iect. T h e m a t e r i a l t y p e d b y t h e c o m p u t e r a n d t h e s e d i f f e r e n t r e s p o n s e s h a v e c a u s e d in t u r n a d i f f e r e n t q u e s t i o n eases at a p o i n t w h e r e t h e c o m p u t e r p r e s e n t s t h e q u e s t i o n , " \ V h a t b r o u g h t y o u in to s~_~e m e t o d a y . " T w o d i f f e r e n t p e o p l e h a v e r e s p o n d e d d i f f e r e n t l y to t h e c o m p n t e r a n d t h e s e d i f f e r e n t r e s p o n s e s h a v e c a u s e d i n tuna a d i f f e r e n t q u e s t i o n to b e a s k e d next. T h e e x a m p l e i m p l i e s a r e c o ~ l i t i o n of d i f f e r e n c e on t h e p a r t of t h e c o m p u t e r p r o g r a m . It is e n o u g h h e r e to r e c o g n i z e a n imlx~rtant w o r d in e a c h case. I n t h e first e x a m p l e , t h e w o r d is "'disc~unaged" a n d in t h e s e c o n d e x a m p l e t h e w o r d is "'jittery" o r p e r h a p s "'jumpy.'" T h i s e x a m p l e is p r i m i t i v e in its a t t e m p t to s i m u l a t e i n t e r v i e w i n g a n d o t h e r k i n d s of f r e e c o n v e r s a t i o n b y u s i n g t h e r e c o g n i t i o n of i n d i v i d u a l w o r d s b u t a s y s t e m of u s i n g t h e c o m p u t e r a l l o w s e x t e n s i o n s to t h e logic i n v o l v e d a n d an i n c r e a s e d abili b" to h a n d l e complex material. Programming languages called COMPUTEST and P1LOT are particularly s u i t e d to this k i n d of p r o b l e m . T h e y a r e n o t a b l e in h a v i n g a n e a s y e n t r y p o i n t into p r o g r a m m i n g c o n v e r s a t i o n a l m a t e r i a l . In T a b l e 2, w e see t h e c o d i n g of a s i m p l e q u e s t i o n , "'Are y o u r e a d y to b e g i n , p l e a s e a n s w e r yes o r no." T h e q u e s t i o n w h i c h is to b e p r e s e n t e d b y t h e c o m p u t e r m u s t h a v e t h e l e t t e r T ( f o r t y p e ) as die first l e t t e r of e a c h line. T h e "'right a n s w e r " is t h e w o r d "'yes" a n d this is indicatexl b y t h e l e t t e r R in t h e first c h a r a c t e r position. T h e letters G and B stand for "Good" and "Bad" comments which a p p e a r d e p e n d i n g upon
.CO,~II'UTER
~IETItODS
FOR
STUDY
OF
INTERV1E%VS
517
Table 1.~A programmed interview in conversation with a human subject (computer typing is indented) Case 1. %VHAT BROUGItT YOU H E R E T O S E E ME TODAY, MISS JONES? In general I'm just terribly discouraged. HO\V BAD IIAS IT B EEN ? Case 2. W H A T B R O U G t I T Y O U H E R E TO SEE ME TODAY, MR. SMITH? I'm sort of jittery and ~urnpy most of the time. IT SOUNDS L I K E YOU HAVE S O M E T H I N G L I K E NERVOUSNESS OR T E N S I O N . IS T H A T RIGHT? Table 2.--PILOT coding of a simple question. T: -k : R: G: t3:
ARE YOU READY TO BEGIN; PLEASE ANSV~ZER YES OR NO.; YES; COOD, H E R E W E GO; PEHIIAPS SOME O T H E R TIME; Table 3.--PILOT coding of an intelligence test question
T:
"F/qlS IS A Q U E S T I O N OF T H E SIMILARITY OF T W O T H ING S. 1tO\%: ARE A ~VATCI[ A N D A CLOCK ALIKE?;
A:
;
11: TIME, ltOUR, M I N U T E , SECOND, HOROLOGIC; G: F I N E , H E R E IS A N O T H E R FOR YOU TO TRY; C: J U M P TO NEXT; R: T I C K , IIANDS, FACE, W I N D , DIAL; G: RIGHT, BUT ]T W O U L D BE BETTER TO SAY "FIIAT T I I E Y T E L L TIME.; B: T H A T ANSWER IS A PUZZLE TO ~tE.; T: NEXT: q l l E NEXT Q U E S T I O N ; w h e t h e r t h e w o r d "'ye~s'" ix f o u n d o r n o t f o u n d . T h e r e m a i n i n g l i n e c o n t a i n s t h e l e t t e r A w h i c h i n s t r u c t s t h e c o m p u t e r to a c c e p t t h e a n s w e r f r o m t h e s u b j e c t . T a b l e 3 s h o w s t h e c o d i n g of a m o r e c o m p l e x q u e s t i o n s u c h as m i g h t b e f o t m d i n a n i n d i v i d u a l i n t e l l i g e n c e t est. q t a e q u e s t i o n p r e s e n t e d f r o m l i n e s m a r k e d b y d i e l e t t e r T is " h o w a r e a w a t c h a n d a c l o c k alike.'" C e r t a i n w o r d s s u c h as "'time, h o u r , m i n u t e , s e c o n d " h a v e b e e n f o u n d to i n d i c a t e r e l i a b l y t h a t a n a p p r o p r i a t e c o n c e p t has b e e n d e s c r i b e d in t h e r e s p o n s e . T h e f i n d i n g of o n e of t h e s e w o r d s r e s u l t s i n t h e " ' g o o d c o m m e n t " w h i c h is "'fine h e r e is a n o t h e r f o r y o u t o try.'" O t h e r w o r d s , s u c h as " t i c k , h a n d s , f a c e , w i n d , d i a l " h a v e b e e n f o u n d to i n d i c a t e a m o r e c o n c r e t e (less a b s t r a c t ) c o n c e p t vehich s h o u l d r e c e i v e d i f f e r e n t t r e a t m e n t . A n a b i l i t y t o r e - s c a n t h e s a m e a n s w e r w i t h d i f f e r e n t lists o f w o r d s a l l o w this k i n d o f p r o b l e m to b e h a n d l e d . T a b l e 4 s h o w s a n e x a m p l e o f t h e k i n d o f i n t e r a c t i o n w h i c h w e f o r e s e e as b e i n g u s e f u l i n c l i n i c a l i n s t n l e t i o n . T h e c o m p u t e r p l a y s t h e r o l e o f a Specific
51~
JOHN
A. S l b ~ , R K ~ , V E A T f t E I 1
T a b l e 4.--A p r o g r a m m e d p a t i e n t in c o n v e r s a t i o n w i t h a h u m a n interviewer. COMPUTER-SIMULaTED INITIAL INTERVIEW ~VItAT F O L L O W S IS A N E X P E R 1 N I E N T 1N C O M P U T E R S I M U L A T I O N O F AN I N I T I A L I N T E R V I E V ¢ \ V I T I t A 1L-XTIENT. TO BEGIN \VITII, PLEASE TYPE YOUR LAST NAME, TIIEN RETURN TttE CARRIAGE. Dr. S m i t h GOOD, YOU H A V E T I l E IDEA. T H E ONLY O ' I l I E R TILING YOU \VILI, N E E D T O KNO'~V IS T t t A T T O R E S P O N D W I T H S I L E N C E , YOU M E R E L Y S T R I K E S, T t t E N REal'URN T H E C A R R I A G E . N O W T I l E I N T E R V I E W B E G I N S : T H E P A T I E N T E N T E R S Y O U R O F F I C E . H E IS A S L E N D E R , C O N V E N T I O N A L L Y D R E S S E D A l A N A P P E A R I N G A B O U T T H I R T Y YEARS O L D . HIS N A M E 1S J O I I N S A N D E R S . Y O U S E A T Y O U R S E L F , A N D ASK t l I M T O B E S E A T E D . H E SITS D O W N A N D SAYS-T t t A N K YOU. W h a t brings y o u in to see m e today? W E L L , MY W I F E W A N T E D M E T O C O M E . Go on
I T ' S N O T MY I D E A , T H A T ' S F O I l S U R E . S I t E l U S T T O L D M E 1 0 U G I I T T O S E E A PSYCHIATRIST.. SHE SAiD ..... SHE SAID SHE WAS GOING TO LEAVE I F I D I D N ' T GO. D o yon h a v e a n y reason yourself for c o m i n g ? t l E L L , I D O N ' T K N O W W H A T T O T E L L YOU. ASK M E S O M E Q U E S T I O N S - T t i E N M A Y B E YOU C A N F I G U R E O U T \ V I I A T ' S T H E _MATTER. W h a t has b e e n h a p p e n i n g ? (SILENCE) S HO'~V~COME YOU N E V E R SAY A N ) ~ I t I I N G , A N Y W A Y ? A S K YOU A Q U E S T I O N A N D YOU J U S T S I T T H E R E . T t l A T ' S '~VttAT i H E A R A B O U T YOU (,UYS. ANYV~\-\Y. YOU J U S T S I T T H E R E A N D N E V E R D O A N Y T H I N ( ; . D o you feel you h a v e a p r o b l e m to see m e al~out? TELL YOU kLL ABOUT MYSELF, ttUIl? W h a t e v e r y o u feel is i m p o r t a n t "~VELL, I ' M A P A I N T E R N O T O N E O F T H E M A R T I S T S , YOU KNO'~V A t t O U S E P A I N T E R . M-kKE P R E T T Y G O O D M O N E Y A F I T T t t R E E T'~VENTYF I V E AN t t O U R , A N D B E E N W O R K I N G P R E T I ~ " S T E A D Y , T O O . patient ,and different subjects can act as interviewer and gather information from the simulated patient. It will be a form of laboratory- exercise for those le,~nfing clinical skills and also a practice device for the retention of skills. This approach can of course be a means to further study of the psychiatric inter-' view, with different insights obtained depending on which side of the inter~qew is s i m u l a t e d ( S t a r k ' w e a t h e r , 1967a, 1967b). O u r f i r s t a t t e m p t t o d e v e l o p a s y s t e m t o h a n d l e thcxse c o n v e r s a t i o n a l needs resulted in a programming language called COMPUTEST, ol×~.rational on the I B N I 16:20 c x ) m p u t e r a n d l i m i t e d t o u s e o n t h a t m a c h i n e ( S t a r k w e a t h e r , 1965). Experience with COMPUTEST has led to an improved language for the cont r o l o f r e m o t e D'pe~,~witers h a v i n g a c c e s s t o a l a r g e c o m p u t e r . This language is c a l l e d P I L O T (Programmed Inquiry., Learning Or Teaching). Like COMPUTEST, PILOT builds conversations around the following form:
CO,"~[PUTI~;II
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NTUD~t"
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I n f o r m a t i o n or a q u e s t i o n is p r e s e n t e d t)y t h e c o m p u t e r . T h e u s e r re-spends. T h e m a c h i n e e o m p ~ r e s t h e r e s p o n s e to a n u m b e r of p o s s i b l e e l e m e n t s of r e s p o n s e s . P r e v i o u s r e s p o n s e s of t h e u s e r c a n affect this e o m p a r k s o n in a v a r i e t y of w a y s . -1. T h e c o m p u t e r m a y m a k e o n e of s e v e r a l c o m m e n t s , or a s k a n o t h e r q u e s tion, b a s e d o n its p r e v i o u s d e c i s i o n s . P I L O T a l l o w s t h e a u t h o r of a p r o g r m n to w r i t e e a s i l y t h e q u e s t i o n s , d e c i s i o n s , a n d c o m m e n t s t h e m a c h i n e uses. T h e s y s t e m c a n a l s o k e e p a r e c o r d of res p o n s e s mad score t h e m as r e q u i r e d . P I L O T h a s m a n y o p t i o n a l feattcres u s e f u l to a n a d v a n c e d user, b u t m a i n t a i n s a s i m p l e level of b a s i c o p e r a t i o n w h i e h lets a n e w a u t h o r g e t s t a r t e d r a p i d l y w i t h u s e f u l w o r k . ~Vo e x p e c t tlmt p r o g n u n s w r i t t e n in P I L O T w i l l b e c o m e c a p a b l e of t e a c h i n g at n o v i c e u s e r of t h e c o m p u t e r h o w to b e n e f i t f r o m its services. T h u s , it is l i k e l y t h a t a s y s t e m w h i c h uses r u d i n a e n t a r y m e t l a o d s of c o n t e n t a n a l y s i s to c o n v e r s e w i t h users of t h e c o m p u t e r will in tuna h e l p t h e m to s t u d y psyehi,-itrie conv e r s a t i o n s m o r e c o m p l e t e l y . As m o r e i n v e s t i g a t o r s m a k e u s e of t h e c o m p u t e r b y this m e a n s , w e b e l i e v e t h e s y s t e m will a d a p t to theii" n e e d s a n d b e c o m e an increasingly valuable assistant. REFERENCES
I. Belhnan, R., Friend. M. B.. & Kurland. L. Psychiatric interviewing a n d multista,ze decision processes and a d a p tive ty"pe. Santa Moniea: T h e R A N D Corporation. RM-3732-NIII, .rune. 196¢3. 2. Be.lhnan, R., Friend, M. B., & Kurland. L. A simulation of the initial psychiatric inten'iew. Santa Monica: T h e R A N D Corporation, R-449-RC, Dee. 1966. 3. Colby, K. M. Experimental t r e a t m e n t of neurot;c c o m p u t e r programs. Arch. ~zen. Psychiat., 1964, 10:220-227. -I. Colby, K..XI. & Gilbert, J. P., P r o g r a m ruing a c-ompnter m o d e l of neurosis. l- Math. INychol., 196-t, 1:405-417. 25. Colby, K. NI. C o m p u t e r simulation of neurotic processes. In R. ~,V. S t a c y & B. 13. ~Vaxman, ( E d s . ) C o m p u t e r s in biomedical research. N e w York: A c a d e m i c Press, 1965. 6. Colby, K. M., Watt, J., & Gilbert, J. P. A c o m p u t e r model of p s y c h o t h e r a p y . J. nerv. ment. Dis,, 1966, 142:148152. 7. Colby, K. M. C o m p u t e r simulation of c h a n g e in personal belief systems. Behavioral Sci., 1967, 12:248-253. ,g. E k m a n , P. V I D - R (Visual Information
Display and ltetrievei) and SCAN ( S y s t e m a t i c Classification a n d Analysis of Nonverbal B e h a v i o r ) : t l a r d w a r e and m e t h o d s in tlae s t u d y of visual records of behavior. -¢). (:ill, M. I)., N e w m a n . R., Redlich, F. C., & Sommers, M. Tile initial interview in psychiatric practice. N e w York: International Universities Press, 195-1. 10. I t a n v a y , N. I. & Iker, I1. P. C o m p u t e r analysis of c o n t e n t in p s y c h o t h e r a p y . Psychol. Rep., 1964, 14:720-722. I1. Kramer, E. J , l d g m e n t o f personal charaeteristic.~; a n d emotions from nonverbal properties of speech. Psyehol. Bul., 1963, 60:408-420. 1:2. Mosteller, F., & Wallace, D. L. Infere n e e a n d d i s p u t e d authorship: T h e Federalist. Reading, ~lass.: AddisonWesley, 1964. 13. Pool, I. de S e l l ( e d . ) T r e n d s in c o n t e n t analysis. Urbana: Univer. of Illinois Press, 1959. 1-1. Stone, P. J., Balers, 1t. F., N a m e n w i r t h , J. Z., a n d O~ilvie, D. M. T h e general inquirer: A c o m p u t e r system for c o n t e n t analysis a n d retrieval based tm the s e n t e n c e as a u n i t of inform't-
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