title: Using fundamental frequency of cancer survivors' speech to investigate emotional distress in out-patient visits.
abstract: Emotions, are in part conveyed by varying levels of fundamental frequency of voice pitch (f0). This study tests the hypothesis that patients display heightened levels of emotional arousal (f0) during Verona Coding Definitions of Emotional Sequences (VR-CoDES) cues and concerns versus during neutral statements.
  
  
  
  The audio recordings of sixteen head and neck cancer survivors' follow-up consultations were coded for patients' emotional distress. Pitch (f0) of coded cues and concerns, including neutral statements was extracted. These were compared using a hierarchical linear model, nested for patient and pitch range, controlling for statement speech length. Utterance content was also explored.
  
  
  
  Clustering by patient explained 30% of the variance in utterances f0. Cues and concerns were on average 13.07Hz higher than neutral statements (p=0.02). Cues and concerns in these consultations contained content with a high proportion of recurrence fears.
  
  
  
  The present study highlights the benefits and challenges of adding f0 and potential other prosodic features to the toolkit of coding emotional distress in the health communication setting.
  
  
  
  The assessment of f0 during clinical conversations can provide additional information for research into emotional expression.
authors: Medical School, University of St. Andrews, KY16 9TF, UK.
authors: Jacqueline
authors: J
authors: Kandsberger
authors: Merseyside Regional Head & Neck Cancer Centre, Aintree Hospital, Liverpool, L9 7AL, UK.
authors: Simon N
authors: SN
authors: Rogers
authors: Medical School, University of St. Andrews, KY16 9TF, UK.
authors: Yuefang
authors: Y
authors: Zhou
authors: Medical School, University of St. Andrews, KY16 9TF, UK; Edinburgh Cancer Centre, Western General Hospital, EH4 2XU, UK. Electronic address: gmh4@st-andrews.ac.uk.
authors: Gerry
authors: G
authors: Humphris
mesh_terms: D000328:Adult; D000368:Aged; D059019:Clinical Coding; D003142:Communication; D003463:Cues; D004644:Emotions; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010817:Physician-Patient Relations; D012017:Referral and Consultation; D013060:Speech; D013315:Stress, Psychological / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D014743:Videotape Recording
keywords: Emotional distress; Fundamental frequency of pitch; Head and neck cancer; Multilevel; The VR-CoDES