The interrelatedness of observed behavior of depressed patients and of a psychiatrist: an ethological study on mutual influence.

The interaction of 61 severely depressed hospitalized patients and a psychiatrist was studied during a clinical interview. Interactional processes were defined by the use of ethological methods. Various observed behaviors were clustered on the basis of statistical criteria, yielding behavior factors of the patients and of the psychiatrist. The present paper deals with the organization of the psychiatrist's behavior and the interrelatedness of the patients' and the psychiatrist's behavior. Analysis of the behavior of the psychiatrist revealed seven factors: restlessness-1 (head, leg movements, object touching), restlessness-2 (body touching, head movements), speech (speech, gesticulating, yes and no movements), active listening (intensive body touching and hand movements), turn-taking (leg movements and gesticulating during listening), encouragement (back-channel behavior and yes-nodding), and change-looking (looking and head movements). Within the constraints of studying interactions which are bidirectional, it was found that restlessness-2, speech, encouragement and active listening of the psychiatrist could be 'predicted' from observed behavior of the patients (multiple regression model). The psychiatrist's behavior was related both to the severity of depression and to observed behavior not directly associated with severity. The psychiatrist's behavior was more strongly related to that of the more severely depressed patients than to that of the less severely depressed patients. These results contribute to an understanding of the behaviors displayed and elicited by depressed patients during a first encounter with a stranger.