Nicholas Cummins

Yuezhou Zhang, Amos A Folarin, Judith Dineley et al.

Language use has been shown to correlate with depression, but large-scale validation is needed. Traditional methods like clinic studies are expensive. So, natural language processing has been employed on social media to predict depression, but limitations remain-lack of validated labels, biased user samples, and no context. Our study identified 29 topics in 3919 smartphone-collected speech recordings from 265 participants using the Whisper tool and BERTopic model. Six topics with a median PHQ-8 greater than or equal to 10 were regarded as risk topics for depression: No Expectations, Sleep, Mental Therapy, Haircut, Studying, and Coursework. To elucidate the topic emergence and associations with depression, we compared behavioral (from wearables) and linguistic characteristics across identified topics. The correlation between topic shifts and changes in depression severity over time was also investigated, indicating the importance of longitudinally monitoring language use. We also tested the BERTopic model on a similar smaller dataset (356 speech recordings from 57 participants), obtaining some consistent results. In summary, our findings demonstrate specific speech topics may indicate depression severity. The presented data-driven workflow provides a practical approach to collecting and analyzing large-scale speech data from real-world settings for digital health research.

Edward L. Campbell, Judith Dineley, Pauline Conde et al.

Major Depressive Disorder (MDD) is a common worldwide mental health issue with high associated socioeconomic costs. The prediction and automatic detection of MDD can, therefore, make a huge impact on society. Speech, as a non-invasive, easy to collect signal, is a promising marker to aid the diagnosis and assessment of MDD. In this regard, speech samples were collected as part of the Remote Assessment of Disease and Relapse in Major Depressive Disorder (RADAR-MDD) research programme. RADAR-MDD was an observational cohort study in which speech and other digital biomarkers were collected from a cohort of individuals with a history of MDD in Spain, United Kingdom and the Netherlands. In this paper, the RADAR-MDD speech corpus was taken as an experimental framework to test the efficacy of a Sequence-to-Sequence model with a local attention mechanism in a two-class depression severity classification paradigm. Additionally, a novel training method, HARD-Training, is proposed. It is a methodology based on the selection of more ambiguous samples for the model training, and inspired by the curriculum learning paradigm. HARD-Training was found to consistently improve - with an average increment of 8.6% - the performance of our classifiers for both of two speech elicitation tasks used and each collection site of the RADAR-MDD speech corpus. With this novel methodology, our Sequence-to-Sequence model was able to effectively detect MDD severity regardless of language. Finally, recognising the need for greater awareness of potential algorithmic bias, we conduct an additional analysis of our results separately for each gender.

Salvatore Fara, Orlaith Hickey, Alexandra Georgescu et al.

Predicting the presence of major depressive disorder (MDD) using behavioural and cognitive signals is a highly non-trivial task. The heterogeneous clinical profile of MDD means that any given speech, facial expression and/or observed cognitive pattern may be associated with a unique combination of depressive symptoms. Conventional discriminative machine learning models potentially lack the complexity to robustly model this heterogeneity. Bayesian networks, however, may instead be well-suited to such a scenario. These networks are probabilistic graphical models that efficiently describe the joint probability distribution over a set of random variables by explicitly capturing their conditional dependencies. This framework provides further advantages over standard discriminative modelling by offering the possibility to incorporate expert opinion in the graphical structure of the models, generating explainable model predictions, informing about the uncertainty of predictions, and naturally handling missing data. In this study, we apply a Bayesian framework to capture the relationships between depression, depression symptoms, and features derived from speech, facial expression and cognitive game data collected at thymia.

Anastasiia Tokareva, Judith Dineley, Zoe Firth et al.

Background: Captured between clinical appointments using mobile devices, spoken language has potential for objective, more regular assessment of symptom severity and earlier detection of relapse in major depressive disorder. However, research to date has largely been in non-clinical cross-sectional samples of written language using complex machine learning (ML) approaches with limited interpretability. Methods: We describe an initial exploratory analysis of longitudinal speech data and PHQ-8 assessments from 5,836 recordings of 586 participants in the UK, Netherlands, and Spain, collected in the RADAR-MDD study. We sought to identify interpretable lexical features associated with MDD symptom severity with linear mixed-effects modelling. Interpretable features and high-dimensional vector embeddings were also used to test the prediction performance of four regressor ML models. Results: In English data, MDD symptom severity was associated with 7 features including lexical diversity measures and absolutist language. In Dutch, associations were observed with words per sentence and positive word frequency; no associations were observed in recordings collected in Spain. The predictive power of lexical features and vector embeddings was near chance level across all languages. Limitations: Smaller samples in non-English speech and methodological choices, such as the elicitation prompt, may have also limited the effect sizes observable. A lack of NLP tools in languages other than English restricted our feature choice. Conclusion: To understand the value of lexical markers in clinical research and practice, further research is needed in larger samples across several languages using improved protocols, and ML models that account for within- and between-individual variations in language.

Shaoxiong Sun, Amos Folarin, Yatharth Ranjan et al.

We aimed to explore the utility of the recently developed open-source mobile health platform RADAR-base as a toolbox to rapidly test the effect and response to NPIs aimed at limiting the spread of COVID-19. We analysed data extracted from smartphone and wearable devices and managed by the RADAR-base from 1062 participants recruited in Italy, Spain, Denmark, the UK, and the Netherlands. We derived nine features on a daily basis including time spent at home, maximum distance travelled from home, maximum number of Bluetooth-enabled nearby devices (as a proxy for physical distancing), step count, average heart rate, sleep duration, bedtime, phone unlock duration, and social app use duration. We performed Kruskal-Wallis tests followed by post-hoc Dunns tests to assess differences in these features among baseline, pre-, and during-lockdown periods. We also studied behavioural differences by age, gender, body mass index (BMI), and educational background. We were able to quantify expected changes in time spent at home, distance travelled, and the number of nearby Bluetooth-enabled devices between pre- and during-lockdown periods. We saw reduced sociality as measured through mobility features, and increased virtual sociality through phone usage. People were more active on their phones, spending more time using social media apps, particularly around major news events. Furthermore, participants had lower heart rate, went to bed later, and slept more. We also found that young people had longer homestay than older people during lockdown and fewer daily steps. Although there was no significant difference between the high and low BMI groups in time spent at home, the low BMI group walked more. RADAR-base can be used to rapidly quantify and provide a holistic view of behavioural changes in response to public health interventions as a result of infectious outbreaks such as COVID-19.

Michael Freitag, Shahin Amiriparian, Sergey Pugachevskiy et al.

auDeep is a Python toolkit for deep unsupervised representation learning from acoustic data. It is based on a recurrent sequence to sequence autoencoder approach which can learn representations of time series data by taking into account their temporal dynamics. We provide an extensive command line interface in addition to a Python API for users and developers, both of which are comprehensively documented and publicly available at https://github.com/auDeep/auDeep. Experimental results indicate that auDeep features are competitive with state-of-the art audio classification.

Roseline Polle, Agnes Norbury, Alexandra Livia Georgescu et al.

Speaker-dependent modelling can substantially improve performance in speech-based health monitoring applications. While mixed-effect models are commonly used for such speaker adaptation, they require computationally expensive retraining for each new observation, making them impractical in a production environment. We reformulate this task as a meta-learning problem and explore three approaches of increasing complexity: ensemble-based distance models, prototypical networks, and transformer-based sequence models. Using pre-trained speech embeddings, we evaluate these methods on a large longitudinal dataset of shift workers (N=1,185, 10,286 recordings), predicting time since sleep from speech as a function of fatigue, a symptom commonly associated with ill-health. Our results demonstrate that all meta-learning approaches tested outperformed both cross-sectional and conventional mixed-effects models, with a transformer-based method achieving the strongest performance.

Si-Ioi Ng, Lingfeng Xu, Ingo Siegert et al.

There has been a surge of interest in leveraging speech as a marker of health for a wide spectrum of conditions. The underlying premise is that any neurological, mental, or physical deficits that impact speech production can be objectively assessed via automated analysis of speech. Recent advances in speech-based Artificial Intelligence (AI) models for diagnosing and tracking mental health, cognitive, and motor disorders often use supervised learning, similar to mainstream speech technologies like recognition and verification. However, clinical speech AI has distinct challenges, including the need for specific elicitation tasks, small available datasets, diverse speech representations, and uncertain diagnostic labels. As a result, application of the standard supervised learning paradigm may lead to models that perform well in controlled settings but fail to generalize in real-world clinical deployments. With translation into real-world clinical scenarios in mind, this tutorial paper provides an overview of the key components required for robust development of clinical speech AI. Specifically, this paper will cover the design of speech elicitation tasks and protocols most appropriate for different clinical conditions, collection of data and verification of hardware, development and validation of speech representations designed to measure clinical constructs of interest, development of reliable and robust clinical prediction models, and ethical and participant considerations for clinical speech AI. The goal is to provide comprehensive guidance on building models whose inputs and outputs link to the more interpretable and clinically meaningful aspects of speech, that can be interrogated and clinically validated on clinical datasets, and that adhere to ethical, privacy, and security considerations by design.

Bahman Mirheidari, André Bittar, Nicholas Cummins et al.

We present a novel feasibility study on the automatic recognition of Expressed Emotion (EE), a family environment concept based on caregivers speaking freely about their relative/family member. We describe an automated approach for determining the \textit{degree of warmth}, a key component of EE, from acoustic and text features acquired from a sample of 37 recorded interviews. These recordings, collected over 20 years ago, are derived from a nationally representative birth cohort of 2,232 British twin children and were manually coded for EE. We outline the core steps of extracting usable information from recordings with highly variable audio quality and assess the efficacy of four machine learning approaches trained with different combinations of acoustic and text features. Despite the challenges of working with this legacy data, we demonstrated that the degree of warmth can be predicted with an $F_{1}$-score of \textbf{61.5\%}. In this paper, we summarise our learning and provide recommendations for future work using real-world speech samples.

Salvatore Fara, Stefano Goria, Emilia Molimpakis et al.

Embedded in any speech signal is a rich combination of cognitive, neuromuscular and physiological information. This richness makes speech a powerful signal in relation to a range of different health conditions, including major depressive disorders (MDD). One pivotal issue in speech-depression research is the assumption that depressive severity is the dominant measurable effect. However, given the heterogeneous clinical profile of MDD, it may actually be the case that speech alterations are more strongly associated with subsets of key depression symptoms. This paper presents strong evidence in support of this argument. First, we present a novel large, cross-sectional, multi-modal dataset collected at Thymia. We then present a set of machine learning experiments that demonstrate that combining speech with features from an n-Back working memory assessment improves classifier performance when predicting the popular eight-item Patient Health Questionnaire depression scale (PHQ-8). Finally, we present a set of experiments that highlight the association between different speech and n-Back markers at the PHQ-8 item level. Specifically, we observe that somatic and psychomotor symptoms are more strongly associated with n-Back performance scores, whilst the other items: anhedonia, depressed mood, change in appetite, feelings of worthlessness and trouble concentrating are more strongly associated with speech changes.

Yuezhou Zhang, Amos A Folarin, Shaoxiong Sun et al.

The Bluetooth sensor embedded in mobile phones provides an unobtrusive, continuous, and cost-efficient means to capture individuals' proximity information, such as the nearby Bluetooth devices count (NBDC). The continuous NBDC data can partially reflect individuals' behaviors and status, such as social connections and interactions, working status, mobility, and social isolation and loneliness, which were found to be significantly associated with depression by previous survey-based studies. This paper aims to explore the NBDC data's value in predicting depressive symptom severity as measured via the 8-item Patient Health Questionnaire (PHQ-8). The data used in this paper included 2,886 bi-weekly PHQ-8 records collected from 316 participants recruited from three study sites in the Netherlands, Spain, and the UK as part of the EU RADAR-CNS study. From the NBDC data two weeks prior to each PHQ-8 score, we extracted 49 Bluetooth features, including statistical features and nonlinear features for measuring periodicity and regularity of individuals' life rhythms. Linear mixed-effect models were used to explore associations between Bluetooth features and the PHQ-8 score. We then applied hierarchical Bayesian linear regression models to predict the PHQ-8 score from the extracted Bluetooth features. A number of significant associations were found between Bluetooth features and depressive symptom severity. Compared with commonly used machine learning models, the proposed hierarchical Bayesian linear regression model achieved the best prediction metrics, R2= 0.526, and root mean squared error (RMSE) of 3.891. Bluetooth features can explain an extra 18.8% of the variance in the PHQ-8 score relative to the baseline model without Bluetooth features (R2=0.338, RMSE = 4.547).

Shuo Liu, Jing Han, Estela Laporta Puyal et al.

This study investigates the potential of deep learning methods to identify individuals with suspected COVID-19 infection using remotely collected heart-rate data. The study utilises data from the ongoing EU IMI RADAR-CNS research project that is investigating the feasibility of wearable devices and smart phones to monitor individuals with multiple sclerosis (MS), depression or epilepsy. Aspart of the project protocol, heart-rate data was collected from participants using a Fitbit wristband. The presence of COVID-19 in the cohort in this work was either confirmed through a positive swab test, or inferred through the self-reporting of a combination of symptoms including fever, respiratory symptoms, loss of smell or taste, tiredness and gastrointestinal symptoms. Experimental results indicate that our proposed contrastive convolutional auto-encoder (contrastive CAE), i. e., a combined architecture of an auto-encoder and contrastive loss, outperforms a conventional convolutional neural network (CNN), as well as a convolutional auto-encoder (CAE) without using contrastive loss. Our final contrastive CAE achieves 95.3% unweighted average recall, 86.4% precision, anF1 measure of 88.2%, a sensitivity of 100% and a specificity of 90.6% on a testset of 19 participants with MS who reported symptoms of COVID-19. Each of these participants was paired with a participant with MS with no COVID-19 symptoms.

Judith Dineley, Grace Lavelle, Daniel Leightley et al.

The ease of in-the-wild speech recording using smartphones has sparked considerable interest in the combined application of speech, remote measurement technology (RMT) and advanced analytics as a research and healthcare tool. For this to be realised, the acceptability of remote speech collection to the user must be established, in addition to feasibility from an analytical perspective. To understand the acceptance, facilitators, and barriers of smartphone-based speech recording, we invited 384 individuals with major depressive disorder (MDD) from the Remote Assessment of Disease and Relapse - Central Nervous System (RADAR-CNS) research programme in Spain and the UK to complete a survey on their experiences recording their speech. In this analysis, we demonstrate that study participants were more comfortable completing a scripted speech task than a free speech task. For both speech tasks, we found depression severity and country to be significant predictors of comfort. Not seeing smartphone notifications of the scheduled speech tasks, low mood and forgetfulness were the most commonly reported obstacles to providing speech recordings.

Vidhyasaharan Sethu, Emily Mower Provost, Julien Epps et al.

Artificial intelligence and machine learning systems have demonstrated huge improvements and human-level parity in a range of activities, including speech recognition, face recognition and speaker verification. However, these diverse tasks share a key commonality that is not true in affective computing: the ground truth information that is inferred can be unambiguously represented. This observation provides some hints as to why affective computing, despite having attracted the attention of researchers for years, may not still be considered a mature field of research. A key reason for this is the lack of a common mathematical framework to describe all the relevant elements of emotion representations. This paper proposes the AMBiguous Emotion Representation (AMBER) framework to address this deficiency. AMBER is a unified framework that explicitly describes categorical, numerical and ordinal representations of emotions, including time varying representations. In addition to explaining the core elements of AMBER, the paper also discusses how some of the commonly employed emotion representation schemes can be viewed through the AMBER framework, and concludes with a discussion of how the proposed framework can be used to reason about current and future affective computing systems.

Fabien Ringeval, Björn Schuller, Michel Valstar et al.

The Audio/Visual Emotion Challenge and Workshop (AVEC 2019) "State-of-Mind, Detecting Depression with AI, and Cross-cultural Affect Recognition" is the ninth competition event aimed at the comparison of multimedia processing and machine learning methods for automatic audiovisual health and emotion analysis, with all participants competing strictly under the same conditions. The goal of the Challenge is to provide a common benchmark test set for multimodal information processing and to bring together the health and emotion recognition communities, as well as the audiovisual processing communities, to compare the relative merits of various approaches to health and emotion recognition from real-life data. This paper presents the major novelties introduced this year, the challenge guidelines, the data used, and the performance of the baseline systems on the three proposed tasks: state-of-mind recognition, depression assessment with AI, and cross-cultural affect sensing, respectively.

Thomas Wiest, Nicholas Cummins, Alice Baird et al.

Generative Adversarial Networks (GANs) have become exceedingly popular in a wide range of data-driven research fields, due in part to their success in image generation. Their ability to generate new samples, often from only a small amount of input data, makes them an exciting research tool in areas with limited data resources. One less-explored application of GANs is the synthesis of speech and audio samples. Herein, we propose a set of extensions to the WaveGAN paradigm, a recently proposed approach for sound generation using GANs. The aim of these extensions - preprocessing, Audio-to-Audio generation, skip connections and progressive structures - is to improve the human likeness of synthetic speech samples. Scores from listening tests with 30 volunteers demonstrated a moderate improvement (Cohen's d coefficient of 0.65) in human likeness using the proposed extensions compared to the original WaveGAN approach.

Jing Han, Zixing Zhang, Nicholas Cummins et al.

Over the past few years, adversarial training has become an extremely active research topic and has been successfully applied to various Artificial Intelligence (AI) domains. As a potentially crucial technique for the development of the next generation of emotional AI systems, we herein provide a comprehensive overview of the application of adversarial training to affective computing and sentiment analysis. Various representative adversarial training algorithms are explained and discussed accordingly, aimed at tackling diverse challenges associated with emotional AI systems. Further, we highlight a range of potential future research directions. We expect that this overview will help facilitate the development of adversarial training for affective computing and sentiment analysis in both the academic and industrial communities.

Gil Keren, Nicholas Cummins, Björn Schuller

Ongoing developments in neural network models are continually advancing the state of the art in terms of system accuracy. However, the predicted labels should not be regarded as the only core output; also important is a well-calibrated estimate of the prediction uncertainty. Such estimates and their calibration are critical in many practical applications. Despite their obvious aforementioned advantage in relation to accuracy, contemporary neural networks can, generally, be regarded as poorly calibrated and as such do not produce reliable output probability estimates. Further, while post-processing calibration solutions can be found in the relevant literature, these tend to be for systems performing classification. In this regard, we herein present two novel methods for acquiring calibrated predictions intervals for neural network regressors: empirical calibration and temperature scaling. In experiments using different regression tasks from the audio and computer vision domains, we find that both our proposed methods are indeed capable of producing calibrated prediction intervals for neural network regressors with any desired confidence level, a finding that is consistent across all datasets and neural network architectures we experimented with. In addition, we derive an additional practical recommendation for producing more accurate calibrated prediction intervals. We release the source code implementing our proposed methods for computing calibrated predicted intervals. The code for computing calibrated predicted intervals is publicly available.