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Affective communication, encompassing verbal and non-verbal cues, is crucial for understanding human interactions. This study introduces a novel framework for enhancing emotional understanding by fusing speech emotion recognition (SER) and sentiment analysis (SA). We leverage diverse features and both classical and deep learning models, including Gaussian naive Bayes (GNB), support vector machines (SVMs), random forests (RFs), multilayer perceptron (MLP), and a 1D convolutional neural network (1D-CNN), to accurately discern and categorize emotions in speech. We further extract text sentiment from speech-to-text conversion, analyzing it using pre-trained models like bidirectional encoder representations from transformers (BERT), generative pre-trained transformer 2 (GPT-2), and logistic regression (LR). To improve individual model performance for both SER and SA, we employ an extended dynamic Bayesian mixture model (DBMM) ensemble classifier. Our most significant contribution is the development of a novel two-layered DBMM (2L-DBMM) for multimodal fusion. This model effectively integrates speech emotion and text sentiment, enabling the classification of more nuanced, second-level emotional states. Evaluating our framework on the EmoUERJ (Portuguese) and ESD (English) datasets, the extended DBMM achieves accuracy rates of 96% and 98% for SER, 85% and 95% for SA, and 96% and 98% for combined emotion classification using the 2L-DBMM, respectively. Our findings demonstrate the superior performance of the extended DBMM for individual modalities compared to individual classifiers and the 2L-DBMM for merging different modalities, highlighting the value of ensemble methods and multimodal fusion in affective communication analysis. The results underscore the potential of our approach in enhancing emotional understanding with broad applications in fields like mental health assessment, human–robot interaction, and cross-cultural communication. [ABSTRACT FROM AUTHOR]

For Deleuze, the creation and conveyance of meaning requires not a strict fidelity to an original idea, message or image but rather its deformation. The forces causing such disfigurations operate in gesture, vocalisation and text, with one level sometimes disrupting the others. Among them, gesture plays an especially important role, given Deleuze's attention to bodily experience. He locates it in theatre, painting and cinema, particularly in the works of Carmelo Bene, Francis Bacon and Jerry Lewis. In these cases, instead of conveying a recognisable message, a deformative gesture sends a shock wave that scrambles normal meaning assignments and codings. Yet, although gesture is a main channel for these communication disruptive forces, their origin may lie elsewhere, namely, in a 'pick-up' of influences resulting from an inter-affective encounter between heterogeneous bodies. [ABSTRACT FROM AUTHOR]

Affective communication, encompassing verbal and non-verbal cues, is crucial for understanding human interactions. This study introduces a novel framework for enhancing emotional understanding by fusing speech emotion recognition (SER) and sentiment analysis (SA). We leverage diverse features and both classical and deep learning models, including Gaussian naive Bayes (GNB), support vector machines (SVMs), random forests (RFs), multilayer perceptron (MLP), and a 1D convolutional neural network (1D-CNN), to accurately discern and categorize emotions in speech. We further extract text sentiment from speech-to-text conversion, analyzing it using pre-trained models like bidirectional encoder representations from transformers (BERT), generative pre-trained transformer 2 (GPT-2), and logistic regression (LR). To improve individual model performance for both SER and SA, we employ an extended dynamic Bayesian mixture model (DBMM) ensemble classifier. Our most significant contribution is the development of a novel two-layered DBMM (2L-DBMM) for multimodal fusion. This model effectively integrates speech emotion and text sentiment, enabling the classification of more nuanced, second-level emotional states. Evaluating our framework on the EmoUERJ (Portuguese) and ESD (English) datasets, the extended DBMM achieves accuracy rates of 96% and 98% for SER, 85% and 95% for SA, and 96% and 98% for combined emotion classification using the 2L-DBMM, respectively. Our findings demonstrate the superior performance of the extended DBMM for individual modalities compared to individual classifiers and the 2L-DBMM for merging different modalities, highlighting the value of ensemble methods and multimodal fusion in affective communication analysis. The results underscore the potential of our approach in enhancing emotional understanding with broad applications in fields like mental health assessment, human–robot interaction, and cross-cultural communication.

Purpose -- To analyze the factors related to the internal communication process that influence the organizational bonds (commitment, entrenchment, and consent) between workers and their employing organizations. Design/methodology/approach -- Qualitative and quantitative research instruments were employed in a sample field consisting of four large organizations in Brazil. Findings emerged from Content Analysis, Exploratory Factor Analysis (EFA) and Structural Equation Modelling (SEM).The qualitative phase involved the participation of 23 respondents. The quantitative phase sample comprised 401 respondents. A scale was developed to assess workers' perceptions of communication processes. Findings -- A relationship between communication processes and organizational bonds was confirmed. Immediate leader communication proved to be a highly significant factor in the internal communication process, as well as affective communication, which directly impacts commitment and acts on engaging communication, which in turn influences commitment. It was observed that the consent bond, through the subordination, directly impacts commitment, albeit in a negative manner. Originality/value -- The study contributes to the field of organizational communication by introducing the IOCS (Internal Organizational Communication Scale) and paves the way to further the still nascent debate on the forms of interaction between organizations and their employees resulting from new management models, labor contracts, as well as organizational value and purposes, stemming from the changes brought about by the Covid-19 heath crisis. [ABSTRACT FROM AUTHOR]

The paper illustrates an evolving theoretical-clinical study about the relationship between psychoanalysis and psychodynamic psychotherapy. It comes from the observation of some recurrent phenomena in the context of daily clinical experience. Small variations, apparently accidental, that occur in the setting, and that are an expression of the complex dynamics of the unconscious intersubjective field. The psychoanalytic exploration of the experiences of affective interaction in the setting has brought out an increasingly real dimension of the implicit and its relationship with the unconscious. This pushes the analysis of the therapeutic process and therapeutic action towards a growing consideration of the silent and fruitful work that takes place beyond the symbolic-verbal support, where is a different way to dialogue, to communicate and influence each other. The approach presented aims to demonstrate that it is possible to take into account the growing evidence in the field of affective neuroscience, epigenetics and infant research, preserving the foundations of the psychoanalytic clinical approach developed in the relational context. An empathic, intersubjective and affective approach based on the phenomenological and holistic experience of mother-infant dyadic interaction. The clinical-technical foundation of this approach is the experience of regression in analysis, a condition not only for resurfacing and processing of trauma, but also for interactive repair. [ABSTRACT FROM AUTHOR]

School is the place where emotions can constitute an obstacle to learning or facilitate it. Feelings of insecurity and even fear are often the cause of failure. It is then a question of trying to control parasite emotions in order to promote a meaningful and more serene learning. This article focuses on students'emotions as processes which, given their cerebral implementations in relation to the systems involved in motivation, attention and memory are at the heart of learning process. Researches suggest that emotional skills are beneficial to both well-being and academic performance. Emotions support attention, working memory, encoding, memory consolidation or processes related to executive control (inhibition). Those cognitive processes are also necessary for academic learning. Emotions therefore accompany the students within the classroom, and may interfere with learning or consolidate it. Research on emotions, their cerebral bases and functions, invite us to question the idea according to which emotions hinder school learning; on the contrary, even if emotions can indeed sometimes affect learning, experimental results suggest that they often facilitate cognitive processes such as attention and memory, which are essential for learning. Moreover, the fact that emotions have an important role in the process of learning suggests that it is important for the student to be able to know, control and use them, in an academic context. [ABSTRACT FROM AUTHOR]

The advent of filmmaking provided a means for affective communication, whereby what was real and what was filmed became conflated, helping to create tourism imaginaries that, in turn, drove tourism. However, increased tourism created negative impacts, especially for charismatic subjects like whales that elicit strong emotional responses of connectedness in viewers. In the whale-watching industry, getting too close to whales to satisfy visitor expectations has a major detrimental impact. Here, we test whether the very characteristics of film that have helped create the problem, might be used to fix the problem by re-creating tourism imaginaries and changing visitor expectations. We produced a video about sustainable whale watching using a formula designed specifically to enhance its affective and emotional qualities. Survey respondents were randomly assigned to Test and Control Groups, and shown the video either before or after recording their likelihood of going whale watching in the future. Those in both groups that were Likely or Very Likely to go whale watching identified affective qualities of the video nearly identically. Elements of the video associated with affective communication (imagery of whales in their natural environment and authentic reactions of tourists seeing whales) were most liked equally by Test and Control Group subjects. However, significantly less of the Test Group found the imagery of close encounters between whales and humans to be their favorite aspect of the video, while significantly more of them noted that the clarity of the message or the way it was told (editing) were their most liked aspects. In sum, the affective features of filmmaking that influence tourism imaginaries, also offer the potential to thwart the negative effects of tourism by invoking changes in attitudinal and behavioral intentions that should lead to more sustainable tourism practices. [ABSTRACT FROM AUTHOR]

Despite the importance of touch in human-human relations, research in affective tactile practices is in its infancy, lacking in-depth understanding needed to inform the design of remote digital touch communication. This article reports two qualitative studies that explore tactile affective communication in specific social contexts, and the bi-directional creation, sending and interpretation of digital touch messages using a purposebuilt research tool, the Tactile Emoticon. The system comprises a pair of remotely connected mitts, which enable users in different locations to communicate through tactile messages, by orchestrating duration and level of three haptic sensations: vibration, pressure and temperature. Qualitative analysis shows the nuanced ways in which 68 participants configured these elements to make meaning from touch messages they sent and received. It points to the affect and emotion of touch, its sensoriality and ambiguity, the significance of context, social norms and expectations of touch participants. Findings suggest key design considerations for digital touch communication, where the emphasis shifts from generating 'recognizable touches' to tools that allow people to shape their touches and establish common understanding about their meaning. [ABSTRACT FROM AUTHOR]

Through evolutionary computation, affective models may emerge autonomously in unanticipated ways. We explored whether core affect would be leveraged through communication with conspecifics (e.g. signalling danger or foraging opportunities). Genetic algorithms served to evolve recurrent neural networks controlling virtual agents in an environment with fitness-increasing food and fitness-reducing predators. Previously, neural oscillations emerged serendipitously, with higher frequencies for positive than negative stimuli, which we replicated here in the fittest agent. The setup was extended so that oscillations could be exapted for the communication between two agents. An adaptive communicative function evolved, as shown by fitness benefits relative to (1) a non-communicative reference simulation and (2) lesioning of the connections used for communication. An exaptation of neural oscillations for communication was not observed but a simpler type of communication developed than was initially expected. The agents approached each other in a periodic fashion and slightly modified these movements to approach food or avoid predators. The coupled agents, though controlled by separate networks, appeared to self-assemble into a single vibrating organism. The simulations (a) strengthen an account of core affect as an oscillatory modulation of neural-network competition, and (b) encourage further work on the exaptation of core affect for communicative purposes. [ABSTRACT FROM AUTHOR]

Emotional contagion, a fundamental aspect of empathy, is an automatic and unconscious process in which individuals mimic and synchronize with the emotions of others. Extensively studied in rodents, this phenomenon is mediated through a range of sensory pathways, each contributing distinct insights. The olfactory pathway, marked by two types of pheromones modulated by oxytocin, plays a crucial role in transmitting emotional states. The auditory pathway, involving both squeaks and specific ultrasonic vocalizations, correlates with various emotional states and is essential for expression and communication in rodents. The visual pathway, though less relied upon, encompasses observational motions and facial expressions. The tactile pathway, a more recent focus, underscores the significance of physical interactions such as allogrooming and socio-affective touch in modulating emotional states. This comprehensive review not only highlights plausible neural mechanisms but also poses key questions for future research. It underscores the complexity of multimodal integration in emotional contagion, offering valuable insights for human psychology, neuroscience, animal welfare, and the burgeoning field of animal-human-AI interactions, thereby contributing to the development of a more empathetic intelligent future. • Explores emotional contagion in rodents, focusing on rats, mice, and prairie voles. • Examines oxytocin and pheromones' role in olfactory emotional contagion. • Discusses multiple types of ultrasonic vocalizations in auditory emotional contagion. • Highlights observable motions and facial expressions in visual emotional contagion. • Presents key questions and methods for multimodal integration in emotional contagion. [ABSTRACT FROM AUTHOR]

Copyright of Revista Habanera de Ciencias Médicas is the property of Universidad de Ciencias Medicas de La Habana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Ironically, the material infrastructure that underpins the digital platforms we use to share information related to environmental degradation comprises reliance on heavily polluting forms of energy which are a staple part of that very same degradation rallied against online. As it is implausible to suggest that we would move away from our new digital reality, it is argued that we should embrace its communicative capacities despite the fact that our digital infrastructure is environmentally destructive. And, it is argued that the greatest capacity of digitality lies not in its ability for information sharing, but in its ability to affect us on a level beyond the consumption of environmental information. In doing so, great caution should be exercised so as not to fall into the trap of reifying the powers of information technology. Rather, we should see it as yet indeterminate and as capable of producing exchanges between people and nature that are of surprising potential. In order to read the potential of these exchanges, the article draws on a philosophical framework developed by the post- structuralist duo Deleuze and Guattari. Following this, two nature-oriented digital artefacts are examined for their ability to communicate with us on a level beyond information exchange. [ABSTRACT FROM AUTHOR]

Background: Web-based health care has the potential to improve health care access and convenience for patients with limited mobility, but its success depends on active physician participation. The economic returns of internet-based health care initiatives are an important factor that can motivate physicians to continue their participation. Although several studies have examined the communication patterns and influences of web-based health consultations, the correlation between physicians' communication characteristics and their economic returns remains unexplored., Objective: This study aims to investigate how the linguistic features of 2 modes of physician-patient communication, instrumental and affective, determine the physician's economic returns, measured by the honorarium their patients agree to pay per consultation. We also examined the moderating effects of communication media (web-based text messages and voice messages) and the compounding effects of different communication features on economic returns., Methods: We collected 40,563 web-based consultations from 528 physicians across 4 disease specialties on a large, web-based health care platform in China. Communication features were extracted using linguistic inquiry and word count, and we used multivariable linear regression and K-means clustering to analyze the data., Results: We found that the use of cognitive processing language (ie, words related to insight, causation, tentativeness, and certainty) in instrumental communication and positive emotion-related words in affective communication were positively associated with the economic returns of physicians. However, the extensive use of discrepancy-related words could generate adverse effects. We also found that the use of voice messages for service delivery magnified the effects of cognitive processing language but did not moderate the effects of affective processing language. The highest economic returns were associated with consultations in which the physicians used few expressions related to negative emotion; used more terms associated with positive emotions; and later, used instrumental communication language., Conclusions: Our study provides empirical evidence about the relationship between physicians' communication characteristics and their economic returns. It contributes to a better understanding of patient-physician interactions from a professional-client perspective and has practical implications for physicians and web-based health care platform executives., (©Shuang Geng, Yuqin He, Liezhen Duan, Chen Yang, Xusheng Wu, Gemin Liang, Ben Niu. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 11.01.2024.)

In recent years, the common and mundane dying has begun to take place in the public space of the Internet. Among the blogs about food, fashion, travel, and other joyful aspects of life, blogs about severe disease and dying have appeared. The aim of this article is to describe some characteristic features of a sample of cancer blogs and to discuss them in the light of Zygmunt Bauman's theory of the rationalization of death in modernity and theories about networked media, especially the theories about "affective labor" and "ambient intimacy" by McCosker, Darcy, and Pfister. It will then be argued that an affective communication is performed in and through these cancer blogs, where not only language but also the deficiencies of language—and what is called shared ineffability —might be valuable and meaningful (although not unproblematic) as part of a late modern approach to death, and in the practicing of the art of dying. [ABSTRACT FROM AUTHOR]

This paper discusses the enactment and evaluation of Embodied Conversational Agents (ECA) capable of affective communication in Collaborative Virtual Environments (CVE) for learning. The CVE discussed is a reconstruction of the European Parliament in Brussels developed using the REVERIE (Real and Virtual Engagement In Realistic Immersive Environment) framework. REVERIE is a framework designed to support the creation of CVEs populated by ECAs capable of natural human-like behaviour, physical interaction and engagement. The ECA provides a tour of the virtual parliament and participates in the learning activity as an intervention mechanism to engage students. The ECA is capable of immediacy behaviour (verbal and non-verbal) and interactions to support a dialogic learning scenario. The design of the ECA is grounded on a theoretical framework that addresses the required characteristics of the ECA to successfully support collaborative learning. In this paper, we discuss the Heuristic Evaluation of the REVERIE ECA which revealed a wealth of usability problems that led to the development of a list of design recommendations to improve their usability, including its immediacy behaviours and interactions. An ECA capable of effectively creating rapport should result in more positive experiences for participants and better learning results for students in dialogic learning scenarios. Future work aims to evaluate this hypothesis in real-world scenarios with teachers and students participating in a shared virtual educational experience. [ABSTRACT FROM AUTHOR]

Abstract The aim of this paper is to propose an alternative pedagogical method for teaching physician-patient communication, which integrates traditional ESL/EFL speaking activities with four main techniques employed in Gestalt psychotherapy/counselling, namely the Empty Chair technique, the Making the Rounds exercise, the Exaggeration task, and Empathic Listening. The existing medical English teaching materials tend to focus almost exclusively on the verbal meaning component of language, with activities aimed at building learners’ knowledge of technical vocabulary, terminology, and fixed expressions to be used in a variety of different contexts and types of interactions. They seem to disregard the fact that communication is an embodied phenomenon involving not just our linguistic and cognitive capacities, but also our ability to properly use non-verbal elements, such as facial expressions, hand gestures, and body movements. The latter elements seem to play a particularly important role to establish rapport and trust in the physician-patient relationship and to promote patients’ compliance. Therefore, a more holistic multimodal approach is called for in order to develop learners’ relational communication skills and emotional awareness, thus teaching them to speak not just effectively but also affectively. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify the predictive value of the relationships between classmates, the affective communication with parents and the generation of prosocial behavior have on the experimentation of positive emotions in adolescents. The sample included 490 middle school students from the Metropolitan Area of Guadalajara. We used the measurement instruments: subscale Relations from the Social Climate Scale, the Affective communication subscale from the Affect Scale, in its version for children; the Positive Behavior Scale and, the Positive Emotion Survey. We used correlation tests and multiple linear regression by the method of successive steps for statistical analysis. Results showed a positive and statistically significant correlation between the variables of affiliation and help, prosocial behavior and affective communication with both parents, and, the experimentation of positive emotions: joy and good humor (p < .01). The communication based in criticism with both parents reported statistically significant negative correlations (p < .01). In the multiple linear regression analysis, we found that prosocial behavior and affective communication with the mother are variables that predict positive emotions (R² = .246). In conclusion, this study found that both, prosocial behavior and positive bonds with the mother, predict the experience of positive emotions. [ABSTRACT FROM AUTHOR]

Responsive parental communication during an infant's first year has been positively associated with later language outcomes. This study explores responsivity in mother–infant communication by modeling how change in guiding language between 7 and 11 months influences toddler vocabulary development. In a group of 32 mother–child dyads, change in early maternal guiding language positively predicted child language outcomes measured at 18 and 24 months. In contrast, a number of other linguistic variables – including total utterances and non-guiding language – did not correlate with toddler vocabulary development, suggesting a critical role of responsive change in infant-directed communication. We further assessed whether maternal affect during early communication influenced toddler vocabulary outcomes, finding that dominant affect during early mother–infant communications correlated to lower child language outcomes. These findings provide evidence that responsive parenting should not only be assessed longitudinally, but unique contributions of language and affect should also be concurrently considered in future study. [ABSTRACT FROM AUTHOR]

Copyright of Revista Turismo & Desenvolvimento (RT&D) / Journal of Tourism & Development is the property of Associacao de Gestao e Planeamento em Turismo da Universidade de Aveiro (AGPTUA) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper discusses the enactment and evaluation of Embodied Conversational Agents (ECA) capable of affective communication in Collaborative Virtual Environments (CVE) for learning. The CVE discussed is a reconstruction of the European Parliament in Brussels developed using the REVERIE (Real and Virtual Engagement In Realistic Immersive Environment) framework. REVERIE is a framework designed to support the creation of CVEs populated by ECAs capable of natural human-like behaviour, physical interaction and engagement. The ECA provides a tour of the virtual parliament and participates in the learning activity as an intervention mechanism to engage students. The ECA is capable of immediacy behaviour (verbal and non-verbal) and interactions to support a dialogic learning scenario. The design of the ECA is grounded on a theoretical framework that addresses the required characteristics of the ECA to successfully support collaborative learning. In this paper, we discuss the Heuristic Evaluation of the REVERIE ECA which revealed a wealth of usability problems that led to the development of a list of design recommendations to improve their usability, including its immediacy behaviours and interactions. An ECA capable of effectively creating rapport should result in more positive experiences for participants and better learning results for students in dialogic learning scenarios. Future work aims to evaluate this hypothesis in real-world scenarios with teachers and students participating in a shared virtual educational experience.

The post-war material culture of Kinmen, a former military outpost in Taiwan, reveals a biography moving from conflict to hope for rapprochement, from matériel to militaria to souvenir. By experimenting with the concept of sensuous materialism, this article looks at touristic things from and of the battlefield past and explores how, through their materialities, things interact with people’s senses and shape their understandings of cross-strait relations. Far from being inert, these things are full of life and energy in their ability to animate the object–human relationship. Social memories are enacted through specific material affordances with the senses. Those memories are sensuous, emotional and affective as well as political and historic. Examining the making, staging and consumption of touristic things and how their commemorative materialities interact with and shape people’s consciousness of past histories, present happenings and future dreams helps us gain a more nuanced understanding of the China–Taiwan rapprochement process. [ABSTRACT FROM AUTHOR]

Onomatopoeia is typically described as involving the use of words which imitate sounds. The study of onomatopoeia is often approached through theories of sound symbolism. However, while such approaches provide rich descriptions of onomatopoeia, they have generally paid little attention to the role of onomatopoeia in communication. In this study, we focus on onomatopoeia as a communicative phenomenon, considering what the use of onomatopoeia communicates, and how it is communicated. Our main claim is that onomatopoeia falls on the showing–saying continuum ( Wharton, 2009 ), and involves elements of both showing and saying, contributing to relevance by providing direct evidence for some of the meaning it communicates. We argue that onomatopoeia involves the exploitation of resemblances, and that the non-arbitrary relationship between sound and meaning is a result of the communicator's attempts to recreate his sensory experience using sounds which provide a faithful enough representation of his experience. What is communicated by the use of onomatopoeia is both vague and context-dependent: it amounts to what relevance theorists call an impression rather than a determinate meaning. Our analysis also extends to multimodal and cross-modal communicative behaviours and should therefore pave the way for further investigation of the interface between verbal and non-verbal communication. [ABSTRACT FROM AUTHOR]

Being able to comprehend another person's intentions and emotions is essential for successful social interaction. However, it is currently unknown whether the human brain possesses a neural mechanism that attracts people to others whose mental states they can easily understand. Here we show that the degree to which a person feels attracted to another person can change while they observe the other's affective behavior, and that these changes depend on the observer's confidence in having correctly understood the other's affective state. At the neural level, changes in interpersonal attraction were predicted by activity in the reward system of the observer's brain. Importantly, these effects were specific to individual observer-target pairs and could not be explained by a target's general attractiveness or expressivity. Furthermore, using multivoxel pattern analysis (MVPA),we found that neural activity in the reward system of the observer's brain varied as a function of how well the target's affective behavior matched the observer's neural representation of the underlying affective state: The greater the match, the larger the brain's intrinsic reward signal. Taken together, these findings provide evidence that reward-related neural activity during social encounters signals how well an individual's "neural vocabulary" is suited to infer another person's affective state, and that this intrinsic reward might be a source of changes in interpersonal attraction. [ABSTRACT FROM AUTHOR]

The present study examined individuals' subjective evaluation of their effectiveness with regard to affective communication and problem-solving communication, and their relation to intimate partner violence (IPV) victimization. Data from 100 Caucasian American and Mexican American couples were collected during the first and during the third year of marriage. For affective communication, a significant partner effect emerged, indicating that husbands' higher dissatisfaction with affective communication was related to wives' higher IPV victimization. For problem-solving communication, a significant actor effect emerged, indicating that husbands' higher dissatisfaction with problem-solving communication was related to husbands' higher IPV victimization. While these findings largely generalized to Caucasian Americans, they did not generalize to Mexican Americans. [ABSTRACT FROM AUTHOR]

Objectives: This study focuses on facilitation of clients' psychosocial communication during prenatal counseling for fetal anomaly screening. We assessed how psychosocial communication by clients is related to midwives' psychosocial and affective communication, client-directed gaze and counseling duration.Methods: During 184 videotaped prenatal counseling consultations with 20 Dutch midwives, verbal psychosocial and affective behavior was measured by the Roter Interaction Analysis System (RIAS). We rated the duration of client-directed gaze. We performed multilevel analyses to assess the relation between clients' psychosocial communication and midwives' psychosocial and affective communication, client-directed gaze and counseling duration.Results: Clients' psychosocial communication was higher if midwives' asked more psychosocial questions and showed more affective behavior (β=0.90; CI: 0.45-1.35; p<0.00 and β=1.32; CI: 0.18-2.47; p=0.025, respectively). Clients "psychosocial communication was not related to midwives" client-directed gaze. Additionally, psychosocial communication by clients was directly, positively related to the counseling duration (β=0.59; CI: 0.20-099; p=0.004).Conclusions: In contrast with our expectations, midwives' client-directed gaze was not related with psychosocial communication of clients.Practice Implications: In addition to asking psychosocial questions, our study shows that midwives' affective behavior and counseling duration is likely to encourage client's psychosocial communication, known to be especially important for facilitating decision-making. [ABSTRACT FROM AUTHOR]