Observed Psychomotor Signs (Video Coding)

Gordon Parker, Daniel J. Widlöcher · 1996

Sign-based coding of psychomotor change in depression — facial immobility, slumped posture, slowed and delayed movement, motor agitation and stereotypy — rated only from what you see.

Depression is one of the few psychiatric syndromes with genuinely observable signs, and the sign-based tradition — Widlöcher's work on retardation, Parker's on melancholia as a disorder of movement — argues they are the most specific thing about melancholic depression. This scheme brings that tradition to a video timeline: nine signs, each rated 0 to 3, judged only from what the recording shows.

Rate what you see, not what you are told. That single rule is what distinguishes this from every symptom scale in the text library. A patient who describes crushing slowness but moves and speaks briskly on camera scores low here — and that discrepancy is itself a finding, not an error to smooth over. HAM-D and MADRS already capture the report; this captures the sign.

Two families, rated differently. Retardation signs are stable states, so rate their average across the interview and, where two ratings look equally defensible, take the less severe. Agitation signs come in episodes, so mark the episodes you saw and let severity reflect their typical intensity rather than the single worst second. Both conventions exist because raters left to their own devices drift in opposite directions on the two families.

Give it enough tape. These are judgements about a person's manner over time, not snapshots. The sign-based literature works from interviews of twenty minutes or more, and ratings from a two-minute clip should be labelled as such.

Stereotypy depends on agitation. Repetitive movements — hand-wringing, picking, rocking — only count as agitated stereotypy in the presence of motor agitation. If you rated no agitation, do not rate stereotypy either; otherwise ordinary habitual movement gets scored as pathology.

What is missing on purpose. Psychomotor change also shows up in speech timing — response latency, pausing, slowed articulation — which needs the audio, not the picture. That lives in the Psychomotor Speech Signs scale in the audio library, and because audio scales can be applied to video studies you can run both against the same recording and get the full picture.

If your protocol specifically requires the CORE measure, license it from Cambridge University Press; this scheme covers the same construct in Tagaroo's own words and is not a substitute for that instrument in a study that names it.

Domains (9)

Facial ImmobilityOFI

Reduced mobility of the face — an expressionless, mask-like quality that persists regardless of the topic.

Curated skill
Postural SlumpingOPS

A collapsed, drooping posture — shoulders forward, head down, body sinking into the chair.

Curated skill
Body ImmobilityOBI

How little the person moves overall — amount of movement, not its speed.

Curated skill
Slowed MovementOSM

How slowly movements are executed — speed, not amount. A person can move often and still move slowly.

Curated skill
Delayed Motor InitiationODI

A visible lag between the cue to move and the beginning of movement — starting, not executing, is what is slow.

Curated skill
Non-ReactivityONR

Failure of visible demeanour to shift with the content of the conversation — nothing lightens it and nothing worsens it.

Curated skill
Facial ApprehensionOFA

Visible anxious tension in the face — brows drawn, eyes widened, a look of dread held over time.

Curated skill
Motor AgitationOMA

Restless, driven movement — shifting, rising, pacing, an inability to settle. Distinguish from ordinary fidgeting.

Curated skill
Stereotyped MovementOST

Repetitive purposeless movement in the context of agitation — hand-wringing, picking, rubbing, rocking. Rate 0 if motor agitation is absent.

Curated skill
Parker G, Hadzi-Pavlovic D, editors. Melancholia: A Disorder of Movement and Mood. Cambridge: Cambridge University Press; 1996. Widlöcher DJ. Psychomotor retardation: clinical, theoretical, and psychometric aspects. Psychiatr Clin North Am. 1983;6(1):27-40. Parker G, Hadzi-Pavlovic D, Brodaty H, et al. Psychomotor disturbance in depression: defining the constructs. J Affect Disord. 1993;27(4):255-265.

Framework-derived: a Tagaroo coding scheme operationalizing the sign-based psychomotor-disturbance literature. It deliberately does NOT reproduce the CORE Assessment of Psychomotor Change, whose item text and anchors remain copyright Cambridge University Press 1996 even in the freely downloaded booklet, nor the Salpetriere Retardation Rating Scale (publisher-copyrighted). Sign names, groupings and anchor wording here are Tagaroo's own. Cite the sources above alongside this scheme, and license CORE from Cambridge University Press if your protocol requires that instrument specifically.