Reading between the lines: Combining pause dynamics and semantic coherence for automated assessment of thought disorder.
Neuropsychologia July 28, 2026 Feng Chen, Weizhe Xu, Changye Li et al.
Pause dynamics in speech—silent intervals between utterances—add unique information beyond semantic coherence for assessing formal thought disorder (FTD) in schizophrenia spectrum disorders. Across three datasets (naturalistic diaries, picture descriptions, and dream narratives; total 255 participants), models combining pause features with semantic coherence predicted clinician-rated FTD severity more accurately than coherence alone. Late fusion of both feature types raised average Spearman correlation from 0.413 to 0.455. The most informative pause patterns varied by context, indicating that pause dynamics and semantic coherence capture complementary aspects of thought disorganization. This multimodal framework offers a scalable, automated approach to assessing disorganized speech.