EEG signature in psychiatrist's subjective experience: a pilot study

The Assessment of Clinician's Subjective Experience (ACSE) is a self-report questionnaire developed to evaluate clinicians' subjective experiences during patient interactions. While its psychometric properties and clinical validity have been supported, its neurobiological correlates have not yet been investigated.

In this pilot study, two clinicians and ten patients participated in a three-phase protocol comprising: (1) a first clinical interview, (2) ACSE administration, and (3) listening to the audio recording of the first clinical interview. EEG activity was recorded from clinicians during both the first clinical interview and questionnaire administration. Neural data were analyzed in terms of relative power spectral density, node strength, and global efficiency computed from imaginary coherence.

Clinicians were psychiatrists, one male and one female. Seven patients were diagnosed with mixed anxiety and depressive disorder, and three with unspecified anxiety disorders. ACSE scores were highest for the Difficulty in attunement and Engagement dimensions, consistent with previous literature. EEG findings revealed dimension-specific and topographically distinct oscillatory patterns for only two ACSE dimensions: Difficulty in Attunement and Engagement. More limited evidence emerged for Disconfirmation. Functional connectivity analyses indicated different network profiles, characterized by differences in global efficiency patterns. Correlational analyses further identified significant associations between ACSE dimensions and EEG-derived features.

These preliminary findings provide initial evidence that clinicians' subjective experiences during clinical encounters could be associated with measurable neural signatures, offering a novel perspective on the neurobiological basis of intersubjective processes in clinical settings.