arXiv subjects

Rachel Hershenberg

Publications and source records attributed to Rachel Hershenberg.

3 recordsLinked to original sources

arXiv2026

TAMI: Temporally Aligned, Missingness-Aware, and Interpretable Multimodal Fusion for Mental Health Assessment in Older Adults with Mild Cognitive Impairment

Depression and anxiety in older adults with Mild Cognitive Impairment (MCI) are frequently underdiagnosed due to limited access to care. Multimodal analysis of remote clinical interviews is a scalable screening approach, but existing methods have three limitations. First, they do not correct temporal misalignment across multimodal features extracted at different resolutions, inducing spurious cross-modal associations. Second, remote recordings exhibit uneven modality dropout, but missing values are often zero-filled, making them indistinguishable from valid near-zero measurements. Finally, they do not jointly attribute predictions to modalities, questions, and interview moments, limiting fine-grained clinical interpretation. We propose a Temporally-Aligned, Missingness-Aware, Interpretable (TAMI) multimodal fusion framework. TAMI aligns speech, language, facial, and physiological features within question-answer segments on a shared timeline, encodes modality-level missingness over time, and conditions fusion on question context. In interviews with 49 older adults with MCI, TAMI achieved area under the receiver operating characteristic curve (AUROC) scores of 0.68 (depression) and 0.69 (anxiety). Fine-grained temporal alignment of multimodal features produced the largest performance gain ($Δ{\geq}0.1$). Multi-level interpretability analysis revealed that depression classification relied on eyegaze and open-ended questions, while anxiety classification depended on eyegaze and head pose, with attribution uniformly distributed across questions. Using only responses to the open-ended questions (5.1min), the depression model achieved an AUROC score of 0.67, which was not significantly different from using the full interview (19min) ($p>0.05$). Our findings support designing interview protocols centered on open-ended questions for depression screening in older adults with MCI.

cs.CV↗

arXiv2026

LLM-Augmented Therapy Normalization and Aspect-Based Sentiment Analysis for Treatment-Resistant Depression on Reddit

Treatment-resistant depression (TRD) is a severe form of major depressive disorder in which patients do not achieve remission despite multiple adequate treatment trials. Evidence across pharmacologic options for TRD remains limited, and trials often do not fully capture patient-reported tolerability. Large-scale online peer-support narratives therefore offer a complementary lens on how patients describe and evaluate medications in real-world use. In this study, we curated a corpus of 5,059 Reddit posts explicitly referencing TRD from 3,480 subscribers across 28 mental health-related subreddits from 2010 to 2025. Of these, 3,839 posts mentioned at least one medication, yielding 23,399 mentions of 81 generic-name medications after lexicon-based normalization of brand names, misspellings, and colloquialisms. We developed an aspect-based sentiment classifier by fine-tuning DeBERTa-v3 on the SMM4H 2023 therapy-sentiment Twitter corpus with large language model based data augmentation, achieving a micro-F1 score of 0.800 on the shared-task test set. Applying this classifier to Reddit, we quantified sentiment toward individual medications across three categories: positive, neutral, and negative, and tracked patterns by drug, subscriber, subreddit, and year. Overall, 72.1% of medication mentions were neutral, 14.8% negative, and 13.1% positive. Conventional antidepressants, especially SSRIs and SNRIs, showed consistently higher negative than positive proportions, whereas ketamine and esketamine showed comparatively more favorable sentiment profiles. These findings show that normalized medication extraction combined with aspect-based sentiment analysis can help characterize patient-perceived treatment experiences in TRD-related Reddit discourse, complementing clinical evidence with large-scale patient-generated perspectives.

cs.CL↗

arXiv2025

Feasibility of Detecting Cognitive Impairment and Psychological Well-being among Older Adults Using Facial, Acoustic, Linguistic, and Cardiovascular Patterns Derived from Remote Conversations

The aging society urgently requires scalable methods to monitor cognitive decline and identify social and psychological factors indicative of dementia risk in older adults. Our machine learning (ML) models captured facial, acoustic, linguistic, and cardiovascular features from 39 older adults with normal cognition or Mild Cognitive Impairment (MCI), derived from remote video conversations and quantified their cognitive status, social isolation, neuroticism, and psychological well-being. Our model could distinguish Clinical Dementia Rating Scale (CDR) of 0.5 (vs. 0) with 0.77 area under the receiver operating characteristic curve (AUC), social isolation with 0.74 AUC, social satisfaction with 0.75 AUC, psychological well-being with 0.72 AUC, and negative affect with 0.74 AUC. Our feature importance analysis showed that speech and language patterns were useful for quantifying cognitive impairment, whereas facial expressions and cardiovascular patterns were useful for quantifying social and psychological well-being. Our bias analysis showed that the best-performing models for quantifying psychological well-being and cognitive states in older adults exhibited significant biases concerning their age, sex, disease condition, and education levels. Our comprehensive analysis shows the feasibility of monitoring the cognitive and psychological health of older adults, as well as the need for collecting largescale interview datasets of older adults to benefit from the latest advances in deep learning technologies to develop generalizable models across older adults with diverse demographic backgrounds and disease conditions.

cs.HC↗