Word-Aligned Prosody Reflects Speaker Differences More Than Depression or PTSD Severity

Abstract

Word-aligned prosody is increasingly used to detect depression and posttraumatic stress disorder (PTSD), yet the stability and clinical relevance of these measurements remain unclear. We examine stability at two levels. At the word level, we ask whether a speaker produces the same word in a similar speaker-specific way across different utterance contexts. At the speaker level, we ask whether averaging prosody across many words produces consistent speaker scores across separate recordings. Drawing on principles of psychological measurement, we compare these representations in four corpora spanning acted, spontaneous, and clinical speech. Word-specific deviations show little cross-context recurrence (0.01-0.16), whereas speaker summaries are highly consistent, reaching 0.997 in ESD, 0.73-0.90 in MSP-Podcast, and 0.84-0.996 in DAIC-WOZ and PTSD-STOP. Despite this consistency, associations with depression or PTSD severity do not exceed 0.15; equivalence tests exclude effects of 0.30 in all analyses and 0.20 in DAIC-WOZ, while within-person associations with daily PTSD symptoms are near zero ($|\rho|\leq0.04$). Thus, aggregation yields stable speaker-level prosodic measures, but these measures do not detectably track depression or PTSD severity in the studied corpora. Code is available at https://github.com/jen900704/word-aligned-prosody.