Updating verbal fluency analysis for the 21st century: Applications for psychiatry

•Verbal fluency assessment is widely employed in psychiatric research, but the traditional ways of analyzing results often yields crude measures based primarily on word counts.•New technology, specifically automatic speech recognition and natural language processing, can derive new metrics on temporal dynamics and semantic relationships in verbal fluency responses.•These metrics can be used to examine many clinical groups, and we demonstrate how responses from depressed patients can compare to those of healthy volunteers. Evaluating patients’ verbal fluency by counting the number of unique words (e.g., animals) produced in a short-period (e.g., 1–3 min) is one of the most widely employed cognitive tests in psychiatric research. We introduce new methods to analyze fluency output that leverage modern computational language technology. This enables moving beyond simple word counts to charting the temporal dynamics of speech and objectively quantifying the semantic relationship of the utterances. These metrics can greatly expand the current psychiatric research toolkit and can help refine clinical theories regarding the nature of putative language differences in patients.