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Yosep I, Hikmat R, Mardhiyah A, Hernawaty T. A Scoping Review of Digital-Based Intervention for Reducing Risk of Suicide Among Adults. J Multidiscip Healthc 2024; 17:3545-3556. [PMID: 39070693 PMCID: PMC11283240 DOI: 10.2147/jmdh.s472264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 07/10/2024] [Indexed: 07/30/2024] Open
Abstract
Suicide is a serious public health problem, especially among adults. Risk factors for suicide include the presence of mental health disorders, history of previous suicide attempts; substance or alcohol use and lack of social support. The impact of suicide risk includes psychological loss, as well as the trauma and emotional stress that can be felt by the families and communities left behind. Digital interventions have emerged as a promising alternative for suicide risk prevention. Previous research has focused on the findings of various designs, which did not provide clear intervention information to inform the implementation of the intervention. This study aims to describe a digital intervention to reduce the risk of suicidal behavior in adults. The design used in this study was a scoping review. The authors conducted a literature search from the Scopus, PubMed, and CINAHL databases. Inclusion criteria in this study were articles discussing digital interventions aimed at preventing suicide risk in adult populations, English language, full-text, RCT or quasi-experiment design, and publication period of the last 10 years (2014-2024). The major keywords used in the article search were suicide prevention, digital intervention, and adults. Data extraction used manual table and data analysis used descriptive qualitative with a content approach. The results showed that there were 9 articles that discussed digital-based interventions to reduce suicide risk in adults. The various types of digital interventions used were smartphone apps, online learning modules, and game-based interventions. These interventions offer significant potential in reducing the risk of suicidal behavior in adults. Digital interventions have an important role in reducing the risk of suicidal behavior in adults by considering aspects of suitability to individual needs and understanding digital literacy. Then, the development of mental health services and public health policies presented needs to be done with collaboration between stakeholders in suicide prevention efforts.
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Affiliation(s)
- Iyus Yosep
- Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
| | - Rohman Hikmat
- Master of Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
| | - Ai Mardhiyah
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
| | - Taty Hernawaty
- Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
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Ladis I, Seitov A, Barnes LE, Teachman BA. Perceived Burdensomeness and Thwarted Belongingness in Text Messages of Suicide Attempt Survivors. Arch Suicide Res 2024; 28:779-790. [PMID: 37350046 PMCID: PMC10739607 DOI: 10.1080/13811118.2023.2226692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
OBJECTIVE Perceived burdensomeness and thwarted belongingness are considered interpersonal risk factors for suicide. Examining these themes in personal text messages may help identify proximal suicide risk. METHOD Twenty-six suicide attempt survivors provided personal text messages and reported dates for past periods characterized by positive mood, depressed mood, suicidal ideation (with no attempt), or the two-week period leading up to suicide attempt(s). Texts were then classified into the applicable period based on matching dates. Texts (N = 194,083; including n = 86,705 outgoing texts) were coded for perceived burdensomeness and thwarted belongingness by masked trained raters. Multilevel models were fit to examine whether the target themes (combined into one overall interpersonal risk variable due to low base rate) were more prevalent in texts sent during higher risk episodes (e.g., suicide attempt vs. depressed mood episodes). RESULTS 0.57% of outgoing texts contained either target theme. As hypothesized, logistic models showed participants were more likely to send texts containing the target themes during suicide attempt episodes relative to suicidal ideation (with no attempt) episodes, depressed mood episodes, and positive mood episodes, and during suicidal ideation (with no attempt) episodes relative to positive mood episodes. All contrasts were robust to post-hoc correction except for suicide attempt episodes vs. ideation (with no attempt) episodes. No other significant pairwise differences for episode type emerged. CONCLUSIONS Despite the small sample size and low base rate of target themes in the texts, perceived burdensomeness and thwarted belongingness were associated with intra-individual suicide risk severity in personal text messages.
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Affiliation(s)
- Ilana Ladis
- Department of Psychology, University of Virginia
| | - Arsen Seitov
- Department of Psychology, University of Virginia
| | - Laura E. Barnes
- Department of Engineering Systems and Environment, University of Virginia
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Azizi H, Fakhari A, Farahbakhsh M, Davtalab Esmaeili E, Chattu VK, Ali Asghari N, Nazemipour M, Mansournia MA. Prevention of Re-attempt Suicide Through Brief Contact Interventions: A Systematic Review, Meta-analysis, and Meta-regression of Randomized Controlled Trials. JOURNAL OF PREVENTION (2022) 2023; 44:777-794. [PMID: 37707696 DOI: 10.1007/s10935-023-00747-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/27/2023] [Indexed: 09/15/2023]
Abstract
Brief contact intervention (BCI) is a low-cost intervention to prevent re-attempt suicide. This meta-analysis and meta-regression study aimed to evaluate the effect of BCI on re-attempt prevention following suicide attempts (SAs). We systematically searched using defined keywords in MEDLINE, Embase, and Scopus up to April, 2023. All randomized controlled trials (RCTs) were eligible for inclusion after quality assessment. Random-effects model and subgroup analysis were used to estimate pooled risk difference (RD) and risk ratio (RR) between BCI and re-attempt prevention with 95% confidence intervals (CIs). Meta-regression analysis was carried out to explore the potential sources of heterogeneity. The pooled estimates were (RD = 4%; 95% CI 2-6%); and (RR = 0.62; 95% CI 0.48-0.77). Subgroup analysis demonstrated that more than 12 months intervention (RR = 0.46; 95% CI 0.10-0.82) versus 12 months or less (RR = 0.67; 95% CI 0.54-0.80) increased the effectiveness of BCI on re-attempt suicide reduction. Meta-regression analysis explored that BCI time (more than 12 months), BCI type, age, and female sex were the potential sources of the heterogeneity. The meta-analysis indicated that BCI could be a valuable strategy to prevent suicide re-attempts. BCI could be utilized within suicide prevention strategies as a surveillance component of mental health since BCI requires low-cost and low-educated healthcare providers.
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Affiliation(s)
- Hosein Azizi
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Fakhari
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mostafa Farahbakhsh
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Vijay Kumar Chattu
- Department of OS & OT, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5G 1V7, Canada
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 600077, India
| | - Nasrin Ali Asghari
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Nazemipour
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, P.O. Box 14155-6446, Tehran, Iran.
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McNeilly EA, Mills KL, Kahn LE, Crowley R, Pfeifer JH, Allen NB. Adolescent Social Communication Through Smartphones: Linguistic Features of Internalizing Symptoms and Daily Mood. Clin Psychol Sci 2023; 11:1090-1107. [PMID: 38149299 PMCID: PMC10750975 DOI: 10.1177/21677026221125180] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
The increasing use of smartphone technology by adolescents has led to unprecedented opportunities to identify early indicators of shifting mental health. This intensive longitudinal study examined the extent to which differences in mental health and daily mood are associated with digital social communication in adolescence. In a sample of 30 adolescents (ages 11-15 years), we analyzed 22,152 messages from social media, email, and texting across one month. Lower daily mood was associated with linguistic features reflecting self-focus and reduced temporal distance. Adolescents with lower daily mood tended to send fewer positive emotion words on a daily basis, and more total words on low mood days. Adolescents with lower daily mood and higher depression symptoms tended to use more future focus words. Dynamic linguistic features of digital social communication that relate to changes in mental states may represent a novel target for passive detection of risk and early intervention in adolescence.
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Affiliation(s)
| | - Kathryn L. Mills
- Department of Psychology, University of Oregon, Eugene, USA
- PROMENTA Research Center, Department of Psychology, University of Oslo, Norway
| | - Lauren E. Kahn
- Department of Psychology, University of Oregon, Eugene, USA
| | - Ryann Crowley
- Department of Psychology, University of Oregon, Eugene, USA
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Bogaert L, Van der Gucht K, Kuppens P, Kock M, Schreuder MJ, Kuyken W, Raes F. The effect of universal school-based mindfulness on anhedonia and emotional distress and its underlying mechanisms: A cluster randomised controlled trial via experience sampling in secondary schools. Behav Res Ther 2023; 169:104405. [PMID: 37797436 PMCID: PMC10938062 DOI: 10.1016/j.brat.2023.104405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 09/04/2023] [Accepted: 09/11/2023] [Indexed: 10/07/2023]
Abstract
This cluster randomised controlled trial examined the effectiveness of universal school-based mindfulness training (MT; vs. passive control) to lower anhedonia and emotional distress among mid-adolescents (15-18 years). It further examined three potential mechanisms: dampening of positive emotions, non-acceptance/suppression of negative emotions, and perceived social pressure not to experience/express negative emotions. Adolescents (ncontrol = 136, nintervention = 95) participated in three assessment points (before, after and two/three months after the in-class MT), consisting of Experience Sampling (ES) assessments and self-report questionnaires (SRQs) to corroborate the ES assessments. Analyses were based on general linear modelling and multilevel modelling. Overall, no evidence was found for a significant beneficial and long-lasting impact of the MT on adolescents' mental health. Importantly, some barriers inherently linked to universal MT approaches (low engagement in and mixed attitudes towards the MT) may have tempered the effectiveness of the MT in the current trial. Further research should prioritise overcoming these barriers to optimise programme implementation. Additionally, given the potential complex interplay of moderators at micro- (home practice), meso- (school climate), and macro-level (broader context), research should simultaneously focus on alternative ways of delivering MT at schools to strengthen adolescents' mental health.
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Affiliation(s)
- Liesbeth Bogaert
- Research Unit Behaviour, Health and Psychopathology, KU Leuven, Belgium; Leuven Mindfulness Centre, KU Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium.
| | - Katleen Van der Gucht
- Leuven Mindfulness Centre, KU Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium; Research Unit Methods, Individual and Cultural Differences, Affect and Social Behavior, KU Leuven, Belgium; Social and Behavioral Sciences, Tilburg University, the Netherlands
| | - Peter Kuppens
- Leuven Mindfulness Centre, KU Leuven, Belgium; Research Unit Methods, Individual and Cultural Differences, Affect and Social Behavior, KU Leuven, Belgium
| | - Merle Kock
- Research Unit Behaviour, Health and Psychopathology, KU Leuven, Belgium; Leuven Mindfulness Centre, KU Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium
| | - Marieke J Schreuder
- Research Unit Methods, Individual and Cultural Differences, Affect and Social Behavior, KU Leuven, Belgium
| | - Willem Kuyken
- Department of Psychiatry, Medical Sciences Division, University of Oxford, United Kingdom; University of Oxford Mindfulness Research Centre, University of Oxford, United Kingdom
| | - Filip Raes
- Research Unit Behaviour, Health and Psychopathology, KU Leuven, Belgium; Leuven Mindfulness Centre, KU Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium.
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Dobbs MF, McGowan A, Selloni A, Bilgrami Z, Sarac C, Cotter M, Herrera SN, Cecchi GA, Goodman M, Corcoran CM, Srivastava A. Linguistic correlates of suicidal ideation in youth at clinical high-risk for psychosis. Schizophr Res 2023; 259:20-27. [PMID: 36933977 PMCID: PMC10504409 DOI: 10.1016/j.schres.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/04/2023] [Accepted: 03/05/2023] [Indexed: 03/20/2023]
Abstract
Suicidal ideation (SI) is prevalent among individuals at clinical high-risk for psychosis (CHR). Natural language processing (NLP) provides an efficient method to identify linguistic markers of suicidality. Prior work has demonstrated that an increased use of "I", as well as words with semantic similarity to "anger", "sadness", "stress" and "lonely", are correlated with SI in other cohorts. The current project analyzes data collected in an SI supplement to an NIH R01 study of thought disorder and social cognition in CHR. This study is the first to use NLP analyses of spoken language to identify linguistic correlates of recent suicidal ideation among CHR individuals. The sample included 43 CHR individuals, 10 with recent suicidal ideation and 33 without, as measured by the Columbia-Suicide Severity Rating Scale, as well as 14 healthy volunteers without SI. NLP methods include part-of-speech (POS) tagging, a GoEmotions-trained BERT Model, and Zero-Shot Learning. As hypothesized, individuals at CHR for psychosis who endorsed recent SI utilized more words with semantic similarity to "anger" compared to those who did not. Words with semantic similarity to "stress", "loneliness", and "sadness" were not significantly different between the two CHR groups. Contrary to our hypotheses, CHR individuals with recent SI did not use the word "I" more than those without recent SI. As anger is not characteristic of CHR, findings have implications for the consideration of subthreshold anger-related sentiment in suicidal risk assessment. As NLP is scalable, findings suggest that language markers may improve suicide screening and prediction in this population.
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Affiliation(s)
- Matthew F Dobbs
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA.
| | - Alessia McGowan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA.
| | - Alexandria Selloni
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA.
| | - Zarina Bilgrami
- Department of Psychology, Emory University, 201 Dowman Dr, Atlanta, GA 3032, USA.
| | - Cansu Sarac
- Department of Psychology, Long Island University-Brooklyn, 1 University Plaza, Brooklyn, NY 11201, USA.
| | - Matthew Cotter
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA.
| | - Shaynna N Herrera
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA.
| | - Guillermo A Cecchi
- IBM T. J. Watson Research Center, 1101 Kitchawan Rd, Yorktown Heights, NY 10598, USA.
| | - Marianne Goodman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA; VISN 2 Mental Illness Research, Education, and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, 130 W Kingsbridge Rd, The Bronx, NY 10468, USA.
| | - Cheryl M Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA; VISN 2 Mental Illness Research, Education, and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, 130 W Kingsbridge Rd, The Bronx, NY 10468, USA.
| | - Agrima Srivastava
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA.
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7
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Ladis I, Valladares TL, Coppersmith DDL, Glenn JJ, Nobles AL, Barnes LE, Teachman BA. Inferring sleep disturbance from text messages of suicide attempt survivors: A pilot study. Suicide Life Threat Behav 2023; 53:39-53. [PMID: 36083138 PMCID: PMC9908817 DOI: 10.1111/sltb.12920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 08/13/2022] [Accepted: 08/26/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Identifying digital markers of sleep disturbance-a known suicide risk factor-may aid in the detection of imminent suicide risk. This study examined sleep-related communication and texting patterns in personal text messages (N = 86,705) of suicide attempt survivors. METHOD Twenty-six participants provided dates of past suicide attempts and 2-week periods of positive mood, depressed mood, or suicidal ideation. Linguistic Inquiry Word Count was used to identify sleep-related texts via a custom dictionary. Mixed effect models were fitted to test the association between suicide/mood episode type (e.g., attempt versus ideation) and three outcomes: likelihood of a text including sleep-related content, nightly count of texts sent from midnight to 5:00 AM, and sum of unique hour bins from midnight to 5:00 AM with outgoing texts. RESULTS Analyses with a sleep dictionary that was manually revised to be more accurate (but not the original unedited dictionary) showed sleep-related communication was more likely during depressed mood episodes than positive mood episodes. Otherwise, there were no significant differences in sleep-related communication or objective texting patterns across episode type. CONCLUSIONS Although we did not detect differences in sleep-related communication tied to suicidal thoughts or behaviors, sleep-related communication may differ as a function of within-person mood level.
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Affiliation(s)
- Ilana Ladis
- Department of Psychology, University of Virginia
| | | | | | | | | | - Laura E. Barnes
- Department of Engineering Systems and Environment, University of Virginia
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8
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Potier R. Revue critique sur le potentiel du numérique dans la recherche en psychopathologie : un point de vue psychanalytique. L'ÉVOLUTION PSYCHIATRIQUE 2022. [DOI: 10.1016/j.evopsy.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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9
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Identifying suicidal emotions on social media through transformer-based deep learning. APPL INTELL 2022. [DOI: 10.1007/s10489-022-04060-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Abstract
BACKGROUND Digital phenotyping has been defined as the moment-by-moment assessment of an illness state through digital means, promising objective, quantifiable data on psychiatric patients' conditions, and could potentially improve diagnosis and management of mental illness. As it is a rapidly growing field, it is to be expected that new literature is being published frequently. OBJECTIVE We conducted this scoping review to assess the current state of literature on digital phenotyping and offer some discussion on the current trends and future direction of this area of research. METHODS We searched four databases, PubMed, Ovid MEDLINE, PsycINFO and Web of Science, from inception to August 25th, 2021. We included studies written in English that 1) investigated or applied their findings to diagnose psychiatric disorders and 2) utilized passive sensing for management or diagnosis. Protocols were excluded. A narrative synthesis approach was used, due to the heterogeneity and variability in outcomes and outcome types reported. RESULTS Of 10506 unique records identified, we included a total of 107 articles. The number of published studies has increased over tenfold from 2 in 2014 to 28 in 2020, illustrating the field's rapid growth. However, a significant proportion of these (49% of all studies and 87% of primary studies) were proof of concept, pilot or correlational studies examining digital phenotyping's potential. Most (62%) of the primary studies published evaluated individuals with depression (21%), BD (18%) and SZ (23%) (Appendix 1). CONCLUSION There is promise shown in certain domains of data and their clinical relevance, which have yet to be fully elucidated. A consensus has yet to be reached on the best methods of data collection and processing, and more multidisciplinary collaboration between physicians and other fields is needed to unlock the full potential of digital phenotyping and allow for statistically powerful clinical trials to prove clinical utility.
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Affiliation(s)
- Alex Z R Chia
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore City, Singapore
| | - Melvyn W B Zhang
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore City, Singapore.,National Addictions Management Service, Institute of Mental Health, Singapore City, Singapore
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11
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Homan S, Gabi M, Klee N, Bachmann S, Moser AM, Duri' M, Michel S, Bertram AM, Maatz A, Seiler G, Stark E, Kleim B. Linguistic features of suicidal thoughts and behaviors: A systematic review. Clin Psychol Rev 2022; 95:102161. [DOI: 10.1016/j.cpr.2022.102161] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 03/28/2022] [Accepted: 04/27/2022] [Indexed: 12/13/2022]
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Liu T, Meyerhoff J, Eichstaedt JC, Karr CJ, Kaiser SM, Kording KP, Mohr DC, Ungar LH. The relationship between text message sentiment and self-reported depression. J Affect Disord 2022; 302:7-14. [PMID: 34963643 PMCID: PMC8912980 DOI: 10.1016/j.jad.2021.12.048] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/15/2021] [Accepted: 12/18/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Personal sensing has shown promise for detecting behavioral correlates of depression, but there is little work examining personal sensing of cognitive and affective states. Digital language, particularly through personal text messages, is one source that can measure these markers. METHODS We correlated privacy-preserving sentiment analysis of text messages with self-reported depression symptom severity. We enrolled 219 U.S. adults in a 16 week longitudinal observational study. Participants installed a personal sensing app on their phones, which administered self-report PHQ-8 assessments of their depression severity, collected phone sensor data, and computed anonymized language sentiment scores from their text messages. We also trained machine learning models for predicting end-of-study self-reported depression status using on blocks of phone sensor and text features. RESULTS In correlation analyses, we find that degrees of depression, emotional, and personal pronoun language categories correlate most strongly with self-reported depression, validating prior literature. Our classification models which predict binary depression status achieve a leave-one-out AUC of 0.72 when only considering text features and 0.76 when combining text with other networked smartphone sensors. LIMITATIONS Participants were recruited from a panel that over-represented women, caucasians, and individuals with self-reported depression at baseline. As language use differs across demographic factors, generalizability beyond this population may be limited. The study period also coincided with the initial COVID-19 outbreak in the United States, which may have affected smartphone sensor data quality. CONCLUSIONS Effective depression prediction through text message sentiment, especially when combined with other personal sensors, could enable comprehensive mental health monitoring and intervention.
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Affiliation(s)
- Tony Liu
- Department of Computer and Information Science, University of Pennsylvania, USA.
| | - Jonah Meyerhoff
- Center for Behavioral Intervention Technologies (CBITs), Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, USA
| | | | | | - Susan M Kaiser
- Center for Behavioral Intervention Technologies (CBITs), Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, USA
| | - Konrad P Kording
- Department of Bioengineering, Department of Neuroscience, University of Pennsylvania, USA
| | - David C Mohr
- Center for Behavioral Intervention Technologies (CBITs), Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, USA
| | - Lyle H Ungar
- Department of Computer and Information Science, University of Pennsylvania, USA
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Bettis AH, Burke TA, Nesi J, Liu RT. Digital Technologies for Emotion-Regulation Assessment and Intervention: A Conceptual Review. Clin Psychol Sci 2022; 10:3-26. [PMID: 35174006 PMCID: PMC8846444 DOI: 10.1177/21677026211011982] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
The ability to regulate emotions in response to stress is central to healthy development. While early research in emotion regulation predominantly employed static, self-report measurement, the past decade has seen a shift in focus toward understanding the dynamic nature of regulation processes. This is reflected in recent refinements in the definition of emotion regulation, which emphasize the importance of the ability to flexibly adapt regulation efforts across contexts. The latest proliferation of digital technologies employed in mental health research offers the opportunity to capture the state- and context-sensitive nature of emotion regulation. In this conceptual review, we examine the use of digital technologies (ecological momentary assessment; wearable and smartphone technology, physical activity, acoustic data, visual data, and geo-location; smart home technology; virtual reality; social media) in the assessment of emotion regulation and describe their application to interventions. We also discuss challenges and ethical considerations, and outline areas for future research.
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Affiliation(s)
| | | | | | - Richard T Liu
- Harvard Medical School
- Massachusetts General Hospital
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14
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Sawhney R, Joshi H, Gandhi S, Jin D, Shah RR. Robust suicide risk assessment on social media via deep adversarial learning. J Am Med Inform Assoc 2021; 28:1497-1506. [PMID: 33779728 PMCID: PMC8279792 DOI: 10.1093/jamia/ocab031] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 01/06/2021] [Accepted: 03/22/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The prevalence of social media for sharing personal thoughts makes it a viable platform for the assessment of suicide risk. However, deep learning models are not able to capture the diverse nature of linguistic choices and temporal patterns that can be exhibited by a suicidal user on social media and end up overfitting on specific cues that are not generally applicable. We propose Adversarial Suicide assessment Hierarchical Attention (ASHA), a hierarchical attention model that employs adversarial learning for improving the generalization ability of the model. MATERIAL AND METHODS We assess the suicide risk of a social media user across 5 levels of increasing severity of risk. ASHA leverages a transformer-based architecture to learn the semantic nature of social media posts and a temporal attention-based long short-term memory architecture for the sequential modeling of a user's historical posts. We dynamically generate adversarial examples by adding perturbations to actual examples that can simulate the stochasticity in historical posts, thereby making the model robust. RESULTS Through extensive experiments, we establish the face-value of ASHA and show that it significantly outperforms existing baselines, with the F1 score of 64%. This is a 2% and a 4% increase over the ContextBERT and ContextCNN baselines, respectively. Finally, we discuss the practical applicability and ethical aspects of our work pertaining to ASHA, as a human-in-the-loop framework. DISCUSSION AND CONCLUSIONS Adversarial samples can be helpful in capturing the diverse nature of suicidal ideation. Through ASHA, we hope to form a component in a larger human-in-the-loop infrastructure for suicide risk assessment on social media.
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Affiliation(s)
| | - Harshit Joshi
- Cluster Innovation Centre, University of Delhi, New Delhi, India
| | - Saumya Gandhi
- Computer Science, Visvesvaraya National Institute of Technology, Nagpur, India
| | - Di Jin
- Computer Science and Artificial Intelligence Lab, Massachussetts Institute of Technology, Cambridge, Massachussetts USA
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Nesi J, Burke TA, Bettis AH, Kudinova AY, Thompson EC, MacPherson HA, Fox KA, Lawrence HR, Thomas SA, Wolff JC, Altemus MK, Soriano S, Liu RT. Social media use and self-injurious thoughts and behaviors: A systematic review and meta-analysis. Clin Psychol Rev 2021; 87:102038. [PMID: 34034038 PMCID: PMC8243901 DOI: 10.1016/j.cpr.2021.102038] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 04/28/2021] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Abstract
Despite considerable public and scholarly debate about the role of social media in self-injurious thoughts and behaviors (SITBs), no comprehensive, quantitative synthesis of this literature has previously been undertaken. The current systematic review and meta-analysis examines associations between social media use and SITBs, including suicidal ideation, suicide plans, suicide attempts, and nonsuicidal self-injury (NSSI). A range of social media behaviors and experiences were identified, including cybervictimization and perpetration, exposure to and generation of SITB-related content, problematic use, sexting, social media importance, and frequency of use. A systematic search of PsycINFO, Medline, CINAHL, and the references of prior reviews yielded 61 eligible studies. Results largely suggested medium effect sizes for associations between specific social media constructs (cybervictimization, SITB-related social media use, problematic social media use) and SITBs. There was no association between frequency of social media use and SITBs; however, studies on this topic were limited. The majority of studies identified focused on cybervictimization, and results suggested positive associations with all SITBs, with the association between cybervictimization and suicidal ideation stronger for adolescents than adults. Overall, findings highlight the utility of examining specific social media behaviors and experiences, and point to the need for more research in this area.
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Affiliation(s)
- Jacqueline Nesi
- Alpert Medical School of Brown University, United States; Rhode Island Hospital, United States.
| | - Taylor A Burke
- Alpert Medical School of Brown University, United States; Rhode Island Hospital, United States
| | | | - Anastacia Y Kudinova
- Alpert Medical School of Brown University, United States; Emma Pendleton Bradley Hospital, United States
| | - Elizabeth C Thompson
- Alpert Medical School of Brown University, United States; Rhode Island Hospital, United States
| | - Heather A MacPherson
- Alpert Medical School of Brown University, United States; Emma Pendleton Bradley Hospital, United States
| | - Kara A Fox
- University of North Carolina at Chapel Hill, United States
| | - Hannah R Lawrence
- McLean Hospital, United States; Havard Medical School, United States
| | - Sarah A Thomas
- Alpert Medical School of Brown University, United States; Emma Pendleton Bradley Hospital, United States
| | - Jennifer C Wolff
- Alpert Medical School of Brown University, United States; Rhode Island Hospital, United States
| | | | - Sheiry Soriano
- Alpert Medical School of Brown University, United States
| | - Richard T Liu
- Havard Medical School, United States; Massachusetts General Hospital, United States
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Sawhney R, Joshi H, Nobles A, Shah RR. Tweet Classification to Assist Human Moderation for Suicide Prevention. PROCEEDINGS OF THE ... INTERNATIONAL AAAI CONFERENCE ON WEBLOGS AND SOCIAL MEDIA. INTERNATIONAL AAAI CONFERENCE ON WEBLOGS AND SOCIAL MEDIA 2021; 15:609-620. [PMID: 35173997 PMCID: PMC8843106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Social media platforms are already engaged in leveraging existing online socio-technical systems to employ just-in-time interventions for suicide prevention to the public. These efforts primarily rely on self-reports of potential self-harm content that is reviewed by moderators. Most recently, platforms have employed automated models to identify self-harm content, but acknowledge that these automated models still struggle to understand the nuance of human language (e.g., sarcasm). By explicitly focusing on Twitter posts that could easily be misidentified by a model as expressing suicidal intent (i.e., they contain similar phrases such as "wanting to die"), our work examines the temporal differences in historical expressions of general and emotional language prior to a clear expression of suicidal intent. Additionally, we analyze time-aware neural models that build on these language variants and factors in the historical, emotional spectrum of a user's tweeting activity. The strongest model achieves high (statistically significant) performance (macro F1=0.804, recall=0.813) to identify social media indicative of suicidal intent. Using three use cases of tweets with phrases common to suicidal intent, we qualitatively analyze and interpret how such models decided if suicidal intent was present and discuss how these analyses may be used to alleviate the burden on human moderators within the known constraints of how moderation is performed (e.g., no access to the user's timeline). Finally, we discuss the ethical implications of such data-driven models and inferences about suicidal intent from social media. Content warning: this article discusses self-harm and suicide.
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Allison GO, Benau EM, Asbaghi S, Pagliacco D, Stewart JG, Auerbach RP. Neurophysiological Markers Related to Negative Self-referential Processing Differentiate Adolescent Suicide Ideators and Attempters. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2021; 1:16-27. [PMID: 36324429 PMCID: PMC9616352 DOI: 10.1016/j.bpsgos.2021.04.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 11/22/2022] Open
Abstract
Background Adolescent suicide is a major public health concern, and presently, there is a limited understanding of the neurophysiological correlates of suicidal behaviors. Cognitive models of suicide indicate that negative views of the self are related to suicidal thoughts and behaviors, and this study investigated whether behavioral and neural correlates of self-referential processing differentiate suicide ideators from recent attempters. Methods Adolescents with depression reporting current suicidal ideation and no lifetime suicide attempts (suicide ideators, n = 30) and past-year suicide attempts (recent attempters, n = 26) completed a self-referential encoding task while high-density electroencephalogram data were recorded. Behavioral analyses focused on negative processing bias (i.e., tendency to attribute negative information as being self-relevant) and drift rate (i.e., slope of reaction time and response type that corresponds to how quickly information is accumulated to make a decision about whether words are self-referent). Neurophysiological markers probing components reflecting early semantic monitoring (P2), engagement (early late positive potential), and effortful encoding (late late positive potential) also were tested. Results Adolescent suicide ideators and recent suicide attempters reported comparable symptom severity, suicide ideation, and mental disorders. Although there were no behavioral differences, compared with suicide ideators, suicide attempters exhibited greater P2 amplitudes for negative versus positive words, which may reflect enhanced attention and arousal in response to negative self-referential stimuli. There were no group differences for the early or late late positive potential. Conclusions Enhanced sensory arousal in response to negative stimuli-that is, attentional orienting to semantic, emotional, and self-relevant features-differentiates adolescent suicide attempters from ideators and thus may signal risk for suicidal behavior.
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Affiliation(s)
- Grace O. Allison
- Department of Psychiatry, Columbia University, New York, New York
| | - Erik M. Benau
- Department of Psychiatry, Columbia University, New York, New York
| | - Steven Asbaghi
- Department of Psychiatry, Columbia University, New York, New York
| | - David Pagliacco
- Department of Psychiatry, Columbia University, New York, New York
| | - Jeremy G. Stewart
- Department of Psychology and Centre for Neuroscience Studies, Queen’s University, Kingston, Ontario, Canada
| | - Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, New York
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, New York
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Macrynikola N, Auad E, Menjivar J, Miranda R. Does social media use confer suicide risk? A systematic review of the evidence. COMPUTERS IN HUMAN BEHAVIOR REPORTS 2021. [DOI: 10.1016/j.chbr.2021.100094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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