Studying How Individuals Who Express the Feeling of Loneliness in an Online Loneliness Forum Communicate in a Nonloneliness Forum: Observational Study

Linguistic Variables and Gender Differences Within a Messenger-Based Psychosocial Chat Counseling Service for Children and Adolescents: Cross-Sectional Study

BACKGROUND

Text messaging is widely used by young people for communicating and seeking mental health support through chat-based helplines. However, written communication lacks nonverbal cues, and language usage is an important source of information about a person's mental health state and is known to be a marker for psychopathology.

OBJECTIVE

The aim of the study was to investigate language usage, and its gender differences and associations with the presence of psychiatric symptoms within a chat counseling service for adolescents and young adults.

METHODS

For this study, the anonymized chat content of a German messenger-based psychosocial chat counseling service for children and adolescents ("krisenchat") between May 2020 and July 2021 was analyzed. In total, 661,131 messages from 6962 users were evaluated using Linguistic Inquiry and Word Count, considering the following linguistic variables: first-person singular and plural pronouns, negations, positive and negative emotion words, insight words, and causation words. Descriptive analyses were performed, and gender differences of those variables were evaluated. Finally, a binary logistic regression analysis examined the predictive value of linguistic variables on the presence of psychiatric symptoms.

RESULTS

Across all analyzed chats, first-person singular pronouns were used most frequently (965,542/8,328,309, 11.6%), followed by positive emotion words (408,087/8,328,309, 4.9%), insight words (341,460/8,328,309, 4.1%), negations (316,475/8,328,309, 3.8%), negative emotion words (266,505/8,328,309, 3.2%), causation words (241,520/8,328,309, 2.9%), and first-person plural pronouns (499,698/8,328,309, 0.6%). Female users and users identifying as diverse used significantly more first-person singular pronouns and insight words than male users (both P<.001). Negations were significantly more used by female users than male users or users identifying as diverse (P=.007). Similar findings were noted for negative emotion words (P=.01). The regression model of predicting psychiatric symptoms by linguistic variables was significant and indicated that increased use of first-person singular pronouns (odds ratio [OR] 1.05), negations (OR 1.11), and negative emotion words (OR 1.15) was positively associated with the presence of psychiatric symptoms, whereas increased use of first-person plural pronouns (OR 0.39) and causation words (OR 0.90) was negatively associated with the presence of psychiatric symptoms. Suicidality, self-harm, and depression showed the most significant correlations with linguistic variables.

CONCLUSIONS

This study highlights the importance of examining linguistic features in chat counseling contexts. By integrating psycholinguistic findings into counseling practice, counselors may better understand users' psychological processes and provide more targeted support. For instance, certain linguistic features, such as high use of first-person singular pronouns, negations, or negative emotion words, may indicate the presence of psychiatric symptoms, particularly among female users and users identifying as diverse. Further research is needed to provide an in-depth look into language processes within chat counseling services.

Social media use and body image issues among adolescents in a vulnerable Louisiana community

Widespread concern has been expressed regarding unrealistic body image and adolescent eating disorder promoting content on social media (SM) platforms. Numerous research studies have examined the impact of SM on body image as well as social vulnerability on negative mental health outcomes. Despite this, few previous studies have examined the impact of SM on body image specifically in vulnerable, underserved, or predominantly minority communities. This study examines the impact of SM on body image issues (BII) in adolescents in a public school system where greater than 50% of the students live in impoverished households. In late 2019, high school student leaders in Northwest Louisiana developed a survey alongside Step Forward, a collective impact initiative. Questions investigated adolescent SM use and mental health in Caddo Parish, namely BII. Teachers within Caddo Parish Public School System administered the survey. Out of the 11,248 total high school students in the school system, nearly 50% were sampled for a sample size of 5,070. Hypotheses included: (1) females were more likely to use SM than males, (2) increasing time spent on SM would correlate with females reporting BII, with males remaining largely unaffected, and (3) highly visual social media (HVSM) platforms would be associated with greater reports of BII than non-HVSM platforms. Results showed females were more likely to use SM (p < 0.001) and report BII (p < 0.001) compared to males, while both sexes reported BII with increasing time spent on SM (p < 0.001). A diversity of platforms were associated with increased BII among SM users compared to non-users (p < 0.001): Pinterest, Reddit, Snapchat, TikTok, Twitter, and YouTube. This conclusion is tempered by the omission of race as a variable in the study design, the use of self-report, and the use of an unvalidated instrument. These findings suggest that the harmful association between SM use and BII may transcend culture and socioeconomic status for a broadly deleterious effect on adolescent mental wellbeing.

Head versus heart: social media reveals differential language of loneliness from depression

We study the language differentially associated with loneliness and depression using 3.4-million Facebook posts from 2986 individuals, and uncover the statistical associations of survey-based depression and loneliness with both dictionary-based (Linguistic Inquiry Word Count 2015) and open-vocabulary linguistic features (words, phrases, and topics). Loneliness and depression were found to have highly overlapping language profiles, including sickness, pain, and negative emotions as (cross-sectional) risk factors, and social relationships and activities as protective factors. Compared to depression, the language associated with loneliness reflects a stronger cognitive focus, including more references to cognitive processes (i.e., differentiation and tentative language, thoughts, and the observation of irregularities), and cognitive activities like reading and writing. As might be expected, less lonely users were more likely to reference social relationships (e.g., friends and family, romantic relationships), and use first-person plural pronouns. Our findings suggest that the mechanisms of loneliness include self-oriented cognitive activities (i.e., reading) and an overattention to the interpretation of information in the environment. These data-driven ecological findings suggest interventions for loneliness that target maladaptive social cognitions (e.g., through reframing the perception of social environments), strengthen social relationships, and treat other affective distress (i.e., depression).

Understanding the expression of loneliness on Twitter across age groups and genders

Some individuals seek support around loneliness on social media forums. In this work, we aim to determine differences in the use of language by users-in different age groups and genders (female, male), who publish posts on Twitter expressing loneliness. We hypothesize that these differences in the use of language will reflect how these users express themselves and some of their support needs. Interventions may vary depending on the age and gender of an individual, hence, in order to identify high-risk individuals who express loneliness on Twitter and provide appropriate interventions for these users, it is important to understand the variations in language use by users who belong to different age groups and genders and post about loneliness on Twitter. We discuss the findings from this work and how they can help guide the design of online loneliness interventions.

The design and development of an experience measure for a peer community moderated forum in a digital mental health service

Online digital mental health communities can contribute to users' mental health positively and negatively. Yet the measurement of experience, outcomes and impact mechanisms relating to digital mental health communities is difficult to capture. In this paper we demonstrate the development of an online experience measure for a specific children and young people's community forum inside a digital mental health service. The development of the Peer Online Community Experience Measure (POCEM) is informed by a multi-phased design: (i) item reduction through Estimate-Talk-Estimate modified Delphi methods, (ii) user testing with think-aloud protocols and (iii) a pilot study within the digital service community to explore observational data within the platform. Experts in the field were consulted to help reduce the items in the pool and to check their theoretical coherence. User testing workshops helped to inform the usability appearance, wording, and purpose of the measure. Finally, the pilot results highlight completion rates, differences in scores for age and roles and "relate to others", as the most frequent domain mechanism of support for this community. Outcomes frequently selected show the importance of certain aspects of the community, such as safety, connection, and non-judgment previously highlighted in the literature. Experience measures like this one could be used as indicators of active therapeutic engagement within the forum community and its content but further research is required to ascertain its acceptability and validity. Multi-phased approaches involving stakeholders and user-centred design activities enhances the development of digitally enabled measurement tools.

Family Caregiver's Loneliness and Related Health Factors: What Can Be Changed?

Background: Loneliness is a public health issue that may affect the entire population. Loneliness is associated with depression, sleep disorders, fatigue, and increased risk of obesity and diabetes. Risk factors for loneliness include having a poor social network and poor physical and mental health. The main objective was to study factors related to loneliness of family caregivers caring for independent older people. Methods: We performed a non-interventional observational cross-sectional study in south-eastern France. Family caregivers caring for people aged 70 and over and living at home were included. These older people were independent, without long-term conditions, and had applied for professional social assistance for daily living. Data were collected through a questionnaire, administered face-to-face or by telephone. Loneliness and perceived health status were measured through a single-question. Burden was assessed through the Mini-Zarit Scale, and frailty was measured through the Gerontopole Frailty Screening Tool. Results: Of the 876 family caregivers included, 10% felt lonely often or always. They reported more physical and mental health issues than those who did not feel loneliness (p < 0.001). Family caregivers with loneliness were more likely to be looking after a parent and were twice as likely to have a moderate to severe burden (OR = 2.6). They were more likely to feel anxious (OR = 5.6), to have sleep disorders (OR = 2.4), to be frail (OR = 2), and to view the status of their health as poor or bad (OR = 2). Conclusions: Loneliness has a negative impact on health, causes frailty, and places a burden on family caregivers. Means must be implemented to anticipate the consequences of the loneliness felt by family caregivers, notably by orienting them towards the relevant services.

Understanding user communication around loneliness on online forums

Increasingly, individuals experiencing loneliness are seeking support on online forums-some of which focus specifically on discussions around loneliness (loneliness forums); loneliness may influence how these individuals communicate in other online forums not focused on loneliness (non-loneliness forums). In order to provide effective and appropriate online interventions around loneliness, it is important to understand how users who publish posts in a loneliness forum communicate in the loneliness forum and non-loneliness forums they belong to. In this paper, using language features, the following analyses are conducted: (1) Posts published on an online loneliness forum on Reddit, /r/Lonely are compared to posts (published by the same users and around the same time period) on two Reddit online forums i.e. an advice seeking forum, /r/AskReddit and a forum focused on discussions around depression (depression forum), /r/depression. (2) Interventions related to loneliness may vary depending on if an individual is lonely and depressed or lonely but not depressed; language use differences in posts published in /r/Lonely by the following set of users are identified: (a) users who post in both /r/Lonely and a depression forum and (b) users who post in /r/Lonely but not in the depression forum. The findings from this work gain new insights, for example: (i) /r/Lonely users tend to seek advice/ask questions related to relationships in the advice seeking forum, /r/AskReddit and (ii) users who are members of the loneliness forum but not the depression forum tend to publish posts (on the loneliness forum) on topic themes related to work/job, however, those who are members of the loneliness and depression forums tend to use more words associated with anger, negation, death, and post on topic themes related to affection relative to relationships in their loneliness forum posts. Some of the findings from this work also align with prior work e.g. users who express loneliness in online forums tend to make more reference to self. These findings aid in gaining insights into how users communicate on these forums and their support needs, thereby informing loneliness interventions.

Understanding Communication in an Online Cancer Forum: Content Analysis Study

Background

Cancer affects individuals, their family members, and friends, and increasingly, some of these individuals are turning to online cancer forums to express their thoughts/feelings and seek support such as asking cancer-related questions. The thoughts/feelings expressed and the support needed from these online forums may differ depending on if (1) an individual has or had cancer or (2) an individual is a family member or friend of an individual who has or had cancer; the language used in posts in these forums may reflect these differences.

Objective

Using natural language processing methods, we aim to determine the differences in the support needs and concerns expressed in posts published on an online cancer forum by (1) users who self-declare to have or had cancer compared with (2) users who self-declare to be family members or friends of individuals with or that had cancer.

Methods

Using latent Dirichlet allocation (LDA), which is a natural language processing algorithm and Linguistic Inquiry and Word Count (LIWC), a psycholinguistic dictionary, we analyzed posts published on an online cancer forum with the aim to delineate the language features associated with users in these different groups.

Results

Users who self-declare to have or had cancer were more likely to post about LDA topics related to hospital visits (Cohen d=0.671) and use words associated with LIWC categories related to health (Cohen d=0.635) and anxiety (Cohen d=0.126). By contrast, users who declared to be family members or friends tend to post about LDA topics related to losing a family member (Cohen d=0.702) and LIWC categories focusing on the past (Cohen d=0.465) and death (Cohen d=0.181) were more associated with these users.

Conclusions

Using LDA and LIWC, we show that there are differences in the support needs and concerns expressed in posts published on an online cancer forum by users with cancer compared with family members or friends of those with cancer. Hence, responders to online cancer forums need to be cognizant of these differences in support needs and concerns and tailor their responses based on these findings.