Proceedings of the Sixth Workshop on Computational Linguistics and Clinical Psychology

Kate Niederhoffer, Kristy Hollingshead, Philip Resnik, Rebecca Resnik, Kate Loveys (Editors)

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Minneapolis, Minnesota
CLPsych | NAACL | WS
Association for Computational Linguistics
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Proceedings of the Sixth Workshop on Computational Linguistics and Clinical Psychology
Kate Niederhoffer | Kristy Hollingshead | Philip Resnik | Rebecca Resnik | Kate Loveys

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Towards augmenting crisis counselor training by improving message retrieval
Orianna Demasi | Marti A. Hearst | Benjamin Recht

A fundamental challenge when training counselors is presenting novices with the opportunity to practice counseling distressed individuals without exacerbating a situation. Rather than replacing human empathy with an automated counselor, we propose simulating an individual in crisis so that human counselors in training can practice crisis counseling in a low-risk environment. Towards this end, we collect a dataset of suicide prevention counselor role-play transcripts and make initial steps towards constructing a CRISISbot for humans to counsel while in training. In this data-constrained setting, we evaluate the potential for message retrieval to construct a coherent chat agent in light of recent advances with text embedding methods. Our results show that embeddings can considerably improve retrieval approaches to make them competitive with generative models. By coherently retrieving messages, we can help counselors practice chatting in a low-risk environment.

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Identifying therapist conversational actions across diverse psychotherapeutic approaches
Fei-Tzin Lee | Derrick Hull | Jacob Levine | Bonnie Ray | Kathy McKeown

While conversation in therapy sessions can vary widely in both topic and style, an understanding of the underlying techniques used by therapists can provide valuable insights into how therapists best help clients of different types. Dialogue act classification aims to identify the conversational “action” each speaker takes at each utterance, such as sympathizing, problem-solving or assumption checking. We propose to apply dialogue act classification to therapy transcripts, using a therapy-specific labeling scheme, in order to gain a high-level understanding of the flow of conversation in therapy sessions. We present a novel annotation scheme that spans multiple psychotherapeutic approaches, apply it to a large and diverse corpus of psychotherapy transcripts, and present and discuss classification results obtained using both SVM and neural network-based models. The results indicate that identifying the structure and flow of therapeutic actions is an obtainable goal, opening up the opportunity in the future to provide therapeutic recommendations tailored to specific client situations.

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CLPsych 2019 Shared Task: Predicting the Degree of Suicide Risk in Reddit Posts
Ayah Zirikly | Philip Resnik | Özlem Uzuner | Kristy Hollingshead

The shared task for the 2019 Workshop on Computational Linguistics and Clinical Psychology (CLPsych’19) introduced an assessment of suicide risk based on social media postings, using data from Reddit to identify users at no, low, moderate, or severe risk. Two variations of the task focused on users whose posts to the r/SuicideWatch subreddit indicated they might be at risk; a third task looked at screening users based only on their more everyday (non-SuicideWatch) posts. We received submissions from 15 different teams, and the results provide progress and insight into the value of language signal in helping to predict risk level.

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CLaC at CLPsych 2019: Fusion of Neural Features and Predicted Class Probabilities for Suicide Risk Assessment Based on Online Posts
Elham Mohammadi | Hessam Amini | Leila Kosseim

This paper summarizes our participation to the CLPsych 2019 shared task, under the name CLaC. The goal of the shared task was to detect and assess suicide risk based on a collection of online posts. For our participation, we used an ensemble method which utilizes 8 neural sub-models to extract neural features and predict class probabilities, which are then used by an SVM classifier. Our team ranked first in 2 out of the 3 tasks (tasks A and C).

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Suicide Risk Assessment with Multi-level Dual-Context Language and BERT
Matthew Matero | Akash Idnani | Youngseo Son | Salvatore Giorgi | Huy Vu | Mohammad Zamani | Parth Limbachiya | Sharath Chandra Guntuku | H. Andrew Schwartz

Mental health predictive systems typically model language as if from a single context (e.g. Twitter posts, status updates, or forum posts) and often limited to a single level of analysis (e.g. either the message-level or user-level). Here, we bring these pieces together to explore the use of open-vocabulary (BERT embeddings, topics) and theoretical features (emotional expression lexica, personality) for the task of suicide risk assessment on support forums (the CLPsych-2019 Shared Task). We used dual context based approaches (modeling content from suicide forums separate from other content), built over both traditional ML models as well as a novel dual RNN architecture with user-factor adaptation. We find that while affect from the suicide context distinguishes with no-risk from those with “any-risk”, personality factors from the non-suicide contexts provide distinction of the levels of risk: low, medium, and high risk. Within the shared task, our dual-context approach (listed as SBU-HLAB in the official results) achieved state-of-the-art performance predicting suicide risk using a combination of suicide-context and non-suicide posts (Task B), achieving an F1 score of 0.50 over hidden test set labels.

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Using natural conversations to classify autism with limited data: Age matters
Michael Hauser | Evangelos Sariyanidi | Birkan Tunc | Casey Zampella | Edward Brodkin | Robert Schultz | Julia Parish-Morris

Spoken language ability is highly heterogeneous in Autism Spectrum Disorder (ASD), which complicates efforts to identify linguistic markers for use in diagnostic classification, clinical characterization, and for research and clinical outcome measurement. Machine learning techniques that harness the power of multivariate statistics and non-linear data analysis hold promise for modeling this heterogeneity, but many models require enormous datasets, which are unavailable for most psychiatric conditions (including ASD). In lieu of such datasets, good models can still be built by leveraging domain knowledge. In this study, we compare two machine learning approaches: the first approach incorporates prior knowledge about language variation across middle childhood, adolescence, and adulthood to classify 6-minute naturalistic conversation samples from 140 age- and IQ-matched participants (81 with ASD), while the other approach treats all ages the same. We found that individual age-informed models were significantly more accurate than a single model tasked with building a common algorithm across age groups. Furthermore, predictive linguistic features differed significantly by age group, confirming the importance of considering age-related changes in language use when classifying ASD. Our results suggest that limitations imposed by heterogeneity inherent to ASD and from developmental change with age can be (at least partially) overcome using domain knowledge, such as understanding spoken language development from childhood through adulthood.

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The importance of sharing patient-generated clinical speech and language data
Kathleen C. Fraser | Nicklas Linz | Hali Lindsay | Alexandra König

Increased access to large datasets has driven progress in NLP. However, most computational studies of clinically-validated, patient-generated speech and language involve very few datapoints, as such data are difficult (and expensive) to collect. In this position paper, we argue that we must find ways to promote data sharing across research groups, in order to build datasets of a more appropriate size for NLP and machine learning analysis. We review the benefits and challenges of sharing clinical language data, and suggest several concrete actions by both clinical and NLP researchers to encourage multi-site and multi-disciplinary data sharing. We also propose the creation of a collaborative data sharing platform, to allow NLP researchers to take a more active responsibility for data transcription, annotation, and curation.

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Depressed Individuals Use Negative Self-Focused Language When Recalling Recent Interactions with Close Romantic Partners but Not Family or Friends
Taleen Nalabandian | Molly Ireland

Depression is characterized by a self-focused negative attentional bias, which is often reflected in everyday language use. In a prospective writing study, we explored whether the association between depressive symptoms and negative, self-focused language varies across social contexts. College students (N = 243) wrote about a recent interaction with a person they care deeply about. Depression symptoms positively correlated with negative emotion words and first-person singular pronouns (or negative self-focus) when writing about a recent interaction with romantic partners or, to a lesser extent, friends, but not family members. The pattern of results was more pronounced when participants perceived greater self-other overlap (i.e., interpersonal closeness) with their romantic partner. Findings regarding how the linguistic profile of depression differs by type of relationship may inform more effective methods of clinical diagnosis and treatment.

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Linguistic Analysis of Schizophrenia in Reddit Posts
Jonathan Zomick | Sarah Ita Levitan | Mark Serper

We explore linguistic indicators of schizophrenia in Reddit discussion forums. Schizophrenia (SZ) is a chronic mental disorder that affects a person’s thoughts and behaviors. Identifying and detecting signs of SZ is difficult given that SZ is relatively uncommon, affecting approximately 1% of the US population, and people suffering with SZ often believe that they do not have the disorder. Linguistic abnormalities are a hallmark of SZ and many of the illness’s symptoms are manifested through language. In this paper we leverage the vast amount of data available from social media and use statistical and machine learning approaches to study linguistic characteristics of SZ. We collected and analyzed a large corpus of Reddit posts from users claiming to have received a formal diagnosis of SZ and identified several linguistic features that differentiated these users from a control (CTL) group. We compared these results to other findings on social media linguistic analysis and SZ. We also developed a machine learning classifier to automatically identify self-identified users with SZ on Reddit.

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Semantic Characteristics of Schizophrenic Speech
Kfir Bar | Vered Zilberstein | Ido Ziv | Heli Baram | Nachum Dershowitz | Samuel Itzikowitz | Eiran Vadim Harel

Natural language processing tools are used to automatically detect disturbances in transcribed speech of schizophrenia inpatients who speak Hebrew. We measure topic mutation over time and show that controls maintain more cohesive speech than inpatients. We also examine differences in how inpatients and controls use adjectives and adverbs to describe content words and show that the ones used by controls are more common than the those of inpatients. We provide experimental results and show their potential for automatically detecting schizophrenia in patients by means only of their speech patterns.

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Computational Linguistics for Enhancing Scientific Reproducibility and Reducing Healthcare Inequities
Julia Parish-Morris

Computational linguistics holds promise for improving scientific integrity in clinical psychology, and for reducing longstanding inequities in healthcare access and quality. This paper describes how computational linguistics approaches could address the “reproducibility crisis” facing social science, particularly with regards to reliable diagnosis of neurodevelopmental and psychiatric conditions including autism spectrum disorder (ASD). It is argued that these improvements in scientific integrity are poised to naturally reduce persistent healthcare inequities in neglected subpopulations, such as verbally fluent girls and women with ASD, but that concerted attention to this issue is necessary to avoid reproducing biases built into training data. Finally, it is suggested that computational linguistics is just one component of an emergent digital phenotyping toolkit that could ultimately be used for clinical decision support, to improve clinical care via precision medicine (i.e., personalized intervention planning), granular treatment response monitoring (including remotely), and for gene-brain-behavior studies aiming to pinpoint the underlying biological etiology of otherwise behaviorally-defined conditions like ASD.

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Temporal Analysis of the Semantic Verbal Fluency Task in Persons with Subjective and Mild Cognitive Impairment
Nicklas Linz | Kristina Lundholm Fors | Hali Lindsay | Marie Eckerström | Jan Alexandersson | Dimitrios Kokkinakis

The Semantic Verbal Fluency (SVF) task is a classical neuropsychological assessment where persons are asked to produce words belonging to a semantic category (e.g., animals) in a given time. This paper introduces a novel method of temporal analysis for SVF tasks utilizing time intervals and applies it to a corpus of elderly Swedish subjects (mild cognitive impairment, subjective cognitive impairment and healthy controls). A general decline in word count and lexical frequency over the course of the task is revealed, as well as an increase in word transition times. Persons with subjective cognitive impairment had a higher word count during the last intervals, but produced words of the same lexical frequencies. Persons with MCI had a steeper decline in both word count and lexical frequencies during the third interval. Additional correlations with neuropsychological scores suggest these findings are linked to a person’s overall vocabulary size and processing speed, respectively. Classification results improved when adding the novel features (AUC=0.72), supporting their diagnostic value.

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Mental Health Surveillance over Social Media with Digital Cohorts
Silvio Amir | Mark Dredze | John W. Ayers

The ability to track mental health conditions via social media opened the doors for large-scale, automated, mental health surveillance. However, inferring accurate population-level trends requires representative samples of the underlying population, which can be challenging given the biases inherent in social media data. While previous work has adjusted samples based on demographic estimates, the populations were selected based on specific outcomes, e.g. specific mental health conditions. We depart from these methods, by conducting analyses over demographically representative digital cohorts of social media users. To validated this approach, we constructed a cohort of US based Twitter users to measure the prevalence of depression and PTSD, and investigate how these illnesses manifest across demographic subpopulations. The analysis demonstrates that cohort-based studies can help control for sampling biases, contextualize outcomes, and provide deeper insights into the data.

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Reviving a psychometric measure: Classification and prediction of the Operant Motive Test
Dirk Johannßen | Chris Biemann | David Scheffer

Implicit motives allow for the characterization of behavior, subsequent success and long-term development. While this has been operationalized in the operant motive test, research on motives has declined mainly due to labor-intensive and costly human annotation. In this study, we analyze over 200,000 labeled data items from 40,000 participants and utilize them for engineering features for training a logistic model tree machine learning model. It captures manually assigned motives well with an F-score of 80%, coming close to the pairwise annotator intraclass correlation coefficient of r = .85. In addition, we found a significant correlation of r = .2 between subsequent academic success and data automatically labeled with our model in an extrinsic evaluation.

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Coherence models in schizophrenia
Sandra Just | Erik Haegert | Nora Kořánová | Anna-Lena Bröcker | Ivan Nenchev | Jakob Funcke | Christiane Montag | Manfred Stede

Incoherent discourse in schizophrenia has long been recognized as a dominant symptom of the mental disorder (Bleuler, 1911/1950). Recent studies have used modern sentence and word embeddings to compute coherence metrics for spontaneous speech in schizophrenia. While clinical ratings always have a subjective element, computational linguistic methodology allows quantification of speech abnormalities. Clinical and empirical knowledge from psychiatry provide the theoretical and conceptual basis for modelling. Our study is an interdisciplinary attempt at improving coherence models in schizophrenia. Speech samples were obtained from healthy controls and patients with a diagnosis of schizophrenia or schizoaffective disorder and different severity of positive formal thought disorder. Interviews were transcribed and coherence metrics derived from different embeddings. One model found higher coherence metrics for controls than patients. All other models remained non-significant. More detailed analysis of the data motivates different approaches to improving coherence models in schizophrenia, e.g. by assessing referential abnormalities.

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Overcoming the bottleneck in traditional assessments of verbal memory: Modeling human ratings and classifying clinical group membership
Chelsea Chandler | Peter W. Foltz | Jian Cheng | Jared C. Bernstein | Elizabeth P. Rosenfeld | Alex S. Cohen | Terje B. Holmlund | Brita Elvevåg

Verbal memory is affected by numerous clinical conditions and most neuropsychological and clinical examinations evaluate it. However, a bottleneck exists in such endeavors because traditional methods require expert human review, and usually only a couple of test versions exist, thus limiting the frequency of administration and clinical applications. The present study overcomes this bottleneck by automating the administration, transcription, analysis and scoring of story recall. A large group of healthy participants (n = 120) and patients with mental illness (n = 105) interacted with a mobile application that administered a wide range of assessments, including verbal memory. The resulting speech generated by participants when retelling stories from the memory task was transcribed using automatic speech recognition tools, which was compared with human transcriptions (overall word error rate = 21%). An assortment of surface-level and semantic language-based features were extracted from the verbal recalls. A final set of three features were used to both predict expert human ratings with a ridge regression model (r = 0.88) and to differentiate patients from healthy individuals with an ensemble of logistic regression classifiers (accuracy = 76%). This is the first ‘outside of the laboratory’ study to showcase the viability of the complete pipeline of automated assessment of verbal memory in naturalistic settings.

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Analyzing the use of existing systems for the CLPsych 2019 Shared Task
Alejandro González Hevia | Rebeca Cerezo Menéndez | Daniel Gayo-Avello

In this paper we describe the UniOvi-WESO classification systems proposed for the 2019 Computational Linguistics and Clinical Psychology (CLPsych) Shared Task. We explore the use of two systems trained with ReachOut data from the 2016 CLPsych task, and compare them to a baseline system trained with the data provided for this task. All the classifiers were trained with features extracted just from the text of each post, without using any other metadata. We found out that the baseline system performs slightly better than the pretrained systems, mainly due to the differences in labeling between the two tasks. However, they still work reasonably well and can detect if a user is at risk of suicide or not.

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Similar Minds Post Alike: Assessment of Suicide Risk Using a Hybrid Model
Lushi Chen | Abeer Aldayel | Nikolay Bogoychev | Tao Gong

This paper describes our system submission for the CLPsych 2019 shared task B on suicide risk assessment. We approached the problem with three separate models: a behaviour model; a language model and a hybrid model. For the behavioral model approach, we model each user’s behaviour and thoughts with four groups of features: posting behaviour, sentiment, motivation, and content of the user’s posting. We use these features as an input in a support vector machine (SVM). For the language model approach, we trained a language model for each risk level using all the posts from the users as the training corpora. Then, we computed the perplexity of each user’s posts to determine how likely his/her posts were to belong to each risk level. Finally, we built a hybrid model that combines both the language model and the behavioral model, which demonstrates the best performance in detecting the suicide risk level.

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Predicting Suicide Risk from Online Postings in Reddit The UGent-IDLab submission to the CLPysch 2019 Shared Task A
Semere Kiros Bitew | Giannis Bekoulis | Johannes Deleu | Lucas Sterckx | Klim Zaporojets | Thomas Demeester | Chris Develder

This paper describes IDLab’s text classification systems submitted to Task A as part of the CLPsych 2019 shared task. The aim of this shared task was to develop automated systems that predict the degree of suicide risk of people based on their posts on Reddit. Bag-of-words features, emotion features and post level predictions are used to derive user-level predictions. Linear models and ensembles of these models are used to predict final scores. We find that predicting fine-grained risk levels is much more difficult than flagging potentially at-risk users. Furthermore, we do not find clear added value from building richer ensembles compared to simple baselines, given the available training data and the nature of the prediction task.

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CLPsych2019 Shared Task: Predicting Suicide Risk Level from Reddit Posts on Multiple Forums
Victor Ruiz | Lingyun Shi | Wei Quan | Neal Ryan | Candice Biernesser | David Brent | Rich Tsui

We aimed to predict an individual suicide risk level from longitudinal posts on Reddit discussion forums. Through participating in a shared task competition hosted by CLPsych2019, we received two annotated datasets: a training dataset with 496 users (31,553 posts) and a test dataset with 125 users (9610 posts). We submitted results from our three best-performing machine-learning models: SVM, Naïve Bayes, and an ensemble model. Each model provided a user’s suicide risk level in four categories, i.e., no risk, low risk, moderate risk, and severe risk. Among the three models, the ensemble model had the best macro-averaged F1 score 0.379 when tested on the holdout test dataset. The NB model had the best performance in two additional binary-classification tasks, i.e., no risk vs. flagged risk (any risk level other than no risk) with F1 score 0.836 and no or low risk vs. urgent risk (moderate or severe risk) with F1 score 0.736. We conclude that the NB model may serve as a tool for identifying users with flagged or urgent suicide risk based on longitudinal posts on Reddit discussion forums.

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Suicide Risk Assessment on Social Media: USI-UPF at the CLPsych 2019 Shared Task
Esteban Ríssola | Diana Ramírez-Cifuentes | Ana Freire | Fabio Crestani

This paper describes the participation of the USI-UPF team at the shared task of the 2019 Computational Linguistics and Clinical Psychology Workshop (CLPsych2019). The goal is to assess the degree of suicide risk of social media users given a labelled dataset with their posts. An appropriate suicide risk assessment, with the usage of automated methods, can assist experts on the detection of people at risk and eventually contribute to prevent suicide. We propose a set of machine learning models with features based on lexicons, word embeddings, word level n-grams, and statistics extracted from users’ posts. The results show that the most effective models for the tasks are obtained integrating lexicon-based features, a selected set of n-grams, and statistical measures.

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Using Contextual Representations for Suicide Risk Assessment from Internet Forums
Ashwin Karthik Ambalavanan | Pranjali Dileep Jagtap | Soumya Adhya | Murthy Devarakonda

Social media posts may yield clues to the subject’s (usually, the writer’s) suicide risk and intent, which can be used for timely intervention. This research, motivated by the CLPsych 2019 shared task, developed neural network-based methods for analyzing posts in one or more Reddit forums to assess the subject’s suicide risk. One of the technical challenges this task poses is the large amount of text from multiple posts of a single user. Our neural network models use the advanced multi-headed Attention-based autoencoder architecture, called Bidirectional Encoder Representations from Transformers (BERT). Our system achieved the 2nd best performance of 0.477 macro averaged F measure on Task A of the challenge. Among the three different alternatives we developed for the challenge, the single BERT model that processed all of a user’s posts performed the best on all three Tasks.

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An Investigation of Deep Learning Systems for Suicide Risk Assessment
Michelle Morales | Prajjalita Dey | Thomas Theisen | Danny Belitz | Natalia Chernova

This work presents the systems explored as part of the CLPsych 2019 Shared Task. More specifically, this work explores the promise of deep learning systems for suicide risk assessment.

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ConvSent at CLPsych 2019 Task A: Using Post-level Sentiment Features for Suicide Risk Prediction on Reddit
Kristen Allen | Shrey Bagroy | Alex Davis | Tamar Krishnamurti

This work aims to infer mental health status from public text for early detection of suicide risk. It contributes to Shared Task A in the 2019 CLPsych workshop by predicting users’ suicide risk given posts in the Reddit subforum r/SuicideWatch. We use a convolutional neural network to incorporate LIWC information at the Reddit post level about topics discussed, first-person focus, emotional experience, grammatical choices, and thematic style. In sorting users into one of four risk categories, our best system’s macro-averaged F1 score was 0.50 on the withheld test set. The work demonstrates the predictive power of the Linguistic Inquiry and Word Count dictionary, in conjunction with a convolutional network and holistic consideration of each post and user.

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Dictionaries and Decision Trees for the 2019 CLPsych Shared Task
Micah Iserman | Taleen Nalabandian | Molly Ireland

In this summary, we discuss our approach to the CLPsych Shared Task and its initial results. For our predictions in each task, we used a recursive partitioning algorithm (decision trees) to select from our set of features, which were primarily dictionary scores and counts of individual words. We focused primarily on Task A, which aimed to predict suicide risk, as rated by a team of expert clinicians (Shing et al., 2018), based on language used in SuicideWatch posts on Reddit. Category-level findings highlight the potential importance of social and moral language categories. Word-level correlates of risk levels underline the value of fine-grained data-driven approaches, revealing both theory-consistent and potentially novel correlates of suicide risk that may motivate future research.