Mental health illness such as depression is a significant risk factor for suicide ideation, behaviors, and attempts. A report by Substance Abuse and Mental Health Services Administration (SAMHSA) shows that 80% of the patients suffering from Borderline Personality Disorder (BPD) have suicidal behavior, 5-10% of whom commit suicide. While multiple initiatives have been developed and implemented for suicide prevention, a key challenge has been the social stigma associated with mental disorders, which deters patients from seeking help or sharing their experiences directly with others including clinicians. This is particularly true for teenagers and younger adults where suicide is the second highest cause of death in the US. Prior research involving surveys and questionnaires (e.g. PHQ-9) for suicide risk prediction failed to provide a quantitative assessment of risk that informed timely clinical decision-making for intervention. Our interdisciplinary study concerns the use of Reddit as an unobtrusive data source for gleaning information about suicidal tendencies and other related mental health conditions afflicting depressed users. We provide details of our learning framework that incorporates domain-specific knowledge to predict the severity of suicide risk for an individual. Our approach involves developing a suicide risk severity lexicon using medical knowledge bases and suicide ontology to detect cues relevant to suicidal thoughts and actions. We also use language modeling, medical entity recognition and normalization and negation detection to create a dataset of 2181 redditors that have discussed or implied suicidal ideation, behavior, or attempt. Given the importance of clinical knowledge, our gold standard dataset of 500 redditors (out of 2181) was developed by four practicing psychiatrists following the guidelines outlined in This paper is published under the Creative Commons Attribution 4.0 International (CC-BY 4.0) license. Authors reserve their rights to disseminate the work on their personal and corporate Web sites with the appropriate attribution.

Terror attacks have been linked in part to online extremist content. Online conversations are cloaked in religious ambiguity, with deceptive intentions, often twisted from mainstream meaning to serve a malevolent ideology. Although tens of thousands of Islamist extremism supporters consume such content, they are a small fraction relative to peaceful Muslims. The efforts to contain the ever-evolving extremism on social media platforms have remained inadequate and mostly ineffective. Divergent extremist and mainstream contexts challenge machine interpretation, with a particular threat to the precision of classification algorithms. Radicalization is a subtle long-running persuasive process that occurs over time. Our context-aware computational approach to the analysis of extremist content on Twitter breaks down this persuasion process into building blocks that acknowledge inherent ambiguity and sparsity that likely challenge both manual and automated classification. Based on prior empirical and qualitative research in social sciences, particularly political science, we model this process using a combination of three contextual dimensions -- religion, ideology, and hate -- each elucidating a degree of radicalization and highlighting independent features to render them computationally accessible. We utilize domain-specific knowledge resources for each of these contextual dimensions such as Qur'an for religion, the books of extremist ideologues and preachers for political ideology and a social media hate speech corpus for hate. The significant sensitivity of the Islamist extremist ideology and its local and global security implications require reliable algorithms for modelling such communications on Twitter. Our study makes three contributions to reliable analysis: (i) Development of a computational approach rooted in the contextual dimensions of religion, ideology, and hate, which reflects strategies employed by online Islamist extremist groups, (ii) An in-depth analysis of relevant tweet datasets with respect to these dimensions to exclude likely mislabeled users, and (iii) A framework for understanding online radicalization as a process to assist counter-programming. Given the potentially significant social impact, we evaluate the performance of our algorithms to minimize mislabeling, where our context-aware approach outperforms a competitive baseline by 10.2% in precision, thereby enhancing the potential of such tools for use in human review.

Suicide is the 10th leading cause of death in the U.S (1999-2019). However, predicting when someone will attempt suicide has been nearly impossible. In the modern world, many individuals suffering from mental illness seek emotional support and advice on well-known and easily-accessible social media platforms such as Reddit. While prior artificial intelligence research has demonstrated the ability to extract valuable information from social media on suicidal thoughts and behaviors, these efforts have not considered both severity and temporality of risk. The insights made possible by access to such data have enormous clinical potential—most dramatically envisioned as a trigger to employ timely and targeted interventions (i.e., voluntary and involuntary psychiatric hospitalization) to save lives. In this work, we address this knowledge gap by developing deep learning algorithms to assess suicide risk in terms of severity and temporality from Reddit data based on the Columbia Suicide Severity Rating Scale (C-SSRS). In particular, we employ two deep learning approaches: time-variant and time-invariant modeling, for user-level suicide risk assessment, and evaluate their performance against a clinician-adjudicated gold standard Reddit corpus annotated based on the C-SSRS. Our results suggest that the time-variant approach outperforms the time-invariant method in the assessment of suicide-related ideations and supportive behaviors (AUC:0.78), while the time-invariant model performed better in predicting suicide-related behaviors and suicide attempt (AUC:0.64). The proposed approach can be integrated with clinical diagnostic interviews for improving suicide risk assessments.

Mental Health America designed ten questionnaires that are used to determine the risk of mental disorders. They are also commonly used by Mental Health Professionals (MHPs) to assess suicidality. Specifically, the Columbia Suicide Severity Rating Scale (C-SSRS), a widely used suicide assessment questionnaire, helps MHPs determine the severity of suicide risk and offer an appropriate treatment. A major challenge in suicide treatment is the social stigma wherein the patient feels reluctance in discussing his/her conditions with an MHP, which leads to inaccurate assessment and treatment of patients. On the other hand, the same patient is comfortable freely discussing his/her mental health condition on social media due to the anonymity of platforms such as Reddit, and the ability to control what, when and how to share.The popular "SuicideWatch" subreddit has been widely used among individuals who experience suicidal thoughts, and provides significant cues for suicidality. The timeliness in sharing thoughts, the flexibility in describing feelings, and the interoperability in using medical terminologies make Reddit an important platform to be utilized as a complementary tool to the conventional healthcare system. As MHPs develop an implicit weighting scheme over the questionnaire (i.e., C-SSRS) to assess suicide risk severity, creating a relative weighting scheme for answers to be automatically generated to the questions in the questionnaire poses as a key challenge.In this interdisciplinary study, we position our approach towards a solution for an automated suicide risk-elicitation framework through a novel question answering mechanism. Our two-fold approach benefits from using: 1) semantic clustering, and 2) sequence-to-sequence (Seq2Seq) models . We also generate a gold standard dataset of suicide posts with their risk levels. This work forms a basis for the next step of building conversational agents that elicit suicide-related natural conversation based on questions.

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Sickle Cell Disease (SCD) is a hereditary disorder of red blood cells in humans. Complications such as pain, stroke, and organ failure occur in SCD as malformed, sickled red blood cells passing through small blood vessels get trapped. Particularly, acute pain is known to be the primary symptom of SCD. The insidious and subjective nature of SCD pain leads to challenges in pain assessment among Medical Practitioners (MPs). Thus, accurate identification of markers of pain in patients with SCD is crucial for pain management. Classifying clinical notes of patients with SCD based on their pain level enables MPs to give appropriate treatment. We propose a binary classification model to predict pain relevance of clinical notes and a multiclass classification model to predict pain level. While our four binary machine learning (ML) classifiers are comparable in their performance, Decision Trees had the best performance for the multiclass classification task achieving 0.70 in F-measure. Our results show the potential clinical text analysis and machine learning offer to pain management in sickle cell patients.

Background In clinical diagnostic interviews, mental health professionals (MHPs) implement a care practice that involves asking open questions (eg, “What do you want from your life?” “What have you tried before to bring change in your life?”) while listening empathetically to patients. During these interviews, MHPs attempted to build a trusting human-centered relationship while collecting data necessary for professional medical and psychiatric care. Often, because of the social stigma of mental health disorders, patient discomfort in discussing their presenting problem may add additional complexities and nuances to the language they use, that is, hidden signals among noisy content. Therefore, a focused, well-formed, and elaborative summary of clinical interviews is critical to MHPs in making informed decisions by enabling a more profound exploration of a patient’s behavior, especially when it endangers life. Objective The aim of this study is to propose an unsupervised, knowledge-infused abstractive summarization (KiAS) approach that generates summaries to enable MHPs to perform a well-informed follow-up with patients to improve the existing summarization methods built on frequency heuristics by creating more informative summaries. Methods Our approach incorporated domain knowledge from the Patient Health Questionnaire-9 lexicon into an integer linear programming framework that optimizes linguistic quality and informativeness. We used 3 baseline approaches: extractive summarization using the SumBasic algorithm, abstractive summarization using integer linear programming without the infusion of knowledge, and abstraction over extractive summarization to evaluate the performance of KiAS. The capability of KiAS on the Distress Analysis Interview Corpus-Wizard of Oz data set was demonstrated through interpretable qualitative and quantitative evaluations. Results KiAS generates summaries (7 sentences on average) that capture informative questions and responses exchanged during long (58 sentences on average), ambiguous, and sparse clinical diagnostic interviews. The summaries generated using KiAS improved upon the 3 baselines by 23.3%, 4.4%, 2.5%, and 2.2% for thematic overlap, Flesch Reading Ease, contextual similarity, and Jensen Shannon divergence, respectively. On the Recall-Oriented Understudy for Gisting Evaluation-2 and Recall-Oriented Understudy for Gisting Evaluation-L metrics, KiAS showed an improvement of 61% and 49%, respectively. We validated the quality of the generated summaries through visual inspection and substantial interrater agreement from MHPs. Conclusions Our collaborator MHPs observed the potential utility and significant impact of KiAS in leveraging valuable but voluminous communications that take place outside of normally scheduled clinical appointments. This study shows promise in generating semantically relevant summaries that will help MHPs make informed decisions about patient status.

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