Linguistic measures of psychological distance track symptom levels and treatment outcomes in a large set of psychotherapy transcripts

Abstract

Significance Using language to “distance” ourselves from distressing situations (i.e., by talking less about ourselves and the present moment) can help us manage emotions. Here, we translate this basic research to discover that such “linguistic distancing” is a replicable measure of mental health in a large set of therapy transcripts ( N = 6,229). Additionally, clustering techniques showed that language alone could identify participants who differed on both symptom severity and treatment outcomes. These findings lay the foundation for 1) tools that can rapidly identify people in need of psychological services based on language alone and 2) linguistic interventions that can improve mental health.

Linguistic distancing predicts response to a digital single-session intervention for adolescent depression

“…As such, a limitation of this study is that avoidance was not measured systematically. Nonetheless, the results presented here and elsewhere (Nook et al, 2022) suggest that linguistic distance promotes positive reductions in symptoms through therapeutic intervention, which better accords with the interpretation that linguistic distancing reflects adaptive emotion regulation rather than maladaptive avoidance. Lastly, because this study was conducted with an online sample completing a digital intervention, the results may not necessarily generalize to face-to-face-treatment.…”

“…For example, it is possible that linguistic distancing in adolescents' withinintervention writing samples could be used to identify those individuals who would be most likely to benefit after completing the intervention. In a previous study, linguistic distancing within individuals' naturalistic within-session language increased over the course of telehealth therapy, and these increases tracked within-person reductions in internalizing symptoms (Nook et al, 2022). This suggests that linguistic distancing within a clinical exchange between therapists and their patients is a practical linguistic marker of internalizing symptom severity and treatment response.…”

“…As such, language that denotes the use of these skills may provide insight into treatment response. Previous research supports this idea, demonstrating that linguistic characteristics can predict a person's response to a psychological intervention (Arntz et al, 2012;Nook et al, 2022;Zimmermann et al, 2017). Change in word use over time, such as using less negative emotion words, significantly predicts better treatment outcomes in traditional, multisession, face-to-face therapy (Zimmermann et al, 2017).…”

“…However, a close examination of whether linguistic distancing tracks avoidance has not been conducted. Nonetheless, previous research indicates that greater linguistic distancing may be connected to better coping with depression (Edwards & Holtzman, 2017;Nook et al, 2022;Tackman et al, 2019).…”

Prospective associations of text‐message‐based sentiment with symptoms of depression, generalized anxiety, and social anxiety

“…However, prior research suggests that while individuals with social anxiety disorder experience greater anger (Versella et al, 2016) passively sensed language markers of depression, generalized anxiety, and social anxiety symptoms that can help narrow the range of potential treatment approaches and targets that will be most effective in the moment. JITAIs could even focus on language directly, as prior research suggests that linguistic changes (namely, reductions in the use of "I" and present-tense verbs) track symptom improvement in therapy, potentially reflecting attempts to distance oneself from negative stimuli in service of emotion regulation (Nook et al, 2022).…”