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Self-reference in psychosis and depression: a language marker of illness

Published online by Cambridge University Press:  29 June 2016

S. K. Fineberg ,
J. Leavitt ,
S. Deutsch-Link ,
S. Dealy ,
C. D. Landry ,
K. Pirruccio ,
S. Shea ,
S. Trent ,
G. Cecchi  and
P. R. Corlett
S. K. Fineberg
Affiliation:
Department of Psychiatry, Yale University, New Haven, CT, USA
J. Leavitt
Affiliation:
Department of Psychiatry, Yale University, New Haven, CT, USA
S. Deutsch-Link
Affiliation:
School of Medicine, Yale University, New Haven, CT, USA
S. Dealy
Affiliation:
Yale College, New Haven, CT, USA
C. D. Landry
Affiliation:
Department of Psychiatry, Yale University, New Haven, CT, USA College of Physicians and Surgeons, Columbia University, New York, NY, USA
K. Pirruccio
Affiliation:
Yale College, New Haven, CT, USA
S. Shea
Affiliation:
Department of Psychiatry, Yale University, New Haven, CT, USA
S. Trent
Affiliation:
Knox College, Galesburg, IL, USA
G. Cecchi
Affiliation:
IBM, Thomas J. Watson Research Center, Yorktown Heights, NY, USA
P. R. Corlett*
Affiliation:
Department of Psychiatry, Yale University, New Haven, CT, USA
*
*Address for correspondence: P. Corlett, Ph.D., Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, 34 Park Street, New Haven, CT 06511, USA. (Email: [email protected])
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Abstract

Background

Language use is of increasing interest in the study of mental illness. Analytical approaches range from phenomenological and qualitative to formal computational quantitative methods. Practically, the approach may have utility in predicting clinical outcomes. We harnessed a real-world sample (blog entries) from groups with psychosis, strong beliefs, odd beliefs, illness, mental illness and/or social isolation to validate and extend laboratory findings about lexical differences between psychosis and control subjects.

Method

We describe the results of two experiments using Linguistic Inquiry and Word Count software to assess word category frequencies. In experiment 1, we compared word use in psychosis and control subjects in the laboratory (23 per group), and related results to subject symptoms. In experiment 2, we examined lexical patterns in blog entries written by people with psychosis and eight comparison groups. In addition to between-group comparisons, we used factor analysis followed by clustering to discern the contributions of strong belief, odd belief and illness identity to lexical patterns.

Results

Consistent with others’ work, we found that first-person pronouns, biological process words and negative emotion words were more frequent in psychosis language. We tested lexical differences between bloggers with psychosis and multiple relevant comparison groups. Clustering analysis revealed that word use frequencies did not group individuals with strong or odd beliefs, but instead grouped individuals with any illness (mental or physical).

Conclusions

Pairing of laboratory and real-world samples reveals that lexical markers previously identified as specific language changes in depression and psychosis are probably markers of illness in general.

Keywords

Depressionlexical analysispsychosisschizophreniaself-reference
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 12 , September 2016 , pp. 2605 - 2615
Copyright
Copyright © Cambridge University Press 2016 

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References

Alloy, LB, Abramson, LY (1979). Judgment of contingency in depressed and nondepressed students: sadder but wiser? Journal of Experimental Psychology-General 108, 441–485.Google Scholar
Andreasen, NC (1983). The Scale for the Assessment of Negative Symptoms (SANS) . The University of Iowa: Iowa City, IA.Google Scholar
Andreasen, NC (1984). The Scale for the Assessment of Positive Symptoms (SAPS) . The University of Iowa: Iowa City, IA.Google Scholar
Baddeley, JL, Daniel, GR, Pennebaker, JW (2011). How Henry Hellyer's use of language foretold his suicide. Crisis 32, 288–292.Google Scholar
Beck, AT (1992). Cognitive therapy – a 30 year retrospective. Which Psychotherapies in Year 2000? 6, 13–28.Google Scholar
Bedi, G, Carrillo, F, Cecchi, GA, Slezak, DF, Sigman, M, Mota, NB, Ribeiro, S, Javitt, DC, Copelli, M, Corcoran, CM (2015). Automated analysis of free speech predicts psychosis onset in high-risk youths. npj Schizophrenia 1, 15030.Google Scholar
Benjamini, Y, Hochberg, Y (1995). Controlling the false discovery rate: a practical and powerful approach to multiple testing. Journal of the Royal Statistical Society 57, 289–300.Google Scholar
Buck, B, Minor, KS, Lysaker, PH (2015 a). Differential lexical correlates of social cognition and metacognition in schizophrenia; a study of spontaneously-generated life narratives. Comprehensive Psychiatry 58, 138–145.CrossRefGoogle ScholarPubMed
Buck, B, Minor, KS, Lysaker, PH (2015 b). Lexical characteristics of anticipatory and consummatory anhedonia in schizophrenia: a study of language in spontaneous life narratives. Journal of Clinical Psychology 71, 696–706.Google Scholar
Buck, B, Penn, DL (2015). Lexical characteristics of emotional narratives in schizophrenia: relationships with symptoms, functioning, and social cognition. Journal of Nervous and Mental Disease 203, 702–708.Google Scholar
Cohen, AS, Alpert, M, Nienow, TM, Dinzeo, TJ, Docherty, NM (2008). Computerized measurement of negative symptoms in schizophrenia. Journal of Psychiatric Research 42, 827–836.Google Scholar
Cohen, AS, St-Hilaire, A, Aakre, JM, Docherty, NM (2009). Understanding anhedonia in schizophrenia through lexical analysis of natural speech. Cognition and Emotion 23, 569–586.Google Scholar
Coid, JW, Ullrich, S, Kallis, C, Keers, R, Barker, D, Cowden, F, Stamps, R (2013). The relationship between delusions and violence: findings from the East London First Episode Psychosis Study. JAMA Psychiatry 70, 465–471.Google Scholar
Corlett, PR, Fletcher, PC (2012). The neurobiology of schizotypy: fronto-striatal prediction error signal correlates with delusion-like beliefs in healthy people. Neuropsychologia 50, 3612–3620.Google Scholar
Dantzer, R, O'Connor, JC, Freund, GG, Johnson, RW, Kelley, KW (2008). From inflammation to sickness and depression: when the immune system subjugates the brain. Nature Reviews Neuroscience 9, 46–56.Google Scholar
Fineberg, SK, Deutsch-Link, S, Ichinose, M, McGuinness, T, Bessette, AJ, Chung, CK, Corlett, PR (2015). Word use in first-person accounts of schizophrenia. British Journal of Psychiatry 206, 32–38.Google Scholar
Fraley, C, Raftery, AE, Murphy, TB, Scrucca, L (2012). mclust Version 4 for R: Normal Mixture Modeling for Model-Based Clustering, Classification, and Density Estimation. Department of Statistics, University of Washington: Seattle, WA.Google Scholar
Hong, K, Nenkova, A, March, ME, Parker, AP, Verma, R, Kohler, CG (2015). Lexical use in emotional autobiographical narratives of persons with schizophrenia and healthy controls. Psychiatry Research 225, 40–49.Google Scholar
Hylwa, SA, Foster, AA, Bury, JE, Davis, MD, Pittelkow, MR, Bostwick, JM (2012). Delusional infestation is typically comorbid with other psychiatric diagnoses: review of 54 patients receiving psychiatric evaluation at Mayo Clinic. Psychosomatics 53, 258–265.Google Scholar
Junghaenel, DU, Smyth, JM, Santner, L (2008). Linguistic dimensions of psychopathology: a quantitative analysis. Journal of Social and Clinical Psychology 27, 36–55.Google Scholar
Lafitte, M, Tastet, S, Perez, P, Serise, MA, Grandoulier, AS, Aouizerate, B, Sibon, I, Capuron, L, Couffinhal, T (2015). High sensitivity C reactive protein, fibrinogen levels and the onset of major depressive disorder in post-acute coronary syndrome. BMC Cardiovascular Disorders 15, 23.Google Scholar
Lester, D (2009). Learning about suicide from the diary of Cesare Pavese. Crisis 30, 222–224.Google Scholar
Minor, KS, Bonfils, KA, Luther, L, Firmin, RL, Kukla, M, MacLain, VR, Buck, B, Lysaker, PH, Salyers, MP (2015). Lexical analysis in schizophrenia: how emotion and social word use informs our understanding of clinical presentation. Journal of Psychiatric Research 64, 74–78.Google Scholar
Misery, L (2013). Morgellons syndrome: a disease transmitted via the media. Annals of Dermatology and Venereology 140, 59–62.Google Scholar
Mortillaro, G, Rodgman, C, Kinzie, E, Ryals, S (2013). A case report highlighting the growing trend of Internet-based self-diagnosis of ‘Morgellon's disease’. Journal of Louisiana State Medical Society 165, 334–336.Google Scholar
O'Donovan, A, Chao, LL, Paulson, J, Samuelson, KW, Shigenaga, JK, Grunfeld, C, Weiner, MW, Neylan, TC (2015). Altered inflammatory activity associated with reduced hippocampal volume and more severe posttraumatic stress symptoms in Gulf War veterans. Psychoneuroendocrinology 51, 557–566.Google Scholar
Oxman, TE, Rosenberg, SD, Schnurr, PP, Tucker, GJ (1988). Diagnostic classification through content analysis of patients’ speech. American Journal of Psychiatry 145, 464–468.Google Scholar
Pearson, ML, Selby, JV, Katz, KA, Cantrell, V, Braden, CR, Parise, ME, Paddock, CD, Lewin-Smith, MR, Kalasinsky, VF, Goldstein, FC, Hightower, AW, Papier, A, Lewis, B, Motipara, S, Eberhard, ML, Unexplained Dermopathy Study Team (2012). Clinical, epidemiologic, histopathologic and molecular features of an unexplained dermopathy. PLOS ONE 7, e29908.Google Scholar
Pennebaker, JW (2011). The Secret Life of Pronouns: What our Words Say About Us. Bloomsbury Press: New York.Google Scholar
Pennebaker, JW, Chung, CK, Ireland, M, Gonzales, A, Booth, RJ (2007). The Development and Psychometric Properties of LIWC2007 (software manual). University of Austin: Austin, TX (http://www.liwc.net/LIWC2007LanguageManual.pdf). Accessed June 2016.Google Scholar
Pennebaker, JW, Kiecolt-Glaser, JK, Glaser, R (1988). Disclosure of traumas and immune function: health implications for psychotherapy. Journal of Consulting and Clinical Psychology 56, 239–245.Google Scholar
Petrie, KJ, Booth, RJ, Pennebaker, JW, Davison, KP, Thomas, MG (1995). Disclosure of trauma and immune response to a hepatitis B vaccination program. Journal of Consulting and Clinical Psychology 63, 787–792.Google Scholar
Petrie, KJ, Fontanilla, I, Thomas, MG, Booth, RJ, Pennebaker, JW (2004). Effect of written emotional expression on immune function in patients with human immunodeficiency virus infection: a randomized trial. Psychosomatic Medicine 66, 272–275.Google Scholar
Rude, SS, Gortner, EM, Pennebaker, JW (2004). Language use of depressed and depression-vulnerable college students. Cognition and Emotion 18, 1121–1133.CrossRefGoogle Scholar
Smith, KJ, Norris, S, O'Farrelly, C, O'Mara, SM (2011). Risk factors for the development of depression in patients with hepatitis C taking interferon-α. Neuropsychiatric Disease and Treatment 7, 275–292.Google Scholar
St-Hilaire, A, Cohen, AS, Docherty, NM (2008). Emotion word use in the conversational speech of schizophrenia patients. Cognitive Neuropsychiatry 13, 343–356.Google Scholar
Stirman, SW, Pennebaker, JW (2001). Word use in the poetry of suicidal and nonsuicidal poets. Psychosomatic Medicine 63, 517–522.Google Scholar
Strous, RD, Koppel, M, Fine, J, Nachliel, S, Shaked, G, Zivotofsky, AZ (2009). Automated characterization and identification of schizophrenia in writing. Journal of Nervous and Mental Disease 197, 585–588.Google Scholar
Swami, V, Chamorro-Premuzic, T, Furnham, A (2010). Unanswered questions: a preliminary investigation of personality and individual difference predictors of 9/11 conspiracist beliefs. Applied Cognitive Psychology 24, 749–761.Google Scholar
Zonis, S, Pechnick, RN, Ljubimov, VA, Mahgerefteh, M, Wawrowsky, K, Michelsen, KS, Chesnokova, V (2015). Chronic intestinal inflammation alters hippocampal neurogenesis. Journal of Neuroinflammation 12, 65.Google Scholar
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