Prevalence of cognitive distortion markers in a suicide prevention chat service (Preprint)

BACKGROUND Suicide helplines increasingly employ chat services to aid those in urgent need, but the wording and structure of text-driven exchanges may affect their effectiveness. OBJECTIVE : Given the association of cognitive distortions with depression and anxiety, here we investigated their prevalence in the language of individuals seeking help from the Dutch 113 suicide help-line. METHODS We observed the prevalence of cognitive distortions for both help-seekers and counselors in a large volume of chat sessions (N=71,148) of the Dutch 113 suicide chat help-line using natural language processing. The results were compared to two large collections of on-line text data from Dutch social media and web content. RESULTS We found that nearly all types of cognitive distortions are more prevalent in the language of help-seekers compared to the control group of helpline counselors. Distortions of the Personalizing, Emotional Reasoning, and Mental Filtering types were respectively 20.22, 7.87, and 4.53 times more prevalent among help seekers, revealing a distinct pattern of thought and language among individuals affected by suicidality. CONCLUSIONS Our results raise the prospect of improving the effectiveness of online therapeutical interventions that target cognitive distortions, through lexical analysis that detects the cognitive and lexical markers of suicidality.