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Loneliness and suicide mitigation for students using GPT3-enabled chatbots 使用支持 GPT3 的聊天机器人缓解学生的孤独感和自杀情绪
Pub Date : 2024-01-22 DOI: 10.1038/s44184-023-00047-6
Bethanie Maples, Merve Cerit, Aditya Vishwanath, Roy Pea
Mental health is a crisis for learners globally, and digital support is increasingly seen as a critical resource. Concurrently, Intelligent Social Agents receive exponentially more engagement than other conversational systems, but their use in digital therapy provision is nascent. A survey of 1006 student users of the Intelligent Social Agent, Replika, investigated participants’ loneliness, perceived social support, use patterns, and beliefs about Replika. We found participants were more lonely than typical student populations but still perceived high social support. Many used Replika in multiple, overlapping ways—as a friend, a therapist, and an intellectual mirror. Many also held overlapping and often conflicting beliefs about Replika—calling it a machine, an intelligence, and a human. Critically, 3% reported that Replika halted their suicidal ideation. A comparative analysis of this group with the wider participant population is provided.
心理健康是全球学习者面临的一个危机,数字支持越来越被视为一种重要的资源。与此同时,智能社交代理比其他对话系统的参与度高出数倍,但其在数字治疗中的应用却刚刚起步。我们对智能社交代理 Replika 的 1006 名学生用户进行了调查,了解了参与者的孤独感、感知到的社会支持、使用模式以及对 Replika 的看法。我们发现,与典型的学生群体相比,参与者更加孤独,但仍然认为社会支持度很高。许多人以多种重叠的方式使用 Replika--作为朋友、治疗师和智力镜子。许多人还对 Replika 持有重叠且经常相互冲突的信念--称其为机器、智能和人类。重要的是,有 3% 的人称 Replika 阻止了他们的自杀念头。本报告对这一群体与更广泛的参与者进行了比较分析。
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引用次数: 0
Predicting state level suicide fatalities in the united states with realtime data and machine learning 利用实时数据和机器学习预测美国各州的自杀死亡人数
Pub Date : 2024-01-16 DOI: 10.1038/s44184-023-00045-8
Devashru Patel, Steven A. Sumner, Daniel Bowen, Marissa Zwald, Ellen Yard, Jing Wang, Royal Law, Kristin Holland, Theresa Nguyen, Gary Mower, Yushiuan Chen, Jenna Iberg Johnson, Megan Jespersen, Elizabeth Mytty, Jennifer M. Lee, Michael Bauer, Eric Caine, Munmun De Choudhury
Digital trace data and machine learning techniques are increasingly being adopted to predict suicide-related outcomes at the individual level; however, there is also considerable public health need for timely data about suicide trends at the population level. Although significant geographic variation in suicide rates exist by state within the United States, national systems for reporting state suicide trends typically lag by one or more years. We developed and validated a deep learning based approach to utilize real-time, state-level online (Mental Health America web-based depression screenings; Google and YouTube Search Trends), social media (Twitter), and health administrative data (National Syndromic Surveillance Program emergency department visits) to estimate weekly suicide counts in four participating states. Specifically, per state, we built a long short-term memory (LSTM) neural network model to combine signals from the real-time data sources and compared predicted values of suicide deaths from our model to observed values in the same state. Our LSTM model produced accurate estimates of state-specific suicide rates in all four states (percentage error in suicide rate of −2.768% for Utah, −2.823% for Louisiana, −3.449% for New York, and −5.323% for Colorado). Furthermore, our deep learning based approach outperformed current gold-standard baseline autoregressive models that use historical death data alone. We demonstrate an approach to incorporate signals from multiple proxy real-time data sources that can potentially provide more timely estimates of suicide trends at the state level. Timely suicide data at the state level has the potential to improve suicide prevention planning and response tailored to the needs of specific geographic communities.
人们越来越多地采用数字跟踪数据和机器学习技术来预测个人层面的自杀相关结果;然而,公共卫生领域也非常需要有关人口层面自杀趋势的及时数据。虽然美国各州的自杀率存在很大的地域差异,但报告各州自杀趋势的国家系统通常会滞后一年或更长时间。我们开发并验证了一种基于深度学习的方法,利用州一级的实时在线数据(美国心理健康协会基于网络的抑郁症筛查;谷歌和 YouTube 搜索趋势)、社交媒体数据(Twitter)和卫生行政数据(国家综合征监测计划急诊科就诊数据)来估算四个参与州的每周自杀人数。具体来说,我们在每个州建立了一个长短期记忆(LSTM)神经网络模型,将来自实时数据源的信号结合在一起,并将我们模型中的自杀死亡预测值与同一州的观察值进行比较。我们的 LSTM 模型对所有四个州的特定自杀率都做出了准确的估计(犹他州的自杀率百分比误差为-2.768%,路易斯安那州为-2.823%,纽约州为-3.449%,科罗拉多州为-5.323%)。此外,我们基于深度学习的方法优于目前仅使用历史死亡数据的黄金标准基线自回归模型。我们展示了一种结合多个代理实时数据源信号的方法,这种方法有可能更及时地估计州一级的自杀趋势。州一级的及时自杀数据有可能改善自杀预防规划,并根据特定地理社区的需求采取应对措施。
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引用次数: 0
Effects of stress on pain in females using a mobile health app in the Russia-Ukraine conflict 在俄乌冲突中使用移动医疗应用程序的女性压力对疼痛的影响
Pub Date : 2024-01-10 DOI: 10.1038/s44184-023-00043-w
Aliaksandr Kazlou, Kateryna Bornukova, Aidan Wickham, Vladimir Slaykovskiy, Kimberly Peven, Anna Klepchukova, Sonia Ponzo, Sarah Garfinkel
The chronic and acute effects of stress can have divergent effects on health; long-term effects are associated with detrimental physical and mental health sequelae, while acute effects may be advantageous in the short-term. Stress-induced analgesia, the attenuation of pain perception due to stress, is a well-known phenomenon that has yet to be systematically investigated under ecological conditions. Using Flo, a women’s health and wellbeing app and menstrual cycle tracker, with a world-wide monthly active usership of more than 57 million, women in Ukraine were monitored for their reporting of stress, pain and affective symptoms before, and immediately after, the onset of the Russian-Ukrainian conflict. To avoid potential selection (attrition) or collider bias, we rely on a sample of 87,315 users who were actively logging multiple symptoms before and after the start of the war. We found an inverse relationship between stress and pain, whereby higher reports of stress predicted lower rates of pain. Stress did not influence any other physiological symptoms with a similar magnitude, nor did any other symptom have a similar effect on pain. This relationship generally decreased in magnitude in countries neighbouring and surrounding Ukraine, with Ukraine serving as the epicentre. These findings help characterise the relationship between stress and health in a real-world setting.
压力的慢性效应和急性效应会对健康产生不同的影响;长期效应与有害的身心健康后遗症有关,而急性效应可能在短期内对健康有利。压力引起的镇痛(压力导致的痛觉减弱)是一种众所周知的现象,但尚未在生态条件下进行系统研究。Flo是一款女性健康和幸福应用程序,同时也是月经周期跟踪器,在全球每月活跃用户超过5700万,我们使用Flo监测了乌克兰妇女在俄乌冲突爆发前后对压力、疼痛和情感症状的报告。为避免潜在的选择(自然减员)或碰撞偏差,我们对战争开始前后积极记录多种症状的 87315 名用户进行了抽样调查。我们发现压力与疼痛之间存在反向关系,即压力报告越高,疼痛发生率越低。压力并没有对其他生理症状产生类似程度的影响,其他症状也没有对疼痛产生类似的影响。在乌克兰的邻国和周边国家,这种关系的程度普遍下降,而乌克兰则是这种关系的中心。这些发现有助于描述现实世界中压力与健康之间的关系。
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引用次数: 0
Differential temporal utility of passively sensed smartphone features for depression and anxiety symptom prediction: a longitudinal cohort study 被动感应智能手机特征在预测抑郁和焦虑症状方面的时间效用差异:一项纵向队列研究
Pub Date : 2024-01-04 DOI: 10.1038/s44184-023-00041-y
Caitlin A. Stamatis, Jonah Meyerhoff, Yixuan Meng, Zhi Chong Chris Lin, Young Min Cho, Tony Liu, Chris J. Karr, Tingting Liu, Brenda L. Curtis, Lyle H. Ungar, David C. Mohr
While studies show links between smartphone data and affective symptoms, we lack clarity on the temporal scale, specificity (e.g., to depression vs. anxiety), and person-specific (vs. group-level) nature of these associations. We conducted a large-scale (n = 1013) smartphone-based passive sensing study to identify within- and between-person digital markers of depression and anxiety symptoms over time. Participants (74.6% female; M age = 40.9) downloaded the LifeSense app, which facilitated continuous passive data collection (e.g., GPS, app and device use, communication) across 16 weeks. Hierarchical linear regression models tested the within- and between-person associations of 2-week windows of passively sensed data with depression (PHQ-8) or generalized anxiety (GAD-7). We used a shifting window to understand the time scale at which sensed features relate to mental health symptoms, predicting symptoms 2 weeks in the future (distal prediction), 1 week in the future (medial prediction), and 0 weeks in the future (proximal prediction). Spending more time at home relative to one’s average was an early signal of PHQ-8 severity (distal β = 0.219, p = 0.012) and continued to relate to PHQ-8 at medial (β = 0.198, p = 0.022) and proximal (β = 0.183, p = 0.045) windows. In contrast, circadian movement was proximally related to (β = −0.131, p = 0.035) but did not predict (distal β = 0.034, p = 0.577; medial β = −0.089, p = 0.138) PHQ-8. Distinct communication features (i.e., call/text or app-based messaging) related to PHQ-8 and GAD-7. Findings have implications for identifying novel treatment targets, personalizing digital mental health interventions, and enhancing traditional patient-provider interactions. Certain features (e.g., circadian movement) may represent correlates but not true prospective indicators of affective symptoms. Conversely, other features like home duration may be such early signals of intra-individual symptom change, indicating the potential utility of prophylactic intervention (e.g., behavioral activation) in response to person-specific increases in these signals.
虽然有研究表明智能手机数据与情感症状之间存在联系,但我们对这些联系的时间范围、特异性(如抑郁与焦虑)以及特定个人(与群体水平)的性质缺乏清晰的认识。我们开展了一项基于智能手机的大规模(n = 1013)被动感应研究,以确定随时间变化的抑郁和焦虑症状的人内和人际数字标记。参与者(74.6% 为女性;平均年龄为 40.9 岁)下载了 LifeSense 应用程序,该应用程序可在 16 周内持续收集被动数据(如 GPS、应用程序和设备使用、通信)。层次线性回归模型测试了被动感知数据的两周窗口与抑郁(PHQ-8)或广泛焦虑(GAD-7)的人内和人际关联。我们使用移动窗口来了解感知特征与心理健康症状相关的时间尺度,预测未来 2 周(远端预测)、未来 1 周(中端预测)和未来 0 周(近端预测)的症状。与平均水平相比,在家中花费更多时间是 PHQ-8 严重程度的早期信号(远端 β = 0.219,p = 0.012),并在中端(β = 0.198,p = 0.022)和近端(β = 0.183,p = 0.045)窗口与 PHQ-8 继续相关。相反,昼夜节律运动与 PHQ-8 的近端相关(β = -0.131,p = 0.035),但不能预测(远端 β = 0.034,p = 0.577;内侧 β = -0.089,p = 0.138)PHQ-8。与 PHQ-8 和 GAD-7 相关的不同通信特征(即呼叫/短信或基于应用程序的消息)。研究结果对确定新的治疗目标、个性化数字心理健康干预以及加强传统的患者与医疗服务提供者之间的互动具有重要意义。某些特征(如昼夜节律运动)可能是情感症状的相关指标,但不是真正的前瞻性指标。相反,其他一些特征(如在家持续时间)可能是个体内部症状变化的早期信号,这表明针对这些信号的个人特异性增加进行预防性干预(如行为激活)具有潜在的实用性。
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引用次数: 0
Specific topics, specific symptoms: linking the content of recurrent involuntary memories to mental health using computational text analysis 特定主题、特定症状:利用计算文本分析将反复出现的非自愿记忆内容与心理健康联系起来
Pub Date : 2023-12-18 DOI: 10.1038/s44184-023-00042-x
Ryan C. Yeung, Myra A. Fernandes
Researchers debate whether recurrent involuntary autobiographical memories (IAMs; memories of one’s personal past retrieved unintentionally and repetitively) are pathological or ordinary. While some argue that these memories contribute to clinical disorders, recurrent IAMs are also common in everyday life. Here, we examined how the content of recurrent IAMs might distinguish between those that are maladaptive (related to worse mental health) versus benign (unrelated to mental health). Over two years, 6187 undergraduates completed online surveys about recurrent IAMs; those who experienced recurrent IAMs within the past year were asked to describe their memories, resulting in 3624 text descriptions. Using a previously validated computational approach (structural topic modeling), we identified coherent topics (e.g., “Conversations”, “Experiences with family members”) in recurrent IAMs. Specific topics (e.g., “Negative past relationships”, “Abuse and trauma”) were uniquely related to symptoms of mental health disorders (e.g., depression, PTSD), above and beyond the self-reported valence of these memories. Importantly, we also found that content in recurrent IAMs was distinct across symptom types (e.g., “Communication and miscommunication” was related to social anxiety, but not symptoms of other disorders), suggesting that while negative recurrent IAMs are transdiagnostic, their content remains unique across different types of mental health concerns. Our work shows that topics in recurrent IAMs—and their links to mental health—are identifiable, distinguishable, and quantifiable.
研究人员争论的焦点是,反复出现的非自愿自传体记忆(IAMs;无意中重复检索到的个人过去的记忆)是病态的还是普通的。虽然有人认为这些记忆会导致临床疾病,但反复出现的自传体记忆在日常生活中也很常见。在这里,我们研究了反复出现的记忆内容如何区分适应不良(与心理健康恶化有关)和良性(与心理健康无关)记忆。在两年的时间里,6187 名本科生完成了有关复发性 IAMs 的在线调查;那些在过去一年中经历过复发性 IAMs 的学生被要求描述他们的记忆,结果得到了 3624 篇文字描述。我们使用之前验证过的计算方法(结构主题建模),确定了复发性 IAMs 中的连贯主题(如 "对话"、"与家人的经历")。特定主题(如 "过去的负面关系"、"虐待和创伤")与心理健康失调症状(如抑郁症、创伤后应激障碍)有着独特的关系,且超出了这些记忆的自我报告价值。重要的是,我们还发现,反复出现的 IAMs 中的内容在不同的症状类型中是不同的(例如,"沟通和沟通不畅 "与社交焦虑有关,但与其他障碍的症状无关),这表明虽然消极的反复出现的 IAMs 具有跨诊断性,但其内容在不同类型的心理健康问题中仍然是独特的。我们的工作表明,反复出现的 IAMs 中的主题及其与心理健康的联系是可识别、可区分和可量化的。
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引用次数: 0
Investigating the reciprocity between cognition and behavior in adaptation to large-scale disasters 调查大规模灾害适应过程中认知与行为之间的互惠关系
Pub Date : 2023-12-04 DOI: 10.1038/s44184-023-00037-8
Tiffany Junchen Tao, Tsz Wai Li, Li Liang, Huinan Liu, Wai Kai Hou
Cognition and behavior could reciprocally impact each other and together determine mental health amid large-scale disasters such as COVID-19. This study reports a six-month cohort study of a population-representative sample of Hong Kong residents (N = 906) from March–August 2021 (T1) to September 2021–February 2022 (T2). Cross-lagged panel analyses reveal that T1 poor behavioral functioning as indicated by high daily routine disruptions is inversely associated with T2 cognitive adaptation as indicated by self-efficacy and meaning-making but not vice versa. T1 routine disruptions but not cognitive adaptation are positively associated with T2 probable depression/anxiety. The positive link between T1 routine disruptions and T2 probable disorders is mediated by poor cognitive adaptation at T2. The present findings suggest that upholding daily behavioral functioning relative to positive states of mind could have a more pivotal role in mental health amid large-scale disasters. Future studies can test interventions that enhance the sustainment of regular daily routines.
认知和行为可以相互影响,共同决定在 COVID-19 等大规模灾难中的心理健康。本研究报告了一项为期 6 个月的队列研究,研究对象是 2021 年 3 月至 8 月(T1)至 2021 年 9 月至 2022 年 2 月(T2)期间具有人口代表性的香港居民样本(N = 906)。交叉滞后面板分析表明,T1 的行为功能较差(表现为日常工作中断较多)与 T2 的认知适应(表现为自我效能和意义建构)成反比,反之亦然。第一阶段的日常干扰与第二阶段的可能抑郁/焦虑呈正相关,但认知适应与之无关。T1 日常生活混乱与 T2 可能的失调之间的正相关是由 T2 认知适应不良所中介的。本研究结果表明,相对于积极的心理状态,保持日常行为功能在大规模灾难中的心理健康方面可能会发挥更关键的作用。未来的研究可以对加强维持有规律的日常生活的干预措施进行测试。
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引用次数: 0
A systematic review on automated clinical depression diagnosis 临床抑郁症自动诊断系统综述
Pub Date : 2023-11-20 DOI: 10.1038/s44184-023-00040-z
Kaining Mao, Yuqi Wu, Jie Chen
Assessing mental health disorders and determining treatment can be difficult for a number of reasons, including access to healthcare providers. Assessments and treatments may not be continuous and can be limited by the unpredictable nature of psychiatric symptoms. Machine-learning models using data collected in a clinical setting can improve diagnosis and treatment. Studies have used speech, text, and facial expression analysis to identify depression. Still, more research is needed to address challenges such as the need for multimodality machine-learning models for clinical use. We conducted a review of studies from the past decade that utilized speech, text, and facial expression analysis to detect depression, as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. We provide information on the number of participants, techniques used to assess clinical outcomes, speech-eliciting tasks, machine-learning algorithms, metrics, and other important discoveries for each study. A total of 544 studies were examined, 264 of which satisfied the inclusion criteria. A database has been created containing the query results and a summary of how different features are used to detect depression. While machine learning shows its potential to enhance mental health disorder evaluations, some obstacles must be overcome, especially the requirement for more transparent machine-learning models for clinical purposes. Considering the variety of datasets, feature extraction techniques, and metrics used in this field, guidelines have been provided to collect data and train machine-learning models to guarantee reproducibility and generalizability across different contexts.
由于多种原因,包括难以获得医疗服务提供者的帮助,评估精神疾病和确定治疗方法可能很困难。评估和治疗可能不具有连续性,而且会受到精神症状不可预知性的限制。使用在临床环境中收集的数据建立机器学习模型可以改善诊断和治疗。已有研究利用语音、文本和面部表情分析来识别抑郁症。然而,我们仍需要更多的研究来应对挑战,例如临床使用多模态机器学习模型的需求。我们采用《系统综述与元分析首选报告项目》(Preferred Reporting Items for Systematic Reviews and Meta-Analysis,PRISMA)指南,对过去十年利用语音、文本和面部表情分析检测《精神疾病诊断与统计手册》(DSM-5)所定义的抑郁症的研究进行了综述。我们提供了每项研究的参与人数、用于评估临床结果的技术、语音诱导任务、机器学习算法、指标和其他重要发现等信息。共审查了 544 项研究,其中 264 项符合纳入标准。我们创建了一个数据库,其中包含查询结果以及如何利用不同特征检测抑郁症的总结。虽然机器学习在加强心理健康障碍评估方面显示出了潜力,但仍有一些障碍必须克服,尤其是要求用于临床目的的机器学习模型更加透明。考虑到这一领域使用的数据集、特征提取技术和衡量标准多种多样,我们提供了收集数据和训练机器学习模型的指南,以保证在不同情况下的可重复性和通用性。
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引用次数: 0
Managing expectations with psychedelic microdosing 管理对迷幻药微型剂量的期望值
Pub Date : 2023-11-08 DOI: 10.1038/s44184-023-00044-9
Omer A. Syed, Benjamin Tsang
Microdosing psychedelics is a growing practice among recreational users, claimed to improve several aspects of mental health, with little supporting empirical research. In this comment, we highlight the potential role of expectations and confirmation bias underlying therapeutic effects of microdosing, and suggest future avenues of research to address this concern.
微量服用迷幻剂在娱乐性使用者中是一种越来越普遍的做法,据称可以改善心理健康的多个方面,但几乎没有支持这种做法的实证研究。在这篇评论中,我们强调了期望和确认偏差在微剂量治疗效果中的潜在作用,并提出了解决这一问题的未来研究途径。
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引用次数: 0
Technical and clinical considerations for electroencephalography-based biomarkers for major depressive disorder 基于脑电图的重度抑郁障碍生物标志物的技术和临床考虑因素
Pub Date : 2023-10-25 DOI: 10.1038/s44184-023-00038-7
Leif Simmatis, Emma E. Russo, Joseph Geraci, Irene E. Harmsen, Nardin Samuel
Major depressive disorder (MDD) is a prevalent and debilitating psychiatric disease that leads to substantial loss of quality of life. There has been little progress in developing new MDD therapeutics due to a poor understanding of disease heterogeneity and individuals’ responses to treatments. Electroencephalography (EEG) is poised to improve this, owing to the ease of large-scale data collection and the advancement of computational methods to address artifacts. This review summarizes the viability of EEG for developing brain-based biomarkers in MDD. We examine the properties of well-established EEG preprocessing pipelines and consider factors leading to the discovery of sensitive and reliable biomarkers.
重度抑郁障碍(MDD)是一种普遍存在且使人衰弱的精神疾病,会导致生活质量大幅下降。由于对疾病的异质性和个体对治疗的反应了解甚少,因此在开发新的 MDD 治疗方法方面进展甚微。脑电图(EEG)由于易于进行大规模数据收集,并采用先进的计算方法解决伪影问题,因此有望改善这一状况。本综述总结了脑电图在开发基于大脑的 MDD 生物标记物方面的可行性。我们研究了成熟的脑电图预处理管道的特性,并考虑了导致发现灵敏可靠的生物标记物的因素。
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引用次数: 0
Natural language processing analysis of the psychosocial stressors of mental health disorders during the pandemic 大流行病期间心理健康障碍的社会心理压力的自然语言处理分析
Pub Date : 2023-10-05 DOI: 10.1038/s44184-023-00039-6
María P. Raveau, Julián I. Goñi, José F. Rodríguez, Isidora Paiva-Mack, Fernanda Barriga, María P. Hermosilla, Claudio Fuentes-Bravo, Susana Eyheramendy
Over the past few years, the COVID-19 pandemic has exerted various impacts on the world, notably concerning mental health. Nevertheless, the precise influence of psychosocial stressors on this mental health crisis remains largely unexplored. In this study, we employ natural language processing to examine chat text from a mental health helpline. The data was obtained from a chat helpline called Safe Hour from the “It Gets Better” project in Chile. This dataset encompass 10,986 conversations between trained professional volunteers from the foundation and platform users from 2018 to 2020. Our analysis shows a significant increase in conversations covering issues of self-image and interpersonal relations, as well as a decrease in performance themes. Also, we observe that conversations involving themes like self-image and emotional crisis played a role in explaining both suicidal behavior and depressive symptoms. However, anxious symptoms can only be explained by emotional crisis themes. These findings shed light on the intricate connections between psychosocial stressors and various mental health aspects in the context of the COVID-19 pandemic.
在过去的几年里,COVID-19 大流行病给世界带来了各种影响,尤其是在心理健康方面。然而,社会心理压力因素对这一心理健康危机的确切影响在很大程度上仍未得到探讨。在本研究中,我们采用自然语言处理技术来研究心理健康求助热线的聊天文本。这些数据来自智利 "It Gets Better "项目中名为 "Safe Hour "的聊天帮助热线。从 2018 年到 2020 年,该数据集包含来自基金会的训练有素的专业志愿者与平台用户之间的 10986 次对话。我们的分析表明,涉及自我形象和人际关系问题的对话大幅增加,而表现主题则有所减少。此外,我们还观察到,涉及自我形象和情感危机等主题的对话在解释自杀行为和抑郁症状方面都发挥了作用。然而,焦虑症状只能通过情感危机主题来解释。这些发现揭示了在 COVID-19 大流行的背景下,社会心理压力因素与心理健康各方面之间错综复杂的联系。
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引用次数: 0
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Npj mental health research
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