Depression and Anxiety Have Distinct and Overlapping Language Patterns: Results From a Clinical Interview

Depression has been associated with heightened first-person singular pronoun use (I-usage; e.g., "I," "my") and negative emotion words. However, past research has relied on nonclinical samples and nonspecific depression measures, raising the question of whether these features are...

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Bibliographic Details
Published in:Journal of psychopathology and clinical science 2023-11, Vol.132 (8), p.972-983
Main Authors: Stade, Elizabeth C., Ungar, Lyle, Eichstaedt, Johannes C., Sherman, Garrick, Ruscio, Ayelet Meron
Format: Article
Language:English
Subjects:
Anxiety
Anxiety - diagnosis
Anxiety disorders
Anxiety Disorders - diagnosis
Anxiety Disorders - epidemiology
Anxiety Disorders - psychology
Clinical interviews
Comorbidity
Computer Linguistics
Depression - diagnosis
Depression - epidemiology
Depression - psychology
Depressive Disorder, Major - diagnosis
Depressive Disorder, Major - epidemiology
Emotional words
Emotions
Female
Generalized anxiety disorder
Human
Humans
Language
Language isolates
Language patterns
Language usage
Life changes
Machine learning
Major Depression
Male
Mental depression
Natural Language
Negative Emotions
Positive emotions
Sadness
Self report
Severity
Speech
Spoken language
Words (Phonetic Units)
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Summary:Depression has been associated with heightened first-person singular pronoun use (I-usage; e.g., "I," "my") and negative emotion words. However, past research has relied on nonclinical samples and nonspecific depression measures, raising the question of whether these features are unique to depression vis-à-vis frequently co-occurring conditions, especially anxiety. Using structured questions about recent life changes or difficulties, we interviewed a sample of individuals with varying levels of depression and anxiety (N = 486), including individuals in a major depressive episode (n = 228) and/or diagnosed with generalized anxiety disorder (n = 273). Interviews were transcribed to provide a natural language sample. Analyses isolated language features associated with gold standard, clinician-rated measures of depression and anxiety. Many language features associated with depression were in fact shared between depression and anxiety. Language markers with relative specificity to depression included I-usage, sadness, and decreased positive emotion, while negations (e.g., "not," "no"), negative emotion, and several emotional language markers (e.g., anxiety, stress, depression) were relatively specific to anxiety. Several of these results were replicated using a self-report measure designed to disentangle components of depression and anxiety. We next built machine learning models to detect severity of common and specific depression and anxiety using only interview language. Individuals' speech characteristics during this brief interview predicted their depression and anxiety severity, beyond other clinical and demographic variables. Depression and anxiety have partially distinct patterns of expression in spoken language. Monitoring of depression and anxiety severity via language can augment traditional assessment modalities and aid in early detection. General Scientific SummaryThere is growing scientific excitement about detecting depression from people's language use, but this work rarely accounts for anxiety, which overlaps substantially and co-occurs frequently with depression. Using clinical interviews with individuals with varying levels of depression and anxiety, we found that some language patterns are shared by these conditions, whereas other patterns distinguish them. Depressed individuals show more I-usage (e.g., "I," "me," "my") and sadness words (e.g., "low," "sad," "alone"), while anxious individuals use a much broader array of negative emotionality
ISSN:2769-7541
2769-755X
DOI:10.1037/abn0000850