research-article

Quantifying and Predicting Mental Illness Severity in Online Pro-Eating Disorder Communities

Authors:

Stevie Chancellor,

Erica L. Goodman,

Stephanie Zerwas,

Munmun De ChoudhuryAuthors Info & Claims

CSCW '16: Proceedings of the 19th ACM Conference on Computer-Supported Cooperative Work & Social Computing

Pages 1171 - 1184

https://doi.org/10.1145/2818048.2819973

Published: 27 February 2016 Publication History

Abstract

Social media sites have struggled with the presence of emotional and physical self-injury content. Individuals who share such content are often challenged with severe mental illnesses like eating disorders. We present the first study quantifying levels of mental illness severity (MIS) in social media. We examine a set of users on Instagram who post content on pro-eating disorder tags (26M posts from 100K users). Our novel statistical methodology combines topic modeling and novice/clinician annotations to infer MIS in a user's content. Alarmingly, we find that proportion of users whose content expresses high MIS have been on the rise since 2012 (13%/year increase). Previous MIS in a user's content over seven months can predict future risk with 81% accuracy. Our model can also forecast MIS levels up to eight months in the future with performance better than baseline. We discuss the health outcomes and design implications as well as ethical considerations of this line of research.

References

[1]

Sofiane Abbar, Yelena Mejova, and Ingmar Weber. 2015. You Tweet What You Eat: Studying Food Consumption Through Twitter. In Proc. CHI.

Digital Library

[2]

Nazanin Andalibi, Pinar Ozturk, and Andrea Forte. 2015. Depression-related Imagery on Instagram. In Proc. CSCW'15 Companion. 231–234.

Digital Library

[3]

Jon Arcelus, Alex J Mitchell, Jackie Wales, and Sren Nielsen. 2011. Mortality rates in patients with anorexia nervosa and other eating disorders: a meta-analysis of 36 studies. Archv. Gen. Psychiatry 68, 7 (2011), 724–731.

[4]

American Psychiatric Association and others. 2013. Diagnostic and statistical manual of mental disorders, (DSM-5). American Psychiatric Pub.

[5]

Jin Yeong Bak, Suin Kim, and Alice Oh. 2012. Self-disclosure and relationship strength in twitter conversations. In Proc. ACL. 60–64.

Digital Library

[6]

Anna M Bardone-Cone and Kamila M Cass. 2006. Investigating the impact of pro-anorexia websites: A pilot study. European Eating Disorders Review 14, 4 (2006), 256–262.

[7]

David M Blei, Andrew Y Ng, and Michael I Jordan. 2003. Latent dirichlet allocation. Journal of Machine Learning Research (JMLR) 3 (2003), 993–1022.

Digital Library

[8]

Dina LG Borzekowski, Summer Schenk, Jenny L Wilson, and Rebecka Peebles. 2010. e-Ana and e-Mia: A content analysis of pro–eating disorder web sites. American journal of public health 100, 8 (2010), 1526.

[9]

Leo Breiman. 2001. Random forests. Machine learning 45, 1 (2001), 5–32.

Digital Library

[10]

Jay Callahan. 1996. A specific therapeutic approach to suicide risk in borderline clients. Clinical Social Work Journal 24, 4 (1996), 443–459.

[11]

Richard F Catalano and J David Hawkins. 1996. A Theory of Antisocial Behavior. Delinquency and crime: Current theories (1996), 149.

[12]

Laurence Claes, Koen Luyckx, Patricia Bijttebier, Brianna Turner, Amarendra Ghandi, Jos Smets, Jan Norre, Leen Van Assche, Els Verheyen, Yvienne Goris, and others. 2015. Non-Suicidal Self-Injury in Patients with Eating Disorder: Associations with Identity Formation Above and Beyond Anxiety and Depression. European Eating Disorders Review 23, 2 (2015), 119–125.

[13]

Michael Collins, Robert E Schapire, and Yoram Singer. 2002. Logistic regression, AdaBoost and Bregman distances. Machine Learning 48, 1-3 (2002), 253–285.

Digital Library

[14]

Karen Conterio, W Lader, and JK Bloom. 1998. Bodily harm: The breakthrough treatmentprogramfor self-injurers. (1998).

[15]

Glen Coppersmith, Mark Dredze, and Craig Harman. 2014. Quantifying mental health signals in twitter. In Proc. ACL CLCP Workshop.

[16]

Munmun De Choudhury. 2015. Anorexia on Tumblr: A Characterization Study. In Proc. Digital Health.

Digital Library

[17]

Munmun De Choudhury, Scott Counts, Eric Horvitz, and Aaron Hoff. 2014. Characterizing and Predicting Postpartum Depression from Facebook Data. In Proc. CSCW.

Digital Library

[18]

Munmun De Choudhury, Michael Gamon, Scott Counts, and Eric Horvitz. 2013. Predicting depression via social media. In Proc. ICWSM.

[19]

Sharon K Farber, Craig C Jackson, Johanna K Tabin, and Eytan Bachar. 2007. Death and annihilation anxieties in anorexia nervosa, bulimia, and self-mutilation. Psychoanalytic Psych 24, 2 (2007), 289.

[20]

Angela Favaro and Paolo Santonastaso. 1998. Impulsive and compulsive self-injurious behavior in bulimia nervosa: Prevalence and psychological correlates. The Journal of Nervous and Mental Disease 186, 3 (1998), 157–165.

[21]

Armando R Favazza, Lori DeRosear, and K Conterio. 1989. Self-Mutilation and Eating Disorders. Suicide & Life-Threatening Behavior 19, 4 (1989), 352–361.

[22]

Rachel A Fleming-May and Laura E Miller. 2010. I'm scared to look. But I'm dying to know: Information seeking and sharing on Pro-Ana weblogs. Proc. ASIST 47, 1 (2010), 1–9.

Digital Library

[23]

Yoav Freund, Robert E Schapire, and others. 1996. Experiments with a new boosting algorithm. In ICML, Vol. 96. 148–156.

Digital Library

[24]

W Gaebel, H Zäske, and AE Baumann. 2006. The relationship between mental illness severity and stigma. Acta Psychiatrica Scandinavica 113, s429 (2006), 41–45.

[25]

Sarah A St Germain and Jill M Hooley. 2012. Direct and indirect forms of non-suicidal self-injury: Evidence for a distinction. Psychiatry research 197, 1 (2012), 78–84.

[26]

Erving Goffman and others. 1959. The presentation of self in everyday life. (1959).

[27]

Kim L Gratz, Sheree Dukes Conrad, and Lizabeth Roemer. 2002. Risk factors for deliberate self-harm among college students. American Journal of Orthopsychiatry 72, 1 (2002), 128.

[28]

P Hasking, R Momeni, S Swannell, and S Chia. 2008. The nature and extent of non-suicidal self-injury in a non-clinical sample of young adults. Archives of Suicide Research 12, 3 (2008), 208–218.

[29]

Matthew Hoffman, Francis R Bach, and David M Blei. 2010. Online learning for latent dirichlet allocation. In Proc. NIPS.

[30]

Christopher M Homan, Ravdeep Johar, Tong Liu, Megan Lytle, Vincent Silenzio, and Cecilia Alm. 2014a. Toward Macro-Insights for Suicide Prevention: Analyzing Fine-Grained Distress at Scale. ACL 2014 (2014), 107.

[31]

Christopher M Homan, Naiji Lu, Xin Tu, Megan C Lytle, and Vincent Silenzio. 2014b. Social structure and depression in TrevorSpace. In Computer-Supported Cooperative Work and Social Computing (CSCW).

Digital Library

[32]

James I Hudson, Eva Hiripi, Harrison G Pope, and Ronald C Kessler. 2007. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological psychiatry 61, 3 (2007), 348–358.

[33]

Grace J Johnson and Paul J Ambrose. 2006. Neo-tribes: The power and potential of online communities in health care. Commun. ACM 49, 1 (2006), 107–113.

Digital Library

[34]

Adrienne S Juarascio, Amber Shoaib, and C Alix Timko. 2010. Pro-eating disorder communities on social networking sites: a content analysis. Eating disorders 18, 5 (2010), 393–407.

[35]

Kelly L Klump, Cynthia M Bulik, Walter H Kaye, Janet Treasure, and Edward Tyson. 2009. Academy for eating disorders position paper: eating disorders are serious mental illnesses. Int J Eat Disord 42, 2 (2009), 97–103.

[36]

Katrina Kostro, Jessica B Lerman, and Evelyn Attia. 2014. The current status of suicide and self-injury in eating disorders: a narrative review. Journal of Eating Disorders 2, 1 (2014), 19.

[37]

Reeva Lederman, Greg Wadley, John Gleeson, Sarah Bendall, and Mario Álvarez-Jiménez. 2014. Moderated online social therapy: Designing and evaluating technology for mental health. ACM Transactions on Computer-Human Interaction (TOCHI) 21, 1 (2014), 5.

Digital Library

[38]

Stephen P Lewis and Alexis E Arbuthnott. 2012. Searching for thinspiration: the nature of internet searches for pro-eating disorder websites. Cyberpsychology, Behavior, and Social Networking 15, 4 (2012), 200–204.

[39]

Rebecca MacKinnon. 2008. Flatter world and thicker walls? Blogs, censorship and civic discourse in China. Public Choice 134, 1-2 (2008), 31–46.

[40]

Diana MacLean, Sonal Gupta, Anna Lembke, Christopher Manning, and Jeffrey Heer. 2015. Forum77: An Analysis of an Online Health Forum Dedicated to Addiction Recovery. In Proc. CSCW.

Digital Library

[41]

Jeanne B Martin. 2010. The development of ideal body image perceptions in the United States. Nutrition Today 45, 3 (2010), 98–110.

[42]

Terence C Mills. 1991. Time series techniques for economists. Cambridge University Press.

[43]

Paul Moran, Carolyn Coffey, Helena Romaniuk, Craig Olsson, Rohan Borschmann, John B Carlin, and

[44]

ge C Patton. 2012. The natural history of self-harm from adolescence to young adulthood: a population-based cohort study. The Lancet 379, 9812 (2012), 236–243.

[45]

Elizabeth L Murnane and Scott Counts. 2014. Unraveling abstinence and relapse: smoking cessation reflected in social media. In Proc. CHI.

Digital Library

[46]

Matthew K Nock and Mitchell J Prinstein. 2004. A functional approach to the assessment of self-mutilative behavior. Journal of consulting and clinical psychology 72, 5 (2004), 885.

[47]

Mark L Norris, Katherine M Boydell, Leora Pinhas, and Debra K Katzman. 2006. Ana and the Internet: A review of pro-anorexia websites. International Journal of Eating Disorders 39, 6 (2006), 443–447.

[48]

Minsu Park, David W McDonald, and Meeyoung Cha. 2013. Perception Differences between the Depressed and Non-depressed Users in Twitter. In Proc. ICWSM.

[49]

Michael J Paul and Mark Dredze. 2011. You Are What You Tweet: Analyzing Twitter for Public Health. In Proc. ICWSM.

[50]

Rebecka Peebles, Jenny L Wilson, and James D Lock. 2011. Self-injury in adolescents with eating disorders:

[51]

elates and provider bias. Journal of Adolescent Health 48, 3 (2011), 310–313.

[52]

Mirella Ruggeri, Morven Leese, Graham Thornicroft, Giulia Bisoffi, and Michele Tansella. 2000. Definition and prevalence of severe and persistent mental illness. The British Journal of Psychiatry 177, 2 (2000), 149–155.

[53]

Hansen Andrew Schwartz, Johannes C Eichstaedt, Margaret L Kern, and Lukasz et al. Dziurzynski. 2013. Characterizing Geographic Variation in Well-Being Using Tweets. In ICWSM.

[54]

Yukari Seko. 2013. Picturesque Wounds: A Multimodal Analysis of Self-Injury Photographs on Flickr. In Forum Qualitative Sozialforschung/Forum: Qualitative Social Research, Vol. 14.

[55]

Leslie Regan Shade. 2003. Weborexics: The Ethical Issues Surrounding Pro-Ana Websites. SIGCAS Comput. Soc. 33, 4 (Dec. 2003).

Digital Library

[56]

Frédérique RE Smink, Daphne van Hoeken, and Hans W Hoek. 2012. Epidemiology of eating disorders: incidence, prevalence and mortality rates. Current psychiatry reports 14, 4 (2012), 406–414.

[57]

John R Suler and Wende L Phillips. 1998. The bad boys of cyberspace: Deviant behavior in a multimedia chat community. CyberPsychology & Behavior 1, 3 (1998), 275–294.

[58]

Karen L Suyemoto. 1998. The functions of self-mutilation. Clinical psych rev 18, 5 (1998), 531–554.

[59]

Brianna J Turner, Angelina Yiu, Brianne K Layden, Laurence Claes, Shannon Zaitsoff, and Alexander L. Chapman. 2015. Temporal associations between disordered eating and nonsuicidal self-injury: examining symptom overlap over 1 year. Behavior Therapy 46, 1 (2015), 125–138.

[60]

Robert F Valois, Keith J Zullig, and Amy A Hunter. 2013. Association between adolescent suicide ideation, suicide attempts and emotional self-efficacy. Journal of Child and Family Studies 24, 2 (2013), 237–248.

[61]

Markus Wolf, Florian Theis, and Hans Kordy. 2013. Language Use in Eating Disorder Blogs Psychological Implications of Social Online Activity. Journal of Language and Social Psychology 32, 2 (2013), 212–226.

[62]

Elad Yom-Tov, Luis Fernandez-Luque, Ingmar Weber, and P Steven Crain. 2012. Pro-Anorexia and Pro-Recovery Photo Sharing: A Tale of Two Warring Tribes. J Med Internet Res (2012).

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cover image ACM Conferences

CSCW '16: Proceedings of the 19th ACM Conference on Computer-Supported Cooperative Work & Social Computing

February 2016

1866 pages

ISBN:9781450335928

DOI:10.1145/2818048

General Chairs:
Darren Gergle
Northwestern University
,
Meredith Ringel Morris
Microsoft Research
,
Program Chairs:
Pernille Bjørn
University of Copenhagen
,
Joseph Konstan
University of Minnesota

Copyright © 2016 ACM.

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Published: 27 February 2016

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