Duck Lips and Smiley Faces May Hint at Psychotic Behavior

Sometimes social media seems like a mindless exchange of duck-face pictures, LOL’s and emoticons.  But what if smiley faces, twitter exchanges and all those sanitized life stories revealed something more?  What if hidden in some of the new social language is an encrypted cry for help - a darker truth, unknown even to the author? 

That hypothesis intrigued Michael Birnbaum, MD, a psychiatrist at Zucker Hillside Hospital, who studies social media use and language patterns (SMLP) among young people with schizophrenia and schizoaffective disorder.  His goal? Identify and predict mental illness in patients age 15-35 and provide intervention before psychosis occurs.

Marketers and advertisers have long sought to harness social media’s power, knowing that somewhere in that sea of likes, shares and chats is the key to increased sales. Government agencies have used linguistic analysis in deciphering chatter to determine whether terror threats are credible or not. The internet and social media exchanges in particular are being mined for countless insights into the human psyche.

“The work being done in behavioral health is similar to that in other areas,” Dr. Birnbaum said. “It bridges the gap between computer science and behavioral health, bringing mental health care to the digital age.” 

Dr. Birnbaum explained that using technology to improve clinical outcomes in behavioral health has lagged behind other areas. While studying social media-based linguistic and behavioral analysis is in its infancy for psychiatric disorders, his studies – published in Early Intervention in Psychiatry show it may be a reliable predictor of the psychotic symptoms.

“Psychiatry is all about early intervention, outreach and engagement.  The research suggests that by studying language patterns and social media usage, and monitoring changes in those areas, that it may be possible to determine the likelihood of a psychosis relapse before it can be clinically detected. That is a huge differentiator that would benefit patients by enabling an intervention before a psychiatric episode even occurs.”

Through research projects at Zucker Hillside Hospital, part of the behavioral health service line within Northwell Health, Dr. Birnbaum is analyzing how young people with psychosis (schizophrenia and schizoaffective disorder) use the internet and specifically social media.   Collaboration with a linguistic analysis team in Texas and James Pennebaker, a psychologist at the University of Texas, who studies the psychological meaning of word usage and computerized text analysis through a scientific “linguistic inquiry word count” (LIWC) method, is able to determine the linguistic style of people who suffer from depression and other mental illness.

“The pilot data suggests the computer algorithms may be able to identify individuals who have psychosis and who are in the midst of a psychotic event,” Dr. Birnbaum said.  “As a possible predictor of the onset of illness or worsening of symptoms, it has the potential for having a wide impact among this population.”  Dr. Birnbaum is applying for additional grants to expand and conduct further research in this area.  While it is still early in the research phase, based on the results, he said he is optimistic a breakthrough for patients and their families is on the horizon.

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