A Novel Site-Agnostic Multimodal Deep Learning Model to Identify Pro-Eating Disorder Content on Social Media

Over the last decade, there has been a vast increase in eating disorder diagnoses and eating disorder-attributed deaths, reaching their zenith during the Covid-19 pandemic. This immense growth derived in part from the stressors of the pandemic but also from increased exposure to social media, which is rife with content that promotes eating disorders. Such content can induce eating disorders in viewers. This study aimed to create a multimodal deep learning model capable of determining whether a given social media post promotes eating disorders based on a combination of visual and textual data. A labeled dataset of Tweets was collected from Twitter, upon which twelve deep learning models were trained and tested. Based on model performance, the most effective deep learning model was the multimodal fusion of the RoBERTa natural language processing model and the MaxViT image classification model, attaining accuracy and F1 scores of 95.9% and 0.959 respectively. The RoBERTa and MaxViT fusion model, deployed to classify an unlabeled dataset of posts from the social media sites Tumblr and Reddit, generated similar classifications as previous research studies that did not employ artificial intelligence, showing that artificial intelligence can develop insights congruent to those of researchers. Additionally, the model was used to conduct a time-series analysis of yet unseen Tweets from eight Twitter hashtags, uncovering that the relative abundance of pro-eating disorder content has decreased drastically. However, since approximately 2018, pro-eating disorder content has either stopped its decline or risen once more in ampleness

Conformity of Eating Disorders through Content Moderation

For individuals with mental illness, social media platforms are considered spaces for sharing and connection. However, not all expressions of mental illness are treated equally on these platforms. Different aggregates of human and technical control are used to report and ban content, accounts, and communities. Through two years of digital ethnography, including online observation and interviews, with people with eating disorders, we examine the experience of content moderation. We use a constructivist grounded theory approach to analysis that shows how practices of moderation across different platforms have particular consequences for members of marginalized groups, who are pressured to conform and compelled to resist. Above all, we argue that platform moderation is enmeshed with wider processes of conformity to specific versions of mental illness. Practices of moderation reassert certain bodies and experiences as 'normal' and valued, while rejecting others. At the same time, navigating and resisting these normative pressures further inscribes the marginal status of certain individuals. We discuss changes to the ways that platforms handle content related to eating disorders by drawing on the concept of multiplicity to inform design

What Twitter Profile and Posted Images Reveal About Depression and Anxiety

Previous work has found strong links between the choice of social media images and users' emotions, demographics and personality traits. In this study, we examine which attributes of profile and posted images are associated with depression and anxiety of Twitter users. We used a sample of 28,749 Facebook users to build a language prediction model of survey-reported depression and anxiety, and validated it on Twitter on a sample of 887 users who had taken anxiety and depression surveys. We then applied it to a different set of 4,132 Twitter users to impute language-based depression and anxiety labels, and extracted interpretable features of posted and profile pictures to uncover the associations with users' depression and anxiety, controlling for demographics. For depression, we find that profile pictures suppress positive emotions rather than display more negative emotions, likely because of social media self-presentation biases. They also tend to show the single face of the user (rather than show her in groups of friends), marking increased focus on the self, emblematic for depression. Posted images are dominated by grayscale and low aesthetic cohesion across a variety of image features. Profile images of anxious users are similarly marked by grayscale and low aesthetic cohesion, but less so than those of depressed users. Finally, we show that image features can be used to predict depression and anxiety, and that multitask learning that includes a joint modeling of demographics improves prediction performance. Overall, we find that the image attributes that mark depression and anxiety offer a rich lens into these conditions largely congruent with the psychological literature, and that images on Twitter allow inferences about the mental health status of users.Comment: ICWSM 201

"Notjustgirls": Exploring Male-related Eating Disordered Content across Social Media Platforms

Eating disorders (EDs) are a worldwide public health concern that impact approximately 10% of the U.S. population. Our previous research characterized these behaviors across online spaces. These characterizations have used clinical terminology, and their lexical variants, to identify ED content online. However, previous HCI research on EDs (including our own) suffers from a lack of gender and cultural diversity. In this paper, we designed a follow-up study of online ED characterizations, extending our previous methodologies to focus specifically on male/masculine-related content. We highlight the similarities and differences found in the terminology utilized and media archetypes associated with the social media content. Finally, we discuss other considerations highlighted through our analysis of the male-related content that is missing from the previous research

IPAN - Interdisciplinary Perspectives on Anorexia Nervosa: Book of Abstracts

This book collects 17 contributions by scholars and experts interested in the study of anorexia nervosa (AN) and eating disorders (ED) in different research fields (among others, Linguistics, Psychology, and Neuropsychiatry). All the contributions will be presented at the upcoming IPAN (Interdisciplinary Perspectives on Anorexia Nervosa) conference, a one-day event that will be hosted in Bologna on May 26, 2023, by the Department of Classical Philology and Italian Study - University of Bologna (Italy), in collaboration with RaAM (Association for Researching and Applying Metaphors). The conference aims at fostering multidisciplinary exchange about research on AN and, more in general, on ED. With this volume we want to mash up ideas and research methods of experts, scholars, and students from different theoretical and experimental backgrounds, this way providing an environment for dialogue and integration

School Violence Prevention: Evaluating a Cognitive-Behavioral Intervention for Aggression Among Adolescents

Schools are held accountable for creating and maintaining safe learning environments for all students. The prevalence of behavior and conduct disorders, specifically aggression, remain problematic for school campuses. When a child’s aggressive behaviors persist over time, the development of established patterns of violence become harder to modify later in life. Further, aggressive behaviors may be comorbid with symptoms of anxiety and depression. Thus, there is a need to implement effective and feasible school-based interventions in order to ameliorate these problems. One such program that has demonstrated effectiveness is Creating Opportunities for Personal Empowerment (COPE), an individually-administered intervention based in cognitive-behavioral therapy (CBT) principles. COPE promotes self-regulation and the development of coping skills for managing stress. In order to evaluate the COPE program, a single-case design study will be implemented for three adolescents with a history of aggressive behaviors. This study aims to assess the effects of COPE on aggression, anxiety, and depression. It is hypothesized that the COPE program will (a) reduce aggressive behavior and (b) improve depression and anxiety symptoms among students

Study protocol for a randomized controlled trial comparing the efficacy of a specialist and a generic parenting programme for the treatment of preschool ADHD

BACKGROUND: The New Forest Parenting Programme (NFPP) is a home-delivered, evidence-based parenting programme to target symptoms of attention-deficit/hyperactivity disorder (ADHD) in preschool children. It has been adapted for use with 'hard-to-reach' or 'difficult-to-treat' children. This trial will compare the adapted-NFPP with a generic parenting group-based programme, Incredible Years (IY), which has been recommended for children with preschool-type ADHD symptoms.METHODS/DESIGN: This multicentre randomized controlled trial comprises three arms: adapted-NFPP, IY and treatment as usual (TAU). A sample of 329 parents of preschool-aged children with a research diagnosis of ADHD enriched for hard-to-reach and potentially treatment-resistant children will be allocated to the arms in the ratio 3:3:1. Participants in the adapted-NFPP and IY arms receive an induction visit followed by 12 weekly parenting sessions of 1½ hours (adapted-NFPP) or 2½ hours (IY) over 2.5 years. Adapted-NFPP will be delivered as a one-to-one home-based intervention; IY, as a group-based intervention. TAU participants are offered a parenting programme at the end of the study. The primary objective is to test whether the adapted-NFPP produces beneficial effects in terms of core ADHD symptoms. Secondary objectives include examination of the treatment impact on secondary outcomes, a study of cost-effectiveness and examination of the mediating role of treatment-induced changes in parenting behaviour and neuropsychological function. The primary outcome is change in ADHD symptoms, as measured by the parent-completed version of the SNAP-IV questionnaire, adjusted for pretreatment SNAP-IV score. Secondary outcome measures are: a validated index of behaviour during child's solo play; teacher-reported SNAP-IV (ADHD scale); teacher and parent SNAP-IV (ODD) Scale; Eyberg Child Behaviour Inventory - Oppositional Defiant Disorder scale; Revised Client Service Receipt Inventory - Health Economics Costs measure and EuroQol (EQ5D) health-related quality-of-life measure. Follow-up measures will be collected 6 months after treatment for participants allocated to adapted-NFPP and IY.DISCUSSION: This trial will provide evidence as to whether the adapted-NFPP is more effective and cost-effective than the recommended treatment and TAU. It will also provide information about mediating factors (improved parenting and neuropsychological function) and moderating factors (parent and child genetic factors) in any increased benefit.TRIAL REGISTRATION: Current Controlled Trials, ISRCTN39288126.</p

Dissociation and interpersonal autonomic physiology in psychotherapy research: an integrative view encompassing psychodynamic and neuroscience theoretical frameworks

Interpersonal autonomic physiology is an interdisciplinary research field, assessing the relational interdependence of two (or more) interacting individual both at the behavioral and psychophysiological levels. Despite its quite long tradition, only eight studies since 1955 have focused on the interaction of psychotherapy dyads, and none of them have focused on the shared processual level, assessing dynamic phenomena such as dissociation. We longitudinally observed two brief psychodynamic psychotherapies, entirely audio and video-recorded (16 sessions, weekly frequency, 45 min.). Autonomic nervous system measures were continuously collected during each session. Personality, empathy, dissociative features and clinical progress measures were collected prior and post therapy, and after each clinical session. Two-independent judges, trained psychotherapist, codified the interactions\u2019 micro-processes. Time-series based analyses were performed to assess interpersonal synchronization and de-synchronization in patient\u2019s and therapist\u2019s physiological activity. Psychophysiological synchrony revealed a clear association with empathic attunement, while desynchronization phases (range of length 30-150 sec.) showed a linkage with dissociative processes, usually associated to the patient\u2019s narrative core relational trauma. Our findings are discussed under the perspective of psychodynamic models of Stern (\u201cpresent moment\u201d), Sander, Beebe and Lachmann (dyad system model of interaction), Lanius (Trauma model), and the neuroscientific frameworks proposed by Thayer (neurovisceral integration model), and Porges (polyvagal theory). The collected data allows to attempt an integration of these theoretical approaches under the light of Complex Dynamic Systems. The rich theoretical work and the encouraging clinical results might represents a new fascinating frontier of research in psychotherapy

Helping Friends Suffering Mental Health Issues: Challenges and Opportunities for Social Support on Social Media from the Peer???s Point of View

Department of Creative Design EngineeringPeople with mental health problems are increasingly using social media to disclose their experiences or to seek help. Recent research has suggested that peer support plays a critical role in achieving better health outcomes for these individuals. However, little is known about the experiences and perceptions of the peers who are expected to provide this support. In this paper, I investigate how student peers recognize, perceive, and support others who describe mental health-related challenges on social media. Online survey (N=227) and interviews (N=20) revealed that a considerable number of people did not proactively support where they could identify others at risk through stigmatized content, unusual online activities, or a gap between online and offline identity. I found that social stigma, fatigue, and susceptibility often hampered social support. I outline the implications of using social media as a supportive platform, and discuss opportunities for using design to enhance the peers??? social support experiences.ope

Evaluation of an Internet-delivered support program for patients with bulimic symptomatology

Eating disorders are often characterized by multiple illness episodes and chronic courses. Despite well established and effective treatment options, a considerable number of patients fail to respond to these treatments or drop-out prematurely. Even after successful treatment, patients experience a high risk of relapse that is particularly pronounced in the first months following treatment termination. Maintenance of treatment gains and promotion of continued recovery is highly relevant to improve outcome and ultimately reduce the burden of illness. Interventions based on new technologies have the potential to extend the reach of treatment providers and to provide such maintenance support at reasonable cost and effort. Acknowledging the widespread use of communication technologies in today’s world and the increasing evidence to support the potential of e-health interventions in prevention, self-help, treatment and maintenance treatment of patients with eating disorders, the three studies presented in this dissertation were concerned with developing and evaluating an Internet-based support program as a step-down strategy for patients with bulimic symptomatology following discharge from treatment. Thus far, no study has addressed patients with BN and related EDNOS using the Internet at post-treatment. The program was developed within a European collaboration and followed an individually tailored intervention strategy which incorporated several modules of differing intensity. In the first study, the feasibility of the program was investigated among 22 participants who utilized the online program for four months. The results indicated the viability of an individually tailored intervention strategy in a heterogeneous sample with high satisfaction and acceptance ratings. In the second study, the efficacy of the intervention in maintaining and/or enhancing treatment gains was studied among 105 women who had received treatment for an eating disorder with bulimic symptomatology in routine care against a wait-list TAU control condition. It was hypothesized that intervention group participants would improve more compared to the control group participants at the end of the four-month intervention period on eating disorder related outcomes. In addition, the feasibility of the program was investigated within a larger sample. The program proved feasible and well-accepted. In tendency, participants of the aftercare intervention showed better results on all outcome measures, but the efficacy could not be demonstrated. Further research and larger trials are needed to determine the optimum intensity and duration of the intervention as well as patient characteristics associated with outcome. The third study was concerned with the text analyses of the moderated group chat sessions of the program to study relevant online themes of the chat interactions following treatment termination. In addition, the linguistic predictors of eating disorder related and general psychological well-being were investigated. The results indicate that using a higher ratio of words related to family of origin was significantly associated with improvements in eating disorder related attitudes, emotional distress, and a reduction in the frequency of binge eating episodes. This is the first study to show the importance of family level variables through sufferers’ own words after the end of treatment and may speak to the use of family-based treatment beyond treatment termination. In sum, the Internet-based intervention to address patients with bulimic symptomatology after discharge was feasible, well-accepted and associated with accelerated improvements on eating disorder related attitudes and general psychological well-being compared to a TAU condition although its efficacy could not be demonstrated in terms of statistical significance. A higher ratio of using family of origin words emerged as a linguistic predictor of improvement. Overall, the three studies discussed here add to the limited knowledge in the field of technology-enhanced interventions for eating disorders and may stimulate further research activities