What does a person’s writing style say about their risk of suicide?

Suicidal thoughts are relatively common whereas acts of suicide are, thankfully, far more rare. But this creates a dilemma – how to judge the risk of thoughts turning into action? A new study claims that an objective way is to use a computer programme to analyse a person's writing style. People who are having suicidal thoughts and who use more pronouns relating to the self (I, me, myself) than pronouns relating to others, are likely to take more time to recover, meaning they will be at risk for longer.

Mira Brancu and her colleagues investigated 114 US students who'd referred themselves to an outpatient counselling centre at their university, and all of whom said they were having suicidal thoughts. When the students started therapy they completed a measure of suicidal risk which involved them writing about what they found most painful, pressing, agitating, and if and why they felt hopeless and self-hating. They also wrote about their reasons for living and dying and about "one thing that would help me no longer feel suicidal".

A computer programme analysed the students' answers to these questions, counting the relative number of mentions of first-person pronouns compared with mentions of other people, including friends and family and people's names. Based on this, the students were categorised as either self-focused or other-focused. The important finding was that this categorisation was related to how the students progressed through therapy, based on their session-by-session self-ratings of their frequency of suicidal thoughts and their assessment of their own suicide risk. Students who were more self-focused at the study start took longer to recover – their suicidal thoughts resolved, on average, in 17 to 18 sessions, compared with 6 to 7 sessions for the students who were categorised as other-focused.

This finding does build on past research linking first-person pronoun use with personal distress, but as a diagnostic tool for suicidal risk it definitely needs replicating in other contexts – these were students who'd self-referred for treatment and all of them recovered, so it's not clear whether the same results would apply with other, potentially more at-risk groups (but note, a prior study of suicidal poets [pdf] found that those who used more first-person pronouns were more likely to die by suicide).

Despite its limitations, this is an intriguing result that shows the possibility of a relatively quick, efficient and objective way to estimate the likely persistence of suicidal thoughts. The measure would be "bias-free" which is important because it's known that clinicians' own subjective judgments can be off-target. Indeed, Brancu and her colleagues note that an informal survey of clinicians at conferences found that they thought more self-focused versus other-focused writings would be a positive sign, indicating that patients were better able to articulate their feelings.

Further reading

Brancu, M., Jobes, D., Wagner, B., Greene, J., & Fratto, T. (2015). Are There Linguistic Markers of Suicidal Writing That Can Predict the Course of Treatment? A Repeated Measures Longitudinal Analysis Archives of Suicide Research DOI: 10.1080/13811118.2015.1040935