Linguistic Research on Specific Features of Suicidal Communication—Past,Present,and Future

To the Editor,

In their article, Al-Mosaiwi and Johnstone (2018) report their findings that anxiety, depression, and especially suicidal ideation forums contained more absolutist words than did control forums. They suggest that absolutist thinking may be a vulnerability factor, and the correction of the maladaptive status of absolutist thinking may be a core element of cognitive therapy.

This study has important antecedents in European suicide research. Research teams in Pécs, Hungary, have identified several features of suicide communication over the past few decades, such as the frequent occurrence of negative linguistic features, denial, or dichotomous linguistic structures (Kezdi, 1995). The high frequency of negative features and dichotomies significantly distinguished the suicidal group from the anxious, depressive, and healthy control groups. This may reflect the underlying psychopathology of suicidal process—the coping strategies of splitting and denial, cognitive rigidity, and dichotomous, stereotyped thinking (Fekete, 2002). This comparative study also showed a decrease in negative and dichotomous structures and in the use of personal references (e.g., “I” and “me”) in the suicidal group during the Christmas period. These changes may be related to interpersonal changes during the Christmas season, when expression of self-preoccupation might be decreased and the use of “we” might be increased, implying group identity. Results also suggested that specific communication changes may reflect the rapidly changing dynamics of interpersonal relations and psychopathological processes, so they can be important in recognition and prevention. Not only individual texts (e.g., letters) or web texts were studied, but also the lyrics and melodies of national anthems. The anthems of countries with higher suicide rates contain more ambivalent and negative contents and more expressions referring to loss, aggression, or even self-destruction (Voros, 2016).

The results of text analyses may have significance in everyday clinical practice, so that suicidality can better be assessed and suicidal patients can be better distinguished from nonsuicidal patients who have depression or anxiety as well as from the healthy population. Screening for negative and dichotomous structures and for absolutist words seems to be useful to detect threatening but hidden or denied suicidality, especially in primary care practice or on overburdened phone hotlines when differentiating the crisis callers from the noncrisis ones. Furthermore, linguistic analysis was also found to be useful in the prediction of the prognosis and relapses of psychoses. The study of Al-Mosaiwi and Johnstone (2018) highlights the importance of research into text analysis, in that the assessment of communication changes in several mental disorders can be a major step forward in improving their recognition and management.