Person:

Progovac, Ana

Natural language processing (NLP) and machine learning were used to predict suicidal ideation and heightened psychiatric symptoms among adults recently discharged from psychiatric inpatient or emergency room settings in Madrid, Spain. Participants responded to structured mental and physical health instruments at multiple follow-up points. Outcome variables of interest were suicidal ideation and psychiatric symptoms (GHQ-12). Predictor variables included structured items (e.g., relating to sleep and well-being) and responses to one unstructured question, “how do you feel today?” We compared NLP-based models using the unstructured question with logistic regression prediction models using structured data. The PPV, sensitivity, and specificity for NLP-based models of suicidal ideation were 0.61, 0.56, and 0.57, respectively, compared to 0.73, 0.76, and 0.62 of structured data-based models. The PPV, sensitivity, and specificity for NLP-based models of heightened psychiatric symptoms (GHQ-12 ≥ 4) were 0.56, 0.59, and 0.60, respectively, compared to 0.79, 0.79, and 0.85 in structured models. NLP-based models were able to generate relatively high predictive values based solely on responses to a simple general mood question. These models have promise for rapidly identifying persons at risk of suicide or psychological distress and could provide a low-cost screening alternative in settings where lengthy structured item surveys are not feasible.

Optimism and cynical hostility are associated with health behaviors and health outcomes, including morbidity and mortality. This analysis assesses their association with longitudinal vigorous physical activity (PA) in postmenopausal women of the Women's Health Initiative (WHI). Subjects include 73,485 women nationwide without history of cancer or cardiovascular disease (CVD), and no missing baseline optimism, cynical hostility, or PA data. The Life Orientation Test-Revised Scale measured optimism. A Cook Medley questionnaire subscale measured cynical hostility. Scale scores were divided into quartiles. Vigorous PA three times or more per week was assessed via self-report at study baseline (1994–1998) and through follow-up year 6. Descriptive analysis mapped lifetime trajectories of vigorous PA (recalled at ages 18, 25, 50; prospectively assessed at baseline, and 3 and 6 years later). Hierarchical generalized linear mixed models examined the prospective association between optimism, cynical hostility, and vigorous PA over 6 years. Models adjusted for baseline sociodemographic variables, psychosocial characteristics, and health conditions and behaviors. Vigorous PA rates were highest for most optimistic women, but fell for all women by approximately 60% between age 50 and study baseline. In adjusted models from baseline through year 6, most vs. least optimistic women were 15% more likely to exercise vigorously (p < 0.001). Cynical hostility was not associated with lower odds of longitudinal vigorous PA after adjustment. Results did not differ by race/ethnicity or socioeconomic status. Higher optimism is associated with maintaining vigorous PA over time in post-menopausal women, and may protect women's health over the lifespan.