Linguistic feature of anorexia nervosa: a prospective case–control pilot study

Abstract

Purpose Attention has recently been paid to Clinical Linguistics for the detection and support of clinical conditions. Many works have been published on the “linguistic profile” of various clinical populations, but very few papers have been devoted to linguistic changes in patients with eating disorders. Patients with Anorexia Nervosa (AN) share similar psychological features such as disturbances in self-perceived body image, inflexible and obsessive thinking and anxious or depressive traits. We hypothesize that these characteristics can result in altered linguistic patterns and be detected using the Natural Language Processing tools. Methods We enrolled 51 young participants from December 2019 to February 2020 (age range: 14–18): 17 girls with a clinical diagnosis of AN, and 34 normal-weighted peers, matched by gender, age and educational level. Participants in each group were asked to produce three written texts (around 10–15 lines long). A rich set of linguistic features was extracted from the text samples and the statistical significance in pinpointing the pathological process was measured. Results Comparison between the two groups showed several linguistics indexes as statistically significant, with syntactic reduction as the most relevant trait of AN productions. In particular, the following features emerge as statistically significant in distinguishing AN girls and their normal-weighted peers: the length of the sentences, the complexity of the noun phrase, and the global syntactic complexity. This peculiar pattern of linguistic erosion may be due to the severe metabolic impairment also affecting the central nervous system in AN. Conclusion These preliminary data showed the existence of linguistic parameters as probable linguistic markers of AN. However, the analysis of a bigger cohort, still ongoing, is needed to consolidate this assumption. Level of evidence III Evidence obtained from case–control analytic studies.

Emotional dysregulation and linguistic patterns as a defining feature of patients in the acute phase of anorexia nervosa

“…Specifically, three linguistic indices were found to be more related to this disorder than others: the sensory-somatic words, the prevalence of negative affect, and the RA Intensity Index (MH-IWRAD), which represents the RP disconnection. The presence of emotional disconnection detected in linguistic measures, together with high indices of sensory-somatic words is in line with the literature linking AN to the use of concrete thinking and metaphors, showing a reduction of symbolic capacity and impaired reflective function [ 58 – 60 ]. Mariani et al [ 37 ] highlighted how language features can be related to a personal expression of psychopathology.…”

“…The clinical vignettes showed specific linguistic features which connected bodily distress, AN symptoms, and personal emotional conflicts. Linguistic analysis emphasizes the relevance in understanding the relationship between words and emotional activation in psychopathology [ 30 , 37 , 60 , 61 ].…”

Determining the Intensity of Basic Emotions among People Suffering from Anorexia Nervosa Based on Free Statements about Their Body

“…Clinical linguistics refers to creating patterns of communication disability concerning a specified illness. Research showed that people suffering from anorexia nervosa compared to healthy people revealed such speech features as concretized emotions (without irony and metaphor), usage of positive words and lower usage of words connected with anxiety, lower level of self-directed attention, little use of firstperson singular sentences, putting sentences mainly in the present tense, narrow range of expression related to the cognitive mechanism, food-related topics were more frequent and few statements were related to the outside world and relations [12].…”

“…Anorexics used a lower number of words per sentence than healthy people, but simultaneously they used more frequently long words (more than six letters). They were less likely to refer to terms pointing to senses (e.g., "see", "feel") and rarely constructed sentences in the present tense [12]. The authors in the second article explored the linguistic markers of differences in Internet self-presentation of selfidentified pro-anorexics who defend anorexia as a lifestyle and self-identified anorexics in recovery.…”

Language and Mental Health: Measures of Emotion Dynamics from Text as Linguistic Biosocial Markers

“…A linguistic biomarker is a language-based measure that is associated with a disease outcome or biology in general (Ballman, 2015;Lena, 2021). Some wellknown linguistic biomarkers include: the proportion of pronouns (indicator of depression, Koops et al (2023)), syntax reduction (Anorexia Nervosa, Cuteri et al (2022)), certain lexical and syntactic features (mild cognitive impairment and dementia, Calzà et al (2021); ), and semantic connectedness (schizophrenia, Corcoran et al (2020). Also, the emotions expressed in text have been shown to correlate with mental health diagnosis.…”