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automatic detection and classification of cognitive distortions in journaling text mai mostafa alia el bolock and slim abdennadher german university in cairo egypt keywords cognitive distortions cognitive behavioral therapy mental ...

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                                                                                     Automatic Detection and Classification of Cognitive Distortions in 
                                                                                                                                                                                                                                                  Journaling Text 
                                                                                                                                                                                   Mai Mostafa, Alia El Bolock and Slim Abdennadher 
                                                                                                                                                                                                                                      German University in Cairo, Egypt 
                                                                         Keywords:                                               Cognitive Distortions, Cognitive Behavioral Therapy, Mental Health, Machine Learning, Deep Learning, 
                                                                                                                                Natural Language Processing. 
                                                                         Abstract:                                              Cognitive distortions are negative thinking patterns that people adopt. Left undetected, it could lead to 
                                                                                                                                developing mental health problems. The goal of cognitive behavioral therapy is to correct and change 
                                                                                                                                cognitive  distortions  that  in  turn  help  with  the  recovery  from  mental  illnesses  such  as  depression  and 
                                                                                                                                anxiety, overcoming addictions, and facing common life challenges. The aim of this study is to provide a 
                                                                                                                                machine learning solution for the automatic detection and classification of common cognitive distortions 
                                                                                                                                from journaling texts. Relatively few works have focused on exploring machine learning solutions and tools 
                                                                                                                                in the context of cognitive-behavioral therapy. And, given the rising popularity of online therapy programs, 
                                                                                                                                this  tool  could  be  used  for  instant  feedback,  and  would  also  be  a  helpful  service  for  therapists  and 
                                                                                                                                psychiatrists to initiate and ease the detection of cognitive distortions. In this study, we provide a novel 
                                                                                                                                dataset that we used to train machine learning and deep learning algorithms. We then employed the best-
                                                                                                                                performing model in an easy-to-use user interface. 
                                                                         1                  INTRODUCTION                                                                                                                                                                                                        distortions  covered  in  this  study  are  provided  in 
                                                                                                                                                                                                                                                                                                                table 1 (de Oliveira, 2012). 
                                                                         Cognitive distortions describe the dysfunctional core                                                                                                                                                                                                In  many  cases,  cognitive  distortions  result  in 
                                                                         beliefs and misconceptions a person might have, that                                                                                                                                                                                   feelings  such  as  anxiety  and  depression.  Beck’s 
                                                                         control the way people feel towards themselves and                                                                                                                                                                                     cognitive theory for depression suggests that people 
                                                                         the                   world  around  them.  These  maladaptive                                                                                                                                                                         with inaccurate and negative core beliefs are more 
                                                                         cognitions  highly  influence  the  way  people  react                                                                                                                                                                                 susceptible  to  depression.  This  cognitive  theory  is 
                                                                         emotionally, psychologically, and how they behave                                                                                                                                                                                      based on the grounds that an individual’s affect and 
                                                                         (Beck,  2011).  For  example,  “The  plant  I  just  got                                                                                                                                                                               behavior are largely determined by the way in which 
                                                                         died, I will never have a beautiful garden because                                                                                                                                                                                     they  structure  the  world  (Beck,  1987).  Cognitive 
                                                                         everything will die” is a type of cognitive distortion,                                                                                                                                                                                Behavioral Therapy (CBT) is a therapeutic approach 
                                                                         because  it  reached  a  conclusion  about  a  single                                                                                                                                                                                  that is derived from Cognitive Therapy model theory 
                                                                         isolated negative event, and applied that conclusion                                                                                                                                                                                   (Beck,  1976;  Beck,  1987)  that  helps  patients 
                                                                         on  all  future  plants.  Cognitive  distortions  are                                                                                                                                                                                  recognize and identify their own thinking errors and 
                                                                         commonly  grouped  into  15  types  (Beck,  1976).                                                                                                                                                                                     distorted  view  of  reality.  They  are  then  helped  to 
                                                                         However, there is no evidence-based way to classify                                                                                                                                                                                    correct  these  thinking  errors,  and  are  taught 
                                                                         cognitive distortions. And it’s important to recognize                                                                                                                                                                                 cognitive  and  behavioral  skills  so  that  they  can 
                                                                         that  there  is  a  degree  of  overlap  between  them.                                                                                                                                                                                develop more accurate beliefs and adopt a healthier 
                                                                         Moreover,  a  single  sentence  can  exhibit  multiple                                                                                                                                                                                 way of making sense of the world around them. 
                                                                         types of cognitive distortions. For example, “I failed                                                                                                                                                                                 CBT was attributed to help with the treatment of 
                                                                         this interview, I’ll probably fail all interviews I get”                                                                                                                                                                               anxiety  disorders,  somatoform  disorders,  bulimia, 
                                                                         can  be  classified  as  overgeneralization,  as  well  as                                                                                                                                                                             anger control problems, and general stress (Hofmann 
                                                                         magnification,                                                     and  catastrophizing.  For  these                                                                                                                                   et                al.,                  2012).                              This                        approach  holds  people 
                                                                         reasons, we have decided to pick only a couple of                                                                                                                                                                                      accountable to their own thoughts and feelings, and 
                                                                         types of cognitive distortions for the purpose of this                                                                                                                                                                                 rather  than  only  delve  into  the  past  to  know  the 
                                                                                                                                                                                                                                                                                                                reasons  for  their  thought  fallacies,  the  goal  is  to  
                                                                         study.  Definitions  and  examples  of  the  cognitive                                                                                                                                                                                  
                                                                         444
                                                                         Mostafa, M., El Bolock, A. and Abdennadher, S.
                                                                         Automatic Detection and Classification of Cognitive Distortions in Journaling Text.
                                                                         DOI: 10.5220/0010713000003058
                                                                         In Proceedings of the 17th International Conference on Web Information Systems and Technologies (WEBIST 2021), pages 444-452
                                                                         ISBN: 978-989-758-536-4; ISSN: 2184-3252
                                                                                                   c
                                                                         Copyright 
 2021 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
                                                                  Automatic Detection and Classification of Cognitive Distortions in Journaling Text
                                                  Table 1: Cognitive distortions, definitions and examples. 
                           Cognitive distortions     Definitions                              Examples 
                    1      Overgeneralization        I  take  isolated  cases  and  generalize  “Every  time  I  have  a  day  off  from 
                                                     them widely by means of words such  work,  it  rains.”  “You  only  pay 
                                                     as “always”, “never”, “everyone”, etc. attention to me when you want sex”. 
                    2      Should       statements  I  tell  myself  that  events,  people’s  “I should have been a better mother”. 
                           (also          “musts”,  behaviors,  and  my  own  attitudes  “He should have married Ann instead 
                           “oughts”, “have tos”)     “should” be the way I expected them  of Mary”. “I shouldn’t have made so 
                                                     to be and not as they really are.        many mistakes.” 
                    
                   identify and correct them. Recently, online therapy         2.1.1  Crowdsourcing 
                   programs have gained a lot of popularity. These 
                   programs are developed to accompany, or replace in-         Crowdsourcing  platforms  are  used  as  a  means  to 
                   person CBT (Ruwaard et al., 2012) One of the main           collect data from a large group of paid participants. 
                   reasons that make it unique and important is because        For  the  purpose  of  collecting  texts  portraying 
                   it can be more frequently accessed, which was found         cognitive distortions, participants  are  given  a  brief 
                   to be one major component for the effectiveness of          description of a cognitive distortion, then asked to 
                   CBT and leads to a more rapid recovery (Bruijniks           mention  a  situation  or  event,  where  they  have 
                   et al., 2015).                                              exhibited that type of thinking (Shickel et al., 2019). 
                       This study is conducted to develop methods for          2.1.2  Online Therapy Partnerships 
                   the  automatic  detection  and  classification  of 
                   cognitive distortions found in mental health journals.      datasets  have  been  collected  in  partnership  with 
                   It will be of assistance to therapists in online therapy    Koko (Morris et al., 2015). Which is an online 
                   programs. Providing detection and instant feedback          therapy  program  that  is  based  on  peer-to-peer 
                   and allowing them to scale more easily. Only a few          therapy. As well as TAO, an online therapy program 
                   machine learning studies were conducted in relation         implemented in various universities across the USA. 
                   to mental health. Fewer in the context of cognitive         As part of the program, students are requested to fill 
                   behavioral  therapy.  The  goal  of  this  study  is  to    out journals and logs to track their progress. Texts 
                   collect a novel dataset to be used to explore ways to       collected  from  actual  journals  are  argued  to  be  a 
                   detect and classify cognitive distortions, and provide      more  accurate  representation  of  the  cognitive 
                   machine learning and deep learning methods for the          distortion  than  those  collected  by  crowdsourcing. 
                   detection  and  classification  of  two  common             Since  the  authors  of  those  text  passages  weren’t 
                   cognitive  distortions.  As  well  as  develop  a  user     specifically  asked  to  recall  a  situation  where  they 
                   interface to visualize the performance of the tool and      exhibited a certain way of thinking (Shickel et al., 
                   put it to use. Which would be highly beneficial and         2016;  Shickel  et  al.,  2019;  RojasBarahona  et  al., 
                   easy for therapists to use in online therapy programs.      2018). 
                   2  RELATED WORK                                             2.1.3  Social Media APIs 
                                                                               Social  media  and  Twitter  in  particular  is  an  ideal 
                   2.1     Data Collection                                     platform to collect data from. As it provides texts 
                                                                               with  the  same  natural  expression  of  cognitive 
                   There is a wide variety of choices when it comes to         distortions  as  those  in  journals.  Meaning  that  the 
                   data  collection.  Most  papers  studying  sentiment        authors  of  the  texts  are  not  asked  to  specifically 
                   analysis and emotion recognition have used already          recall a situation where they felt they were thinking 
                   existing  datasets  that  are  publicly  available  to      in a specific manner. In addition to the easy, free of 
                   conduct their research. Unfortunately, due to the fact      charge use of the application programming interface 
                   that cognitive distortion detection and classification      (API), it can provide big volumes of data in a short 
                   is still not widely researched, we haven’t been able        amount of time.   Due to the popularity of the 
                   to  find  an  available  dataset. In this subsection, we    platform itself, and the ease of data collection, many 
                   discuss multiple sources for data collection.               academic  research  studies  have  employed  the 
                                                                                                                                  445
                     WEBIST2021-17thInternational Conference on Web Information Systems and Technologies
                     Twitter API to build their dataset. (Hu et al., 2019)             Where the NLP unit receives input from the user and 
                     (Mozeticˇ  et  al.,  2016)(Cliche,  2017)(Chatterjee  et          builds  a  natural  language  query.  The  reasoning 
                     al.,  2019). (Campan et al., 2018) Have shown that                subsystem with the help of the ontology evaluates 
                     using Twitter API is a reliable way of collecting data            the  query  and  delivers  a  natural  language  answer. 
                     for research purposes.                                            (Shiv-hare  and  Khethawat,  2012;  Minu  and 
                                                                                       R.Ezhilarasi, 2012) were able to classify emotions 
                     2.2     Methods for Detection and                                 from  natural  language  texts  based  on  an  emotion 
                             Classification                                            hierarchy  defined  by  the  ontology.  Ontologies  are 
                                                                                       also utilized to understand and recognize the way of 
                     Cognitive  distortion  detection  and  classification             speaking when feeling a certain emotion, and to get 
                     tasks  are  similar  to  the  tasks  of  emotion  detection       the similarity between sentences, not just to classify 
                     and  sentiment  analysis. In a way, emotion                       the  emotion  based  on  keywords  (Haggag  et  al., 
                     classification and cognitive distortion classification            2015). 
                     are  tasks  to  classify  different  negative  sentiments.        2.2.2  Learning-based Approach 
                     We have compiled and referred to a few studies in 
                     these areas in this section.                                      Traditional  Learning:  The  automatic  detection  and 
                     2.2.1  Rule-based Approach                                        classification  of  emotions  from  texts  are  in  great 
                                                                                       demand.  A  lot  of  papers  have  studied  multiple 
                     Rule-based knowledge consists of grammatical and                  approaches  and  techniques  to  be  able  to  perform 
                     logical rules to follow. The approach may rely on                 such a task. One of the methods is classifiers such as 
                     dictionaries, lexicons, and ontologies.                           Support Vector Machine (SVM) that are trained to 
                         Keyword  Recognition:  The  task  is  to  find                be   able    to   detect    emotions  (Teng  et  al., 
                     occurrences of certain keywords in a sentence. These              2006)(Balabantaray et al., 2012)(Hasan et al., 2014). 
                     keywords are stored in a constructed dictionary or                (Asghar et al., 2020) applied and compared different 
                     lexicon.(Bracewell  et  al.,  2006)  presented  an                machine  learning  algorithms,  which  are  Na¨ıve 
                     emotion  dictionary,  where  emotion  words  and                  Bayes,  Random  Forest,  Support  Vector  Machine 
                     phrases  were  gathered  from  different  sources                 (SVM),  Logistic  regression,  K-Nearest  neighbor, 
                     including  news  articles.  These  words  were  then              and XG boost to try and suggest the algorithm with 
                     labeled  either  positive  or  negative.  An  emotion             the best text classification results. The algorithm that 
                     classification algorithm is then used on news articles            performed best with respect to the accuracy, recall, 
                     to  classify  the  overall  sentiment.  The  algorithm            and precision was the logistic regression algorithm. 
                     counts the number of positive and negative emotion                Detecting and classifying cognitive distortions is an 
                     words, and a simple equation is used to determine                 important  task  for  the  improvement  of  online 
                     the article’s emotion.                                            therapy services. Both tasks of detecting whether a 
                         Ontological  Knowledge:  Gruber  defined  an                  text  contained  cognitive  distortions  or  not,  and 
                     ontology  as  “an  explicit  specification  of  a                 classifying  a  text  known  to  contain  a  cognitive 
                     conceptualization”(Gruber,  1993).  Ontologies  offer             distortion  into  one  of  fifteen  cognitive  distortions 
                     meaning  to  terms  and  address  the  relationship               have  been  performed.  After  testing  out  multiple 
                     between them. Most medical ontology applications                  classifiers,  it  was  found  that  logistic  regression 
                     follow a symptom-treatment or symptom-diagnosis                   performs best for a relatively small data set (Shickel 
                     categorization.  Some  are  used  to  assist  health              et al., 2019). 
                     professionals  in  clinical  decisions  by  making                    Deep  Learning:  Given  a  large  data  set,  deep 
                     evidence-based  inferences.  These  inferences  are               learn-ing techniques can outperform and scale more 
                     delivered  by  providing  knowledge  through  the                 effectively  with  data,  than  traditional  machine 
                     ontology regarding treatments, symptoms, diagnosis,               learning techniques. In addition, given the fact that it 
                     and  prevention  methods(Yamada  et  al.,  2020),                 requires less feature extraction and engineering, it is 
                     therefore    require    limited    options     for   input.       increasingly  being  adopted  for  natural  language 
                     Nonetheless,  ontologies  were  used  to  assist  with            processing  tasks.  One  such  task  is  SemEval  2017 
                     natural  language  processing  (NLP)  applications                task    4.   Which  includes         Twitter    sentiment 
                     when  it  comes  to  categorizing  a  natural  language           classification  on  a  5-point  scale  (Rosenthal  et  al., 
                     text,  or  with  Artificial  Intelligence  (AI)  chatbots.        2017).  The  best  performing  system  belonged  to 
                     One such ontology is introduced in (Estival et al.,               (Cliche,  2017)  which  uses  Long  Short-Term 
                     2004)  as  part  of  a  virtual  environment  project.            Memory  (LSTM)  and  Convolutional  Neural 
                     446
                                                                      Automatic Detection and Classification of Cognitive Distortions in Journaling Text
                    Network  (CNN)  models.  For  the  participation  of            entries were collected using the API, and they were 
                    (Baziotis  et  al.,  2018)  in SemEval 2018 Task 1,             reviewed for relevance and labeled. 
                    which included determining the existence of none,                   Web      Crawling:     Examples       of    cognitive 
                    one  or  more  out  of  11  emotions  in  Twitter  texts.       distortions are provided on most websites and blogs 
                    Bidirectional LSTM were trained by a fairly large               about  cognitive  behavioral  therapy.  we  collected 
                    data set of around 60,000 annotated tweets.   LSTM              some  of  these  examples,  as  well  as  examples 
                    models were also used by (Cachola et al., 2018) who             provided  in  research  papers.  (Beck,  1970;  Yurica 
                    focused  on  the  effect  of  using  vulgar  words  and         and DiTomasso, 2005; de Oliveira, 2012). 
                    expressions on the perceived sentiment.                             Survey:  We  also  constructed  and  distributed  a 
                        Using  a  large  data  set,  deep  learning  models         survey.  We  first  presented  the  participants  with  a 
                    were trained, and unsupervised learning for a large             short  description  of  the  cognitive  distortion  and 
                    quantity  of  unlabeled  data  was  utilized  to  classify      provided two examples. We then asked the 
                    cognitive  distortions,  as  well  as  emotions  and            participants to recall a time in their own lives when 
                    situations (RojasBarahona et al., 2018).                        they exhibited the described pattern of thinking, and 
                                                                                    provide examples of what they might have said to 
                                                                                    themselves, or to others. We encouraged participants 
                    3  METHODS                                                      to provide multiple examples or paraphrase the same 
                                                                                    example.  The  survey  was  distributed  on  different 
                    3.1     Data Collection and Annotation                          social  media  platforms,  and  participants  were 
                                                                                    requested to share it. In total, we were able to collect 
                    Due to  the  fact  that  cognitive  distortion  detection       147 entries from 49 responses. These responses were 
                    and  classification  tasks  are  not  widely  researched        reviewed for relevance and labeled. 
                    topics,  there  is  no  publicly  available  dataset                HappyDB  Dataset:  We  utilized  (Asai  et  al., 
                    containing  text  with  labeled  cognitive  distortions.        2018)  data  set  to  collect  non  distorted  texts. 
                    Hence, we collected and annotated a novel dataset.              HappyDB  was  collected  using  crowdsourcing, 
                    The dataset contains text passages labeled into one             where  the  workers  were  asked  to  answer  either: 
                    of  three  categories.  Namely,  overgeneralization,            ”what made you happy in the last 24 hours?” or, 
                    should      statement,      and     non-distorted.      A       ”what made you happy in the last 3 months?” We 
                    summarization of the dataset is provided in table 2.            added 1101 answers to our dataset and labeled them 
                    Each collected entry was reviewed for relevance and             as nondistorted. These entries were again reviewed 
                    annotated  by  the  authors  and  a  life  coach  with  a       for  relevance.  It’s  important  for  the  research  to 
                    Meta  coaching  certification.  The  life  coach  was           collect nondistorted texts, as the goal is to create a 
                    presented with the text data in a shared excel sheet.           tool   that   can  automatically  detect  cognitive 
                    The sheet contained the sentences, the given label,             distortions.  So  providing  plenty  of  nondistorted 
                    and a checkbox. There was another column next to                examples was crucial to be able to separate distorted 
                    the checkbox that was left blank to be filled with the          and nondistorted texts. 
                    correct label in case the given label was incorrect.                Preprocessing:      We       performed      common 
                    Corrections to the dataset were applied according to            preprocessing  techniques,  including  converting  all 
                    the excel sheet.                                                text  to  lower  case  and  removing  punctuation  and 
                        Twitter  API:  We  decided  to  collect  data  from         emojis. For the machine learning models, a couple 
                    Twitter. The social media platform provides an easy-            of vectorizers were used. Namely, tf-idf vectorizer, 
                    touse  API  that  can  be  deployed  to  collect  big           and count vectorizer. These vectorizers transformed 
                    volumes of data in a short amount of time. Using the            our  dataset  textual  entries  into  sparse  vectors. 
                    API,  we only collected  the  body  of  the  tweet,  no         Multiple  n-gram  ranges  were  tested  using  these 
                    demographics  or  any  other  information  about  the           vectorizers,  to  find  that,  in  general,  unigrams  and 
                    author  of  the  tweet  were  collected.  Search  words         bigrams  performed  the  best.  We  also  utilized 
                    were required for filtering relevant tweets. From the           multiple dense embeddings that are most popular in 
                    examples provided by (de Oliveira, 2012), we have               similar NLP tasks for the machine learning models, 
                    been able to deduce a pattern or form that sentences            such as GloVe, Bert, and Flair. For our deep 
                    exhibiting  a  certain  cognitive  distortion  usually          learning models, we train 100 and 300 dimensions 
                    acquire. One example, “Every time I have a day off              for   GloVe  embeddings,  as  well  as  BERT 
                    from work, it rains” the sentence form that could be            embeddings. 
                    derived  is  “Every  time  .  .  .  ,  it  .  .  .  ”  Where         
                    something negative happens after “it”. Overall, 1122 
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...Automatic detection and classification of cognitive distortions in journaling text mai mostafa alia el bolock slim abdennadher german university cairo egypt keywords behavioral therapy mental health machine learning deep natural language processing abstract are negative thinking patterns that people adopt left undetected it could lead to developing problems the goal is correct change turn help with recovery from illnesses such as depression anxiety overcoming addictions facing common life challenges aim this study provide a solution for texts relatively few works have focused on exploring solutions tools context given rising popularity online programs tool be used instant feedback would also helpful service therapists psychiatrists initiate ease we novel dataset train algorithms then employed best performing model an easy use user interface introduction covered provided table de oliveira describe dysfunctional core many cases result beliefs misconceptions person might feelings beck s c...

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