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We applied covariate-adjusted linear mixed effects models to assess the association between word count and expression of positive vs negative sentiment (emotional valence) in first-person bereavement narratives and standardized Patient Health Questionnaire-4 (PHQ-4) total, anxiety, and depression symptom scores over 6\u00a0months, stratified by loss of a partner or child vs a close other. Emotional valence was quantified using the Valence Aware Dictionary and sEntiment Reasoner (VADER) algorithm. Among women bereaved of a close other, word count was positively associated with log PHQ-4 total (0.06 SD [95% CI, 0.02-0.09]), anxiety (0.05 SD [95% CI, 0.02-0.09]), and depression (0.06 SD [95 % CI, 0.03-0.09]) symptom scores. Negatively scored emotional valence was associated with elevated log PHQ-4 total (-0.05 SD [95% CI, -0.08 to -0.01]), anxiety (-0.04 SD [95% CI, -0.08 to 0.00]), and depression (-0.04 SD [95% CI, -0.07 to -0.01]) symptom scores. Estimated associations among women bereaved of a partner or child were elevated but underpowered. Qualitative approaches in epidemiologic cohorts offer promise in identifying novel characteristics associated with bereavement outcomes among older women.<\/jats:p>","DOI":"10.1093\/aje\/kwaf056","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T16:24:51Z","timestamp":1741796691000},"page":"1210-1221","source":"Crossref","is-referenced-by-count":0,"title":["Detecting risk for depression and anxiety symptoms among older bereaved women using text-based analysis in the Nurses\u2019 Health Study II"],"prefix":"10.1093","volume":"195","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2697-3236","authenticated-orcid":false,"given":"Alexandra","family":"Hillcoat","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Harvard T.H. Chan School of Public Health , Boston, MA 02115 ,","place":["United States"]},{"name":"Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine D","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Harvard T.H. Chan School of Public Health , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maleeka","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaili C","family":"Jha","sequence":"additional","affiliation":[{"name":"Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4812-0557","authenticated-orcid":false,"given":"Jae H","family":"Kang","sequence":"additional","affiliation":[{"name":"Division of Women\u2019s Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School , Boston, MA 02115 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet W","family":"Rich-Edwards","sequence":"additional","affiliation":[{"name":"Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital , Boston, MA 02114 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4362-203X","authenticated-orcid":false,"given":"Christy A","family":"Denckla","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Harvard T.H. 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