{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T19:00:32Z","timestamp":1776106832491,"version":"3.50.1"},"reference-count":69,"publisher":"Association for Computing Machinery (ACM)","issue":"CSCW","license":[{"start":{"date-parts":[[2017,12,6]],"date-time":"2017-12-06T00:00:00Z","timestamp":1512518400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.acm.org\/publications\/policies\/copyright_policy#Background"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["1R01GM11269701"],"award-info":[{"award-number":["1R01GM11269701"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["dl.acm.org"],"crossmark-restriction":true},"short-container-title":["Proc. ACM Hum.-Comput. Interact."],"published-print":{"date-parts":[[2017,12,6]]},"abstract":"<jats:p>Self-disclosure of stigmatized conditions is known to yield therapeutic benefits. Social media sites are emerging as promising platforms enabling disclosure around a variety of stigmatized concerns, including mental illness. What kind of behavioral changes precede and follow such disclosures? Do the therapeutic benefits of \"opening up\" manifest in these changes? In this paper, we address these questions by focusing on disclosures of schizophrenia diagnoses made on Twitter. We adopt a clinically grounded quantitative approach to first identify temporal phases around disclosure during which symptoms of schizophrenia are likely to be significant. Then, to quantify behaviors before and after disclosures, we define linguistic measures drawing from literature on psycholinguistics and the socio-cognitive model of schizophrenia. Along with significant linguistic differences before and after disclosures, we find indications of therapeutic outcomes following disclosures, including improved readability and coherence in language, future orientation, lower self preoccupation, and reduced discussion of symptoms and stigma perceptions. We discuss the implications of social media as a new therapeutic tool in supporting disclosures of stigmatized conditions.<\/jats:p>","DOI":"10.1145\/3134678","type":"journal-article","created":{"date-parts":[[2017,12,6]],"date-time":"2017-12-06T21:23:15Z","timestamp":1512595395000},"page":"1-27","update-policy":"https:\/\/doi.org\/10.1145\/crossmark-policy","source":"Crossref","is-referenced-by-count":79,"title":["Linguistic Markers Indicating Therapeutic Outcomes of Social Media Disclosures of Schizophrenia"],"prefix":"10.1145","volume":"1","author":[{"given":"Sindhu Kiranmai","family":"Ernala","sequence":"first","affiliation":[{"name":"Georgia Institute of Technology, Atlanta, GA, USA"}]},{"given":"Asra F.","family":"Rizvi","sequence":"additional","affiliation":[{"name":"Zucker Hillside Hospital, Psychiatry Research, Glen Oaks, NY, USA"}]},{"given":"Michael L.","family":"Birnbaum","sequence":"additional","affiliation":[{"name":"Zucker Hillside Hospital, Psychiatry Research, Glen Oaks, NY, USA"}]},{"given":"John M.","family":"Kane","sequence":"additional","affiliation":[{"name":"Zucker Hillside Hospital, Psychiatry Research, Glen Oaks, NY, USA"}]},{"given":"Munmun","family":"De Choudhury","sequence":"additional","affiliation":[{"name":"Georgia Institute of Technology, Atlanta, GA, USA"}]}],"member":"320","published-online":{"date-parts":[[2017,12,6]]},"reference":[{"key":"e_1_2_1_1_1","volume-title":"Awareness of illness in schizophrenia. Schizophrenia bulletin 17, 1","author":"Amador Xavier F","year":"1991"},{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1145\/2858036.2858096"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1145\/2998181.2998243"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1982.04290070020005"},{"key":"e_1_2_1_5_1","first-page":"625","article-title":"Information Technology. Counselling in cyberspace","volume":"11","author":"Anthony K","year":"2000","journal-title":"COUNSELLING-RUGBY-"},{"key":"e_1_2_1_6_1","volume-title":"Emotional and physical health benefits of expressive writing. Advances in psychiatric treatment 11, 5","author":"Baikie Karen A","year":"2005"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1145\/2702613.2732733"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcom.12106"},{"key":"e_1_2_1_9_1","volume-title":"Mariano Sigman, Nat\u00e1lia B Mota, Sidarta Ribeiro, Daniel C Javitt, Mauro Copelli, and Cheryl M Corcoran.","author":"Bedi Gillinder","year":"2015"},{"key":"e_1_2_1_10_1","first-page":"993","article-title":"Latent dirichlet allocation","author":"Blei David M","year":"2003","journal-title":"Journal of machine Learning research 3"},{"key":"e_1_2_1_11_1","volume-title":"The secret life of pronouns flexibility in writing style and physical health. Psychological science 14, 1","author":"Sherlock Campbell R","year":"2003"},{"key":"e_1_2_1_12_1","doi-asserted-by":"publisher","DOI":"10.1145\/2818048.2819973"},{"key":"e_1_2_1_13_1","doi-asserted-by":"publisher","DOI":"10.1145\/2818048.2819963"},{"key":"e_1_2_1_14_1","first-page":"1","article-title":"From ADHD to SAD: Analyzing the language of mental health on Twitter through self-reported diagnoses","volume":"2015","author":"Coppersmith Glen","year":"2015","journal-title":"NAACL HLT"},{"key":"e_1_2_1_15_1","volume-title":"Self-disclosure: a literature review. Psychological bulletin 79, 2","author":"Cozby Paul C","year":"1973"},{"key":"e_1_2_1_17_1","doi-asserted-by":"publisher","DOI":"10.1145\/2441776.2441937"},{"key":"e_1_2_1_18_1","doi-asserted-by":"crossref","unstructured":"Munmun De Choudhury and Sushovan De. 2014. Mental Health Discourse on reddit: Self-Disclosure Social Support and Anonymity. In ICWSM.  Munmun De Choudhury and Sushovan De. 2014. Mental Health Discourse on reddit: Self-Disclosure Social Support and Anonymity. In ICWSM.","DOI":"10.1609\/icwsm.v8i1.14526"},{"key":"e_1_2_1_19_1","unstructured":"Munmun De Choudhury Michael Gamon Scott Counts and Eric Horvitz. 2013. Predicting Depression via Social Media.  Munmun De Choudhury Michael Gamon Scott Counts and Eric Horvitz. 2013. Predicting Depression via Social Media."},{"key":"e_1_2_1_20_1","unstructured":"Munmun De Choudhury Sanket Sharma Tomaz Logar Wouter Eekhout and Ren\u00e9 Nielsen. 2017. Quantifying and Understanding Gender and Cross-Cultural Differences in Mental Health Expression via Social Media. In CSCW.  Munmun De Choudhury Sanket Sharma Tomaz Logar Wouter Eekhout and Ren\u00e9 Nielsen. 2017. Quantifying and Understanding Gender and Cross-Cultural Differences in Mental Health Expression via Social Media. In CSCW."},{"key":"e_1_2_1_21_1","volume-title":"Self-disclosure: Theory, research, and therapy","author":"Derlaga Valerian J","year":"2013"},{"key":"e_1_2_1_22_1","volume-title":"Self-disclosure: Origins, patterns, and implications of openness in interpersonal relationships","author":"Derlega Valerian J","year":"1979"},{"key":"e_1_2_1_23_1","volume-title":"Experiences of stigma among outpatients with schizophrenia. Schizophrenia bulletin 28, 1","author":"Dickerson Faith B","year":"2002"},{"key":"e_1_2_1_24_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-0167.51.3.340"},{"key":"e_1_2_1_25_1","unstructured":"E Feinstein. 1993. Muse: for ET In Sixty Women Poets. (1993).  E Feinstein. 1993. Muse: for ET In Sixty Women Poets. (1993)."},{"key":"e_1_2_1_26_1","first-page":"233","article-title":"Advocacy, recovery, and the challenges of consumerism for schizophrenia","volume":"21","author":"Frese Frederick J","year":"1998","journal-title":"Psychiatric Clinics"},{"key":"e_1_2_1_27_1","volume-title":"Stigma: Notes on the management of spoiled identity","author":"Goffman Erving","year":"2009"},{"key":"e_1_2_1_28_1","doi-asserted-by":"publisher","DOI":"10.1145\/2675133.2675152"},{"key":"e_1_2_1_29_1","volume-title":"Time series analysis","author":"Hamilton James Douglas"},{"key":"e_1_2_1_30_1","volume-title":"The linguistics of schizophrenia: thought disturbance as language pathology across positive symptoms. Frontiers in psychology 6","author":"Hinzen Wolfram","year":"2015"},{"key":"e_1_2_1_31_1","doi-asserted-by":"publisher","DOI":"10.1037\/1040-3590.15.4.443"},{"key":"e_1_2_1_32_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0264180100000904"},{"key":"e_1_2_1_33_1","unstructured":"Adam Joinson. 1998. Causes and implications of disinhibited behavior on the Internet. (1998).  Adam Joinson. 1998. Causes and implications of disinhibited behavior on the Internet. (1998)."},{"key":"e_1_2_1_34_1","volume-title":"Self-disclosure in computer-mediated communication: The role of self-awareness and visual anonymity. European journal of social psychology 31, 2","author":"Joinson Adam N","year":"2001"},{"key":"e_1_2_1_35_1","doi-asserted-by":"publisher","DOI":"10.5555\/1211649"},{"key":"e_1_2_1_36_1","volume-title":"Self-disclosure: An experimental analysis of the transparent self.","author":"Jourard Sidney M","year":"1971"},{"key":"e_1_2_1_37_1","volume-title":"Reliability and validity of the positive and negative syndrome scale for schizophrenics. Psychiatry research 23, 1","author":"Kay Stanley R","year":"1988"},{"key":"e_1_2_1_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(92)90049-9"},{"key":"e_1_2_1_39_1","doi-asserted-by":"publisher","DOI":"10.1145\/1978942.1979420"},{"key":"e_1_2_1_40_1","doi-asserted-by":"publisher","DOI":"10.1145\/2675133.2675175"},{"key":"e_1_2_1_41_1","volume-title":"The early stages of schizophrenia: speculations on pathogenesis, pathophysiology, and therapeutic approaches. Biological psychiatry 50, 11","author":"Lieberman Jeffrey A","year":"2001"},{"key":"e_1_2_1_42_1","doi-asserted-by":"crossref","unstructured":"Lydia Manikonda and Munmun De Choudhury. 2017. Modeling and Understanding Visual Attributes of Mental Health Disclosures in Social Media. (2017).  Lydia Manikonda and Munmun De Choudhury. 2017. Modeling and Understanding Visual Attributes of Mental Health Disclosures in Social Media. (2017).","DOI":"10.1145\/3025453.3025932"},{"key":"e_1_2_1_43_1","volume-title":"I tweet passionately: Twitter users, context collapse, and the imagined audience. New media & society 13, 1","author":"Marwick Alice E","year":"2011"},{"key":"e_1_2_1_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chb.2017.05.009"},{"key":"e_1_2_1_45_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.44.6.1234"},{"key":"e_1_2_1_46_1","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocv165"},{"key":"e_1_2_1_47_1","volume-title":"Gregory J Mchugo, J\u00fcrgen Un\u00fctzer, Stephen J Bartels, and Lisa A Marsch.","author":"Naslund John A","year":"2017"},{"key":"e_1_2_1_48_1","doi-asserted-by":"publisher","DOI":"10.1207\/S15327957PSPR0402_05"},{"key":"e_1_2_1_49_1","unstructured":"Minsu Park David W McDonald and Meeyoung Cha. 2013. Perception Differences between the Depressed and Non-Depressed Users in Twitter. In ICWSM.  Minsu Park David W McDonald and Meeyoung Cha. 2013. Perception Differences between the Depressed and Non-Depressed Users in Twitter. In ICWSM."},{"key":"e_1_2_1_50_1","first-page":"97","article-title":"Self-experience in the prodromal phases of schizophrenia: A pilot study of first-admissions","volume":"6","author":"Parnas J","year":"1998","journal-title":"Neurology Psychiatry and Brain Research"},{"key":"e_1_2_1_51_1","doi-asserted-by":"publisher","DOI":"10.1145\/2818048.2820030"},{"key":"e_1_2_1_52_1","volume-title":"Writing about emotional experiences as a therapeutic process. Psychological science 8, 3","author":"Pennebaker James W","year":"1997"},{"key":"e_1_2_1_53_1","doi-asserted-by":"publisher","DOI":"10.1093\/clipsy.bph063"},{"key":"e_1_2_1_54_1","first-page":"2001","article-title":"Linguistic inquiry and word count: LIWC 2001. Mahway","volume":"71","author":"Pennebaker James W","year":"2001","journal-title":"Lawrence Erlbaum Associates"},{"key":"e_1_2_1_55_1","volume-title":"Psychological aspects of natural language use: Our words, our selves. Annual review of psychology 54, 1","author":"Pennebaker James W","year":"2003"},{"key":"e_1_2_1_56_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4679(199910)55:10<1243::AID-JCLP6>3.0.CO;2-N"},{"key":"e_1_2_1_57_1","doi-asserted-by":"publisher","DOI":"10.5555\/1613715.1613742"},{"key":"e_1_2_1_58_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0015815"},{"key":"e_1_2_1_59_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.161.3.473"},{"key":"e_1_2_1_60_1","doi-asserted-by":"publisher","DOI":"10.1521\/jscp.2006.25.9.1023"},{"key":"e_1_2_1_61_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0033413"},{"key":"e_1_2_1_62_1","volume-title":"Sharing one's story: Translating emotional experiences into words as a coping tool. Coping: The psychology of what works","author":"Smyth Joshua M","year":"1999"},{"key":"e_1_2_1_63_1","volume-title":"Matching methods for causal inference: A review and a look forward. Statistical science: a review journal of the Institute of Mathematical Statistics 25, 1","author":"Stuart Elizabeth A","year":"2010"},{"key":"e_1_2_1_64_1","volume-title":"Conceptual foundations and empirical evidence\". Psychological inquiry 15, 1","author":"Tedeschi Richard G","year":"2004"},{"key":"e_1_2_1_65_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.163.3.365"},{"key":"e_1_2_1_66_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1011125220522"},{"key":"e_1_2_1_67_1","unstructured":"Bessel A Van der Kolk. 1996. The complexity of adaptation to trauma: Self regulation stimulus discrimination and characterological development. (1996).  Bessel A Van der Kolk. 1996. The complexity of adaptation to trauma: Self regulation stimulus discrimination and characterological development. (1996)."},{"key":"e_1_2_1_68_1","volume-title":"Self-efficacy and empowerment as outcomes of self-stigmatizing and coping in schizophrenia. Psychiatry research 150, 1","author":"Vauth Roland","year":"2007"},{"key":"e_1_2_1_69_1","doi-asserted-by":"publisher","DOI":"10.1145\/2531602.2531672"},{"key":"e_1_2_1_70_1","doi-asserted-by":"publisher","DOI":"10.1145\/2818048.2820010"}],"container-title":["Proceedings of the ACM on Human-Computer Interaction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dl.acm.org\/doi\/10.1145\/3134678","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dl.acm.org\/doi\/pdf\/10.1145\/3134678","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T02:11:24Z","timestamp":1750212684000},"score":1,"resource":{"primary":{"URL":"https:\/\/dl.acm.org\/doi\/10.1145\/3134678"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,6]]},"references-count":69,"journal-issue":{"issue":"CSCW","published-print":{"date-parts":[[2017,12,6]]}},"alternative-id":["10.1145\/3134678"],"URL":"https:\/\/doi.org\/10.1145\/3134678","relation":{},"ISSN":["2573-0142"],"issn-type":[{"value":"2573-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,6]]},"assertion":[{"value":"2017-12-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}