Abstract
This exploratory research aims to develop, validate, and implement a semantic ontology in Spanish for the detection of anxiety symptoms in written narratives by young Colombians aged 18 to 30. 430 young people responded to a questionnaire on sociodemographic data, six open-ended questions, and the DASS-21 scale, in an online form. A mixed methods design was used, implementing a text analysis study using natural language processing, a semantic ontology of anxiety symptomatology, and agile software development methodology. The procedure included six phases: 1) development and validation of open-ended questions on anxiety symptomatology to collect information from narrative texts, 2) data collection, 3) ontology construction, 4) ontology validation through interjudge analysis, 5) software development and application, and 6) Efficacy of software for automatic symptom identification. The software developed in this project proved to be effective in its intended task of accurately identifying symptoms in both clinical and non-clinical participants, with more than 80% agreement with clinical experts. The results showed that the majority of symptoms had higher percentages in clinical participants compared to non-clinical participants.
References
Aiken, L. R. (1980). Content validity and reliability of single items or questionnaires. Educational and. Psychological Measurement, 40, 955-959.
Aiken, L. R. (1985). Three coefficients for analyzing the reliability and validity of ratings. Educational and Psychological Measurement, 45, 131-142.
Akbari, M., & Khanipour, H. (2018). The transdiagnostic model of worry: The mediating role of experiential avoidance. Personality and Individual Differences, 135, 166-172. https://doi.org/10.1016/j.paid.2018.07.011
Akbari, M., Seydavi, M., Hosseini, Z. S., Krafft, J., & Levin, M. E. (2022). Experiential avoidance in depression, anxiety, obsessive-compulsive related, and posttraumatic stress disorders: A comprehensive systematic review and meta-analysis. Journal of Contextual Behavioral Science, 24, 65-78. https://doi.org/10.1016/j.jcbs.2022.03.007
Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales (DASS) in clinical groups and a community sample. Psychological Assessment, 10, 176-181. https://doi.org/10.1037/1040-3590.10.2.176
American Psychological Association (2023). Ethical Principles of Psychologists and Code of Conduct. https://www.apa.org/ethics/code/
Bardeen, J. R., & Fergus, T. A. (2016). The interactive effect of cognitive fusion and experiential avoidance on anxiety, depression, stress and posttraumatic stress symptoms. Journal of Contextual Behavioral Science, 5, 1-6. https://doi.org/10.1016/j.jcbs.2016.02.002
Benfares, C., Idrissi, Y. E. B. E., & Hamid, K. (2019). Personalized Healthcare System Based on Ontologies. Coastal Research Library, 185-196. https://doi.org/10.1007/978-3-030-11884-6_18.
Berghoff, C. R., Tull, M. T., DiLillo, D., Messman-Moore, T., & Gratz, K. L. (2017). The Role of Experiential Avoidance in the Relation between Anxiety Disorder Diagnoses and Future Physical Health Symptoms in a Community Sample of Young Adult Women. Journal of contextual behavioral science, 6(1), 29-34. https://doi.org/10.1016/j.jcbs.2016.11.002
Blakey, S. M., & Abramowitz, J. S. (2020). Introduction to Part I: Why Psychological Maintenance Processes? In J. S. Abramowitz & S. M. Blakey (Eds.), Clinical Handbook of Fear and Anxiety: Maintenance Processes and Treatment Mechanisms (pp. 3-6). American Psychological Association.
Bruner, J. S. (1990). Acts of meaning. Harvard University Press.
Chang, Y.-S., Fan, C.-T., Lo, W.-T., Hung, W.-C., & Yuan, S.-M. (2015). Mobile cloud-based depression diagnosis using an ontology and a Bayesian network. Future Generation Computer Systems, 43-44, 87-98. https://doi.org/10.1016/j.future.2014.05.004
Charter, R. A. (2003). A breakdown of reliability coefficients by test type and reliability method, and the clinical implications of low reliability. Journal of General Psychology, 130, 290-304.
Chen, X., & Genc, Y. (2022). A Systematic Review of Artificial Intelligence and Mental Health in the Context of Social Media. In H. Degen & S. Ntoa (Eds.), Artificial Intelligence in HCI: 3rd International Conference, AI-HCI 2022, Held as Part of the 24th HCI International Conference, HCII 2022, Virtual Event, June 26 – July 1, 2022, Proceedings (pp. 353-368). https://doi.org/10.1007/978-3-031-05643-7_23
Colizzi, M., Lasalvia, A., & Ruggeri, M. (2020). Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care?. International journal of mental health systems, 14, 23. https://doi.org/10.1186/s13033-020-00356-9
Cookson, C., Luzon, O., Newland, J., & Kingston, J. (2019). Examining the role of cognitive fusion and experiential avoidance in predicting anxiety and depression. Psychology and Psychotherapy: Theory, Research and Practice. https://doi.org/10.1111/papt.12233
Cordón, J. R. (2017). Prueba V Excel. Retrieved from https://www.researchgate.net/publication/316740035_prueba_V_Excel
Cummins, N., Matcham, F., Klapper, J., & Schuller, B. (2020). Artificial intelligence to aid the detection of mood disorders. In D. Barh (Ed.), Artificial Intelligence in Precision Health (pp. 231-255). Elsevier.
Dias, L. P. S., Barbosa, J. L. V., Feijó, L. P., & Vianna, H. D. (2020). Development and testing of iAware model for ubiquitous care of patients with symptoms of stress, anxiety and depression. Computer methods and programs in biomedicine, 187, 105113. https://doi.org/10.1016/j.cmpb.2019.105113
Di Cara, N. H., Maggio, V., Davis, O. S. P., & Haworth, C. M. A. (2023). Methodologies for Monitoring Mental Health on Twitter: Systematic Review. Journal of medical Internet research, 25, e42734. https://doi.org/10.2196/42734
El Bolock, A., Elaraby, N., Herbert, C., & Abdennadher, S. (2021a). CCOnto: The Character Computing Ontology. En S. Cherfi, A. Perini y S. Nurcan (Eds.), Research Challenges in Information Science. RCIS 2021 (pp. 313-329). Springer. https://doi.org/10.1007/978-3-030-75018-3_21
El Bolock, A., Abdennadher, S., & Herbert, C. (2021b). An Ontology-Based Framework for Psychological Monitoring in Education During the COVID-19 Pandemic. Frontiers in Psychology, 12, 673586. https://doi.org/10.3389/fpsyg.2021.673586
Elaraby, N., El Bolock, A., Herbert, C., & Abdennadher, S. (2021). Anxiety Detection During COVID-19 Using the Character Computing Ontology. In Highlights in Practical Applications of Agents, Multi-Agent Systems, and Social Good. The PAAMS Collection Communications in Computer and Information Science (pp. 5-16). Springer. https://10.1007/978-3-030-85710-3_1.
Faustino, B. (2020). Transdiagnostic perspective on psychological inflexibility and emotional dysregulation. Behavioural and Cognitive Psychotherapy, 49(2), 233-246. https://doi.org/10.1017/s1352465820000600
Faustino, B., Vasco, A. B., Farinha-Fernandes, A., & Delgado, J. (2021). Psychological inflexibility as a transdiagnostic construct: relationships between cognitive fusion, psychological well-being and symptomatology. Current Psychology. https://doi.org/10.1007/s12144-021-01943-w
Gamble, B., Fodeh, S. J., & Cheung, K. (2014). Post-Traumatic Stress Disorder (PTSD) Ontology and Use Case. In ICBO (pp. 56-59).
Gronholm, P. C., Thornicroft, G., Laurens, K. R., & Evans-Lacko, S. (2017). Mental health-related stigma and pathways to care for people at risk of psychotic disorders or experiencing first-episode psychosis: a systematic review. Psychological medicine, 47(11), 1867-1879. https://doi.org/10.1017/S0033291717000344
Harvey, A., Watkins, E., Mansell, W. and Shafran, R. (2004). Cognitive behavioral processes across psychological disorders: A transdiagnostic approach to research and treatment. Oxford University Press.
Hayes, S. C., Barnes-Holmes, D., & Roche, B. (Eds.). (2001). Relational frame theory: A post-Skinnerian account of human language and cognition. Kluwer Academic/Plenum Publishers.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy: The Process and Practice of Mindful Change (2nd edn). The Guilford Press Press.
Healy, O., Barnes-Holmes, D., & Smeets, P. M. (2000). Derived Relational Responding As Generalized Operant Behavior. Journal of the Experimental Analysis of Behavior, 74(2), 207-227. https://doi.org/10.1901/jeab.2000.74-207
Hernández- Sampieri, R. y Mendoza C. (2018). Metodología de la investigación: las rutas cuantitativa, cualitativa y mixta. McGraw Hill México.
Hughes, S., & Barnes-Holmes, D. (2016). Relational Frame Theory: The Basic Account. In R. D. Zettle, S. C. Hayes, D. Barnes-Holmes, A. Biglan (Eds.), The Wiley Handbook of Contextual Behavioral Science (pp. 129-178). Wiley-Blackwell. https://doi.org/10.1002/9781118489857.ch9
Jefferies, P., & Ungar, M. (2020). Social anxiety in young people: A prevalence study in seven countries. PloS One, 15(9), e0239133. https://doi.org/10.1371/journal.pone.0239133
Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review, 30(7), 865-878. https://doi.org/10.1016/j.cpr.2010.03.001
Kersloot, M. G., van Putten, F. J. P., Abu-Hanna, A., et al. (2020). Natural language processing algorithms for mapping clinical text fragments onto ontology concepts: a systematic review and recommendations for future studies. Journal of Biomedical Semantics, 11(1),14. https://doi.org/10.1186/s13326-020-00231-z
Kissi, A., Hughes, S., Mertens, G., Barnes-Holmes, D., De Houwer, J., & Crombez, G. (2017). A Systematic Review of Pliance, Tracking, and Augmenting. Behavior Modification, 41(5), 683-707. https://doi.org/10.1177/0145445517693811
Law 1090 of 2006: Whereby the practice of the profession of Psychology is regulated, the Code of Ethics and Bioethics and other provisions are issued. September 6, 2006. D.O. No. 46.383
Le Glaz, A., Haralambous, Y., Kim-Dufor, D. H., Lenca, P., Billot, R., Ryan, T. C., Marsh, J., DeVylder, J., Walter, M., Berrouiguet, S., & Lemey, C. (2021). Machine Learning and Natural Language Processing in Mental Health: Systematic Review. Journal of medical Internet research, 23(5), e15708. https://doi.org/10.2196/15708
Landi, G., Pakenham, K. I., Crocetti, E., Grandi, S., & Tossani, E. (2021). The Multidimensional Psychological Flexibility Inventory (MPFI): Discriminant validity of psychological flexibility with distress. Journal of Contextual Behavioral Science, 21, 22-29. https://doi.org/10.1016/j.jcbs.2021.05.004
Levin, M. E., MacLane, C., Daflos, S., Seeley, J. R., Hayes, S. C., Biglan, A., & Pistorello, J. (2014). Examining psychological inflexibility as a transdiagnostic process across psychological disorders. Journal of Contextual Behavioral Science, 3(3), 155-163. https://doi.org/10.1016/j.jcbs.2014.06.003
Lieblich, A., Tuval-Mashiach, R., & Zilber, T. (1998). Narrative research: Reading, analysis, and interpretation. Sage.
Luciano, C., Gómez-Becerra, I., & Rodríguez-Valverde, M. (2007). The Role of Multiple-Exemplar Training and Naming in Establishing Derived Equivalence in an Infant. Journal of Experimental Analysis of Behavior, 87,349-365. https://doi.org/10.1901/jeab.2007.08-06
McAdams, D. P. (2001). The psychology of life stories. Review of General Psychology, 5(2), 100-122. https://doi.org/10.1037/1089-2680.5.2.100
McAuliffe, D., Hughes, S., & Barnes-Holmes, D. (2014). The Dark-Side of Rule Governed Behavior. Behavior Modification, 38(4), 587-613. https://doi.org/10.1177/0145445514521630
Merino-Soto, C., & Livia-Segovia, J. (2009). Intervalos de confianza asimétricos para el índice la validez de contenido: Un programa Visual Basic para la V de Aiken [Confidence intervals for the content validity: A Visual Basic computer program for the Aiken’s V]. Anales de Psicología/Annals of Psychology, 25, 169-171.
Ministerio de Salud y Protección Social de Colombia & Departamento Administrativo de Ciencia, Tecnología e Innovación (2015). Encuesta nacional de salud mental 2015 – Tomo I. Bogotá D.C., Colombia. https://www.minjusticia.gov.co/programas-co/ODC/Publicaciones/Publicaciones/CO031102015-salud_mental_tomoI.pdf
Nachiya, Y., Sekar, K., Manikandan, R., & Ravichandran, K. (2018). Investigation of Obsessive Compulsive Disorder through Domain Ontology Construction-Survey. International Journal of Pure and Applied Mathematics, 119(7), 643-651.
Naslund, J. A., Bondre, A., Torous, J., et al. (2020). Social Media and Mental Health: Benefits, Risks, and Opportunities for Research and Practice. Journal of Technology in Behavioral Science, 5, 245-257. https://doi.org/10.1007/s41347-020-00134-x
Noy, N. F., & McGuinness, D. L. (2020). Ontology Development 101: A Guide to Creating Your First Ontology. Stanford University. Retrieved from http://protege.stanford.edu/publications/ontology_development/ontology101-noy-mcguinness.html
Ortiz, E., Barrero, J., Castro-Osorio, R., Domínguez, A., & Caicedo, N. (2024, September). Detection of Depressive Symptomatology in Written Narratives in Spanish Using Machine Learning and Semantic Ontology. In Colombian Conference on Computing (pp. 13-26). Cham: Springer Nature Switzerland.
Pennebaker, J. W., Mehl, M. R., & Niederhoffer, K. G. (2003). Psychological aspects of natural language. use: our words, our selves. Annual review of psychology, 54, 547-577. https://doi.org/10.1146/annurev.psych.54.101601.145041
Polkinghorne, D. E. (1988). Narrative knowing and the human sciences. State University of New York Press.
Riessman, C. K. (2008). Narrative methods for the human sciences. Sage.
Rolffs, J. L., Rogge, R. D., & Wilson, K. G. (2016). Disentangling Components of Flexibility via the Hexaflex Model Development and Validation of the Multidimensional Psychological Flexibility Inventory (MPFI). Assessment, 25(4), 458-482. https://doi.org/10.1177/1073191116645905.
Ruiz, F. J., García-Martín, M. B., Su´arez-Falc´on, J. C., & Odriozola-Gonz´alez, P. (2017). The hierarchical factor structure of the Spanish version of Depression Anxiety and Stress Scale - 21. International Journal of Psychology and Psychological Therapy, 17,97-105.
Russ, T. C., Woelbert, E., Davis, K. A. S., Hafferty, J. D., Ibrahim, Z., Inkster, B., John, A., Lee, W., Maxwell, M., McIntosh, A. M., Stewart, R., & MQ Data Science group (2019). How data science can advance mental health research. Nature human behaviour, 3(1), 24-32. https://doi.org/10.1038/s41562-018-0470-9
Sandín, B., Chorot, P., & Valiente, R. M. (2012). Transdiagnóstico: Nueva frontera en psicología clínica. Revista de Psicopatología y Psicología Clínica, 17(3), 185-203. https://doi.org/10.5944/rppc.vol.17.num.3.2012.11839
Sheikhan, N. Y., Kuluski, K., McKee, S., Hiebert, M., & Hawke, L. D. (2023). Exploring the impact of engagement in mental health and substance use research: A scoping review and thematic analysis. Health Expectations, 26, 1806-1819. https://doi.org/10.1111/hex.13779
Sierra, M. A., & Ortiz, E. I. (2022). Psychological inflexibility components as trans-diagnostic predictors of emotional symptomatology and suicide risk among young adults. Mediterranean Journal of Clinical Psychology, 10(3) https://doi.org/10.13129/2282-1619/mjcp-3565
Singh, V., Kumar, A., & Gupta, S. (2022). Mental Health Prevention and Promotion-A Narrative Review. Frontiers in Psychiatry, 13, 898009. https://doi.org/10.3389/fpsyt.2022.898009
Sonbol, R., Rebdawi, G., & Ghneim, N. (2022). The Use of NLP-Based Text Representation Techniques to Support Requirement Engineering Tasks: A Systematic Mapping Review. IEEE Access, 10, 62811-62830. https://doi.org/10.1109/ACCESS.2022.3182372
Spinhoven, P., van Hemert, A. M., & Penninx, B. W. J. H. (2017). Experiential Avoidance and Bordering Psychological Constructs as Predictors of the Onset, Relapse and Maintenance of Anxiety Disorders: One or Many?. Cognitive therapy and research, 41(6), 867-880. https://doi.org/10.1007/s10608-017-9856-7
Statutory Law 1266 of 2008: Whereby the general provisions of habeas data are issued and the handling of information contained in personal databases is regulated, especially financial, credit, commercial, services and information from third countries, and other provisions are issued. December 31, 2008. D.O. No. 47.219
Statutory Law 1581 of 2012: Whereby general provisions are issued for the protection of personal data. October 18, 2012. D.O. No. 48.587
Tajuddin, M., Kabeer, M., & Misbahuddin, M. (2020, January). Analysis of social media for psychological stress detection using ontologies. In 2020 Fourth International Conference on Inventive Systems and Control (ICISC) (pp. 181-185). IEEE.
Törneke, N., Luciano, C., & Valdivia-Salas, S. (2008). Rule-Governed Behavior and Psychological Problems. International Journal of Psychology and Psychological Therapy, 8(2), 141-156.
Toro-Tobar, R. A., Beltrán-Aguirre, K. V., González-Gómez, L. J., Sabogal-Mancipe, Á. P., Reyes-Parra, K., Guerrero-Ortiz, L. M. (2018). Variables transdiagnósticas predictoras de los problemas emocionales y afectivos en una muestra colombiana. Duazary, 15(2), 1-13. https://www.redalyc.org/journal/5121/512158205002/html/
Vos, T., Lim, S. S., Abbafati, C., Abbas, K. M., Abbasi, M., Abbasifard, M., Abbasi-Kangevari, M., Abbastabar, H., Abd-Allah, F., Abdelalim, A., Abdollahi, M., Abdollahpour, I., Abolhassani, H., Aboyans, V., Abrams, E. M., Abreu, L. G., Abrigo, M. R. M., Abu-Raddad, L. J., Abushouk, A. I., … Murray, C. J. L. (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet, 396(10258), 1204-1222. https://doi.org/10.1016/S0140-6736(20)30925-9
Waechter, R., Gallant, C., De Wilde, K., Arens, G., Brady, T., Custodio, J., Wakita, Y., Landon, B., Boateng, Y., Parthab, N., & Bhagat, A. (2023). Prevention of mental illness within public health: An analysis of progress via systematic literature review and a pathway forward. Preventive Medicine Reports, 34, 102249. https://doi.org/10.1016/j.pmedr.2023.102249
White, M., & Epston, D. (1990). Narrative means to therapeutic ends. Norton.
Wilson, K. G., & Luciano, C. (2002). Terapia de Aceptación y Compromiso: Un Tratamiento conductual orientado a los valores. Pirámide
Wongkoblap, A., Vadillo, M. A., & Curcin, V. (2017). Researching Mental Health Disorders in the Era of Social Media: Systematic Review. Journal of medical Internet research, 19(6), e228. https://doi.org/10.2196/jmir.7215
World Medical Association (2013). World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA, 310(20), 2191-2194. https://doi.org/10.1001/jama.2013.281053
World Health Organization: WHO. (2022, 17 junio). Mental health. https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response
World Health Organization. COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide [Internet]. 2022 [cited 2022 May 22]. Available from:
Zhang, T., Schoene, A. M., Ji, S., & Ananiadou, S. (2022). Natural language processing applied to mental illness detection: A narrative review. NPJ Digital Medicine, 5(1), 46. https://doi.org/10.1038/s41746-022-00589-7
Zettle, R. D., & Hayes, S. C. (1982). Rule-Governed Behavior: A Potential Theoretical Framework For Cognitive–Behavioral Therapy. Advances In Cognitive - Behavioral Research And Therapy, 73-118. https://doi.org/10.1016/B978-0-12-010601-1.50008-5

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