JMIR Publications

ABSTRACT

Background:

Online communities and the posts they generate represent an unprecedented resource for studying subjective emotional experiences, capturing population types and sizes not typically available in the laboratory. Here we mined such a platform to explore a putative specificity of the emotional experience of substance cessation and its cross-substance overlap.

Objective:

An important motivation for this exploration was to investigate transdiagnostic clues that could ultimately be used for mental health outreach. Specifically, we aimed to characterize the emotions associated with cessation of three major substances and compare them to emotional experiences reported in non-substance cessation posts.

Methods:

Two million pseudonymous posts made respectively in the fall of 2020 (discovery dataset) and fall of 2019 (replication) were obtained from 394 forums at Reddit.com. We tracked emotion word frequencies in posts from three substance cessation forums (for alcohol, nicotine, and cannabis topic categories), contrasting them to general forums. Emotion word frequencies were further tracked on multiple distinct categories of emotions and represented as a multidimensional emotion vector for each forum. We quantified the degree of emotional resemblance between different forums by computing cosine similarity on these vectorized representations. For substance cessation posts with self-reported time since last use, we explored changes in the use of emotion words as a function of abstinence duration.

Results:

Compared to posts from general forums, substance cessation posts showed more expression of anxiety, disgust, pride, and gratitude words. ‘Anxious’ emotion words were attenuated for abstinence durations > 100 days compared to shorter durations (t12=3.08, two-tailed, P=.009). The cosine similarity analysis identified an emotion profile preferentially expressed in the cessation posts across substances, with lesser but still prominent similarities to posts about social anxiety and ADHD. These results were replicated in the 2019 (pre-COVID-19) data and were distinct from control analyses using non-emotion words.

Conclusions:

We identified a unique subjective experience phenotype of emotions associated with the cessation of three major substance types, replicable across two time periods. We noted changes to this experience as a function of duration of abstinence. Although to a lesser extent, this phenotype quantifiably resembled the emotion phenomenology of other relevant subjective experiences (social anxiety, ADHD). Taken together, these transdiagnostic results suggest a novel approach for future identification of at-risk populations, allowing for the development and deployment of specific and timely interventions.