Accepted for/Published in: JMIR Mental Health
Date Submitted: Jul 24, 2025
Open Peer Review Period: Jul 26, 2025 - Sep 20, 2025
Date Accepted: Mar 9, 2026
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Prevalence of cognitive distortion markers in a suicide prevention chat service
ABSTRACT
Background:
Suicide helplines increasingly employ chat services to aid those in urgent need, but the wording and structure of text-driven exchanges may affect their effectiveness.
Objective:
: Given the association of cognitive distortions with depression and anxiety, here we investigated their prevalence in the language of individuals seeking help from the Dutch 113 suicide help-line.
Methods:
We observed the prevalence of cognitive distortions for both help-seekers and counselors in a large volume of chat sessions (N=71,148) of the Dutch 113 suicide chat help-line using natural language processing. The results were compared to two large collections of on-line text data from Dutch social media and web content.
Results:
We found that nearly all types of cognitive distortions are more prevalent in the language of help-seekers compared to the control group of helpline counselors. Distortions of the Personalizing, Emotional Reasoning, and Mental Filtering types were respectively 20.22, 7.87, and 4.53 times more prevalent among help seekers, revealing a distinct pattern of thought and language among individuals affected by suicidality.
Conclusions:
Our results raise the prospect of improving the effectiveness of online therapeutical interventions that target cognitive distortions, through lexical analysis that detects the cognitive and lexical markers of suicidality.
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.