Depression is a global health concern with severe consequences for individuals, making its recognition and understanding crucial. Recently, there has been a growing interest in utilizing social media platforms as valuable sources of information to gain insights into individuals' experiences with depression. Analyzing textual data from diverse user populations enables the identification of common symptoms, triggers, coping mechanisms, and potential warning signs. Researchers have developed algorithms and machine learning models to automate the detection of depressive symptoms in text, facilitating more eficient screening and early intervention. This paper describes the participation of team NailP in the CLEF eRisk 2023 task 1, which focuses on ranking sentences from user writings based on their relevance to symptoms of depression. The goal is to evaluate the sentences and determine their level of relevance to each symptom outlined in the Beck Depression Questionnaire-II. Such participation contributes to the development of efective methods and tools for identifying and predicting potential risks and dangers associated with depression in online environments.
The World Health Organization (WHO) estimates that, in 2015, approximately 4.4% of the global
population was afected by depression ( i.e., around 322 million people) [
Depression is a serious health condition that may lead to severe consequences on individuals.
It can cause significant sufering and impair their ability to perform efectively in various
domains such as work, school, and family life [
In recent years, there has been a significant number of studies dedicated to exploring the data
related to depression on various social media platforms [
Analyzing a wide range of textual data from diverse user populations enables researchers to identify common symptoms, triggers, coping mechanisms, and even identify potential warning signs for early intervention. By developing algorithms and machine learning models, these studies aim to automate the detection of depressive symptoms in text, enabling more eficient screening and early intervention. Such research contributes to the development of innovative tools and techniques that can assist healthcare professionals in identifying individuals at risk of depression in several languages. For example, since 2014 Linguistic Inquiry and Word Count (LIWC [7]) has been used for depression detection, as described in [8]. Since LIWC has been developed for multiple languages [9], it can be adapted in a similar manner across diferent languages to detect manifestations of depression. This advancement in linguistic analysis tools, such as LIWC, and their extensive language coverage ofer researchers valuable resources to investigate the expression of depression within diverse cultural and linguistic contexts.
Early intervention, combined with the use of early detection technologies, plays a key role in efectively addressing the challenges posed by depression. The use of early detection technologies finds significant applications across various domains, with particular relevance to areas encompassing health and safety. Notably, the Conference and Labs of the Evaluation Forum (CLEF) has played a significant role since 2010 by establishing tasks focused on early risk (eRisk) prediction on the internet. These initiatives have contributed to the development of efective methods and tools for identifying and predicting potential risks and dangers in online environments
In this paper, we describe the participation of our team, NailP, in the Task 1 of CLEF eRisk 20231. The goal of this task is to rank sentences from a collection of user writings based on their relevance to symptoms of depression. Participants are tasked with providing rankings for the 21 symptoms of depression as outlined in the BDI (Beck Depression Inventory) Questionnaire [10]. By evaluating the sentences, the aim was to determine their level of relevance to each symptom. An overview of the competition can be found at [11].
The rest of this paper is organized as follows. Section 2 outlines some related work. Section 3 is dedicated to the description of the task we participated, and includes both the methodology used and the obtained results. We conclude the paper and discuss future work in Section 4.
The organization of eRisk at CLEF in 2017 marked its inaugural year, representing a significant milestone in the field [ 12]. The main purpose of eRisk was to investigate evaluation methodologies, eficacy measures, and other process issues related to early detection of risk. Early detection techniques can be used in various areas, especially health and safety. In the first edition of eRisk, a significant component was dedicated to a pilot task focused on early detection of depression risk. Participants were invited to engage in this task, which aimed to explore novel approaches and methodologies for identifying early indicators of depression utilizing diverse data sources. Since then, the task of depression detection has been consistently proposed and included in subsequent editions of eRisk. This ongoing focus on depression detection highlights the recognition of its significance as a critical area of research within the early risk detection domain.
As part of the Early Detection of Depression task at CLEF 2017, Trottek et al. [13] conducted a thorough investigation of various linguistic and meta features, which encompassed items such as personal and possessive pronouns, past tense verbs, occurrences of the word ‘I,’ and text readability measures. The authors combined these features with n-gram features to train a logistic regression classifier. This work achieved top scores in precision, F1, and ERDE 5.
In the following year (i.e., 2018), diferent authors achieved the top performance measures in the Early Detection of Depression task at CLEF. Trotzek et al. [14] achieved the best ERDE50 and F1 scores by establishing a threshold for the logistic regression probabilities. Funez et al. [15] employed the Flexible Temporal Variation of Terms (FTVT) approach, utilizing sequential information on term variations across diferent post chunks, resulting in the best 5 score for the task. Paul et al. [16] utilized an Ada Boost classifier with Bag of Words (BoW) features, leading to the highest precision score.
Since then, several other approaches have been proposed for the Early Detection of Depression task. In 2019, Cacheda et al. [17] used data from social media networks to investigate various machine learning-based methods for early detection of Major Depressive Disorders (MDDs). Through a comprehensive analysis of the dataset, the subjects’ behavior was characterized based on diferent aspects of their writings, including textual spreading, time gap, and time span. Two distinct approaches were proposed, namely the singleton and dual methods, both relying on machine learning techniques. The singleton approach employed a single random forest (RF) classifier with two threshold functions, while the dual approach utilized two independent RF classifiers. One classifier aimed to detect depressed subjects, while the other aimed to identify nondepressed individuals. In both cases, features were derived from textual, semantic, and writing similarities, enhancing the efectiveness of the classification process for early detection of MDDs. The results improved state-of-the-art detection models by more than 10%.
Figuerêdo et al. [18] proposed a method for early detection of depression in social media applying a combination of a convolutional neural network, context-independent word embeddings, and Early and Late Fusion approaches. Experimental evaluations were conducted, taking into account the significance of the underlying emotions conveyed by emoticons. The findings reveal that the proposed method successfully identified potentially depressive users, achieving a precision of 0.76. Moreover, the method exhibited equivalent or superior efectiveness compared to several baseline approaches, as evidenced by an F1 score of 0.71.
In [19], the authors used neural language models to devise two distinct methods to detect depression symptoms by computing semantic similarities using the cosine similarity on both the sentences and descriptions of BDI-II. The first exploits users’ general language based on their publications. The second seeks more direct evidence from publications that specifically mention the symptoms concerns. The authors find that approaches based on neural language models are a feasible alternative for estimating depression rating scales.
The provided dataset was a collection of writings (posts) gathered from social media. The collection presents writings from 3,107 diferent users. In this collection, each user is the author of many writings. Also, each writing is a sequence of text sentences. There are in total 3,606,209 sentences.
The participants were also pointed to the Beck’s Depression Inventory (BDI). This questionnaire consists of 21 multiple-choice items that assess the severity of depressive symptoms experienced by an individual. Each item describes a specific symptom or feeling related to depression, and the respondent is asked to choose the statement that best reflects their experience. The BDI items cover a wide range of depressive symptoms, including emotional, cognitive, motivational, and physical aspects. The questionnaire is typically scored by summing the responses to the individual items, with higher scores indicating a greater severity of depression. The list below presents the general theme of each BDI item.
1. Sadness 2. Pessimism 3. Past Failure 4. Loss of Pleasure 5. Guilty Feelings 6. Punishment Feelings 7. Self-Dislike 8. Self-Criticalness 9. Suicidal Thoughts or Wishes 10. Crying 11. Agitation 12. Loss of Interest 13. Indecisiveness 14. Worthlessness 15. Loss of Energy 16. Changes in Sleep Patterns 17. Irritability 18. Changes in Appetite 19. Concentration Dificulty 20. Tiredness or Fatigue 21. Loss of Interest in Sex
Each item above is associated to four possible answers, that are presented in increasing level of severity. When fulfilling this questionnaire, an individual should choose exactly one answer for each item. The answers are associated to integer number in such a way that a total score can be attributed to an individual, and this score is used to assess her/his corresponding level of depression.
In Task 1, participants were assigned the task of ranking sentences of the provided collection according to their relevance to the set of BDI depression symptoms. The organizers stated that, to be considered relevant to a BDI symptom, a sentence must convey information about the user’s state concerning the symptom. Hence, a sentence should be considered relevant even when it indicates that the user is ok with the symptom.
We first performed some data preparation on the provided collection (which is given as a set of XML documents) to put it in a tabular format. During this steps, we replaced all 386,328 URL occurrences by a special marker ‘[URL]’. As a result, a tabular dataset of 3,606,209 entries was created. For each entry, we have fours data items: user_ID, sequence_ID, doc_ID, and text. These are the user identifier, the sentence identifier, the post identifier and the sentence content, respectively.
Based on the information that indicators of depression in textual content involve emotional
content and self-reference [
For the self-reference metadata, we tokenized each sentence to break it into individual words. We then assigned part-of-speech tags to the resulting tokens. This allowed us to enrich each sentence with a self-reference flag: if an input sentence contains at least one reference to a personal pronoun (from a predefined list), we flag it as a self-referential content. We used the following list of personal pronouns: ‘myself’, ‘my’, ‘I’, ‘ourselves’, ‘me’.
In the next step, we filtered the collection of sentences, using the following procedure. We kept only sentences with self-referential content. From this subset, we applied a second filter: we discarded predominantly neutral or positive sentences; we also ignored completely nonnegative sentences. As a result of this step, the number of potentially relevant sentences was reduced drastically, going from 3,606,209 to 109,230.
Next, we built vector embeddings for the sentences that remained after applying the previous (filtering) step. To build the vector embeddings, we used the all-MiniLM-L6-v2 pretrained model“3. This is a language model based on the MiniLM architecture. The MiniLM model is a variant of the Transformer architecture, which is a type of neural network architecture widely used for natural language processing tasks. The all-MiniLM-L6-v2 model has been pretrained on a large corpus of text data to learn general language representations. The model is designed to be smaller and more computationally eficient compared to larger language models. The all-MiniLM-L6-v2 model was trained to understand and generate text in a variety of languages and can perform tasks such as text classification, named entity recognition, sentiment analysis, 2https://www.nltk.org 3https://huggingface.co/sentence-transformers/all-MiniLM-L6-v2 and more. We used the MiniLM model to map each input sentence to a 384 dimensional dense vector. As a result, a total of 109,230 vector embeddings were created.
We also used MiniLM to encode the textual content related to the answers in each of the 21 items in the BDI questionnaire. Let be the set of 84 (4 × 21) answers in this questionnaire. We first used GPT3 to automatically generate semantically equivalent answers for each answer ∈ . As a result, an augmented set + of answers was generated for each original answer , 1 ≤ ≤ 84. These augmented sets are presented in Appendix A. We then generated vector embeddings for each element of each set +.
In this section, to simplify mathematical notation, we use the same symbol to denote a fragment of textual content and its corresponding vector embedding. This way, we use to denote both a sentence written by some user, and the vector embedding computed for . We do the same for a given answer in one of the BDI items, denoting both its textual content and vector embedding by the same symbol .
The general approach we used in our systems (i.e, alternative solutions) to rank sentences in the provided collection according to the BDI items was the following. For each candidate sentence , we compute a set of real numbers { }, which are the similarities between and item in the BDI questionnaire, 1 ≤ ≤ 21. For a given pair (, ), we compute as the maximum value considering the similarities between and the corresponding answers of , (). We use the cosine similarity as our measure of similarity between sentences and answers. See Eq. 1.
=
max cosine(, ) ∈() (1)
By using the procedure outline above, we compute the similarities between the set of candidate sentences and the set of BDI items. Then, to determine the set of most similar sentences to a given item , we sort the elements ∈ by decreasing values of and select the top-ranked sentences in the resulting sorted list. The number of selected sentences for a given BDI-item is controlled by a hyperparameter which we call minimum-score, a value between 0 and 1. All the sentences with similarity greater than or equal to this predefined value are selected as relevant.
We built five ranking systems using the general approach described above. These systems (aka runs) are named T1_M1, T1_M2, T1_M3, T1_M4, and T1_M5. These systems basically difer in (1) how the set () for each item was built, and (2) which sentiment polarities were considered to filter the set of candidate sentences. The particularities of each proposed ranking system are described below.
• T1_M1. When build the () sets, ignores predominantly positive or neutral posts (i.e., keeps “neg” posts). Minimum score value is set to 0.0. Also, considers only negative posts. • T1_M2. T1_M1. When build the () sets, ignores predominantly neutral posts (i.e., keeps both “neg” and “pos” posts). This system was inspired by one of the instructions provided by the organizers: A sentence will be deemed relevant to a BDI symptom when it conveys information about the user’s state concerning the symptom. That is, it may be relevant even when it indicates that the user is ok with the symptom. Minimum score value is set to 0.0. • T1_M3. This approach is similar to T1-M2. Minimum score value is set to 0.4. Also, considers only negative posts. • T1_M4. This approach is similar to T1-M2. Additionally, considers equivalent ways to express the answers in each item (symptom). Minimum score value is set to 0.4. • T1_M5. This approach is similar to T1-M2. Additionally, considers equivalent ways to express the answers in each item (symptom). That is, () is built considering the set of equivalent answers. Minimum score value is set to 0.0.
Task participants had to provide a resulting file for each proposed ranking system. Each resulting ifle was required to have at most 1, 000 lines for each BDI item. Each line contained five columns: item_number (a value from 1 to 21 identifying the Beck’s Depression Inventory item), the string “Q0” (for TREC format compliance), the sentence_id, position_in_ranking, score (we used the cosine similarity), and system_name (one of “T1_M1”, “T1_M2”, “T1_M3”, “T1_M4”, “T1_M5”, identifying the ranking system corresponding to the file).
The performance results obtained by our team are presented in Table 1 (majority-based qrels) and Table 2 (unanimity-based qrels). These tables report values for multiple standard performance metrics, such as Average Precision (AP), R-Precision, Precision at 10 and NDCG at 1000. For comparison purposes, we present our results along with the best results obtained in this task by the winning team. In this task, 10 diferent teams submitted 37 runs. The table reports several standard performance metrics, such as Average Precision (AP), R-Precision, Precision at 10 and NDCG at 1000.
We presented in this paper the methodology and corresponding results of our team’s participation in the Task1 of eRisk2023. Despite using simple, similarity-based approaches, our systems were competitive, achieving fifth place in a total of ten participating teams. Through this challenge we came to understand that the analysis of social media texts has the potential to provide insights into understanding a user’s mental health status and for the early detection of possible related symptoms of depression. Being this our first participation in these challenges, we understand there is still room to improve our methodology. Indeed, the results obtained encourage us to further contribute to this area of research. For future work, we plan to extend the methodology we used, which was completely unsupervised, with supervised techniques. Concretely, we plan to investigate how several classifier models trained on diferent symptoms of depression could leverage the detection of improved values of similarities. Adding more information coming from the collected metadata (such as the user-id) is also in our plans.
The authors thank CNPq, CAPES, FAPERJ, and CEFET/RJ for partially funding this research. The authors are grateful to the Foundation for Science and Technology (FCT, Portugal) for ifnancial support through national funds FCT/MCTES (PIDDAC) to CeDRI (UIDB/05757/2020 and UIDP/05757/2020) and SusTEC (LA/P/0007/2021). A review on recognizing depression in social networks: challenges and opportunities, Journal of Ambient Intelligence and Humanized Computing 11 (2020) 4713–4729. [5] D. William, D. Suhartono, Text-based depression detection on social media posts: A systematic literature review, Procedia Computer Science 179 (2021) 582–589. [6] D. Liu, X. L. Feng, F. Ahmed, M. Shahid, J. Guo, et al., Detecting and measuring depression on social media using a machine learning approach: systematic review, JMIR Mental Health 9 (2022) e27244. [7] Y. R. Tausczik, J. W. Pennebaker, The psychological meaning of words: Liwc and computerized text analysis methods, Journal of language and social psychology 29 (2010) 24–54. [8] T. Nguyen, D. Phung, B. Dao, S. Venkatesh, M. Berk, Afective and content analysis of online depression communities, IEEE Transactions on Afective Computing 5 (2014) 217–226. [9] F. Carvalho, F. P. Junior, E. Ogasawara, L. Ferrari, G. Guedes, Evaluation of the brazilian portuguese version of linguistic inquiry and word count 2015 (bp-liwc2015), Language Resources and Evaluation (2023) 1–20. [10] A. T. Beck, R. A. Steer, G. Brown, Beck depression inventory–II (BDI-II), Psychological assessment (1996). doi:10.1037/t00742-000. [11] J. Parapar, P. Martín Rodilla, D. E. Losada, F. Crestani, Overview of erisk 2023: Early risk prediction on the internet, in: Experimental IR Meets Multilinguality, Multimodality, and Interaction: 14th International Conference of the CLEF Association, CLEF 2023, Springer International Publishing, Thessaloniki, Greece, 2023. [12] D. E. Losada, F. Crestani, A test collection for research on depression and language use, in: Experimental IR Meets Multilinguality, Multimodality, and Interaction: 7th International Conference of the CLEF Association, CLEF 2016, Évora, Portugal, September 5-8, 2016, Proceedings 7, Springer, 2016, pp. 28–39. [13] M. Trotzek, S. Koitka, C. M. Friedrich, Linguistic metadata augmented classifiers at the clef 2017 task for early detection of depression., in: CLEF (Working Notes), 2017, p. 2017. [14] M. Trotzek, S. Koitka, C. M. Friedrich, Word embeddings and linguistic metadata at the clef 2018 tasks for early detection of depression and anorexia., in: CLEF (Working Notes), 2018. [15] D. G. Funez, M. J. G. Ucelay, M. P. Villegas, S. Burdisso, L. C. Cagnina, M. Montes-y Gómez,
M. Errecalde, Unsl’s participation at erisk 2018 lab., in: CLEF (Working Notes), 2018. [16] S. Paul, S. K. Jandhyala, T. Basu, Early detection of signs of anorexia and depression over social media using efective machine learning frameworks., in: CLEF (Working notes), 2018. [17] F. Cacheda, D. Fernandez, F. J. Novoa, V. Carneiro, Early detection of depression: Social network analysis and random forest techniques, J Med Internet Res 21 (2019) e12554. doi:10.2196/12554. [18] J. S. L. Figuerêdo, A. L. L. Maia, R. T. Calumby, Early depression detection in social media based on deep learning and underlying emotions, Online Social Networks and Media 31 (2022) 100225. [19] A. Pérez, J. Parapar, Álvaro Barreiro, Automatic depression score estimation with word embedding models, Artificial Intelligence in Medicine 132 (2022) 102380. doi: 10.1016/j.
1. I do not feel sad → { I am not experiencing sadness, I don’t feel down, I’m not feeling unhappy, I’m not feeling melancholy, I’m not feeling dejected, I’m not feeling gloomy, I’m not feeling low, I’m not feeling blue, I’m not feeling depressed, I’m not feeling upset } 2. I feel sad → { I am experiencing sadness, I feel down, I’m feeling unhappy, I’m feeling melancholy, I’m feeling dejected, I’m feeling gloomy, I’m feeling low, I’m feeling blue, I’m feeling depressed, I’m feeling upset } 3. I am sad all the time and I can’t snap out of it → { I’m constantly sad and can’t seem to shake it of, I’m always sad and can’t get over it, I’m continually sad and can’t break free from it, I’m sad all the time and can’t recover from it, I’m persistently sad and can’t bounce back from it, I’m consistently sad and can’t snap out of it, I’m regularly sad and can’t shake it of, I’m frequently sad and can’t seem to get over it, I’m invariably sad and can’t break free from it, I’m perpetually sad and can’t recover from it } 4. I am so sad and unhappy that I can’t stand it → { I’m extremely sad and unhappy that I can’t bear it, I’m so sad and unhappy that it’s unbearable, I’m very sad and unhappy that I can’t endure it, I’m incredibly sad and unhappy that I can’t tolerate it, I’m excessively sad and unhappy that I can’t handle it, I’m overwhelmingly sad and unhappy that I can’t cope with it, I’m deeply sad and unhappy that I can’t take it, I’m really sad and unhappy that I can’t deal with it, I’m intensely sad and unhappy that I can’t manage it, I’m acutely sad and unhappy that I can’t withstand it } Equivalent answers for item 2 1. I am not particularly discouraged about the future → { I am somewhat hopeful about the future, I am moderately optimistic about the future, I am not entirely pessimistic about the future, I am somewhat positive about the future, I am not completely discouraged about the future, I am slightly optimistic about the future, I am cautiously hopeful about the future, I am somewhat encouraged about the future, I am not overly discouraged about the future, I am mildly positive about the future } 2. I feel discouraged about the future → { I am feeling pessimistic about the future, I am not hopeful about the future, I am not optimistic about the future, I am feeling down about the future, I am feeling disheartened about the future, I am feeling bleak about the future, I am feeling gloomy about the future, I am feeling hopeless about the future, I am feeling despair about the future, I am feeling demotivated about the future } Equivalent answers for item 3 1. I do not feel like a failure → { I feel successful, I feel accomplished, I feel like I am doing well, I feel like I am succeeding, I do not feel like I am failing, I feel competent, I feel confident in my abilities, I feel good about my achievements, I feel proud of myself, I feel capable of achieving my goals } 2. I feel I have failed more than the average person → { I feel like I have not been as successful as others, I feel like I have experienced more failures than most people, I feel like I am not as accomplished as others, I feel like I am not meeting the same level of success as others, I feel like I have had more setbacks than the average person, I feel like I am behind in achieving my goals compared to others, I feel like I am not as competent as others, I feel like I have not achieved as much as I should have, I feel like I have fallen short of my own expectations and the expectations of others, I feel like I am struggling more than most people } 3. As I look back on my life, all I can see is a lot of failures → { When I reflect on my life, I see a history of unsuccessful moments, As I look back on my past, I see a long list of mistakes and disappointments, As I think about my life, all I can see is a series of failures and setbacks, Looking back at my life, I see a lot of missed opportunities and failures, When I consider my life, I can only see a trail of failures and shortcomings, As I reminisce on my life, all I can see is a sequence of failures and mistakes, As I ponder my life, I can only see a string of disappointments and letdowns, Reflecting on my past, all I can see is a history of failures and setbacks, As I review my life, I see a lot of areas where I fell short, As I look back on my life, I see a lot of things I wish I had done diferently } 4. I feel I am a complete failure as a person → { I feel like I am not a successful person, I feel like I am not good at anything, I feel like I am a disappointment to myself and others, I feel like I have no purpose or value in life, I feel like I am a total letdown, I feel like I am not living up to my potential, I feel like I am a burden on those around me, I feel like I am useless, I feel like I am a waste of space, I feel like I am a failure in every aspect of my life } Equivalent answers for item 4
1. I don’t feel particularly guilty → { I don’t feel overly guilty, I don’t feel excessively guilty, I don’t feel very guilty, I don’t feel extremely guilty, I don’t feel unduly guilty, I don’t feel abnormally guilty, I don’t feel unreasonably guilty, I don’t feel inordinately guilty, I don’t feel overly remorseful, I don’t feel excessively remorseful } 2. I feel guilty a good part of the time → { I feel guilty often, I feel guilty frequently, I feel guilty regularly, I feel guilty consistently, I feel guilty a lot of the time, I feel guilty most of the time, I feel guilty much of the time, I feel guilty a significant amount of time, I feel guilty a large part of the time, I feel guilty on a regular basis } 3. I feel quite guilty most of the time → { I feel extremely guilty most of the time, I feel overwhelmingly guilty most of the time, I feel very guilty most of the time, I feel excessively guilty most of the time, I feel unduly guilty most of the time, I feel abnormally guilty most of the time, I feel unreasonably guilty most of the time, I feel inordinately guilty most of the time, I feel tremendously guilty most of the time, I feel acutely guilty most of the time }
1. I don’t feel disappointed in myself → { I am satisfied with myself, I am content with myself, I am proud of myself, I am happy with myself, I am confident in myself, I am comfortable with myself, I am pleased with myself, I am at ease with myself, I am self-assured, I am self-confident } 2. I am disappointed in myself → { I am dissatisfied with myself, I am not satisfied with myself, I am unhappy with myself, I am not proud of myself, I am not content with myself, I am not fulfilled with myself, I am not pleased with myself, I am regretful about myself, I am disheartened with myself, I am let down by myself } 3. I am disgusted with myself → { I am repulsed by myself, I am loathing myself, I am sickened by myself, I am revolted by myself, I am abhorred by myself, I am detesting myself, I am nauseated by myself, I am hating myself, I am feeling self-disgust, I am ifnding myself contemptible }
1. I don’t feel I am any worse than anybody else → { I don’t think I’m any less capable than others, I don’t believe I’m any inferior to others, I don’t feel I’m any less deserving than others, I don’t see myself as any less important than others, I don’t consider myself any less competent than others, I don’t judge myself as any worse than others, I don’t view myself as any less valuable than others, I don’t perceive myself as any weaker than others, I don’t regard myself as any less worthy than others, I don’t feel any less confident than others } 2. I am critical of myself for my weaknesses or mistakes → { I am hard on myself for my lfaws or errors, I am self-critical for my imperfections or blunders, I am tough on myself for my shortcomings or lapses, I am harsh on myself for my weaknesses or missteps, I am strict with myself for my faults or oversights, I am demanding of myself for my limitations or mishaps, I am unsatisfied with myself for my weaknesses or inaccuracies, I am exacting of myself for my deficiencies or slip-ups, I am rigorous with myself for my imperfections or misjudgments, I am unforgiving of myself for my flaws or oversights } 3. I blame myself all the time for my faults → { I constantly hold myself responsible for my lfaws, I consistently point the finger at myself for my shortcomings, I perpetually fault myself for my inadequacies, I continually attribute blame to myself for my weaknesses, I persistently accuse myself for my defects, I incessantly reproach myself for my imperfections, I repeatedly criticize myself for my mistakes, I always find fault with myself for my flaws, I habitually assign blame to myself for my limitations, I constantly condemn myself for my errors } 4. I blame myself for everything bad that happens → { I hold myself responsible for all the bad things that happen, I believe that I am to blame for every negative occurrence, I attribute fault to myself for every unpleasant situation, I see myself as the cause of every unfortunate event, I believe that everything bad is my fault, I take the blame for everything that goes wrong, I consider myself responsible for every negative outcome, I feel accountable for everything that goes awry, I put the responsibility for every bad thing on myself, I think that I am at fault for everything bad that occurs } Equivalent answers for item 9 1. I don’t have any thoughts of killing myself → { I don’t have suicidal thoughts, I have no desire to kill myself, I’m not thinking about suicide, Suicide is not on my mind, I’m not contemplating suicide, I’m not considering suicide, I’m not planning to kill myself, I’m not fantasizing about suicide, I’m not tempted to kill myself, I’m not preoccupied with suicidal thoughts } 2. I have thoughts of killing myself, but I would not carry them out → { I have suicidal thoughts, but I’m not going to act on them, I sometimes think about suicide, but I won’t actually do it, I have occasional suicidal ideations, but I won’t go through with them, I have suicidal tendencies, but I won’t take my own life, I have suicidal impulses, but I won’t follow through with them, I have fleeting thoughts of suicide, but I won’t commit suicide, I have passing suicidal thoughts, but I won’t harm myself, I have suicidal fantasies, but I won’t act them out, I have suicidal urges, but I won’t act on them, I have suicidal inclinations, but I won’t kill myself } 3. I would like to kill myself → { I have a strong desire to end my life, I wish to commit suicide, I want to end my life, I desire to take my own life, I have a longing to kill myself, I have an urge to commit suicide, I feel like killing myself, I have a need to end my life, I crave to kill myself, I yearn to take my own life } 4. I would kill myself if I had the chance → { If I had the opportunity, I would take my own life, I would commit suicide if I had the chance, Given the chance, I would end my life, I would take my life if I had the chance, I would end my life if I had the opportunity, If the chance arose, I would kill myself, I would take my own life if I had the chance to do so, I would commit suicide if given the chance to do so, If the opportunity presented itself, I would end my life, I would take my life if given the chance }
1. I don’t cry any more than usual → { I cry the same amount as usual, I cry as much as I normally do, My crying frequency is normal, My crying is not excessive, I don’t cry more than is typical for me, I cry within normal limits, My crying is not out of the ordinary, My crying is not unusual for me, I am not crying excessively, My crying is not unusual } 2. I cry more now than I used to → { I am crying more frequently now, I cry more often now, I am shedding more tears now than before, I am more emotional now and cry more, I have been crying more often lately, I have been crying more frequently lately, I am crying more frequently than in the past, My crying has increased compared to before, I am crying more than I did in the past, I cry more now than I did previously } 3. I cry all the time now → { I am crying constantly now, I cry non-stop now, I am always crying now, I am crying all the time these days, I am crying incessantly now, I am shedding tears constantly now, I am crying every moment now, I am constantly weeping now, I am crying continuously now, I am shedding tears all the time now } 4. I used to be able to cry, but now I can’t cry even though I want to → { I can’t cry anymore even though I want to, I have lost the ability to cry even when I feel like it, I am unable to cry now despite wanting to, I used to be able to cry but now I am unable to, I have lost the ability to cry even when I feel sad, I wish I could cry, but I am unable to, I want to cry, but I can’t anymore, I have become emotionally numb and can’t cry anymore, Despite my desire to cry, I am unable to, I used to cry easily, but now it’s hard for me to cry } Equivalent answers for item 11 1. I am no more irritated by things than I ever was → { I am not any more annoyed by things than I used to be, I am just as irritated by things as I have always been, My level of irritation towards things has remained constant, Things don’t bother me any more now than they used to, I am just as easily annoyed by things as I have always been, I am not any more bothered by things now than before, My level of annoyance towards things has not changed, I am not any more irritated by things than in the past, Things don’t get under my skin any more now than before, I have always been annoyed by things to the same degree } 2. I am slightly more irritated now than usual → { I am a bit more annoyed than usual, I am somewhat more irritated than I normally am, I am a little more bothered than usual, I am slightly more agitated than usual, I am somewhat more frustrated than usual, I am a bit more bothered than I normally am, I am somewhat more vexed than usual, I am slightly more upset than usual, I am somewhat more troubled than I normally am, I am a tad more irritated than usual } 3. I am quite annoyed or irritated a good deal of the time → { I am frequently annoyed or irritated, I am regularly bothered or frustrated, I am constantly agitated or vexed, I am often upset or troubled, I am regularly irritated or bothered, I am frequently vexed or frustrated, I am constantly annoyed or agitated, I am often troubled or upset, I am frequently irritated or frustrated, I am constantly bothered or vexed } 4. I feel irritated all the time → { I am constantly feeling annoyed, I am perpetually feeling bothered, I am always feeling frustrated, I am constantly feeling vexed, I am continually feeling irritated, I am persistently feeling agitated, I am constantly feeling troubled, I am always feeling annoyed or irritated, I am incessantly feeling bothered or vexed, I am continuously feeling frustrated or troubled } Equivalent answers for item 12 1. I have not lost interest in other people → { I still have interest in other people, I am still interested in other people, My interest in other people remains intact, I haven’t lost my curiosity about other people, I still find other people interesting, Other people still hold my interest, I still care about other people, I am still invested in other people, I still enjoy interacting with other people, I still like meeting new people } 2. I am less interested in other people than I used to be → { My interest in other people has decreased, I don’t find other people as interesting as I used to, I am not as curious about other people as I used to be, I am not as invested in other people as I used to be, I am not as engaged with other people as I used to be, I am not as enthusiastic about other people as I used to be, My interest in other people has waned, I am not as captivated by other people as I used to be, I am not as fascinated by other people as I used to be, I am not as absorbed by other people as I used to be } 3. I have lost most of my interest in other people → { I am mostly disinterested in other people, I am largely uninterested in other people, I have lost the bulk of my interest in other people, I am barely interested in other people anymore, I have lost a significant amount of interest in other people, My interest in other people has significantly diminished, I am mostly indiferent to other people, I am mostly apathetic towards other people, My interest in other people has dwindled, I am mostly bored by other people } 4. I have lost all of my interest in other people → { I am completely uninterested in other people, I have no interest in other people whatsoever, I am entirely disinterested in other people, I have absolutely no interest in other people, I am completely apathetic towards other people, I have lost all of my curiosity about other people, I am completely indiferent to other people, I have lost all desire to interact with other people, I am completely bored by other people, I have zero interest in other people }
1. I make decisions about as well as I ever could → { I am just as good at making decisions as I always have been, My decision-making abilities have not changed much over time, I am just as competent at making decisions as ever, My ability to make decisions is about the same as it always has been, I have the same level of skill at decision-making as ever, My decision-making skills are still intact, I am as capable of making decisions as I always have been, My decision-making ability is still strong, I am just as efective at making decisions as ever, My decision-making hasn’t changed much over the years } 2. I put of making decisions more than I used to → { I procrastinate more when it comes to making decisions, I delay making decisions more often than I used to, I am more hesitant to make decisions than before, I am more indecisive now than I used to be, I am less decisive than I was in the past, I have a harder time making decisions than I did before, I am more cautious in making decisions than before, I am more reluctant to make decisions than I used to be, I take longer to make decisions than I used to, I am more apprehensive about making decisions than before } 3. I have greater dificulty in making decisions more than I used to → { I find it harder to make decisions now than I used to, Making decisions is more challenging for me now than it was before, I struggle with decision-making more than I did in the past, I face more obstacles when making decisions than I used to, I am less confident in my decision-making abilities than before, I have a harder time coming to decisions now than in the past, I am more overwhelmed by the decision-making process now, I am more confused when making decisions than I was in the past, I have more trouble making up my mind now than I did before, I am more unsure of myself when making decisions now } 4. I can’t make decisions at all anymore → { I am completely indecisive now, I am incapable of making decisions now, I am utterly paralyzed when it comes to decision-making, I am completely unable to make decisions anymore, I am completely immobilized when it comes to making decisions, I am completely stymied when it comes to decision-making, I am completely incapacitated when it comes to making decisions, I am completely frozen when it comes to decision-making, I am completely helpless when it comes to making decisions, I am completely at a loss when it comes to decision-making } Equivalent answers for item 14 1. I don’t feel that I look any worse than I used to → { I feel that my appearance hasn’t changed much over time, I don’t see any noticeable diference in my appearance compared to the past, I feel that I look as good as I used to, I don’t think that my appearance has deteriorated over time, I feel that my looks are pretty much the same as before, I don’t feel that I have aged ungracefully, I feel that I am aging gracefully, I don’t feel that I am looking worse with age, I feel that my appearance has held up well over time, I don’t see any significant decline in my looks } 2. I am worried that I am looking old or unattractive → { I am concerned that my appearance is deteriorating with age, I am anxious that I am losing my youthful looks, I am apprehensive that I am becoming unattractive, I am troubled by signs of aging that are showing on my face, I am worried that I am losing my physical appeal, I am concerned that I am no longer looking as good as I used to, I am anxious that I am looking older than I actually am, I am worried that I am starting to look worn out, I am concerned that I am developing wrinkles and fine lines, I am anxious that my skin is losing its elasticity } 3. I feel there are permanent changes in my appearance that make me look unattractive → { I believe that my appearance has been permanently altered for the worse, I feel that my appearance has changed in a way that is not reversible, I am convinced that there are changes in my appearance that are unappealing, I feel that my looks have been negatively afected by irreversible changes, I am certain that there are permanent changes in my appearance that are not attractive, I feel that there are physical changes that are making me look unappealing, I am convinced that my appearance has been permanently marred, I feel that my looks have been permanently altered in an unflattering way, I am certain that there are unattractive permanent changes in my appearance, I feel that my appearance has been permanently damaged in some way } 4. I believe that I look ugly → { I feel that I am physically unattractive, I am convinced that I am not good-looking, I feel that my looks are repulsive, I am certain that I am not attractive, I believe that I am ugly, I feel that I am not aesthetically pleasing, I am convinced that I am not physically appealing, I feel that I am unappealing to others, I am certain that I am not pretty, I believe that I am not physically attractive }
1. I can work about as well as before → { My work output is about the same as before, I am able to perform work at a similar level to before, My work abilities are largely unchanged, I can still work with the same level of competence, My work performance is consistent with my previous abilities, I am still capable of performing work as before, My work skills have not deteriorated significantly, I have not lost much of my work capacity, I am still productive at a similar level to before, My work proficiency is largely unafected } 2. It takes an extra efort to get started at doing something → { I need to put in more efort to initiate a task, I require additional motivation to begin a task, I need to push myself harder to get started on something, Starting a task requires more efort than before, I find it harder to get motivated to start tasks, I need a little extra push to begin tasks, Initiating tasks requires more energy than before, I need to apply more force to get the ball rolling, Starting tasks requires more work than before, I need to give myself an extra nudge to get started on tasks } 3. I have to push myself very hard to do anything → { I need to exert a lot of efort to do anything, I have to work very hard to get anything done, Everything takes a lot of efort for me, I need to apply a lot of force to accomplish anything, I have to put in a lot of sweat and tears to get things done, I need to strain myself to accomplish even simple tasks, I have to push myself to the limit to do anything, Getting anything done requires a lot of efort on my part, I need to expend a great deal of energy to accomplish anything, I have to put forth a significant amount of efort to do anything } 4. I can’t do any work at all → { I am completely unable to work, I cannot perform any work whatsoever, I am incapable of doing any work at all, I cannot accomplish anything in my current state, I am completely unproductive at the moment, I am totally incapacitated and unable to work, My work abilities have been entirely compromised, I am currently unable to perform any tasks, I am completely immobilized and unable to work, I am unable to complete any work in my present condition } Equivalent answers for item 16 1. I can sleep as well as usual → { My sleep quality is the same as usual, I am sleeping as well as I normally do, My sleeping pattern has not changed, I am able to sleep normally, I am getting the same amount of restful sleep, My sleep is not disturbed, I am not having any trouble sleeping, I am able to fall asleep as easily as before, I am sleeping just as soundly as usual, My sleep is not afected } 2. I don’t sleep as well as I used to → { My sleep quality has declined, I am not sleeping as well as before, My sleeping pattern has changed, I am not able to sleep as soundly as before, I am not getting as much restful sleep as before, My sleep is disturbed, I am having trouble sleeping, I am not able to fall asleep as easily as before, I am waking up more frequently at night, My sleep is afected } 3. I wake up 1-2 hours earlier than usual and find it hard to get back to sleep → { I am experiencing early morning awakening and have trouble falling back asleep, I wake up prematurely and have dificulty returning to sleep, I am waking up too early and unable to sleep again, I am waking up a couple of hours earlier than usual and struggling to fall back asleep, I am experiencing sleep disruption in the early hours of the morning, I wake up too soon and find it hard to go back to sleep, I am waking up earlier than usual and feeling alert and unable to sleep again, I am waking up before my regular time and unable to fall asleep again, I am having trouble sleeping past my usual waking time, I am waking up ahead of time and finding it dificult to resume sleeping } 4. I wake up several hours earlier than I used to and cannot get back to sleep → { I am experiencing significant early morning awakening and cannot fall back asleep, I wake up much earlier than before and have trouble returning to sleep, I am waking up a few hours earlier than usual and struggling to fall back asleep, I am experiencing severe sleep disruption in the early hours of the morning, I wake up much earlier than I used to and ifnd it hard to go back to sleep, I am waking up several hours ahead of my usual time and feeling alert and unable to sleep again, I am waking up hours before my regular time and unable to fall asleep again, I am having trouble sleeping past my new waking time, I am waking up much earlier than before and unable to resume sleeping, I am experiencing significant sleep disturbance in the early hours of the morning } Equivalent answers for item 17
1. My appetite is no worse than usual → { My appetite is normal, My appetite is the same as usual, My appetite hasn’t changed, My appetite is steady, My appetite is consistent, My appetite is average, My appetite is not unusual, My appetite is not diferent from usual, My appetite is not worse than before, My appetite is not afected } 2. My appetite is not as good as it used to be → { My appetite has decreased, My appetite is not what it used to be, My appetite is weaker than before, My appetite is less than before, My appetite has diminished, My appetite is reduced, My appetite is not as strong as before, My appetite is not as healthy as before, My appetite is not as robust as before, My appetite is not as hearty as before } 3. My appetite is much worse now → { My appetite is greatly decreased, My appetite has significantly decreased, My appetite is much weaker than before, My appetite is much less than before, My appetite has deteriorated significantly, My appetite is significantly reduced, My appetite has taken a turn for the worse, My appetite is greatly afected, My appetite is much poorer than before, My appetite is much lower than before } 4. I have no appetite at all anymore → { I don’t feel like eating at all, I have lost my appetite completely, I have no desire to eat anymore, I can’t eat anything anymore, I am not hungry at all anymore, I have no urge to eat anymore, I am not interested in food anymore, I am not able to eat anymore, I have no taste for food anymore, I feel sick at the thought of eating } Equivalent answers for item 19 1. I haven’t lost much weight, if any, lately → { I haven’t lost a significant amount of weight recently, I haven’t seen much change in my weight lately, I haven’t made much progress in losing weight lately, I haven’t noticed much diference in my weight lately, I haven’t shed much weight, if any, recently, I haven’t had much success in losing weight lately, I haven’t lost much weight, if any, in the recent past, I haven’t slimmed down much, if at all, lately, I haven’t dropped much weight, if any, recently, I haven’t shed many pounds, if any, lately } 2. I have lost more than five pounds → { I have shed more than five pounds, I have lost over five pounds, I have dropped more than five pounds, I have reduced my weight by more than five pounds, I have lost at least five pounds, I have shed a significant amount of weight, I have made progress in losing weight, I have successfully lost more than five pounds, I have decreased my weight by more than five pounds, I have managed to lose more than five pounds } 3. I have lost more than ten pounds → { I have shed more than ten pounds, I have lost over ten pounds, I have dropped more than ten pounds, I have reduced my weight by more than ten pounds, I have lost at least ten pounds, I have shed a significant amount of weight, I have made progress in losing weight, I have successfully lost more than ten pounds, I have decreased my weight by more than ten pounds, I have managed to lose more than ten pounds } 4. I have lost more than fifteen pounds → { I have shed more than fifteen pounds, I have lost over fifteen pounds, I have dropped more than fifteen pounds, I have reduced my weight by more than fifteen pounds, I have lost at least fifteen pounds, I have shed a significant amount of weight, I have made progress in losing weight, I have successfully lost more than fifteen pounds, I have decreased my weight by more than fifteen pounds, I have managed to lose more than fifteen pounds }
1. I am no more worried about my health than usual → { I am not particularly concerned about my health, I am not more anxious about my health than usual, I am not feeling more worried about my health than usual, I am not more preoccupied with my health than usual, I am not more apprehensive about my health than usual, I am not more distressed about my health than usual, I am not feeling more uneasy about my health than usual, I am not more troubled about my health than usual, I am not more bothered about my health than usual, I am not more nervous about my health than usual } 2. I am worried about physical problems like aches, pains, upset stomach, or constipation → { I am concerned about physical issues such as pain, discomfort, and digestive problems, I am anxious about physical symptoms like aches, cramps, and digestive distress, I am troubled by physical ailments like discomfort, soreness, and digestive issues, I am preoccupied with physical discomfort like pain, soreness, and digestive problems, I am bothered by physical complaints such as aches, pains, and digestive distress, I am distressed by physical symptoms like soreness, discomfort, and digestive issues, I am feeling uneasy about physical issues such as pain, discomfort, and digestive problems, I am experiencing physical concerns like aches, pains, and digestive distress, I am struggling with physical symptoms such as pain, soreness, and digestive discomfort, I am worried about my physical health and the discomfort I am experiencing } 3. I am very worried about physical problems and it’s hard to think of much else → { I am extremely concerned about my physical health and can’t focus on anything else, I am deeply anxious about my physical health and can’t concentrate on anything else, I am excessively preoccupied with my physical health and can’t think about much else, My physical health concerns are dominating my thoughts and making it hard to focus on anything else, My worries about my physical health are all-consuming and making it dificult to think about anything else, I am consumed by worry about my physical health and can’t seem to think of anything else, I am intensely worried about my physical health and it’s afecting my ability to concentrate on other things, My fears about my physical health are overwhelming and it’s hard to focus on anything else, My concerns about my physical health are all-encompassing and making it hard to think about much else, My physical health worries are all I can think about and it’s making it hard to focus on other things } 4. I am so worried about my physical problems that I cannot think of anything else → { My physical problems are causing me such great worry that I can’t focus on anything else, I am so preoccupied with my physical problems that I can’t think about anything else, My worries about my physical problems are taking up all of my mental energy and I can’t think of anything else, My concern for my physical problems is so great that I can’t seem to focus on anything else, My anxiety about my physical problems is all-consuming and preventing me from thinking of anything else, I am completely preoccupied with my physical problems and can’t seem to think about anything else, My worries about my physical problems are dominating my thoughts and making it impossible to focus on anything else, I am so worried about my physical problems that they are the only thing on my mind and I can’t think of anything else, My physical problems are causing me so much worry that I can’t concentrate on anything else, My fears about my physical problems are all-consuming and making it impossible to think of anything else }
1. I have not noticed any recent change in my interest in sex → { My interest in sex has been consistent lately, I haven’t experienced any significant change in my sexual interest, My sexual interest has remained steady, I haven’t observed any alterations in my sexual interest recently, I haven’t seen any decline in my sexual interest recently, My sexual interest has been constant lately, There haven’t been any notable changes in my sexual interest recently, I haven’t noticed any shifts in my sexual interest lately, My sexual interest hasn’t wavered recently, I haven’t felt any changes in my sexual desire recently } 2. I am less interested in sex than I used to be → { My interest in sex has decreased over time, I am not as interested in sex as I used to be, My sexual desire has dwindled over time, My sexual interest has declined from what it used to be, I have lost some of my interest in sex compared to the past, I have seen a drop in my sexual interest compared to the past, My interest in sex has diminished over time, I have noticed a decline in my sexual interest over time, My sexual desire has lessened over time, My interest in sex has decreased over the years } 3. I have almost no interest in sex → { I am hardly interested in sex at all, My interest in sex is close to nonexistent, I have almost completely lost interest in sex, I have a minimal interest in sex, I am barely interested in sex at all, My interest in sex is almost nonexistent, I have virtually no interest in sex, I have little to no interest in sex, My sexual interest is almost nonexistent, I am almost completely uninterested in sex } 4. I have lost interest in sex completely → { I have no interest in sex at all, I am completely disinterested in sex, My sexual interest is entirely gone, I am no longer interested in sex at all, I have completely lost my sexual interest, I have zero interest in sex, I am completely uninterested in sex, My interest in sex has completely disappeared, I have no desire for sex at all, I have completely lost all interest in sex }