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<article xmlns:xlink="http://www.w3.org/1999/xlink">
  <front>
    <journal-meta>
      <journal-title-group>
        <journal-title>Conference and Labs of the Evaluation Forum, September</journal-title>
      </journal-title-group>
    </journal-meta>
    <article-meta>
      <title-group>
        <article-title>Automatically Finding Evidence and Predicting Answers in Mental Health Self-Report Questionnaires</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Diego Maupomé</string-name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Yves Ferstler</string-name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Sébastien Mosser</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Marie - Jean Meurs</string-name>
          <xref ref-type="aff" rid="aff1">1</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>McMaster University</institution>
          ,
          <addr-line>ON</addr-line>
          ,
          <country country="CA">Canada</country>
        </aff>
        <aff id="aff1">
          <label>1</label>
          <institution>Université du Québec à Montréal</institution>
          ,
          <addr-line>QC</addr-line>
          ,
          <country country="CA">Canada</country>
        </aff>
      </contrib-group>
      <pub-date>
        <year>2022</year>
      </pub-date>
      <volume>0</volume>
      <fpage>9</fpage>
      <lpage>12</lpage>
      <abstract>
        <p>This paper describes the participation of the RELAI team in the eRisk 2024 shared tasks related to the search for symptoms of depression (T1) and the measure of severity of the signs of eating disorders (T3). Both tasks centered on self-report questionnaires and social media textual content. In T1, sentences relevant to each item in a standard depression were mined from a large set of sentences collected from social media. Our approach relied on ground-truth relevance judgments to train multi-label classifiers in deciding whether a sentence is relevant to each item. The goal of T3 was to automatically fill out a standard eating disorder questionnaire based on histories of writings from social media. Given the small set of annotated data and large output space, our approach proceeded by making global, aggregate predictions first and use those predictions to make precise per-item predictions.</p>
      </abstract>
      <kwd-group>
        <kwd>eol&gt;Mental Health</kwd>
        <kwd>Mental Disorders</kwd>
        <kwd>Depression</kwd>
        <kwd>Eating Disorders</kwd>
        <kwd>Natural Language Processing</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>1. Introduction</title>
      <p>According to the WHO fact sheets, around 5% of adults worldwide sufer from depression in 2023 1,
and 14 million people experienced eating disorders in 20192. Since the number of social media users
worldwide reached more than 5 millions in 2024, i.e. almost 63% of the world’s population, it is still
critical to contribute to early detection of mental disorders by developing scalable tools based on natural
language processing and machine learning, which can automatically analyze online textual content
shared by social media users.</p>
      <p>
        The 2024 edition of the eRisk evaluation campaign proposed three tasks respectively focusing on the
search of depression symptoms (T1), the early detection of signs of anorexia (T2) and the estimation
of severity of signs of eating disorders (T3) [
        <xref ref-type="bibr" rid="ref1 ref2">1, 2</xref>
        ]. T1 was the continuation of the similar task created
in 2023, though teams were provided this year with a ground truth set of tagged sentences created
for last year task. T2 was a continuation of eRisk 2018 and 2019 tasks. T3 was a continuation of 2022
and 2023 eRisk tasks. This paper describes the participation of the RELAI team to tasks 1 and 3, using
lightweight approaches to minimize computation costs and infrastructure needs, as in most of our
previous work [
        <xref ref-type="bibr" rid="ref3">3, 4, 5</xref>
        ].
      </p>
      <p>In T1, the goal of the system is to retrieve relevant sentences, and rank them according to their
relevance to signs and symptoms of depression described in the Beck Depression Inventory, 2nd
edition (BDI-II) [6]. Our approaches make use of ground-truth relevance judgments to train multi-label
classifiers to predict the relevance of sentences to each BDI item.</p>
      <p>In T3, the system must fill questions 1-12 and 19-28 of the Eating Disorder Examination Questionnaire
(EDE-Q) [7], in order to automatically estimate the severity of signs of eating disorders. Given this
complexity of predicting 22 variables and limited availability of training data, our approach makes use
of global and subscale scores: beginning with predicting broader aggregate scores and relying on this
output to make more precise, item-level predictions.</p>
    </sec>
    <sec id="sec-2">
      <title>2. Task 1: Search for symptoms of depression</title>
      <sec id="sec-2-1">
        <title>2.1. Task and Data</title>
        <p>The task consists in retrieving and ranking sentences based on their relevance to signs and symptoms
of depression, as identified by the Beck Depression Inventory (BDI) [ 6]. This self-report questionnaire
inventories afective, cognitive, somatic and vegetative symptoms of depression in 21 items to provide a
measure of the overall severity of depression.However, the task is not concerned with the severity of
these symptoms, consisting instead in finding sentences relevant to each of these items from a common
pool of several million sentences from Internet fora. For each of the 21 items, a relevance ranking of up
to 1000 sentences is expected. Sentences are allowed to appear in several item rankings. Relevance is
defined as the presence of both pertinence to the given symptom and "explicit information about the
individual’s state in relation to it" [8].</p>
        <p>Training data consists of 3.8M sentences, among which 16.1k have been manually assessed for
relevance. Relevance judgments are provided based on a majority as well as the unanimity of the three
annotators. Statistics on these relevance judgments are presented in Table 1. Sentences assessed for
relevance were pooled from the rankings provided by task participants in the previous iteration of the
task (2023). The test set contains 15.5M sentences.</p>
        <p>As shown in Table 1 around 16.1k unique sentences were assessed for relevance over 21.6k attributions
across items. For both majority and consensus relevance, a small proportion (resp. 11%, 22%) of these
attributions were deemed relevant overall. The number of relevant sentences varies by an order of
magnitude across items (Figure 1a). Furthermore, relevance to several items decreases exponentially in
the number of items (Figure 1b).</p>
        <p>
          Task performance was evaluated using standard information retrieval performance measures, namely
average precision (AP), top-ten precision (P@10), r-precision (R-P) and non-discounted cumulative gain
(NDCG) [
          <xref ref-type="bibr" rid="ref2">2</xref>
          ].
        </p>
      </sec>
      <sec id="sec-2-2">
        <title>2.2. Approaches and training</title>
        <p>Participants in the previous iteration of this task did not have access to ground-truth relevance judgments.
Past approaches are therefore completely unsupervised. These approaches are based on the use of
textual similarity between target sentences and reference texts. Choices for the latter vary between the
text of the questionnaire itself, paraphrases and expansions thereof and expert features. By and large,
the measure of similarity is based on pretrained transformer approaches, with coarser-grained filtering
based on feature words applied on occasion.
(a) Number of sentences labeled as relevant per BDI item
(b) Frequency of multiple relevances per sentence</p>
        <p>However, such approaches rely on the design of relevant reference texts for items or the assumption
that textual similarity to the questionnaire entails positive relevance as defined by the task. Given these
dificulties capturing relevance through unsupervised means and the availability of relevance judgments,
our approach to the task was to induce relevance in a supervised manner, namely through classification.
The task was framed as a multilabel classification task with each item acting as a label. The scores
produced by the resulting probabilistic models were then used as relevance scores for ranking purposes.</p>
        <p>These multilabel classification models were feed-forward neural networks operating on transformer
embeddings of the input sentences. That is, sentences were encoded using pretrained neural sentence
encoders. From this representation, feed-forward networks were trained to predict the relevance of
sentences to all items of the BDI in a joint manner.</p>
        <p>An initial concern in training these networks was the efect on model conditioning of the large
number of overall negative sentences (not relevant to any item) in the dataset. To measure these efects,
validation experiments controlled the proportion of overall negative sentences in training. The efects
observed were contrary to initial intuitions, with a larger number of negative examples yielding better
results across all metrics. Indeed, as shown in Table 2, results appear to improve overall as the number
of negative sentences in training increases, likely due to the increase in total number of examples. Only
in using all negative examples as per majority annotation does performance decrease with respect to</p>
        <p>model
paraphrase-MiniLM-L12-v2
paraphrase-MiniLM-L6-v2
all-MiniLM-L6-v2-simcse</p>
        <p>tfidf sgd</p>
        <p>R-P
0.738
0.590
0.595
0.552
the highest controlled ratio. In light of this, the number of negative sentences was not controlled during
the training of models for submission.</p>
        <p>Model selection was done by performing grid search on the choice of sentence encoder and depth of
the feed-forward classifier, using a 40% validation set. The sentence encoders evaluated were several
variants and sizes of Mini-LM, namely the variants trained on paraphrasing as well as the default,
all-task variants [9]. The number of hidden layers test varied from one to three. Models were ranked by
their average z-score across metrics with respect to other models [10]. As a baseline classification-based
approach, we used term frequency representations with a logistic regression model.</p>
      </sec>
      <sec id="sec-2-3">
        <title>2.3. Results</title>
        <p>Results on the test set are shown in Tables 3 and 4. Our transformer-based approaches outperformed the
baselines overall and performed consistently with validation results. However, they were outperformed
by top participating runs across all metrics, especially in r-precision. Whether these diferences are
due to reduced capacity (the only parameters are those of the classifier) or the premise of the approach
is dificult to establish without further experimentation. Within our transformer-based approaches,
the largest model (paraphrase MiniLM with 12 layers) obtained the best results overall. No marked
diference was observed between the two smaller models that difer only in their pretraining task.</p>
        <p>model</p>
      </sec>
    </sec>
    <sec id="sec-3">
      <title>3. Task 3: Measuring the severity of the signs of eating disorders</title>
      <sec id="sec-3-1">
        <title>3.1. Task and Data</title>
        <p>The third task of eRisk 2024 consists in measuring the severity of the signs of eating disorders. These
signs are selected questions coming from the Eating Disorder Examination Questionnaire (EDE-Q) [7],
a list of 22 questions of a scale from 0 to 6 included. These questions are grouped into four subscales
concerning diferent aspects of eating disorders : restraint and eating, shape and weight concern. Scores
for each question are averaged to obtain a score for each subscale, which are in turn used to compute a
global score. Thus, the goal of task 3 is to predict the severity of eating disorder symptoms by forecasting
the responses to the EDE-Q questionnaire from users.</p>
        <p>The dataset matches partial histories of writings of Reddit users to their set of answers to the EDE-Q.
The data for each user contains an id and a list of posts they made. The number of posts per user can
vary. Each post contains a title and a body holding the content from the post. Notice that a post without
title specified will be considered as a response. The combination of the data from 2022 and 2023 was
used as training data, for a total of 74 examples. The test set contained 18 examples.</p>
        <p>Models were evaluated using eight diferent metrics based on proximity to the true answers given by
a subject to the EDE-Q. The first three evaluation metrics are based on the scores of all the questions
from the psychometric scale independently. The five following metrics are concerned with the error
in total scores resulting from the answers provided by the model, with possible focus on particular
subscales. These metrics are presented below:</p>
        <p>Mean Zero-One Error (MZOE): Calculate the error rate between the questionnaire filled by the
user and predicted by the system.</p>
        <p>(, ) = |{ ∈  : () ̸=  ()}|
||
Where  represent the classifier,  the set of question from the questionnaire and the function (i)
the real user answers from the question -th. If a predicted answer form the system doesn’t match with
the real answer, the value will be equal to 1, and 0 otherwise. Mean Absolute Error (MAE): Calculate
the deviation between the questionnaire filled by the user and predicted by the system.
 (, ) =
∑︀∈ |() −  ()|
||
Instead of a binary evaluation, the metric calculate the discrete diference between the system and the
real user answers. Knowing that the response can go from 0 included to 6 included.</p>
        <p>Macroaveraged Mean Absolute Error (MAEmacro): Calculate the deviation between the
questionnaire filled by the user and predicted by the system.</p>
        <p>6 ∑︀∈ |() −  ()|
 macro(, ) = 71 ∑︁
=0
| |
Similarly to the MAE metric, MAEmacro calculates the deviation by grouping the questions with the
same answer together.</p>
        <p>Restraint Subscale (RS): calculates the mean response of the question from the restraint subscale
only. The mean is calculated between the questionnaire filled by the user and predicted by the system.
 (,  ) =
√︃ ∑︀∈ (() − ())2
| |
where  represent the set of question relative to the specific subscale from the questionnaire. ()
represent the estimated restraint subscale RS score and () the real one.</p>
        <p>Eating Concern Subscale (ECS): calculates the mean response of the question from the eating
concern subscale only.</p>
        <p>(,  ) =
√︃ ∑︀∈ (() − ())2
| |
where () represent the estimated eating concern subscale ECS score and () the real one.</p>
        <p>Shape Concern Subscale (SCS): calculates the mean response of the question from the shape
concern subscale only.</p>
        <p>(,  ) =</p>
        <p>√︃ ∑︀∈ (() − ())2
where () represent the estimated shape concern subscale SCS score and () the real one.</p>
        <p>Weight Concern Subscale (WCS): calculates the mean response of the question from the weight
concern subscale only.</p>
        <p>(,  ) =</p>
        <p>√︃ ∑︀∈ ( () −  ())2
where  () represent the estimated weight concern subscale WCS score and  () the real
one.</p>
        <p>Global ED (GED): Finally the global score is calculated by making the mean of all the subscale.
 (,  ) =
√︃ ∑︀∈ (() − ())2
| |
| |
| |</p>
      </sec>
      <sec id="sec-3-2">
        <title>3.2. Approaches and Training</title>
        <p>3.2.1. Past work
Task 3 is in its third iteration, having taken place in 2022 and 2023. However, only participants to
the 2023 iteration had accessed to labeled data, with 2022 participants having to propose completely
unsupervised approaches. Thus, we examine the approaches proposed in 2023 [8]. It should be noted
that the approach proposed by GMU-FAST is omitted from this treatment, as a detailed methodology is
not available.</p>
        <p>BFH-AMI used first the GPT-2 [ 11] model to embed the questions from the psychometric scale EDE-Q
and the content of the users post, then used this embedding to do the prediction with a logistic regression
model.</p>
        <p>UMU used manual prepossessing techniques removing contractions, mentions, hashtags, URLs, and
AMP expressions. Additionally, they used emoji extraction on the data. Finally they fine-tuned the
model multi-qa-mpnet-base-dot-v1 which is based on MPNet to achieve their result.
Finally RiskBusters used a topic-driven approach in order to solve the task. By using BERTopic [12]
framework to extract a list of topics from the user’s posts and supported by a domain-adapted model
MentalBERT [13], RiskBusters achieved the best performance, GMU-FAST notwithstanding.</p>
        <sec id="sec-3-2-1">
          <title>3.2.2. Challenges</title>
          <p>There are two main challenges that persist in Task 3 of eRisk. The first one is the complexity of the
expected output. Indeed, the objective of this task is to predict with an automated system the answers
form the questionnaire EDE-Q, i.e. predict 22 questions with answers ranging from 0 to 6. Making these
predictions jointly complexifies the model and sparsifies the available data. In contrast, treating the
prediction of each question as an independent task ignores the interactions between them.</p>
          <p>Another challenge in this task is the small amount of data: 74 labelled examples. This limitation
increases the dificulty to have a robust system. Moreover, the sum of posts for some users can be low
and not relevant for the process. Thus, throughout this project, it will be important to address these
two main challenges in addition to any others that may arise.
3.2.3. Design
In order to address these challenges, our approach leverages the structure of the EDE-Q. Indeed, our
approach avoids directly predicting all items jointly, by predicting more global scores over several steps:
1. Predict global score: the total score resulting from the entire set of answers is predicted from
the input writing histories.
2. Predict subscale scores: the aggregate scores for each subscale is predicted jointly from the
input as well as the total predicted global score
3. Predict answers to questions : Finally, the last stage aims to predict the answer for each
question based on the input and the aggregate predictions of the previous steps.</p>
          <p>By proceeding in this manner, we created a dependence between each question. The final score of a
question will not only depend on the user’s posts but also on stage 1, which estimates whether the user
shows signs of an eating disorder, and stage 2, which estimates the concern score for the question.</p>
          <p>Further, the global score of the EDE-Q, which ranges between 0 and 6, can be compared against
a threshold of 3, which indicates pathological severity. Extending this threshold to subscales and
questions, each stage of prediction can be transformed into a binary classification task. A priori, this
transformation can be applied independently to each stage. To produce answers from classification
models, equal-width probability strata are used.</p>
        </sec>
        <sec id="sec-3-2-2">
          <title>3.2.4. Detailed Model</title>
          <p>Given the variable size of writing histories, an appropriate representation needs to be built to feed into
the model. We decided to use BERTopic [12] to extract topics from each user and use these topics as
features for prediction.</p>
          <p>Once the list of topics is found for each user, we selected the 16 topics with the most correlation with
signs of eating disorder. In order to know which topics are the most important, a random forest was
trained, and the most salient features were selected.</p>
          <p>Prediction models were feed-forward neural networks taking as input topic probabilities as well as
the applicable broaded score prediction. Several combinations of stage approaches (classification or
regression) were tested in validation. Further, sharing layers between stages was also evaluated.</p>
        </sec>
      </sec>
      <sec id="sec-3-3">
        <title>3.3. Results</title>
        <p>Five runs have been submitted for the evaluation. For the two first runs, all the stages have been framed
as classification. The second run uses a shared encoder between these tasks, whereas the first one and
all the other runs have separate encoders. The third run uses classification for the first two stages and
regression for its last stage, and the run 4 only has been trained as a regression matter.</p>
        <p>Results on the test are shown in Table 5. The scores obtained from the 5 runs indicate that the model
trained with classification generally achieved the lowest errors globally. Notably, run 3 also produced
low results, particularly in the MZOE and ECS metrics.</p>
        <p>However, run 1 shows the best result in the WCS metric. Additionally, when compared to the baseline
results, the model scores are consistently higher.</p>
        <p>Overall, the performance of the model requires significant improvement in the independent questions
areas. Despite this, the model shows encouraging results with the WCS metric, indicating competitive
performance in this specific area.</p>
      </sec>
    </sec>
    <sec id="sec-4">
      <title>4. Conclusion</title>
      <p>Our participation in eRisk 2024 was centered around self-report questionnaires. In T1, the goal was to
mine sentences relevant to each item in the Beck Depression Inventory from a pool of sentences from
social media. Our approach made use of ground-truth relevance judgments to train neural classifiers to
predict the relevance of sentences to items in a multi-label setup. This approach obtained consistent
results in validation and testing that were ultimately weaker than other approaches proposed in the
shared task. Future work could involve combining both unsupervised, similarity-based methods of
ranking with supervised means.</p>
      <p>In contrast, T3 requires to fill out a standard eating disorder severity questionnaire, EDE-Q, based on
partial histories of writings of social media users. Given the complexity of prediction and limited access
to annotated data, our approach used staggered models with increasingly specific predictions, starting
with global score prediction and ending with specific answer prediction. This approach yielded modest
results, outperforming shared task baselines but remaining shy of leading approaches. However, we
sustain the core principle of our approach as a sound means to leverage the structure built into the
design of the questionnaire. There is vast room for improvement within this approach, from exploring
diferent writing history representations to improving model calibration when applying a classification
transformation.</p>
    </sec>
    <sec id="sec-5">
      <title>Acknowledgments</title>
      <p>The authors thank Sublime Tshimpangila, Jessica Dawson and Matthew Curtis for the fruitful discussions.
Ayed Naber, Benjamin Chinnery, Michael Breau, Mohamed Aly, Rylan Sykes, Shrill Patel, Yaruo Tian,
Yili Liu are also thanked for their interest in the RELAI team’s work. This research was enabled in part
by support provided by Calcul Québec and the Digital Research Alliance of Canada. We acknowledge
the support of the Natural Sciences and Engineering Research Council of Canada (NSERC) [MJ Meurs,
NSERC Grant number 06487-2017].
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