Analysis of Weekly Narratives Using Natural Language Processing in Patients Undergoing Residential Rehabilitation: A Hybrid Approach for the Dynamic Assessment of Clinical Processes
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 35
- 试验地点
- 1
- 主要终点
- Change in negative automatic thoughts measured by the Automatic Thoughts Questionnaire 8-item version
研究概览
简要总结
This prospective observational study follows adults undergoing residential rehabilitation for severe substance use disorders at a specialized treatment center in Mexico. Participants provide weekly written narratives describing their emotions, challenges, coping strategies, and treatment experiences, and complete validated psychological questionnaires every two weeks, including the Generalized Anxiety Disorder-7 (GAD-7), Environmental Reward Observation Scale (EROS), Automatic Thoughts Questionnaire-8 (ATQ-8), and Behavioral Activation for Depression Scale (BADS).
The study applies natural language processing (NLP) and machine learning methods to analyze participants' narratives and identify emotional, cognitive, and behavioral patterns associated with clinical change over time. Narrative-derived features are combined with questionnaire scores to generate a dynamic clinical risk representation that may help detect early signs of psychological worsening or improvement during residential treatment.
Participants continue receiving standard residential care, and the study does not modify treatment decisions or clinical interventions. Up to 35 participants with sufficient longitudinal follow-up data will be included in the primary analysis. Data collection is expected to continue through September 2026.
详细描述
Patients undergoing treatment for substance use disorders frequently describe changes in mood, motivation, hopelessness, cognitive rigidity, emotional distress, and coping strategies through spontaneous written language. These narratives may contain clinically meaningful indicators associated with psychological deterioration, treatment progress, or relapse vulnerability. However, systematic manual analysis of longitudinal written narratives is difficult to implement in routine clinical practice because of the volume and complexity of the data.
Recent developments in natural language processing (NLP), representation learning, and deep learning provide methods for extracting quantitative linguistic and semantic information from written text. Integrating these features with repeated psychometric assessments may support the development of longitudinal models capable of characterizing changes in mental health status over time in patients receiving residential addiction treatment.
Objectives
The objectives of this study are:
To extract semantic, emotional, and linguistic features from weekly patient narratives using NLP methods, including sentence embeddings, sentiment and emotion classification, and semantic similarity analyses based on Acceptance and Commitment Therapy (ACT) constructs.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- Male
- 接受健康志愿者
- 否
入选标准
- •Clinical diagnosis of severe substance use disorder (polydrug use, including cocaine, methamphetamines, alcohol, and/or cannabis), confirmed by the center's admission assessment.
- •Male sex (all participants in the center's residential program are male).
- •Age 18 years or older.
- •Current resident of the participating residential rehabilitation center in Mexico.
- •Completed at least four weeks of residential treatment at the time of study enrollment.
- •Able to write coherent weekly narratives in Spanish (no severe cognitive impairment or active psychosis).
- •Willing to provide written informed consent.
排除标准
- •Presence of acute psychotic symptoms that interfere with the ability to write or understand the study procedures.
- •Severe cognitive impairment (e.g., due to traumatic brain injury, intellectual disability) that prevents meaningful narrative production.
- •Inability to comply with weekly narrative writing (e.g., illiteracy, severe visual impairment).
- •Planned discharge from the residential program within less than 4 weeks from enrollment.
- •Enrollment in another interventional clinical trial that could confound the interpretation of outcomes.
研究组 & 干预措施
Residential rehabilitation cohort
Adult men (≥18 years) with severe substance use disorder, admitted to a residential rehabilitation center in Mexico. All participants receive the center's standard, multimodal treatment program, which includes group therapy, individual counseling, occupational activities, 12-step facilitation, and relapse prevention education. The study does not assign, modify, or withhold any component of this program. Participants are followed prospectively for the duration of their stay (10-20 weeks).
干预措施: Residential rehabilitation as usual (Other)
结局指标
主要结局
Change in negative automatic thoughts measured by the Automatic Thoughts Questionnaire 8-item version
时间窗: Every 2 weeks from baseline until discharge from residential treatment (up to 20 weeks)
The Automatic Thoughts Questionnaire 8-item version is administered every two weeks. Total scores range from 8 to 40, with higher scores indicating more frequent negative automatic thoughts. The primary outcome is the change from baseline in total score over the course of residential treatment.
次要结局
- Change in generalized anxiety symptoms measured by the Generalized Anxiety Disorder 7 item scale(Every 2 weeks from baseline until discharge (up to 20 weeks))
- Change in environmental reward measured by the Environmental Reward Observation Scale(Every 2 weeks from baseline until discharge (up to 20 weeks))
- Change in behavioral activation and avoidance measured by the Behavioral Activation for Depression Scale(Every 2 weeks from baseline until discharge (up to 20 weeks))
- Weekly self-reported emotional intensity(Weekly from baseline until discharge (up to 20 weeks))
- Weekly self-reported craving intensity(Weekly from baseline until discharge (up to 20 weeks))
研究者
Lauro Gutiérrez Castro
Principal Investigator
Under The Tree Therapeutic Community