Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States.
ALACRITY Center, University of Washington, Seattle, WA, United States.
J Med Internet Res. 2021 May 6;23(5):e27918. doi: 10.2196/27918.
Despite decades of research to better understand suicide risk and to develop detection and prevention methods, suicide is still one of the leading causes of death globally. While large-scale studies using real-world evidence from electronic health records can identify who is at risk, they have not been successful at pinpointing when someone is at risk. Personalized social media and online search history data, by contrast, could provide an ongoing real-world datastream revealing internal thoughts and personal states of mind.
We conducted this study to determine the feasibility and acceptability of using personalized online information-seeking behavior in the identification of risk for suicide attempts.
This was a cohort survey study to assess attitudes of participants with a prior suicide attempt about using web search data for suicide prevention purposes, dates of lifetime suicide attempts, and an optional one-time download of their past web searches on Google. The study was conducted at the University of Washington School of Medicine Psychiatry Research Offices. The main outcomes were participants' opinions on internet search data for suicide prediction and intervention and any potential change in online information-seeking behavior proximal to a suicide attempt. Individualized nonparametric association analysis was used to assess the magnitude of difference in web search data features derived from time periods proximal (7, 15, 30, and 60 days) to the suicide attempts versus the typical (baseline) search behavior of participants.
A total of 62 participants who had attempted suicide in the past agreed to participate in the study. Internet search activity varied from person to person (median 2-24 searches per day). Changes in online search behavior proximal to suicide attempts were evident up to 60 days before attempt. For a subset of attempts (7/30, 23%) search features showed associations from 2 months to a week before the attempt. The top 3 search constructs associated with attempts were online searching patterns (9/30 attempts, 30%), semantic relatedness of search queries to suicide methods (7/30 attempts, 23%), and anger (7/30 attempts, 23%). Participants (40/59, 68%) indicated that use of this personalized web search data for prevention purposes was acceptable with noninvasive potential interventions such as connection to a real person (eg, friend, family member, or counselor); however, concerns were raised about detection accuracy, privacy, and the potential for overly invasive intervention.
Changes in online search behavior may be a useful and acceptable means of detecting suicide risk. Personalized analysis of online information-seeking behavior showed notable changes in search behavior and search terms that are tied to early warning signs of suicide and are evident 2 months to 7 days before a suicide attempt.
尽管几十年来一直在研究自杀风险，以开发检测和预防方法，但自杀仍然是全球主要的死亡原因之一。虽然使用电子健康记录中的真实世界证据进行的大规模研究可以确定哪些人有风险，但它们并不能准确确定某人何时有风险。相比之下，个性化的社交媒体和在线搜索历史数据可以提供一个持续的真实世界数据流，揭示内部想法和个人心理状态。
我们进行这项研究是为了确定使用个性化在线信息搜索行为来识别自杀企图风险的可行性和可接受性。
这是一项队列调查研究，旨在评估有自杀未遂史的参与者对使用网络搜索数据进行自杀预防目的的态度、一生中自杀尝试的日期以及可选的一次性下载他们过去在谷歌上的搜索记录。该研究在华盛顿大学医学院精神病学研究办公室进行。主要结果是参与者对互联网搜索数据进行自杀预测和干预的看法，以及在自杀企图发生前的近期是否存在任何在线信息搜索行为的变化。使用非参数关联分析来评估从自杀尝试前 7、15、30 和 60 天（近端）到参与者典型（基线）搜索行为的时间段内，源自网络搜索数据特征的差异幅度。
共有 62 名过去曾试图自杀的参与者同意参与研究。个人的互联网搜索活动各不相同（中位数每天 2-24 次搜索）。在自杀尝试前的 60 天内，就可以明显看出在线搜索行为的变化。对于部分尝试（7/30，23%），从尝试前 2 个月到 1 周内就显示出与搜索特征的关联。与尝试相关的前 3 个搜索结构是在线搜索模式（9/30 次尝试，30%）、搜索查询与自杀方法的语义相关性（7/30 次尝试，23%）和愤怒（7/30 次尝试，23%）。40/59 名参与者（68%）表示，使用这种个性化的网络搜索数据进行预防目的是可以接受的，并且可以进行非侵入性的潜在干预，例如与真实的人（例如朋友、家人或顾问）联系；但是，对检测准确性、隐私性和过度侵入性干预的可能性表示担忧。
在线搜索行为的变化可能是一种有用且可接受的检测自杀风险的方法。个性化分析在线信息搜索行为显示，搜索行为和搜索词发生了显著变化，这些变化与自杀的预警信号有关，并且在自杀企图前 2 个月到 7 天内就已经明显。
