Nikzad Amir H, Lysaker Paul H, Minor Kyle S, Leonhardt Bethany, Liberman Mark Y, Vohs Jenifer, Wiesepape Courtney N, Tang Sunny X
Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA.
Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York.
Early Interv Psychiatry. 2025 Jan;19(1):e13628. doi: 10.1111/eip.13628. Epub 2024 Nov 21.
Metacognitive Reflection and Insight Therapy (MERIT) is a form of person-centred psychotherapy that promotes recovery-oriented outcomes by targeting metacognitive capacity. Previous research has shown the feasibility and clinical benefits of MERIT. However, it is not clear whether and how the specific processes targeted by MERIT (e.g., improved sense of agency, self-reflectivity, awareness of others, etc.) are manifested in the patient-therapist communications. In this study, we used natural language processing (NLP) to explore objective linguistic markers of change during MERIT for early psychosis.
Five patients underwent 24 sessions each of MERIT, which were recorded and transcribed verbatim. The transcripts underwent NLP to determine the patterns of pronoun use and the frequency of semantic categories related to temporality and mental processing. Mixed linear regressions were used to examine how NLP features evolve over the course of psychotherapeutic sessions.
Analyses detected shifts in specific language signals over time including (1) changes in patterns of pronoun usage with more active and central first-person plural pronoun (We); (2) transition in temporal focus of speech from past-focus towards present- and future-focus and (3) increased words representing perceptual and cognitive processes.
Our findings suggest NLP can objectively quantify meaningful signals consistent with expected subjective changes in MERIT and potentially other psychotherapeutic interventions.
元认知反思与洞察疗法（MERIT）是一种以患者为中心的心理治疗形式，通过针对元认知能力来促进以康复为导向的结果。先前的研究已经表明了MERIT的可行性和临床益处。然而，尚不清楚MERIT所针对的具体过程（例如，行动感增强、自我反思性、对他人的意识等）是否以及如何在患者与治疗师的交流中体现出来。在本研究中，我们使用自然语言处理（NLP）来探索MERIT治疗早期精神病过程中变化的客观语言标记。
五名患者每人接受了24次MERIT治疗，治疗过程进行了录音并逐字转录。对转录文本进行NLP分析，以确定代词使用模式以及与时间性和心理加工相关的语义类别频率。使用混合线性回归来检验NLP特征在心理治疗过程中的演变情况。
分析检测到特定语言信号随时间的变化，包括：（1）代词使用模式的变化，第一人称复数代词（我们）使用更加活跃且处于中心位置；（2）言语的时间焦点从过去焦点向现在和未来焦点的转变；（3）代表感知和认知过程的词汇增加。
我们的研究结果表明，NLP可以客观地量化与MERIT以及可能的其他心理治疗干预中预期的主观变化相一致的有意义信号。
