The way children talk about stressful or difficult events can predict future mental health struggles, according to a new study.
Researchers at Stanford University found that how a child speaks about stressful or difficult events is more predictive of future mental health risks than the content of what they say.
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Exposure to early life stress is a major public health challenge, accounting for up to one-third of adult psychiatric diagnoses worldwide, the authors noted, adding that there is a lack of tools to identify who is most vulnerable.
“This study provides a robust proof of concept for the development of scalable tools that identify markers of risk before individuals are diagnosed,” said Chase Antonacci, the study’s lead author at Stanford’s School of Humanities and Sciences.
Adolescence is when depression and anxiety most often emerge, and once these disorders take hold, they are notoriously difficult to treat, Antonacci noted.
The authors noted that not every child who experiences adverse events in early life will develop mental and behavioural disorders, and many may even show resilience.
This variability creates a significant ‘prediction gap’, making it difficult to identify who is on a maladaptive trajectory, they wrote.
Researchers interviewed over 200 children, aged nine to 13, about stressful experiences. Using AI language analysis tools, they were able to predict which children would go on to develop problems like anxiety and depression, based simply on the language they used.
The study identified some tell-tale signs in the speech that were associated with a higher risk of mental struggles later in life.
For example, higher use of prepositions, indicating greater narrative complexity, was a major predictor of future internalising problems.
Another risk-associated style included "certitude", or absolute language, words such as “always” or “never”.
In contrast, a style that included greater use of third-person pronouns —she, her, he, him, they, which indicates a focus on others and the external world rather than just the self — was tied to a lower risk.
Content versus style
The researchers also looked at the content of the children’s narratives and found that while it was not as effective as the style in predicting the onset of clinical conditions, it was effective at predicting symptom severity.
Narratives focused on conflict, distress, and fear, using words like "fighting," "scary," and "attacked", were found to be risk-associated themes. They included raw descriptions of physical violence, acute social exclusion and high emotional arousal, such as screaming.
By contrast, narratives focused on positive activities and hobbies, using words like "playing", "football" and "dog", were linked to a lower risk — as were emotionally neutral descriptions of structured, routine contexts and direct mentions of mental healthcare.
The authors found that what the participants said revealed the specific details of the stressor or the child's life, while how they said it, the style, showed how they organise and frame those experiences.
Speech is inexpensive and scalable, said Ian Gotlib, the study's senior author. "It's easy, it's accessible, and it may be a stronger predictor of the development of problems than any of these other factors alone."
