Anxiety support in an online forum

Anxiety is a growing, worldwide phenomenon. The World Health Organization estimates that there are 264 million people living with anxiety disorders, which are characterised by excessive fear and behavioural disturbances, and which include specific phobias, panic disorder, social anxiety disorder and generalized anxiety disorder. In this project, we investigate an online forum dedicated to providing anxiety support and hosted by Health Unlocked: the world’s largest social network for health (https://healthunlocked.com/). Like many online forums, Health Unlocked offers users a space to get the informational and emotional support they seek in relation to a range of health-related topics. By examining the contributions and interactions of the Anxiety Support forum, we set out to better understand the lived experiences of those with anxiety, including the coping strategies they adopt to mitigate the impact of anxiety disorders.

Our data comprises approximately 21 million words of text posted to the Anxiety Support forum between March 2012 and October 2020. We are using corpus-based methods to analyse this data with respect to the following areas:

Sketching Anxiety: Our analysis begins with a focus on the word anxiety, using the corpus analysis tool Sketch Engine to provide a detailed ‘Word Sketch’ of its use in the forum, e.g. looking at its occurrence in different grammatical patterns. In demonstrating how anxiety is discursively constructed, we aim to show how users perceive anxiety disorders and how they talk about strategies for coping with anxiety. We also compare anxiety to related terms such as depression, fear, panic and stress to investigate how users of the forum relate these aspects of their mental health and how they differentiate between these often co-occurring experiences.

The Lived Experience: Research has shown that the stories people tell about their illness experiences “restore a coherent self by providing a meaningful explanation for a being in the world burdened by illness” (Kleinmann, 1988, p.48). We will investigate the narratives provided by contributors to the forum as a way of understanding how anxiety operates in the context of users’ lives and how the forum functions for participants to share their stories.

Creating a Community: Online forums provide invaluable opportunities to engage with other people’s experiences in a way that facilitates relatability and empathy, ultimately fostering solidarity and a community that extends beyond geographical barriers. Our work will investigate the affordances of the online platform by looking at the ways that participants respond to each other’s posts and how users elicit informational and emotional support from others in the forum. Focusing more on interactional aspects of the forum, we consider how users reach consensus and deal with conflict, establishing the conventions for the nature and manner in which participants support each other.

Sex and gender: Diagnoses of anxiety disorders are more common among females than males (4.6% compared to 2.6% at the global level) (World Health Organization, 2017). However, researchers argue that prevalence of anxiety among men is comparable to women and that normative gender ideologies affect how individuals talk about and seek help for experiences of anxiety (Gough et al. 2021). We will explore the forum both in relation to how posts made by female and male users compare in fulfilling particular kinds of support roles, as well as how participants refer to gender stereotypes, that shape their experiences of anxiety, including how and where they find support.

Comparing cultures: The Anxiety Support forum includes contributions from participants around the globe, with 38.84% of posts made by people from the UK and 33.94% made by those from the USA. Our analysis will include a comparison of contributions from the US and the UK, highlighting cultural differences in the way that anxiety is understood (in addition to spelling (favorite) and lexical choices (vacation)). This investigation will help to highlight how the respective health services of these countries shape users’ experiences of anxiety and their interactions with support services.

Changing Times: Our corpus contains posts made over an 8-year period, offering us the opportunity to look at how language has changed over the time, focussing on changes in how anxiety discourses are conceptualised (e.g. increasingly medicalised). Research has also shown that national and global events lead to increases in the prevalence of anxiety disorders. We can, for instance, examine the impact of Brexit on how users from the UK use the forum, or how participants discuss the impacts of the Covid-19 pandemic. The timespan of the data also enables us to investigate how posting behaviour ‘evolves’ over time. As an online community, we can see how more established contributors demonstrate their expertise and negotiate the communicative practices of the forum with newer participants. The diachronic nature of the forum will also help us to understand how we can support various stakeholders in living well with anxiety.

The project will run for 2 years and through our findings, we aim to demonstrate how important online spaces like the Anxiety Support forum are for individuals experiencing mental health issues, as well as to researchers who are interested in understanding lived experiences of health and illness.

Team

Professor Paul Baker (Principal Investigator)
Dr Luke Collins (Senior Research Associate)

References

Kleinman, A. M. (1988). The Illness Narratives: Suffering, Healing, and the Human Condition. New York: Basic Books.

World Health Organization (2017). Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization. Licence: CC BY-NC-SA.

Fully Funded PhD Studentship in Linguistics at Lancaster University

The Department of Linguistics and English Language at Lancaster University, UK is delighted to offer a fully funded PhD studentship (UK home-rate fee) as part of the UKRI-funded project, ‘Public Discourses of Dementia: Challenging Stigma and Promoting Personhood’, starting in January 2022.

The aim of this project is to challenge dementia stigma by changing the ways in which dementia is discussed in the public domain, focusing in particular on the mainstream media, public health bodies and charities in the UK. This project will explore the language and imagery that are used to represent dementia in texts produced by these organisations and compare these against those used by the general public to talk about dementia on social media and by people living with dementia when giving first-hand accounts of their lives with the syndrome. The project team will work closely with media, public health and charity organisations to implement changes to communicative practices around dementia in ways that challenge stigma and promote personhood, through the development of communication guidelines and the delivery of training to public communicators from charities, the media, research and public health. Crucially, the project team will collaborate closely with people with dementia themselves to ensure that their voices are heard and valued not only in future public discourse but also in the research process itself. The Project team will be led by Dr Gavin Brookes and supported by Professor Tony McEnery. The project will also be supported by an externally based academic advisory committee. You can read more about the project here: https://www.lancaster.ac.uk/news/new-research-fellowship-team-to-examine-language-about-dementia.

We are seeking to recruit a strong and enthusiastic PhD candidate with demonstrable knowledge and interest in at least two of the following areas: corpus linguistics; multimodal (visual) discourse analysis; health communication. The successful candidate should hold a Master’s degree in linguistics or a related area. However, clearly outstanding and particularly well-suited candidates who have completed a first degree will be considered. Candidates may be invited to interview (dates and format to be confirmed).

This studentship is open to students eligible for UK Home fees only (for more information, see: https://www.lancaster.ac.uk/study/postgraduate/postgraduate-courses/research-fees/).

If you are interested in this opportunity, by way of application please email Gavin Brookes (g.brookes@lancaster.ac.uk) with the following:

  • A short CV (max 2 pages) outlining your qualifications, achievements and publications (if applicable)
  • A personal statement describing your suitability to the project (focusing in particular on your knowledge and skills, including relating to methodological approaches) (max. 500 words)
  • An example of your writing (either an assignment or chapter from a dissertation)

Start date: 1 January 2022 (or as soon as possible thereafter)

Duration: 3 years

Application deadline: 31st October 2021

Funding information: A stipend of £15,609 for 21/22, which will increase each year in line with the UK Research and Innovation (UKRI) rate, plus Home-rate fee allowance of £4,500 (with automatic increase to UKRI rate each year). The successful candidate will also have access to a generous training and conference budget.

William Dance – Introductory Blog

My name is William Dance and I’m one of two new Senior Research Associates in CASS.

I’m currently finishing my PhD in the linguistics department here and my main research interests are corpus approaches to deception and manipulation, using methods like (critical) discourse analysis to study online disinformation (better known as ‘fake news’).

I’m working alongside Tara Coltman-Patel on the new ESRC-funded ‘Questioning Vaccination Discourse’ Project (or Quo VaDis – Latin for ‘Where are you going?’). Alongside collaborators from Public Health England, UCL, and University of Leeds, the project looks at how the public, press, and policymakers speak and write about vaccinations both online and offline. The goal of the project (which believe it or not was submitted before the COVID-19 pandemic!) is to get a better understanding of how pro- and anti-vaccination views spread online, as well as how the vaccine uncertain people in the middle express their views.

I’ve found myself over the last few years researching topics just as they seem to gain global attention. I started researching disinformation during my Masters just as Donald Trump was elected president and “fake news” become a hot topic. Similarly, I joined the Quo VaDis just as a global pandemic began and vaccination became more important than ever before.

My research into disinformation has given me some amazing opportunities over the past few years. I’ve had the fortune to do things like present my research to parliamentarians, second to Whitehall for three months, and work with over 50 news organisations and state broadcasters to disseminate my research and help inform the public about online deception. This kind of external engagement is a theme throughout all of my work and I always try to reach out to communities outside of academia whenever I can. I also run a blog which you can find here.

Disinformation is a wide-reaching topic and my research on this has mainly focused on areas such as social media users’ motivations for sharing disinformation, analysing hostile-state information operations (HSIOs), with future publications focusing on exploring algorithmic disinformation and the spread of online disinformation.

Outside of work, one of my favourite hobbies is baking. This is something I do most evenings and weekends as I enjoy planning and writing recipes, and then baking things for friends and family (although I enjoy the washing up a lot less…). I’ve been baking and cooking pretty much since I could walk as I was taught to cook from a young age. You can see some of my creations here but my favourite thing to bake is bread.

I think the best way to end this introduction is just to say how much I’m looking forward to what the Quo VaDis project, and working in CASS in general, has to offer. I’m grateful to be working in the one of the best corpus research centres in the world and I can’t wait to see what the next three years brings.

Tara Coltman-Patel – Introductory Blog

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My name is Tara Coltman-Patel and I am so excited to be a new member of CASS.

I am working as one of the Senior Research Associates on the ESRC-funded Quo VaDis project: Questioning Vaccination Discourse: A Corpus-Based Study project, which explores discussions about vaccinations in UK parliamentary debates, UK national newspapers and on the social media sites, Twitter, Reddit and Mumsnet. Using a variety of corpus tools and techniques, we will aim to gain a better understanding of the wide spectrum of pro-, anti- and undecided views surrounding vaccinations. Analysing how vaccinations are discussed across a variety of contexts, how the different views are communicated, and how people with different views interact, particularly on social media, will be an invaluable tool for addressing vaccine hesitancy. With our results we aim to inform, facilitate and help design future public health campaigns about vaccinations. As vaccinations are a salient topic, especially given the time we are currently living through, I am extremely grateful to have the opportunity to work on this research.

Before joining CASS I was working at Nottingham Trent University, where I recently finished my PhD which focussed on weight stigma and the representation of obesity in the British Press. In doing so I explored how metaphors can sensationalise and dehumanise people with obesity, I explored how science is recontextualised and misrepresented, and I explored the linguistic strategies of representation used in personal stories about weight loss. I am currently in the process of turning that research into a book titled ‘(Mis)Representing Obesity in the Press: Fear, Divisiveness, Shame and Stigma’, which will hopefully be published towards the end of 2022. Weight discrimination is a topic I am incredibly passionate about and in addition to research I have also worked as an anti-weight discrimination advocate and have consulted on global campaigns with the World Obesity Federation.

Outside of research I am a massive book worm and I love to read, I’m obsessed with RuPaul’s Drag Race and I’m also a sucker for a nice beer garden. Before Covid I loved to travel and have backpacked around Australia, Thailand, The Philippines, Mauritius and South Africa. I have some amazing and memorable moments from those trips, from bad ones like falling off a (small) cliff in Mauritius and being bitten on my hand by a spider in Australia, to incredible ones like canyoneering in The Philippines and swimming with sharks in Australia and South Africa. Sharks are my favourite animal and I have a plethora of fun facts about them ready to share at any given moment, so you definitely won’t regret inviting me to parties …

To conclude, I’m really thrilled to be a part of CASS and the Quo VaDis project, and as I have run out of interesting things to say about myself, I’ll end this blog post here.

New CASS project: Feedback on NHS Cancer services

 In recent months, CASS members Paul Baker  and Gavin Brookes  have embarked on a project working with the National Health Service (NHS), using corpus linguistics methods to investigate patient concerns in a large corpus (approx. 14 million words) of patient feedback on NHS cancer care. Below we discuss what the project will entail.

If this project sounds familiar, it is because we carried out a similar project four years ago, also using corpus techniques to examine NHS patient feedback more generally (you can read about this work in this book and this journal article in BMJ Open).

This latest project was made possible with ESRC funding (£84,006 FEC) and involves collaboration between CASS and NHS England who provided us with electronic versions of approximately 200,000 patient questionnaires given annually to all patients who receive treatment for cancer in England. We have been given access to four years of data (2015-2018) which has been mounted on Lancaster University’s online corpus analysis system CQPWeb.

We will be using and refining some of the techniques we developed in that earlier work to explore, for example, what kinds of concerns drive patients’ evaluations, how patients’ priorities change throughout the duration of their care, and what types of concerns patients regard as being most urgent. This set of comments differs from that which we analysed previously in an important respect; specifically, we have access to metadata regarding patients’ age, ethnicity, sex and sexuality, as well the type of cancer they received treatment for and the hospital they attended. Therefore, our analysis will also explore what impacts these variables are likely to have on patients’ expectations and how that impacts on the language they use when talking about and evaluating NHS services.

Another important difference between this project and the last one is that we will be able to draw on the expertise of Professor Sheila Payne – an expert in palliative and end of life care who has also been involved in other CASS projects in the past (e.g. Metaphor in End of Life Care (MELC).  Sheila’s insight will help to guide the aims of the project and to ensure that these are relevant and of value to the NHS, while her expertise will be key to interpreting the significance of our findings.

Representations of Obesity in the News: Project update and book announcement!

Gavin Brookes and Paul Baker

We are delighted to announce the forthcoming publication of a book based on research carried out as part of the CASS project, ‘Representations of Obesity in the News’. The book, titled Obesity in the News: Language and Representation in the Press, will be published by Cambridge University Press in 2021. You can see a sneak preview of the cover here!

The book reports analysis of a 36 million-word corpus of all UK national newspaper articles mentioning obese or obesity published over a ten-year period (2008-2017). This analysis combines methods from Corpus Linguistics with Critical Discourse Studies to explore the discourses that characterise press coverage of obesity during this period. The book explores a wide range of themes in this large dataset, with chapters that answer the following questions:

• What discourses characterise representations of obesity in the press as a whole?

• How do obesity discourses differ according to newspapers’ formats and political leanings?

• How have obesity discourses changed over time, and how do they interact with the annual news cycle?

• How does the press use language to shame and stigmatise people with obesity, and how are attempts to ‘reclaim’ the notion of obesity depicted?

• What discourses surround the core concepts of the ‘healthy body’, ‘diet’ and ‘exercise’ in press coverage of obesity?

• How do obesity discourses interact with gender, and how does this influence the ways in which men and women with obesity are represented?

• How does the press talk about social class in relation to obesity, and how do such discourses contribute to differing depictions of obesity in people from different social class groups?

• Finally, how do audiences respond to press depictions of obesity in below-the-line comments on online articles?

The book will be the latest output from this project. You can read more about our work on changing representations of obesity over time in this recent Open Access article published in Social Science & Medicine. We are also working on articles which expand our analysis of obesity and social class, depictions of obesity risk, and obesity discourses in press coverage of the coronavirus pandemic, so keep your eyes peeled for further announcements!

Questioning Vaccination Discourse (Quo VaDis): A Corpus-based Study

A new three-year project based in CASS will use corpus linguistic methods to study how vaccinations (including future vaccines for Covid-19) are talked about in the UK press, UK parliamentary discourse and social media. Through collaborations with governmental and public health partners, the findings will be used to help address vaccine hesitancy, which is one of the World Health Organizations top 10 global health challenges.

The project will start in March 2021 and is funded by the Economic and Social Research Council, part of UK Research and Innovation.

To find out more, read Lancaster University’s announcement and watch a brief introduction to the project by Principal Investigator Elena Semino.

English language assessment and training for medical professionals

Proficiency in English is crucial for effective and appropriate medical communication and U.K. regulating bodies for nurse and doctor practitioners use standardised tests (such as IELTS, OET, TOEFL) to assess English proficiency of non-UK/EU applicants.

The aim of this project is to investigate a corpus of authentic clinical interactions to identify patterns of interaction and language used by health professionals and as such, determine how well the English tests taken by applicants reflect English as used in ‘real life’ encounters. Our investigation will help us to identify the key communication skills required to deliver effective clinical care and allow us to support industrial partners with specific recommendations for language assessment and training for healthcare staff.

With a broad focus on the various participant roles within the patient journey through Emergency Departments, we are investigating how the language used by patients, nurses, doctors and other hospital staff reflects their various responsibilities and status. Specifically, we focus on the following aspects of language: –

Questions: which participants ask questions throughout the encounter? How are they phrased and to what do they refer? How do health professionals check understanding?

Directives: how do health professionals issue instructions? What types of mitigation or hedging are used?

Openings: how do the participants introduce themselves and establish their roles? Do health professionals use names/titles?

Pronouns: how do participants establish and maintain individual/collective identities through the use of pronouns?

Small talk: how and when do health professionals engage in small talk with patients? Or with other health professionals?

Empathy: how do we evidence expressions of empathy in the data? What kinds of empathy phrases do we observe and does this differ according to role?

Our approach is designed to identify those recurring interactional features of Emergency Department encounters that can help inform the teaching and assessment procedures that prepare candidates for the ‘real world’ of healthcare communication.

Team

Dr Dana Gablasova (https://www.lancaster.ac.uk/linguistics/about/people/dana-gablasova) (Lead Investigator)

Dr Luke Collins (https://www.lancaster.ac.uk/linguistics/about/people/luke-collins) (Senior Research Associate)

Dr Vaclav Brezina (https://www.lancaster.ac.uk/linguistics/about/people/vaclav-brezina) (Co-Investigator)

Dr John Pill (https://www.lancaster.ac.uk/linguistics/about/people/john-pill) (Co-Investigator)

Introductory Blog – Luke Collins

I am delighted to have joined the CASS team as Senior Research Associate and will be working across the new programme of studies in Corpus Approaches to Health(care) Communication. I have already begun working on a fascinating strand exploring the Narratives of Voice-hearers and I will be working closely with Professor Elena Semino in applying corpus methods to see what effects a therapeutic intervention has on the experiences of those who hear distressing voices – and how they articulate these experiences – over time. More broadly, we will be examining representations of mental health and illness in the media, looking to address issues of stigmatisation and support public awareness and understanding.

Working towards the application of corpus linguistics and the findings of corpus analysis to health services is a great motivation to me and I am thrilled to have the opportunity to build on my previous work in this area. I have published work on the experiences of people undergoing a therapeutic intervention and demonstrated how corpus approaches can help to capture some of the complexities of those experiences. I have also implemented corpus analyses to investigate discussions of complex global issues in the news media (specifically, climate change and AMR), thinking about public understanding and how media reporting can help readers to comprehend their role in such issues. I have recently been working on my edition of the Routledge ‘Corpus Linguistics for..’ series, focusing on applications of corpus tools for analysing different types of online communication and hope to announce its release early next year. Throughout my work, I have endeavoured to raise awareness of corpus methods outside of the discipline and create opportunities to work with collaborators from various backgrounds. I am glad to find that in my role with CASS, this can continue!

Outside of my work, I have a reputation for hand-made greeting cards and I am an avid record collector. Since I have moved to Lancaster I have been exploring the local area and discovering what a picturesque part of the country this is. I don’t even mind the rain!