ArticleAmerican journal of epidemiology2026
Detecting risk for depression and anxiety symptoms among older bereaved women using text-based analysis in the Nurses' Health Study II.
Article in American journal of epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
We analyzed free-text narratives about recent bereavement experiences from 1997 women aged 55-73 years (M = 65.9, SD = 4.4) enrolled in the Nurses' Health Study II to identify associations between text characteristics and postbereavement mental health. We applied covariate-adjusted linear mixed effects models to assess the association between word count and expression of positive vs negative sentiment (emotional valence) in first-person bereavement narratives and standardized Patient Health Questionnaire-4 (PHQ-4) total, anxiety, and depression symptom scores over 6 months, stratified by loss of a partner or child vs a close other. Emotional valence was quantified using the Valence Aware Dictionary and sEntiment Reasoner (VADER) algorithm. Among women bereaved of a close other, word count was positively associated with log PHQ-4 total (0.06 SD [95% CI, 0.02-0.09]), anxiety (0.05 SD [95% CI, 0.02-0.09]), and depression (0.06 SD [95 % CI, 0.03-0.09]) symptom scores. Negatively scored emotional valence was associated with elevated log PHQ-4 total (-0.05 SD [95% CI, -0.08 to -0.01]), anxiety (-0.04 SD [95% CI, -0.08 to 0.00]), and depression (-0.04 SD [95% CI, -0.07 to -0.01]) symptom scores. Estimated associations among women bereaved of a partner or child were elevated but underpowered. Qualitative approaches in epidemiologic cohorts offer promise in identifying novel characteristics associated with bereavement outcomes among older women.
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