NLP Analysis of Weekly Narratives for Dynamic Clinical Assessment in SUD

Summary

This prospective observational study follows adults undergoing residential rehabilitation for severe substance use disorders at a specialized treatment center in Mexico. Participants provide weekly written narratives describing their emotions, challenges, coping strategies, and treatment experiences, and complete validated psychological questionnaires every two weeks, including the Generalized Anxiety Disorder-7 (GAD-7), Environmental Reward Observation Scale (EROS), Automatic Thoughts Questionnaire-8 (ATQ-8), and Behavioral Activation for Depression Scale (BADS). The study applies natural language processing (NLP) and machine learning methods to analyze participants' narratives and identify emotional, cognitive, and behavioral patterns associated with clinical change over time. Narrative-derived features are combined with questionnaire scores to generate a dynamic clinical risk representation that may help detect early signs of psychological worsening or improvement during residential treatment. Participants continue receiving standard residential care, and the study does not modify treatment decisions or clinical interventions. Up to 35 participants with sufficient longitudinal follow-up data will be included in the primary analysis. Data collection is expected to continue through September 2026.

Eligibility

Inclusion Criteria:

1. Clinical diagnosis of severe substance use disorder (polydrug use, including cocaine, methamphetamines, alcohol, and/or cannabis), confirmed by the center's admission assessment.
2. Male sex (all participants in the center's residential program are male).
3. Age 18 years or older.
4. Current resident of the participating residential rehabilitation center in Mexico.
5. Completed at least four weeks of residential treatment at the time of study enrollment.
6. Able to write coherent weekly narratives in Spanish (no severe cognitive impairment or active psychosis).
7. Willing to provide written informed consent.

Exclusion Criteria:

1. Presence of acute psychotic symptoms that interfere with the ability to write or understand the study procedures.
2. Severe cognitive impairment (e.g., due to traumatic brain injury, intellectual disability) that prevents meaningful narrative production.
3. Inability to comply with weekly narrative writing (e.g., illiteracy, severe visual impairment).
4. Planned discharge from the residential program within less than 4 weeks from enrollment.
5. Enrollment in another interventional clinical trial that could confound the interpretation of outcomes.

Conditions5

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