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Research Methods and Statistics

(PS7-82) Using Large Language Models to Explore Urge to Escape as a Risk factor and Mindfulness as a Protective factor of Suicidal Thoughts and Behaviors from Mental Health Reddit posts

Saturday, November 22, 2025
3:00 PM - 4:00 PM CST
Location: Elite Hall A, Level 1
Abstract Text: Suicide is a leading cause of death worldwide. Stigma, financial costs, and limited availability restrict traditional mental health care (Carbonell et al., 2020). Reddit, a popular social media platform, allows users to express distress, seek support, and disclose suicidal thoughts in mental health subforums (i.e., subreddits). Theoretical and empirical studies show that the urge to escape may drive suicidal thoughts and behaviors (STBs) when individuals fail to regulate aversive internal states (Wang et al., 2023). Mindfulness, defined by present-moment awareness and nonjudgmental acceptance, may protect against suicidality by helping individuals tolerate aversive internal states, yet its role in suicidality remains unclear (De Aguiar et al., 2022). Reddit contains extensive text-based mental health data, and large language models (LLMs) offer a scalable way to analyze psychological constructs within unstructured data. This study examines 16,791 posts from three mental health subreddits (r/SuicideWatch, r/MentalHealth, and r/Depression), from December 2008 to February 2025, to analyze descriptions of STBs and mindfulness. We prompted the LLM (OpenAI GPT-4o 2024-11-20 via a Python API) with definitions and examples of STBs (Nock et al., 2007), and facets of mindfulness (Baer et al., 2006). The LLM classified each post using a binary coding system: 0 = not mentioned or unclear, and 1 = clearly mentioned. Preliminary comparisons with human ratings suggest that the model effectively identified relevant constructs. We calculated construct prevalence by determining the percentage of posts that mentioned each category: 25.5% of posts mentioned passive suicidal thoughts, 13.1% active suicidal thoughts, 7.1% described a suicide attempt, and 0.6% referenced at least one facet of mindfulness. We used logistic regression to assess whether mindfulness and the urge to escape were associated with STBs. Higher urge to escape was significantly associated (p < .05) with greater odds of all STBs, ranging from passive suicidal thoughts (β = 1.55, OR = 4.71) to suicide attempts (β = 0.23, OR = 1.26). Higher mindfulness was significantly associated (p < .05) with lower odds of both passive suicidal thoughts (β = -1.29, OR = 0.24) and active suicidal thoughts (β = -2.19, OR = 0.11), but not suicide attempts (p = 0.93). These findings suggest that the urge to escape increases risk for STBs, while mindfulness may act as a protective factor; however, other confounding factors may help explain these relationships. This study demonstrates that LLMs applied to large-scale ecological text data offer a scalable, systematic approach to identifying how individuals’ express distress and coping strategies and further develop psychological theory.