Rising mental health issues among youth have increased interest in automated approaches for detecting early signs of psychological distress in digital text. One key focus is the identification of cognitive distortions, irrational thought patterns that have a role in aggravating mental distress. Early detection of these distortions may enable timely, low-cost interventions. While prior work has focused on English clinical data, we present the first in-depth study of cross-lingual and cross-register generalization of cognitive distortion detection, analyzing forum posts written by Dutch adolescents. Our findings show that while changes in language and writing style can significantly affect model performance, domain adaptation methods show the most promise.

Mental illness remains one of the most critical public health issues of our time, due to the severe scarcity and accessibility limit of professionals. Psychotherapy requires high-level expertise to conduct deep, complex reasoning and analysis on the cognition modeling of the patients. In the era of Large Language Models, we believe it is the right time to develop AI assistance for computational psychotherapy. We study the task of cognitive distortion detection and propose the Diagnosis of Thought (DoT) prompting. DoT performs diagnosis on the patient's speech via three stages: subjectivity assessment to separate the facts and the thoughts; contrastive reasoning to elicit the reasoning processes supporting and contradicting the thoughts; and schema analysis to summarize the cognition schemas. The generated diagnosis rationales through the three stages are essential for assisting the professionals. Experiments demonstrate that DoT obtains significant improvements over ChatGPT for cognitive distortion detection, while generating high-quality rationales approved by human experts.