Bridging Online Behavior and Clinical Insight: A Longitudinal LLM-based Study of Suicidality on YouTube Reveals Novel Digital Markers
Journal:
arXiv
Published Date:
Jun 11, 2025
Abstract
Suicide remains a leading cause of death in Western countries, underscoring
the need for new research approaches. As social media becomes central to daily
life, digital footprints offer valuable insight into suicidal behavior.
Focusing on individuals who attempted suicide while uploading videos to their
channels, we investigate: How do suicidal behaviors manifest on YouTube, and
how do they differ from expert knowledge? We applied complementary approaches:
computational bottom-up, hybrid, and expert-driven top-down, on a novel
longitudinal dataset of 181 YouTube channels from individuals with
life-threatening attempts, alongside 134 control channels. In the bottom-up
approach, we applied LLM-based topic modeling to identify behavioral
indicators. Of 166 topics, five were associated with suicide-attempt, with two
also showing temporal attempt-related changes ($p<.01$) - Mental Health
Struggles ($+0.08$)* and YouTube Engagement ($+0.1$)*. In the hybrid approach,
a clinical expert reviewed LLM-derived topics and flagged 19 as
suicide-related. However, none showed significant attempt-related temporal
effects beyond those identified bottom-up. Notably, YouTube Engagement, a
platform-specific indicator, was not flagged by the expert, underscoring the
value of bottom-up discovery. In the top-down approach, psychological
assessment of suicide attempt narratives revealed that the only significant
difference between individuals who attempted before and those attempted during
their upload period was the motivation to share this experience: the former
aimed to Help Others ($\beta=-1.69$, $p<.01$), while the latter framed it as
part of their Personal Recovery ($\beta=1.08$, $p<.01$). By integrating these
approaches, we offer a nuanced understanding of suicidality, bridging digital
behavior and clinical insights.
* Within-group changes in relation to the suicide attempt.
