Understanding the Sociocultural Dimensions of Mental Health Discourse in Arabic-Language X Communities
Authors: Amal Alqahtani, Rana Salama, Mona Diab
Organizations: King Saud University, Riyadh, Saudi Arabia · King Saud University, Riyadh, KSA · Cairo University, Egypt · Faculty of Computers and Artificial Intelligence, Cairo University, Egypt · Carnegie Mellon University, Pittsburgh, USA · Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
Abstract
Computational mental health research has predominantly centered on English-speaking populations, leaving Arabic-language discourse comparatively under-examined. We present an exploratory computational study of 8,147 tweets from 607 users classified by a GPT-4.1 personal-disclosure pipeline as likely lived-experience authors in three condition-specific Arabic-language X (formerly Twitter) Communities. We focus on discourse related to borderline personality disorder (BPD), bipolar disorder, and ADHD, and characterize community-associated linguistic patterns using a multi-domain cultural keyword framework. The results suggest that in this corpus, Bipolar tweets contain more religious and medical vocabulary, BPD tweets contain more relational, identity, and emotional-distress vocabulary, and ADHD tweets more often focus on practical symptoms and medication management. We treat these patterns as hypothesis-generating rather than confirmatory because the corpus is imbalanced across conditions, some subcorpora are temporally concentrated, and the keyword framework is an initial operationalization rather than a validated measurement instrument. The paper contributes a reusable LLM-assisted personal-disclosure pipeline and an exploratory cultural keyword framework for Arabic mental health discourse.
Detecting mental health disorders from Arabic social media text remains challenging due to dialectal variation, informal language, limited high-quality annotated resources, and severe class imbalance. While English mental health natural language processing (NLP) has progressed substantially, Arabic multi-class disorder classification remains insufficiently studied. This study proposes a two-phase framework for Arabic mental health text classification. In phase 1, three Arabic pre-trained language models, AraBERT, CAMeLBERT, and MARBERT, undergo Domain-Adaptive and Task-Adaptive Pretraining (DAPT and TAPT) using a large-scale corpus of unlabeled Arabic mental health tweets. The adapted models are evaluated under a unified protocol to identify the most effective backbone model. In phase 2, the selected model is assessed across four configurations combining single-stage and hierarchical two-stage classification architectures with full fine-tuning and Low-Rank Adaptation (LoRA). To support this study, we constructed a novel annotated Arabic mental health dataset comprising 50,670 tweets across six categories, with strong inter annotator agreement (Krippendorff's Alpha = 0.733, average pairwise agreement = 0.797). Experimental results show that the domain-adapted MARBERT (MentalMARBERT) achieves statistically significant improvements over baseline models in both accuracy and macro-F1. The hierarchical two-stage architecture combined with full fine-tuning achieves the best overall performance, reaching a macro-F1 of 0.861 and an accuracy of 0.877. These findings demonstrate the effectiveness of domain-specific adaptive pretraining and hierarchical classification for Arabic mental health disorder detection.
Detecting mental health disorders in a timely manner is an important societal challenge. NLP and machine learning (ML) methods used to assist with detection rely on data collected primarily from social media. However, such datasets often have sampling biases and inherent ethical and privacy issues. One avenue to overcome these limitations is non-social media data. We present the first comprehensive review of non-social media, free-text datasets for mental health research. We use the PRISMA methodology to conduct our survey and we review datasets available in multiple languages. We find that non-social media free-text based datasets are predominantly focused on English and on detecting depression. These datasets also vary in demographics, platforms, data types, annotation techniques, and methodologies. This systematic review also reveals key gaps and highlights opportunities to develop more diverse, reliable and clinically-relevant resources.
Prior clinical psychology research shows that Western individuals with depression tend to report psychological symptoms, while Eastern individuals report somatic ones. We test whether Large Language Models (LLMs), which are increasingly used in mental health, reproduce these cultural patterns by prompting them with Western or Eastern personas. Results show that LLMs largely fail to replicate the patterns when prompted in English, though prompting in major Eastern languages (i.e., Chinese, Japanese, and Hindi) improves alignment in several configurations. Our analysis pinpoints two key reasons for this failure: the models' low sensitivity to cultural personas and a strong, culturally invariant symptom hierarchy that overrides cultural cues. These findings reveal that while prompt language is important, current general-purpose LLMs lack the robust, culture-aware capabilities essential for safe and effective mental health applications.