Panel 1 | Health

CADAAD2022 | 06-08/07/2022 | Bergamo, Italy

33 | Elisabeth Scherr

Individually normal. Negotiating the concept of normality in the body positivity discourse

With the advance of industrialisation and technology in the early 19th century – which strongly promoted the collection and statistical analysis of mass data –, mean values and the concept of ‘normality‘ became central points of reference also in everyday life (cf. Link 2013: 20). As a counterforce, a more flexible concept of ‘normality’ was emphasized from the 1960s onwards, characterized by the individualisation of lifestyles and the relevance of self-centeredness (cf. Coupland 2007: 29). The currently ever-growing network of digital communities, especially in the field of social media, plays a key role in these processes: It selectively constructs and reproduces culture- and time-specific concepts of ‘normality’ and at the same time it facilitates the more or less structured rebellion against established opinions.

Negotiating ‘normality’ is particularly relevant in the discourse on visual appearances: On the one hand, the human body was and still is the object of extensive measuring with a comparatively narrow range of ‘normality’, represented by institutions like the fashion industry, the medical sector or the insurance business. On the other hand, body acceptance movements like body positivity become increasingly popular also in (Western) Europe, arguing for a flexibilization of the concept of a ‘normal’ body. From a linguistic point of view, members of this movement constitute a community of practice (Eckert/McConnell-Ginet 2003: 57), first and foremost by showing a similar linguistic behaviour on multiple levels.

After conducting a macro- and meso-level analysis with special focus on online-communication, the study investigates which characteristics are constitutive for negotiating ‘normality’ in the body positivity discourse. Following a corpus-based discourse linguistic approach, the database consists of almost 180.000 tokens of text material originating from non-commercial German blog post. As a first step, this corpus material is subjected to quantitative analyses (frequency distribution, keyword analysis) in order to assess the thematic foci. Following this, mixed-method (quantitative-qualitative) analyses will be applied in order to investigate the argumentation patterns in debating the concept of a ‘normal’ body. Preliminary results show that three basic positions must be distinguished: (i) The complete rejection of the concept of ‘normality’. This position is accompanied by a critical semasiological discussion of the word itself, i.e. of its signifié. The main topoi of this position deconstruct ‘normality’ as a fluid, purely social construct, invented by prejudiced opinion-makers or by capitalistic forces. As a consequence, (ii) the second basic position demands the pluralization of the body image, i.e. a flexibilization of ‘normality’. The main lines of argumentation here inter alia refer to the historically variable body image or to the inviolability of human dignity. This fundamental rejection of the homogeneous concept of ‘normality’, however, is indirectly abolished by (iii) the third argumentative position arguing for self-normalisation (‘I am normal.’). Hence the unconditional acceptance of all bodies does not necessarily lead to the dissolution of ‘normality’. This could be a symptom of what Link (2013: 126f.) called “fear of destabilization” and the striving for “self-assertiveness”: Apparently, not even flexible concepts can be free of an orientation towards ‘normality’ and its self-assuring quality. These findings provide implications for many current social developments, for linguistics as well as for sociology, media theory or psychology.

Coupland, Nikolas (2007), Style. Language Variation and Identity. Cambridge.

Eckert, Penelope/Sally McConnell-Ginet (2003), Language and Gender. Cambridge.

Link, Jürgen (2013), Versuch über den Normalismus. Wie Normalität produziert wird. 5th edition. Göttingen.

48 | Luke Collins & Paul Baker

Sketching Anxiety: Lexicogrammatical patterns used to discuss anxiety in an online support forum

The World Health Organization (WHO, 2017) reports that an estimated 264 million people around the world experience anxiety disorders, characterised by excessive fear and anxiety. Furthermore, research has shown that anxiety and depression have bidirectional relationships with one another and that comorbid anxiety and depression necessitates additional treatment adjustments compared with treating either condition alone (Jacobson and Newman, 2017). This highlights a need to urgently attend to experiences of comorbidity involving anxiety and depression in order to improve treatment outcomes for those severely affected by the disorders. The clinical threshold between anxiety as an adaptive behaviour and pathological anxiety leading to maladaptive behaviours is not clear cut and subject to clinical judgement. As such, better understanding of experiences of anxiety is required, from both the biophysical standpoint of clinical medicine and the experiential viewpoint that can be conveyed through language.

In our study, we explore contributions to the anxiety support forum hosted by Health Unlocked, offering a view of how an online community discusses their lived experiences of anxiety disorders.

Using the Word Sketch function in Sketch Engine (Kilgarriff et al., 2014), we investigate descriptions of 'anxiety' and the related terms 'depression', 'fear', 'stress', 'panic' and 'worry' across approximately 300 000 posts between March 2012 and October 2020. Our analysis identified four clines in terms of how anxiety and the related terms are discursively constructed:

1. catastrophisation vs minimisation

2. medicalisation vs non-medicalisation

3. personalisation vs impersonalisation

4. internalisation vs externalisation.

These clines capture the ways in which posters convey the seriousness and extremity of their anxiety, the pathological status of their experiences, and the extent to which the disorder is part of or separate from them, with its own agency.

Through our comparison of anxiety with related terms in the data, we discuss how the different discursive constructions of anxiety and mood disorders offers insights into how those with lived experience develop coping strategies. For instance, depression is often conceptualised using spatial metaphors, as contributors sink, fall and slip into depressive episodes. Anxiety is more likely to be described as an attack and thereby, something to be fought. Following the findings of Semino et al. (2017) in relation to metaphors around cancer, we report the range of opposing discourses used by posters to the anxiety support forum with a view to understanding the articulations that are available and viable to people as they navigate their experiences of anxiety disorders.


Jacobson, N. C. and Newman, M. G. (2017). Anxiety and depression as bidirectional risk factors for one another: A meta-analysis of longitudinal studies. Psychological Bulletin, 143(11), 1155–1200.

Kilgarriff, A., Baisa, V., Bušta, J., Jakubíček, M., Kovář, V., Michelfeit, J., Rychlý, P. and Suchomel, V. (2014). The Sketch Engine: ten years on. Lexicography, 1: 7-36.

Semino, E., Demjén, Z., Demmen, J., Koller, V., Payne, S., Hardie, A. and Rayson, P. (2017). The online use of Violence and Journey metaphors by patients with cancer, as compared with health professionals: a mixed methods study. BMJ Supportive & Palliative Care, 7: 60-66.

World Health Organization (2017). Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization. Licence: CC BY-NC-SA

131 | Saira Fitzgerald

Algorithms and examinations: A corpus-based study of #ibscandal

A recent Human Rights Watch report (HRW, 2021) expresses concern about how algorithms are increasingly used in public services such as social security payments, employment prospects and grades on exams, pointing out that this type of data driven decision-making further entrenches existing inequalities, an issue which gets obscured as media attention becomes focused on privacy and individual rights. This study looks at how “algorithmic decision-making” revealed the pitfalls of normativity in a case involving the International Baccalaureate (IB), a key player in the “global education industry” (Verger et al., 2016).

Due to the pandemic, in 2020 the IB organization cancelled its high stakes diploma examinations for the first time in its history and instead implemented an alternate assessment model based on an algorithm. When results for 174,355 students in 146 countries were published on July 6, large discrepancies were evident. Students, parents, teachers, academics and journalists demanded to know how grades were calculated and what statistical model was used. An online petition calling for “Justice for May 2020 IB Graduates” with the hashtag #ibscandal collected 15,000 signatures within the first four days. This study examines reaction to these results on Twitter between July and September, 2020, which provides a new context for IB discourse.

This study combines corpus linguistics, the discourse historical approach and social media critical discourse studies to search for linguistic patterns and identify discourses (Baker & McEnery, 2015; Wodak & Meyer, 2016). Corpus techniques (keywords, collocations, clusters, concordances) are used to capture the dynamic aspect of tweets by examining how one topic or “discourse strand” (Wodak, 2021) unfolded in real time, an approach that makes it possible to disclose how shifts in discourses were intertextually linked to events in the wider world.

Twitter data were collected from #ibscandal beginning with the first tweet to use this hashtag (Monday, July 6, 2020) and spanning two full months (Monday, September 7, 2020). Once data had been cleaned, the final corpus consisted of 4,278 original tweets and 117,253 words. Using AntConc (Anthony, 2020), keyword lists were obtained for each week by comparing each subcorpus to the remainder as the reference corpus to identify the most salient differences between them (Baker, Brookes & Evans, 2019). Individual words were first qualitatively analyzed, then grouped by discursive strategies and semantic domains to help draw out trends and patterns that might not be seen at the individual word level.


Anthony, L. (2020). AntConc (Version 3.5.9) [Computer Software]. Tokyo, Japan: Waseda University. Available from

Baker, P., G. Brookes, and C. Evans. (2019) The Language of Patient Feedback: A Corpus Linguistic Study of Online Health Communication. (London: Routledge).

Baker, P., & McEnery, T. (Eds.). (2015). Corpora and discourse studies: Integrating discourse and corpora. London, UK: Palgrave Macmillan.

Human Rights Watch (2021). How the EU’s flawed Artificial Intelligence regulation endangers the social safety net: Questions and answers. Available at:

Verger, A., Lubienski, C., & Steiner-Khamsi, G. (Eds.). (2016). World yearbook of education 2016: The global education industry. London, UK: Routledge

Wodak, R. (2021). Crisis communication and crisis management during COVID-19. Global Discourse. Advance online publication. doi:

Wodak, R. and Meyer, M. (Eds) (2009) Methods of critical discourse analysis. 2nd ed. (London: Sage).

149 | Carly Bray, Monika Bednarek, Gavin Brookes, Tara Coltman-Patel, Catriona Bonfiglioli, & Paul Baker

Weight stigma: towards a corpus-informed linguistic framework for critical discourse analysis

It is widely recognised that weight stigma in news media is a problem. News coverage of obesity can be stigmatising, with selection of images, language, and news frames shown to contribute to negative and stereotypical representations of people with obesity. Such weight stigma/bias has demonstrable adverse health consequences for people living with obesity. However, analyses of news discourse in this area have been predominantly non-linguistic, examining the frames and topics of news content. The few (emerging) corpus linguistic studies that exist are limited to the national context of the UK and tend mainly to apply corpus-driven methods such as keywords analysis. In contrast, this study will present a corpus-based rather than corpus-driven study, while shifting the national context to Australia, whose media landscape differs significantly from the UK. We will show how a triangulation of different sources (media guidelines, non-linguistic research, UK studies) can together provide an impetus for developing linguistic frameworks for (corpus-informed) discourse analysis of weight stigma. We then provide a case study of a newly-developed corpus of Australian news media coverage (over 26,000 articles from 12 newspapers 2008-2019) in order to investigate the extent to which such weight stigma applies across newspapers. Finally, we discuss whether the developed framework is usable both in manual, qualitative CDA and in corpus linguistic CDA (corpus-driven and corpus-based research). The study will have implications beyond obesity news coverage, providing insights into the development of corpus-informed frameworks for analysis of stigmatising, excluding, or otherwise problematic language practices.

166 | Tara Coltman-Patel

Personal Stories of Obesity and Weight Loss in News Discourse: Challenging Linguistic Strategies of Representation

This paper examines the phenomenon of internalised bias and investigates if it affects linguistic strategies of self-representation. The corpus is comprised of 604 personal stories about individuals with lived experience of obesity which have been printed in British national newspapers between 2006-2016. The articles which comprise the corpus were extracted from a larger corpus of general news articles about obesity through quantitative down-sampling methods using Corpus Linguistic techniques. Research into the general representations of obesity in news discourse has provided evidence of a stigmatising, sensationalist and misrepresentative narrative (Lawrence 2004; Boero 2007; Couch et al. 2015; Coltman-Patel 2020). The research investigates if the very individuals who have been stigmatised and disenfranchised as a result of oppressive weight-based ideals, repeat and perpetuate these principles through their self-representations. The analysis takes a Corpus-Assisted Critical Discourse Analysis approach (Baker et al. 2008) and follows frequent and statistically significant linguistic patterns including emotive verbs, adjectives and presupposition triggers. The linguistic patterns were identified through Corpus Linguistic techniques and then subsequently analysed through a Critical Discourse Analysis lens. Within these articles two types of stories were told. Stories of weight loss and stories about living with obesity, the former being the most frequent. Two recurrent identities are presented in these stories, they are multi-faceted and at times, antithetical in nature. The first presented identity has undergone weight loss and is thin, beautiful, healthy and happy. Conversely, the other presented identity is overweight, unattractive, unhealthy and unhappy. These identities are packaged into two specific self-representation strategies which are both negative in nature. The first is used when presenting the post-weight loss identity wherein the indidviduals compare their previous, heavier self to their present thinner self. Therefore, this involves negative self-representation being used as a tool within a broader, nuanced variation of positive self-representation. The second is used when presenting the present day overweight identity and is an undiluted negative self-representation, wherein internalised weight bias is stark and clear. Leading linguistic representation strategies dictate that information tends to be highlighted or suppressed in order to better and more favourably represent speakers/writers and the social group to which they belong (van Dijk 1998: 267). However, the strategies of self-representation found in this research begin to demonstrate how internalised bias can cause individuals to operate outside of this framework.


BAKER, P, GABRIELATOS, C, KHOSRAVINIK, M, KRZYŻANOWSKI, M, MCENERY, T, WODAK, R. (2008). A Useful Methodological Synergy? Combining Critical Discourse Analysis and Corpus Linguistics to Examine Discourses of Refugees and Asylum Seekers in the UK Press. Discourse and Society, 19 (3), 273-306.

BOERO, N. (2007). All the News That’s Fat to Print: The American “Obesity Epidemic” and the Media. Qualitative Sociology, 30 (1), 41-61.

COUCH, D, THOMAS, S.L, LEWIS, S, BLOOD, R.W, AND KOMESAROFF, P. (2015). Obese Adults’ Perceptions of News Reporting on Obesity: The Panopticon and Synopticon at Work, SAGE Open, 5 (4), 1-14.

COLTMAN-PATEL, T. (2020). Weight Stigma in Britain: The Linguistic Representation of Obesity in Newspapers (Doctoral Dissertation). Nottingham Trent University: Nottingham.

LAWRENCE, R. (2004). Framing Obesity: The Evolution of News Discourse on a Public Health Issue. International Journal of Press/Politics, 9 (3), 57-75.

VAN DIJK, T. (1998). Ideology: A Multidisciplinary Approach. London: Sage Publications.

217 | Mariana Pascual

Is there a (new) normal for patients with a chronic disease? A multi-methods analysis of narratives of women with endometriosis

In this study we report the results of the analysis of autobiographical interviews conducted by Chilean women who suffer endometriosis, a gynecological chronic disease characterized by frequent incapacitating pain which causes nearly 50% of all cases of infertility (Laganà et al., 2017). Our aim is twofold, to describe the patients’ concerns and how the pandemic has affected their everyday life, and, in that general context, to determine the extent to which the new conditions relate to their chronic condition. The corpus consists of a total of 30 interviews conducted during May 2020 to women in their reproductive age who had been diagnosed with endometriosis. The texts were transcribed and then described and analyzed using a mixed-methods approach. For the quantitative phase, we included the use of Python and packages such as NLTK and Sci-kit learn to determine semantic nodes, sentiment analysis nodes and collocation patterns. The qualitative phase consisted in the identification of entities and tokens of evaluation based on the System of Appraisal (Martin, 2000; Martin & White, 2007). We focused on those segments that specifically described their perceptions of how the pandemic has affected their lives. Results indicate that the feelings of sadness which had been previously identified in endometriosis patients (Pascual, 2020; Pascual & Díaz Alegría, 2021) became more serious in times of Covid-19 and that their interactions with doctors were further affected by the global health crisis. The various analytical tools used in this study have allowed for the identification of meanings, and patterns of meanings that may be ignored from less flexible approaches to the data. Our findings may shed light on the aspects that should be emphasized when interacting with women who suffer this chronic condition, especially in the case of health professionals, to improve not only their health, and, therefore, adherence to treatments (Bukstein, 2016), but also their life quality.

Bukstein, D. (2016). Patient adherence and effective communication. Annals of Allergy, Asthma & Immunology, 117,(6), 613-619.

Laganà, A. S., La Rosa, V. L., Rapisarda, A. M. C., Valenti, G., Sapia, F., Chiofalo, B., Rossetti, D., Ban Frangež, H., Vrtačnik Bokal, E., & Giovanni Vitale, S. (2017). Anxiety and depression in patients with endometriosis: Impact and management challenges. International Journal of Women’s Health.

Martin, J. R. (2000). Beyond Exchange: Appraisal Systems in English. Evaluation in Text: Authorial Stance and the Construction of Discourse.

Martin, J. R., & White, P. R. R. (2007). The Language of Evaluation: Appraisal in English. In The Language of Evaluation: Appraisal in English.

Pascual, M. (2020). Discurso, salud e información desde el relato de pacientes de endometriosis. Discurso & Sociedad, 14(2), 421–442.

Pascual, M., & Díaz Alegría, N. (2021). El afecto en relatos de dolor crónico en comentarios de Facebook de mujeres chilenas. Nueva Revista del Pacífico, 74, 47-64.

296 | Sara Vilar-Lluch

Talking about death to young children: a study of the representation of death in children picture books

When and how do we have to talk about the death of a loved one to a child? Death is still a taboo in Western society, and the suffering that adults experience in coping with the death of a beloved one may be exacerbated by the anxiety experienced in talking about it to the children. Children picture books about death can be valuable resources for families to help children during the bereavement, and are also employed in therapy sessions and schools as aids for emotional education (Arruda-Colli et al., 2017; Corr, 2004).

This paper studies the representation of death and dying in books aimed at 5–11-year-olds and children under 5, all of them recommended by the charity Child Bereavement UK. The paper considers how linguistic and visual representations cohere together to provide different portrayals of death and communicate emotions, facilitating the identification of the targeted readers with the characters. Due to the importance of metaphors in describing abstract and complex topics, this paper focuses on the metaphors adopted in the different picture books combining linguistic and visual metaphor analysis (Cameron, 2008, 2010; El Refaie, 2003; Forceville & Urios-Aparisi, 2009). The metaphor analysis is further complemented with an examination of attitude (Martin & White, 2005). The study shows that the books combine different representations, with a predominance of a mechanist view in non-fiction books, and rest and parting portrayals in storybooks. In both fiction and non-fiction books, metaphoric portrayals evolve throughout the story or explanations, evidencing that metaphor use is ultimately conditioned by the discourse activity taking place. Metonymic and metaphor visual representations of death accompany the explanations, although mainly as repetitions of the linguistic descriptions.


Arruda-Colli, M. N., Weaver, M. S., & Wiener, L. (2017). Communication about dying, death, and bereavement: a systematic review of children's literature. Journal of palliative medicine, 20(5), 548-559.

Cameron, L. (2008). “A discourse approach to metaphor: Explaning systematic metaphors for literacy processes in a school discourse community”. In: A. Tyler, Y. Kim, M. Takada (Eds.), Language in the Context of Use (pp. 321-337). Berlin/NY: Mouton de Gruyter.

Cameron, L. (2010) “The discourse dynamics framework for metaphor”. In: L. Cameron and R. Maslen (eds.) Metaphor Analysis. Research Practice in Applied Linguistics, Social Sciences and the Humanities, pp.77-94. London: Equinox.

Corr, C. A. (2004). Bereavement, grief, and mourning in death-related literature for children. Omega-Journal of Death and Dying, 48(4), 337-363.

El Refaie, E. (2003). Understanding visual metaphor: The example of newspaper cartoons. Visual communication, 2(1), 75-95.

Forceville, C. and Urios-Aparisi E. (eds.), 2009. Multimodal metaphor. Berlin: Mouton de Gruyter.

Martin, J. R. and White P. R. R. (2005). The Language of Evaluation. Appraisal in English. New York: Palgrave.

Children picture books:

Karst, P. and Lew-Vriethoff, J. (2018) The Invisible String. Little, Brown Books for Young Readers.

Krasny Brown, L. and Brown M. (1998) When dinosaurs die: a guide to understanding death. Little, Brown Books for Young Readers

Teckentrup, B. (2014) The memory tree. Orchard Books

Thomas, P. (2001) I miss you: a first look at death. B.E.S.

Varley, S. (1987) Badger's Parting Gifts: 35th Anniversary Edition of a picture book to help children deal with death. Andersen Press

316 | James Balfour

Mad or bad?: A corpus-based analysis of representations of Borderline Personality disorder on the BPDlovedones subreddit

‘Seeing people with BPD as ‘fire’ instead of ‘monsters’ helped me immensely’ writes one user on the BPDlovedones subreddit ‘they are dangerous and will hurt us if we get too close.’ The NHS website (2022) describes borderline personality disorder (BPD) as “a mood disorder which affects the way people feel and perceive the world”. Typical symptoms include emotional dysregulation, chronic feeling of emptiness and intense but stormy relationships with others (NHS website, 2022). People with the disorder who are untreated may have intense feelings of emotional pain and, as a result, are significantly more likely to self-harm and attempt suicide than the general population (Söderholm et al, 2020). Because BPD affects the way people with the disorder interact with others, friends, family and loved ones are likely alarmed or confused when faced with unpredictable behaviour and violent mood swings. As a result, various online forums have emerged where friends, family and loved ones of people with BPD narrate their own experiences and use language to negotiate ways of understanding people with the disorder. Unfortunately, given the lack of information around BPD, and because many users have had negative experiences, these forums can quickly become breeding grounds for a host of stigmatising metaphors, tropes and pejorative terms. These in turn serve to frame other users’ experiences with people with BPD in potentially problematic ways. The most popular forum used by relatives and friends of people with BPD is the BPDlovedones subreddit which has 38,700 members. The purpose of the forum, according to its ‘about section’, is to help users ‘process and understand the confusion, frustration and pain that can arise from people involved with someone who has this disorder (BPDlovedones, 2022).

In this pilot study, I introduce the BPDlovedones corpus, a 2 million word corpus of all posts and comments on the forum posted between 1 December and 31 December 2021. I then begin looking for broad themes in the dataset by deriving a set of 32 keywords by comparing the corpus with the spoken BNC corpus. Collocates of each keyword are then examined in more detail to uncover more subtle meanings. The analysis reveals that users of this subreddit use language creatively to frame their relationships with people with BPD in different ways. Typically, people with BPD are represented as intentionally malevolent and attention seeking, which reflects broader stereotypes around the disorder. These stereotypes contribute to stigma towards people who are already vulnerable and put them further at risk. Two linguistic strategies emerge as salient. First, users make use of sophisticated jargon which frames relationships with BPD as following a strict narrative, where people with the disorder intentionally exploit friends and family. Second, users of the forum make use of a range of creative metaphors to represent people with BPD as more or less malevolent. People with BPD are variously construed as ‘emotional vampires’, ‘black holes’ and ‘fire’ and each of these metaphors represents the behaviour of people with BPD as more or less intentional. The talk concludes by highlighting the lack of information around BPD which allows such stigmatising stereotypes to persist.


BPDlovedones. (2022). r/bpdlovedones. Reddit. Available at: (Accessed: 21 January 2022).

National Health Service. (2022). Borderline personality disorder. Available at: (Accessed: 12 February 2021)

Söderholm, J., Socada, J., Rosenström, T., Ekelund, J., & Isometsä, E. (2020). Borderline Personality Disorder With Depression Confers Significant Risk of Suicidal Behavior in Mood Disorder Patients-A Comparative Study. Frontiers in Psychiatry, 11, 290.

323 | Gavin Brookes

Killer, thief or companion? A critical analysis of dementia metaphors in the British press

This talk examines the most frequent metaphors that are used to represent dementia in British tabloid newspapers over a ten-year period (2010-2019). The analysis takes a corpus-based approach to metaphor identification and analysis, utilising in particular the corpus linguistic technique of collocation analysis. Metaphors are considered in terms of the ‘targets’ they frame, which include the following aspects of dementia: prevalence; causes; symptoms and prognosis; lived experience; responses. A range of metaphors are identified, with the tabloids exhibiting a particular preference for metaphors which construct dementia as an agentive and violent entity, people with dementia as passive victims, and which foreground preventative responses to dementia such as pharamacological intervention and individual behaviour change. It is argued that such metaphors have the potential to contribute to dementia stigma and place focus on preventing or eliminating dementia while backgrounding responses which may help people to ‘live well’ with the syndrome in the here-and-now. Metaphors which frame dementia as a companion or the experience of dementia as a journey are put forward as potentially less-stigmatising alternatives which might better reflect the particularities of this complex public health issue. Through its analysis, the paper will reflect on the affordances and limitations of corpus-based (critical) metaphor analysis, and project forward to future research examining multimodal metaphors of dementia through a critical, corpus linguistic lens.