Using AI chatbots to provide self-help depression interventions for university students: A randomized trial of effectiveness
Background: Depression impacts the lives of a large number of university students. Mobile-based therapy chatbots are increasingly being used to help young adults who suffer from depression. However, previous trials have short follow-up periods. Evidence of effectiveness in pragmatic conditions are s...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-03-01
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| Series: | Internet Interventions |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214782922000021 |
| _version_ | 1798035557213798400 |
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| author | Hao Liu Huaming Peng Xingyu Song Chenzi Xu Meng Zhang |
| author_facet | Hao Liu Huaming Peng Xingyu Song Chenzi Xu Meng Zhang |
| author_sort | Hao Liu |
| collection | DOAJ |
| description | Background: Depression impacts the lives of a large number of university students. Mobile-based therapy chatbots are increasingly being used to help young adults who suffer from depression. However, previous trials have short follow-up periods. Evidence of effectiveness in pragmatic conditions are still in lack. Objective: This study aimed to compare chatbot therapy to bibliotherapy, which is a widely accepted and proven-useful self-help psychological intervention. The main objective of this study is to add to the evidence of effectiveness for chatbot therapy as a convenient, affordable, interactive self-help intervention for depression. Methods: An unblinded randomized controlled trial with 83 university students was conducted. The participants were randomly assigned to either a chatbot test group (n = 41) to receive a newly developed chatbot-delivered intervention, or a bibliotherapy control group (n = 42) to receive a minimal level of bibliotherapy. A set of questionnaires was implemented as measurements of clinical variables at baseline and every 4 weeks for a period of 16 weeks, which included the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder scale (GAD-7), the Positive and Negative Affect Scale (PANAS). The Client Satisfaction Questionnaire-8 (CSQ-8) and the Working Alliance Inventory-Short Revised (WAI-SR) were used to measure satisfaction and therapeutic alliance after the intervention. Participants' self-reported adherence and feedback on the therapy chatbot were also collected. Results: Participants were all university students (undergraduate students (n = 31), postgraduate students (n = 52)). They were between 19 and 28 years old (mean = 23.08, standard deviation (SD) = 1.76) and 55.42% (46/83) female. 24.07% (20/83) participants were lost to follow-up. No significant group difference was found at baseline. In the intention-to-treat analysis, individuals in the chatbot test group showed a significant reduction in the PHQ-9 scores (F = 22.89; P < 0.01) and the GAD-7 scores (F = 5.37; P = 0.02). Follow-up analysis of completers suggested that the reduction of anxiety was significant only in the first 4 weeks. The WAI-SR scores in the chatbot group were higher compared to the bibliotherapy group (t = 7.29; P < 0.01). User feedback showed that process factors were more influential than the content factors. Conclusions: The chatbot-delivered self-help depression intervention was proven to be superior to the minimal level of bibliotherapy in terms of reduction on depression, anxiety, and therapeutic alliance achieved with participants. |
| first_indexed | 2024-04-11T20:59:51Z |
| format | Article |
| id | doaj.art-19fbbae82cd44813bd67c1e2912f77ea |
| institution | Directory Open Access Journal |
| issn | 2214-7829 |
| language | English |
| last_indexed | 2024-04-11T20:59:51Z |
| publishDate | 2022-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Internet Interventions |
| spelling | doaj.art-19fbbae82cd44813bd67c1e2912f77ea2022-12-22T04:03:32ZengElsevierInternet Interventions2214-78292022-03-0127100495Using AI chatbots to provide self-help depression interventions for university students: A randomized trial of effectivenessHao Liu0Huaming Peng1Xingyu Song2Chenzi Xu3Meng Zhang4School of Design, South China University of Technology, B11 Building, University Town Campus, South China University of Technology, Guangzhou Higher Education Mega Center, Panyu District, 510006 Guangzhou, ChinaSchool of Design, South China University of Technology, B11 Building, University Town Campus, South China University of Technology, Guangzhou Higher Education Mega Center, Panyu District, 510006 Guangzhou, ChinaSchool of Psychology, Central China Normal University, The 8th Floor, Nanhu Complex Building, Central China Normal University, No. 152 Luoyu Road, Wuhan 430079, ChinaSocial Work Research Center, South China University of Technology, 5th Building, Wushan Campus, South China University of Technology, 381 Wushan Road, Tianhe District, Guangzhou 510640, ChinaSocial Work Research Center, South China University of Technology, 5th Building, Wushan Campus, South China University of Technology, 381 Wushan Road, Tianhe District, Guangzhou 510640, China; Corresponding author.Background: Depression impacts the lives of a large number of university students. Mobile-based therapy chatbots are increasingly being used to help young adults who suffer from depression. However, previous trials have short follow-up periods. Evidence of effectiveness in pragmatic conditions are still in lack. Objective: This study aimed to compare chatbot therapy to bibliotherapy, which is a widely accepted and proven-useful self-help psychological intervention. The main objective of this study is to add to the evidence of effectiveness for chatbot therapy as a convenient, affordable, interactive self-help intervention for depression. Methods: An unblinded randomized controlled trial with 83 university students was conducted. The participants were randomly assigned to either a chatbot test group (n = 41) to receive a newly developed chatbot-delivered intervention, or a bibliotherapy control group (n = 42) to receive a minimal level of bibliotherapy. A set of questionnaires was implemented as measurements of clinical variables at baseline and every 4 weeks for a period of 16 weeks, which included the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder scale (GAD-7), the Positive and Negative Affect Scale (PANAS). The Client Satisfaction Questionnaire-8 (CSQ-8) and the Working Alliance Inventory-Short Revised (WAI-SR) were used to measure satisfaction and therapeutic alliance after the intervention. Participants' self-reported adherence and feedback on the therapy chatbot were also collected. Results: Participants were all university students (undergraduate students (n = 31), postgraduate students (n = 52)). They were between 19 and 28 years old (mean = 23.08, standard deviation (SD) = 1.76) and 55.42% (46/83) female. 24.07% (20/83) participants were lost to follow-up. No significant group difference was found at baseline. In the intention-to-treat analysis, individuals in the chatbot test group showed a significant reduction in the PHQ-9 scores (F = 22.89; P < 0.01) and the GAD-7 scores (F = 5.37; P = 0.02). Follow-up analysis of completers suggested that the reduction of anxiety was significant only in the first 4 weeks. The WAI-SR scores in the chatbot group were higher compared to the bibliotherapy group (t = 7.29; P < 0.01). User feedback showed that process factors were more influential than the content factors. Conclusions: The chatbot-delivered self-help depression intervention was proven to be superior to the minimal level of bibliotherapy in terms of reduction on depression, anxiety, and therapeutic alliance achieved with participants.http://www.sciencedirect.com/science/article/pii/S2214782922000021Public health informaticsAI Artificial IntelligencemHealth |
| spellingShingle | Hao Liu Huaming Peng Xingyu Song Chenzi Xu Meng Zhang Using AI chatbots to provide self-help depression interventions for university students: A randomized trial of effectiveness Internet Interventions Public health informatics AI Artificial Intelligence mHealth |
| title | Using AI chatbots to provide self-help depression interventions for university students: A randomized trial of effectiveness |
| title_full | Using AI chatbots to provide self-help depression interventions for university students: A randomized trial of effectiveness |
| title_fullStr | Using AI chatbots to provide self-help depression interventions for university students: A randomized trial of effectiveness |
| title_full_unstemmed | Using AI chatbots to provide self-help depression interventions for university students: A randomized trial of effectiveness |
| title_short | Using AI chatbots to provide self-help depression interventions for university students: A randomized trial of effectiveness |
| title_sort | using ai chatbots to provide self help depression interventions for university students a randomized trial of effectiveness |
| topic | Public health informatics AI Artificial Intelligence mHealth |
| url | http://www.sciencedirect.com/science/article/pii/S2214782922000021 |
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