Fulmer Russell, Joerin Angela, Gentile Breanna, Lakerink Lysanne, Rauws Michiel
Northwestern University, Evanston, IL, United States.
X2AI Inc, San Francisco, CA, United States.
JMIR Ment Health. 2018 Dec 13;5(4):e64. doi: 10.2196/mental.9782.
Students in need of mental health care face many barriers including cost, location, availability, and stigma. Studies show that computer-assisted therapy and 1 conversational chatbot delivering cognitive behavioral therapy (CBT) offer a less-intensive and more cost-effective alternative for treating depression and anxiety. Although CBT is one of the most effective treatment methods, applying an integrative approach has been linked to equally effective posttreatment improvement. Integrative psychological artificial intelligence (AI) offers a scalable solution as the demand for affordable, convenient, lasting, and secure support grows.
This study aimed to assess the feasibility and efficacy of using an integrative psychological AI, Tess, to reduce self-identified symptoms of depression and anxiety in college students.
In this randomized controlled trial, 75 participants were recruited from 15 universities across the United States. All participants completed Web-based surveys, including the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and Positive and Negative Affect Scale (PANAS) at baseline and 2 to 4 weeks later (T2). The 2 test groups consisted of 50 participants in total and were randomized to receive unlimited access to Tess for either 2 weeks (n=24) or 4 weeks (n=26). The information-only control group participants (n=24) received an electronic link to the National Institute of Mental Health's (NIMH) eBook on depression among college students and were only granted access to Tess after completion of the study.
A sample of 74 participants completed this study with 0% attrition from the test group and less than 1% attrition from the control group (1/24). The average age of participants was 22.9 years, with 70% of participants being female (52/74), mostly Asian (37/74, 51%), and white (32/74, 41%). Group 1 received unlimited access to Tess, with daily check-ins for 2 weeks. Group 2 received unlimited access to Tess with biweekly check-ins for 4 weeks. The information-only control group was provided with an electronic link to the NIMH's eBook. Multivariate analysis of covariance was conducted. We used an alpha level of .05 for all statistical tests. Results revealed a statistically significant difference between the control group and group 1, such that group 1 reported a significant reduction in symptoms of depression as measured by the PHQ-9 (P=.03), whereas those in the control group did not. A statistically significant difference was found between the control group and both test groups 1 and 2 for symptoms of anxiety as measured by the GAD-7. Group 1 (P=.045) and group 2 (P=.02) reported a significant reduction in symptoms of anxiety, whereas the control group did not. A statistically significant difference was found on the PANAS between the control group and group 1 (P=.03) and suggests that Tess did impact scores.
This study offers evidence that AI can serve as a cost-effective and accessible therapeutic agent. Although not designed to appropriate the role of a trained therapist, integrative psychological AI emerges as a feasible option for delivering support.
International Standard Randomized Controlled Trial Number: ISRCTN61214172; https://doi.org/10.1186/ISRCTN61214172.
需要心理健康护理的学生面临诸多障碍，包括费用、地点、可及性和污名化等。研究表明，计算机辅助治疗以及提供认知行为疗法（CBT）的对话式聊天机器人为治疗抑郁症和焦虑症提供了一种强度较低且更具成本效益的选择。尽管CBT是最有效的治疗方法之一，但采用综合方法也与同样有效的治疗后改善效果相关。随着对经济实惠、便捷、持久且安全的支持需求的增长，综合心理人工智能（AI）提供了一种可扩展的解决方案。
本研究旨在评估使用综合心理AI Tess减轻大学生自我报告的抑郁和焦虑症状的可行性和有效性。
在这项随机对照试验中，从美国15所大学招募了75名参与者。所有参与者在基线时以及2至4周后（T2）完成基于网络的调查，包括患者健康问卷（PHQ - 9）、广泛性焦虑障碍量表（GAD - 7）和正负性情绪量表（PANAS）。两个试验组共有50名参与者，随机分为两组，一组可无限制使用Tess两周（n = 24），另一组可无限制使用Tess四周（n = 26）。仅提供信息的对照组参与者（n = 24）收到了美国国立精神卫生研究所（NIMH）关于大学生抑郁症的电子书的电子链接，且仅在研究完成后才能使用Tess。
74名参与者完成了本研究，试验组的损耗率为0%，对照组的损耗率低于1%（1/24）。参与者的平均年龄为22.9岁，70%的参与者为女性（52/74），大多数是亚洲人（37/74，51%）和白人（32/74，41%）。第一组可无限制使用Tess，并在两周内每天进行签到。第二组可无限制使用Tess，并在四周内每两周进行一次签到。仅提供信息的对照组收到了NIMH电子书的电子链接。进行了多变量协方差分析。所有统计检验的α水平均为0.05。结果显示，对照组与第一组之间存在统计学上的显著差异，即第一组报告称，用PHQ - 9测量的抑郁症状有显著减轻（P = 0.03），而对照组则没有。用GAD - 7测量的焦虑症状方面，对照组与试验组1和2之间均存在统计学上的显著差异。第一组（P = 0.045）和第二组（P = 0.02）报告称焦虑症状有显著减轻，而对照组则没有。对照组与第一组在PANAS上存在统计学上的显著差异（P = 0.03），这表明Tess确实影响了得分。
本研究提供了证据，表明AI可以作为一种具有成本效益且易于获得的治疗手段。尽管并非旨在取代训练有素的治疗师的角色，但综合心理AI已成为提供支持的一种可行选择。
国际标准随机对照试验编号：ISRCTN61214172；https://doi.org/10.1186/ISRCTN61214172。
