Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany.
Institute of Distributed Systems, Ulm University, Ulm, Germany.
JMIR Ment Health. 2024 May 28;11:e50454. doi: 10.2196/50454.
Stress levels and the prevalence of mental disorders in the general population have been rising in recent years. Chatbot-based interventions represent novel and promising digital approaches to improve health-related parameters. However, there is a lack of research on chatbot-based interventions in the area of mental health.
The aim of this study was to investigate the effects of a 3-week chatbot-based intervention guided by the chatbot ELME, specifically with respect to the ability to reduce stress and improve various health-related parameters in a stressed sample.
In this multicenter two-armed randomized controlled trial, 118 individuals with medium to high stress levels were randomized to the intervention group (n=59) or the treatment-as-usual control group (n=59). The ELME chatbot guided participants of the intervention group through 3 weeks of training based on the topics stress, mindfulness, and interoception, with practical and psychoeducative elements delivered in two daily interactive intervention sessions via a smartphone (approximately 10-20 minutes each). The primary outcome (perceived stress) and secondary outcomes (mindfulness; interoception or interoceptive sensibility; subjective well-being; and emotion regulation, including the subfacets reappraisal and suppression) were assessed preintervention (T1), post intervention (T2; after 3 weeks), and at follow-up (T3; after 6 weeks). During both conditions, participants also underwent ecological momentary assessments of stress and interoceptive sensibility.
There were no significant changes in perceived stress (β=-.018, SE=.329; P=.96) and momentary stress. Mindfulness and the subfacet reappraisal significantly increased in the intervention group over time, whereas there was no change in the subfacet suppression. Well-being and momentary interoceptive sensibility increased in both groups over time.
To gain insight into how the intervention can be improved to achieve its full potential for stress reduction, besides a longer intervention duration, specific sample subgroups should be considered. The chatbot-based intervention seems to have the potential to improve mindfulness and emotion regulation in a stressed sample. Future chatbot-based studies and interventions in health care should be designed based on the latest findings on the efficacy of rule-based and artificial intelligence-based chatbots.
German Clinical Trials Register DRKS00027560; https://drks.de/search/en/trial/DRKS00027560.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-doi.org/10.3389/fdgth.2023.1046202.
近年来，人群中的压力水平和精神障碍患病率一直在上升。基于聊天机器人的干预措施代表了改善与健康相关参数的新颖而有前途的数字方法。然而，在心理健康领域，基于聊天机器人的干预措施的研究还很缺乏。
本研究旨在调查基于聊天机器人 ELME 的 3 周干预对压力样本中减轻压力和改善各种与健康相关参数的能力的影响。
在这项多中心、两臂随机对照试验中，118 名中高度压力个体被随机分配至干预组（n=59）或常规治疗对照组（n=59）。ELME 聊天机器人通过智能手机引导干预组的参与者进行 3 周的培训，培训主题包括压力、正念和内感受，同时提供实际和心理教育元素，通过每日两次互动干预（每次约 10-20 分钟）进行。主要结局（感知压力）和次要结局（正念；内感受或内感受敏感性；主观幸福感；情绪调节，包括再评价和抑制亚方面）在干预前（T1）、干预后（T2；3 周后）和随访时（T3；6 周后）进行评估。在两种情况下，参与者还进行了压力和内感受敏感性的生态瞬时评估。
感知压力（β=-.018，SE=.329；P=.96）和瞬时压力均无显著变化。正念和再评价亚方面随着时间的推移在干预组中显著增加，而抑制亚方面没有变化。幸福感和瞬时内感受敏感性在两组中均随时间增加。
为了深入了解如何改进干预措施以充分发挥其减轻压力的潜力，除了延长干预时间外，还应考虑特定的样本亚组。基于聊天机器人的干预措施似乎有可能改善压力样本的正念和情绪调节。未来的基于聊天机器人的健康护理研究和干预措施应根据基于规则和人工智能的聊天机器人功效的最新发现进行设计。
德国临床试验注册中心 DRKS00027560；https://drks.de/search/en/trial/DRKS00027560。
国际注册报告标识符（IRRID）：RR2-doi.org/10.3389/fdgth.2023.1046202。
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