scholarly journals Conversational Agents in the Treatment of Mental Health Problems: Mixed-Method Systematic Review (Preprint)

2019 ◽  
Author(s):  
Hannah Gaffney ◽  
Warren Mansell ◽  
Sara Tai

BACKGROUND The use of conversational agent interventions (including chatbots and robots) in mental health is growing at a fast pace. Recent existing reviews have focused exclusively on a subset of embodied conversational agent interventions despite other modalities aiming to achieve the common goal of improved mental health. OBJECTIVE This study aimed to review the use of conversational agent interventions in the treatment of mental health problems. METHODS We performed a systematic search using relevant databases (MEDLINE, EMBASE, PsycINFO, Web of Science, and Cochrane library). Studies that reported on an autonomous conversational agent that simulated conversation and reported on a mental health outcome were included. RESULTS A total of 13 studies were included in the review. Among them, 4 full-scale randomized controlled trials (RCTs) were included. The rest were feasibility, pilot RCTs and quasi-experimental studies. Interventions were diverse in design and targeted a range of mental health problems using a wide variety of therapeutic orientations. All included studies reported reductions in psychological distress postintervention. Furthermore, 5 controlled studies demonstrated significant reductions in psychological distress compared with inactive control groups. In addition, 3 controlled studies comparing interventions with active control groups failed to demonstrate superior effects. Broader utility in promoting well-being in nonclinical populations was unclear. CONCLUSIONS The efficacy and acceptability of conversational agent interventions for mental health problems are promising. However, a more robust experimental design is required to demonstrate efficacy and efficiency. A focus on streamlining interventions, demonstrating equivalence to other treatment modalities, and elucidating mechanisms of action has the potential to increase acceptance by users and clinicians and maximize reach.

10.2196/14166 ◽  
2019 ◽  
Vol 6 (10) ◽  
pp. e14166 ◽  
Author(s):  
Hannah Gaffney ◽  
Warren Mansell ◽  
Sara Tai

Background The use of conversational agent interventions (including chatbots and robots) in mental health is growing at a fast pace. Recent existing reviews have focused exclusively on a subset of embodied conversational agent interventions despite other modalities aiming to achieve the common goal of improved mental health. Objective This study aimed to review the use of conversational agent interventions in the treatment of mental health problems. Methods We performed a systematic search using relevant databases (MEDLINE, EMBASE, PsycINFO, Web of Science, and Cochrane library). Studies that reported on an autonomous conversational agent that simulated conversation and reported on a mental health outcome were included. Results A total of 13 studies were included in the review. Among them, 4 full-scale randomized controlled trials (RCTs) were included. The rest were feasibility, pilot RCTs and quasi-experimental studies. Interventions were diverse in design and targeted a range of mental health problems using a wide variety of therapeutic orientations. All included studies reported reductions in psychological distress postintervention. Furthermore, 5 controlled studies demonstrated significant reductions in psychological distress compared with inactive control groups. In addition, 3 controlled studies comparing interventions with active control groups failed to demonstrate superior effects. Broader utility in promoting well-being in nonclinical populations was unclear. Conclusions The efficacy and acceptability of conversational agent interventions for mental health problems are promising. However, a more robust experimental design is required to demonstrate efficacy and efficiency. A focus on streamlining interventions, demonstrating equivalence to other treatment modalities, and elucidating mechanisms of action has the potential to increase acceptance by users and clinicians and maximize reach.


2021 ◽  
pp. 002076402110175
Author(s):  
Roberto Rusca ◽  
Ike-Foster Onwuchekwa ◽  
Catherine Kinane ◽  
Douglas MacInnes

Background: Relationships are vital to recovery however, there is uncertainty whether users have different types of social networks in different mental health settings and how these networks may impact on users’ wellbeing. Aims: To compare the social networks of people with long-term mental illness in the community with those of people in a general adult in-patient unit. Method: A sample of general adult in-patients with enduring mental health problems, aged between 18 and 65, was compared with a similar sample attending a general adult psychiatric clinic. A cross-sectional survey collected demographic data and information about participants’ social networks. Participants also completed the Short Warwick Edinburgh Mental Well-Being Scale to examine well-being and the Significant Others Scale to explore their social network support. Results: The study recruited 53 participants (25 living in the community and 28 current in-patients) with 339 named as important members of their social networks. Both groups recorded low numbers in their social networks though the community sample had a significantly greater number of social contacts (7.4 vs. 5.4), more monthly contacts with members of their network and significantly higher levels of social media use. The in-patient group reported greater levels of emotional and practical support from their network. Conclusions: People with serious and enduring mental health problems living in the community had a significantly greater number of people in their social network than those who were in-patients while the in-patient group reported greater levels of emotional and practical support from their network. Recommendations for future work have been made.


2021 ◽  
pp. 1-10
Author(s):  
Beate Muschalla ◽  
Clio Vollborn ◽  
Anke Sondhof

<b><i>Introduction:</i></b> Embitterment can occur as a reaction to perceived injustice. During the pandemic and restrictions in daily living due to infection risk management, a range of many smaller or severe injustices have occurred. <b><i>Objective:</i></b> The aim of this study is to investigate what characterizes persons with high embitterment, mental illness, embitterment and mental illness, and those without embitterment or mental health problems. <b><i>Methods:</i></b> We conducted an online survey including persons from the general population in November 2020 and December 2020, the phase during which a second lockdown took place, with closed shops, restaurants, cultural and activity sites. 3,208 participants (mean age 47 years) gave self-ratings on their present well-being, burdens experienced during the pandemic, embitterment, wisdom, and resilience. <b><i>Results:</i></b> Embitterment occurred among 16% of the sample, which is a high rate in comparison with 4% during pre-pandemic times. Embitterment was weakly correlated with unspecific mental well-being. There were more persons with embitterment than those with embitterment and a mental health problem. Persons with embitterment reported less coronavirus-related anxiety than persons without embitterment. However, embittered persons reported more social and economic burdens and more frequent experiences of losses (job loss and canceling of medical treatments). Embittered persons perceive their own wisdom competencies on a similar level as persons with mental health problems or persons without mental health problems. <b><i>Conclusion:</i></b> Embitterment is a specific potentially alone-standing affective state, which is distinguishable from general mental health and coping capacities (here: wisdom). The economic and social consequences of pandemic management should be carefully recognized and prevented by policy.


Author(s):  
Herbert E. Ainamani ◽  
Godfrey Z. Rukundo ◽  
Timothy Nduhukire ◽  
Eunice Ndyareba ◽  
Tobias Hecker

Abstract Background Child maltreatment poses high risks to the mental health and cognitive functioning of children not only in childhood but also in later life. However, it remains unclear whether child maltreatment is directly associated with impaired cognitive functioning or whether this link is mediated by mental health problems. Our study aimed at examining this research question among children and adolescents in Uganda. Methods A sample of 232 school-going children and adolescents with a mean age of 14.03 (SD = 3.25) was assessed on multiple forms of maltreatment using the Maltreatment and Abuse Chronology Exposure—Pediatric Version (pediMACE). Executive functions were assessed by the Tower of London task and working memory by the Corsi Block Tapping task, while mental health problems were assessed using the Child PTSD Symptom Scale for PTSD and the Center for Epidemiological Studies Depression Scale for Children (CES-DC). Results In total, 232 (100%) of the participant reported to have experienced at least one type of maltreatment in their lifetime including emotional, physical, and sexual violence as well as neglect. We found a negative association between child maltreatment and executive functions (β = − 0.487, p < 0.001) and working memory (β = − 0.242, p = 0.001). Mental health problems did not mediate this relationship. Conclusions Child maltreatment seems to be related to lower working memory and executive functioning of affected children and adolescents even after controlling for potential cofounders. Our study indicates that child maltreatment the affects children’s cognitive functionality beyond health and well-being.


2015 ◽  
Vol 202 (10) ◽  
pp. 537-542 ◽  
Author(s):  
Debra J Rickwood ◽  
Kelly R Mazzer ◽  
Nic R Telford ◽  
Alexandra G Parker ◽  
Chris J Tanti ◽  
...  

2021 ◽  
Author(s):  
Kathryn M Bell ◽  
Diane Holmberg

Amidst the ongoing COVID-19 pandemic, people are facing heightened uncertainty about the future and increasing rates of psychological distress. Intolerance of uncertainty (IU) and perceived COVID-19 threat may be contributing to mental health problems. This study investigated changes in mental health problems prior to and during the first two pandemic waves in the U.S., and the extent to which IU and perceived COVID-19 threat predicted these problems. MTurk participants (n=192; 50% women) were recruited from a pre-pandemic study in December 2019/January 2020 for a follow-up study on COVID-19 experiences, across five timepoints between April and August 2020. IU, perceived COVID-19 threat, and mental health problems (i.e., worry, COVID-19 fear, and trauma symptoms) were assessed. On average, mental health problems were not elevated, relative to pre-pandemic levels, and remained stable across time. Heightened IU and perceived COVID-19 threat were associated with more mental health problems. Surprisingly, objective measures of COVID-19 threat (e.g., state case rates) showed no associations with IU, and were slightly negatively correlated with psychological distress and perceived threat. Pre-existing mental health symptoms, IU and perceived COVID-19 threat may foster vulnerability to mental health problems during the pandemic, more so than objective threat levels.


2011 ◽  
Vol 8 (1) ◽  
pp. 4-5 ◽  
Author(s):  
AbdulKareem AlObaidi

Children and adolescents constitute half of Iraq's population of over 30 million. Mental health problems experienced by Iraqi children and adolescents are a hidden problem. Many factors contribute to the mental health problems of young Iraqis, including being victims and witnesses to violence, seeing family members become victims, being displaced from their homes, and experiencing the instability that still plagues their nation. Iraqis have experienced severe deprivation caused by many years of war, economic embargoes and civil unrest. Violence, poverty and the failure of the education and health systems have severely undermined the well-being of Iraqis, especially children (AlObaidi et al, 2009).


2020 ◽  
Author(s):  
Herbert E Ainamani ◽  
Godfrey Z Rukundo ◽  
Timothy Nduhukire ◽  
Eunice Ndyareba ◽  
Tobias Hecker

Abstract Background: Child maltreatment poses high risks to the mental health and cognitive functioning of children not only in childhood but also in later life. However, it remains unclear whether child maltreatment is directly associated with impaired cognitive functioning or whether this link is mediated by mental health problems. Our study aimed at examining this research question among children and adolescents in Uganda. Methods: A sample of 232 school-going children and adolescents with a mean age of 14.03 (SD = 3.25) was assessed on multiple forms of maltreatment using the Maltreatment and Abuse Chronology Exposure – Pediatric Version (pediMACE). Executive functions were assessed by the Tower of London task and working memory by the Corsi Block Tapping task, while mental health problems were assessed using the Child PTSD Symptom Scale for PTSD and the Center for Epidemiological Studies Depression Scale for Children (CES-DC).Results: In total, 232(100%) of the participant reported to have experienced at least one type of maltreatment in their lifetime ranging from having been intentionally pushed by an authority figure (89.7%, n = 208) to entering an object in the participant’s body (2.6%, n =6). We found a negative association between child maltreatment and executive functions (β = -0.487, p < .001) and working memory (β = -0.242, p = .001). Mental health problems did not mediate this relationship.Conclusions: Child maltreatment seems to be related to lower working memory and executive functioning of affected children and adolescents even after controlling for potential cofounders. Our study indicates that child maltreatment affects children’s cognitive functionality beyond health and well-being.


2021 ◽  
Vol 12 ◽  
Author(s):  
Gökmen Arslan ◽  
Murat Yıldırım ◽  
Mega M. Leung

Research Problem: The onset of the COVID-19 pandemic has triggered a multi-faceted crisis worldwide. Researchers and health authorities in various parts of the world echoed the dire condition of the public's mental health. This study sought to examine the mediating effect of personal meaning on the association between coronavirus (COVID-19)-related suffering, mental health problems, and life satisfaction. Participants included 231 adults (mean age = 46.65 ± 13.98; 68% female) and completed measures of suffering related to COVID-19, meaning, life satisfaction, and mental health problems online.Results: Findings from mediation analysis showed that suffering had significant associations with personal meaning, mental health, and well-being. Furthermore, personal meaning was significantly associated with adults' mental health and well-being and mediated the negative effect of suffering on mental health and well-being.Discussion: Overall, results from this study indicate that personal meaning is an important promotive factor that may help to understand the negative effect of coronavirus-related suffering on mental health and well-being amid the public health crisis.


Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1588
Author(s):  
Sunhwa Shin ◽  
Eunhye Lee

The purpose of this study was to confirm the relationship between internal health locus of control, mental health problems, and subjective well-being in adults during the prolonged COVID-19 pandemic. In particular, the mediating effect of mental health problems on the relationship between internal health locus of control and subjective well-being was examined. A cross-sectional descriptive design was conducted via online survey. The participants were 600 adults over 20 years of age living in South Korea. The collected data were analyzed using hierarchical regression analysis and SPSS Process Macro (Model 4). As a result of the study, the internal health locus of control had a significant negative effect on mental health problems. In addition, in the process of the internal health locus of control affecting subjective well-being, the mediating effect of mental health problems was significantly shown. In the period of an infectious disease pandemic such as COVID-19, it is necessary to establish a strong internal health locus of control of individuals and to promote monitoring and treatment introduction for those with a low internal health locus of control. In addition, it was discussed that controlling mental health problems can improve subjective well-being, which is life satisfaction and happiness.


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