Artificially intelligent chatbots in digital mental health interventions: a review.

INTRODUCTION: Increasing demand for mental health services and the expanding capabilities of artificial intelligence (AI) in recent years has driven the development of digital mental health interventions (DMHIs). To date, AI-based chatbots have been integrated into DMHIs to support diagnostics and screening, symptom management and behavior change, and content delivery. AREAS COVERED: We summarize the current landscape of DMHIs, with a focus on AI-based chatbots. Happify Health's AI chatbot, Anna, serves as a case study for discussion of potential challenges and how these might be addressed, and demonstrates the promise of chatbots as effective, usable, and adoptable within DMHIs. Finally, we discuss ways in which future research can advance the field, addressing topics including perceptions of AI, the impact of individual differences, and implications for privacy and ethics. EXPERT OPINION: Our discussion concludes with a speculative viewpoint on the future of AI in DMHIs, including the use of chatbots, the evolution of AI, dynamic mental health systems, hyper-personalization, and human-like intervention delivery.

The Impact of a Digital Intervention (Happify) on Loneliness During COVID-19: Qualitative Focus Group.

BACKGROUND: Loneliness is a growing area of concern, attracting attention as a public health concern due to its association with a variety of psychological and physical health problems. However, interventions targeting loneliness are less common than interventions for other mental health problems, such as depression and anxiety, and existing interventions focus primarily on building social skills and increasing opportunities for social interaction despite research suggesting these techniques are not the most effective. Furthermore, although there is an increasing need for scalable and convenient interventions, digital interventions for loneliness are even less common. OBJECTIVE: Using a qualitative approach, we explore how adults (18-64 years of age) who express wanting to be more connected to others experience loneliness and react to a digital mental health intervention targeting loneliness. METHODS: A total of 11 participants were recruited from a pilot randomized controlled trial exploring the impact of a digital mental health intervention, Happify Health, on loneliness among adults aged 18-64 years who indicated wanting to feel more connected to others when signing up for the platform. Participants were invited to participate in a 3-day asynchronous focus group about their experiences with loneliness, with Happify Health, and with social distancing during the COVID-19 pandemic. All 11 participants completed the focus group in May 2020. RESULTS: Participants' responses were coded using thematic analysis, which led to identifying five themes, each with separate subthemes, that could be applied across the 3-day focus group: loneliness, relationships, social distancing, skill acquisition, and coping. Overall, we observed variability across participants in terms of the source of their loneliness, their perceptions of their social connections, and their motivation to reduce feelings of loneliness; however, participants commonly referred to negative self-perceptions as a cause or consequence of loneliness. Participants also varied in the extent to which they felt social distancing increased or decreased feelings of loneliness. In regard to the intervention, participants showed evidence of adopting skills they used to address their loneliness, particularly mindfulness and gratitude, and then using these skills to shift toward more active coping strategies following the intervention, including during the COVID-19 pandemic. CONCLUSIONS: The heterogeneity in participants' experiences with loneliness described during this focus group emphasizes the subjective and complex nature of loneliness. This highlights the importance of developing loneliness interventions that use a variety of strategies, including both direct and indirect strategies for reducing loneliness. However, based on our data, a key component to loneliness interventions is incorporating strategies for addressing underlying negative self-perceptions that stem from, but also contribute to, loneliness. This data also provides preliminary evidence that digital platforms may be an effective tool for disseminating loneliness interventions while providing the added benefit of offering a productive distraction when feeling lonely.

The redemption and contamination research form: exploring relations with narrative identity, personality traits, response styles, and life satisfaction.

Narrative identity is typically assessed by collecting participants' autobiographical scenes and then coding these stories for themes including redemption (negative beginning, positive ending) and contamination (positive beginning, negative ending). Complimenting this approach, we introduce a self-report measure capturing the degree to which individuals explicitly view their lives and social worlds in redemptive and contaminated ways - the Redemption and Contamination Research Form (RCRF). In Studies 1 and 2, participants completed the RCRF and a measure of life satisfaction. In Study 2, participants also provided three autobiographical scenes, later coded for redemption and contamination. Across studies, our novel self-rated redemptive mindset variable corresponded positively with life satisfaction and, in Study 2, the redemption present in scenes. Relations remained significant after considering several covariates (e.g., traits, response styles). These results, which illustrate the utility of self-rated redemptive mindsets, carry implications for the multi-method assessment of constructs indigenous to narrative identity.

Narrating the nadir: examining personal and vicarious stories of cancer-related low points among survivors and romantic partners.

Objective: To investigate low point autobiographical narratives among cancer survivors and romantic partners.Design: Cancer survivors (Study 1) and romantic partners (Study 2) narrated the low points of their cancer experiences. Partners also narrated stories of cancer survivors' low points. Narratives were coded for their manifest content, as well as redemption (negative-to-positive arc), contamination (positive-to-negative arc), and tone (positive or negative valence).Main Outcome Measures: Self-reported measures of health and well-being (life satisfaction, cancer-related worry, impact of cancer).Results: The diagnosis moment was the most frequently recognised low point among survivors and partners. Survivors who narrated contaminated low points reported marginally less somatisation, salience of cancer recurrence, and that cancer had a marginally less positive impact, relative to survivors whose narratives did not contain contamination. Tone in partners' low points predicted marginally less worry and more somatisation. The tone of their vicarious low points negatively correlated with anxiety.Conclusion: This research contributes to the growing body of work examining, and giving voice to, the experiences of cancer survivors and those close to them. As such, it informs applied health researchers of potentially challenging cancer-related experiences, and the way(s) in which the storying of these experiences align with psychological flourishing.

Sticking to the (romantic) script: an examination of love life scripts, stories, and self-reports of normality.

Life scripts represent cultural expectations regarding the events in the prototypical life whereas life stories represent narrative constructions of the events occurring in individuals' own lives. In Study 1, we generated an outline of the love life script and a list of the self-definitional events individuals tend to associate with their own love lives. Participants were prompted to produce and rate seven important events in the prototypical love life and several significant moments from their own love lives. Building upon these descriptive efforts, in Study 2, we developed self-report measures of perceived and desired love life normality. These characteristics positively predicted the conventionality of autobiographical narratives drawn from participants' love life stories. Furthermore, perceived normality and desired normality were positively and negatively related to functioning within the romantic domain, respectively. These results underscore the role love life scripts and love life stories play in functioning within the romantic domain.