AI as a Novel Digital Stressor in Adolescent Psychosis: Clinical and Ethical Implications
Abstract
ObjectiveWith the rapid adoption of artificial intelligence (AI) technologies by adolescents, the impact on their mental health is of critical concern. This article examines the emerging phenomenon of AI-related psychosis, which can be defined as new-onset or exacerbated psychotic experiences associated with generative AI platforms, such as chatbots, avatars, and virtual agents like Siri and Alexa.MethodNarrative review and perspective.ResultsAdolescents are particularly susceptible due to ongoing neurodevelopmental immaturity, including underdeveloped prefrontal regulatory circuits and heightened limbic system reactivity, which may impair emotional regulation and reality testing. Combined with extensive digital engagement, these factors increase vulnerability to psychotic experiences in response to AI interactions. There are behavioral risk factors, online habits, and neurobiological susceptibilities that may predispose adolescents to such experiences. In addition, implications are outlined for healthcare providers, including an emphasis on proactive screening, digital literacy education, and early intervention strategies. Clinical approaches to recognize and manage AI-related mental health risks in adolescents are also proposed.ConclusionsA multidisciplinary response by clinicians, educators, developers, and policymakers is needed to guide ethical AI design and safeguard the well-being of adolescents in today's digital environment.
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Within the diathesis-stress model of psychosis, LLM-CB use may increase risk factors such as sleep disturbance, social withdrawal, and a decrease in executive functioning, especially for adolescents who are vulnerable regarding neurocognitive development.
“Within the diathesis-stress model of psychosis, LLM-CBs use may increase risk factors such as sleep disturbance (due to constant availability), social withdrawal, and a decrease in executive functioning134, especially for adolescents who are vulnerable regarding neurocognitive development135.”
From A scoping review on the mental health harms of LLM-based chatbots (2026) · cites this paper as [135]
Cites
The association between adolescent well-being and digital technology use
Orben, A., & Przybylski, A. K. (2019) · Nature Human Behaviour · doi:10.1038/s41562-018-0506-1 · Cited by 1,500 · cited 1× · see citing works
“9,17,24”
Twenge, J. M., & Campbell, W. K. (2018) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2018.10.003 · Cited by 1,304 · see citing works
Odgers, C. L., & Jensen, M. R. (2020) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13190 · Cited by 1,189 · see citing works
Does time spent using social media impact mental health?: An eight year longitudinal study
Coyne, S. M., Rogers, A. A., Zurcher, J. D., Stockdale, L., & Booth, M. (2020) · Computers in Human Behavior · doi:10.1016/j.chb.2019.106160 · Cited by 701 · see citing works
Braking and accelerating of the adolescent brain
Casey, B. J., Jones, R. M., & Somerville, L. H. (2011) · Journal of Research on Adolescence · doi:10.1111/j.1532-7795.2010.00712.x · Cited by 621 · see citing works
Randomized Trial of a Generative AI Chatbot for Mental Health Treatment
Heinz, M. V., Mackin, D. M., Trudeau, B. M., Bhattacharya, S., Wang, Y., Banta, H. A., Jewett, A. D., Salzhauer, A. J., Griffin, T. Z., & Jacobson, N. C. (2025) · NEJM AI · doi:10.1056/aioa2400802 · Cited by 287 · see citing works
The Impact of Social Media on the Mental Health of Adolescents and Young Adults: A Systematic Review
Khalaf, A. M., Alubied, A. A., Khalaf, A. M., & Rifaey, A. A. (2023) · Cureus · doi:10.7759/cureus.42990 · Cited by 252 · see citing works
Artificial intelligence and chatbots in psychiatry
Pham, K. T., Nabizadeh, A., & Selek, S. (2022) · Psychiatric Quarterly · doi:10.1007/s11126-022-09973-8 · Cited by 241 · see citing works
A Call to Address AI “Hallucinations” and How Healthcare Professionals Can Mitigate Their Risks
Hatem, R., Simmons, B., & Thornton, J. E. (2023) · Cureus · doi:10.7759/cureus.44720 · Cited by 175 · see citing works
Østergaard, S. D. (2023) · Schizophrenia Bulletin · doi:10.1093/schbul/sbad128 · Cited by 87 · see citing works
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A scoping review on the mental health harms of LLM-based chatbots
Diel, A., Torous, J., Cuijpers, P., Kleesiek, J., Nensa, F., Weber, N., Faust, F., Lalgi, T. J., Mellis, F. S., Teufel, M., et al. (2026) · npj Digital Medicine · doi:10.1038/s41746-026-03054-x · Cited by 4 · see citing works
“Within the diathesis-stress model of psychosis, LLM-CBs use may increase risk factors such as sleep disturbance (due to constant availability), social withdrawal, and a decrease in executive functioning 134 , especially for adolescents who are vulnerable regarding neurocognitive development 135 .”
- Authors
- Chamarthi, V. S., Das, P., & Kashyap, R.
- Affiliations
- Children's Hospital Central California (US)
- Gunderson Medical Center
- WellSpan Health (US)
- Corresponding author
- Chamarthi, Venkata Sushma
- Venue
- The International Journal of Psychiatry in Medicine
- Publisher
- SAGE Publications
- Published
- 2025-10-22
- Volume
- 61
- Issue
- 4
- Pages
- 486-497
- ISSN
- 0033-278X (ISSN-L)
- 0091-2174
- 1541-3527
- OpenAlex
- W4415431304
- Cited by
- 7
- References
- 10
- Citations by year
- 2026: 7
- FWCI
- 12.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The International Journal of Psychiatry in Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Social Psychology › Technostress in Professional Settings
- Keywords
- adolescent psychosis, generative AI, chatbots, virtual agents, adolescent mental health, emotion regulation, digital literacy, early intervention, screening, ethical AI design
- MeSH terms
- Internet Use, Digital Health, Digital Media, Generative Artificial Intelligence, Adolescent, Adolescent Behavior, Artificial Intelligence, Humans, Psychotic Disorders
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