Reporting Mental Health Symptoms: Breaking Down Barriers to Care with Virtual Human Interviewers
Open accessAbstract
A common barrier to healthcare for psychiatric conditions is the stigma associated with these disorders. Perceived stigma prevents many from reporting their symptoms. Stigma is a particularly pervasive problem among military service members, preventing them from reporting symptoms of combat-related conditions like posttraumatic stress disorder (PTSD). However, research shows increased reporting by service members when anonymous assessments are used. For example, service members report more symptoms of PTSD when they anonymously answer the Post-Deployment Health Assessment (PDHA) symptom checklist compared to the official PDHA, which is identifiable and linked to their military records. To investigate the factors that influence reporting of psychological symptoms by service members, we used a transformative technology: automated virtual humans that interview people about their symptoms. Such virtual human interviewers allow simultaneous use of two techniques for eliciting disclosure that would otherwise be incompatible; they afford anonymity while also building rapport. We examined whether virtual human interviewers could increase disclosure of mental health symptoms among active-duty service members that just returned from a year-long deployment in Afghanistan. Service members reported more symptoms during a conversation with a virtual human interviewer than on the official PDHA. They also reported more to a virtual human interviewer than on an anonymized PDHA. A second, larger sample of active-duty and former service members found a similar effect that approached statistical significance. Because respondents in both studies shared more with virtual human interviewers than an anonymized PDHA -even though both conditions control for stigma and ramifications for service members’ military records- virtual human interviewers that build rapport may provide a superior option to encourage reporting.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Relational agents built based on the theory of rapport can induce users' openness.
“Researchers further found that relational agents, which were built based on the theory of rapport, can induce users' openness (77, 78).”
From Digital Therapeutic Alliance With Fully Automated Mental Health Smartphone Apps: A Narrative Review (2022) · cites this paper as [78]
Embodiment makes conversations with chatbots more empathetic and facilitates effective rapport with users.
“It is purported that embodiment makes conversations with chatbots more empathetic and facilitates effective rapport with users [19,42,43].”
From Effectiveness and safety of using chatbots to improve mental health: systematic review and meta-analysis (2020) · cites this paper as [42]
This may make artificial intelligence chatbots more effective in building rapport with users, thereby improving their mental health.
“This may make artificial intelligence chatbots more effective in building rapport with users, thereby improving their mental health [42].”
From Effectiveness and safety of using chatbots to improve mental health: systematic review and meta-analysis (2020) · cites this paper as [42]
Chatbots may encourage interaction by those who have traditionally been reluctant to seek mental health advice due to stigmatization.
“chatbots may encourage interaction by those who have traditionally been reluctant to seek mental health advice due to stigmatization [6, 12].”
From An overview of the features of chatbots in mental health: A scoping review (2019) · cites this paper as [12]
Most previous chatbot research relied on either finite-state or frame-based systems.
“Most previous chatbot research relied on either finite-state (ie, dialog consisting of a sequence of predetermined steps or states) or frame-based systems (ie, dialog is not predetermined but dependent on the content of the user’s input and the information that the system has to elicit) [34-36].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care
Hoge, C. W., Castro, C. A., Messer, S. C., McGurk, D., Cotting, D. I., & Koffman, R. L. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa040603 · Cited by 4,778 · see citing works
Psychometric properties of the PTSD checklist (PCL)
Blanchard, E. B., Jones-Alexander, J., Buckley, T. C., & Forneris, C. A. (1996) · Behaviour Research and Therapy · doi:10.1016/0005-7967(96)00033-2 · Cited by 3,997 · see citing works
Hoge, C. W., Auchterlonie, J. L., & Milliken, C. S. (2006) · JAMA · doi:10.1001/jama.295.9.1023 · Cited by 1,979 · see citing works
Self-disclosure in computer-mediated communication: The role of self-awareness and visual anonymity
Joinson, A. N. (2001) · European Journal of Social Psychology · doi:10.1002/ejsp.36 · Cited by 1,458 · see citing works
Link, B. G., Struening, E. L., Neese-Todd, S., Asmussen, S., & Phelan, J. C. (2001) · Psychiatric Services · doi:10.1176/appi.ps.52.12.1621 · Cited by 1,254 · see citing works
Thornicroft, G., Brohan, E., Rose, D. S., Sartorius, N., & Leese, M. (2009) · The Lancet · doi:10.1016/s0140-6736(08)61817-6 · Cited by 1,189 · see citing works
It's only a computer: virtual humans increase willingness to disclose
Lucas, G. M., Gratch, J., King, A., & Morency, L.-P. (2014) · Computers in Human Behavior · doi:10.1016/j.chb.2014.04.043 · Cited by 977 · see citing works
Self-citationThe nature of rapport and its nonverbal correlates
Tickle-Degnen, L., & Rosenthal, R. (1990) · Psychological Inquiry · doi:10.1207/s15327965pli0104_1 · Cited by 960 · cited 2× · see citing works
“Tickle-Degnen and Rosenthal (1990) suggest several features of “the human element” that are important in increasing rapport, including both verbal and non-verbal behavior.”
BackgroundThomas, J. L., Wilk, J. E., Riviere, L. A., McGurk, D., Castro, C. A., & Hoge, C. W. (2010) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2010.54 · Cited by 935 · see citing works
The distress analysis interview corpus of human and computer interviews
Gratch, J., Artstein, R., Lucas, G., Stratou, G., Scherer, S., Nazarian, A., Wood, R., Boberg, J., DeVault, D., Marsella, S., et al. (2014) · Proceedings of the Language Resources and Evaluation Conference · doi:10.63317/3o7bccg9xequ · Cited by 599 · see citing works
Self-citationFear, N. T., Jones, M., Murphy, D., Hull, L., Iversen, A. C., Coker, B., Machell, L., Sundin, J., Woodhead, C., Jones, N., et al. (2010) · The Lancet · doi:10.1016/s0140-6736(10)60672-1 · Cited by 586 · see citing works
(2014) · doi:10.5555/2615731.2617415 · Cited by 553 · see citing works
Self-citationLink, B. G., Mirotznik, J., & Cullen, F. T. (1991) · Journal of Health and Social Behavior · doi:10.2307/2136810 · Cited by 525 · see citing works
Openers: Individuals who elicit intimate self-disclosure.
Miller, L. C., Berg, J. H., & ARCHER, R. L. (1983) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.44.6.1234 · Cited by 524 · see citing works
Establishing the computer-patient working alliance in automated health behavior change interventions
Bickmore, T., Gruber, A., & Picard, R. (2005) · Patient Education and Counseling · doi:10.1016/j.pec.2004.09.008 · Cited by 494 · see citing works
Assessing the economic costs of serious mental illness
Insel, T. R. (2008) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2008.08030366 · Cited by 487 · see citing works
Creating Rapport with Virtual Agents
Gratch, J., Wang, N., Gerten, J., Fast, E., & Duffy, R. (2007) · Lecture Notes in Computer Science · doi:10.1007/978-3-540-74997-4_12 · Cited by 419 · see citing works
Self-citationIs clinical virtual reality ready for primetime?
Rizzo, A. “., & Koenig, S. T. (2017) · Neuropsychology · doi:10.1037/neu0000405 · Cited by 372 · see citing works
Self-citationNonverbal behavior in clinician—patient interaction
Hall, J. A., Harrigan, J. A., & Rosenthal, R. (1995) · Applied and Preventive Psychology · doi:10.1016/s0962-1849(05)80049-6 · Cited by 309 · see citing works
Warner, C. H. (2011) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.112 · Cited by 276 · see citing works
Negotiated Collusion: Modeling Social Language and its Relationship Effects in Intelligent Agents
Cassell, J., & Bickmore, T. (2003) · User Modeling and User-Adapted Interaction · doi:10.1023/a:1024026532471 · Cited by 253 · see citing works
Bringing Chatbots into education: Towards Natural Language Negotiation of Open Learner Models
Kerlyl, A., Hall, P., & Susan Bull, A. (2007) · Springer eBooks · doi:10.1007/978-1-84628-666-7_14 · Cited by 250 · see citing works
Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD
Rizzo, A. ‘., & Shilling, R. (2017) · European Journal of Psychotraumatology · doi:10.1080/20008198.2017.1414560 · Cited by 241 · see citing works
Self-citationA Computer Interview for Suicide-Risk Prediction
GREIST, J. H., LAUGHREN, T. P., GUSTAFSON, D. H., STAUSS, F. F., ROWSE, G. L., & CHILES, J. A. (1973) · American Journal of Psychiatry · doi:10.1176/ajp.130.12.1327 · Cited by 221 · see citing works
van der Heijden, P. G. M., van der Heijden, P. G. M., BOUTS, J., & Hox, J. J. (2000) · Sociological Methods & Research · doi:10.1177/0049124100028004005 · Cited by 180 · see citing works
Burgoon, J. K., Guerrero, L. K., & Manusov, V. (2016) · Routledge eBooks · doi:10.4324/9781315663425 · Cited by 180 · see citing works
A probabilistic multimodal approach for predicting listener backchannels
Morency, L.-P., de Kok, I., & Gratch, J. (2010) · Autonomous Agents and Multi-Agent Systems · doi:10.1007/s10458-009-9092-y · Cited by 162 · see citing works
Self-citationPickard, M. D., Roster, C. A., & Chen, Y. (2016) · Computers in Human Behavior · doi:10.1016/j.chb.2016.08.004 · Cited by 157 · see citing works
Hudlická, E., & McNeese, M. D. (2002) · User Modeling and User-Adapted Interaction · doi:10.1023/a:1013337427135 · Cited by 137 · see citing works
The effect of informal social support: Face-to-face versus computer-mediated communication
Lewandowski, J., Rosenberg, B. D., Parks, M. J., & Siegel, J. T. (2011) · Computers in Human Behavior · doi:10.1016/j.chb.2011.03.008 · Cited by 136 · see citing works
Patient reaction to computer-based medical interviewing
Slack, W. V., & Cura, L. J. V. (1968) · Computers and Biomedical Research · doi:10.1016/0010-4809(68)90018-9 · Cited by 131 · see citing works
Soldier Attitudes toward Mental Health Screening and Seeking Care upon Return from Combat
Warner, C. H., Appenzeller, G. N., Mullen, K., Warner, C. M., & Grieger, T. A. (2008) · Military Medicine · doi:10.7205/milmed.173.6.563 · Cited by 105 · see citing works
SimCoach: an intelligent virtual human system for providing healthcare information and support
Rizzo, A., Lange, B. S., Buckwalter, J. G., Forbell, E., Kim, J., Sagae, K., Williams, J., Difede, J., ROTHBAUM, B. O., Reger, G. M., et al. (2011) · International Journal on Disability and Human Development · doi:10.1515/ijdhd.2011.046 · Cited by 94 · see citing works
Self-citationSocially-Aware Animated Intelligent Personal Assistant Agent
Matsuyama, Y., Bhardwaj, A., Zhao, R., Romeo, O., Akoju, S. A., & Cassell, J. (2016) · Annual Meeting of the Special Interest Group on Discourse and Dialogue · doi:10.18653/v1/w16-3628 · Cited by 81 · see citing works
Interviewing Style and Respondent Behavior
Dijkstra, W. (1987) · Sociological Methods & Research · doi:10.1177/0049124187016002006 · Cited by 73 · see citing works
Zhao, R., Sinha, T., Black, A. W., & Cassell, J. (2016) · Lecture notes in computer science · doi:10.1007/978-3-319-47665-0_20 · Cited by 73 · see citing works
New Technology in Survey Research: Computer-Assisted Personal Interviewing ( CAPI )
Baker, R. P. (1992) · Social Science Computer Review · doi:10.1177/089443939201000202 · Cited by 70 · see citing works
Conversations with a virtual human: Synthetic emotions and human responses
Qu, C., Brinkman, W., Ling, Y., Wiggers, P., & Heynderickx, I. E. J. (2014) · Computers in Human Behavior · doi:10.1016/j.chb.2014.01.033 · Cited by 55 · see citing works
On-the-Record Screenings Versus Anonymous Surveys in Reporting PTSD
McLay, R. N., Deal, W. E., Murphy, J. A., Kolkow, T. T., & Grieger, T. A. (2008) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2008.07121960 · Cited by 49 · see citing works
Stigma, American military personnel and mental health care: challenges from Iraq and Afghanistan
Schreiber, M., & McEnany, G. P. (2015) · Journal of Mental Health · doi:10.3109/09638237.2014.971147 · Cited by 48 · see citing works
Warner, C. H., Breitbach, J. E., Appenzeller, G. N., Yates, V., Grieger, T. A., & Webster, W. G. (2007) · Military Medicine · doi:10.7205/milmed.172.9.912 · Cited by 44 · see citing works
Using Social Agents to Explore Theories of Rapport and Emotional Resonance
Gratch, J. S., Kang, S., & Wang, N. (2013) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780195387643.003.0012 · Cited by 40 · see citing works
Self-citationCoping with stigma and discrimination: evidence from mental health service users in England
Isaksson, A., Corker, E., Cotney, J., Hamilton, S., Pinfold, V., Rose, D. S., Rüsch, N., Henderson, C., Thornicroft, G., & Evans-Lacko, S. E. (2017) · Epidemiology and Psychiatric Sciences · doi:10.1017/s204579601700021x · Cited by 35 · see citing works
Learning Backchannel Prediction Model from Parasocial Consensus Sampling: A Subjective Evaluation
Huang, L., Morency, L., & Gratch, J. S. (2010) · Lecture notes in computer science · doi:10.1007/978-3-642-15892-6_17 · Cited by 32 · see citing works
Self-citationOlson, C. B., Stander, V. A., & Merrill, L. L. (2004) · Military Psychology · doi:10.1207/s15327876mp1601_4 · Cited by 29 · see citing works
Psychological Screening Procedures for Deploying U.S. Forces
Wright, K. M., Thomas, J. L., Adler, A. B., Ness, J. W., Hoge, C. W., & Castro, C. A. (2005) · Military Medicine · doi:10.7205/milmed.170.7.555 · Cited by 28 · see citing works
Rizzo, A., Scherer, S. J., DeVault, D., Gratch, J. S., Artstein, R., Hartholt, A., Lucas, G., Marsella, S., Morbini, F., Nazarian, A., et al. (2014) · ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) · Cited by 28 · see citing works
Self-citationHyams, K. C., Riddle, J. R., Trump, D. H., & Wallace, M. R. (2002) · Clinical Infectious Diseases · doi:10.1086/340705 · Cited by 21 · see citing works
Computer-Assisted Questioning: the New Survey Methods in the Perception of the Respondents
Beckenbach, A. (1995) · Bulletin of Sociological Methodology/Bulletin de Méthodologie Sociologique · doi:10.1177/075910639504800111 · Cited by 20 · see citing works
The development and initial psychometric validation of the eHealth readiness scale
Bhalla, A., Durham, R. L., Al-Tabaa, N., & Yeager, C. M. (2016) · Computers in Human Behavior · doi:10.1016/j.chb.2016.09.015 · Cited by 19 · see citing works
Postdeployment Health Reassessment: A Sustainable Method for Brigade Combat Teams
Appenzeller, G. N., Warner, C. H., & Grieger, T. A. (2007) · Military Medicine · doi:10.7205/milmed.172.10.1017 · Cited by 13 · see citing works
Use of Capi With the U.S. National Health Interview Survey
Thornberry, O. T., Rowe, B., & Biggar, R. S. (1991) · Bulletin of Sociological Methodology/Bulletin de Méthodologie Sociologique · doi:10.1177/075910639103000103 · Cited by 12 · see citing works
Developing a benefits counseling website for Veterans using Motivational Interviewing techniques
Serowik, K. L., Ablondi, K. M., Black, A. C., & Rosen, M. I. (2014) · Computers in Human Behavior · doi:10.1016/j.chb.2014.03.019 · Cited by 6 · see citing works
Flagged first, then by citations
Research works printed but not linked: 5
- Cassell, J., Gill, A., and Tepper, P. (2007). "Conversational coordination and rapport, " in Proceedings of Workshop on Embodied Language Processing at ACL 2007 (Prague, CZ).
- Institute of Medicine (IOM). (2014). Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Final Assessment. Washington, DC: The National Academies Press.
- Sebestik, J., Zelon, H., DeWitt, D., O'Reilly, J. M., and McGowan, K. (1988). "Initial experiences with CAPI, " in Proceedings of the Bureau of the Census Fourth Annual Research Conference, Arlington, VA, 357-365.
- Weisband, S., and Kiesler, S. (1996). "Self disclosure on computer forms: meta-anal- ysis and implications, " in Proceedings of the SIGCHI Conference on Human Factors in Computing Systems (Vancouver, BC: ACM), 3-10.
- World Economic Forum. (2011). The Global Economic Burden of Non- Communicable Diseases, Cambridge: Harvard.
Cited by
Sorted by citations
Conversational agents in healthcare: a systematic review
Laranjo, L., Dunn, A. G., Tong, H. L., Kocaballi, A. B., Chen, J., Bashir, R., Surian, D., Gallego, B., Magrabi, F., Lau, A. Y. S., et al. (2018) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocy072 · Cited by 1,388 · see citing works
“The most common conditions were related to mental health, which was the focus of 6 studies (6 different conversational agents).(19,20,22,24,26,35) Other conditions included asthma,(28) hypertension,(33,34) type 2 diabetes, breast cancer,(25) obstructive sleep apnea,(23) sexual health,(27) pain monitoring,(32) and lang…”
Inkster, B., Sarda, S., & Subramanian, V. (2018) · doi:10.2196/preprints.12106 · Cited by 1,063 · see citing works
An overview of the features of chatbots in mental health: A scoping review
Abd-alrazaq, A. A., Alajlani, M., Alalwan, A. A., Bewick, B. M., Gardner, P., & Househ, M. (2019) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2019.103978 · Cited by 605 · see citing works
Abd-Alrazaq, A. A., Rababeh, A., Alajlani, M., Bewick, B. M., & Househ, M. (2020) · Journal of Medical Internet Research · doi:10.2196/16021 · Cited by 503 · see citing works
“It is purported that embodiment makes conversations with chatbots more empathetic and facilitates effective rapport with users [19,42,43].”
Artificially intelligent chatbots in digital mental health interventions: a review
Boucher, E. M., Harake, N. R., Ward, H. E., Stoeckl, S. E., Vargas, J., Minkel, J., Parks, A. C., & Zilca, R. (2021) · Expert Review of Medical Devices · doi:10.1080/17434440.2021.2013200 · Cited by 440 · see citing works
Physicians’ perceptions of chatbots in health Care: cross-sectional web-based survey
Palanica, A., Flaschner, P., Thommandram, A., Li, M., & Fossat, Y. (2019) · Journal of Medical Internet Research · doi:10.2196/12887 · Cited by 384 · see citing works
Zhang, J., Oh, Y. J., Lange, P., Yu, Z., & Fukuoka, Y. (2020) · Journal of Medical Internet Research · doi:10.2196/22845 · Cited by 363 · see citing works
"I Hear You, I Feel You": Encouraging Deep Self-disclosure through a Chatbot
Lee, Y.-C., Yamashita, N., Huang, Y., & Fu, W. (2020) · Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems · doi:10.1145/3313831.3376175 · Cited by 339 · see citing works
Perceptions and opinions of patients about mental health chatbots: scoping review
Abd-Alrazaq, A. A., Alajlani, M., Ali, N., Denecke, K., Bewick, B. M., & Househ, M. (2021) · Journal of Medical Internet Research · doi:10.2196/17828 · Cited by 301 · see citing works
Effectiveness of an Empathic Chatbot in Combating Adverse Effects of Social Exclusion on Mood
de Gennaro, M., Krumhuber, E. G., & Lucas, G. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.03061 · Cited by 265 · see citing works
Self-citationProchaska, J. J., Vogel, E. A., Chieng, A., Kendra, M., Baiocchi, M., Pajarito, S., & Robinson, A. (2021) · Journal of Medical Internet Research · doi:10.2196/24850 · Cited by 257 · see citing works
Fox, J., & Gambino, A. (2021) · Cyberpsychology, Behavior, and Social Networking · doi:10.1089/cyber.2020.0181 · Cited by 225 · see citing works
Lee, Y., Yamashita, N., & Huang, Y. (2020) · Proceedings of the ACM on Human-Computer Interaction · doi:10.1145/3392836 · Cited by 195 · see citing works
Artificial Intelligence for Chatbots in Mental Health: Opportunities and Challenges
Denecke, K., Abd-Alrazaq, A., & Househ, M. (2021) · Lecture Notes in Bioengineering · doi:10.1007/978-3-030-67303-1_10 · Cited by 177 · see citing works
Optimizing Students’ Mental Health and Academic Performance: AI-Enhanced Life Crafting
Dekker, I., De Jong, E. M., Schippers, M. C., De Bruijn-Smolders, M., Alexiou, A., & Giesbers, B. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.01063 · Cited by 176 · see citing works
Sweeney, C., Potts, C., Ennis, E., Bond, R., Mulvenna, M. D., O’Neill, S. M., Malcolm, M., Kuosmanen, L., Kostenius, C., Vakaloudis, A., et al. (2021) · ACM Transactions on Computing for Healthcare · doi:10.1145/3453175 · Cited by 173 · see citing works
Loh, E. (2018) · BMJ Leader · doi:10.1136/leader-2018-000071 · Cited by 171 · see citing works
Trauma-Informed Computing: Towards Safer Technology Experiences for All
Chen, J. X., McDonald, A., Zou, Y., Tseng, E., Roundy, K., Tamersoy, A., Schaub, F., Ristenpart, T., & Dell, N. L. (2022) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3491102.3517475 · Cited by 169 · see citing works
A survey on big data-driven digital phenotyping of mental health
Liang, Y., Zheng, X., & Zeng, D. D. (2019) · Information Fusion · doi:10.1016/j.inffus.2019.04.001 · Cited by 154 · see citing works
A Review of Telepresence, Virtual Reality, and Augmented Reality Applied to Clinical Care
Hilty, D. M., Randhawa, K., Maheu, M. M., McKean, A. J. S., Pantera, R. L., Mishkind, M. C., & Rizzo, A. (2020) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-020-00126-x · Cited by 146 · see citing works
Self-citationAI chatbots cannot replace human interactions in the pursuit of more inclusive mental healthcare
Brown, J. E. H., & Halpern, J. (2021) · SSM - Mental Health · doi:10.1016/j.ssmmh.2021.100017 · Cited by 139 · see citing works
Is AI the Future of Mental Healthcare?
Minerva, F., & Giubilini, A. (2023) · Topoi · doi:10.1007/s11245-023-09932-3 · Cited by 140 · see citing works
Chatbots to Support Young Adults’ Mental Health: An Exploratory Study of Acceptability
Koulouri, T., Macredie, R. D., & Olakitan, D. (2022) · ACM Transactions on Interactive Intelligent Systems · doi:10.1145/3485874 · Cited by 127 · see citing works
Health-focused conversational agents in person-centered care: a review of apps
Parmar, P., Ryu, J., Pandya, S., Sedoc, J., & Agarwal, S. (2022) · npj Digital Medicine · doi:10.1038/s41746-022-00560-6 · Cited by 113 · see citing works
Considering the role of human empathy in AI-driven therapy
Rubin, M., Arnon, H., Huppert, J. D., & Perry, A. (2024) · JMIR Mental Health · doi:10.2196/56529 · Cited by 111 · see citing works
The benefits and dangers of anthropomorphic conversational agents
Peter, S., Riemer, K., & West, J. D. (2025) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2415898122 · Cited by 110 · see citing works
Digital Therapeutic Alliance With Fully Automated Mental Health Smartphone Apps: A Narrative Review
Tong, F., Lederman, R., D'Alfonso, S., Berry, K., & Bucci, S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.819623 · Cited by 106 · see citing works
“Computer scientists have argued that users can trust, be open to, and keep a long-term relationship with relational agents (77, 78, 91, 92).”
BackgroundPhilip, P., Dupuy, L., Auriacombe, M., Serre, F., de Sevin, É., Sauteraud, A., & Micoulaud‐Franchi, J. (2020) · npj Digital Medicine · doi:10.1038/s41746-019-0213-y · Cited by 105 · see citing works
Wutz, M., Hermes, M., Winter, V., & Köberlein–Neu, J. (2023) · Journal of Medical Internet Research · doi:10.2196/46548 · Cited by 111 · see citing works
Reimagining Healthcare: Unleashing the Power of Artificial Intelligence in Medicine
Iqbal, J., Jaimes, D. C. C., Makineni, P., Subramani, S., Hemaida, S., Thugu, T. R., Butt, A. N., Sikto, J. T., Kaur, P., Lak, M. A., et al. (2023) · Cureus · doi:10.7759/cureus.44658 · Cited by 109 · see citing works
Xygkou, A., Siriaraya, P., Covaci, A., Prigerson, H. G., Neimeyer, R., Ang, C. S., & She, W.-J. (2023) · Proceedings of the 2023 CHI Conference on Human Factors in Computing Systems · doi:10.1145/3544548.3581154 · Cited by 91 · see citing works
Kim, M., Lee, S., Kim, S., Heo, J.-I., Lee, S., Shin, Y., Cho, C., & Jung, D. (2025) · Journal of Medical Internet Research · doi:10.2196/65589 · Cited by 117 · see citing works
The Digital Therapeutic Alliance and Human-Computer Interaction
D'Alfonso, S., Lederman, R., Bucci, S., & Berry, K. (2020) · JMIR Mental Health · doi:10.2196/21895 · Cited by 90 · see citing works
Deploying a robotic positive psychology coach to improve college students’ psychological well-being
Jeong, S., Aymerich-Franch, L., Arias, K., Alghowinem, S., Lapedriza, À., Picard, R. W., Park, H. W., & Breazeal, C. (2022) · User Modeling and User-Adapted Interaction · doi:10.1007/s11257-022-09337-8 · Cited by 90 · see citing works
Rheu, M., Dai, Y. H., Meng, J., & Peng, W. (2024) · Communication Research · doi:10.1177/00936502231221669 · Cited by 91 · see citing works
Health chatbots acceptability moderated by perceived stigma and severity: A cross-sectional survey
Miles, O., West, R., & Nadarzynski, T. (2021) · Digital Health · doi:10.1177/20552076211063012 · Cited by 90 · see citing works
Early detection of depression using a conversational AI bot: A non-clinical trial
Kaywan, P., Ahmed, K. E. U., Ibaida, A., Miao, Y., & Gu, B. (2023) · PLoS ONE · doi:10.1371/journal.pone.0279743 · Cited by 83 · see citing works
Vaidyam, A. N., Linggonegoro, D. W., & Torous, J. B. (2020) · The Canadian Journal of Psychiatry · doi:10.1177/0706743720966429 · Cited by 83 · see citing works
A Robotic Positive Psychology Coach to Improve College Students’ Wellbeing
Jeong, S., Alghowinem, S., Aymerich-Franch, L., Arias, K., Lapedriza, À., Picard, R. W., Park, H. W., & Breazeal, C. (2020) · IEEE RO-MAN · doi:10.1109/ro-man47096.2020.9223588 · Cited by 86 · see citing works
Automated vs. Human Health Coaching
Mitchell, E. G., Maimone, R., Cassells, A. N., Tobin, J. N., Davidson, P., Smaldone, A. M., & Mamykina, L. (2021) · Proceedings of the ACM on Human-Computer Interaction · doi:10.1145/3449173 · Cited by 78 · see citing works
The avatar will see you now: Support from a virtual human provides socio-emotional benefits
Pauw, L. S., Sauter, D. A., Kleef, G. A. V., Lucas, G., Gratch, J. S., & Fischer, A. H. (2022) · Computers in Human Behavior · doi:10.1016/j.chb.2022.107368 · Cited by 80 · see citing works
Self-citationCroes, E. A. J., Antheunis, M. L., van der Lee, C., & de Wit, J. (2024) · Interacting with Computers · doi:10.1093/iwc/iwae016 · Cited by 87 · see citing works
Digital Psychiatry: Risks and Opportunities for Public Health and Wellbeing
Burr, C., Morley, J., Taddeo, M., & Floridi, L. (2020) · IEEE Transactions on Technology and Society · doi:10.1109/tts.2020.2977059 · Cited by 78 · see citing works
Nashwan, A. J., Gharib, S., Alhadidi, M. M. B., El‐Ashry, A. M., Alamgir, A., Al-Hassan, M., Khedr, M. A., Dawood, S. S., & Abufarsakh, B. (2023) · Issues in Mental Health Nursing · doi:10.1080/01612840.2023.2263579 · Cited by 82 · see citing works
The Illusion of Empathy? Notes on Displays of Emotion in Human-Computer Interaction
Cuadra, A., Wang, M., Stein, L. A., Jung, M. F., Dell, N., Estrin, D., & Landay, J. A. (2024) · Proceedings of the CHI Conference on Human Factors in Computing Systems · doi:10.1145/3613904.3642336 · Cited by 80 · see citing works
Chatbot-Based Assessment of Employees’ Mental Health: Design Process and Pilot Implementation
Hungerbuehler, I., Daley, K., Cavanagh, K., Garcia Claro, H., & Kapps, M. (2021) · JMIR Formative Research · doi:10.2196/21678 · Cited by 73 · see citing works
Jo, E., Jeong, Y., Park, S., Epstein, D. A., & Kim, Y. (2024) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3613904.3642420 · Cited by 75 · see citing works
Anmella, G., Sanabra, M., Primé‐Tous, M., Segú, X., Cavero, M., Morilla, I., Grande, I., Ruíz, V., Mas, A., Martín‐Villalba, I., et al. (2023) · Journal of Medical Internet Research · doi:10.2196/43293 · Cited by 74 · see citing works
Computer-Controlled Virtual Humans in Patient-Facing Systems: Systematic Review and Meta-Analysis
Chattopadhyay, D., Ma, T., Sharifi, H., & Martyn-Nemeth, P. A. (2020) · Journal of Medical Internet Research · doi:10.2196/18839 · Cited by 66 · see citing works
van Bussel, M. J. P., Odekerken–Schröder, G. J., Ou, C., Swart, R. R., & Jacobs, M. J. G. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08189-7 · Cited by 60 · see citing works
“Others disclosed more sensitive information due to anonymity [44].”
BackgroundLoveys, K., Hiko, C., Sagar, M. A., Zhang, X., & Broadbent, E. (2022) · International Journal of Human-Computer Studies · doi:10.1016/j.ijhcs.2021.102771 · Cited by 67 · see citing works
Celino, I., & Calegari, G. R. (2020) · International Journal of Human-Computer Studies · doi:10.1016/j.ijhcs.2020.102410 · Cited by 66 · see citing works
Potts, C., Lindström, F., Bond, R., Mulvenna, M. D., Booth, F. G., Ennis, E., Parding, K., Kostenius, C., Broderick, T., Boyd, K., et al. (2023) · Journal of Medical Internet Research · doi:10.2196/43051 · Cited by 68 · see citing works
Jin, J., Walker, J., & Reczek, R. W. (2024) · Journal of Consumer Psychology · doi:10.1002/jcpy.1414 · Cited by 65 · see citing works
Miloff, A., Carlbring, P., Hamilton, W., Andersson, G., Reuterskiöld, L., & Lindner, P. (2020) · Journal of Medical Internet Research · doi:10.2196/16660 · Cited by 60 · see citing works
Vilaza, G. N., & McCashin, D. (2021) · Frontiers in Digital Health · doi:10.3389/fdgth.2021.689736 · Cited by 60 · see citing works
The digital therapeutic Alliance: prospects and considerations
Lederman, R., & D'Alfonso, S. (2021) · JMIR Mental Health · doi:10.2196/31385 · Cited by 56 · see citing works
Advancing Artificial Intelligence in Health Settings Outside the Hospital and Clinic
Aggarwal, N., Ahmed, M. K., Basu, S., Curtin, J. J., Evans, B. J., Matheny, M. E., Nundy, S., Sendak, M., Shachar, C., Shah, R. U., et al. (2020) · NAM Perspectives · doi:10.31478/202011f · Cited by 63 · see citing works
Sharing Our Emotions With Robots: Why Do We Do It and How Does It Make Us Feel?
Laban, G., & Cross, E. S. (2024) · IEEE Transactions on Affective Computing · doi:10.1109/taffc.2024.3470984 · Cited by 56 · see citing works
Lee, H. S., Wright, C., Ferranto, J., Buttimer, J., Palmer, C. E., Welchman, A., Mazor, K. M., Fisher, K. A., Smelson, D., O’Connor, L., et al. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1505024 · Cited by 55 · see citing works
Jain, G., Pareek, S., & Carlbring, P. (2024) · Internet Interventions · doi:10.1016/j.invent.2024.100745 · Cited by 51 · see citing works
"I’m Hurt Too": The Effect of a Chatbot's Reciprocal Self-Disclosures on Users’ Painful Experiences
Chung, L. L., & Kang, J. (2023) · Archives of Design Research · doi:10.15187/adr.2023.11.36.4.67 · Cited by 30 · see citing works
Nelekar, S., Abdulrahman, A., Gupta, M., & Richards, D. (2021) · British Journal of Educational Technology · doi:10.1111/bjet.13174 · Cited by 47 · see citing works
Pataranutaporn, P., Winson, K., Yin, P., Lapapirojn, A., Ouppaphan, P., Lertsutthiwong, M., Maes, P., & Ersner-Hershfield, H. (2024) · IEEE Frontiers in Education Conference (FIE) · doi:10.1109/fie61694.2024.10893443 · Cited by 45 · see citing works
Xygkou, A., Siriaraya, P., She, W. J., Covaci, A., & Ang, C. S. (2024) · International Journal of Human-Computer Interaction · doi:10.1080/10447318.2023.2292880 · Cited by 50 · see citing works
Daryanto, T., Ding, X., Wilhelm, L. A., Stil, S., Knutsen, K. M., & Rho, E. H. R. (2025) · Proceedings of the ACM on Human-Computer Interaction · doi:10.1145/3701188 · Cited by 59 · see citing works
A Robotic Companion for Psychological Well-being
Jeong, S., Aymerich-Franch, L., Alghowinem, S., Picard, R. W., Breazeal, C., & Park, H. W. (2023) · ACM/IEEE International Conference on Human-Robot Interaction (HRI) · doi:10.1145/3568162.3578625 · Cited by 43 · see citing works
Miller, E. J., Foo, Y. Z., Mewton, P., & Dawel, A. (2023) · Computers in Human Behavior Reports · doi:10.1016/j.chbr.2023.100283 · Cited by 48 · see citing works
Discourse Behavior of Older Adults Interacting with a Dialogue Agent Competent in Multiple Topics
Razavi, S. Z., Schubert, L. K., Orden, K. A. V., Ali, M. R., Kane, B., & Hoque, M. E. (2022) · ACM Transactions on Interactive Intelligent Systems · doi:10.1145/3484510 · Cited by 45 · see citing works
Clinical Results Using Virtual Reality
Rizzo, A., Koenig, S. T., & Talbot, T. B. (2019) · Journal of Technology in Human Services · doi:10.1080/15228835.2019.1604292 · Cited by 42 · see citing works
Self-citationMedical Instructed Real-Time Assistant for Patient with Glaucoma and Diabetic Conditions
Rehman, U. U., Chang, D. J., Jung, Y., Akhtar, U., Razzaq, M. A., & Lee, S. (2020) · Applied Sciences · doi:10.3390/app10072216 · Cited by 37 · see citing works
Pimentel, D., & Vinkers, C. (2021) · Frontiers in Robotics and AI · doi:10.3389/frobt.2021.634520 · Cited by 35 · see citing works
Xu, S., & Li, W. (2022) · New Media & Society · doi:10.1177/14614448221108112 · Cited by 43 · see citing works
Kim, J., Muhic, J., Robert, L., & Park, S. Y. (2022) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3491102.3502116 · Cited by 41 · see citing works
Clinical Virtual Reality: Emerging Opportunities for Psychiatry
Rizzo, A., Koenig, S. T., & Talbot, T. B. (2018) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20180011 · Cited by 40 · see citing works
Self-citationInternet-based Tailored Virtual Human Health Intervention to Promote Colorectal Cancer Screening
Zalake, M. S., Tavassoli, F., Griffin, L. N., Krieger, J. L. R., & Lok, B. C. L. (2019) · ACM International Conference on Intelligent Virtual Agents (IVA) · doi:10.1145/3308532.3329471 · Cited by 40 · see citing works
Chou, Y.-H., Lin, C., Lee, S.-H., Lee, Y.-F., & Cheng, L.-C. (2024) · JMIR Formative Research · doi:10.2196/49462 · Cited by 38 · see citing works
Kim, H., Han, B., Kim, J., Syawaludin, M. F., Kim, G. J., & Hwang, J. (2024) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3613904.3642917 · Cited by 38 · see citing works
Rapport Between Humans and Socially Interactive Agents
Gratch, J., & Lucas, G. (2021) · The Handbook on Socially Interactive Agents · doi:10.1145/3477322.3477335 · Cited by 36 · see citing works
Self-citationThe Future of Skull Base Surgery: A View Through Tinted Glasses
Sekhar, L. N., Juric‐Sekhar, G., Zeeshan, Q., Patel, A. P., McGrath, L. B., Pridgeon, J. S., Kalavakonda, N., & Hannaford, B. (2020) · World Neurosurgery · doi:10.1016/j.wneu.2020.06.172 · Cited by 36 · see citing works
Social Robots for Supporting Post-traumatic Stress Disorder Diagnosis and Treatment
Laban, G., Ben‐Zion, Z., & Cross, E. S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.752874 · Cited by 37 · see citing works
Exploring Effects of Chatbot-based Social Contact on Reducing Mental Illness Stigma
Lee, Y., Cui, Y., Jamieson, J., Fu, W., & Yamashita, N. (2023) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3544548.3581384 · Cited by 38 · see citing works
Bartle, V., Lyu, J., El Shabazz-Thompson, F., Oh, Y., Chen, A. A., Chang, Y.-J., Holstein, K., & Dell, N. (2022) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3491102.3517683 · Cited by 35 · see citing works
Petsolari, M., Ibrahim, S. B., & Slovak, P. (2024) · Proceedings of the CHI Conference on Human Factors in Computing Systems · doi:10.1145/3613904.3642619 · Cited by 35 · see citing works
Griffin, A. C., Xing, Z., Mikles, S. P., Bailey, S., Khairat, S., Arguello, J., Wang, Y., & Chung, A. E. (2021) · JAMIA Open · doi:10.1093/jamiaopen/ooab021 · Cited by 31 · see citing works
Multimodal Analysis and Estimation of Intimate Self-Disclosure
Soleymani, M., Stefanov, K., Kang, S., Ondras, J., & Gratch, J. S. (2019) · INTERNATIONAL CONFERENCE ON MULTIMODAL INTERACTION · doi:10.1145/3340555.3353737 · Cited by 33 · see citing works
Self-citationZahedi, F. M., Zhao, H., Sanvanson, P. P., Walia, N., Jain, H. K., & Shaker, R. (2022) · Information & Management · doi:10.1016/j.im.2022.103706 · Cited by 33 · see citing works
Naqishbandi, T. A., Mohamed, E. S., & Veronese, G. (2023) · International Journal of E-Adoption · doi:10.4018/ijea.316537 · Cited by 32 · see citing works
The Ethics of Privacy and Surveillance
Véliz, C. (2024) · doi:10.1093/oso/9780198870173.001.0001 · Cited by 32 · see citing works
Lee, Y., Yamashita, N., & Huang, Y. (2021) · Proceedings of the ACM on Human-Computer Interaction · doi:10.1145/3449196 · Cited by 29 · see citing works
Microexpressions in digital humans: perceived affect, sincerity, and trustworthiness
Tastemirova, A., Schneider, J., Kruse, L. C., Heinzle, S., & Brocke, J. V. (2022) · Electronic Markets · doi:10.1007/s12525-022-00563-x · Cited by 32 · see citing works
Maharjan, R., Doherty, K., Rohani, D. A., Bækgaard, P., & Bardram, J. E. (2022) · ACM Transactions on Interactive Intelligent Systems · doi:10.1145/3484508 · Cited by 29 · see citing works
Empowerment or Engagement? Digital Health Technologies for Mental Healthcare
Burr, C., & Morley, J. (2020) · Digital ethics lab yearbook · doi:10.1007/978-3-030-29145-7_5 · Cited by 29 · see citing works
Boustani, M. M., Lunn, S. J., Visser, U., & Lisetti, C. (2021) · Journal of Medical Internet Research · doi:10.2196/25837 · Cited by 28 · see citing works
Dupuy, L., Morin, C. M., de Sevin, É., Taillard, J., Salles, N., Bioulac, S., Auriacombe, M., Micoulaud‐Franchi, J., & Philip, P. (2021) · Journal of Sleep Research · doi:10.1111/jsr.13489 · Cited by 26 · see citing works
Designing Voice-First Ambient Interfaces to Support Aging in Place
Cuadra, A., Bethune, J., Krell, R., Lempel, A., Hänsel, K., Shahrokni, A., Estrin, D. L., & Dell, N. L. (2023) · Designing Interactive Systems Conference · doi:10.1145/3563657.3596104 · Cited by 28 · see citing works
Hsu, M.-C. (2023) · Sustainability · doi:10.3390/su15107905 · Cited by 29 · see citing works
Conversational agents for depression screening: A systematic review
Otero-González, I., Pacheco-Lorenzo, M. R., Iglesias, M. J. F., & Anido, L. (2023) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2023.105272 · Cited by 26 · see citing works
Synchrony facilitates altruistic decision making for non-human avatars
Fujiwara, K., Hoegen, R., Gratch, J. S., & Dunbar, N. E. (2021) · Computers in Human Behavior · doi:10.1016/j.chb.2021.107079 · Cited by 24 · see citing works
Self-citationLau, Y., Ang, W. H. D., Ang, W. W., Pang, P. C., Wong, S. H., & Chan, K. S. (2025) · Depression and Anxiety · doi:10.1155/da/8930012 · Cited by 22 · see citing works
- Authors
- Lucas, G. M., Rizzo, A., Gratch, J., Scherer, S., Stratou, G., Boberg, J., & Morency, L.-P.
- Affiliations
- University of Southern California (US)
- Carnegie Mellon University (US)
- Corresponding author
- Lucas, Gale M.
- Venue
- Frontiers in Robotics and AI
- Publisher
- Frontiers Media SA
- Published
- 2017-10-12
- Volume
- 4
- ISSN
- 2296-9144 (ISSN-L)
- OpenAlex
- W2763552934
- Cited by
- 308
- References
- 53
- Citations by year
- 2026: 33 · 2025: 37 · 2024: 63 · 2023: 39 · 2022: 32 · 2021: 42 · 2020: 39 · 2019: 14 · 2018: 9
- FWCI
- 24.27
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Robotics and AI (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Defense Sciences Office, DARPA
- Army Research Office
- Topics
- Social Sciences › Psychology › Social Psychology › Social Robot Interaction and HRI
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- stigma, post-traumatic stress disorder, military personnel, anonymity, rapport building, disclosure, Afghanistan deployment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
