{"id":"https://openalex.org/W7160134448","doi":"https://doi.org/10.48550/arxiv.2605.00275","title":"Engagement Phenotypes for a Sample of 102,684 AI Mental Health Chatbot Users and Dose-Response Associations with Clinical Outcomes","display_name":"Engagement Phenotypes for a Sample of 102,684 AI Mental Health Chatbot Users and Dose-Response Associations with Clinical Outcomes","publication_year":2026,"publication_date":"2026-04-30","ids":{"openalex":"https://openalex.org/W7160134448","doi":"https://doi.org/10.48550/arxiv.2605.00275"},"language":null,"primary_location":{"id":"doi:10.48550/arxiv.2605.00275","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2605.00275","pdf_url":null,"source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"article"},"type":"preprint","indexed_in":["datacite"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://doi.org/10.48550/arxiv.2605.00275","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5126622375","display_name":"Emma C. Wolfe","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Wolfe, Emma C.","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5103877854","display_name":"Ting Su","orcid":"https://orcid.org/0000-0002-3185-8144"},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Su, Ting","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5135251993","display_name":"Olivier Tieleman","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Tieleman, Olivier","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5123979222","display_name":"Thomas D. Hull","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Hull, Thomas D.","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5135100684","display_name":"Matteo Malgaroli","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Malgaroli, Matteo","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5135147417","display_name":"Caitlin A. Stamatis","orcid":null},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Stamatis, Caitlin A.","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":6,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11519","display_name":"Digital Mental Health Interventions","score":0.9797000288963318,"subfield":{"id":"https://openalex.org/subfields/3202","display_name":"Applied Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T11519","display_name":"Digital Mental Health Interventions","score":0.9797000288963318,"subfield":{"id":"https://openalex.org/subfields/3202","display_name":"Applied Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T12488","display_name":"Mental Health via Writing","score":0.004699999932199717,"subfield":{"id":"https://openalex.org/subfields/3207","display_name":"Social Psychology"},"field":{"id":"https://openalex.org/fields/32","display_name":"Psychology"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T12128","display_name":"AI in Service Interactions","score":0.00430000014603138,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/mental-health","display_name":"Mental health","score":0.6929000020027161},{"id":"https://openalex.org/keywords/depression","display_name":"Depression (economics)","score":0.5626000165939331},{"id":"https://openalex.org/keywords/anxiety","display_name":"Anxiety","score":0.4837999939918518},{"id":"https://openalex.org/keywords/chatbot","display_name":"Chatbot","score":0.4641999900341034},{"id":"https://openalex.org/keywords/session","display_name":"Session (web analytics)","score":0.43160000443458557},{"id":"https://openalex.org/keywords/ehealth","display_name":"eHealth","score":0.3849000036716461},{"id":"https://openalex.org/keywords/sample","display_name":"Sample (material)","score":0.37959998846054077},{"id":"https://openalex.org/keywords/alliance","display_name":"Alliance","score":0.366100013256073}],"concepts":[{"id":"https://openalex.org/C134362201","wikidata":"https://www.wikidata.org/wiki/Q317309","display_name":"Mental health","level":2,"score":0.6929000020027161},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.618399977684021},{"id":"https://openalex.org/C2776867660","wikidata":"https://www.wikidata.org/wiki/Q1814941","display_name":"Depression (economics)","level":2,"score":0.5626000165939331},{"id":"https://openalex.org/C70410870","wikidata":"https://www.wikidata.org/wiki/Q199906","display_name":"Clinical psychology","level":1,"score":0.5126000046730042},{"id":"https://openalex.org/C558461103","wikidata":"https://www.wikidata.org/wiki/Q154430","display_name":"Anxiety","level":2,"score":0.4837999939918518},{"id":"https://openalex.org/C2779041454","wikidata":"https://www.wikidata.org/wiki/Q870780","display_name":"Chatbot","level":2,"score":0.4641999900341034},{"id":"https://openalex.org/C2779182362","wikidata":"https://www.wikidata.org/wiki/Q17126187","display_name":"Session (web analytics)","level":2,"score":0.43160000443458557},{"id":"https://openalex.org/C202645933","wikidata":"https://www.wikidata.org/wiki/Q4930","display_name":"eHealth","level":3,"score":0.3849000036716461},{"id":"https://openalex.org/C198531522","wikidata":"https://www.wikidata.org/wiki/Q485146","display_name":"Sample (material)","level":2,"score":0.37959998846054077},{"id":"https://openalex.org/C2778431023","wikidata":"https://www.wikidata.org/wiki/Q878249","display_name":"Alliance","level":2,"score":0.366100013256073},{"id":"https://openalex.org/C118552586","wikidata":"https://www.wikidata.org/wiki/Q7867","display_name":"Psychiatry","level":1,"score":0.34630000591278076},{"id":"https://openalex.org/C12725497","wikidata":"https://www.wikidata.org/wiki/Q810247","display_name":"Baseline (sea)","level":2,"score":0.34389999508857727},{"id":"https://openalex.org/C176217482","wikidata":"https://www.wikidata.org/wiki/Q860554","display_name":"Metric (unit)","level":2,"score":0.2921000123023987},{"id":"https://openalex.org/C75630572","wikidata":"https://www.wikidata.org/wiki/Q538904","display_name":"Applied psychology","level":1,"score":0.2865999937057495},{"id":"https://openalex.org/C2778087770","wikidata":"https://www.wikidata.org/wiki/Q2297111","display_name":"Social support","level":2,"score":0.27889999747276306},{"id":"https://openalex.org/C205545832","wikidata":"https://www.wikidata.org/wiki/Q17156455","display_name":"Young adult","level":2,"score":0.27559998631477356},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.273499995470047},{"id":"https://openalex.org/C2779382274","wikidata":"https://www.wikidata.org/wiki/Q1756074","display_name":"Presenteeism","level":3,"score":0.26649999618530273},{"id":"https://openalex.org/C2781160688","wikidata":"https://www.wikidata.org/wiki/Q2234192","display_name":"Work engagement","level":3,"score":0.2605000138282776},{"id":"https://openalex.org/C138496976","wikidata":"https://www.wikidata.org/wiki/Q175002","display_name":"Developmental psychology","level":1,"score":0.2549999952316284},{"id":"https://openalex.org/C186625053","wikidata":"https://www.wikidata.org/wiki/Q1130191","display_name":"Information overload","level":2,"score":0.2538999915122986},{"id":"https://openalex.org/C2781210005","wikidata":"https://www.wikidata.org/wiki/Q6738337","display_name":"Major depressive episode","level":3,"score":0.2531999945640564}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.48550/arxiv.2605.00275","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2605.00275","pdf_url":null,"source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":null,"raw_source_name":null,"raw_type":"article"}],"best_oa_location":{"id":"doi:10.48550/arxiv.2605.00275","is_oa":true,"landing_page_url":"https://doi.org/10.48550/arxiv.2605.00275","pdf_url":null,"source":{"id":"https://openalex.org/S4306400194","display_name":"arXiv (Cornell University)","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I205783295","host_organization_name":"Cornell University","host_organization_lineage":["https://openalex.org/I205783295"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":null,"is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"article"},"sustainable_development_goals":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":[],"abstract_inverted_index":{"Background:":[0],"Conversational":[1],"AI":[2,36,184],"chatbots":[3],"are":[4],"emerging":[5],"as":[6,206],"scalable":[7],"mental":[8,37,185],"health":[9,38,186],"tools,":[10],"but":[11],"little":[12],"is":[13,188],"known":[14],"about":[15],"real":[16],"world":[17],"engagement":[18,28,57,88,209],"or":[19],"its":[20],"relationship":[21],"to":[22,195],"clinical":[23,44,192,217],"outcomes.":[24],"Objective:":[25],"To":[26],"characterize":[27],"phenotypes":[29,58,89],"among":[30,59],"users":[31,79],"of":[32,198,219],"Ash,":[33],"a":[34,104,150,207],"purpose-built":[35,220],"chatbot,":[39],"and":[40,46,69,75,103,133,175,190,211],"examine":[41],"associations":[42],"with":[43,153,183],"change":[45],"working":[47,170],"alliance.":[48],"Methods:":[49],"K-means":[50],"clustering":[51],"across":[52,110],"eight":[53],"behavioral":[54],"features":[55],"identified":[56],"102,684":[60],"users.":[61],"Subsamples":[62],"completed":[63,80],"the":[64,177,216],"PHQ-9":[65,155],"(n=298),":[66,68],"GAD-7":[67],"MSPSS":[70],"(social":[71],"support;":[72],"n=194)":[73],"baseline":[74,81],"3":[76],"weeks;":[77],"11,437":[78],"Working":[82],"Alliance":[83],"Inventory":[84],"(WAI).":[85],"Results:":[86],"Five":[87],"emerged:":[90],"Early":[91,164],"Dropouts":[92,165],"(52.2%),":[93],"Power":[94,159],"Users":[95,98,101,160],"(1.6%),":[96],"Intensive":[97],"(4.1%),":[99],"Weekly":[100],"(25.3%),":[102],"novel":[105],"Concentrated":[106],"User":[107],"pattern":[108],"(16.8%);":[109],"users,":[111],"66.9%":[112],"had":[113],"at":[114],"least":[115],"one":[116],"overnight":[117],"session":[118,204],"(9pm-5am).":[119],"Significant":[120],"pre-post":[121],"improvements":[122],"occurred":[123],"in":[124,143,149],"depression":[125,145,173],"(d":[126,130,136],"=":[127,131,137,157,162,167],"-0.51),":[128],"anxiety":[129],"-0.57),":[132],"social":[134],"support":[135,179],"0.22).":[138],"An":[139],"observed":[140],"dose-response":[141],"gradient":[142],"self-reported":[144],"improvement":[146,174],"was":[147],"replicated":[148],"larger":[151],"sample":[152],"model-predicted":[154],"(n":[156],"23,813;":[158],"d":[161,166],"-0.54;":[163],"-0.13).":[168],"Higher":[169],"alliance":[171],"predicted":[172],"moderated":[176],"engagement-social":[178],"relationship.":[180],"Conclusions:":[181],"Engagement":[182],"tools":[187],"multidimensional,":[189],"different":[191,196],"outcomes":[193],"respond":[194],"dimensions":[197],"use.":[199],"Findings":[200],"caution":[201],"against":[202],"treating":[203],"counts":[205],"primary":[208],"metric":[210],"offer":[212],"naturalistic":[213],"evidence":[214],"for":[215],"value":[218],"conversational":[221],"AI.":[222]},"counts_by_year":[],"updated_date":"2026-06-11T09:08:48.828518","created_date":"2026-05-05T00:00:00"}
