Background

Software agents are computer-programs that conduct conversations with a human. The present study evaluates the feasibility of the software agent “SISU” aiming to uplift psychological wellbeing. Methods: Within a one-group pretest-posttest trial, N = 30 German-speaking participants were recruited. Assessments took place before (t1), during (t2) and after (t3) the intervention. The ability of SISU to guide participants through the intervention, acceptability, and negative effects were investigated. Data analyses are based on intention-to-treat principles. Linear mixed models will be used to investigate short-term changes over time in mood, depression, anxiety.

Intervention

The intervention consists of two sessions. Each session comprises writing tasks on autobiographical negative life events and an Acceptance- and Commitment Therapy-based exercise respectively. Participants interact with the software agent on two consecutive days for about 30 min each.

Results

All participants completed all sessions within two days. User experience was positive, with all subscales of the user experience questionnaire (UEQ) M > 0.8. Participants experienced their writings as highly self-relevant and personal. However, 57% of the participants reported at least one negative effect attributed to the intervention. Results on linear mixed models indicate an increase in anxiety over time (β = 1.33, p = .001). Qualitative User Feedback revealed that the best thing about SISU was its innovativeness (13%) and anonymity (13%). As worst thing about SISU participants indicated that the conversational style of SISU often felt unnatural (73%).

Conclusion

SISU successfully guided participants through the two-day intervention. Moreover, SISU has the potential to enter the inner world of participants. However, intervention contents have the potential to evoke negative effects in individuals. Expectable short-term symptom deterioration due to writing about negative autobiographical life events could not be prevented by acceptance and commitment therapy-based exercises. Hence, results suggest a revision of intervention contents as well as of the conversational style of SISU. The good adherence rate indicates the useful and acceptable format of SISU as a mental health chatbot. Overall, little is known about the effectiveness of software agents in the context of psychological wellbeing. Results of the present trial underline that the innovative technology bears the potential of SISU to act as therapeutic agent but should not be used with its current intervention content.

Trial-registration

The Trial is registered at the WHO International Clinical Trials Registry Platform via the German Clinical Studies Register (DRKS): DRKS00014933 (date of registration: 20.06.2018). Link: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00014933.

中文翻译：

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软件代理提供简短的自助干预以提升心理健康（“SISU”）的可行性。一项单组前测后测试验，调查 SISU 作为治疗剂的潜力

背景

软件代理是与人类进行对话的计算机程序。本研究评估旨在提升心理健康的软件代理“SISU”的可行性。方法：在一组前测后测试验中，招募了N  = 30 名讲德语的参与者。评估发生在干预之前 (t1)、期间 (t2) 和之后 (t3)。对 SISU 指导参与者进行干预的能力、可接受性和负面影响进行了调查。数据分析基于意向治疗原则。线性混合模型将用于调查情绪、抑郁、焦虑随时间的短期变化。

干涉

干预包括两个会话。每节课分别包括关于自传负面生活事件的写作任务和基于接受和承诺治疗的练习。参与者连续两天与软件代理交互，每次约 30 分钟。

结果

所有参与者在两天内完成了所有课程。用户体验是积极的，用户体验问卷 (UEQ) 的所有分量表 M > 0.8。参与者认为他们的作品具有高度的自我相关性和个人性。然而，57% 的参与者报告了至少一种归因于干预的负面影响。线性混合模型的结果表明随着时间的推移焦虑会增加（β = 1.33，p  = .001）。定性用户反馈显示，SISU 最好的地方在于其创新性（13%）和匿名性（13%）。最糟糕的是 SISU 参与者表示 SISU 的对话风格经常让人感觉不自然（73%）。

结论

SISU 成功指导参与者完成了为期两天的干预。此外，上外还有进入参与者内心世界的潜力。然而，干预内容有可能对个人产生负面影响。通过接受和承诺治疗为基础的练习无法防止由于撰写负面自传生活事件而导致的可预期的短期症状恶化。因此，结果表明对干预内容以及 SISU 的会话风格进行了修订。良好的依从率表明 SISU 作为心理健康聊天机器人的有用和可接受的格式。总体而言，人们对软件代理在心理健康方面的有效性知之甚少。

试用注册

该试验通过德国临床研究注册中心 (DRKS) 在 WHO 国际临床试验注册平台注册：DRKS00014933（注册日期：20.06.2018）。链接：https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00014933。