Background

Attention deficit is a growing problem in adults, and early diagnosis and treatment are needed. Previous studies have shown that cognitive behavioral therapy (CBT) is effective in improving attention deficit symptoms. However, many patients are not receiving adequate treatment due to time, space, and cost constraints. Recently, in other mental illnesses, mobile-based chatbots delivering CBT and psychoeducation have been used for symptom mitigation and treatment.

Objective

This study aimed to investigate the feasibility and usability of a short-term intervention, specifically a mobile-based interactive chatbot application, in alleviating attention deficit symptoms.

Methods

This was a randomized, non-blind parallel-group pilot study conducted from September 2019 to March 2020. Forty-six individuals with attention deficit aged 19–60 were randomly allocated to the chatbot (n = 23) and information-only control groups (n = 23) for 4 weeks. The former group was instructed to use the chatbot application “Todaki,” while the latter group was provided with a book on managing attention deficit symptoms. Participants were administered questionnaires to assess their symptoms of attention deficit, depression, and anxiety and evaluated at baseline and 4 weeks after the intervention. The post-intervention survey assessed the chatbot’s usability, acceptability, and side effects.

Results

The average age of the participants was 25.1 years (standard deviation [SD] 7.5 years), and 56.5 % (26/46) participants were female. Intention-to-treat analysis (chatbot, n = 23; control, n = 23) revealed a significant reduction of attention deficit symptoms only in the chatbot group, which is represented by group-by-time interaction in Conner’s Adult ADHD Rating Scale subscales of Diagnostic and Statistical Manual-IV Attention-Deficit/Hyperactivity Disorder (ADHD) Hyperactive-Impulsive symptoms (F = 4.39; p = .04) and ADHD symptoms total (F = 6.74, p = .01). Further, the results of the paired t-test were significant only in the chatbot group. The average number of times the chatbots were used in 4 weeks was 20.32 (SD 12.89). The total average usage time was 1 h 15 min (SD 1 h 20 min). The degree of improvement in the ADHD symptoms total score was correlated with the number of times the psychoeducation program was used. According to the participants, the empathic/friendly character and unnatural flow of conversation were the best and worst features of the chatbot, respectively.

Conclusions

This study identified the feasibility and usability of using the mobile-based chatbot to improve attention deficit and its associated psychiatric symptoms. Using this novel intervention to conduct CBT would provide a useful digital therapeutic tool that allows easy accessibility and self-guided management for people with attention deficit, which should be verified through the large scale randomized controlled trial.

中文翻译：

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基于移动应用程序的聊天机器人，为注意力不足的成年人提供认知行为疗法和心理教育：一项发展和可行性/可用性研究

背景

注意缺陷在成年人中是一个日益严重的问题，因此需要早期诊断和治疗。先前的研究表明，认知行为疗法（CBT）可有效改善注意力缺陷症状。但是，由于时间，空间和费用的限制，许多患者没有得到适当的治疗。近来，在其他精神疾病中，提供CBT和心理教育的基于移动的聊天机器人已被用于缓解症状和治疗。

客观的

这项研究旨在调查短期干预措施（特别是基于移动的交互式聊天机器人应用程序）缓解注意力不足症状的可行性和可用性。

方法

这是一项从2019年9月至2020年3月进行的随机，无盲的平行小组试点研究。将46名19-60岁注意力缺陷的个体随机分配给聊天机器人（n = 23）和仅提供信息的对照组（ n = 23），持续4周。指示前一组使用聊天机器人应用程序“ Todaki”，而后一组则提供了一本有关处理注意力不足症状的书。参与者接受问卷调查以评估他们的注意力不足，抑郁和焦虑症状，并在基线和干预后4周进行评估。干预后的调查评估了聊天机器人的可用性，可接受性和副作用。

结果

参与者的平均年龄为25.1岁（标准差[SD] 7.5岁），女性为56.5％（26/46）。意向治疗分析（chatbot，n = 23；对照组，n = 23）显示，仅在聊天机器人组中，注意力不足症状显着减少，这由Conner成人ADHD评分量表的逐时交互作用表示诊断和统计手册-IV注意缺陷/多动障碍（ADHD）多动-冲动症状（F = 4.39; p = .04）和ADHD症状总计（F = 6.74，p = .01）。此外，配对t的结果-test仅在chatbot组中有意义。聊天机器人在4周内的平均使用次数为20.32（SD 12.89）。总平均使用时间为1小时15分钟（标准时间为1小时20分钟）。ADHD症状总评分的改善程度与使用心理教育程序的次数相关。参与者认为，善解人意/友好的性格和不自然的交谈是聊天机器人的最佳和最差特征。

结论

这项研究确定了使用基于移动的聊天机器人来改善注意力不足及其相关精神症状的可行性和可用性。使用这种新颖的干预措施进行CBT，将提供有用的数字治疗工具，使注意力不足的人容易获得和进行自我指导的治疗，应通过大规模的随机对照试验进行验证。