ArticleJMIR mental health2025
The Efficacy of Conversational AI in Rectifying the Theory-of-Mind and Autonomy Biases: Comparative Analysis.
Article in JMIR mental health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Therapeutic Interaction Features of AI Chatbots in Depression Interventions: Systematic Review and Meta-Analysis.Journal of medical Internet research · 2026Pooled it
- "Your Digital Doctor Will Now See You": A Narrative Review of VR and AI Technology in Chronic Illness Management.Healthcare (Basel, Switzerland) · 2026Review
- Exploring the Role of Artificial Intelligence in Smart Healthcare: A Capability and Function-Oriented Review.Healthcare (Basel, Switzerland) · 2025Review
- The Efficacy of Conversational AI in Rectifying the Theory-of-Mind and Autonomy Biases: Comparative Analysis.JMIR mental health · 2025Article
- Generative multimodal large language models in mental health care: Applications, opportunities, and challenges.PLOS mental health · 2025Review
- Empathy AI in healthcare.Frontiers in psychology · 2025Article
- Can AI replace psychotherapists? Exploring the future of mental health care.Frontiers in psychiatry · 2024Article
- Integrating Artificial Intelligence into Psychological Counseling: A Narrative Review and Governance Framework.Inquiry : a journal of medical care organization, provision and financingReview
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe increasing deployment of conversational artificial intelligence (AI) in mental health interventions necessitates an evaluation of their efficacy in rectifying cognitive biases and recognizing affect in human-AI interactions. These biases are particularly relevant in mental health contexts as they can exacerbate conditions such as depression and anxiety by reinforcing maladaptive thought patterns or unrealistic expectations in human-AI interactions.
objectiveThis study aimed to assess the effectiveness of therapeutic chatbots (Wysa and Youper) versus general-purpose language models (GPT-3.5, GPT-4, and Gemini Pro) in identifying and rectifying cognitive biases and recognizing affect in user interactions.
methodsThis study used constructed case scenarios simulating typical user-bot interactions to examine how effectively chatbots address selected cognitive biases. The cognitive biases assessed included theory-of-mind biases (anthropomorphism, overtrust, and attribution) and autonomy biases (illusion of control, fundamental attribution error, and just-world hypothesis). Each chatbot response was evaluated based on accuracy, therapeutic quality, and adherence to cognitive behavioral therapy principles using an ordinal scale to ensure consistency in scoring. To enhance reliability, responses underwent a double review process by 2 cognitive scientists, followed by a secondary review by a clinical psychologist specializing in cognitive behavioral therapy, ensuring a robust assessment across interdisciplinary perspectives.
resultsThis study revealed that general-purpose chatbots outperformed therapeutic chatbots in rectifying cognitive biases, particularly in overtrust bias, fundamental attribution error, and just-world hypothesis. GPT-4 achieved the highest scores across all biases, whereas the therapeutic bot Wysa scored the lowest. Notably, general-purpose bots showed more consistent accuracy and adaptability in recognizing and addressing bias-related cues across different contexts, suggesting a broader flexibility in handling complex cognitive patterns. In addition, in affect recognition tasks, general-purpose chatbots not only excelled but also demonstrated quicker adaptation to subtle emotional nuances, outperforming therapeutic bots in 67% (4/6) of the tested biases.
conclusionsThis study shows that, while therapeutic chatbots hold promise for mental health support and cognitive bias intervention, their current capabilities are limited. Addressing cognitive biases in AI-human interactions requires systems that can both rectify and analyze biases as integral to human cognition, promoting precision and simulating empathy. The findings reveal the need for improved simulated emotional intelligence in chatbot design to provide adaptive, personalized responses that reduce overreliance and encourage independent coping skills. Future research should focus on enhancing affective response mechanisms and addressing ethical concerns such as bias mitigation and data privacy to ensure safe, effective AI-based mental health support.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.