Evidence map›Paper›PMID 42229881›Full record

ArticleJMIR AI2026

Artificial Intelligence Discontinuation Effects (AI-DICE): An Emerging Phenomenon in Mental Health Applications.

Megan M Kelly, Phoebe S Moore, Adrian H Zai, Jeroan Allison

Abstract read
In one paragraph

Article in JMIR AI, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Megan M KellyDepartment of Psychiatry and Behavioral Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States.ORCID https://orcid.org/0000-0003-1433-1129
Phoebe S MooreDepartment of Psychiatry and Behavioral Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States.ORCID https://orcid.org/0009-0008-4607-4562
Adrian H ZaiDepartment of Psychiatry and Behavioral Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States.ORCID https://orcid.org/0000-0002-2972-6839
Jeroan AllisonDepartment of Psychiatry and Behavioral Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States.ORCID https://orcid.org/0000-0003-4472-2112

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Artificial intelligence (AI) has emerged as a powerful tool for fostering positive behavior change and enhancing mental health support. However, the abrupt discontinuation or functional degradation of AI-driven interventions, particularly those featuring conversational agents, may trigger unintended psychological consequences. Therefore, we introduce and examine the concept of Artificial Intelligence Discontinuation Effects (AI-DICE), drawing parallels from abandonment-like experiences observed from problematic termination experiences with therapists. We propose a conceptual framework for AI-DICE mitigation that draws on evidence-based behavior change principles and explores clinical modalities that may inform mitigation toolkits (eg, Acceptance and Commitment Therapy, Cognitive Behavioral Therapy, Dialectical Behavior Therapy, and Motivational Interviewing). We also ground our approach in user experience research and community-engaged research. AI-DICE raises critical ethical challenges, including transparency, the ability to withdraw or adapt participation as the users' knowledge of the intervention grows, and access to support postintervention. Prioritizing long-term continuation, or at least some form of ongoing access, over the best-planned complete discontinuation strategy may help ensure that AI-driven mental health solutions deliver lasting benefits rather than unintended harm. Finally, although not yet empirically established, incorporating discontinuation planning and AI-DICE mitigation from the outset may also improve intervention effectiveness by strengthening user autonomy, supporting skills transfer, and reducing dependence-related vulnerabilities.

Indexed as

artificial intelligencebehavior changeethical challengesintervention discontinuationlarge language modelsmental healththerapeutic alliance, digital health

Identifiers

PMID42229881
PMCPMC13273200

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.