ArticleScientific reports2026
Trust-driven healthy engagement with conversational AI for mental health support in young adults: a mixed methods study.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Young adults aged 18-35 years increasingly engage with conversational artificial intelligence (C-AI) in everyday contexts in which they may perceive emotional relief, cognitive clarification, and psychological support. However, the mechanisms through which C-AI interactions are associated with users' perceived psychological health support remain insufficiently understood. Drawing on an extended stimulus-organism-response (S-O-R) framework, this mixed-methods study examined the associations among Conversational AI Perceived Trust (C-AIPT), Conversational AI Perceived Warmth (C-AIPW), Technology Healthy Use (THU), and Perceived Psychological Health Support (PHS). In this study, PHS was conceptualized as users' subjective appraisal of psychological support arising from everyday C-AI interactions, rather than as mental health-specific use or clinically verified improvement in mental health symptoms. THU was conceptualized not as objectively observed use behavior or usage frequency, but as a self-regulatory orientation toward C-AI engagement encompassing moderate use, reflective judgment, goal orientation, and boundary awareness. Survey data from 1,006 participants with prior C-AI use experience, collected between July and August 2025, were analyzed using partial least squares structural equation modeling (PLS-SEM) with 5,000 bootstrap resamples. These quantitative analyses were complemented by asynchronous in-depth interviews with 50 experienced C-AI users. The results showed that C-AIPT significantly predicted both C-AIPW (β = 0.774, P < 0.001) and THU (β = 0.409, P < 0.001), whereas only THU was directly associated with PHS (β = 0.382, P < 0.001). Mediation analyses identified THU as the primary self-regulatory pathway linking C-AIPT to PHS. In addition, AI autonomy (AIAu) weakened the association between C-AIPT and THU, whereas AI attachment (AIAt) weakened the association between THU and PHS. Qualitative findings further suggest that perceived warmth primarily functions as an interactional cue rather than a direct therapeutic mechanism. Overall, the findings suggest that perceived psychological health support in everyday C-AI use is more closely related to goal-oriented, self-regulated, and boundary-aware healthy engagement than to emotional warmth alone.
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