Monthly Archives: January 2025

Study Of Virtual Avatars in Mental Health Care

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New research from Cedars-Sinai Medical Center in Los Angeles describes the use of AI driven avatars programmed for motivational interviewing and cognitive behavioral therapy can be accepted by patients and considered helpful in counseling sessions.

Patients reported that after 30 minute sessions using virtual reality goggles, 85% of participants said they found the experience to be helpful, and 90% expressed interest in doing it again.

The patients were individuals who were awaiting liver transplants for cirrhosis and according to Dr. Brennan Spiegel, director of health services research at Cedars-Sinai, ‘alcohol addiction remains a high-risk factor.’ “We see VR as a way to augment traditional interventions, which often fall short due to a shortage of mental health professionals, societal stigmatizing of alcoholism and other factors.”

In the US, over 29 million individuals were identified with alcohol use disorder (AUD) in 2019 and is projected to increase further by 2030. Despite this, treatment access is low, with only 7.6% of affected individuals receiving AUD-related treatment in 2021. Furthermore, only 16% of individuals receiving AUD-directed therapy achieved abstinence. Relapse prevention treatment remains a challenge, with more than 60% relapsing within the first year of treatment

Treatment modalities for AUD encompass both pharmacotherapy and psychotherapeutic approaches, with increasing emphasis on combination therapy. Psychotherapeutic approaches, such as motivational interviewing (MI) and cognitive behavioral therapy (CBT), are widely disseminated evidence-based interventions for AUD and recommended by professional societies as they serve to address harmful drinking patterns. Unfortunately, treatment access is limited and aggravated by a scarcity of mental health professionals, pervasive societal stigma, financial, attitudinal, and geographic barriers.

New Technology Solutions

Technological solutions, such as telemedicine and mobile applications, have begun to address barriers to access. Including advancements in virtual reality (VR) is emerging as a valuable supplementary tool for AUD assessment and treatment. Current, traditional cognitive behavior therapy (CBT) and VR-assisted CBT have involved preprogrammed or scripted methods. Recently, advancements in artificial intelligence (AI) have introduced large language models (LLMs) capable of generating more dynamic and responsive interactions. LLMs have shown a remarkable ability to facilitate personalized treatment plans and enhance patient engagement in the fields of medicine. The applications of VR with integrative, interview-based therapies enabled through LLMs have been unexplored.

Results

The new study introduces a novel program that combines spatial computing with AI to deliver self-administered mental health support for patients with AUD. In earlier research, the researchers found this program to be feasible, safe, and acceptable for patients experiencing mild-to-moderate depression or anxiety. Building on this foundation, the study aimed to adapt the program to integrate motivational interviewing (MI) techniques, as well as to assess its feasibility, safety, and efficacy in delivering combined CBT and MI in VR to address persisting gaps in psychotherapeutic care delivery for patients with alcohol-associated cirrhosis.

Building upon the insights drawn from the thematic content analysis with 20 socioeconomically diverse participants, our study evaluated a program combining spatial computing and AI to deliver self-administered, immersive mental health support targeting alcohol craving reduction. The participants offered mostly positive feedback on their interaction with the virtual AI therapist.

Patient Assessment

Patients highlighted the program’s usability and acceptability, its personalized engagement, as well as the empathetic, private, and nonjudgmental therapeutic alliance it fostered. Participants described the AI avatar as realistic and engaging in its communication style, which many reported to be comparable with a human therapist. Most participants expressed a willingness to recommend this form of self-administered psychotherapy to others. These findings are notable given that three-quarters of participants reported minimal prior experience with VR.

Source:

Yeo YH, Clark A, Mehra M, Danovitch I, Osilla K, Yang JD, Kuo A, Kim H-S, Vipani A, Wang Y, Ayoub W, Trivedi H, Samaan, Wu T, Shah, Liran O, and Spiegel B. (2024) The feasibility and usability of an artificial intelligence-enabled conversational agent in virtual reality for patients with alcohol-associated cirrhosis: A multi-methods study, Journal of Medical Extended Reality 1:1, 257–270, DOI: 10.1089/jmxr.2024.0033.

[Link to virtualmedicine.org]

Link Between Social Media Use and Irritability

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A new survey led by researchers from the Center for Quantitative Health at Massachusetts General Hospital and Harvard Medical School has analyzed the association between self-reported social media use and irritability among US adults. Data suggests that frequent social media use, especially among active posters, was correlated with higher levels of irritability.

Previous research on social media use has demonstrated connections to increased depressive symptoms, but how much social media engagement is associated with irritability or its influence on depression and anxiety has remained unclear.

Symptom Measurements

The survey collected sociodemographic data, self-reported social media usage, and measures of irritability from 42,597 participants (mean age of 46 years, with 58.5% identifying as women, 40.4% as men, and 1.1% as nonbinary). The Brief Irritability Test (BITe), was used, which consists of five statements evaluating irritability symptoms over the previous two weeks. Scores range from 5 to 30, with higher scores indicating higher levels of irritability. The analysis also included depression and anxiety metrics to account for overlapping psychological symptoms.

Social Media Assessment

Social media use was categorized based on frequency: never, less than once per week, once per week, several times per week, once per day, several times per day, or most of the day. Platforms analyzed included Facebook, Instagram, TikTok, and Twitter/X. Frequency of active posting, political engagement, and political affiliation were also examined to identify potential confounding factors.

Results

  • Frequent social media use correlated with higher irritability scores, even after adjusting for anxiety and depression.
  • Participants using social media most of the day scored higher on the BITe in unadjusted models. After adjusting for anxiety and depression, the increase remained significant.
  • Platform-specific analyses revealed a dose-response relationship between posting frequency and irritability. Posting multiple times per day was associated with the highest irritability levels across all platforms, with TikTok users showing the largest increase.
  • High social media engagement levels, particularly frequent posting, were associated with greater irritability in US adults. Although the study could not establish direct causation, findings suggest a potential feedback loop relationship, where irritability may both influence a desire to engage and increase irritation from social media use.

Conclusion

Researchers suggest that there is an association between high levels of social media use, particularly posting on social media, and irritability among US adults. The implications of this irritability and the potential for interventions to address this association require additional investigation.

Source: Roy H. Perlis et al, Irritability and Social Media Use in US Adults, JAMA Network Open (2025). DOI: 10.1001/jamanetworkopen.2024.52807

Teletherapy Has Not Improved Access to Mental Health Care for Those Who Cannot Pay

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A recent study published in the American Journal of Psychiatry has demonstrated that while the use of teletherapy has become more widespread over the last few years, access to such care has not increased for those who cannot afford it.

The researchers, from Columbia University, note that since the pandemic, the percentage of Americans seeking psychotherapy has more than doubled and has remained at higher levels since then, primarily due to the ease of access online.

For this study, the research team looked at previous research that focused on highlighting trends in patients seeking outpatient care in the U.S.— this earlier study involved 89,619 psychotherapy patients. A comparison of previous versus current data found that despite the hope that increasing the use of teletherapy would lead to more help for low-income people, there was no noticeable improvement. Patients using such services tended to be young, well educated and in higher income brackets.

The researchers also looked at data from another study focused on the use of telehealth by children and adolescents and found similar results. Most were members of high-income families, especially those with good health insurance.

The research team concluded that it appears that teletherapy has done little to improve access to mental health care for low-income people, primarily because those who offer such services expect to be paid the same as for in-office sessions, either by clients or their insurance companies.

Source: Mark Olfson et al, Use of Telemental Health Care by Children and Adolescents in the United States, American Journal of Psychiatry (2025). DOI: 10.1176/appi.ajp.20240193