TY - JOUR

T1 - Predicting Engagement With Conversational Agents in Mental Health Therapy by Examining the Role of Epistemic Trust, Personality, and Fear of Intimacy

T2 - Cross-Sectional Web-Based Survey Study

AU - Guglielmucci, Fanny

AU - Di Basilio, Daniela

PY - 2025/7/30

Y1 - 2025/7/30

N2 - The use of conversational agents (CAs) in mental health therapy is gaining traction due to their accessibility, anonymity, and nonjudgmental nature. However, understanding the psychological factors driving preferences for CA-based therapy remains critical to ensure ethical and effective application. Variables such as epistemic trust, attachment styles, personality traits, and fear of intimacy appear central in shaping attitudes toward these artificial intelligence (AI)-driven interventions. This study aimed to investigate the role of epistemic trust, attachment styles, personality traits, and fear of intimacy in influencing individuals' willingness to engage with CA-based therapy. An online survey was administered to 876 psychology students, yielding 736 responses (84.01% response rate). Variables measured included epistemic trust, attachment styles, personality traits, and fear of intimacy. A 5-point ordinal scale assessed willingness to engage in CA-based therapy. The data were analyzed using ordinal logistic regression models, including proportional odds models (POMs), nonproportional odds models (NPOMs), and partial proportional odds models (PPOMs), with residual deviance used to compare model fit. The PPOM provided the best model fit (residual deviance=3530.47), outperforming both the NPOM (deviance=6244.01) and the POM based on Brant test results indicating violations of the proportional odds assumption (χ²105=187.8; P

AB - The use of conversational agents (CAs) in mental health therapy is gaining traction due to their accessibility, anonymity, and nonjudgmental nature. However, understanding the psychological factors driving preferences for CA-based therapy remains critical to ensure ethical and effective application. Variables such as epistemic trust, attachment styles, personality traits, and fear of intimacy appear central in shaping attitudes toward these artificial intelligence (AI)-driven interventions. This study aimed to investigate the role of epistemic trust, attachment styles, personality traits, and fear of intimacy in influencing individuals' willingness to engage with CA-based therapy. An online survey was administered to 876 psychology students, yielding 736 responses (84.01% response rate). Variables measured included epistemic trust, attachment styles, personality traits, and fear of intimacy. A 5-point ordinal scale assessed willingness to engage in CA-based therapy. The data were analyzed using ordinal logistic regression models, including proportional odds models (POMs), nonproportional odds models (NPOMs), and partial proportional odds models (PPOMs), with residual deviance used to compare model fit. The PPOM provided the best model fit (residual deviance=3530.47), outperforming both the NPOM (deviance=6244.01) and the POM based on Brant test results indicating violations of the proportional odds assumption (χ²105=187.8; P

KW - psychotherapy

KW - Young Adult

KW - Personality

KW - Adolescent

KW - Adult

KW - Humans

KW - artificial intelligence

KW - CA

KW - Psychotherapy - methods

KW - conversational agents

KW - mental health

KW - Cross-Sectional Studies

KW - personality

KW - Surveys and Questionnaires

KW - Fear - psychology

KW - epistemic trust

KW - Female

KW - AI

KW - Male

KW - Trust - psychology

KW - Middle Aged

U2 - 10.2196/70698

DO - 10.2196/70698

M3 - Journal article

C2 - 40737594

VL - 12

JO - JMIR Human Factors

JF - JMIR Human Factors

SN - 2292-9495

M1 - e70698

ER -