Exploring artificial intelligence (AI) Chatbot usage behaviors and their association with mental health outcomes in...

Technology dependence has long been a critical public health issue, especially among young people. With the development of AI chatbots, many individuals are integrating these tools into their daily lives. However, we have limited knowledge about the issues related to AI chatbot usage and dependence. Therefore, we conducted a cross-sectional survey to investigate AI chatbot usage behaviors and their association with mental health outcomes among Chinese university students. A total of 1004 students who met the inclusion criteria were included in the analysis. Our survey revealed that 45.8 % of students reported using AI chatbots in the last month, with most using them one to three days per week (78.5 %) and showing light (38.2 %) to moderate (37.6 %) dependence. University students who use AI chatbots exhibited significantly higher levels of depression (p < 0.01) and a greater proportion scoring in the moderate to high levels of depression compared to non-users (p < 0.01). Among these users, depression was directly associated with higher AI chatbot usage and dependence (β = 0.14 to 0.20, p < 0.05). However, no direct association was found between AI chatbot-related behaviors and mental well-being or resilience (p > 0.05). Nevertheless, resilience may be indirectly linked to AI chatbot usage/dependence via depression (β = -0.077 to -0.052; p < 0.05). In conclusion, AI chatbot usage is relatively common among university students, though overuse and severe dependence are infrequent. AI chatbot usage and dependence are associated with higher levels of depression; however, the causal relationship warrants further investigation.