Ting Su

Emma C. Wolfe, Ting Su, Olivier Tieleman et al.

Background: Conversational AI chatbots are emerging as scalable mental health tools, but little is known about real world engagement or its relationship to clinical outcomes. Objective: To characterize engagement phenotypes among users of Ash, a purpose-built AI mental health chatbot, and examine associations with clinical change and working alliance. Methods: K-means clustering across eight behavioral features identified engagement phenotypes among 102,684 users. Subsamples completed the PHQ-9 (n=298), GAD-7 (n=298), and MSPSS (social support; n=194) baseline and 3 weeks; 11,437 users completed baseline Working Alliance Inventory (WAI). Results: Five engagement phenotypes emerged: Early Dropouts (52.2%), Power Users (1.6%), Intensive Users (4.1%), Weekly Users (25.3%), and a novel Concentrated User pattern (16.8%); across users, 66.9% had at least one overnight session (9pm-5am). Significant pre-post improvements occurred in depression (d = -0.51), anxiety (d = -0.57), and social support (d = 0.22). An observed dose-response gradient in self-reported depression improvement was replicated in a larger sample with model-predicted PHQ-9 (n = 23,813; Power Users d = -0.54; Early Dropouts d = -0.13). Higher working alliance predicted depression improvement and moderated the engagement-social support relationship. Conclusions: Engagement with AI mental health tools is multidimensional, and different clinical outcomes respond to different dimensions of use. Findings caution against treating session counts as a primary engagement metric and offer naturalistic evidence for the clinical value of purpose-built conversational AI.

Jiahao Cheng, Tiancheng Su, Jia Yuan et al.

Large Language Models (LLMs) often exhibit \textit{hallucinations}, generating factually incorrect or semantically irrelevant content in response to prompts. Chain-of-Thought (CoT) prompting can mitigate hallucinations by encouraging step-by-step reasoning, but its impact on hallucination detection remains underexplored. To bridge this gap, we conduct a systematic empirical evaluation. We begin with a pilot experiment, revealing that CoT reasoning significantly affects the LLM's internal states and token probability distributions. Building on this, we evaluate the impact of various CoT prompting methods on mainstream hallucination detection methods across both instruction-tuned and reasoning-oriented LLMs. Specifically, we examine three key dimensions: changes in hallucination score distributions, variations in detection accuracy, and shifts in detection confidence. Our findings show that while CoT prompting helps reduce hallucination frequency, it also tends to obscure critical signals used for detection, impairing the effectiveness of various detection methods. Our study highlights an overlooked trade-off in the use of reasoning. Code is publicly available at: https://github.com/ECNU-Text-Computing/cot-hallu-detect .