Generative AI use and psychosis risk: A cross-sectional survey of usage frequency, motivations, and delusion-related experiences (Preprint)

BACKGROUND We conducted a large-scale cross-sectional survey of N = 1004 U.S. young adults (Mage = 22.68, 56.4% women, 46.8% White, 16.6% Black, 14.8% Latine, 11.4% Asian), divided the sample of individuals that had used genAI into “elevated risk” (PQ-B Distress Score ≥ 20; N = 267, 28.0%) and “low risk” groups (PQ-B Distress Score < 20; N = 685, 72.0%), and compared groups on several assessments related to genAI use. OBJECTIVE We aimed to evaluate associations of psychosis risk to genAI use frequency, motivations for use, and genAI interactions involving potential delusions. METHODS We conducted a large-scale cross-sectional survey of N = 1004 U.S. young adults (Mage = 22.68, 56.4% women, 46.8% White, 16.6% Black, 14.8% Latine, 11.4% Asian), divided the sample of individuals that had used genAI into “elevated risk” (PQ-B Distress Score ≥ 20; N = 267, 28.0%) and “low risk” groups (PQ-B Distress Score < 20; N = 685, 72.0%), and compared groups on several assessments related to genAI use. RESULTS We found that while members of the elevated risk group were no more likely to have ever used genAI, they were significantly more likely to report aberrantly high use (i.e. several times per day, more than 30 minutes per day, six or more chatbot conversations per day). Those at elevated risk were more likely to report using genAI to receive social and emotional support and significantly more likely to ascribe human-like roles to their chatbot interactions (e.g. companion, friend, therapist, and romantic partner). Delusion-like experiences and interactions were also much more likely to be reported among those at risk for psychosis. CONCLUSIONS GenAI chatbots may play a role in shifting symptom-related experiences among young adults at risk. While this cross-sectional study does not assess the causal impact of genAI on symptoms, it highlights the importance of intentional design of these systems to limit risks and maximize benefits for individuals at risk for psychosis.