Affichage des articles dont le libellé est clinique. Afficher tous les articles
Affichage des articles dont le libellé est clinique. Afficher tous les articles

14 mai 2017

Agents de conversation incarnés en psychologie clinique: une revue sur la portée

Aperçu: G.M.
Les agents de conversation intégrés (ECA) sont des personnages générés par ordinateur qui simulent les propriétés clés de la conversation humaine en face à face , comme le comportement verbal et non verbal. Dans les interventions en ligne sur la cybersanté, les ECA peuvent être utilisées pour la fourniture de facteurs automatisés de soutien humain.
L'étude donne un aperçu des possibilités technologiques et cliniques, ainsi que la base de données fondées sur les preuves pour les applications ECA en psychologie clinique, afin d'informer les professionnels de la santé de l'activité dans ce domaine de recherche. 
Cette étude comprenait N = 54 publications (N = 49 études). Plus de la moitié des études (n = 26) ont porté sur le traitement de l'autisme, et les ECA ont été utilisées le plus souvent pour la formation en compétences sociales (n = 23). Les applications variaient du simple renforcement des comportements sociaux par des expressions émotionnelles à des systèmes de conversation multimodaux sophistiqués. La plupart des applications (n ​​= 43) étaient encore dans la phase de développement et de pilotage, ce qui n'est pas encore prêt pour l'évaluation ou l'application de routine. Peu d'études ont mené une recherche contrôlée sur les effets cliniques des ECA, comme la réduction de la gravité des symptômes.
Les ECA pour les troubles mentaux sont en train d'émerger. Les techniques de pointe, impliquant, par exemple, la communication par langage naturel ou le comportement non verbal, sont de plus en plus considérées et adoptées pour les interventions psychothérapeutiques dans les recherches de l'ECA avec des résultats prometteurs. Toutefois, la preuve de leur application clinique reste rare.
Pour accroître la base de données probantes en ce qui concerne les interventions sur Internet, nous proposons un accent supplémentaire sur les solutions ECA de faible  technologie qui peuvent être rapidement développées, testées et appliquées dans la pratique courante.


J Med Internet Res. 2017 May 9;19(5):e151. doi: 10.2196/jmir.6553.

Embodied Conversational Agents in Clinical Psychology: A Scoping Review

Provoost S1,2, Lau HM2,3, Ruwaard J1,2, Riper H1,2,3,4.

Author information

1
Department of Clinical, Neuro & Developmental Psychology, Section Clinical Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
2
EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, Netherlands.
3
GGZ inGeest, Amsterdam, Netherlands.
4
Telepsychiatry Unit, Faculty of Health Science, University of Southern Denmark, Odense, Denmark.

Abstract

BACKGROUND:

Embodied conversational agents (ECAs) are computer-generated characters that simulate key properties of human face-to-face conversation, such as verbal and nonverbal behavior. In Internet-based eHealth interventions, ECAs may be used for the delivery of automated human support factors.

OBJECTIVE:

We aim to provide an overview of the technological and clinical possibilities, as well as the evidence base for ECA applications in clinical psychology, to inform health professionals about the activity in this field of research.

METHODS:

Given the large variety of applied methodologies, types of applications, and scientific disciplines involved in ECA research, we conducted a systematic scoping review. Scoping reviews aim to map key concepts and types of evidence underlying an area of research, and answer less-specific questions than traditional systematic reviews. Systematic searches for ECA applications in the treatment of mood, anxiety, psychotic, autism spectrum, and substance use disorders were conducted in databases in the fields of psychology and computer science, as well as in interdisciplinary databases. Studies were included if they conveyed primary research findings on an ECA application that targeted one of the disorders. We mapped each study's background information, how the different disorders were addressed, how ECAs and users could interact with one another, methodological aspects, and the study's aims and outcomes.

RESULTS:

This study included N=54 publications (N=49 studies). More than half of the studies (n=26) focused on autism treatment, and ECAs were used most often for social skills training (n=23). Applications ranged from simple reinforcement of social behaviors through emotional expressions to sophisticated multimodal conversational systems. Most applications (n=43) were still in the development and piloting phase, that is, not yet ready for routine practice evaluation or application. Few studies conducted controlled research into clinical effects of ECAs, such as a reduction in symptom severity.

CONCLUSIONS:

ECAs for mental disorders are emerging. State-of-the-art techniques, involving, for example, communication through natural language or nonverbal behavior, are increasingly being considered and adopted for psychotherapeutic interventions in ECA research with promising results. However, evidence on their clinical application remains scarce. At present, their value to clinical practice lies mostly in the experimental determination of critical human support factors. In the context of using ECAs as an adjunct to existing interventions with the aim of supporting users, important questions remain with regard to the personalization of ECAs' interaction with users, and the optimal timing and manner of providing support. To increase the evidence base with regard to Internet interventions, we propose an additional focus on low-tech ECA solutions that can be rapidly developed, tested, and applied in routine practice.

PMID: 28487267
DOI: 10.2196/jmir.6553