Artificial Companions, Authentic Feelings? Examining the Impact of Conversational AI on Adolescent Empathy Development: A Literature Review
DOI:
https://doi.org/10.47701/c62j0455Keywords:
conversational AI, adolescents, empathy, parasocial attachment, social cognitionAbstract
This literature review examined whether interaction with conversational artificial intelligence affects empathy development in adolescents aged 10 to 19 years. A narrative synthesis was conducted using searches of PubMed, IEEE Xplore, and Scopus for open-access, peer-reviewed studies published in English or Indonesian between 2010 and 2026. Studies were included when they reported empirical data on adolescents' interaction with a chatbot and measured empathy as an outcome, and findings were organized by empathy type and chatbot type. The evidence did not show that conversational AI develops empathy in adolescents. No study followed adolescent users of general-purpose chatbots over time against a comparison group. The only controlled trial, using a purpose-built training application with a mixed-age sample, found improved verbal empathetic responding after repeated practice with immediate feedback. General-purpose chatbots were consistently perceived as empathic, mainly in cognitive rather than affective terms, but this reflects empathy received rather than developed. Relational use appeared limited to a small, lonelier subgroup, and measurement approaches varied widely. Designed, feedback-rich chatbots may therefore supplement empathic skill practice, but they should not replace human interaction. Future research should use controlled longitudinal designs that measure cognitive and affective empathy separately.
References
Abilkaiyrkyzy, A., Laamarti, F., Hamdi, M., & El Saddik, A. (2024). Dialogue system for early mental illness detection: Toward a digital twin solution. IEEE Access, 12, 2007–2024. https://doi.org/10.1109/ACCESS.2023.3348783
Allouch, M., Azaria, A., & Azoulay, R. (2021). Conversational Agents: Goals, Technologies, Vision and Challenges. Sensors, 21(24), 8448. https://doi.org/10.3390/s21248448
Chan, C. K. Y., & Tse, S. (2026). Exploring student perceptions of generative AI therapists and their benefits and challenges in schools. International Journal of Psychology, 61, Article e70207. https://doi.org/10.1002/ijop.70207
Common Sense Media. (2025, July 16). Talk, Trust, and Trade-Offs: How and Why Teens Use AI Companions. https://www.commonsensemedia.org/research/talk-trust-and-trade-offs-how-and-why-teens-use-ai-companions
Ding, X., & Barbic, S. (2025). Perception of AI use in youth mental health services: Qualitative study. Journal of Participatory Medicine, 17, Article e69449. https://doi.org/10.2196/69449
Hanzawa, M., Hasei, J., Okada, A., Tanaka, C., Shigeyasu, Y., Fujii, C., Horiuchi, M., Sugihara, A., Takeuchi, K., Nakahara, R., Katayama, H., Takahashi, Y., Ozaki, T., & Tsukahara, H. (2026). Development of a generative AI agent for family support in implementing family-based treatment for children and adolescents with anorexia nervosa. Frontiers in Digital Health, 8, Article 1759690. https://doi.org/10.3389/fdgth.2026.1759690
Herbener, A. B., & Damholdt, M. F. (2025). Are lonely youngsters turning to chatbots for companionship? The relationship between chatbot usage and social connectedness in Danish high-school students. International Journal of Human-Computer Studies, 196, 103409. https://doi.org/10.1016/j.ijhcs.2024.103409
Hill, K. (2025, August 26). A Teen Was Suicidal. ChatGPT Was the Friend He Confided In. The New York Times. https://www.nytimes.com/2025/08/26/technology/chatgpt-openai-suicide.html
Ho, A., Miner, A. S., & Hancock, J. (2018). Psychological, Relational, and Emotional Effects of Self-Disclosure After Conversations With a Chatbot |. Journal of Communication, 68(4), 712–733. https://doi.org/https://doi.org/10.1093/joc/jqy026
Jafarnia, J. L., Haff, P. L., Moore, R. P., Osheim, A. L., Riley, K. M., Zheng, S., Roth, M., Salge, M. H., & Nelson, K. C. (2026). Quality, empathy, and readability of AI chatbot responses to the survivorship needs of adolescents and young adults with melanoma: Evaluation study. JMIR Cancer, 12, Article e84234. https://doi.org/10.2196/84234
K. G., A., & Joseph, J. (2025). The compassion illusion: Can artificial empathy ever be emotionally authentic? Frontiers in Psychology, 16. https://doi.org/10.3389/fpsyg.2025.1723149
Kim, J.-W., Yoon, H., Jung, D., Oh, W., Choi, D., Yoon, S.-H., Kim, D.-J., Lee, S.-Y., Kim, B.-N., & Yang, C.-M. (2026). DSM-Guided Large Language Model Reasoning for Depression and PTSD Assessment From Psychiatric Interview Transcripts. IEEE Access, 1–1. https://doi.org/10.1109/ACCESS.2026.3727881
Koegel, L. K., Ponder, E., Bruzzese, T., Wang, M., Semnani, S. J., Chi, N., Koegel, B. L., Lin, T. Y., Swarnakar, A., & Lam, M. S. (2026). Using Artificial Intelligence to Improve Empathetic Statements in Autistic Adolescents and Adults: A Randomized Clinical Trial. Journal of Autism and Developmental Disorders, 56(7), 2513–2529. https://doi.org/10.1007/s10803-025-06734-x
Kusal, S., Patil, S., Choudrie, J., Kotecha, K., Mishra, S., & Abraham, A. (2022). AI-Based Conversational Agents: A Scoping Review From Technologies to Future Directions. IEEE Access, 10, 92337–92356. https://doi.org/10.1109/ACCESS.2022.3201144
Laine, T. H., Lee, W., Moon, J., Hasanov, A., & Suk, H. J. (2025). Scenario-based immersive virtual reality platform for testing empathy types: A development study. IEEE Access, 13, 183242–183261. https://doi.org/10.1109/ACCESS.2025.3624300
Lee, H. J., Lee, S., Kim, H., Park, S., & Cho, S. (2026). OSED-Ko: Open-source empathy-driven dialogue dataset for emotional support of marginalized populations in South Korea. IEEE Access, 14, 99910–99928. https://doi.org/10.1109/ACCESS.2026.3707234
Liu, C. H., & Yip, T. (2026). AI and Teen Identity Formation. Pediatrics, 158(3), e2026076609. https://doi.org/10.1542/peds.2026-076609
Maida, E., Moccia, M., Palladino, R., Borriello, G., Affinito, G., Clerico, M., Repice, A. M., Di Sapio, A., Iodice, R., Spiezia, A. L., Sparaco, M., Miele, G., Bile, F., Scandurra, C., Ferraro, D., Stromillo, M. L., Docimo, R., De Martino, A., Mancinelli, L., … Digital Technologies, Web, Social Media Study Group of the Italian Society of Neurology (SIN). (2024). ChatGPT vs. neurologists: A cross-sectional study investigating preference, satisfaction ratings and perceived empathy in responses among people living with multiple sclerosis. Journal of Neurology, 271(7), 4057–4066. https://doi.org/10.1007/s00415-024-12328-x
Miklikowska, M., Tilton-Weaver, L., & Burk, W. J. (2022). With a little help from my empathic friends: The role of peers in the development of empathy in adolescence. Developmental Psychology, 58(6), 1156–1162. https://doi.org/10.1037/dev0001347
Ocaña, J. M., Morales-Urrutia, E. K., Pérez-Marín, D., & Pizarro, C. (2020). Can a Learning Companion Be Used to Continue Teaching Programming to Children Even During the COVID-19 Pandemic? IEEE Access, 8, 157840–157861. https://doi.org/10.1109/ACCESS.2020.3020007
Pavarini, G., Murta, S. G., Mendes, J. A. A., Siston, F. R., et al., Talk2U, & Singh, I. (2025). Cadê o Kauê? Co-design and acceptability testing of a chat-story aimed at enhancing youth participation in the promotion of mental health in Brazil. Journal of Child Psychology and Psychiatry, 66(5), 697–715.
Placani, A. (2024). Anthropomorphism in AI: Hype and fallacy. AI and Ethics, 4(3), 691–698. https://doi.org/10.1007/s43681-024-00419-4
Saka, A. B., Oyedele, L. O., Akanbi, L. A., Ganiyu, S. A., Chan, D. W. M., & Bello, S. A. (2023). Conversational artificial intelligence in the AEC industry: A review of present status, challenges and opportunities. Advanced Engineering Informatics, 55, 101869. https://doi.org/10.1016/j.aei.2022.101869
Skjuve, M., Følstad, A., & Brandtzaeg, P. B. (2026). ChatGPT as a mental health advisory service: Comparing evaluations from youth and health professionals. Digital Health, 12, 1–16.
Sun, X., Wang, Y., & McDaniel, B. T. (2026). AI companions and adolescent social relationships: Benefits, risks, and bidirectional influences. Child Development Perspectives, 20(2), 91–98. https://doi.org/10.1093/cdpers/aadaf009
Theophilou, E., Lobo-Quintero, R., Hernández-Leo, D., Sánchez-Reina, R., & Ognibene, D. (2024). Embedding educational narrative scripts in a social media environment. IEEE Transactions on Learning Technologies, 17, 1780–1793. https://doi.org/10.1109/TLT.2024.3409063
Topsfield, A. J., & Grainger, S. A. (2026). Emotional Valence Influences Empathic Capacity in Adolescence and Young Adulthood. Journal of Adolescence, n/a(n/a). https://doi.org/10.1002/jad.70216
