Qualitative Processes Associated with Social Interaction with ChatGPT and Digital Mental Health Literacy among Indonesian Generation Z
DOI:
https://doi.org/10.47679/jopp.8316092026Keywords:
ChatGPT, digital mental health literacy, Generation Z, grounded theory, Mixed Methods, Social Interaction, Generative AIAbstract
The rapid adoption of generative artificial intelligence among Indonesian Generation Z has not been accompanied by adequate readiness to critically navigate the mental health information it provides. This study examined the association between Social Interaction with ChatGPT and Digital Mental Health Literacy (DMHL) and explored the qualitative processes that may help explain this association. It was hypothesized that social interaction with ChatGPT would be positively associated with digital mental health literacy. This study employed an explanatory sequential mixed-methods design. The quantitative phase involved 195 Indonesian Generation Z ChatGPT users aged 18–25 years and was analyzed using Pearson's and Spearman's correlation analyses, followed by simple linear regression. Subsequently, twelve participants were purposively selected to represent four qualitative sampling profiles: High–High, Medium–Medium, Low–Low, and High–Low. The quantitative findings revealed a significant positive relationship between social interaction with ChatGPT and digital mental health literacy (r = 0.660, R² = 0.435, p < .001). The qualitative findings suggested that the association may be expressed through different patterns of emotional accessibility, perceived relational closeness, critical awareness, reflective practice, and continued reliance on human support. The findings indicate that interaction with ChatGPT should be understood in relation to both users’ cognitive evaluation of information and their emotional and relational experiences, while maintaining appropriate human and professional support.
References
Asosiasi Penyelenggara Jasa Internet Indonesia. (2025). Survei profil internet Indonesia 2025.
Ban, S., Kim, Y., & Seomun, G. (2024). Digital health literacy: A concept analysis. Digital Health, 10, Article 20552076241287894. https://doi.org/10.1177/20552076241287894
Brandtzaeg, P. B., Skjuve, M., & Følstad, A. (2022). My AI friend: How users of a social chatbot understand their human–AI friendship. Human Communication Research, 48(3), 404–429. https://doi.org/10.1093/hcr/hqac008
Brooks, H., Irmansyah, I., Syarif, A. K., Pedley, R., Renwick, L., Rahayu, A. P., Manik, C., Prawira, B., Hann, M., Brierley, H., Lovell, K., & Bee, P. (2023). Evaluating a prototype digital mental health literacy intervention for children and young people aged 11–15 in Java, Indonesia: A mixed method, multi-site case study evaluation. Child and Adolescent Psychiatry and Mental Health, 17(1), Article 79. https://doi.org/10.1186/s13034-023-00608-9
Corbin, J., & Strauss, A. (2015). Basics of qualitative research: Techniques and procedures for developing grounded theory (4th ed.). SAGE Publications.
Creswell, J. W., & Plano Clark, V. L. (2018). Designing and conducting mixed methods research (3rd ed.). SAGE Publications.
Daraz, L., Morrow, A. S., Ponce, O. J., Beuschel, B., Farah, M. H., Katabi, A., Alsawas, M., Majzoub, A. M., Benkhadra, R., Seisa, M. O., Ding, J. F., Prokop, L., & Murad, M. H. (2019). Can patients trust online health information? A meta-narrative systematic review addressing the quality of health information on the Internet. Journal of General Internal Medicine, 34(9), 1884–1891. https://doi.org/10.1007/s11606-019-05109-0
Diviani, N., van den Putte, B., Giani, S., & van Weert, J. C. M. (2015). Low health literacy and evaluation of online health information: A systematic review of the literature. Journal of Medical Internet Research, 17(5), Article e112. https://doi.org/10.2196/jmir.4018
Fang, C. M., Liu, A. R., Danry, V., Lee, E., Chan, S. W. T., Pataranutaporn, P., Maes, P., Phang, J., Lampe, M., Ahmad, L., & Agarwal, S. (2025). How AI and human behaviors shape psychosocial effects of chatbot use: A longitudinal randomized controlled study [Preprint]. arXiv. https://doi.org/10.48550/arXiv.2503.17473
Fetters, M. D., Curry, L. A., & Creswell, J. W. (2013). Achieving integration in mixed methods designs: Principles and practices. Health Services Research, 48(6, Pt. 2), 2134–2156. https://doi.org/10.1111/1475-6773.12117
Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Aldine Publishing Company.
Guetterman, T. C., Fetters, M. D., & Creswell, J. W. (2015). Integrating quantitative and qualitative results in health science mixed methods research through joint displays. The Annals of Family Medicine, 13(6), 554–561. https://doi.org/10.1370/afm.1865
Hawkins, A., Taba, M., Caldwell, P. H. Y., Kang, M., Skinner, S. R., McCaffery, K., & Scott, K. M. (2025). Enhancing digital health literacy in adolescents: Evaluation of a co-designed educational app. BMC Public Health, 25, Article 3869. https://doi.org/10.1186/s12889-025-25022-y
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, Article 103409. https://doi.org/10.1016/j.ijhcs.2024.103409
Horton, D., & Wohl, R. R. (1956). Mass communication and para-social interaction: Observations on intimacy at a distance. Psychiatry, 19(3), 215–229. https://doi.org/10.1080/00332747.1956.11023049
Huang, S., Lai, X., Ke, L., Li, Y., Wang, H., Zhao, X., Dai, X., & Wang, Y. (2024). AI technology panic—is AI dependence bad for mental health? A cross-lagged panel model and the mediating roles of motivations for AI use among adolescents. Psychology Research and Behavior Management, 17, 1087–1102. https://doi.org/10.2147/PRBM.S440889
Jayatissa, K. A. D. U. (2023). Generation Z-A new lifeline: A systematic literature review. Sri Lanka Journal of Social Sciences and Humanities, 3(2), 179–186. https://doi.org/10.4038/sljssh.v3i2.110
Jorm, A. F. (2012). Mental health literacy: Empowering the community to take action for better mental health. American Psychologist, 67(3), 231–243. doi: 10.1037/a0025957. DOI record
Koulouri, T., Macredie, R. D., & Olakitan, D. (2022). Chatbots to support young adults’ mental health: An exploratory study of acceptability. ACM Transactions on Interactive Intelligent Systems, 12(2), Article 11. https://doi.org/10.1145/3485874
Laestadius, L., Bishop, A., Gonzalez, M., Illenčík, D., & Campos-Castillo, C. (2024). Too human and not human enough: A grounded theory analysis of mental health harms from emotional dependence on the social chatbot Replika. New Media & Society, 26(10), 5923–5941. https://doi.org/10.1177/14614448221142007
Luo, X., Ghosh, S., Tilley, J. L., Besada, P., Wang, J., & Xiang, Y. (2025a). “Shaping ChatGPT into my digital therapist”: A thematic analysis of social media discourse on using generative artificial intelligence for mental health. Digital Health, 11, Article 20552076251351088. https://doi.org/10.1177/20552076251351088
Luo, X., Wang, Z., Tilley, J. L., Balarajan, S., Bassey, U. A., & Cheang, C. I. (2025b). Seeking emotional and mental health support from generative AI: Mixed-methods study of ChatGPT user experiences. JMIR Mental Health, 12, Article e77951. https://doi.org/10.2196/77951
McBain, R. K., Cantor, J. H., Breslau, J., Diliberti, M., Zhang, L. A., Zhang, F., Burnett, A., Kofner, A., Rader, B., Pataranutaporn, P., Stein, B. D., Mehrotra, A., & Yu, H. (2026). AI chatbot use and disclosure for mental health among US adolescents and young adults. JAMA Pediatrics, 180(8), 884–890. https://doi.org/10.1001/jamapediatrics.2026.2015
Neter, E., & Brainin, E. (2012). eHealth literacy: Extending the digital divide to the realm of health information. Journal of Medical Internet Research, 14(1), Article e19. https://doi.org/10.2196/jmir.1619
Norman, C. D., & Skinner, H. A. (2006). eHealth literacy: Essential skills for consumer health in a networked world. Journal of Medical Internet Research, 8(2), Article e9. https://doi.org/10.2196/jmir.8.2.e9
Pallant, J. (2020). SPSS survival manual: A step by step guide to data analysis using IBM SPSS (7th ed.). Routledge.
Pentina, I., Hancock, T., & Xie, T. (2023). Exploring relationship development with social chatbots: A mixed-method study of Replika. Computers in Human Behavior, 140, Article 107600. https://doi.org/10.1016/j.chb.2022.107600
Podsakoff, P. M., MacKenzie, S. B., Lee, J. Y., & Podsakoff, N. P. (2003). Common method biases in behavioral research: A critical review of the literature and recommended remedies. Journal of Applied Psychology, 88(5), 879–903. https://doi.org/10.1037/0021-9010.88.5.879
Rahsepar Meadi, M., Sillekens, T., Metselaar, S., van Balkom, A., Bernstein, J., & Batelaan, N. (2025). Exploring the ethical challenges of conversational AI in mental health care: Scoping review. JMIR Mental Health, 12, Article e60432. https://doi.org/10.2196/60432
Rudianto, Z. N. (2022). Pengetahuan generasi Z tentang literasi kesehatan dan kesadaran mental di masa pandemi. Jurnal Pendidikan Kesehatan, 11(1), 49–72. https://doi.org/10.31290/jpk.v11i1.2843
Skjuve, M., Følstad, A., Fostervold, K. I., & Brandtzaeg, P. B. (2021). My chatbot companion—A study of human–chatbot relationships. International Journal of Human-Computer Studies, 149, Article 102601. https://doi.org/10.1016/j.ijhcs.2021.102601
Sundar, S. S. (2020). Rise of machine agency: A framework for studying the psychology of human–AI interaction (HAII). Journal of Computer-Mediated Communication, 25(1), 74–88. https://doi.org/10.1093/jcmc/zmz026
Tashakkori, A., & Teddlie, C. (Eds.). (2010). SAGE handbook of mixed methods in social & behavioral research (2nd ed.). SAGE Publications. https://doi.org/10.4135/9781506335193
van der Vaart, R., & Drossaert, C. (2017). Development of the Digital Health Literacy Instrument: Measuring a broad spectrum of Health 1.0 and Health 2.0 skills. Journal of Medical Internet Research, 19(1), Article e27. https://doi.org/10.2196/jmir.6709
Downloads
Published
How to Cite
Issue
Section
Citation Check
License
Copyright (c) 2026 Igriya Fauzi Nabilah., M.Psi.,Psikolog., Wihda Maulani., S.I.P.,M.I.P., Amelia Putri Nirmala.,M.Psi.,Psikolog

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Journal of Psychological Perspective (JOPP) is committed to promoting academic freedom and open access. To that end, we apply a copyright policy that empowers authors while ensuring the broad dissemination and responsible reuse of published work. More...
Submit Online


