{"meta":{"exportedAt":"2026-10-11T08:02:55.088Z","formatVersion":2,"selection":{"q":"anxiety","system":"","harm":"","context":"","country":"","role":"","relation":"","evidence":"","year":"2024","response":"","severity":"","verification":"","view":"incidents","sort":"added"},"totalIncidents":1,"coverage":{"cases":1,"countries":0,"languages":1,"unknownLocation":1,"locationPending":0,"unknownLanguage":0,"unknownDate":0,"lawsuits":0,"regulatory":0,"minors":0,"coreRelations":1,"contextualRelations":0,"mixedRelations":0,"unknownRelations":0,"relationPending":0,"relationUnknown":0},"countingNote":"Distinct public cases in this selection. People counts apply within individual cases only; cross-case person overlap has not been resolved. No population incidence estimate.","affectedCountNote":"Interpret person counts with affectedCountStatus and the reported effects. Unquantified zeros are placeholders, not a measured zero.","source":"AI incidents","publisher":"NOPE","url":"https://nope.net/incidents","license":"CC BY 4.0"},"incidents":[{"id":"2024-jmir-case-report-young-adult-anxiety-chatgpt-reassurance-reliance-lost-confidence","caseFacts":{"claims":[{"id":"c1","status":"reported","evidence":[{"locator":"'She was introduced to AI at work in the summer of 2024, when her boss recommended that she and her coworkers use the tool to write emails to customers'; 'over the subsequent 2 years, she found herself increasingly turning to AI when feeling uncertain. She relied on ChatGPT rather than other generative AI models.'","relation":"supports","source_id":"s1"}],"assertion":"The patient, a woman in her mid-20s with generalised anxiety disorder and major depressive disorder, was introduced to ChatGPT at work in summer 2024 and over the following two years increasingly turned to it when she felt uncertain.","causal_attribution":"The patient's history as taken and written up by the case report's author."},{"id":"c2","status":"reported","evidence":[{"locator":"'she used AI to write professional emails approximately 90% of the time'; 'When dating someone new, she uploaded screen captures of a text conversation and asked ChatGPT if the new partner was losing interest.'; 'When applying to graduate schools, she would ask ChatGPT to make predictions about her likelihood of being accepted.'; 'When coping with a breakup, she asked ChatGPT if she and her ex-boyfriend were going to get back together.'","relation":"supports","source_id":"s1"}],"assertion":"She used ChatGPT to draft about 90% of her professional emails, to interpret a new partner's texts, to predict graduate-school admissions and whether she and an ex-boyfriend would reunite.","causal_attribution":"The patient's reported use as written up by the psychiatrist."},{"id":"c3","status":"reported","evidence":[{"locator":"'began to view ChatGPT more as an authority than an assistant.'; 'She became distressed by her own use and described negative cognitions and decreased confidence in her own judgment and skills.'; 'She would compulsively use it even when she knew it was not helping her. For example, asking the tool to predict the outcome of graduate school applications increased her distress, yet she had a hard time abstaining.'; 'described using ChatGPT as an alternative to talking with friends, family, or a therapist.'","relation":"supports","source_id":"s1"}],"assertion":"The psychiatrist reports that she came to view ChatGPT as an authority, became distressed by her own use, described decreased confidence in her judgment and skills, used it compulsively even when it increased her distress, and used it as an alternative to talking with friends, family or a therapist.","causal_attribution":"The psychiatrist's account of the patient's reports and observed pattern."},{"id":"c4","status":"reported","evidence":[{"locator":"'Now [when faced with a writing task], I just stare at the screen and can’t write a sentence.'; 'finally concluded that it was more an issue of confidence.'; 'During one therapy appointment, she stated without prompting, “I’m worried I’m becoming dependent on ChatGPT.”'","relation":"supports","source_id":"s1"}],"assertion":"She said she now stared at the screen and could not write a sentence, concluded the problem was confidence more than competence, and raised her worry about becoming dependent on ChatGPT unprompted in therapy.","causal_attribution":"The patient's own words as quoted in the case report."},{"id":"c5","status":"reported","evidence":[{"locator":"'It was always available and agreeable. As a result, reassurance-seeking behaviors could be sustained without interruption, likely reinforcing her underlying anxiety.'; 'Predisposing factors (person), including mild anxiety and low confidence, contributed to discomfort in situations involving uncertainty.'; 'case demonstrates that even in the absence of significant functional impairment'; 'It cannot confirm a causal relationship between generative AI use and changes in confidence, cognition, or functioning.'; 'There was no clear way to differentiate actual decline from perceived decline.'","relation":"supports","source_id":"s1"}],"assertion":"The author writes that ChatGPT's constant availability and agreeableness likely reinforced her reassurance seeking and underlying anxiety, alongside predisposing anxiety and low confidence, notes the absence of significant functional impairment, and states that the report cannot confirm a causal relationship between generative AI use and changes in confidence and that actual and perceived decline could not be distinguished.","causal_attribution":"The psychiatrist's interpretation; predisposing factors are named, so causation is alleged."}],"effects":[{"label":"distress over her own compulsive ChatGPT use and decreased confidence in her own judgment and skills","claim_id":"c3","direction":"negative"},{"label":"reported she could no longer start writing tasks she had once done easily","claim_id":"c4","direction":"negative"}],"sources":[{"id":"s1","url":"https://www.ebi.ac.uk/europepmc/webservices/rest/PMC13581145/fullTextXML","kind":"clinical_case_report","access":"read","language":"en","translation_note":"Full text of the case report read as Europe PMC fullTextXML for PMC13581145 (HTTP 200) on 2026-10-11, including the case presentation, discussion and author information. Written by a physician in a psychiatry department from routine clinical care. The JMIR article page returned HTTP 202 with no body.","independence_group":"jmir-form-res-armstrong-2026-case-report"},{"id":"s2","url":"https://pubmed.ncbi.nlm.nih.gov/42748377/","kind":"bibliographic_record","access":"read","language":"en","translation_note":"PubMed record of the same article read on 2026-10-11 as NCBI E-utilities efetch XML (title and abstract). Not independent of s1.","independence_group":"jmir-form-res-armstrong-2026-case-report"}],"version":1,"ai_roles":["own_use"],"contexts":["health","work","relationships","education"],"unknowns":["Where the patient lived and was treated.","What ChatGPT replied in most exchanges; the report quotes prompts and one reply framing only.","The course of her AI use after the report."],"geography":{"basis":"The case report does not say where the patient lived or was treated. The author is affiliated with Western University in London, Ontario; author affiliation is not used as an event location. No court proceeding is reported.","court_countries":[],"event_countries":[],"affected_person_countries":[]},"publication":{"basis":"Core case (communicated_with): the case report describes about two years of reassurance-seeking exchanges with ChatGPT and the distress and lost confidence in her own judgment that the patient reported. All claims are reported from the clinical account; the author names predisposing anxiety, notes no significant functional impairment and states that the report cannot confirm causation, so causation is alleged and severity low.","reviewed_on":"2026-10-11"},"ai_involvement":{"basis":"The case report, drawn from routine clinical care, records that the patient used ChatGPT for about two years to draft and re-check messages, interpret partners' texts, predict outcomes and make decisions, that she asked it for reassurance and received replies she found credible, and links this repeated exchange to her distress and lost confidence. The report quotes the patient's prompts and one reply framing, but no full chat transcripts.","status":"reported"},"person_relations":["communicated_with"]},"name":"Case report: woman in her mid-20s with anxiety came to rely on ChatGPT for reassurance and decisions, reported lost confidence in her judgment (JMIR Form Res)","summary":"A psychiatrist's case report in JMIR Formative Research (published online 16 September 2026) describes a woman in her mid-20s with generalised anxiety disorder and major depressive disorder who began using ChatGPT at work in summer 2024 and over the next two years increasingly turned to it when she felt uncertain: to draft and re-check emails and personal messages, interpret partners' texts, predict outcomes such as graduate-school admissions and a breakup, and make decisions. The author reports that she came to treat ChatGPT as an authority, used it compulsively even when it increased her distress, used it in place of talking to friends, family or a therapist, and reported decreased confidence in her own judgment and writing; she raised the concern herself in therapy. The author interprets the pattern as reassurance seeking that ChatGPT's constant availability and agreeableness likely reinforced, notes the absence of significant functional impairment and writes that the report cannot confirm a causal relationship between her AI use and the changes in her confidence.","incidentDate":"2024-01-01","incidentKind":"ongoing_experience","incidentDatePrecision":"year","exposurePattern":"cumulative_relationship","reportedDate":"2026-09-16","aiSystem":"ChatGPT (OpenAI), used by the patient for writing, social interpretation, outcome prediction and decisions over about two years (clinical case report)","aiProduct":"ChatGPT","aiCompany":"OpenAI","severity":"low","verificationStatus":"credible","harmCategories":[],"harmOutcomes":["psychological_distress","loss_of_autonomy"],"harmOutcomeSummary":"The case report's author reports that the patient became distressed by her compulsive ChatGPT use and described decreased confidence in her own judgment and writing; the author attributes this to reassurance seeking that ChatGPT's availability and agreeableness likely reinforced, notes no significant functional impairment and writes that the report cannot confirm a causal relationship.","frameworkFacets":[],"causationStatus":"alleged","participantUsersAffectedMin":1,"otherPeopleHarmedMin":0,"affectedCountStatus":"exact","affectedCountEvidence":"One patient, the subject of the case report. Exact 1.","victimAgeRange":"adult","platformType":"assistant","outcomeType":"media_coverage","outcomeStatus":"unknown","primarySourceUrl":"https://www.ebi.ac.uk/europepmc/webservices/rest/PMC13581145/fullTextXML","primarySourceLabel":"JMIR Formative Research, 16 September 2026: Armstrong, Problematic Reliance on Generative AI in an Anxious Young Adult (case report, Europe PMC full text)","firstPublishedAt":"2026-10-11T03:16:12.978692+00:00","updatedAt":"2026-10-11T07:53:03.055252+00:00","scopeVersion":"facts-v3","tags":["chatgpt","openai","case-report","dependence","reassurance-seeking","anxiety","communicated-with"]}]}