Mental Health Impacts of AI Companions: Triangulating Social Media Quasi-Experiments, User Perspectives, and Relational Theory

Abstract: AI-powered companion chatbots (AICCs) such as Replika are increasingly popular, offering empathetic interactions, yet their psychosocial impacts remain unclear. We examined how engaging with AICCs shaped wellbeing and how users perceived these experiences. First, we conducted a large-scale quasi-experimental study of longitudinal Reddit data, applying stratified propensity score matching and Difference-in-Differences regression. Findings revealed mixed effects -- greater affective and grief expression, readability, and interpersonal focus, alongside increases in language about loneliness and suicidal ideation. Second, we complemented these results with 15 semi-structured interviews, which we thematically analyzed and contextualized using Knapp's relationship development model. We identified trajectories of initiation, escalation, and bonding, wherein AICCs provided emotional validation and social rehearsal but also carried risks of over-reliance and withdrawal. Triangulating across methods, we offer design implications for AI companions that scaffold healthy boundaries, support mindful engagement, support disclosure without dependency, and surface relationship stages -- maximizing psychosocial benefits while mitigating risks.