Moderate Evidence 11 min read Updated 2025-12-25

Kairos Research Gaps & Priorities for Peer-Review Fill

Date Created: December 24, 2025
Purpose: Systematic identification of research gaps requiring peer-reviewed citations
Status: Active - Prioritized for Research Agent Investigation

Executive Summary

This document identifies 25 research gaps across Kairos's evidence base, prioritized by:

  1. Impact on product development (MVP vs. future features)
  2. Strength of current evidence (weak vs. moderate vs. missing)
  3. Availability of peer-reviewed research (likely to exist vs. emerging field)

Immediate Action: Launch deep-research agents to fill High Priority gaps with peer-reviewed sources from PubMed, arXiv, ACM Digital Library, and academic journals.

Gap Classification System

Priority Levels

  • 🔴 P1 - Critical: Needed for MVP launch, safety, or core claims
  • 🟡 P2 - High: Needed for differentiation, future features (3-6 months)
  • 🟢 P3 - Medium: Nice-to-have, research publication, long-term validation

Evidence Status

  • ❌ Missing: No current research in repository
  • ⚠️ Weak: Single study, anecdotal, or non-peer-reviewed
  • 📊 Moderate: Some evidence but needs strengthening
  • ✅ Strong: Well-documented but could use updates

🔴 Priority 1: Critical for MVP & Safety

1. AI Crisis Detection & Safety Protocols

Current Status: ⚠️ Weak - Research 12 notes "0/29 chatbots meet adequate criteria"
Gap: Need peer-reviewed protocols for:

  • Suicide/self-harm detection algorithms
  • Appropriate escalation pathways
  • False positive/negative rates in crisis detection
  • Best practices for AI limitations in crisis

Search Terms:

  • "AI crisis detection mental health"
  • "suicide prevention chatbot algorithms"
  • "automated risk assessment validation"
  • "crisis response protocols AI mental health"

Expected Sources: PMC/PubMed (clinical), ACM/IEEE (technical), JMIR Mental Health

2. Quantifying the "2-Week Wall" with Biomarkers

Current Status: 📊 Moderate - Research 04 has behavioral evidence
Gap: Need physiological validation:

  • HRV changes during extinction burst (weeks 2-3)
  • Cortisol/stress biomarker patterns
  • Neural imaging during pattern change resistance
  • Objective markers correlating with subjective "wall"

Search Terms:

  • "extinction burst biomarkers"
  • "habit change HRV heart rate variability"
  • "neuroplasticity timeline cortisol"
  • "behavioral change physiological markers"

Expected Sources: PubMed/PMC (neuroscience, psychology)

3. AI Pattern Recognition vs. Human Therapist Accuracy

Current Status: ❌ Missing - No direct comparison
Gap: Head-to-head studies on:

  • Pattern identification accuracy (AI vs. human)
  • Therapeutic insights quality
  • Blind comparisons of AI vs. therapist observations
  • Which patterns AI misses that humans catch

Search Terms:

  • "AI pattern recognition psychotherapy comparison"
  • "machine learning clinical insight validation"
  • "automated vs human therapeutic assessment"
  • "NLP therapy notes accuracy"

Expected Sources: JMIR, AI in Medicine, Psychological Assessment journals

4. Privacy-Preserving AI Architecture for Mental Health

Current Status: ⚠️ Weak - General privacy mentioned but no specific implementations
Gap: Technical validation for:

  • Federated learning in mental health contexts
  • On-device processing feasibility
  • Differential privacy in therapy data
  • Encrypted computation for pattern analysis

Search Terms:

  • "federated learning mental health privacy"
  • "on-device processing therapy AI"
  • "differential privacy clinical data"
  • "homomorphic encryption healthcare"

Expected Sources: arXiv, IEEE Security & Privacy, JMIR

5. Informed Consent Best Practices for AI Mental Health

Current Status: ⚠️ Weak - Principles stated but no empirical validation
Gap: Evidence-based consent design:

  • Comprehension testing of AI limitations disclosure
  • Optimal consent timing and reinforcement
  • User misconceptions about AI consciousness
  • Effective consent language/formats

Search Terms:

  • "informed consent AI mental health"
  • "user understanding AI limitations"
  • "digital therapeutic consent design"
  • "AI misconceptions disclosure effectiveness"

Expected Sources: PMC, bioethics journals, HCI conferences

🟡 Priority 2: High Value for Differentiation

6. Framework Integration Mechanisms (IFS + Somatic + AI)

Current Status: ❌ Missing - Individual frameworks validated separately
Gap: How integrated approaches work:

  • IFS parts work enhanced by somatic awareness
  • AI pattern recognition accelerating IFS progress
  • Combined effect sizes vs. individual modalities
  • Optimal sequencing of modalities

Search Terms:

  • "multimodal psychotherapy integration"
  • "IFS combined somatic therapy outcomes"
  • "technology-assisted parts work"
  • "embodied psychotherapy AI augmentation"

Expected Sources: Psychotherapy journals, integrative medicine

7. Optimal Group Composition for Collective Healing

Current Status: 📊 Moderate - Research 11 validates groups generally
Gap: Specific composition guidelines:

  • Optimal diversity vs. homogeneity
  • Group size for online vs. in-person
  • Matching algorithms for therapeutic groups
  • Contraindications for group participation

Search Terms:

  • "therapeutic group composition outcomes"
  • "group therapy matching algorithms"
  • "optimal group size psychotherapy"
  • "online group therapy effectiveness"

Expected Sources: Group Dynamics journals, psychotherapy research

8. Cultural Adaptation of Western Psychological Models

Current Status: ❌ Missing - All research is Western-centric
Gap: Non-Western validation:

  • IFS applicability in collectivist cultures
  • Somatic practices cultural variations
  • Cultural differences in parts work
  • Language/metaphor adaptations needed

Search Terms:

  • "IFS internal family systems cross-cultural"
  • "somatic therapy cultural adaptation"
  • "psychotherapy cultural competence non-Western"
  • "collectivist culture individual therapy"

Expected Sources: Transcultural Psychiatry, Cultural Diversity journals

9. Long-Term Outcomes of AI Mental Health Interventions

Current Status: ⚠️ Weak - Research 12 notes "only 6 studies with follow-up"
Gap: Sustained effectiveness:

  • 6+ month outcomes for AI therapy
  • Relapse rates compared to traditional therapy
  • Skills retention after AI intervention ends
  • Long-term dependency risks

Search Terms:

  • "digital mental health long-term outcomes"
  • "AI therapy sustained effectiveness"
  • "chatbot mental health follow-up"
  • "digital therapeutic durability"

Expected Sources: JMIR, Lancet Digital Health, psychological journals

10. Collective Coherence Measurement

Current Status: ⚠️ Weak - Conceptual but not operationalized
Gap: Objective measurement of:

  • Group HRV synchrony protocols
  • Neural synchrony in group settings
  • Physiological markers of collective states
  • Validation of "group coherence" construct

Search Terms:

  • "group heart rate variability synchrony"
  • "collective physiological coherence"
  • "interpersonal synchrony measurement"
  • "group neural entrainment"

Expected Sources: Social Neuroscience, Frontiers in Psychology

11. Digital Twin Accuracy & User Experience

Current Status: 📊 Moderate - Research on HDTs exists but needs expansion
Gap: Validation studies for:

  • Personality model accuracy (claim is 85%)
  • User satisfaction with digital twin interactions
  • Uncanny valley effects in digital twins
  • Long-term relationship with own digital twin

Search Terms:

  • "digital twin personality accuracy"
  • "human digital twin user experience"
  • "AI persona consistency validation"
  • "digital representation satisfaction"

Expected Sources: HCI conferences (CHI, CSCW), AI journals

12. Agent-to-Agent Matching Effectiveness

Current Status: ❌ Missing - Novel concept, limited research
Gap: HDT-to-HDT pre-screening:

  • Accuracy of digital twin compatibility prediction
  • User acceptance of HDT-mediated matching
  • Efficiency gains vs. direct human matching
  • Ethical considerations of automated matching

Search Terms:

  • "AI-mediated matching algorithms"
  • "digital twin compatibility prediction"
  • "automated relationship matching effectiveness"
  • "proxy-based social matching"

Expected Sources: arXiv, ACM conferences, social computing

🟢 Priority 3: Medium - Research & Long-Term

13. Individual Variation Predictors (Who Benefits Most)

Current Status: ❌ Missing
Gap: Predictive models for:

  • Baseline characteristics predicting response
  • Contraindications for Kairos approach
  • Optimal personalization strategies
  • Subgroup analyses by demographics

Search Terms:

  • "psychotherapy response predictors"
  • "digital mental health individual differences"
  • "treatment matching algorithms"
  • "personalized intervention outcomes"

Expected Sources: Clinical Psychology Review, personalized medicine journals

14. Intergenerational Trauma Patterns

Current Status: ❌ Missing - Mentioned as future direction
Gap: Epigenetic and systemic trauma:

  • Epigenetic markers of trauma transmission
  • Family systems patterns in digital data
  • Intergenerational healing frameworks
  • Historical trauma in contemporary patterns

Search Terms:

  • "intergenerational trauma epigenetics"
  • "family systems digital patterns"
  • "historical trauma contemporary symptoms"
  • "transgenerational trauma mechanisms"

Expected Sources: Trauma journals, epigenetics research

15. Societal-Level Mental Health Interventions

Current Status: ❌ Missing
Gap: Population health impact:

  • Scaling individual interventions to communities
  • Network effects in mental health apps
  • Public health metrics for digital therapeutics
  • Social contagion of wellbeing

Search Terms:

  • "population mental health digital interventions"
  • "network effects mental health apps"
  • "social contagion wellbeing"
  • "community-level psychological interventions"

Expected Sources: American Journal of Public Health, population health journals

16. Voice Agent Effectiveness (Hume AI, Vapi Integration)

Current Status: ❌ Missing
Gap: Voice-based therapy:

  • Voice AI empathy detection accuracy
  • User preference voice vs. text
  • Vocal biomarkers of mental health
  • Therapeutic alliance via voice

Search Terms:

  • "voice AI mental health empathy"
  • "vocal biomarkers depression anxiety"
  • "conversational AI therapeutic outcomes"
  • "voice-based digital therapeutics"

Expected Sources: JMIR, Speech Communication, affective computing

17. Economic Models for Scaling Impact

Current Status: ❌ Missing
Gap: Business + social impact:

  • Cost-effectiveness vs. traditional therapy
  • ROI for healthcare systems
  • Value-based pricing models
  • Sustainability of hybrid models

Search Terms:

  • "digital mental health cost-effectiveness"
  • "hybrid therapy economic models"
  • "AI mental health return on investment"
  • "value-based mental health pricing"

Expected Sources: Health Economics journals, health services research

18. Algorithmic Bias in Mental Health AI (Kairos-Specific)

Current Status: 📊 Moderate - General bias research exists (Research 13)
Gap: Mental health specific:

  • Bias in pattern recognition across demographics
  • Cultural bias in therapeutic language models
  • Age bias in mental health algorithms
  • Mitigation strategies that work

Search Terms:

  • "algorithmic bias mental health AI"
  • "cultural bias digital therapeutics"
  • "demographic fairness mental health algorithms"
  • "bias mitigation mental health AI"

Expected Sources: AI Ethics journals, FAccT conference, medical AI

19. Energy Work Mechanisms (Honest Scientific Investigation)

Current Status: ⚠️ Weak - Research 08 acknowledges uncertainty
Gap: Rigorous investigation of:

  • Placebo vs. specific effects in energy work
  • Neurobiological correlates of energy practices
  • Active ingredients in somatic techniques
  • What actually works and why

Search Terms:

  • "biofield therapy mechanisms"
  • "energy healing neurobiological effects"
  • "placebo mechanisms somatic therapy"
  • "touch therapy active ingredients"

Expected Sources: PMC, Complementary Medicine journals (with caution)

20. Measurement & Attribution in Integrated Interventions

Current Status: ❌ Missing
Gap: What causes improvement:

  • Isolating effects of different modalities
  • Attribution modeling for multi-component interventions
  • Active ingredients identification
  • Necessary vs. sufficient components

Search Terms:

  • "component analysis psychotherapy"
  • "active ingredients therapeutic change"
  • "multimodal intervention attribution"
  • "mechanism-based treatment development"

Expected Sources: Clinical Psychology Science, psychotherapy research

Additional Gaps (Lower Priority)

21. Neurodiversity & Kairos Approach

Status: ❌ Missing
Need: Autism, ADHD, other neurodivergent populations

22. Trauma Typology & Differential Effectiveness

Status: ❌ Missing
Need: Complex PTSD vs. single-incident vs. developmental trauma

23. Meditation/Contemplative Practice Dose-Response

Status: 📊 Moderate
Need: Optimal frequency, duration, type

24. Attachment Style & Digital Therapeutic Alliance

Status: ❌ Missing
Need: How attachment patterns affect AI relationship

25. Spiritual/Existential Dimensions in Secular Framework

Status: ❌ Missing
Need: Meaning-making without religious framing

Research Agent Deployment Plan

Phase 1: Critical Safety & MVP (P1 Gaps)

Timeline: Immediate (Week 1)
Agents: 5 deep-research-agents in parallel
Focus: Gaps 1-5
Deliverable: Peer-reviewed literature reviews with citations

Phase 2: Differentiation & Future Features (P2 Gaps)

Timeline: Weeks 2-3
Agents: 4 deep-research-agents in parallel
Focus: Gaps 6-12
Deliverable: Integrated research documents with applications to Kairos

Phase 3: Long-Term Research Agenda (P3 Gaps)

Timeline: Month 2 onwards
Agents: 2 deep-research-agents, ongoing
Focus: Gaps 13-25
Deliverable: Research roadmap and future studies design

Success Criteria

For Each Gap Filled:

  • Minimum 10 peer-reviewed sources identified
  • Quality rating: 🟢 Strong or 🟡 Moderate minimum
  • Direct application to Kairos documented
  • Limitations honestly acknowledged
  • Added to appropriate Research/## document
  • MASTER_RESEARCH_NAVIGATION.md updated

Overall Repository Health:

  • No P1 gaps remaining
  • < 3 P2 gaps remaining
  • P3 gaps documented for future research
  • All claims in product have citation support
  • Limitations transparently communicated

Notes for Research Agents

Source Prioritization:

  1. Tier 1: Systematic reviews, meta-analyses (Cochrane, JAMA, Lancet)
  2. Tier 2: Peer-reviewed RCTs, longitudinal studies
  3. Tier 3: Well-designed observational studies
  4. Tier 4: Expert consensus, clinical guidelines (WHO, APA)
  5. Use Cautiously: Single studies, non-peer-reviewed, industry-funded

Search Databases (in order):

  1. PubMed/PMC - Medical and psychological research
  2. PsycINFO - Psychology-specific
  3. IEEE Xplore - Technical/AI research
  4. ACM Digital Library - Computer science, HCI
  5. arXiv - Preprints (verify quality)
  6. Google Scholar - Broad coverage, citation tracking

Quality Checks:

  • Verify peer-review status
  • Check sample sizes (n > 30 minimum for quantitative)
  • Note conflicts of interest
  • Prefer recent (last 5 years) unless foundational
  • Ensure methodology is sound

Maintenance

Quarterly Review: Update this document with:

  • Newly filled gaps (move to "Completed" section)
  • Emerging research areas
  • New gaps identified
  • Priority re-ranking based on product roadmap

Owner: Research Lead
Next Review: March 2026

Document Created: December 24, 2025
Status: Active - Ready for Research Agent Deployment
Immediate Action: Launch Phase 1 agents on P1 gaps 1-5