Daily Papers

In mental health counseling, a variety of earlier studies have focused on dialogue modeling. However, most of these studies give limited to no emphasis on the quality of interaction between a patient and a therapist. The therapeutic bond between a patient and a therapist directly correlates with effective mental health counseling. It involves developing the patient's trust on the therapist over the course of counseling. To assess the therapeutic bond in counseling, we introduce trust as a therapist-assistive metric. Our definition of trust involves patients' willingness and openness to express themselves and, consequently, receive better care. We conceptualize it as a dynamic trajectory observable through textual interactions during the counseling. To facilitate trust modeling, we present MENTAL-TRUST, a novel counseling dataset comprising manual annotation of 212 counseling sessions with first-of-its-kind seven expert-verified ordinal trust levels. We project our problem statement as an ordinal classification task for trust quantification and propose a new benchmark, TrustBench, comprising a suite of classical and state-of-the-art language models on MENTAL-TRUST. We evaluate the performance across a suite of metrics and lay out an exhaustive set of findings. Our study aims to unfold how trust evolves in therapeutic interactions.

Objective: This study aims to develop and validate an evaluation framework to ensure the safety and reliability of mental health chatbots, which are increasingly popular due to their accessibility, human-like interactions, and context-aware support. Materials and Methods: We created an evaluation framework with 100 benchmark questions and ideal responses, and five guideline questions for chatbot responses. This framework, validated by mental health experts, was tested on a GPT-3.5-turbo-based chatbot. Automated evaluation methods explored included large language model (LLM)-based scoring, an agentic approach using real-time data, and embedding models to compare chatbot responses against ground truth standards. Results: The results highlight the importance of guidelines and ground truth for improving LLM evaluation accuracy. The agentic method, dynamically accessing reliable information, demonstrated the best alignment with human assessments. Adherence to a standardized, expert-validated framework significantly enhanced chatbot response safety and reliability. Discussion: Our findings emphasize the need for comprehensive, expert-tailored safety evaluation metrics for mental health chatbots. While LLMs have significant potential, careful implementation is necessary to mitigate risks. The superior performance of the agentic approach underscores the importance of real-time data access in enhancing chatbot reliability. Conclusion: The study validated an evaluation framework for mental health chatbots, proving its effectiveness in improving safety and reliability. Future work should extend evaluations to accuracy, bias, empathy, and privacy to ensure holistic assessment and responsible integration into healthcare. Standardized evaluations will build trust among users and professionals, facilitating broader adoption and improved mental health support through technology.

Evaluating Large Language Models (LLMs) for mental health support is challenging due to the emotionally and cognitively complex nature of therapeutic dialogue. Existing benchmarks are limited in scale, reliability, often relying on synthetic or social media data, and lack frameworks to assess when automated judges can be trusted. To address the need for large-scale dialogue datasets and judge reliability assessment, we introduce two benchmarks that provide a framework for generation and evaluation. MentalBench-100k consolidates 10,000 one-turn conversations from three real scenarios datasets, each paired with nine LLM-generated responses, yielding 100,000 response pairs. MentalAlign-70k}reframes evaluation by comparing four high-performing LLM judges with human experts across 70,000 ratings on seven attributes, grouped into Cognitive Support Score (CSS) and Affective Resonance Score (ARS). We then employ the Affective Cognitive Agreement Framework, a statistical methodology using intraclass correlation coefficients (ICC) with confidence intervals to quantify agreement, consistency, and bias between LLM judges and human experts. Our analysis reveals systematic inflation by LLM judges, strong reliability for cognitive attributes such as guidance and informativeness, reduced precision for empathy, and some unreliability in safety and relevance. Our contributions establish new methodological and empirical foundations for reliable, large-scale evaluation of LLMs in mental health. We release the benchmarks and codes at: https://github.com/abeerbadawi/MentalBench/

Objectives: While Large Language Models (LLMs) have been widely used to assist clinicians and support patients, no existing work has explored dialogue systems for standard diagnostic interviews and assessments. This study aims to bridge the gap in mental healthcare accessibility by developing an LLM-powered dialogue system that replicates clinician behavior. Materials and Methods: We introduce TRUST, a framework of cooperative LLM modules capable of conducting formal diagnostic interviews and assessments for Post-Traumatic Stress Disorder (PTSD). To guide the generation of appropriate clinical responses, we propose a Dialogue Acts schema specifically designed for clinical interviews. Additionally, we develop a patient simulation approach based on real-life interview transcripts to replace time-consuming and costly manual testing by clinicians. Results: A comprehensive set of evaluation metrics is designed to assess the dialogue system from both the agent and patient simulation perspectives. Expert evaluations by conversation and clinical specialists show that TRUST performs comparably to real-life clinical interviews. Discussion: Our system performs at the level of average clinicians, with room for future enhancements in communication styles and response appropriateness. Conclusions: Our TRUST framework shows its potential to facilitate mental healthcare availability.

Large language models (LLMs) have demonstrated remarkable capabilities across a range of natural language processing (NLP) tasks, capturing the attention of both practitioners and the broader public. A key question that now preoccupies the AI community concerns the capabilities and limitations of these models, with trustworthiness emerging as a central issue, particularly as LLMs are increasingly applied in sensitive fields like healthcare and finance, where errors can have serious consequences. However, most previous studies on the trustworthiness of LLMs have been limited to a single language, typically the predominant one in the dataset, such as English. In response to the growing global deployment of LLMs, we introduce XTRUST, the first comprehensive multilingual trustworthiness benchmark. XTRUST encompasses a diverse range of topics, including illegal activities, hallucination, out-of-distribution (OOD) robustness, physical and mental health, toxicity, fairness, misinformation, privacy, and machine ethics, across 10 different languages. Using XTRUST, we conduct an empirical evaluation of the multilingual trustworthiness of five widely used LLMs, offering an in-depth analysis of their performance across languages and tasks. Our results indicate that many LLMs struggle with certain low-resource languages, such as Arabic and Russian, highlighting the considerable room for improvement in the multilingual trustworthiness of current language models. The code is available at https://github.com/LluckyYH/XTRUST.

The swift progress and widespread acceptance of artificial intelligence (AI) systems highlight a pressing requirement to comprehend both the capabilities and potential risks associated with AI. Given the linguistic complexity, cultural richness, and underrepresented status of Arabic in AI research, there is a pressing need to focus on Large Language Models (LLMs) performance and safety for Arabic-related tasks. Despite some progress in their development, there is a lack of comprehensive trustworthiness evaluation benchmarks, which presents a major challenge in accurately assessing and improving the safety of LLMs when prompted in Arabic. In this paper, we introduce AraTrust, the first comprehensive trustworthiness benchmark for LLMs in Arabic. AraTrust comprises 522 human-written multiple-choice questions addressing diverse dimensions related to truthfulness, ethics, safety, physical health, mental health, unfairness, illegal activities, privacy, and offensive language. We evaluated a set of LLMs against our benchmark to assess their trustworthiness. GPT-4 was the most trustworthy LLM, while open-source models, particularly AceGPT 7B and Jais 13B, struggled to achieve a score of 60% in our benchmark.

As generative artificial intelligence (GAI) enters the mental health landscape, questions arise about how individuals weigh AI tools against human therapists. Drawing on the Health Belief Model (HBM), this study examined belief-based predictors of intention to use GAI and therapists across two populations: a university sample (N = 1,155) and a nationally representative adult sample (N = 651). Using repeated-measures ANOVA and LASSO regression, we found that therapists were consistently valued for emotional, relational, and personalization benefits, while GAI was favored for accessibility and affordability. Yet structural advantages alone did not predict adoption; emotional benefit and personalization emerged as decisive factors. Adoption patterns diverged across groups: students treated GAI as a complement, whereas national adults approached it as a substitute. Concerns about privacy and reliability constrained GAI use in both groups. These findings extend HBM to multi-modality contexts and highlight design implications for trustworthy, emotionally resonant digital mental health tools.

Linguistic expressions of emotions such as depression, anxiety, and trauma-related states are pervasive in clinical notes, counseling dialogues, and online mental health communities, and accurate recognition of these emotions is essential for clinical triage, risk assessment, and timely intervention. Although large language models (LLMs) have demonstrated strong generalization ability in emotion analysis tasks, their diagnostic reliability in high-stakes, context-intensive medical settings remains highly sensitive to prompt design. Moreover, existing methods face two key challenges: emotional comorbidity, in which multiple intertwined emotional states complicate prediction, and inefficient exploration of clinically relevant cues. To address these challenges, we propose APOLO (Automated Prompt Optimization for Linguistic Emotion Diagnosis), a framework that systematically explores a broader and finer-grained prompt space to improve diagnostic efficiency and robustness. APOLO formulates instruction refinement as a Partially Observable Markov Decision Process and adopts a multi-agent collaboration mechanism involving Planner, Teacher, Critic, Student, and Target roles. Within this closed-loop framework, the Planner defines an optimization trajectory, while the Teacher-Critic-Student agents iteratively refine prompts to enhance reasoning stability and effectiveness, and the Target agent determines whether to continue optimization based on performance evaluation. Experimental results show that APOLO consistently improves diagnostic accuracy and robustness across domain-specific and stratified benchmarks, demonstrating a scalable and generalizable paradigm for trustworthy LLM applications in mental healthcare.

In order to develop machine learning and deep learning models that take into account the guidelines and principles of trustworthy AI, a novel information theoretic trustworthy AI framework is introduced. A unified approach to "privacy-preserving interpretable and transferable learning" is considered for studying and optimizing the tradeoffs between privacy, interpretability, and transferability aspects. A variational membership-mapping Bayesian model is used for the analytical approximations of the defined information theoretic measures for privacy-leakage, interpretability, and transferability. The approach consists of approximating the information theoretic measures via maximizing a lower-bound using variational optimization. The study presents a unified information theoretic approach to study different aspects of trustworthy AI in a rigorous analytical manner. The approach is demonstrated through numerous experiments on benchmark datasets and a real-world biomedical application concerned with the detection of mental stress on individuals using heart rate variability analysis.

Human-like personality traits have recently been discovered in large language models, raising the hypothesis that their (known and as yet undiscovered) biases conform with human latent psychological constructs. While large conversational models may be tricked into answering psychometric questionnaires, the latent psychological constructs of thousands of simpler transformers, trained for other tasks, cannot be assessed because appropriate psychometric methods are currently lacking. Here, we show how standard psychological questionnaires can be reformulated into natural language inference prompts, and we provide a code library to support the psychometric assessment of arbitrary models. We demonstrate, using a sample of 88 publicly available models, the existence of human-like mental health-related constructs (including anxiety, depression, and Sense of Coherence) which conform with standard theories in human psychology and show similar correlations and mitigation strategies. The ability to interpret and rectify the performance of language models by using psychological tools can boost the development of more explainable, controllable, and trustworthy models.

Vision-language models (VLMs) excel at multimodal understanding, yet their text-only decoding forces them to verbalize visual reasoning, limiting performance on tasks that demand visual imagination. Recent attempts train VLMs to render explicit images, but the heavy image-generation pre-training often hinders the reasoning ability. Inspired by the way humans reason with mental imagery-the internal construction and manipulation of visual cues-we investigate whether VLMs can reason through interleaved multimodal trajectories without producing explicit images. To this end, we present a Machine Mental Imagery framework, dubbed as Mirage, which augments VLM decoding with latent visual tokens alongside ordinary text. Concretely, whenever the model chooses to ``think visually'', it recasts its hidden states as next tokens, thereby continuing a multimodal trajectory without generating pixel-level images. Begin by supervising the latent tokens through distillation from ground-truth image embeddings, we then switch to text-only supervision to make the latent trajectory align tightly with the task objective. A subsequent reinforcement learning stage further enhances the multimodal reasoning capability. Experiments on diverse benchmarks demonstrate that Mirage unlocks stronger multimodal reasoning without explicit image generation.

Frontier models are transitioning from multimodal large language models (MLLMs) that merely ingest visual information to unified multimodal models (UMMs) capable of native interleaved generation. This shift has sparked interest in using intermediate visualizations as a reasoning aid, akin to human mental imagery. Central to this idea is the ability to form, maintain, and manipulate visual representations in a goal-oriented manner. To evaluate and probe this capability, we develop MentisOculi, a procedural, stratified suite of multi-step reasoning problems amenable to visual solution, tuned to challenge frontier models. Evaluating visual strategies ranging from latent tokens to explicit generated imagery, we find they generally fail to improve performance. Analysis of UMMs specifically exposes a critical limitation: While they possess the textual reasoning capacity to solve a task and can sometimes generate correct visuals, they suffer from compounding generation errors and fail to leverage even ground-truth visualizations. Our findings suggest that despite their inherent appeal, visual thoughts do not yet benefit model reasoning. MentisOculi establishes the necessary foundation to analyze and close this gap across diverse model families.

Recent research shows that Large Language Models (LLMs) exhibit a compelling level of proficiency in Theory of Mind (ToM) tasks. This ability to impute unobservable mental states to others is vital to human social cognition and may prove equally important in principal-agent relations between individual humans and Artificial Intelligences (AIs). In this paper, we explore how a mechanism studied in developmental psychology known as Violation of Expectation (VoE) can be implemented to reduce errors in LLM prediction about users by leveraging emergent ToM affordances. And we introduce a metacognitive prompting framework to apply VoE in the context of an AI tutor. By storing and retrieving facts derived in cases where LLM expectation about the user was violated, we find that LLMs are able to learn about users in ways that echo theories of human learning. Finally, we discuss latent hazards and augmentative opportunities associated with modeling user psychology and propose ways to mitigate risk along with possible directions for future inquiry.

Brain-Computer Interface (BCI) systems allow users to perform actions by translating their brain activity into commands. Such systems usually need a training phase, consisting in training a classification algorithm to discriminate between mental states using specific features from the recorded signals. This phase of feature selection and training is crucial for BCI performance and presents specific constraints to be met in a clinical context, such as post-stroke rehabilitation. In this paper, we present HappyFeat, a software making Motor Imagery (MI) based BCI experiments easier, by gathering all necessary manipulations and analysis in a single convenient GUI and via automation of experiment or analysis parameters. The resulting workflow allows for effortlessly selecting the best features, helping to achieve good BCI performance in time-constrained environments. Alternative features based on Functional Connectivity can be used and compared or combined with Power Spectral Density, allowing a network-oriented approach. We then give details of HappyFeat's main mechanisms, and a review of its performances in typical use cases. We also show that it can be used as an efficient tool for comparing different metrics extracted from the signals, to train the classification algorithm. To this end, we show a comparison between the commonly-used Power Spectral Density and network metrics based on Functional Connectivity. HappyFeat is available as an open-source project which can be freely downloaded on GitHub.

Existing LLM reasoning methods have shown impressive capabilities across various tasks, such as solving math and coding problems. However, applying these methods to scenarios without ground-truth answers or rule-based verification methods - such as tracking the mental states of an agent - remains challenging. Inspired by the sequential Monte Carlo algorithm, we introduce thought-tracing, an inference-time reasoning algorithm designed to trace the mental states of specific agents by generating hypotheses and weighting them based on observations without relying on ground-truth solutions to questions in datasets. Our algorithm is modeled after the Bayesian theory-of-mind framework, using LLMs to approximate probabilistic inference over agents' evolving mental states based on their perceptions and actions. We evaluate thought-tracing on diverse theory-of-mind benchmarks, demonstrating significant performance improvements compared to baseline LLMs. Our experiments also reveal interesting behaviors of the recent reasoning models - e.g., o3 and R1 - on theory-of-mind, highlighting the difference of social reasoning compared to other domains.