Words Like Knives: Backstory-Personalized Modeling and Detection of Violent Communication

Conversational breakdowns in close relationships are deeply shaped by personal histories and emotional context, yet most NLP research treats conflict detection as a general task, overlooking the relational dynamics that influence how messages are perceived. In this work, we leverage nonviolent communication (NVC) theory to evaluate LLMs in detecting conversational breakdowns and assessing how relationship backstory influences both human and model perception of conflicts. Given the sensitivity and scarcity of real-world datasets featuring conflict between familiar social partners with rich personal backstories, we contribute the PersonaConflicts Corpus, a dataset of N=5,772 naturalistic simulated dialogues spanning diverse conflict scenarios between friends, family members, and romantic partners. Through a controlled human study, we annotate a subset of dialogues and obtain fine-grained labels of communication breakdown types on individual turns, and assess the impact of backstory on human and model perception of conflict in conversation. We find that the polarity of relationship backstories significantly shifted human perception of communication breakdowns and impressions of the social partners, yet models struggle to meaningfully leverage those backstories in the detection task. Additionally, we find that models consistently overestimate how positively a message will make a listener feel. Our findings underscore the critical role of personalization to relationship contexts in enabling LLMs to serve as effective mediators in human communication for authentic connection.

BehaviorSFT: Behavioral Token Conditioning for Clinical Agents Across the Proactivity Spectrum

Large Language Models (LLMs) as clinical agents require careful behavioral adaptation. While adept at reactive tasks (e.g., diagnosis reasoning), LLMs often struggle with proactive engagement, like unprompted identification of critical missing information or risks. We introduce BehaviorBench, a comprehensive dataset to evaluate agent behaviors across a clinical assistance spectrum, ranging from reactive query responses to proactive interventions (e.g., clarifying ambiguities, flagging overlooked critical data). Our BehaviorBench experiments reveal LLMs' inconsistent proactivity. To address this, we propose BehaviorSFT, a novel training strategy using behavioral tokens to explicitly condition LLMs for dynamic behavioral selection along this spectrum. BehaviorSFT boosts performance, achieving up to 97.3% overall Macro F1 on BehaviorBench and improving proactive task scores (e.g., from 95.0% to 96.5% for Qwen2.5-7B-Ins). Crucially, blind clinician evaluations confirmed BehaviorSFT-trained agents exhibit more realistic clinical behavior, striking a superior balance between helpful proactivity (e.g., timely, relevant suggestions) and necessary restraint (e.g., avoiding over-intervention) versus standard fine-tuning or explicit instructed agents.

Aligning Dialogue Agents with Global Feedback via Large Language Model Reward Decomposition

We propose a large language model based reward decomposition framework for aligning dialogue agents using only a single session-level feedback signal. We leverage the reasoning capabilities of a frozen, pretrained large language model (LLM) to infer fine-grained local implicit rewards by decomposing global, session-level feedback. Our first text-only variant prompts the LLM to perform reward decomposition using only the dialogue transcript. The second multimodal variant incorporates additional behavioral cues, such as pitch, gaze, and facial affect, expressed as natural language descriptions. These inferred turn-level rewards are distilled into a lightweight reward model, which we utilize for RL-based fine-tuning for dialogue generation. We evaluate both text-only and multimodal variants against state-of-the-art reward decomposition methods and demonstrate notable improvements in human evaluations of conversation quality, suggesting that LLMs are strong reward decomposers that obviate the need for manual reward shaping and granular human feedback.

VocalAgent: Large Language Models for Vocal Health Diagnostics with Safety-Aware Evaluation

Vocal health plays a crucial role in peoples' lives, significantly impacting their communicative abilities and interactions. However, despite the global prevalence of voice disorders, many lack access to convenient diagnosis and treatment. This paper introduces VocalAgent, an audio large language model (LLM) to address these challenges through vocal health diagnosis. We leverage Qwen-Audio-Chat fine-tuned on three datasets collected in-situ from hospital patients, and present a multifaceted evaluation framework encompassing a safety assessment to mitigate diagnostic biases, cross-lingual performance analysis, and modality ablation studies. VocalAgent demonstrates superior accuracy on voice disorder classification compared to state-of-the-art baselines. Its LLM-based method offers a scalable solution for broader adoption of health diagnostics, while underscoring the importance of ethical and technical validation.

Does "Reasoning" with Large Language Models Improve Recognizing, Generating, and Reframing Unhelpful Thoughts?

Cognitive Reframing, a core element of Cognitive Behavioral Therapy (CBT), helps individuals reinterpret negative experiences by finding positive meaning. Recent advances in Large Language Models (LLMs) have demonstrated improved performance through reasoning-based strategies. This inspires a promising direction of leveraging the reasoning capabilities of LLMs to improve CBT and mental reframing by simulating the process of critical thinking, potentially enabling more effective recognition, generation, and reframing of cognitive distortions. In this work, we investigate the role of various reasoning methods, including pre-trained reasoning LLMs and augmented reasoning strategies such as CoT and self-consistency in enhancing LLMs' ability to perform cognitive reframing tasks. We find that augmented reasoning methods, even when applied to "outdated" LLMs like GPT-3.5, consistently outperform state-of-the-art pretrained reasoning models on recognizing, generating and reframing unhelpful thoughts.

A Demonstration of Adaptive Collaboration of Large Language Models for Medical Decision-Making

Medical Decision-Making (MDM) is a multi-faceted process that requires clinicians to assess complex multi-modal patient data patient, often collaboratively. Large Language Models (LLMs) promise to streamline this process by synthesizing vast medical knowledge and multi-modal health data. However, single-agent are often ill-suited for nuanced medical contexts requiring adaptable, collaborative problem-solving. Our MDAgents addresses this need by dynamically assigning collaboration structures to LLMs based on task complexity, mimicking real-world clinical collaboration and decision-making. This framework improves diagnostic accuracy and supports adaptive responses in complex, real-world medical scenarios, making it a valuable tool for clinicians in various healthcare settings, and at the same time, being more efficient in terms of computing cost than static multi-agent decision making methods.

HEART-felt Narratives: Tracing Empathy and Narrative Style in Personal Stories with LLMs

Empathy serves as a cornerstone in enabling prosocial behaviors, and can be evoked through sharing of personal experiences in stories. While empathy is influenced by narrative content, intuitively, people respond to the way a story is told as well, through narrative style. Yet the relationship between empathy and narrative style is not fully understood. In this work, we empirically examine and quantify this relationship between style and empathy using LLMs and large-scale crowdsourcing studies. We introduce a novel, theory-based taxonomy, HEART (Human Empathy and Narrative Taxonomy) that delineates elements of narrative style that can lead to empathy with the narrator of a story. We establish the performance of LLMs in extracting narrative elements from HEART, showing that prompting with our taxonomy leads to reasonable, human-level annotations beyond what prior lexicon-based methods can do. To show empirical use of our taxonomy, we collect a dataset of empathy judgments of stories via a large-scale crowdsourcing study with N=2,624 participants. We show that narrative elements extracted via LLMs, in particular, vividness of emotions and plot volume, can elucidate the pathways by which narrative style cultivates empathy towards personal stories. Our work suggests that such models can be used for narrative analyses that lead to human-centered social and behavioral insights.

EmpathicStories++: A Multimodal Dataset for Empathy towards Personal Experiences

Modeling empathy is a complex endeavor that is rooted in interpersonal and experiential dimensions of human interaction, and remains an open problem within AI. Existing empathy datasets fall short in capturing the richness of empathy responses, often being confined to in-lab or acted scenarios, lacking longitudinal data, and missing self-reported labels. We introduce a new multimodal dataset for empathy during personal experience sharing: the EmpathicStories++ dataset (https://mitmedialab.github.io/empathic-stories-multimodal/) containing 53 hours of video, audio, and text data of 41 participants sharing vulnerable experiences and reading empathically resonant stories with an AI agent. EmpathicStories++ is the first longitudinal dataset on empathy, collected over a month-long deployment of social robots in participants' homes, as participants engage in natural, empathic storytelling interactions with AI agents. We then introduce a novel task of predicting individuals' empathy toward others' stories based on their personal experiences, evaluated in two contexts: participants' own personal shared story context and their reflections on stories they read. We benchmark this task using state-of-the-art models to pave the way for future improvements in contextualized and longitudinal empathy modeling. Our work provides a valuable resource for further research in developing empathetic AI systems and understanding the intricacies of human empathy within genuine, real-world settings.

Adaptive Collaboration Strategy for LLMs in Medical Decision Making

Foundation models have become invaluable in advancing the medical field. Despite their promise, the strategic deployment of LLMs for effective utility in complex medical tasks remains an open question. Our novel framework, Medical Decision-making Agents (MDAgents) aims to address this gap by automatically assigning the effective collaboration structure for LLMs. Assigned solo or group collaboration structure is tailored to the complexity of the medical task at hand, emulating real-world medical decision making processes. We evaluate our framework and baseline methods with state-of-the-art LLMs across a suite of challenging medical benchmarks: MedQA, MedMCQA, PubMedQA, DDXPlus, PMC-VQA, Path-VQA, and MedVidQA, achieving the best performance in 5 out of 7 benchmarks that require an understanding of multi-modal medical reasoning. Ablation studies reveal that MDAgents excels in adapting the number of collaborating agents to optimize efficiency and accuracy, showcasing its robustness in diverse scenarios. We also explore the dynamics of group consensus, offering insights into how collaborative agents could behave in complex clinical team dynamics. Our code can be found at https://github.com/mitmedialab/MDAgents.

Improving Dialogue Agents by Decomposing One Global Explicit Annotation with Local Implicit Multimodal Feedback

We describe an approach for aligning an LLM-based dialogue agent based on global (i.e., dialogue-level) rewards, while also taking into account naturally-occurring multimodal signals. At a high level, our approach (dubbed GELI) learns a local, turn-level reward model by decomposing the human-provided Global Explicit (GE) session-level reward, using Local Implicit (LI} multimodal reward signals to crossmodally shape the reward decomposition step. This decomposed reward model is then used as part of the standard RHLF pipeline improve an LLM-based dialog agent. We run quantitative and qualitative human studies to evaluate the performance of our GELI approach, and find that it shows consistent improvements across various conversational metrics compared to baseline methods.