When Symptoms Are Not Enough: Evidence-Weighting Patterns in Large Language Model Psychiatric Screening

As demand for mental health care outpaces clinician-delivered assessment, scalable screening tools are increasingly needed. Large language models (LLMs) may identify psychiatric risk from patient narratives, but their reliability across diagnoses, demographic subgroups, and evidence-use patterns remains uncertain. We introduce a SCID-anchored benchmark of 555 semi-structured experiential interviews paired with diagnostic reference labels for anxiety disorder, major depressive disorder, post-traumatic stress disorder, and any current mental health disorder. Using zero-shot task-specific prompting, we evaluated five state-of-the-art LLMs and examined whether false-negative errors reflected missed psychiatric evidence or differential weighting of symptom, functional-impairment, and protective-context cues. Performance varied across tasks and models, with accuracy ranging from 0.49 to 0.86 and Matthews correlation coefficients from 0.16 to 0.38. GPT-4.1 Mini and GPT-5 Mini showed the most consistent disorder-specific accuracy. Subgroup analyses found higher depression-classification accuracy among male than female participants, no consistent age-related pattern, and modest non-uniform variation across race strata. Evidence-integration analyses showed that false-negative anxiety and PTSD classifications often contained explicit symptom evidence but were accompanied by preserved functioning, coping ability, or social support. Functional-impairment evidence shifted model outputs toward positive classifications, whereas protective-context evidence shifted outputs away. These findings suggest that LLMs may support scalable psychiatric screening, but their tendency to discount symptom evidence in the presence of preserved functioning or protective context requires careful validation before clinical deployment.

Understanding Risk and Dependency in AI Chatbot Use from User Discourse

Generative AI systems are increasingly embedded in everyday life, yet empirical understanding of how psychological risk associated with AI use emerges, is experienced, and is regulated by users remains limited. We present a large-scale computational thematic analysis of posts collected between 2023 and 2025 from two Reddit communities, r/AIDangers and r/ChatbotAddiction, explicitly focused on AI-related harm and distress. Using a multi-agent, LLM-assisted thematic analysis grounded in Braun and Clarke's reflexive framework, we identify 14 recurring thematic categories and synthesize them into five higher-order experiential dimensions. To further characterize affective patterns, we apply emotion labeling using a BERT-based classifier and visualize emotional profiles across dimensions. Our findings reveal five empirically derived experiential dimensions of AI-related psychological risk grounded in real-world user discourse, with self-regulation difficulties emerging as the most prevalent and fear concentrated in concerns related to autonomy, control, and technical risk. These results provide early empirical evidence from lived user experience of how AI safety is perceived and emotionally experienced outside laboratory or speculative contexts, offering a foundation for future AI safety research, evaluation, and responsible governance.

Evaluating LLM Alignment on Personality Inference from Real-World Interview Data

Large Language Models (LLMs) are increasingly deployed in roles requiring nuanced psychological understanding, such as emotional support agents, counselors, and decision-making assistants. However, their ability to interpret human personality traits, a critical aspect of such applications, remains unexplored, particularly in ecologically valid conversational settings. While prior work has simulated LLM "personas" using discrete Big Five labels on social media data, the alignment of LLMs with continuous, ground-truth personality assessments derived from natural interactions is largely unexamined. To address this gap, we introduce a novel benchmark comprising semi-structured interview transcripts paired with validated continuous Big Five trait scores. Using this dataset, we systematically evaluate LLM performance across three paradigms: (1) zero-shot and chain-of-thought prompting with GPT-4.1 Mini, (2) LoRA-based fine-tuning applied to both RoBERTa and Meta-LLaMA architectures, and (3) regression using static embeddings from pretrained BERT and OpenAI's text-embedding-3-small. Our results reveal that all Pearson correlations between model predictions and ground-truth personality traits remain below 0.26, highlighting the limited alignment of current LLMs with validated psychological constructs. Chain-of-thought prompting offers minimal gains over zero-shot, suggesting that personality inference relies more on latent semantic representation than explicit reasoning. These findings underscore the challenges of aligning LLMs with complex human attributes and motivate future work on trait-specific prompting, context-aware modeling, and alignment-oriented fine-tuning.

Leveraging Large Language Models to Analyze Emotional and Contextual Drivers of Teen Substance Use in Online Discussions

Adolescence is a critical stage often linked to risky behaviors, including substance use, with significant developmental and public health implications. Social media provides a lens into adolescent self-expression, but interpreting emotional and contextual signals remains complex. This study applies Large Language Models (LLMs) to analyze adolescents' social media posts, uncovering emotional patterns (e.g., sadness, guilt, fear, joy) and contextual factors (e.g., family, peers, school) related to substance use. Heatmap and machine learning analyses identified key predictors of substance use-related posts. Negative emotions like sadness and guilt were significantly more frequent in substance use contexts, with guilt acting as a protective factor, while shame and peer influence heightened substance use risk. Joy was more common in non-substance use discussions. Peer influence correlated strongly with sadness, fear, and disgust, while family and school environments aligned with non-substance use. Findings underscore the importance of addressing emotional vulnerabilities and contextual influences, suggesting that collaborative interventions involving families, schools, and communities can reduce risk factors and foster healthier adolescent development.

Investigating Large Language Models in Inferring Personality Traits from User Conversations

Large Language Models (LLMs) are demonstrating remarkable human like capabilities across diverse domains, including psychological assessment. This study evaluates whether LLMs, specifically GPT-4o and GPT-4o mini, can infer Big Five personality traits and generate Big Five Inventory-10 (BFI-10) item scores from user conversations under zero-shot prompting conditions. Our findings reveal that incorporating an intermediate step--prompting for BFI-10 item scores before calculating traits--enhances accuracy and aligns more closely with the gold standard than direct trait inference. This structured approach underscores the importance of leveraging psychological frameworks in improving predictive precision. Additionally, a group comparison based on depressive symptom presence revealed differential model performance. Participants were categorized into two groups: those experiencing at least one depressive symptom and those without symptoms. GPT-4o mini demonstrated heightened sensitivity to depression-related shifts in traits such as Neuroticism and Conscientiousness within the symptom-present group, whereas GPT-4o exhibited strengths in nuanced interpretation across groups. These findings underscore the potential of LLMs to analyze real-world psychological data effectively, offering a valuable foundation for interdisciplinary research at the intersection of artificial intelligence and psychology.