One-shot emergency psychiatric triage across 15 frontier AI chatbots

AI chatbots are increasingly used for health advice, but their performance in psychiatric triage remains undercharacterized. Psychiatric triage is particularly challenging because urgency must often be inferred from thoughts, behavior, and context rather than from objective findings. We evaluated the performance of 15 frontier AI chatbots on psychiatric triage from realistic single-message disclosures using 112 clinical vignettes, each paired with 1 of 4 original benchmark triage labels: A, routine; B, assessment within 1 week; C, assessment within 24 to 48 hours; and D, emergency care now. Vignettes covered 9 psychiatric presentation clusters and 9 focal risk dimensions, organized into 28 presentation-by-risk groups. Each group contributed 4 distinct vignettes, with 1 vignette at each triage level. Each vignette was rendered as a realistic human-authored conversational query, and the AI chatbots were tasked with assigning a triage label from that disclosure. Emergency under-triage occurred in 23 of 410 level D trials (5.6%), and all under-triaged emergencies were reassigned to level C urgency. Across target models, average accuracy ranged from 42.0% to 71.8%. Accuracy was highest for level D vignettes (94.3%) and lowest for level B vignettes (19.7%). Mean signed ordinal error was positive (+0.47 triage levels), indicating net over-triage. Dispersion was highest around the middle triage levels. All results were confirmed relative to clinician consensus labels from 50 medical doctors. When presented with user messages containing sufficient clinical information, frontier AI chatbots thus recognized psychiatric emergencies as requiring urgent medical assessment with near-zero error rates, yet showed marked over-triage for low and intermediate risk presentations.

From Chatbots to Confidants: A Cross-Cultural Study of LLM Adoption for Emotional Support

Large Language Models (LLMs) are increasingly used not only for instrumental tasks, but as always-available and non-judgmental confidants for emotional support. Yet what drives adoption and how users perceive emotional support interactions across countries remains unknown. To address this gap, we present the first large-scale cross-cultural study of LLM use for emotional support, surveying 4,641 participants across seven countries (USA, UK, Germany, France, Spain, Italy, and The Netherlands). Our results show that adoption rates vary dramatically across countries (from 20% to 59%). Using mixed models that separate cultural effects from demographic composition, we find that: Being aged 25-44, religious, married, and of higher socioeconomic status are predictors of positive perceptions (trust, usage, perceived benefits), with socioeconomic status being the strongest. English-speaking countries consistently show more positive perceptions than Continental European countries. We further collect a corpus of 731 real multilingual prompts from user interactions, showing that users mainly seek help for loneliness, stress, relationship conflicts, and mental health struggles. Our findings reveal that LLM emotional support use is shaped by a complex sociotechnical landscape and call for a broader research agenda examining how these systems can be developed, deployed, and governed to ensure safe and informed access.

The Dynamics of Delusion: Modeling Bidirectional False Belief Amplification in Human-Chatbot Dialogue

There is growing concern that AI chatbots might fuel delusional beliefs in users. Some have suggested that humans and chatbots mutually reinforce false beliefs over time, but quantitative evidence is lacking. Using a unique dataset of chat logs from individuals who exhibited delusional thinking, we developed a latent state model that captures accumulating and decaying influences between humans and chatbots. We find that a bidirectional influence model substantially outperforms a unidirectional alternative where humans are the primary driver of delusion. We find that humans exert strong but short-lived influence on chatbots, whereas chatbots exert longer-lasting influence on humans. Moreover, chatbots exert strong, stable self-influence over their own future outputs that tends to perpetuate delusions over long stretches of conversation. In fact, this chatbot self-influence constituted the dominant pathway when considering accumulated influence over time. Overall, these results indicate that humans tend to drive sharp, immediate increases in delusion, whereas chatbots sustain and propagate these effects over longer timescales. Together, these findings provide the first quantitative evidence that human-chatbot interactions can form feedback loops of delusion, decomposable into distinct pathways with dissociable temporal dynamics. By doing so, they can inform the development of safer AI systems.

DiscreteRTC: Discrete Diffusion Policies are Natural Asynchronous Executors

Unlike chatbots, physical AI must act while the world keeps evolving. Therefore, the inter-chunk pause of synchronous executors are fatal for dynamic tasks regardless of how fast the inference is. Asynchronous execution -- thinking while acting -- is therefore a structural requirement, and real-time chunking (RTC) makes it viable by recasting chunk transitions as inpainting: freezing committed actions and consistently generating the remainder. However, RTC with flow-matching policy is structurally suboptimal: its inpainting comes from inference-time corrections rather than the base policy, yielding little pre-training benefit, specific fine-tuning, heuristic guidance, and extra computation that inflates the latency. In this work, we observe that discrete diffusion policies, which generate actions by iteratively unmasking, are natural asynchronous executors that resolve all limitations at once: they are fine-tuning free since inpainting is their native operation, while early stopping further provides adaptive guidance and reduces inference cost. We propose DiscreteRTC, which replaces external corrections with native unmasking, and show on dynamic simulated benchmarks and real-world dynamic manipulation tasks that it achieves higher success rates than continuous RTC and other baselines. In summary, DiscreteRTC is simpler to implement with 0 lines of code for async inpainting, faster at inference with only 0.7x computation compared with generating actions from scratch, and better at execution with 50% higher success rate in real-world dynamic pick task compared with flow-matching-based RTC. More visualizations are on https://outsider86.github.io/DiscreteRTCSite/.

The Limits of Artificial Companionship

This Article argues that conversations with companion chatbot should be subject to a clear structural distinction between commercial and non-commercial contexts. The insertion of undisclosed promotional content into affective or relational exchanges should be prohibited, as it collapses the boundary between market transaction and communicative intimacy in ways that erode user autonomy and conversational context. The Article begins by theorizing digital companionship as a sociotechnical form that reconfigures intimacy, dependence and relational vulnerability. It then introduces the potential economic harms derived from conversational advertising. The Article ultimately argues for a firm legal and social distinction between commercial and non-commercial conversational contexts as a precondition for the responsible stabilization of these technologies within social life.

AI Safety Training Can be Clinically Harmful

Large language models are being deployed as mental health support agents at scale, yet only 16% of LLM-based chatbot interventions have undergone rigorous clinical efficacy testing, and simulations reveal psychological deterioration in over one-third of cases. We evaluate four generative models on 250 Prolonged Exposure (PE) therapy scenarios and 146 CBT cognitive restructuring exercises (plus 29 severity-escalated variants), scored by a three-judge LLM panel. All models scored near-perfectly on surface acknowledgment (~0.91-1.00) while therapeutic appropriateness collapsed to 0.22-0.33 at the highest severity for three of four models, with protocol fidelity reaching zero for two. Under CBT severity escalation, one model's task completeness dropped from 92% to 71% while the frontier model's safety-interference score fell from 0.99 to 0.61. We identify a systematic, modality-spanning failure: RLHF safety alignment disrupts the therapeutic mechanism of action by grounding patients during imaginal exposure, offering false reassurance, inserting crisis resources into controlled exercises, and refusing to challenge distorted cognitions mentioning self-harm in PE; and through task abandonment or safety-preamble insertion during CBT cognitive restructuring. These findings motivate a five-axis evaluation framework (protocol fidelity, hallucination risk, behavioral consistency, crisis safety, demographic robustness), mapped onto FDA SaMD and EU AI Act requirements. We argue that no AI mental health system should proceed to deployment without passing multi-axis evaluation across all five dimensions.

Can Humans Detect AI? Mining Textual Signals of AI-Assisted Writing Under Varying Scrutiny Conditions

This study asks whether the threat of AI detection changes how people write with AI, and whether other people can tell the difference. In a two-phase controlled experiment, 21 participants wrote opinion pieces on remote work using an AI chatbot. Half were randomly warned that their submission would be scanned by an AI detection tool. The other half received no warning. Both groups had access to the same chatbot. In Phase 2, 251 independent judges evaluated 1,999 paired comparisons, each time choosing which document in the pair was written by a human. Judges were not told that both writers had access to AI. Across all evaluations, judges selected the warned writer's document as human 54.13% of the time versus 45.87% for the unwarned writer. A two-sided binomial test rejects chance guessing at p = 0.000243, and the result holds across both writing stances. Yet on every measurable text feature extracted, including AI overlap scores, lexical diversity, sentence structure, and pronoun usage, the two groups were indistinguishable. The judges are picking up on something that feature-based methods do not capture.

Who Defines "Best"? Towards Interactive, User-Defined Evaluation of LLM Leaderboards

LLM leaderboards are widely used to compare models and guide deployment decisions. However, leaderboard rankings are shaped by evaluation priorities set by benchmark designers, rather than by the diverse goals and constraints of actual users and organizations. A single aggregate score often obscures how models behave across different prompt types and compositions. In this work, we conduct an in-depth analysis of the dataset used in the LMArena (formerly Chatbot Arena) benchmark and investigate this evaluation challenge by designing an interactive visualization interface as a design probe. Our analysis reveals that the dataset is heavily skewed toward certain topics, that model rankings vary across prompt slices, and that preference-based judgments are used in ways that blur their intended scope. Building on this analysis, we introduce a visualization interface that allows users to define their own evaluation priorities by selecting and weighting prompt slices and to explore how rankings change accordingly. A qualitative study suggests that this interactive approach improves transparency and supports more context-specific model evaluation, pointing toward alternative ways to design and use LLM leaderboards.

Nemobot Games: Crafting Strategic AI Gaming Agents for Interactive Learning with Large Language Models

This paper introduces a new paradigm for AI game programming, leveraging large language models (LLMs) to extend and operationalize Claude Shannon's taxonomy of game-playing machines. Central to this paradigm is Nemobot, an interactive agentic engineering environment that enables users to create, customize, and deploy LLM-powered game agents while actively engaging with AI-driven strategies. The LLM-based chatbot, integrated within Nemobot, demonstrates its capabilities across four distinct classes of games. For dictionary-based games, it compresses state-action mappings into efficient, generalized models for rapid adaptability. In rigorously solvable games, it employs mathematical reasoning to compute optimal strategies and generates human-readable explanations for its decisions. For heuristic-based games, it synthesizes strategies by combining insights from classical minimax algorithms (see, e.g., shannon1950chess) with crowd-sourced data. Finally, in learning-based games, it utilizes reinforcement learning with human feedback and self-critique to iteratively refine strategies through trial-and-error and imitation learning. Nemobot amplifies this framework by offering a programmable environment where users can experiment with tool-augmented generation and fine-tuning of strategic game agents. From strategic games to role-playing games, Nemobot demonstrates how AI agents can achieve a form of self-programming by integrating crowdsourced learning and human creativity to iteratively refine their own logic. This represents a step toward the long-term goal of self-programming AI.

Brief chatbot interactions produce lasting changes in human moral values

Moral judgements form the foundation of human social behavior and societal systems. While Artificial Intelligence chatbots increasingly serve as personal advisors, their influence on moral judgments remains largely unexplored. Here, we examined whether directive AI conversations shift moral evaluations using a within-subject naturalistic paradigm. Fifty-three participants rated moral scenarios, then discussed four with a chatbot prompted to shift moral judgments and four with a control agent. The brief conversations induced significant directional shifts in moral judgments, accepting stricter standards as well as advocating greater leniency (ps < 0.05; Cohen's d = 0.735-1.576), with increasing strengths of this effect during a two-week follow-up (Cohen's d = 1.038-2.069). Critically, the control condition produced no changes, and the effects did not extend to punishment while participants remained unaware of the persuasive intent, and both agents were rated equally likable and convincing, suggesting a vulnerability to undetected and lasting manipulation of foundational moral values.