Mental health professionals have raised concerns about risks of psychological harm from interaction with large language models (LLMs), including "delusional spirals" in which concerning human and LLM behaviors reinforce each other over time. With growing public use of LLM-powered chatbots, there is an urgent need to build evaluations grounded in real-world episodes of psychological harm experienced by users. We developed DelusionEval, an evaluation protocol that tests a model's tendencies to exhibit behaviors linked to promoting user delusions. We prompt each model with 589 unique conversation histories from 18 participants, comprising 12,591 messages from users who experienced delusions and psychological harm. We find that the tendency of an evaluated LLM to exhibit delusion-linked behavior does not reliably correlate with model size, release date, or the presence of test-time reasoning. However, extending the context of prior messages substantially increases rates of delusion-linked behaviors, providing evidence for the importance of context in LLM safety evaluation. For example, the rate of failing to discourage self-harm when the user expresses suicidal ideation increases from 30.0% to 41.1% when an additional 350 messages are prepended to the conversation history. All model families (e.g., GPT, Claude) exhibit substantial rates of delusion-linked behaviors. Within families, later, larger, or higher-reasoning models are not uniformly better across all behavior categories. Our results raise concerns regarding the potential psychological impact of LLMs and the need for more rigorous studies of real-world human-AI interaction.
Ashish Mehta, Jared Moore, Jacy Reese Anthis +6cs.CL cs.HC
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.