Ryan L Boyd

Vivienne Bihe Chi, Adithya V Ganesan, Ryan L Boyd et al.

Large language models are increasingly used for mental health support, yet little is known about whether their responses are psychologically safe across different help-seeking styles. We examine a foundational distinction in emotional disclosure, venting vs. advice-seeking, and whether LLMs respond in ways that regulate or amplify distress. Using 178,800 Reddit posts, we first show the two help-seeking styles are linguistically distinguishable at scale. We then introduce a measurement framework grounded in interpersonal emotion regulation theory that captures Regulation and Escalation as empirically independent dimensions. Across persona conditions (default, friend, therapist), GPT-5.3 responses systematically mirror help-seeking style: venting elicits more regulation, but also more escalation. Therapist personas reduce escalation while maintaining regulation, whereas friend personas increase both. A crowdsourced human study finds no user experience penalty for the safer therapist condition, but reveals that lay raters cannot reliably detect escalation without expert knowledge. Responses that feel supportive may simultaneously intensify distress in ways standard safety evaluation cannot see, and empathy metrics alone cannot replace a framework that measures both.

Adithya V Ganesan, Vasudha Varadarajan, Oscar NE Kjell et al.

While NLP typically treats documents as independent and unordered samples, in longitudinal studies, this assumption rarely holds: documents are nested within authors and ordered in time, forming person-indexed, time-ordered $\textit{behavioral sequences}$. Here, we demonstrate the need for and propose a longitudinal modeling and evaluation paradigm that consequently updates four parts of the NLP pipeline: (1) evaluation splits aligned to generalization over people ($\textit{cross-sectional}$) and/or time ($\textit{prospective}$); (2) accuracy metrics separating between-person differences from within-person dynamics; (3) sequence inputs to incorporate history by default; and (4) model internals that support different $\textit{coarseness}$ of latent state over histories (pooled summaries, explicit dynamics, or interaction-based models). We demonstrate the issues ensued by traditional pipeline and our proposed improvements on a dataset of 17k daily diary transcripts paired with PTSD symptom severity from 238 participants, finding that traditional document-level evaluation can yield substantially different and sometimes reversed conclusions compared to our ecologically valid modeling and evaluation. We tie our results to a broader discussion motivating a shift from word-sequence evaluation toward $\textit{behavior-sequence}$ paradigms for NLP.