arXiv:2411.13800cs.CL2024-11被引 3

分析GPT对抑郁症状的内在理解,揭示其认知模式与临床差异。

Explaining GPTs' Schema of Depression: A Machine Behavior Analysis

  • 用测量理论解析GPT-4/5如何关联抑郁症状
  • 发现其对自杀意念关联弱、运动迟缓过度强调
  • 提出睡眠疲劳受多症状影响等新机制假说

大型语言模型如ChatGPT(GPT-4/GPT-5)在心理健康支持中的应用迅速增长,成为评估和帮助情绪障碍患者的重要途径。然而,我们对其内部对精神障碍(如抑郁)的认知架构了解有限。本文利用现代测量理论,解码GPT-4与GPT-5如何关联抑郁症状,揭示其内部推理机制并为临床应用提供依据。结果显示,GPT-4与标准量表及专家判断具有较强收敛效度(r = 0.70–0.81),且症状间行为关联(症状间相关系数 r = 0.23–0.78)符合抑郁症文献;但其对自杀意念与其他症状的关联被低估,而对躯体运动症状过度强调;同时提出新假设:睡眠与疲劳受其他抑郁症状广泛影响,而无价值感/内疚仅与低落情绪相关。GPT-5虽与自评量表收敛性略低,但机器行为分析揭示了其症状关联模式的转变。这些发现为理解大模型心理健康评估提供了实证基础,并展示了可推广的可解释性方法,有助于各方在医疗系统中合理部署此类技术。

原文摘要 · Abstract (English)

Use of large language models such as ChatGPT (GPT-4/GPT-5) for mental health support has grown rapidly, emerging as a promising route to assess and help people with mood disorders like depression. However, we have a limited understanding of these language models' schema of mental disorders, that is, how they internally associate and interpret symptoms of such disorders. In this work, we leveraged contemporary measurement theory to decode how GPT-4 and GPT-5 interrelate depressive symptoms, providing an explanation of how LLMs apply what they learn and informing clinical applications. We found that GPT-4 (a) had strong convergent validity with standard instruments and expert judgments $(r = 0.70 - 0.81)$, and (b) behaviorally linked depression symptoms with each other (symptom inter-correlates $r = 0.23 - 0.78$) in accordance with established literature on depression; however, it (c) underemphasized the relationship between $\textit{suicidality}$ and other symptoms while overemphasizing $\textit{psychomotor symptoms}$; and (d) suggested novel hypotheses of symptom mechanisms, for instance, indicating that $\textit{sleep}$ and $\textit{fatigue}$ are broadly influenced by other depressive symptoms, while $\textit{worthlessness/guilt}$ is only tied to $\textit{depressed mood}$. GPT-5 showed a slightly lower convergence with self-report, a difference our machine-behavior analysis makes interpretable through shifts in symptom-symptom relationships. These insights provide an empirical foundation for understanding language models' mental health assessments and demonstrate a generalizable approach for explainability in other models and disorders. Our findings can guide key stakeholders to make informed decisions for effectively situating these technologies in the care system.

大模型可解释性心理评估抑郁症状

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