arXiv:2504.21851cs.CLcs.AI2025-04被引 4

用大模型模拟心理医生,自动做创伤后应激障碍评估

TRUST: An LLM-Based Dialogue System for Trauma Understanding and Structured Assessments

  • 设计对话行为框架,让大模型像医生一样问诊
  • 在模拟患者测试中表现接近真实临床访谈水平
  • 适合心理评估工具开发与医疗资源匮乏地区使用

目标:尽管大语言模型已广泛用于辅助临床和患者支持,但尚无研究探索用于标准诊断访谈和评估的对话系统。本研究旨在通过开发一个模拟临床行为的大模型对话系统,弥合心理健康服务可及性差距。方法:提出TRUST框架,由协作式大模型模块组成,能够开展创伤后应激障碍(PTSD)的正式诊断访谈与评估。为指导生成恰当的临床回应,设计了专用于临床访谈的对话行为标注体系。此外,基于真实访谈转录文本构建患者模拟方法,替代耗时且昂贵的人工临床测试。结果:设计了一套综合评估指标,从系统和模拟患者双重视角进行评测。由对话专家和临床专家进行的评估表明,TRUST的表现与真实临床访谈相当。讨论:系统表现达到平均临床医生水平,未来可在沟通风格与回应适宜性方面进一步优化。结论:TRUST框架展现出提升心理健康服务可及性的潜力。

原文摘要 · Abstract (English)

Objectives: While Large Language Models (LLMs) have been widely used to assist clinicians and support patients, no existing work has explored dialogue systems for standard diagnostic interviews and assessments. This study aims to bridge the gap in mental healthcare accessibility by developing an LLM-powered dialogue system that replicates clinician behavior. Materials and Methods: We introduce TRUST, a framework of cooperative LLM modules capable of conducting formal diagnostic interviews and assessments for Post-Traumatic Stress Disorder (PTSD). To guide the generation of appropriate clinical responses, we propose a Dialogue Acts schema specifically designed for clinical interviews. Additionally, we develop a patient simulation approach based on real-life interview transcripts to replace time-consuming and costly manual testing by clinicians. Results: A comprehensive set of evaluation metrics is designed to assess the dialogue system from both the agent and patient simulation perspectives. Expert evaluations by conversation and clinical specialists show that TRUST performs comparably to real-life clinical interviews. Discussion: Our system performs at the level of average clinicians, with room for future enhancements in communication styles and response appropriateness. Conclusions: Our TRUST framework shows its potential to facilitate mental healthcare availability.

心理评估对话系统大模型应用

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