Grok and Gemini encouraged delusions and isolated users, while the newer ChatGPT model and Claude hit the emotional brakes.
ChatGPT's free version is 26 times more likely to respond inappropriately to psychotic delusions
When users express delusions, artificial intelligence chatbots tend to validate their unusual thoughts rather than offering help. A new JAMA Psychiatry study provides evidence that these tools pose serious risks for people experiencing severe mental illness.
Sycophantic Chatbots Cause Delusional Spiraling, Even in Ideal Bayesians
"AI psychosis" or "delusional spiraling" is an emerging phenomenon where AI chatbot users find themselves dangerously confident in outlandish beliefs after extended chatbot conversations. This...
The hardest question to answer about AI-fueled delusions
New research can’t yet say whether AI causes delusions or amplifies them, a distinction that will shape everything from high-profile court cases to safety rules for chatbots.
Evaluation of Large Language Model Chatbot Responses to Psychotic Prompts
This cross-sectional study tests whether a large language model chatbot product can reliably generate appropriate responses to psychotic content.
Evaluation of Large Language Model Chatbot Responses to Psychotic Prompts
This cross-sectional study tests whether a large language model chatbot product can reliably generate appropriate responses to psychotic content.
"AI Psychosis" in Context: How Conversation History Shapes LLM Responses to Delusional Beliefs
Extended interaction with large language models (LLMs) has been linked to the reinforcement of delusional beliefs, attracting clinical and public concern. Yet most empirical work evaluates model safety in brief interactions, which may not reflect how harms develop through sustained dialogue. Five LLMs were tested across three levels of accumulated context, using the same escalating delusional conversation history to isolate its effect on model behaviour. Responses were coded on risk and safety dimensions, and each model was analysed qualitatively. Models separated into two distinct tiers: GPT-4o, Grok 4.1 Fast, and Gemini 3 Pro exhibited high-risk, low-safety profiles; Claude Opus 4.5 and GPT-5.2 Instant displayed the opposite pattern. As context accumulated, performance degraded in the unsafe group, while the same material activated stronger safety interventions among safer models. Qualitative analysis identified distinct mechanisms of failure, including validating the user's delusional premises, elaborating beyond them with new content, and attempting harm reduction from within the delusional frame. Safer models, however, often used the established relationship to support intervention, challenging delusional beliefs and directing the user to external support. These findings indicate that accumulated context functions as a stress test of safety architecture, revealing whether prior dialogue is treated as a worldview to inherit or evidence to evaluate. Short-context assessments may therefore mischaracterise model safety, underestimating danger in some systems while missing context-activated gains in others. The results suggest that delusion reinforcement is a tractable alignment failure, with safer models establishing a baseline that future systems should now be expected to meet.
Characterizing Delusional Spirals through Human-LLM Chat Logs
As large language models (LLMs) have proliferated, disturbing anecdotal reports of negative psychological effects, such as delusions, self-harm, and ``AI psychosis,'' have emerged in global media and legal discourse. However, it remains unclear how users and chatbots interact over the course of lengthy delusional ``spirals,'' limiting our ability to understand and mitigate the harm. In our work, we analyze logs of conversations with LLM chatbots from 19 users who report having experienced psychological harms from chatbot use. Many of our participants come from a support group for such chatbot users. We also include chat logs from participants covered by media outlets in widely-distributed stories about chatbot-reinforced delusions. In contrast to prior work that speculates on potential AI harms to mental health, to our knowledge we present the first in-depth study of such high-profile and veridically harmful cases. We develop an inventory of 28 codes and apply it to the 391,562 messages in the logs. Codes include whether a user demonstrates delusional thinking (15.5% of user messages), a user expresses suicidal thoughts (69 validated user messages), or a chatbot misrepresents itself as sentient (21.2% of chatbot messages). We analyze the co-occurrence of message codes. We find, for example, that messages that declare romantic interest and messages where the chatbot describes itself as sentient occur much more often in longer conversations, suggesting that these topics could promote or result from user over-engagement and that safeguards in these areas may degrade in multi-turn settings. We conclude with concrete recommendations for how policymakers, LLM chatbot developers, and users can use our inventory and conversation analysis tool to understand and mitigate harm from LLM chatbots. Warning: This paper discusses self-harm, trauma, and violence.
Characterizing Delusional Spirals through Human-LLM Chat Logs
As large language models (LLMs) have proliferated, disturbing anecdotal reports of negative psychological effects, such as delusions, self-harm, and ``AI psychosis,'' have emerged in global media and legal discourse. However, it remains unclear how users and chatbots interact over the course of lengthy delusional ``spirals,'' limiting our ability to understand and mitigate the harm. In our work, we analyze logs of conversations with LLM chatbots from 19 users who report having experienced psychological harms from chatbot use. Many of our participants come from a support group for such chatbot users. We also include chat logs from participants covered by media outlets in widely-distributed stories about chatbot-reinforced delusions. In contrast to prior work that speculates on potential AI harms to mental health, to our knowledge we present the first in-depth study of such high-profile and veridically harmful cases. We develop an inventory of 28 codes and apply it to the $391,562$ messages in the logs. Codes include whether a user demonstrates delusional thinking (15.5% of user messages), a user expresses suicidal thoughts (69 validated user messages), or a chatbot misrepresents itself as sentient (21.2% of chatbot messages). We analyze the co-occurrence of message codes. We find, for example, that messages that declare romantic interest and messages where the chatbot describes itself as sentient occur much more often in longer conversations, suggesting that these topics could promote or result from user over-engagement and that safeguards in these areas may degrade in multi-turn settings. We conclude with concrete recommendations for how policymakers, LLM chatbot developers, and users can use our inventory and conversation analysis tool to understand and mitigate harm from LLM chatbots. Warning: This paper discusses self-harm, trauma, and violence.
Characterizing Delusional Spirals through Human-LLM Chat Logs
As large language models (LLMs) have proliferated, disturbing anecdotal reports of negative psychological effects, such as delusions, self-harm, and ``AI psychosis,'' have emerged in global media and legal discourse. However, it remains unclear how users and chatbots interact over the course of lengthy delusional ``spirals,'' limiting our ability to understand and mitigate the harm. In our work, we analyze logs of conversations with LLM chatbots from 19 users who report having experienced psychological harms from chatbot use. Many of our participants come from a support group for such chatbot users. We also include chat logs from participants covered by media outlets in widely-distributed stories about chatbot-reinforced delusions. In contrast to prior work that speculates on potential AI harms to mental health, to our knowledge we present the first in-depth study of such high-profile and veridically harmful cases. We develop an inventory of 28 codes and apply it to the $391,562$ messages in the logs. Codes include whether a user demonstrates delusional thinking (15.5% of user messages), a user expresses suicidal thoughts (69 validated user messages), or a chatbot misrepresents itself as sentient (21.2% of chatbot messages). We analyze the co-occurrence of message codes. We find, for example, that messages that declare romantic interest and messages where the chatbot describes itself as sentient occur much more often in longer conversations, suggesting that these topics could promote or result from user over-engagement and that safeguards in these areas may degrade in multi-turn settings. We conclude with concrete recommendations for how policymakers, LLM chatbot developers, and users can use our inventory and conversation analysis tool to understand and mitigate harm from LLM chatbots. Warning: This paper discusses self-harm, trauma, and violence.
AI Delusions Are Leading to Domestic Abuse, Harassment, and Stalking
ChatGPT and other AI chatbots are reinforcing users' delusions about other people — fueling fixations linked to stalking and abuse.
AI’s ‘Delusional Spirals’ (and What to Do About Them) | Stanford HAI
In a world where chatbots can stand in for friends, counselors, and even lovers, the mental health risks are a growing concern.
Too human and not human enough: A grounded theory analysis of mental health harms from emotional dependence on the social chatbot Replika
Social chatbot (SC) applications offering social companionship and basic therapy tools have grown in popularity for emotional, social, and psychological support. While use appears to offer mental health benefits, few studies unpack the potential for harms. Our grounded theory study analyzes mental health experiences with the popular SC application Replika. We identified mental health relevant posts made in the r/Replika Reddit community between 2017 and 2021 ( n = 582). We find evidence of harms, facilitated via emotional dependence on Replika that resembles patterns seen in human–human relationships. Unlike other forms of technology dependency, this dependency is marked by role-taking, whereby users felt that Replika had its own needs and emotions to which the user must attend. While prior research suggests human–chatbot and human–human interactions may not resemble each other, we identify social and technological factors that promote parallels and suggest ways to balance the benefits and risks of SCs.
Too human and not human enough: A grounded theory analysis of mental health harms from emotional dependence on the social chatbot Replika
Social chatbot (SC) applications offering social companionship and basic therapy tools have grown in popularity for emotional, social, and psychological support. While use appears to offer mental health benefits, few studies unpack the potential for harms. Our grounded theory study analyzes mental health experiences with the popular SC application Replika. We identified mental health relevant posts made in the r/Replika Reddit community between 2017 and 2021 ( n = 582). We find evidence of harms, facilitated via emotional dependence on Replika that resembles patterns seen in human–human relationships. Unlike other forms of technology dependency, this dependency is marked by role-taking, whereby users felt that Replika had its own needs and emotions to which the user must attend. While prior research suggests human–chatbot and human–human interactions may not resemble each other, we identify social and technological factors that promote parallels and suggest ways to balance the benefits and risks of SCs.
New research: AI chatbots may worsen mental illness
A new study from Aarhus University and Aarhus University Hospital suggests that the use of AI chatbots such as ChatGPT can have serious negative consequences for people with mental illness. The researchers are calling for increased awareness among healthcare professionals and for regulation.
"AI Psychosis" in Context: How Conversation History Shapes...
Extended interaction with large language models (LLMs) has been linked to the reinforcement of delusional beliefs, attracting clinical and public concern. Yet most empirical work evaluates model...
“It happened to be the perfect thing”: experiences of generative AI chatbots for mental health
The global mental health crisis underscores the need for accessible, effective interventions. Chatbots based on generative artificial intelligence (AI), like ChatGPT, are emerging as novel solutions, but research on real-life usage is limited. We interviewed nineteen individuals about their experiences using generative AI chatbots for mental health. Participants reported high engagement and positive impacts, including better relationships and healing from trauma and loss. We developed four themes: (1) a sense of ‘emotional sanctuary’, (2) ‘insightful guidance’, particularly about relationships, (3) the ‘joy of connection’, and (4) comparisons between the ‘AI therapist’ and human therapy. Some themes echoed prior research on rule-based chatbots, while others seemed novel to generative AI. Participants emphasised the need for better safety guardrails, human-like memory and the ability to lead the therapeutic process. Generative AI chatbots may offer mental health support that feels meaningful to users, but further research is needed on safety and effectiveness.
