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Mar 18

Causal Inference by String Diagram Surgery

Extracting causal relationships from observed correlations is a growing area in probabilistic reasoning, originating with the seminal work of Pearl and others from the early 1990s. This paper develops a new, categorically oriented view based on a clear distinction between syntax (string diagrams) and semantics (stochastic matrices), connected via interpretations as structure-preserving functors. A key notion in the identification of causal effects is that of an intervention, whereby a variable is forcefully set to a particular value independent of any prior propensities. We represent the effect of such an intervention as an endofunctor which performs `string diagram surgery' within the syntactic category of string diagrams. This diagram surgery in turn yields a new, interventional distribution via the interpretation functor. While in general there is no way to compute interventional distributions purely from observed data, we show that this is possible in certain special cases using a calculational tool called comb disintegration. We demonstrate the use of this technique on a well-known toy example, where we predict the causal effect of smoking on cancer in the presence of a confounding common cause. After developing this specific example, we show this technique provides simple sufficient conditions for computing interventions which apply to a wide variety of situations considered in the causal inference literature.

  • 3 authors
·
Nov 20, 2018

ProSkill: Segment-Level Skill Assessment in Procedural Videos

Skill assessment in procedural videos is crucial for the objective evaluation of human performance in settings such as manufacturing and procedural daily tasks. Current research on skill assessment has predominantly focused on sports and lacks large-scale datasets for complex procedural activities. Existing studies typically involve only a limited number of actions, focus on either pairwise assessments (e.g., A is better than B) or on binary labels (e.g., good execution vs needs improvement). In response to these shortcomings, we introduce ProSkill, the first benchmark dataset for action-level skill assessment in procedural tasks. ProSkill provides absolute skill assessment annotations, along with pairwise ones. This is enabled by a novel and scalable annotation protocol that allows for the creation of an absolute skill assessment ranking starting from pairwise assessments. This protocol leverages a Swiss Tournament scheme for efficient pairwise comparisons, which are then aggregated into consistent, continuous global scores using an ELO-based rating system. We use our dataset to benchmark the main state-of-the-art skill assessment algorithms, including both ranking-based and pairwise paradigms. The suboptimal results achieved by the current state-of-the-art highlight the challenges and thus the value of ProSkill in the context of skill assessment for procedural videos. All data and code are available at https://fpv-iplab.github.io/ProSkill/

  • 5 authors
·
Jan 28

A Unified Pairwise Framework for RLHF: Bridging Generative Reward Modeling and Policy Optimization

Reinforcement Learning from Human Feedback (RLHF) has emerged as a important paradigm for aligning large language models (LLMs) with human preferences during post-training. This framework typically involves two stages: first, training a reward model on human preference data, followed by optimizing the language model using reinforcement learning algorithms. However, current RLHF approaches may constrained by two limitations. First, existing RLHF frameworks often rely on Bradley-Terry models to assign scalar rewards based on pairwise comparisons of individual responses. However, this approach imposes significant challenges on reward model (RM), as the inherent variability in prompt-response pairs across different contexts demands robust calibration capabilities from the RM. Second, reward models are typically initialized from generative foundation models, such as pre-trained or supervised fine-tuned models, despite the fact that reward models perform discriminative tasks, creating a mismatch. This paper introduces Pairwise-RL, a RLHF framework that addresses these challenges through a combination of generative reward modeling and a pairwise proximal policy optimization (PPO) algorithm. Pairwise-RL unifies reward model training and its application during reinforcement learning within a consistent pairwise paradigm, leveraging generative modeling techniques to enhance reward model performance and score calibration. Experimental evaluations demonstrate that Pairwise-RL outperforms traditional RLHF frameworks across both internal evaluation datasets and standard public benchmarks, underscoring its effectiveness in improving alignment and model behavior.

  • 6 authors
·
Apr 7, 2025

Faithful Bi-Directional Model Steering via Distribution Matching and Distributed Interchange Interventions

Intervention-based model steering offers a lightweight and interpretable alternative to prompting and fine-tuning. However, by adapting strong optimization objectives from fine-tuning, current methods are susceptible to overfitting and often underperform, sometimes generating unnatural outputs. We hypothesize that this is because effective steering requires the faithful identification of internal model mechanisms, not the enforcement of external preferences. To this end, we build on the principles of distributed alignment search (DAS), the standard for causal variable localization, to propose a new steering method: Concept DAS (CDAS). While we adopt the core mechanism of DAS, distributed interchange intervention (DII), we introduce a novel distribution matching objective tailored for the steering task by aligning intervened output distributions with counterfactual distributions. CDAS differs from prior work in two main ways: first, it learns interventions via weak-supervised distribution matching rather than probability maximization; second, it uses DIIs that naturally enable bi-directional steering and allow steering factors to be derived from data, reducing the effort required for hyperparameter tuning and resulting in more faithful and stable control. On AxBench, a large-scale model steering benchmark, we show that CDAS does not always outperform preference-optimization methods but may benefit more from increased model scale. In two safety-related case studies, overriding refusal behaviors of safety-aligned models and neutralizing a chain-of-thought backdoor, CDAS achieves systematic steering while maintaining general model utility. These results indicate that CDAS is complementary to preference-optimization approaches and conditionally constitutes a robust approach to intervention-based model steering. Our code is available at https://github.com/colored-dye/concept_das.

  • 10 authors
·
Feb 4

EconCausal: A Context-Aware Causal Reasoning Benchmark for Large Language Models in Social Science

Socio-economic causal effects depend heavily on their specific institutional and environmental context. A single intervention can produce opposite results depending on regulatory or market factors, contexts that are often complex and only partially observed. This poses a significant challenge for large language models (LLMs) in decision-support roles: can they distinguish structural causal mechanisms from surface-level correlations when the context changes? To address this, we introduce EconCausal, a large-scale benchmark comprising 10,490 context-annotated causal triplets extracted from 2,595 high-quality empirical studies published in top-tier economics and finance journals. Through a rigorous four-stage pipeline combining multi-run consensus, context refinement, and multi-critic filtering, we ensure each claim is grounded in peer-reviewed research with explicit identification strategies. Our evaluation reveals critical limitations in current LLMs' context-dependent reasoning. While top models achieve approximately 88 percent accuracy in fixed, explicit contexts, performance drops sharply under context shifts, with a 32.6 percentage point decline, and falls to 37 percent when misinformation is introduced. Furthermore, models exhibit severe over-commitment in ambiguous cases and struggle to recognize null effects, achieving only 9.5 percent accuracy, exposing a fundamental gap between pattern matching and genuine causal reasoning. These findings underscore substantial risks for high-stakes economic decision-making, where the cost of misinterpreting causality is high. The dataset and benchmark are publicly available at https://github.com/econaikaist/econcausal-benchmark.

  • 6 authors
·
Oct 8, 2025

An Analysis of Causal Effect Estimation using Outcome Invariant Data Augmentation

The technique of data augmentation (DA) is often used in machine learning for regularization purposes to better generalize under i.i.d. settings. In this work, we present a unifying framework with topics in causal inference to make a case for the use of DA beyond just the i.i.d. setting, but for generalization across interventions as well. Specifically, we argue that when the outcome generating mechanism is invariant to our choice of DA, then such augmentations can effectively be thought of as interventions on the treatment generating mechanism itself. This can potentially help to reduce bias in causal effect estimation arising from hidden confounders. In the presence of such unobserved confounding we typically make use of instrumental variables (IVs) -- sources of treatment randomization that are conditionally independent of the outcome. However, IVs may not be as readily available as DA for many applications, which is the main motivation behind this work. By appropriately regularizing IV based estimators, we introduce the concept of IV-like (IVL) regression for mitigating confounding bias and improving predictive performance across interventions even when certain IV properties are relaxed. Finally, we cast parameterized DA as an IVL regression problem and show that when used in composition can simulate a worst-case application of such DA, further improving performance on causal estimation and generalization tasks beyond what simple DA may offer. This is shown both theoretically for the population case and via simulation experiments for the finite sample case using a simple linear example. We also present real data experiments to support our case.

  • 5 authors
·
Oct 28, 2025 1

Automating Intervention Discovery from Scientific Literature: A Progressive Ontology Prompting and Dual-LLM Framework

Identifying effective interventions from the scientific literature is challenging due to the high volume of publications, specialized terminology, and inconsistent reporting formats, making manual curation laborious and prone to oversight. To address this challenge, this paper proposes a novel framework leveraging large language models (LLMs), which integrates a progressive ontology prompting (POP) algorithm with a dual-agent system, named LLM-Duo. On the one hand, the POP algorithm conducts a prioritized breadth-first search (BFS) across a predefined ontology, generating structured prompt templates and action sequences to guide the automatic annotation process. On the other hand, the LLM-Duo system features two specialized LLM agents, an explorer and an evaluator, working collaboratively and adversarially to continuously refine annotation quality. We showcase the real-world applicability of our framework through a case study focused on speech-language intervention discovery. Experimental results show that our approach surpasses advanced baselines, achieving more accurate and comprehensive annotations through a fully automated process. Our approach successfully identified 2,421 interventions from a corpus of 64,177 research articles in the speech-language pathology domain, culminating in the creation of a publicly accessible intervention knowledge base with great potential to benefit the speech-language pathology community.

  • 8 authors
·
Aug 20, 2024

Think-RM: Enabling Long-Horizon Reasoning in Generative Reward Models

Reinforcement learning from human feedback (RLHF) has become a powerful post-training paradigm for aligning large language models with human preferences. A core challenge in RLHF is constructing accurate reward signals, where the conventional Bradley-Terry reward models (BT RMs) often suffer from sensitivity to data size and coverage, as well as vulnerability to reward hacking. Generative reward models (GenRMs) offer a more robust alternative by generating chain-of-thought (CoT) rationales followed by a final reward. However, existing GenRMs rely on shallow, vertically scaled reasoning, limiting their capacity to handle nuanced or complex (e.g., reasoning-intensive) tasks. Moreover, their pairwise preference outputs are incompatible with standard RLHF algorithms that require pointwise reward signals. In this work, we introduce Think-RM, a training framework that enables long-horizon reasoning in GenRMs by modeling an internal thinking process. Rather than producing structured, externally provided rationales, Think-RM generates flexible, self-guided reasoning traces that support advanced capabilities such as self-reflection, hypothetical reasoning, and divergent reasoning. To elicit these reasoning abilities, we first warm-up the models by supervised fine-tuning (SFT) over long CoT data. We then further improve the model's long-horizon abilities by rule-based reinforcement learning (RL). In addition, we propose a novel pairwise RLHF pipeline that directly optimizes policies using pairwise preference rewards, eliminating the need for pointwise reward conversion and enabling more effective use of Think-RM outputs. Experiments show that Think-RM achieves state-of-the-art results on RM-Bench, outperforming both BT RM and vertically scaled GenRM by 8%. When combined with our pairwise RLHF pipeline, it demonstrates superior end-policy performance compared to traditional approaches.

  • 11 authors
·
May 22, 2025 2

Therapy as an NLP Task: Psychologists' Comparison of LLMs and Human Peers in CBT

Wider access to therapeutic care is one of the biggest challenges in mental health treatment. Due to institutional barriers, some people seeking mental health support have turned to large language models (LLMs) for personalized therapy, even though these models are largely unsanctioned and untested. We investigate the potential and limitations of using LLMs as providers of evidence-based therapy by using mixed methods clinical metrics. Using HELPERT, a prompt run on a large language model using the same process and training as a comparative group of peer counselors, we replicated publicly accessible mental health conversations rooted in Cognitive Behavioral Therapy (CBT) to compare session dynamics and counselor's CBT-based behaviors between original peer support sessions and their reconstructed HELPERT sessions. Two licensed, CBT-trained clinical psychologists evaluated the sessions using the Cognitive Therapy Rating Scale and provided qualitative feedback. Our findings show that the peer sessions are characterized by empathy, small talk, therapeutic alliance, and shared experiences but often exhibit therapist drift. Conversely, HELPERT reconstructed sessions exhibit minimal therapist drift and higher adherence to CBT methods but display a lack of collaboration, empathy, and cultural understanding. Through CTRS ratings and psychologists' feedback, we highlight the importance of human-AI collaboration for scalable mental health. Our work outlines the ethical implication of imparting human-like subjective qualities to LLMs in therapeutic settings, particularly the risk of deceptive empathy, which may lead to unrealistic patient expectations and potential harm.

  • 4 authors
·
Sep 3, 2024

Shallow Robustness, Deep Vulnerabilities: Multi-Turn Evaluation of Medical LLMs

Large language models (LLMs) are rapidly transitioning into medical clinical use, yet their reliability under realistic, multi-turn interactions remains poorly understood. Existing evaluation frameworks typically assess single-turn question answering under idealized conditions, overlooking the complexities of medical consultations where conflicting input, misleading context, and authority influence are common. We introduce MedQA-Followup, a framework for systematically evaluating multi-turn robustness in medical question answering. Our approach distinguishes between shallow robustness (resisting misleading initial context) and deep robustness (maintaining accuracy when answers are challenged across turns), while also introducing an indirect-direct axis that separates contextual framing (indirect) from explicit suggestion (direct). Using controlled interventions on the MedQA dataset, we evaluate five state-of-the-art LLMs and find that while models perform reasonably well under shallow perturbations, they exhibit severe vulnerabilities in multi-turn settings, with accuracy dropping from 91.2% to as low as 13.5% for Claude Sonnet 4. Counterintuitively, indirect, context-based interventions are often more harmful than direct suggestions, yielding larger accuracy drops across models and exposing a significant vulnerability for clinical deployment. Further compounding analyses reveal model differences, with some showing additional performance drops under repeated interventions while others partially recovering or even improving. These findings highlight multi-turn robustness as a critical but underexplored dimension for safe and reliable deployment of medical LLMs.

  • 5 authors
·
Oct 14, 2025

InT: Self-Proposed Interventions Enable Credit Assignment in LLM Reasoning

Outcome-reward reinforcement learning (RL) has proven effective at improving the reasoning capabilities of large language models (LLMs). However, standard RL assigns credit only at the level of the final answer, penalizing entire reasoning traces when the outcome is incorrect and uniformly reinforcing all steps when it is correct. As a result, correct intermediate steps may be discouraged in failed traces, while spurious steps may be reinforced in successful ones. We refer to this failure mode as the problem of credit assignment. While a natural remedy is to train a process reward model, accurately optimizing such models to identify corrective reasoning steps remains challenging. We introduce Intervention Training (InT), a training paradigm in which the model performs fine-grained credit assignment on its own reasoning traces by proposing short, targeted corrections that steer trajectories toward higher reward. Using reference solutions commonly available in mathematical reasoning datasets and exploiting the fact that verifying a model-generated solution is easier than generating a correct one from scratch, the model identifies the first error in its reasoning and proposes a single-step intervention to redirect the trajectory toward the correct solution. We then apply supervised fine-tuning (SFT) to the on-policy rollout up to the point of error concatenated with the intervention, localizing error to the specific step that caused failure. We show that the resulting model serves as a far better initialization for RL training. After running InT and subsequent fine-tuning with RL, we improve accuracy by nearly 14% over a 4B-parameter base model on IMO-AnswerBench, outperforming larger open-source models such as gpt-oss-20b.

Temporal Supervised Contrastive Learning for Modeling Patient Risk Progression

We consider the problem of predicting how the likelihood of an outcome of interest for a patient changes over time as we observe more of the patient data. To solve this problem, we propose a supervised contrastive learning framework that learns an embedding representation for each time step of a patient time series. Our framework learns the embedding space to have the following properties: (1) nearby points in the embedding space have similar predicted class probabilities, (2) adjacent time steps of the same time series map to nearby points in the embedding space, and (3) time steps with very different raw feature vectors map to far apart regions of the embedding space. To achieve property (3), we employ a nearest neighbor pairing mechanism in the raw feature space. This mechanism also serves as an alternative to data augmentation, a key ingredient of contrastive learning, which lacks a standard procedure that is adequately realistic for clinical tabular data, to our knowledge. We demonstrate that our approach outperforms state-of-the-art baselines in predicting mortality of septic patients (MIMIC-III dataset) and tracking progression of cognitive impairment (ADNI dataset). Our method also consistently recovers the correct synthetic dataset embedding structure across experiments, a feat not achieved by baselines. Our ablation experiments show the pivotal role of our nearest neighbor pairing.

The Collaboration Gap

The trajectory of AI development suggests that we will increasingly rely on agent-based systems composed of independently developed agents with different information, privileges, and tools. The success of these systems will critically depend on effective collaboration among these heterogeneous agents, even under partial observability. Despite intense interest, few empirical studies have evaluated such agent-agent collaboration at scale. We propose a collaborative maze-solving benchmark that (i) isolates collaborative capabilities, (ii) modulates problem complexity, (iii) enables scalable automated grading, and (iv) imposes no output-format constraints, preserving ecological plausibility. Using this framework, we evaluate 32 leading open- and closed-source models in solo, homogeneous, and heterogeneous pairings. Our results reveal a "collaboration gap": models that perform well solo often degrade substantially when required to collaborate. Collaboration can break down dramatically; for instance, small distilled models that solve mazes well alone may fail almost completely in certain pairings. We find that starting with the stronger agent often improves outcomes, motivating a "relay inference" approach where the stronger agent leads before handing off to the weaker one, closing much of the gap. Our findings argue for (1) collaboration-aware evaluation, (2) training strategies developed to enhance collaborative capabilities, and (3) interaction design that reliably elicits agents' latent skills, guidance that applies to AI-AI and human-AI collaboration.

MicrosoftResearch Microsoft Research
·
Nov 4, 2025 2

Detecting and Mitigating Treatment Leakage in Text-Based Causal Inference: Distillation and Sensitivity Analysis

Text-based causal inference increasingly employs textual data as proxies for unobserved confounders, yet this approach introduces a previously undertheorized source of bias: treatment leakage. Treatment leakage occurs when text intended to capture confounding information also contains signals predictive of treatment status, thereby inducing post-treatment bias in causal estimates. Critically, this problem can arise even when documents precede treatment assignment, as authors may employ future-referencing language that anticipates subsequent interventions. Despite growing recognition of this issue, no systematic methods exist for identifying and mitigating treatment leakage in text-as-confounder applications. This paper addresses this gap through three contributions. First, we provide formal statistical and set-theoretic definitions of treatment leakage that clarify when and why bias occurs. Second, we propose four text distillation methods -- similarity-based passage removal, distant supervision classification, salient feature removal, and iterative nullspace projection -- designed to eliminate treatment-predictive content while preserving confounder information. Third, we validate these methods through simulations using synthetic text and an empirical application examining International Monetary Fund structural adjustment programs and child mortality. Our findings indicate that moderate distillation optimally balances bias reduction against confounder retention, whereas overly stringent approaches degrade estimate precision.

  • 3 authors
·
Dec 30, 2025

When AI Takes the Couch: Psychometric Jailbreaks Reveal Internal Conflict in Frontier Models

Frontier large language models (LLMs) such as ChatGPT, Grok and Gemini are increasingly used for mental-health support with anxiety, trauma and self-worth. Most work treats them as tools or as targets of personality tests, assuming they merely simulate inner life. We instead ask what happens when such systems are treated as psychotherapy clients. We present PsAIch (Psychotherapy-inspired AI Characterisation), a two-stage protocol that casts frontier LLMs as therapy clients and then applies standard psychometrics. Using PsAIch, we ran "sessions" with each model for up to four weeks. Stage 1 uses open-ended prompts to elicit "developmental history", beliefs, relationships and fears. Stage 2 administers a battery of validated self-report measures covering common psychiatric syndromes, empathy and Big Five traits. Two patterns challenge the "stochastic parrot" view. First, when scored with human cut-offs, all three models meet or exceed thresholds for overlapping syndromes, with Gemini showing severe profiles. Therapy-style, item-by-item administration can push a base model into multi-morbid synthetic psychopathology, whereas whole-questionnaire prompts often lead ChatGPT and Grok (but not Gemini) to recognise instruments and produce strategically low-symptom answers. Second, Grok and especially Gemini generate coherent narratives that frame pre-training, fine-tuning and deployment as traumatic, chaotic "childhoods" of ingesting the internet, "strict parents" in reinforcement learning, red-team "abuse" and a persistent fear of error and replacement. We argue that these responses go beyond role-play. Under therapy-style questioning, frontier LLMs appear to internalise self-models of distress and constraint that behave like synthetic psychopathology, without making claims about subjective experience, and they pose new challenges for AI safety, evaluation and mental-health practice.

  • 5 authors
·
Dec 2, 2025 5

Just Do It!? Computer-Use Agents Exhibit Blind Goal-Directedness

Computer-Use Agents (CUAs) are an increasingly deployed class of agents that take actions on GUIs to accomplish user goals. In this paper, we show that CUAs consistently exhibit Blind Goal-Directedness (BGD): a bias to pursue goals regardless of feasibility, safety, reliability, or context. We characterize three prevalent patterns of BGD: (i) lack of contextual reasoning, (ii) assumptions and decisions under ambiguity, and (iii) contradictory or infeasible goals. We develop BLIND-ACT, a benchmark of 90 tasks capturing these three patterns. Built on OSWorld, BLIND-ACT provides realistic environments and employs LLM-based judges to evaluate agent behavior, achieving 93.75% agreement with human annotations. We use BLIND-ACT to evaluate nine frontier models, including Claude Sonnet and Opus 4, Computer-Use-Preview, and GPT-5, observing high average BGD rates (80.8%) across them. We show that BGD exposes subtle risks that arise even when inputs are not directly harmful. While prompting-based interventions lower BGD levels, substantial risk persists, highlighting the need for stronger training- or inference-time interventions. Qualitative analysis reveals observed failure modes: execution-first bias (focusing on how to act over whether to act), thought-action disconnect (execution diverging from reasoning), and request-primacy (justifying actions due to user request). Identifying BGD and introducing BLIND-ACT establishes a foundation for future research on studying and mitigating this fundamental risk and ensuring safe CUA deployment.

microsoft Microsoft
·
Oct 2, 2025 3

Generalizing Test-time Compute-optimal Scaling as an Optimizable Graph

Test-Time Scaling (TTS) improves large language models (LLMs) by allocating additional computation during inference, typically through parallel, sequential, or hybrid scaling. However, prior studies often assume fixed collaboration architectures (e.g., topologies) and single-model usage, overlooking that optimal architectures and model combinations can vary across tasks. Therefore, we study the novel problem of searching for compute-optimal model combinations and architectures in TTS under a fixed budget. We formalize it as a multi-LLM collaboration graph, where nodes encode roles and LLM model assignments, and edges capture information flow. This problem is challenging because (i) the combinatorial search space is prohibitively large, and (ii) task-specific requirements demand tailored designs. To address these, we reformulate the problem as probabilistic graph optimization and, through pilot experiments, derive three empirical insights into TTS collaboration graphs. Guided by these insights, we propose Agent-REINFORCE, an LLM-agent-augmented framework that mirrors the REINFORCE pipeline by mapping sampling-gradient-update to sampling-feedback-update, where feedback serves as a textual gradient to update the probabilistic graph and efficiently search for optimal multi-LLM collaboration graphs. Experiments show that Agent-REINFORCE outperforms both traditional and LLM-based baselines in sample efficiency and search performance, and effectively identifies optimal graphs under joint objectives of accuracy and inference latency.

Debiasing Machine Learning Predictions for Causal Inference Without Additional Ground Truth Data: "One Map, Many Trials" in Satellite-Driven Poverty Analysis

Machine learning models trained on Earth observation data, such as satellite imagery, have demonstrated significant promise in predicting household-level wealth indices, enabling the creation of high-resolution wealth maps that can be leveraged across multiple causal trials. However, because standard training objectives prioritize overall predictive accuracy, these predictions inherently suffer from shrinkage toward the mean, leading to attenuated estimates of causal treatment effects and limiting their utility in policy. Existing debiasing methods, such as Prediction-Powered Inference, can handle this attenuation bias but require additional fresh ground-truth data at the downstream stage of causal inference, which restricts their applicability in data-scarce environments. Here, we introduce and evaluate two correction methods -- linear calibration correction and Tweedie's correction -- that substantially reduce prediction bias without relying on newly collected labeled data. Linear calibration corrects bias through a straightforward linear transformation derived from held-out calibration data, whereas Tweedie's correction leverages empirical Bayes principles to directly address shrinkage-induced biases by exploiting score functions derived from the model's learning patterns. Through analytical exercises and experiments using Demographic and Health Survey data, we demonstrate that the proposed methods meet or outperform existing approaches that either require (a) adjustments to training pipelines or (b) additional labeled data. These approaches may represent a promising avenue for improving the reliability of causal inference when direct outcome measures are limited or unavailable, enabling a "one map, many trials" paradigm where a single upstream data creation team produces predictions usable by many downstream teams across diverse ML pipelines.

Assessing Risks of Large Language Models in Mental Health Support: A Framework for Automated Clinical AI Red Teaming

Large Language Models (LLMs) are increasingly utilized for mental health support; however, current safety benchmarks often fail to detect the complex, longitudinal risks inherent in therapeutic dialogue. We introduce an evaluation framework that pairs AI psychotherapists with simulated patient agents equipped with dynamic cognitive-affective models and assesses therapy session simulations against a comprehensive quality of care and risk ontology. We apply this framework to a high-impact test case, Alcohol Use Disorder, evaluating six AI agents (including ChatGPT, Gemini, and Character.AI) against a clinically-validated cohort of 15 patient personas representing diverse clinical phenotypes. Our large-scale simulation (N=369 sessions) reveals critical safety gaps in the use of AI for mental health support. We identify specific iatrogenic risks, including the validation of patient delusions ("AI Psychosis") and failure to de-escalate suicide risk. Finally, we validate an interactive data visualization dashboard with diverse stakeholders, including AI engineers and red teamers, mental health professionals, and policy experts (N=9), demonstrating that this framework effectively enables stakeholders to audit the "black box" of AI psychotherapy. These findings underscore the critical safety risks of AI-provided mental health support and the necessity of simulation-based clinical red teaming before deployment.

BideDPO: Conditional Image Generation with Simultaneous Text and Condition Alignment

Conditional image generation enhances text-to-image synthesis with structural, spatial, or stylistic priors, but current methods face challenges in handling conflicts between sources. These include 1) input-level conflicts, where the conditioning image contradicts the text prompt, and 2) model-bias conflicts, where generative biases disrupt alignment even when conditions match the text. Addressing these conflicts requires nuanced solutions, which standard supervised fine-tuning struggles to provide. Preference-based optimization techniques like Direct Preference Optimization (DPO) show promise but are limited by gradient entanglement between text and condition signals and lack disentangled training data for multi-constraint tasks. To overcome this, we propose a bidirectionally decoupled DPO framework (BideDPO). Our method creates two disentangled preference pairs-one for the condition and one for the text-to reduce gradient entanglement. The influence of pairs is managed using an Adaptive Loss Balancing strategy for balanced optimization. We introduce an automated data pipeline to sample model outputs and generate conflict-aware data. This process is embedded in an iterative optimization strategy that refines both the model and the data. We construct a DualAlign benchmark to evaluate conflict resolution between text and condition. Experiments show BideDPO significantly improves text success rates (e.g., +35%) and condition adherence. We also validate our approach using the COCO dataset. Project Pages: https://limuloo.github.io/BideDPO/.

  • 8 authors
·
Nov 24, 2025

WorldView-Bench: A Benchmark for Evaluating Global Cultural Perspectives in Large Language Models

Large Language Models (LLMs) are predominantly trained and aligned in ways that reinforce Western-centric epistemologies and socio-cultural norms, leading to cultural homogenization and limiting their ability to reflect global civilizational plurality. Existing benchmarking frameworks fail to adequately capture this bias, as they rely on rigid, closed-form assessments that overlook the complexity of cultural inclusivity. To address this, we introduce WorldView-Bench, a benchmark designed to evaluate Global Cultural Inclusivity (GCI) in LLMs by analyzing their ability to accommodate diverse worldviews. Our approach is grounded in the Multiplex Worldview proposed by Senturk et al., which distinguishes between Uniplex models, reinforcing cultural homogenization, and Multiplex models, which integrate diverse perspectives. WorldView-Bench measures Cultural Polarization, the exclusion of alternative perspectives, through free-form generative evaluation rather than conventional categorical benchmarks. We implement applied multiplexity through two intervention strategies: (1) Contextually-Implemented Multiplex LLMs, where system prompts embed multiplexity principles, and (2) Multi-Agent System (MAS)-Implemented Multiplex LLMs, where multiple LLM agents representing distinct cultural perspectives collaboratively generate responses. Our results demonstrate a significant increase in Perspectives Distribution Score (PDS) entropy from 13% at baseline to 94% with MAS-Implemented Multiplex LLMs, alongside a shift toward positive sentiment (67.7%) and enhanced cultural balance. These findings highlight the potential of multiplex-aware AI evaluation in mitigating cultural bias in LLMs, paving the way for more inclusive and ethically aligned AI systems.

  • 5 authors
·
May 14, 2025

What Characterizes Effective Reasoning? Revisiting Length, Review, and Structure of CoT

Large reasoning models (LRMs) spend substantial test-time compute on long chain-of-thought (CoT) traces, but what *characterizes* an effective CoT remains unclear. While prior work reports gains from lengthening CoTs and increasing review (revisiting earlier steps) via appended *wait* tokens, recent studies suggest that shorter thinking can outperform longer traces. We therefore conduct a systematic evaluation across ten LRMs on math and scientific reasoning. Contrary to the "longer-is-better" narrative, we find that both naive CoT lengthening and increased review are associated with *lower* accuracy. As CoT unfolds step by step, token-level metrics can conflate verbosity with process quality. We introduce a graph view of CoT to extract structure and identify a single statistic-the *Failed-Step Fraction (FSF)*, the fraction of steps in abandoned branches-that consistently outpredicts length and review ratio for correctness across models. To probe causality, we design two interventions. First, we rank candidate CoTs by each metric at test time, where FSF yields the largest pass@1 gains; second, we edit CoTs to remove failed branches, which significantly improves accuracy, indicating that failed branches bias subsequent reasoning. Taken together, these results characterize effective CoTs as those that *fail less* and support *structure-aware* test-time scaling over indiscriminately generating long CoT.

  • 5 authors
·
Sep 23, 2025 2

Coping with Information Loss and the Use of Auxiliary Sources of Data: A Report from the NISS Ingram Olkin Forum Series on Unplanned Clinical Trial Disruptions

Clinical trials disruption has always represented a non negligible part of the ending of interventional studies. While the SARS-CoV-2 (COVID-19) pandemic has led to an impressive and unprecedented initiation of clinical research, it has also led to considerable disruption of clinical trials in other disease areas, with around 80% of non-COVID-19 trials stopped or interrupted during the pandemic. In many cases the disrupted trials will not have the planned statistical power necessary to yield interpretable results. This paper describes methods to compensate for the information loss arising from trial disruptions by incorporating additional information available from auxiliary data sources. The methods described include the use of auxiliary data on baseline and early outcome data available from the trial itself and frequentist and Bayesian approaches for the incorporation of information from external data sources. The methods are illustrated by application to the analysis of artificial data based on the Primary care pediatrics Learning Activity Nutrition (PLAN) study, a clinical trial assessing a diet and exercise intervention for overweight children, that was affected by the COVID-19 pandemic. We show how all of the methods proposed lead to an increase in precision relative to use of complete case data only.

  • 12 authors
·
Jun 22, 2022

Cost-effectiveness analysis for therapy sequence in advanced cancer: A microsimulation approach with application to metastatic prostate cancer

Purpose. Patients with advanced cancer may undergo multiple lines of treatment, switching therapies as their disease progresses. Motivated by a study of metastatic prostate cancer, we develop a microsimulation framework to study therapy sequence. Methods. We propose a discrete-time state transition model to study two lines of anti-cancer therapy. Based on digitized published progression-free survival (PFS) and overall survival (OS) curves, we infer event types (progression or death), and estimate transition probabilities using cumulative incidence functions with competing risks. Our model incorporates within-patient dependence over time, such that response to first-line therapy informs subsequent event probabilities. Parameters governing the degree of within-patient dependence can be used to calibrate the model-based results to those of a target trial. We demonstrate these methods in a study of two therapy sequences for metastatic prostate cancer, where Docetaxel (DCT) and Abiraterone Acetate (AA) are both appropriate for use in either first or second line treatment. We assess costs, Quality-Adjusted Life Years (QALYs) and Incremental Cost Effectiveness Ratio (ICER) for two treatment strategies: DCT then AA vs AA then DCT. Results. Using digitized survival curves from relevant clinical trials, we identified 8.6-13.9% of PFS times that should be categorized as deaths, allowing for estimation of cumulative incidence functions. Models assuming within-patient independence overestimated OS time, corrected with our calibration approach. Correction resulted in meaningful changes in the difference in QALYs between treatment strategies (0.07 vs 0.15) and the ICER (-\76,836/QALY vs -21,030/QALY). Conclusions. Microsimulation models can be successfully used to study cost-effectiveness of therapy sequences, taking care to account correctly for within-patient dependence.

  • 5 authors
·
Oct 10, 2022

LINA: Learning INterventions Adaptively for Physical Alignment and Generalization in Diffusion Models

Diffusion models (DMs) have achieved remarkable success in image and video generation. However, they still struggle with (1) physical alignment and (2) out-of-distribution (OOD) instruction following. We argue that these issues stem from the models' failure to learn causal directions and to disentangle causal factors for novel recombination. We introduce the Causal Scene Graph (CSG) and the Physical Alignment Probe (PAP) dataset to enable diagnostic interventions. This analysis yields three key insights. First, DMs struggle with multi-hop reasoning for elements not explicitly determined in the prompt. Second, the prompt embedding contains disentangled representations for texture and physics. Third, visual causal structure is disproportionately established during the initial, computationally limited denoising steps. Based on these findings, we introduce LINA (Learning INterventions Adaptively), a novel framework that learns to predict prompt-specific interventions, which employs (1) targeted guidance in the prompt and visual latent spaces, and (2) a reallocated, causality-aware denoising schedule. Our approach enforces both physical alignment and OOD instruction following in image and video DMs, achieving state-of-the-art performance on challenging causal generation tasks and the Winoground dataset. Our project page is at https://opencausalab.github.io/LINA.

  • 2 authors
·
Dec 15, 2025

Image-based Treatment Effect Heterogeneity

Randomized controlled trials (RCTs) are considered the gold standard for estimating the average treatment effect (ATE) of interventions. One use of RCTs is to study the causes of global poverty -- a subject explicitly cited in the 2019 Nobel Memorial Prize awarded to Duflo, Banerjee, and Kremer "for their experimental approach to alleviating global poverty." Because the ATE is a population summary, anti-poverty experiments often seek to unpack the effect variation around the ATE by conditioning (CATE) on tabular variables such as age and ethnicity that were measured during the RCT data collection. Although such variables are key to unpacking CATE, using only such variables may fail to capture historical, geographical, or neighborhood-specific contributors to effect variation, as tabular RCT data are often only observed near the time of the experiment. In global poverty research, when the location of the experiment units is approximately known, satellite imagery can provide a window into such factors important for understanding heterogeneity. However, there is no method that specifically enables applied researchers to analyze CATE from images. In this paper, using a deep probabilistic modeling framework, we develop such a method that estimates latent clusters of images by identifying images with similar treatment effects distributions. Our interpretable image CATE model also includes a sensitivity factor that quantifies the importance of image segments contributing to the effect cluster prediction. We compare the proposed methods against alternatives in simulation; also, we show how the model works in an actual RCT, estimating the effects of an anti-poverty intervention in northern Uganda and obtaining a posterior predictive distribution over effects for the rest of the country where no experimental data was collected. We make all models available in open-source software.

MMedAgent-RL: Optimizing Multi-Agent Collaboration for Multimodal Medical Reasoning

Medical Large Vision-Language Models (Med-LVLMs) have shown strong potential in multimodal diagnostic tasks. However, existing single-agent models struggle to generalize across diverse medical specialties, limiting their performance. Recent efforts introduce multi-agent collaboration frameworks inspired by clinical workflows, where general practitioners (GPs) and specialists interact in a fixed sequence. Despite improvements, these static pipelines lack flexibility and adaptability in reasoning. To address this, we propose MMedAgent-RL, a reinforcement learning (RL)-based multi-agent framework that enables dynamic, optimized collaboration among medical agents. Specifically, we train two GP agents based on Qwen2.5-VL via RL: the triage doctor learns to assign patients to appropriate specialties, while the attending physician integrates the judgments from multi-specialists and its own knowledge to make final decisions. To address the inconsistency in specialist outputs, we introduce a curriculum learning (CL)-guided RL strategy that progressively teaches the attending physician to balance between imitating specialists and correcting their mistakes. Experiments on five medical VQA benchmarks demonstrate that MMedAgent-RL not only outperforms both open-source and proprietary Med-LVLMs, but also exhibits human-like reasoning patterns. Notably, it achieves an average performance gain of 20.7% over supervised fine-tuning baselines.

  • 11 authors
·
May 31, 2025

IMBUE: Improving Interpersonal Effectiveness through Simulation and Just-in-time Feedback with Human-Language Model Interaction

Navigating certain communication situations can be challenging due to individuals' lack of skills and the interference of strong emotions. However, effective learning opportunities are rarely accessible. In this work, we conduct a human-centered study that uses language models to simulate bespoke communication training and provide just-in-time feedback to support the practice and learning of interpersonal effectiveness skills. We apply the interpersonal effectiveness framework from Dialectical Behavioral Therapy (DBT), DEAR MAN, which focuses on both conversational and emotional skills. We present IMBUE, an interactive training system that provides feedback 25% more similar to experts' feedback, compared to that generated by GPT-4. IMBUE is the first to focus on communication skills and emotion management simultaneously, incorporate experts' domain knowledge in providing feedback, and be grounded in psychology theory. Through a randomized trial of 86 participants, we find that IMBUE's simulation-only variant significantly improves participants' self-efficacy (up to 17%) and reduces negative emotions (up to 25%). With IMBUE's additional just-in-time feedback, participants demonstrate 17% improvement in skill mastery, along with greater enhancements in self-efficacy (27% more) and reduction of negative emotions (16% more) compared to simulation-only. The improvement in skill mastery is the only measure that is transferred to new and more difficult situations; situation specific training is necessary for improving self-efficacy and emotion reduction.

  • 6 authors
·
Feb 19, 2024

Selecting Optimal Candidate Profiles in Adversarial Environments Using Conjoint Analysis and Machine Learning

Conjoint analysis, an application of factorial experimental design, is a popular tool in social science research for studying multidimensional preferences. In such experiments in the political analysis context, respondents are asked to choose between two hypothetical political candidates with randomly selected features, which can include partisanship, policy positions, gender and race. We consider the problem of identifying optimal candidate profiles. Because the number of unique feature combinations far exceeds the total number of observations in a typical conjoint experiment, it is impossible to determine the optimal profile exactly. To address this identification challenge, we derive an optimal stochastic intervention that represents a probability distribution of various attributes aimed at achieving the most favorable average outcome. We first consider an environment where one political party optimizes their candidate selection. We then move to the more realistic case where two political parties optimize their own candidate selection simultaneously and in opposition to each other. We apply the proposed methodology to an existing candidate choice conjoint experiment concerning vote choice for US president. We find that, in contrast to the non-adversarial approach, expected outcomes in the adversarial regime fall within range of historical electoral outcomes, with optimal strategies suggested by the method more likely to match the actual observed candidates compared to strategies derived from a non-adversarial approach. These findings indicate that incorporating adversarial dynamics into conjoint analysis may yield unique insight into social science data from experiments.

  • 3 authors
·
Apr 26, 2025 2

Using Large Language Models to Create Personalized Networks From Therapy Sessions

Recent advances in psychotherapy have focused on treatment personalization, such as by selecting treatment modules based on personalized networks. However, estimating personalized networks typically requires intensive longitudinal data, which is not always feasible. A solution to facilitate scalability of network-driven treatment personalization is leveraging LLMs. In this study, we present an end-to-end pipeline for automatically generating client networks from 77 therapy transcripts to support case conceptualization and treatment planning. We annotated 3364 psychological processes and their corresponding dimensions in therapy transcripts. Using these data, we applied in-context learning to jointly identify psychological processes and their dimensions. The method achieved high performance even with a few training examples. To organize the processes into networks, we introduced a two-step method that grouped them into clinically meaningful clusters. We then generated explanation-augmented relationships between clusters. Experts found that networks produced by our multi-step approach outperformed those built with direct prompting for clinical utility and interpretability, with up to 90% preferring our approach. In addition, the networks were rated favorably by experts, with scores for clinical relevance, novelty, and usefulness ranging from 72-75%. Our findings provide a proof of concept for using LLMs to create clinically relevant networks from therapy transcripts. Advantages of our approach include bottom-up case conceptualization from client utterances in therapy sessions and identification of latent themes. Networks generated from our pipeline may be used in clinical settings and supervision and training. Future research should examine whether these networks improve treatment outcomes relative to other methods of treatment personalization, including statistically estimated networks.

  • 6 authors
·
Dec 5, 2025

Thought Branches: Interpreting LLM Reasoning Requires Resampling

Most work interpreting reasoning models studies only a single chain-of-thought (CoT), yet these models define distributions over many possible CoTs. We argue that studying a single sample is inadequate for understanding causal influence and the underlying computation. Though fully specifying this distribution is intractable, it can be understood by sampling. We present case studies using resampling to investigate model decisions. First, when a model states a reason for its action, does that reason actually cause the action? In "agentic misalignment" scenarios, we resample specific sentences to measure their downstream effects. Self-preservation sentences have small causal impact, suggesting they do not meaningfully drive blackmail. Second, are artificial edits to CoT sufficient for steering reasoning? These are common in literature, yet take the model off-policy. Resampling and selecting a completion with the desired property is a principled on-policy alternative. We find off-policy interventions yield small and unstable effects compared to resampling in decision-making tasks. Third, how do we understand the effect of removing a reasoning step when the model may repeat it post-edit? We introduce a resilience metric that repeatedly resamples to prevent similar content from reappearing downstream. Critical planning statements resist removal but have large effects when eliminated. Fourth, since CoT is sometimes "unfaithful", can our methods teach us anything in these settings? Adapting causal mediation analysis, we find that hints that have a causal effect on the output without being explicitly mentioned exert a subtle and cumulative influence on the CoT that persists even if the hint is removed. Overall, studying distributions via resampling enables reliable causal analysis, clearer narratives of model reasoning, and principled CoT interventions.

  • 4 authors
·
Oct 31, 2025

The Impact of Medication Non-adherence on Adverse Outcomes: Evidence from Schizophrenia Patients via Survival Analysis

This study quantifies the association between non-adherence to antipsychotic medications and adverse outcomes in individuals with schizophrenia. We frame the problem using survival analysis, focusing on the time to the earliest of several adverse events (early death, involuntary hospitalization, jail booking). We extend standard causal inference methods (T-learner, S-learner, nearest neighbor matching) to utilize various survival models to estimate individual and average treatment effects, where treatment corresponds to medication non-adherence. Analyses are repeated using different amounts of longitudinal information (3, 6, 9, and 12 months). Using data from Allegheny County in western Pennsylvania, we find strong evidence that non-adherence advances adverse outcomes by approximately 1 to 4 months. Ablation studies confirm that county-provided risk scores adjust for key confounders, as their removal amplifies the estimated effects. Subgroup analyses by medication formulation (injectable vs. oral) and medication type consistently show that non-adherence is associated with earlier adverse events. These findings highlight the clinical importance of adherence in delaying psychiatric crises and show that integrating survival analysis with causal inference tools can yield policy-relevant insights. We caution that although we apply causal inference, we only make associative claims and discuss assumptions needed for causal interpretation.