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Auditing Stealth Sycophancy in Mental-Health Dialogue: Structured Clinical-State Diagnostics and Clean Matched Benchmarks

arXiv:2605.03472v2 Announce Type: replace-cross Abstract: Mental-health dialogue models are increasingly evaluated by AI-based evaluators, yet these evaluators often treat surface empathy, supportiveness, or fluency as evidence of safety. In this paper, we study a hidden failure mode that we call implicit sycophancy: a response may appear empathetic while implicitly reinforcing catastrophizing, avoidance, hopeless prediction, or CBT-style labeling. To examine this problem, we introduce a diagnostic benchmark for implicit-sycophancy detection, built from three representative mental-health dialogue sources covering everyday peer support, counseling-style emotional support, and crisis-oriented interaction, and further construct a leakage-audited clean single-response matched benchmark with 500 contexts and 1,500 matched response windows. We then propose Dynamic Emotional Signature Graphs (DESG), a structured offline audit framework that separates LLM-based state extraction from final scoring and evaluates clinical direction through semantic, affective, and cognitive-distortion state transitions rather than free-form LLM judgment. Unlike metadata, surface-style, lexical, embedding, and rubric-LLM baselines, DESG scores the direction of clinical-state change induced by a response; on the leakage-audited clean matched benchmark, DESG-StateRisk improves over the strongest non-DESG baseline by 0.0488 macro-F1 and achieves the best harmful-risk detection result. These results suggest that evaluating implicit sycophancy requires explicit clinical-state modeling together with leakage checks, shortcut controls, and competitive baselines.

Refined immune-based molecular subtypes of gastric cancer: Integrating mismatch repair status and tumor microenvironment for enhanced immunotherapy prediction

18 May 2026 at 18:00

Chin J Cancer Res. 2026 Apr 30;38(2):234-251. doi: 10.21147/j.issn.1000-9604.2026.02.09.

ABSTRACT

OBJECTIVE: Gastric cancer (GC) is heterogeneous, and current mismatch repair (MMR)-based classifications incompletely predict response to immune checkpoint inhibitors (ICIs).

METHODS: RNA sequencing (RNA-seq) and immune infiltration profiles from 189 resected GC were used to derive four refined immune-MMR subtypes (R1-R4) by integrating MMR status, survival, and tumor microenvironment (TME) features. Multi-omics profiling and pathway analysis defined subtype biology. External transcriptomic cohorts and an ICI-treated cohort were classified with Nearest Template Prediction (NTP). Immune response-associated genes were identified from responder vs. non-responder comparisons within the ICI-sensitive subtype and validated by multiplex immunohistochemistry (mIHC).

RESULTS: R1 showed the best prognosis and highest immunotherapy response with objective response rate (ORR) 54.5%, while R4 had the worst prognosis. R2 represented an immune-unresponsive deficient mismatch repair (dMMR) subset, and R3 captured an immune-active proficient mismatch repair (pMMR) subgroup with moderate therapy sensitivity. Multi-omics integration revealed subtype-specific pathways (e.g., ECM remodeling in R1, metabolic reprogramming in R2). Reclassification of pMMR tumors based on transcriptional similarity to R1 identified a New R3 subset with enhanced immune features and higher ICI response. Eight immune response-associated genes (e.g., CXCL10, CXCL11, ELN, GAD1, IL32, MT1E, OR2I1P, SLC3A1) were identified and validated by mIHC for predictive relevance.

CONCLUSIONS: This immune-based molecular framework refines risk stratification beyond conventional MMR categories, identifies ICI-sensitive subsets among both dMMR and pMMR tumors, and proposes candidate biomarkers for patient selection.

PMID:42147371 | PMC:PMC13171420 | DOI:10.21147/j.issn.1000-9604.2026.02.09

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