Predicting Psychological Well-Being from Spontaneous Speech using LLMs

Natural Language Processing (NLP) models predicting mental health outcomes rarely specify what they measure: contextual knowledge, emotional content, or syntactic structure. NLP Psychometrics treats psychological prediction from text as a psychometric problem, linking scores to interpretable linguistic evidence and testing beyond the training text format. Nine LLMs, conditioned on controlled personas (cognitive digital shadows), completed psychometric questionnaires with textual explanations per item. We extracted emotional profiles and syntactic-semantic structure via textual forma mentis networks, combined with personality and sociodemographic variables in ablated random forest (RF) regressors, using SHAP to identify which features drove performance and in which direction. Full RF models explained up to 70.8% of variance in life satisfaction (SWLS), 55.7% in depression (PHQ-9), and, for DASS-21, 68.5% depression, 76.0% anxiety, 72.4% stress. Sociodemographics alone explained no meaningful variance in depression, anxiety, or stress, but did so for life satisfaction, where emotion features and income were the strongest predictors; neuroticism and network topology instead dominated depression and anxiety, reversing direction between them. Without retraining, RF models separated diaries from low- and high-score personas ($r$ up to 0.91) and, using only network/emotion features, classified clinical from control participants in real transcripts with up to 68% accuracy. These results show the promise and limits of synthetic data: LLM personas can expose model biases, recover patterns consistent with clinical rumination, and support psychometric prediction from human text without a matched questionnaire, but cannot substitute for human validation. NLP Psychometrics makes these distinctions explicit, measurable, and testable through interpretable AI and network/emotional features.

LLMs can estimate Hospital Anxiety and Depression Scale (HADS) scores from speech in a zero-shot manner, but clinical deployment requires reliability across three dimensions: intra-model consistency, ASR robustness, and evidence faithfulness. We evaluate three LLMs (Phi-4, Gemma-2-9B, and Llama-3.1-8B) on 111 English-speaking participants using ground-truth transcripts and three Whisper ASR variants (Large, Medium, Small), with three independent runs per model-condition pair. We find that (i) Phi-4 and Gemma-2-9B achieve excellent intra-model consistency (ICC > 0.89) with minimal degradation under ASR; (ii) Llama-3.1-8B shows ASR-fragile consistency, with ICC dropping from 0.82 to 0.36 at 10% WER; (iii) predictive validity is largely preserved under ASR for robust models; and (iv) keyword groundedness exceeds 93% for Phi-4 and Gemma-2-9B but falls to 77-81% for Llama-3.1-8B. Inter-model keyword agreement is far lower than score-level agreement, revealing a score-evidence dissociation with implications for clinical interpretability.

Anticipating LLM behavioral tendencies from low-cost psychometric probes is critical for safe deployment, but only if self-reports (SR) reliably predict behavior. Recent work documented substantial SR-behavior dissociation in LLMs, but relied on broad personality traits (Big 5) that predict specific behaviors weakly, even in humans. Furthermore, the isolation of conversational sessions combined with weak context matching left open whether LLMs truly lack coherence or whether the conditions needed to detect such coherence were not met. We contrast Big 5 with the Theory of Planned Behavior (TPB), which measures intention targeted to a specific behavior and predicts human behavior substantially better than broad traits. We run experiments across four behavioral tasks and 11 frontier LLMs, while also varying session context and identity induction. We find that SR-behavior coherence exists but is selective. 1) Within a shared conversation, the Theory of Planned Behavior reaches human-level coherence; Big 5 does not. 2) Across separate conversations, coherence survives only for behaviors anchored outside the immediate prompt, such as implicit bias shaped by training, and collapses when behavior is strongly primed by context, as with sycophancy. 3) Persona prompting makes self-reports more consistent across conversations, but does not bring behavior into alignment. These findings suggest that coarse personality frameworks, such as Big 5 may not be the best tools for testing deployment behavior. More task- and behavior-specific instruments are needed, and even these must be evaluated across tasks and contexts.