q-bio.NCOct 5, 2026

COMPASS 2.0: psychometric representational similarity analysis distinguishes symptom structure from personal signal

Authors: Baihan Lin

Organizations: Department of Artificial Intelligence and Human Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA · Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA · Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA · Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA · Berkman Klein Center for Internet & Society, Harvard University, Cambridge, MA, USA

Abstract

Language models can score psychiatric questionnaires from speech, but agreement with self-report may reflect the questionnaire rather than the person. We introduce psychometric representational similarity analysis, a framework for comparing the structure of speech-derived scores, self-report, item wording and theory, and implement it alongside person-level construct scoring in COMPASS 2.0. We show how similarly worded items induce covariance without psychological signal. In pre-registered discovery and confirmation analyses of clinical interviews from 275 participants, language-derived symptom geometry resembled wording more than self-report, with no structure beyond wording detected by the registered tests. Geometric agreement with self-report survived assigning participants someone else's answers, whereas person-paired scores captured distress more than specific symptoms. Complementary analyses examined counselling quality and wording structure across 34 instruments and the Research Domain Criteria (RDoC) framework. These findings distinguish agreement about psychological structure from evidence that language-derived assessments track individual people.

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