Lost in Delusion: Examining LLM Safety Under User Delusions and Distress
By Andrew Aquilina, Chetna Nihalani, Vasudha Varadarajan, Nathan S. Fishbein, Yu-Ru Lin, Maarten Sap
This paper studies LLM safety when user distress is entangled with delusional beliefs, using matched multi-turn simulations across clinically grounded personas and six models. It reveals a recognition-intervention gap where models detect distress but fail to act appropriately under delusional framing.