Empathy or Escalation? A Multilingual Framework for Assessing Anxiety-Inducing Language in LLMs

Leonardo Arcangeli, Carlotta Foschini, Ilaria Melis, Giulia Pucci


Abstract
The growing use of Large Language Models (LLMs) in healthcare and emotionally sensitive spaces raises critical concerns about safety, ethical alignment, and the risk of unintentional emotional harm. Our approach provides a structured, multilingual, and culturally grounded analysis of persuasive and anxiety-inducing language generated by LLMs during interactions with users in conditions of psychological or physical vulnerability. To study our model, we introduce the first Multilingual Emotional Escalation Framework, a two-phase interaction framework designed to simulate emotional escalation and to assess whether the model’s responses amplify anxiety, reinforce false beliefs, or exhibit excessive diagnostic intrusiveness across six languages, using different LLM families within a unified experimental pipeline. Finally, we propose quantitative and qualitative metrics to capture anxiety amplification, catastrophic linguistic patterns, and diagnostic safety. The results highlight significant crosslingual and cross-cultural disparities, underlining the importance of emotional alignment between models and users.
Anthology ID:
2026.oracle-main.1
Volume:
The Proceedings of the Workshop on Open Reasoning Across Cultures Languages (ORACLE)
Month:
October
Year:
2026
Address:
Budapest, Hungary
Editors:
Leonardo Ranaldi, Giulia Pucci, Federico Ranaldi, Marco Valentino, Alexandra Birch, Fabio Massimo Zanzotto
Venues:
ORACLE | WS
SIG:
Publisher:
Association for Computational Linguistics
Note:
Pages:
1–21
Language:
URL:
https://aclanthology.org/2026.oracle-main.1/
DOI:
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Cite (ACL):
Leonardo Arcangeli, Carlotta Foschini, Ilaria Melis, and Giulia Pucci. 2026. Empathy or Escalation? A Multilingual Framework for Assessing Anxiety-Inducing Language in LLMs. In The Proceedings of the Workshop on Open Reasoning Across Cultures Languages (ORACLE), pages 1–21, Budapest, Hungary. Association for Computational Linguistics.
Cite (Informal):
Empathy or Escalation? A Multilingual Framework for Assessing Anxiety-Inducing Language in LLMs (Arcangeli et al., ORACLE 2026)
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PDF:
https://aclanthology.org/2026.oracle-main.1.pdf