Large language models in healthcare often miss critical emotional cues, delivering medically sound but emotionally flat advice. Such responses are insufficient in clinical encounters, where distressed or vulnerable patients rely on empathic communication to support safety, adherence, and trust. We present RECAP (Reflect-Extract-Calibrate-Align-Produce), an inference-time framework that guides models through structured emotional reasoning without retraining. RECAP decomposes patient input into appraisal-theoretic stages, identifies psychological factors, and assigns Likert-based emotion likelihoods that clinicians can inspect or override, producing nuanced and auditable responses. Across EmoBench, SECEU, and EQ-Bench, RECAP improves emotional reasoning by 22-28% on 8B models and 10-13% on larger models over zero-shot baselines. In blinded evaluations, oncology clinicians rated RECAP's responses as more empathetic, supportive, and context-appropriate than prompting baselines. These findings demonstrate that modular, principled prompting can enhance emotional intelligence in medical AI while maintaining transparency and accountability for clinical deployment.

According to what we call the Emotional Alignment Design Policy, artificial entities should be designed to elicit emotional reactions from users that appropriately reflect the entities' capacities and moral status, or lack thereof. This principle can be violated in two ways: by designing an artificial system that elicits stronger or weaker emotional reactions than its capacities and moral status warrant (overshooting or undershooting), or by designing a system that elicits the wrong type of emotional reaction (hitting the wrong target). Although presumably attractive, practical implementation faces several challenges including: How can we respect user autonomy while promoting appropriate responses? How should we navigate expert and public disagreement and uncertainty about facts and values? What if emotional alignment seems to require creating or destroying entities with moral status? To what extent should designs conform to versus attempt to alter user assumptions and attitudes?

Evaluating Large Language Models' (LLMs) anthropomorphic capabilities has become increasingly important in contemporary discourse. Utilizing the emotion appraisal theory from psychology, we propose to evaluate the empathy ability of LLMs, i.e., how their feelings change when presented with specific situations. After a careful and comprehensive survey, we collect a dataset containing over 400 situations that have proven effective in eliciting the eight emotions central to our study. Categorizing the situations into 36 factors, we conduct a human evaluation involving more than 1,200 subjects worldwide. With the human evaluation results as references, our evaluation includes seven LLMs, covering both commercial and open-source models, including variations in model sizes, featuring the latest iterations, such as GPT-4, Mixtral-8x22B, and LLaMA-3.1.

Generating music from images can enhance various applications, including background music for photo slideshows, social media experiences, and video creation. This paper presents an emotion-guided image-to-music generation framework that leverages the Valence-Arousal (VA) emotional space to produce music that aligns with the emotional tone of a given image. Unlike previous models that rely on contrastive learning for emotional consistency, the proposed approach directly integrates a VA loss function to enable accurate emotional alignment. The model employs a CNN-Transformer architecture, featuring pre-trained CNN image feature extractors and three Transformer encoders to capture complex, high-level emotional features from MIDI music. Three Transformer decoders refine these features to generate musically and emotionally consistent MIDI sequences. Experimental results on a newly curated emotionally paired image-MIDI dataset demonstrate the proposed model's superior performance across metrics such as Polyphony Rate, Pitch Entropy, Groove Consistency, and loss convergence.

Generative AI systems are increasingly capable of expressing emotions via text and imagery. Effective emotional expression will likely play a major role in the efficacy of AI systems -- particularly those designed to support human mental health and wellbeing. This motivates our present research to better understand the alignment of AI expressed emotions with the human perception of emotions. When AI tries to express a particular emotion, how might we assess whether they are successful? To answer this question, we designed a survey to measure the alignment between emotions expressed by generative AI and human perceptions. Three generative image models (DALL-E 2, DALL-E 3 and Stable Diffusion v1) were used to generate 240 examples of images, each of which was based on a prompt designed to express five positive and five negative emotions across both humans and robots. 24 participants recruited from the Prolific website rated the alignment of AI-generated emotional expressions with a text prompt used to generate the emotion (i.e., "A robot expressing the emotion amusement"). The results of our evaluation suggest that generative AI models are indeed capable of producing emotional expressions that are well-aligned with a range of human emotions; however, we show that the alignment significantly depends upon the AI model used and the emotion itself. We analyze variations in the performance of these systems to identify gaps for future improvement. We conclude with a discussion of the implications for future AI systems designed to support mental health and wellbeing.

Large Language Models (LLMs) have demonstrated a number of human-like abilities, however the empathic understanding and emotional state of LLMs is yet to be aligned to that of humans. In this work, we investigate how the emotional state of generative LLM agents evolves as they perceive new events, introducing a novel architecture in which new experiences are compared to past memories. Through this comparison, the agent gains the ability to understand new experiences in context, which according to the appraisal theory of emotion is vital in emotion creation. First, the agent perceives new experiences as time series text data. After perceiving each new input, the agent generates a summary of past relevant memories, referred to as the norm, and compares the new experience to this norm. Through this comparison we can analyse how the agent reacts to the new experience in context. The PANAS, a test of affect, is administered to the agent, capturing the emotional state of the agent after the perception of the new event. Finally, the new experience is then added to the agents memory to be used in the creation of future norms. By creating multiple experiences in natural language from emotionally charged situations, we test the proposed architecture on a wide range of scenarios. The mixed results suggests that introducing context can occasionally improve the emotional alignment of the agent, but further study and comparison with human evaluators is necessary. We hope that this paper is another step towards the alignment of generative agents.