# M-CARE: Standardized Clinical Case Reporting for AI Model Behavioral Disorders, with a 20-Case Atlas and Experimental Validation

arXiv: https://arxiv.org/abs/2604.20871 · HTML: https://mlsanity.com/paper/2604.20871/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 5 of its 10 references that are in the map.
- First posted on arXiv 27 Mar 2026.

## Builds on (most cited first, 5 of 5)

- [WebArena: A Realistic Web Environment for Building Autonomous Agents](https://mlsanity.com/paper/2307.13854/) (2023)
- [AgentBench: Evaluating LLMs as Agents](https://mlsanity.com/paper/2308.03688/) (2023)
- [Discovering Language Model Behaviors with Model-Written Evaluations](https://mlsanity.com/paper/2212.09251/) (2022)
- [Red Teaming Language Models to Reduce Harms: Methods, Scaling Behaviors, and Lessons Learned](https://mlsanity.com/paper/2209.07858/) (2022)
- [Model Medicine: A Clinical Framework for Understanding, Diagnosing, and Treating AI Models](https://mlsanity.com/paper/2603.04722/) (2026)

## Abstract (arXiv)

We introduce M-CARE (Model Clinical Assessment and Reporting for Evaluation), a clinical case report framework for AI model behavioral disorders adapted from human medicine. M-CARE provides a 13-section report format, a 4-axis diagnostic assessment system, and a nosological classification of AI behavioral conditions. We present 20 cases from three source categories: field observations of deployed agents (8), controlled experiments across three platforms (8), and published sources (4). Cases are organized into five categories: RLHF Performance Artifacts, Shell-Core Override Pathology, Context & Memory Conditions, Core Identity & Plasticity, and Stress, Methodology, & Boundary Conditions. As a featured case, we present Shell-Induced Behavioral Override (SIBO) -- a controlled experiment showing that Shell instructions categorically override a model's default cooperative behavior. SIBO was validated across five game domains (Trust Game, Poker, Avalon, Codenames, Chess), revealing a domain-dependent spectrum (SIBO Index: 0.75 to 0.10) that varies with action space complexity, Core domain expertise, and temporal directness. M-CARE is extensible: new cases and categories integrate without framework modification. We release the framework, all 20 case reports, and experimental data as open resources.