用心理韧性引导可穿戴生理信号,提升阿片类药物渴求预测准确率。
RETRACE: Resilience-Guided Trait-Conditioned Craving Estimation from Wearable Physiology in Opioid Use Disorder

- 通过心理韧性指标重构渴求检测,区分压力与渴求的生理信号。
- 在跨被试评估中相比最强基线提升7%准确率。
- 无需个体标签或重训练,适合临床实时干预场景。
从可穿戴生理信号中检测阿片类药物渴求对支持戒断干预至关重要,但极具挑战性,尤其在跨被试评估下——因渴求主观性强、个体差异大,且常与压力信号混杂。实证分析表明,压力引发强烈且可复现的自主神经反应,而渴求相关信号较弱、稀疏,大多嵌入压力生理中。我们进一步发现,心理韧性(影响压力调节与渴求易感性)无法通过短时可穿戴数据可靠观测,但可通过长期可复用的个体指标捕捉,如压力后心率恢复和自传体记忆回忆。基于此,提出RETRACE框架:一种基于心理韧性的特质条件化跨被试渴求估计方法。其将渴求检测重构为特质条件化的生理解读:不假设同一生理模式在所有人中意义相同,而是利用韧性相关的个体上下文指导推断。技术上,采用新型双编码器设计,分离通用压力生理与个体特异性渴求解释;结合冻结预训练的压力编码器与韧性条件化渴求编码器,通过特征级门控与表示级融合,实现轻量级个性化,无需目标用户渴求标签或每用户微调。在包含可穿戴生理、压力与渴求标注及自传体叙事的新型多模态OUD数据集上评估,于留一被试者(LOSO)设置下,性能较最强基线最高提升7个百分点。
原文摘要 · Abstract (English)
Detecting opioid craving from wearable physiological signals is critical yet difficult, with the potential to support proactive interventions for individuals with opioid use disorder (OUD). This challenge is especially pronounced under subject-independent evaluation because craving is subjective, heterogeneous, and often physiologically entangled with stress. Our empirical analysis shows that stress elicits strong and reproducible autonomic responses, while craving-related signals are weaker, sparse, and largely embedded within stress-related physiology. We further show that psychological resilience, which shapes stress regulation and craving vulnerability, is not reliably observable from short-term wearable windows, but can be captured through reusable subject-level proxies, including post-stress heart-rate recovery and autobiographical memory recall. Motivated by these findings, we introduce RETRACE, a resilience-guided trait-conditioned framework for subject-independent craving estimation from wearable physiology. RETRACE reframes craving detection as trait-conditioned physiological interpretation: rather than assuming the same physiological pattern has the same meaning across individuals, it uses resilience-related subject context to guide inference. Technically, RETRACE introduces a novel dual-encoder design that separates generalizable stress physiology from subject-specific craving interpretation. It combines a frozen stress-pretrained encoder with resilience-conditioned craving encoder, using feature-level gating and representation-level fusion to enable lightweight personalization without target-user craving labels or per-user retraining. We evaluate RETRACE on a novel multimodal OUD dataset containing wearable physiology, stress and craving annotations, and autobiographical narratives. Under LOSO setup, RETRACE achieves up to 7% absolute improvement over the strongest baseline.
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