BALMS: Benchmarking Agentic LLMs for Longitudinal Mental Health Sensing

Mental health assessment relies on episodic self-report scales, which convert subjective states such as stress into numerical scores but provide only sparse snapshots of wellbeing. Wearable devices offer longitudinal behavioral and physiological signals for continuous, low-burden monitoring. Recent LLM-driven personal-health agents enable natural language queries over wearable signals, but mainly handle short-term, retrieval-based lookups (e.g., highest step count over a week). They do not evaluate whether agents can reason over long-term signals to predict wellbeing scores paired with evidence-grounded rationales. To address this gap, we introduce BALMS, the first systematic benchmark of LLM-based agentic systems for longitudinal mental health sensing. BALMS spans 3 real-world longitudinal datasets, 2 task families (closed-form wellbeing-score prediction and rationale generation auto-graded by an LLM-as-Judge), 3 agentic paradigms evaluated across 5 open- and closed-source LLM backbones. We find that zero-shot agents rarely outperform a simple mean baseline, except with stronger backbones or compact, semantically meaningful features. Chain-of-thought prompting improves reasoning-oriented backbones, but does not guarantee temporal grounding or numerical correctness. Together with more analysis on efficiency and temporal scaling, BALMS highlights the need for longitudinal mental health agents that selectively retrieve history, ground temporal evidence, and reason over interpretable behavioral features.

A Low-Power Wearable Respiratory Sensor for Non-Invasive Stress Monitoring

Respiration provides a continuously available window into physiological state and behavior. However, monitoring it outside controlled settings remains challenging because a wearable system must capture small body deformations while remaining comfortable, low power, and robust to changes in posture and motion. We present a compact non-invasive respiratory sensing system based on a force-sensitive resistor (FSR) embedded in an abdominal belt and integrated with a custom Bluetooth Low Energy acquisition board. The system combines a simple piezoresistive readout with a mechanical holder designed to transfer abdominal expansion to the sensor without analog amplification. We evaluate the complete sensing pipeline across multiple breathing patterns and body positions. In stationary settings, the recorded signals exhibit consistent amplitude changes and recurring peak-to-peak timing across breathing maneuvers; under light movement, these variations remain visible despite motion-induced baseline shifts. We further design a five-phase stress-induction protocol and collect respiratory recordings from 12 participants. Using interpretable time-domain features and standard classifiers, we examine whether the acquired signals distinguish relaxation from stress-induction phases. In this preliminary experiment, the best-performing model achieves 88.0% test accuracy, indicating that the extracted respiratory features distinguish stress-induced phases from relaxation phases in this dataset. Overall, our results show that the proposed platform enables real-time respiratory monitoring across diverse daily-life scenarios and captures respiratory changes that distinguish stress-induction from relaxation phases, supporting its potential for affective-computing applications.

Rethinking PPG-based Sleep Staging: Datasets, Metrics, and Benchmarks

Automated sleep staging assigns discrete stage labels to successive time epochs throughout an overnight recording; conventionally each window spans at least 30 seconds, reflecting the minimum temporal resolution of the clinical scoring standard. Wearable photoplethysmography (PPG) has attracted sustained interest as an ambulatory alternative to laboratory-based polysomnography, which relies on electroencephalography (EEG) and other recording modalities that are impractical outside clinical environments. Yet PPG-based staging trails EEG-based methods by a substantial margin, and we argue this gap largely reflects a mismatch between signal and task. Within a stable stage, PPG's inter-stage feature differences are more subtle than those in EEG; yet at stage boundaries, PPG's principal cardiovascular features, heart rate variability and pulse morphology, shift sharply within seconds. The conventional practice of assigning one label to each 30-second epoch therefore suppresses feature that is concentrated near boundaries. We address this gap in two steps. First, we develop a label expansion pipeline based on Hidden Semi-Markov Models that converts coarse epoch labels into sec-level annotations. To assess whether these expanded labels are reliable enough for downstream supervision, we validate them on a separate expert-reviewed dataset and through an auxiliary sleep-wake task whose labels are independent of the expansion pipeline. Second, we use the resulting sec-level supervision on MESA to improve conventional four-class epoch-level staging across four architecturally diverse baselines by 3.7--5.7\,pp in accuracy against the original epoch labels, with supplementary zero-shot evaluation on CFS showing that the transfer benefit persists under cohort and annotation-protocol shift.

Evidence-Grounded Mapping of Multimodal Human Sensing Psychological Transdiagnostic Dimensions

Mobile and wearable sensing enables longitudinal observation of behavior, yet translating these signals into meaningful mental health constructs remains difficult. We introduce a clinician-in-the-loop benchmark for evaluating whether large language models (LLMs) can generate evidence-grounded Brief Hierarchical Taxonomy of Psychopathology (B-HiTOP) item profiles from passive sensing, ecological momentary assessment (EMA), and questionnaire evidence. Using the Generalization of Longitudinal Behavior Modeling (GLOBEM) dataset, we construct 14,592 participant-day instances and align multimodal evidence to 29 B-HiTOP items across five spectra. Since GLOBEM lacks B-HiTOP responses, we evaluate evidence compatibility (C) rather than diagnostic accuracy, separating substantive predictions from abstentions when evidence is insufficient for item-level scoring. Two-stage prediction improves C for EMA and questionnaire evidence, but reduces C under passive sensing and combined evidence and produces more conservative score distributions across models, spectra, and evidence settings. Overall, semantic abstraction helps organize heterogeneous self-report evidence while becoming an information bottleneck for indirect behavioral sensing signals.

Physical activities enable scalable foundation modelling for broad-spectrum health prediction

Wearable and mobile sensing technologies have demonstrated strong potential for health inference; however, most sensor models are designed for specific disease types, limiting their transferability across different health risks. Wearable foundation models offer a more generalizable approach in diverse health risk types. Nevertheless, most existing methods rely on high-frequency raw sensor data, raising concerns about privacy, computational overhead, and scalability across devices and populations. In this paper, we propose StepFM, a foundation model built solely on step counter data for broad-spectrum health prediction. Leveraging the ubiquity and low-dimensional nature of step data, StepFM provides a practical, privacy-preserving, and computation-efficient alternative to traditional sensor-based models. We design a scalable pre-training framework that captures temporal dynamics and behavioral patterns from large-scale step sequences, enabling transfer across more than 20 health risk prediction tasks spanning diverse devices, new regions, and novel disease types. Extensive experiments demonstrate that StepFM achieves strong performance compared to existing methods while maintaining robustness across heterogeneous settings. Furthermore, our analysis reveals interpretable and generalizable relationships between physical activity patterns and various health risks, offering new insights into activity-based health modeling. Our work establishes step-based sensing as a viable foundation for scalable and real-world health monitoring.

Inertia-1: An Open Exploration of Wearable Motion Foundation Models

Wearable motion sensing provides a continuous and scalable window into human behavior and health, making it a natural fit for foundation models, yet its pretraining and scaling principles remain poorly understood. Prior work studies isolated design choices, such as sensor placement or sampling frequency, often under fixed settings and narrow downstream tasks that fail to capture real-world sensing diversity. We introduce Inertia-1, a fully open exploration of wearable motion foundation models. Using massive corpora of accelerometer data from global sources spanning more than 18.2M hours, we build a controlled framework for studying the full lifecycle of wearable motion foundation models, covering data choices such as sensor modality, device placement, sampling rate, window length; model choices such as architectures and model size; and training choices such as pretraining objective and data scale. Extensive evaluations across 15 datasets spanning human activity recognition, freezing-of-gait detection, and disease prediction reveal intriguing findings for building motion foundation models that generalize across tasks and sensing conditions. Collectively, Inertia-1 not only presents state-of-the-art recipes for diverse downstream tasks, but also serves as a comprehensive, practical, and open cookbook for wearable motion representation learning.

Representation Matters in Longitudinal Affective Computing

Longitudinal, in-the-wild, wearable sensing yields day-level physiology, sleep, activity, and environmental streams, whereas affect and cognition are labeled only episodically (per waves). We recast this cadence mismatch as a temporal representation problem and compare three wave-level mappings from dense histories to sparse labels: levels (within-wave summaries), absolute drift (change across waves), and proportional drift. Using almost a year of data from 82 adults in the Providemus alz study, we model 21 affect and cognition outcomes. Day-scale signals are reduced to compact wave-level descriptors (central tendency, dispersion, and distributional shape) and learned with four regressors under two orthogonal evaluation axes: leave-one-subject-out and leave-one-wave-out. Performance is reported as scaled MAE using both mean and median across folds. Differences emerge: affective states are best predicted by wave-to-wave absolute drift, whereas cognitive performance aligns with within-wave levels, reflecting emotion dynamic theories. Across windowing features, shape descriptors (e.g., minima, kurtosis) carry more signal than simple means/medians. We contribute a representation triad for sparse-label modelling, a wave-level feature schema applicable on-device, and a dual-axis reporting practice that separates cross-participant generalization from temporal robustness. These results convert temporal representation from an implicit preprocessing step into an explicit, testable design choice for real-world affective-computing applications in brain health.

Beyond AHI: An Interpretable Causal-Discovery-Guided Framework for Sleep Recovery in Connected Health

Objective sleep assessment relies on polysomnography (PSG), yet clinical impact is often better reflected in patient-reported outcomes (PROs) such as sleepiness and fatigue. Existing summary indices, including the Apnea-Hypopnea Index (AHI), provide limited insight into the multidomain physiology underlying functional recovery. We propose an interpretable, causal-discovery-guided framework for deriving a hierarchical Sleep Recovery Score (SRS) from multimodal PSG. Using two large population cohorts (MESA: \(n=1{,}540\); MrOS: \(n=825\)), we apply directed acyclic graph (DAG) learning to identify candidate physiological drivers spanning respiratory burden, hypoxic burden, sleep fragmentation, sleep architecture, and autonomic regulation. Although derived from clinical PSG, these domains map naturally to sensing streams increasingly available in connected health technologies, including wearable ECG, oximetry, and sleep-stage estimation devices. To preserve mechanistic plausibility, we introduce a two-stage screening process that combines physiology-based constraints with constrained LLM-assisted auditing to identify and remove structural confounders and construct-overlapping variables. Across cohorts, these five domains emerge as recurrent physiological domains associated with recovery, and the resulting SRS shows up to \(3.4\times\) stronger alignment with perceived recovery than AHI. By linking multimodal sleep physiology to patient-centered outcomes through an interpretable, bias-aware, and domain-structured framework, this work provides a practical foundation for recovery modeling across both clinical sleep studies and emerging smart and connected health settings.

Ride, Track, and Recover: Pilot Randomized Trial of a Wearable Digital Self-Management Intervention During a Veteran Endurance-Cycling Program

Post-traumatic stress disorder (PTSD) in veterans is characterized by persistent hyperarousal and comorbid anxiety and depressive symptoms that are difficult to monitor and manage outside clinical settings. Thirteen veterans participating in a Project Hero cycling event in Texas were randomized by computer-generated sequence in a naturalistic setting to two arms: (1) digital intervention plus physical activity, or (2) physical activity only, plus a third at-home monitoring control cohort consisting of 7 veterans selected from the broader Project Hero veteran community. Continuous smartwatch sensing combined heart rate and accelerometer features to detect hyperarousal events, which were confirmed in real time by participants. Weekly self-report measures of anxiety, depression, and PTSD severity were collected. Generalized additive mixed models characterized nonlinear trajectories over time. Baseline-normalized hyperarousal trajectories differed significantly across conditions, with the digital intervention group (n=7) showing structured stabilization compared to late-study escalation in the physical-only group (n=3). Both cycling groups exhibited acute symptom improvements during the endurance event; however, the digital intervention group demonstrated a higher overall maintenance of gains. The at-home control group (n=4) showed gradual symptom declines. Perceived precision of ML detections varied substantially across individuals and was positively associated with symptom severity, with higher-severity participants confirming a greater proportion of detected events. These results suggest that coupling wearable detection with digital self-management tools may support stabilization of hyperarousal and symptom improvement while emphasizing the importance of personalization and human-centered design in wearable mental health systems.

AnyMo: Geometry-Aware Setup-Agnostic Modeling of Human Motion in the Wild

As wearable and mobile devices become increasingly embedded in daily life, they offer a practical way to continuously sense human motion in the wild. But inertial signals are highly dependent on the sensing setup, including body location, mounting position, sensor orientation, device hardware, and sampling protocol. This setup dependence makes it difficult to learn motion representations that transfer across devices and datasets, and limits the broader use of wearable IMUs beyond closed-set recognition. We introduce AnyMo, a geometry-aware framework for setup-agnostic human motion modeling. AnyMo uses physics-grounded IMU simulation over dense body-surface placements to generate diverse and plausible synthetic signals, pre-trains a graph encoder from paired synthetic placement views and masked partial observations, tokenizes multi-position IMU into full-body motion tokens, and aligns these tokens with an LLM for motion-language understanding. We evaluate AnyMo on three complementary tasks: zero-shot activity recognition across 14 unseen downstream datasets, cross-modal retrieval, and wearable IMU motion captioning, where it improves average Accuracy/F1/R@2 by 11.7\%/11.6\%/22.6\% on HAR, increases zero-shot IMU-to-text and text-to-IMU retrieval MRR by 15.9\% and 28.6\%, respectively, and improves zero-shot captioning BERT-F1 by 18.8\%. These results support AnyMo as a generalist model for wearable motion understanding in the wild. Project page: https://baiyuchen.com/project/AnyMo.