Diogo Morais

ULHT - Universidade Lusofona de Humanidades e Tecnologias, Psychology, Faculty Member

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Papers by Diogo Morais

Adaptive Non-Immersive VR Environment for Eliciting Fear of Cockroaches: A Physiology-Driven Approach Combined with 3D-TV Exposure

International Journal of Psychological Research, 2020

Non-immersive VR environments are related to the least interactive application of VR techniques, ... more Non-immersive VR environments are related to the least interactive application of VR techniques, such that interaction with the VR environment can occur commonly by 3D-TV without full immersion into the environment. This study presents how 3D-TV exposure combined with physiology recording can elicit fear of cockroaches among individuals with different levels of fear. Thirty-six participants, set apart into three fear groups (low vs. moderate vs. high), were exposed to VR environment with cockroaches for 4 minutes while recording and using cardiac activity as input to the VR environment. Results revealed significant effects on self-report measures and heart rate between different fear groups. Moreover, participants with higher levels of fear were more likely to trigger cockroaches into the scenario due to their cardiac acceleration. Overall results suggest that our physiology-driven VR environment is valid for fear elicitation while having potential use in therapeutic domain.

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Eye Movement Analysis and Cognitive Assessment. The Use of Comparative Visual Search Tasks in a Non-immersive VR Application

Methods of information in medicine, Jan 6, 2016

An adequate behavioral response depends on attentional and mnesic processes. When these basic cog... more An adequate behavioral response depends on attentional and mnesic processes. When these basic cognitive functions are impaired, the use of non-immersive Virtual Reality Applications (VRAs) can be a reliable technique for assessing the level of impairment. However, most non-immersive VRAs use indirect measures to make inferences about visual attention and mnesic processes (e.g., time to task completion, error rate). To examine whether the eye movement analysis through eye tracking (ET) can be a reliable method to probe more effectively where and how attention is deployed and how it is linked with visual working memory during comparative visual search tasks (CVSTs) in non-immersive VRAs. The eye movements of 50 healthy participants were continuously recorded while CVSTs, selected from a set of cognitive tasks in the Systemic Lisbon Battery (SLB). Then a VRA designed to assess of cognitive impairments were randomly presented. The total fixation duration, the number of visits in the are...

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15. Active Confluence: A Proposal to Integrate Social and Health Support with Technological Tools

Transforming Human Experience Through Symbiotic Technologies, 2015

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Systemic Lisbon Battery: Normative Data for Memory and Attention Assessments

JMIR Rehabilitation and Assistive Technologies, 2016

Background: Memory and attention are two cognitive domains pivotal for the performance of instrum... more Background: Memory and attention are two cognitive domains pivotal for the performance of instrumental activities of daily living (IADLs). The assessment of these functions is still widely carried out with pencil-and-paper tests, which lack ecological validity. The evaluation of cognitive and memory functions while the patients are performing IADLs should contribute to the ecological validity of the evaluation process. Objective: The objective of this study is to establish normative data from virtual reality (VR) IADLs designed to activate memory and attention functions. Methods: A total of 243 non-clinical participants carried out a paper-and-pencil Mini-Mental State Examination (MMSE) and performed 3 VR activities: art gallery visual matching task, supermarket shopping task, and memory fruit matching game. The data (execution time and errors, and money spent in the case of the supermarket activity) was automatically generated from the app. Results: Outcomes were computed using non-parametric statistics, due to non-normality of distributions. Age, academic qualifications, and computer experience all had significant effects on most measures. Normative values for different levels of these measures were defined. Conclusions: Age, academic qualifications, and computer experience should be taken into account while using our VR-based platform for cognitive assessment purposes.

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Assessing Cognitive Functions with VR-Based Serious Games that Reproduce Daily Life: Pilot Testing for Normative Values

Communications in Computer and Information Science, 2015

Acquired brain impairments are responsible for cognitive dysfunctions that affect daily life acti... more Acquired brain impairments are responsible for cognitive dysfunctions that affect daily life activities. Promoting recovery via exercises stimulating cognitive functions through ecologically valid interactive media such as virtual reality (VR) is a fast-emerging option. However, assessment still relies largely on non-ecological measures such as pencil-and-paper protocols. We propose that an effective alternative to those protocols is to assess patients while they execute exercises that mimic real-life tasks in a VR scenario (e.g. shopping, dressing, or preparing breakfast). For this, normative data is required. We describe a VR scenario-based assessment tool and report a study to define normative (non-clinical sample) performance levels in daily-life exercises with that tool. We discuss the results on task performance and effects of prior experience with video-games.

PSPT e Veteranos da Guerra do Ultramar: um Estudo Cliníco Controlado

Gamito P., Oliveira J, Morais D., Rosa P, Saraiva T. (2011). PSPT e Veteranos da Guerra do Ultram... more

Traumatic brain injury memory training: a virtual reality online solution

International Journal on Disability and Human Development, 2011

This study aims at assessing an online portal where patients with traumatic brain injury (TBI) ca... more This study aims at assessing an online portal where patients with traumatic brain injury (TBI) can carry on memory and attention exercises outside clinic premises. The training took place in a VR setup where one TBI patient had to complete a set of 10 online VR sessions. The neuropsychological evaluation was carried out with the PASAT (Paced Auditory Serial Addition Task) at pre, during and after treatment assessments. The results showed an increase in working memory and attention levels from the first to the final assessment, which can suggest that VR applications may promote the autonomy and increase in overall quality of life of these patients. The average time for task conclusion was of 5 minutes.

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Executive functioning in addicts following health mobile cognitive stimulation Evidence from alcohol and heroin patients

Proceedings of the ICTs for improving Patients Rehabilitation Research Techniques, 2013

The consequences of alcohol and opioid dependence are severe and may range from physical diseases... more The consequences of alcohol and opioid dependence are severe and may range from physical diseases to neuropsychological deficits in several cognitive domains. Alcohol and opioid abuse has also been related to brain dysfunction specifically in the prefrontal cortex. In order to assess these deficits and the application of a novel approach of cognitive stimulation to alcohol and heroin addicts, we have carried out a neuropsychological intervention program with mobile technology. Sixty-six alcohol and heroin addicts in rehabilitation were submitted to cognitive stimulation during four weeks in a three-day/week basis. The results of the neuropsychological assessments showed an overall increase of general cognitive abilities and executive functioning following cognitive stimulation, being more pronounced in alcoholics who were assigned to treatment group with mobile technologies in comparison to paper-and-pencil group and controls. These results support the usefulness of mobile serious games for neuropsychological stimulation to overcome executive dysfunction in patients with alcohol and heroin dependence.

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PTSD Elderly War Veterans: A Clinical Controlled Pilot Study

CyberPsychology & Behavior, 2009

Around 25,000 war veterans in Portugal suffer posttraumatic stress disorder (PTSD). This clinical... more Around 25,000 war veterans in Portugal suffer posttraumatic stress disorder (PTSD). This clinically controlled study evaluates virtual reality exposure therapy (VRET) as an alternative procedure to reduce PTSD symptoms. Ten patients were assigned to three groups: VRET, exposure in imagination (EI), and waiting list (WL). The patients were Portuguese veterans from a series of wars fought in former African colonies more than 30 years ago. While the EI group participated in traditional imagination therapy, the VRET group was exposed to a virtual reality (VR) war scenario. Cues such as ambush, mortar blasting, and waiting for rescue were used in the VR. Patients enrolled in the VRET group showed statistical reduction of PTSD-associated disorders like depression and anxiety. Far from being conclusive, this pilot study nonetheless presents some promising data on the use of VRET on old war veteran populations.

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Grabbing attention while reading website pages: the influence of verbal emotional cues in advertising

The increasing use of the World Wide Web has promised a huge advertising platform for marketers. ... more The increasing use of the World Wide Web has promised a huge advertising platform for marketers. Investment in online advertising is growing and is expected to overcome traditional media. However, recent studies have reported that users avoid looking at advertising displayed on the World Wide Web. This study aimed at examining the impact of verbal emotional cues (negative/neutral/positive) to capture attention on website's advertising areas through an eye tracker system. The results revealed significant statistical differences between fixations to negative, positive words and neutral words. Significant differences between the number of fixations and recognition of the target words were found only for the negative valence words. We conclude that negative emotional words could play a major role on user attention to advertising.

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War PTSD: A VR Pre-Trial Case Study

Annual Review of …, 2007

ANNUAL REVIEW OF CYBERTHERAPY AND TELEMEDICINE 191 War PTSD: a VR pre-trial case study Pedro Gami... more

The Immersive Virtual Reality Experience: A Typology of Users Revealed Through Multiple Correspondence Analysis Combined with Cluster Analysis Technique

Cyberpsychology, behavior and social networking, 2016

Immersive virtual reality is thought to be advantageous by leading to higher levels of presence. ... more Immersive virtual reality is thought to be advantageous by leading to higher levels of presence. However, and despite users getting actively involved in immersive three-dimensional virtual environments that incorporate sound and motion, there are individual factors, such as age, video game knowledge, and the predisposition to immersion, that may be associated with the quality of virtual reality experience. Moreover, one particular concern for users engaged in immersive virtual reality environments (VREs) is the possibility of side effects, such as cybersickness. The literature suggests that at least 60% of virtual reality users report having felt symptoms of cybersickness, which reduces the quality of the virtual reality experience. The aim of this study was thus to profile the right user to be involved in a VRE through head-mounted display. To examine which user characteristics are associated with the most effective virtual reality experience (lower cybersickness), a multiple corre...

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Neuropsychological Predictors of Alcohol Abtinence Following a Detoxification Program

Communications in Computer and Information Science, 2017

Alcohol dependence syndrome has been associated to disfunctions of the pre-frontal cortex, with a... more Alcohol dependence syndrome has been associated to disfunctions of the pre-frontal cortex, with a negative impact on several areas of cognitive functioning, such as attention, memory and learning, visual-spatial synthesis, executive functions, and psychomotor functions. These changes in turn contribute to the perpetuation of the addictive behavior. We report a study with 249 recovering alcoholics assessed with neuropsychological tests pre- and post-treatment at an alcoholism rehab clinic, with follow-up for abstinence 3 and 6 months after treatment. We found that 3-month abstinence was associated to speed of psychomotor processing, whereas 6-month abstinence was related with decision-making, (lack of) impulsivity, speed of psychomotor processing, and emotional adjustment.

Nicotine craving: ERPs correlates after VR exposure to smoking cues

Studies in Health Technology and Informatics, 2012

Even though it is diminishing in Europe, smoking is still a serious health problem. The craving o... more Even though it is diminishing in Europe, smoking is still a serious health problem. The craving of Nicotine is one of the hardest behaviours to tackle when a smoking cessation programme is implemented. Following on previous work [1], which aimed at evaluating the possibility of inducing smoking craving in smokers using a VR platform, the present study was devised to assess the role of craving in cognitive processing through event related potentials (ERP). From an initial sample of 89 university students (smokers and non-smokers), which was randomly exposed to VR smoking cues and VR non-smoking cue scenarios, a subsample of 13 smokers and non-smokers was drawn. This subsample (M = 23.08; SD = 4.39), which had previously been immersed in the VR smoking cues environment, was presented to a rapid (1 sec) serial of smoking and neutral images. Data on brain activity was recorded through an EEG during this task to further estimate ERPs. When compared to non-smokers, smokers showed higher f...

Virtual Reality Therapy Controlled Study for War Veterans with PTSD. Preliminary Results

Studies in Health Technology and Informatics, 2009

More than 30 years after signing truces, there are still around 20,000 Portuguese war veterans th... more More than 30 years after signing truces, there are still around 20,000 Portuguese war veterans that fill PTSD (Posttraumatic Stress Disorder) diagnose criteria. Despite many of them attending therapy, the outcome is not cheerful. In this way, a research protocol was devised to investigate the opportunity of adopting virtual reality exposure therapy (VRET) to reduce PTSD symptomathology. This protocol consists on a controlled study (VRET vs. traditional psychotherapy vs. waiting list), where in the VRET condition patients will be graded by being exposed to a virtual reality jungle scenario. The activating episodes, that are comprised of three cues (ambush, mortar blasting and waiting for injured rescue), are repeated 3 times each session. The cues' intensity and frequency increase from session to session. Patients are exposed to the VR world through a HMD (Head Mounted Display). This paper reports on the ongoing research where 4 VRET patients that filled CAPS DSM-IV PTSD criteria...

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Assessment of frontal brain functions in alcoholics following a health mobile cognitive stimulation approach

Studies in Health Technology and Informatics, 2013

The consequences of alcohol dependence syndrome are severe, ranging from physical diseases to neu... more The consequences of alcohol dependence syndrome are severe, ranging from physical diseases to neuropsychological deficits in several cognitive domains. Alcohol abuse has also been related to brain dysfunction specifically in the prefrontal cortex. We assessed these deficits and the effects of traditional (pen-and-paper) and novel (mobile technology) approaches to cognitive stimulation of alcoholics in a neuropsychological intervention program. Thirty alcoholics in treatment of alcohol dependence syndrome were assessed during four weeks on a three-day/week basis. The results showed an overall increase in frontal lobe function between the first and the final assessment, being more pronounced in alcoholics who were assigned to a treatment group with mobile technologies than to those assigned to a paper-and-pencil treatment and to a control group. These results support the use of ecologically sound and available approaches of neuropsychological stimulation to treat executive dysfunction...

The Art Gallery Test: assessing visual attention through art - UNDER SUBMISSION

Assessment of Attentional and Mnesic Processes Through Gaze Tracking Analysis: Inferences from Comparative Search Tasks Embedded in VR Serious Games

Communications in Computer and Information Science

The impairment of basic cognitive functions such as attention and visual working memory can have ... more The impairment of basic cognitive functions such as attention and visual working memory can have a significant negative impact in our ability to adapt to the permanent changes in the environment. VR Serious Games are being used as a new tool for both assessment, stimulation and rehabilitation of such impaired functions. Even though the results of these novel applications seem to be promising, some of the assessments based in these solutions use indirect measures to evaluate attentional and mnesic performance (e.g. number of errors, task completion time). Gaze tracking (GT) can provide more accurate and direct indicators of these cognitive processes. On a sample of 46 non-clinical participants (33 Female; 71.7%), with an age average of 27.96 years old (SD = 11.92), ocular movements were recorded in two different comparative visual search tasks (CVSTs) that are an integrant part of the cognitive assessment protocol of the Systemic Lisbon Battery (SLB). Number of visits and total fixations differed based on the assessment with the Mini-mental state examination test (MMSE). These results highlight the possibility of combining both the data from the GT and the results of the “spot the differences” tasks in SLB, adding an unobtrusive and reliable solution for cognitive assessment in clinical and non-clinical settings.

Emotional Reality: Virtual Reality Environments as a tool for emotional elicitation

Attentional orienting to biologically fear-relevant stimuli: data from eye tracking

Snakes are thought as fear-relevant stimuli (biologically prepared to be associated with fear) wh... more Snakes are thought as fear-relevant stimuli (biologically prepared to be associated with fear) which can lead to an enhanced attentional capture when compared fear-irrelevant stimuli. Inherent limitations related to the key-press behaviour might be bypassed with the measurement of eye movements, since they are more closely related to attentional processes than reaction times. An eye tracking technique was combined with the flicker paradigm in two studies. A sample of university students was gathered. In both studies, an instruction to detect changes between the pair of scenes was given. Attentional orienting for the changing element in the scene was analyzed, as well the role of fear of snakes as a moderator variable. The results for both studies revealed a significant shorter time to first fixation for snake stimuli when compared to control stimuli. A facilitating effect of fear of snakes was also found for snakes, presenting the highly fear participants a shorter a time to first f...

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Diogo Morais

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