Effective Tutoring with Empathic Embodied Conversational Agents

This thesis examines the prospect of using empathy in an Embodied Tutoring System (ETS) that guides students through an online quiz (by providing feedback on student answers and responding to self-reported student emotion). The ETS seeks to imitate human behaviours successfully used in one-to-one human tutorial interactions. The main hypothesis is that the interaction with an empathic ETS results in greater learning gains than a neutral ETS, primarily by encouraging positive and reducing negative student emotions using empathic feedback. In a preparatory study we investigated different strategies for expressing emotion by the ETS. We established that a multimodal strategy achieves the best results regarding how accurately human participants can recognise the emotions. This approach was used in developing the feedback strategy for our empathic ETS. The preparatory study was followed by two studies in which we compared a neutral with an empathic ETS. The ETS in the second of these studies was developed using results from the first of these studies. In both studies, we found no statistically significant difference in learning gains between the neutral and empathic ETS. However, we did discover a number of interactions between the ETS system, learning gains and, in particular 1) student scores on an empathic tendency test and 2) student ability. We also analysed the subjective responses and the relation between self-reported emotions during the quiz and student learning gains. Based on our studies in a formal class room setting, we assess the prospects of using empathic agents in a classroom setting and describe a number of requirements for their effective use

An Experimental Investigation of Emotional Labor Display Rules and Performance in a Human Resources Sexual Harassment Interview Simulation

Human Resource (HR) professionals are expected to engage in emotional labor (EL), or, management and control of their own emotions and emotional expression, during sexual harassment (SH) investigations. This EL expectation, or display rule (DR), is dynamic and complex requiring suppression of emotions and expressions of neutral empathy and is thus termed a dynamic neutral-empathic DR. Prior research shows that DRs in other occupations function as job demands that can deplete employees’ personal resources and negatively affect performance. The current study investigates the impact of the dynamic neutral-empathic DR by testing a process model that was developed via an integration of Job Demands-Resources and Conservation of Resources theories. The model tests predictions that emotion regulation and negative affect mediate relationships between the dynamic neutral-empathic DR and performance in the SH investigation context. The SH context comprised a simulated, SH investigation interview, which is part of professional training program developed by attorneys and psychologists and implemented in organizations. In the simulation, college students played the role of HR managers who interviewed an SH claimant as well as the alleged harasser. I used an experimental design to test the effects of this unique DR by randomly assigning participants to one of three conditions including a control condition with no DR, and two DR conditions. In the first DR condition, participants were instructed to adhere to the dynamic neutral-empathic DR. In the second DR condition, I manipulated DR adherence expectation, where more stringent requirements to adhere to the same, neutral-empathic DR were implemented. As such, I was able to test the impact of these two different DR conditions. Performance was measured during the simulated SH interviews via objective performance variables, and after via self-assessed performance and a memory task. Results providing evidence of resource depletion associated with the DR conditions were mixed. Negative affect mediated the relationship between DR condition and performance for participants in the DR conditions where greater levels of negative affect were negatively associated with performance. Emotional labor also mediated this relationship, but was unexpectedly associated with enhanced performance. Results are followed by a discussion and suggestions for future research

An Embodied Conversational Agent to Minimize the Effects of Social Isolation During Hospitalization

Social isolation and loneliness contribute to the development of depression and anxiety. Comorbidity of mental health issues in hospitalized patients increases the length of stay in hospital by up to 109% and costs the healthcare sector billions of dollars each year. This study aims to understand the potential suitability of embodied conversational agents (ECAs) to reduce feelings of social isolation and loneliness among hospital patients. To facilitate this, a video prototype of an ECA was developed for use in single-occupant hospital rooms. The ECA was designed to act as an intelligent assistant, a rehabilitation guide, and a conversational partner. A co-design workshop involving five healthcare professionals was conducted. The thematic analysis of the workshop transcripts identified some major themes including improving health literacy, reducing the time burden on healthcare professionals, preventing secondary mental health issues, and supporting higher acceptance of digital technologies by elderly patients

Multidimensional apathy and executive dysfunction in amyotrophic lateral sclerosis

Apathy and cognitive dysfunction are prominent symptoms of Amyotrophic lateral sclerosis (ALS). More specifically ALS patients show increased Initiation apathy-a lack of motivation for self-generation of thoughts as assessed by the Dimensional Apathy Scale. This study aimed to investigate the cognitive underpinnings of apathy subtypes in ALS. We hypothesized that increased Initiation apathy would be associated deficits on tests of intrinsic response generation, such as verbal fluency. We also explored the relationship of other apathy subtypes to cognitive processes, in particular emotional apathy with emotional and social cognition deficits and executive apathy with planning and goal management deficits. ALS patients, and their carers (N = 30), and healthy matched controls, and their informants (N = 29) were recruited. All participants completed self- and informant/carer-rated Dimensional Apathy Scale, to quantify apathy subtypes (Executive, Emotional and Initiation), along with standard apathy and depression measures. Patients and controls completed the Edinburgh Cognitive and behavioural ALS Screen, and a comprehensive neuropsychological battery including emotional recognition, social cognition, intrinsic response generation tasks (verbal fluency and random number generation) and a new ecologically valid, computerised measure of planning and goal management. The results demonstrated that increased Initiation apathy was the only significantly elevated subtype in ALS (self-rated p < .05, informant/carer-rated p < .01). Initiation apathy was found to be significantly associated with verbal fluency deficit, while Emotional apathy was significantly associated with emotional recognition deficits. No associations were found between apathy subtypes and depression or in controls. This is the first study to show specific associations between apathy subtypes (Emotional and Initiation) and executive and emotional cognitive dysfunction, indicating possible distinct underlying mechanisms to these demotivational symptoms

The relationship between social cognitive processes and behavior changes in people with amnestic Mild Cognitive Impairment or dementia using the Edinburgh Social Cognition Test (ESCoT)

Objectives: People with amnestic Mild Cognitive Impairment (aMCI) or dementia often exhibit a decline in their social abilities, but few tests of social cognition exist that are suitable for clinical use. Moreover, the relationship between changes in behaviour and impairments in social cognition is poorly understood. We examined the utility of the Edinburgh Social Cognition Test (ESCoT) in people with aMCI/dementia and explored associations between social cognition performance and behaviour changes. Methods: We administered the ESCoT and two established social cognition tests (Reading the Mind in the Eyes; RME and the Social Norms Questionnaire; SNQ) to 28 people with aMCI or dementia and 28 age and sex matched cognitively healthy controls. Behaviour change was measured using a semi-structured interview which assesses behavioural abnormalities found in frontotemporal dementia. Results: People with aMCI/dementia were impaired on the ESCoT affective ToM, ESCoT total score and the RME. Behaviour changes in the domains of apathy, loss of sympathy/empathy, perseveration, and psychotic symptoms were associated with poorer affective ToM scores. Disinhibition, loss of sympathy/empathy and hyperorality or altered food preferences were associated with cognitive ToM. All behaviours were significantly associated with poorer performance on ESCoT total score, but not the RME or SNQ.Conclusion: The ESCoT was sensitive to social cognition impairments in people with aMCI/dementia and it relates to behaviour change in aMCI/dementia unlike established tests. Different subtests of the ESCoT were related to different behaviour changes. These findings suggest that the ESCoT may be a clinically valuable tool when examining social cognition

Unraveling Moral Reasoning in Amyotrophic Lateral Sclerosis: How Emotional Detachment Modifies Moral Judgment

In the last decade, scientific literature provided solid evidence of cognitive deficits in amyotrophic lateral sclerosis (ALS) patients and their effects on end-life choices. However, moral cognition and judgment are still poorly investigated in this population. Here we aimed at evaluating both socio-cognitive and socio-affective components of moral reasoning in a sample of 28 ALS patients. Patients underwent clinical and neuropsychological evaluation including basic cognitive and social cognition measures. Additionally, we administered an experimental task including moral dilemmas, with instrumental and incidental conditions. Patients’ performances were compared with a control group [healthy control (HC)], including 36 age-, gender-, and education-matched healthy subjects. Despite that the judgment pattern was comparable in ALS and HC, patients resulted less prone to carry out a moral transgression compared to HC. Additionally, ALS patients displayed higher levels of moral permissibility and lower emotional arousal, with similar levels of engagement in both instrumental and incidental conditions. Our findings expanded the current literature about cognitive deficits in ALS, showing that in judging moral actions, patients may present non-utilitarian choices and emotion flattening. Such a decision-making profile may have relevant implications in applying moral principles in real-life situations and for the judgment of end-of-life treatments and care in clinical settings