Generative AI and Physiological Sensors for Obsessive Compulsive Disorder Exposure Therapy

November 24, 2025

Exposure and Response Prevention (ERP) is the gold-standard therapy for Obsessive-Compulsive Disorder (OCD), a debilitating anxiety disorder. This treatment approach faces challenges related to personalization and long-term effectiveness. This thesis investigated the feasibility and preliminary efficacy of a novel system designed to enhance exposure therapy for contamination-subtype OCD by integrating generative Artificial Intelligence (AI) imagery and physiological sensors (Electrodermal Activity (EDA), Electrocardiogram (ECG), and accelerometer). A proof-of-concept was developed to determine whether exposure to AI-generated imagery can provoke a measurable emotional response. A complete signal processing pipeline was implemented and relevant features were extracted. Its performance was validated through in silico simulations reproducing expected autonomic responses under experimental conditions. Real-patient results showed no statistically significant differences across physiological metrics when comparing exposure and neutral conditions. Therefore, this static, two-dimensional generative AI implementation is likely insufficient to induce the necessary emotional and physiological responses for effective therapy outcomes. Participant feedback supported these findings, with common concerns including limited realism, weak immersion, and lack of image personalization. While the multimodal acquisition and analysis framework proved technically feasible, the quality of the stimulus delivery remains a major barrier. Findings highlight the need for increased immersion, possibly in a Virtual Reality (VR) environment. This work constitutes a strong foundation for future research toward real-time, biofeedback-based adaptive systems for OCD exposure therapy.

Authors in the community:

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  M

  Maria Beatriz Dias Correia

  ist1110919

Supervisors of this institution:

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  H

  Hugo Humberto Plácido da Silva

  ist46129

industrial-biotechnology - Industrial Biotechnology

eng - English

Instituto Superior Técnico