Slide
Centre Interdisciplinaire
de Recherche et d’Innovation
en Cybersécurité et Société
de Recherche et d’Innovation
en Cybersécurité et Société
1.
Delangle, M.; Moïse-Richard, A.; Leclercq, A. -L.; Labbé, D.; Bouchard, S.; Andrews, S.; Ménard, L.
Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results Journal Article
In: Journal of Fluency Disorders, vol. 87, 2026, ISSN: 0094730X (ISSN).
Abstract | Links | BibTeX | Tags: Adolescent, adult, Anxiety, Arousal, article, Avatar, avoidance behavior, Canada, Child, clinical article, cognitive behavioral therapy, complication, controlled study, distance learning, ecological validity, electrocardiogram, electrodermal response, exposure, female, Heart Rate, heart rate variability, human, Humans, Liebowitz Social Anxiety Scale, Likert scale, male, nonverbal communication, physiological stress, Pilot Projects, pilot study, procedures, psychology, questionnaire, randomized controlled trial, role playing, School-age children, Self Concept, Self Efficacy, self report, Signal processing, skin conductance, social anxiety, speech, student, Students, Stuttering, Therapy, treatment outcome, virtual reality, virtual reality exposure therapy
@article{delangle_speaking_2026,
title = {Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results},
author = {M. Delangle and A. Moïse-Richard and A. -L. Leclercq and D. Labbé and S. Bouchard and S. Andrews and L. Ménard},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105028302364&doi=10.1016%2Fj.jfludis.2026.106194&partnerID=40&md5=af0d246f9187ee19796f36456887400b},
doi = {10.1016/j.jfludis.2026.106194},
issn = {0094730X (ISSN)},
year = {2026},
date = {2026-01-01},
journal = {Journal of Fluency Disorders},
volume = {87},
abstract = {Purpose Speaking in class is challenging for students who stutter. Cognitive-behavioral therapy (CBT) with exposure in virtual reality (VR) emerges as a promising intervention for treating speaking anxiety in pediatric populations. This pilot study tested if real-time avatar-based VR can elicit anxiety responses while remaining acceptable to youth who stutter. Method Twelve students who stutter (aged 9–18) were randomly assigned to a single training session conducted either (1) in VR with a realistic avatar controlled live by their SLP, or (2) in role-play with their SLP, before facing a real actor. We assessed system acceptability, anxiety levels and perceived self-efficacy. Results The VR system was well accepted and elicited physiological arousal comparable to real-life interactions. Although participants reported experiencing less anxiety during VR, skin conductance level showed higher arousal; suggesting a divergence between the subjective report and physiological response. Finally, one training session (either in VR or with the SLP) did not produce gains in self-efficacy or decrease in anxiety related to the final real-actor conversation. Conclusion This study demonstrates evidence that the potential use of immersive VR could represent an acceptable and viable complementary strategy for SLP treatment, that could control exposure parameters while evoking physiological responses similar to real-life contexts. The differences between subjective and physiological measures suggest that VR is inducing anxiety responses differently than it was perceived. Further research could investigate the use of VR as anxiety interventions for students who stutter and should be explored across multi-session studies to understand their therapeutic effect. © 2026 The Authors.},
keywords = {Adolescent, adult, Anxiety, Arousal, article, Avatar, avoidance behavior, Canada, Child, clinical article, cognitive behavioral therapy, complication, controlled study, distance learning, ecological validity, electrocardiogram, electrodermal response, exposure, female, Heart Rate, heart rate variability, human, Humans, Liebowitz Social Anxiety Scale, Likert scale, male, nonverbal communication, physiological stress, Pilot Projects, pilot study, procedures, psychology, questionnaire, randomized controlled trial, role playing, School-age children, Self Concept, Self Efficacy, self report, Signal processing, skin conductance, social anxiety, speech, student, Students, Stuttering, Therapy, treatment outcome, virtual reality, virtual reality exposure therapy},
pubstate = {published},
tppubtype = {article}
}
Purpose Speaking in class is challenging for students who stutter. Cognitive-behavioral therapy (CBT) with exposure in virtual reality (VR) emerges as a promising intervention for treating speaking anxiety in pediatric populations. This pilot study tested if real-time avatar-based VR can elicit anxiety responses while remaining acceptable to youth who stutter. Method Twelve students who stutter (aged 9–18) were randomly assigned to a single training session conducted either (1) in VR with a realistic avatar controlled live by their SLP, or (2) in role-play with their SLP, before facing a real actor. We assessed system acceptability, anxiety levels and perceived self-efficacy. Results The VR system was well accepted and elicited physiological arousal comparable to real-life interactions. Although participants reported experiencing less anxiety during VR, skin conductance level showed higher arousal; suggesting a divergence between the subjective report and physiological response. Finally, one training session (either in VR or with the SLP) did not produce gains in self-efficacy or decrease in anxiety related to the final real-actor conversation. Conclusion This study demonstrates evidence that the potential use of immersive VR could represent an acceptable and viable complementary strategy for SLP treatment, that could control exposure parameters while evoking physiological responses similar to real-life contexts. The differences between subjective and physiological measures suggest that VR is inducing anxiety responses differently than it was perceived. Further research could investigate the use of VR as anxiety interventions for students who stutter and should be explored across multi-session studies to understand their therapeutic effect. © 2026 The Authors.
2.
Delangle, M.; Moïse-Richard, A.; Leclercq, A. -L.; Labbé, D.; Bouchard, S.; Andrews, S.; Ménard, L.
Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results Journal Article
In: Journal of Fluency Disorders, vol. 87, 2026, ISSN: 0094730X (ISSN).
Abstract | Links | BibTeX | Tags: Adolescent, adult, Anxiety, Arousal, article, Avatar, avoidance behavior, Canada, Child, clinical article, cognitive behavioral therapy, complication, controlled study, distance learning, ecological validity, electrocardiogram, electrodermal response, exposure, female, Heart Rate, heart rate variability, human, Humans, Liebowitz Social Anxiety Scale, Likert scale, male, nonverbal communication, physiological stress, Pilot Projects, pilot study, procedures, psychology, questionnaire, randomized controlled trial, role playing, School-age children, Self Concept, Self Efficacy, self report, Signal processing, skin conductance, social anxiety, speech, student, Students, Stuttering, Therapy, treatment outcome, virtual reality, virtual reality exposure therapy
@article{delangleSpeakingFacetofaceVirtual2026,
title = {Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results},
author = {M. Delangle and A. Moïse-Richard and A. -L. Leclercq and D. Labbé and S. Bouchard and S. Andrews and L. Ménard},
url = {https://www.scopus.com/pages/publications/105028302364?origin=resultslist},
doi = {10.1016/j.jfludis.2026.106194},
issn = {0094730X (ISSN)},
year = {2026},
date = {2026-01-01},
journal = {Journal of Fluency Disorders},
volume = {87},
publisher = {Elsevier Inc.},
abstract = {Purpose Speaking in class is challenging for students who stutter. Cognitive-behavioral therapy (CBT) with exposure in virtual reality (VR) emerges as a promising intervention for treating speaking anxiety in pediatric populations. This pilot study tested if real-time avatar-based VR can elicit anxiety responses while remaining acceptable to youth who stutter. Method Twelve students who stutter (aged 9–18) were randomly assigned to a single training session conducted either (1) in VR with a realistic avatar controlled live by their SLP, or (2) in role-play with their SLP, before facing a real actor. We assessed system acceptability, anxiety levels and perceived self-efficacy. Results The VR system was well accepted and elicited physiological arousal comparable to real-life interactions. Although participants reported experiencing less anxiety during VR, skin conductance level showed higher arousal; suggesting a divergence between the subjective report and physiological response. Finally, one training session (either in VR or with the SLP) did not produce gains in self-efficacy or decrease in anxiety related to the final real-actor conversation. Conclusion This study demonstrates evidence that the potential use of immersive VR could represent an acceptable and viable complementary strategy for SLP treatment, that could control exposure parameters while evoking physiological responses similar to real-life contexts. The differences between subjective and physiological measures suggest that VR is inducing anxiety responses differently than it was perceived. Further research could investigate the use of VR as anxiety interventions for students who stutter and should be explored across multi-session studies to understand their therapeutic effect. © 2026 The Authors.},
keywords = {Adolescent, adult, Anxiety, Arousal, article, Avatar, avoidance behavior, Canada, Child, clinical article, cognitive behavioral therapy, complication, controlled study, distance learning, ecological validity, electrocardiogram, electrodermal response, exposure, female, Heart Rate, heart rate variability, human, Humans, Liebowitz Social Anxiety Scale, Likert scale, male, nonverbal communication, physiological stress, Pilot Projects, pilot study, procedures, psychology, questionnaire, randomized controlled trial, role playing, School-age children, Self Concept, Self Efficacy, self report, Signal processing, skin conductance, social anxiety, speech, student, Students, Stuttering, Therapy, treatment outcome, virtual reality, virtual reality exposure therapy},
pubstate = {published},
tppubtype = {article}
}
Purpose Speaking in class is challenging for students who stutter. Cognitive-behavioral therapy (CBT) with exposure in virtual reality (VR) emerges as a promising intervention for treating speaking anxiety in pediatric populations. This pilot study tested if real-time avatar-based VR can elicit anxiety responses while remaining acceptable to youth who stutter. Method Twelve students who stutter (aged 9–18) were randomly assigned to a single training session conducted either (1) in VR with a realistic avatar controlled live by their SLP, or (2) in role-play with their SLP, before facing a real actor. We assessed system acceptability, anxiety levels and perceived self-efficacy. Results The VR system was well accepted and elicited physiological arousal comparable to real-life interactions. Although participants reported experiencing less anxiety during VR, skin conductance level showed higher arousal; suggesting a divergence between the subjective report and physiological response. Finally, one training session (either in VR or with the SLP) did not produce gains in self-efficacy or decrease in anxiety related to the final real-actor conversation. Conclusion This study demonstrates evidence that the potential use of immersive VR could represent an acceptable and viable complementary strategy for SLP treatment, that could control exposure parameters while evoking physiological responses similar to real-life contexts. The differences between subjective and physiological measures suggest that VR is inducing anxiety responses differently than it was perceived. Further research could investigate the use of VR as anxiety interventions for students who stutter and should be explored across multi-session studies to understand their therapeutic effect. © 2026 The Authors.
3.
Delangle, M.; Moïse-Richard, A.; Leclercq, A. -L.; Labbé, D.; Bouchard, S.; Andrews, S.; Ménard, L.
Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results Journal Article
In: Journal of Fluency Disorders, vol. 87, 2026, ISSN: 0094730X (ISSN).
Abstract | Links | BibTeX | Tags: Adolescent, adult, Anxiety, Arousal, article, Avatar, avoidance behavior, Canada, Child, clinical article, cognitive behavioral therapy, complication, controlled study, distance learning, ecological validity, electrocardiogram, electrodermal response, exposure, female, Heart Rate, heart rate variability, human, Humans, Liebowitz Social Anxiety Scale, Likert scale, male, nonverbal communication, physiological stress, Pilot Projects, pilot study, procedures, psychology, questionnaire, randomized controlled trial, role playing, School-age children, Self Concept, Self Efficacy, self report, Signal processing, skin conductance, social anxiety, speech, student, Students, Stuttering, Therapy, treatment outcome, virtual reality, virtual reality exposure therapy
@article{delangleSpeakingFacetofaceVirtual2026a,
title = {Speaking face-to-face with a virtual avatar to reduce anxiety in students who stutter: Tool development and pilot study results},
author = {M. Delangle and A. Moïse-Richard and A. -L. Leclercq and D. Labbé and S. Bouchard and S. Andrews and L. Ménard},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105028302364&doi=10.1016%2Fj.jfludis.2026.106194&partnerID=40&md5=af0d246f9187ee19796f36456887400b},
doi = {10.1016/j.jfludis.2026.106194},
issn = {0094730X (ISSN)},
year = {2026},
date = {2026-01-01},
journal = {Journal of Fluency Disorders},
volume = {87},
abstract = {Purpose Speaking in class is challenging for students who stutter. Cognitive-behavioral therapy (CBT) with exposure in virtual reality (VR) emerges as a promising intervention for treating speaking anxiety in pediatric populations. This pilot study tested if real-time avatar-based VR can elicit anxiety responses while remaining acceptable to youth who stutter. Method Twelve students who stutter (aged 9–18) were randomly assigned to a single training session conducted either (1) in VR with a realistic avatar controlled live by their SLP, or (2) in role-play with their SLP, before facing a real actor. We assessed system acceptability, anxiety levels and perceived self-efficacy. Results The VR system was well accepted and elicited physiological arousal comparable to real-life interactions. Although participants reported experiencing less anxiety during VR, skin conductance level showed higher arousal; suggesting a divergence between the subjective report and physiological response. Finally, one training session (either in VR or with the SLP) did not produce gains in self-efficacy or decrease in anxiety related to the final real-actor conversation. Conclusion This study demonstrates evidence that the potential use of immersive VR could represent an acceptable and viable complementary strategy for SLP treatment, that could control exposure parameters while evoking physiological responses similar to real-life contexts. The differences between subjective and physiological measures suggest that VR is inducing anxiety responses differently than it was perceived. Further research could investigate the use of VR as anxiety interventions for students who stutter and should be explored across multi-session studies to understand their therapeutic effect. © 2026 The Authors.},
keywords = {Adolescent, adult, Anxiety, Arousal, article, Avatar, avoidance behavior, Canada, Child, clinical article, cognitive behavioral therapy, complication, controlled study, distance learning, ecological validity, electrocardiogram, electrodermal response, exposure, female, Heart Rate, heart rate variability, human, Humans, Liebowitz Social Anxiety Scale, Likert scale, male, nonverbal communication, physiological stress, Pilot Projects, pilot study, procedures, psychology, questionnaire, randomized controlled trial, role playing, School-age children, Self Concept, Self Efficacy, self report, Signal processing, skin conductance, social anxiety, speech, student, Students, Stuttering, Therapy, treatment outcome, virtual reality, virtual reality exposure therapy},
pubstate = {published},
tppubtype = {article}
}
Purpose Speaking in class is challenging for students who stutter. Cognitive-behavioral therapy (CBT) with exposure in virtual reality (VR) emerges as a promising intervention for treating speaking anxiety in pediatric populations. This pilot study tested if real-time avatar-based VR can elicit anxiety responses while remaining acceptable to youth who stutter. Method Twelve students who stutter (aged 9–18) were randomly assigned to a single training session conducted either (1) in VR with a realistic avatar controlled live by their SLP, or (2) in role-play with their SLP, before facing a real actor. We assessed system acceptability, anxiety levels and perceived self-efficacy. Results The VR system was well accepted and elicited physiological arousal comparable to real-life interactions. Although participants reported experiencing less anxiety during VR, skin conductance level showed higher arousal; suggesting a divergence between the subjective report and physiological response. Finally, one training session (either in VR or with the SLP) did not produce gains in self-efficacy or decrease in anxiety related to the final real-actor conversation. Conclusion This study demonstrates evidence that the potential use of immersive VR could represent an acceptable and viable complementary strategy for SLP treatment, that could control exposure parameters while evoking physiological responses similar to real-life contexts. The differences between subjective and physiological measures suggest that VR is inducing anxiety responses differently than it was perceived. Further research could investigate the use of VR as anxiety interventions for students who stutter and should be explored across multi-session studies to understand their therapeutic effect. © 2026 The Authors.
4.
António, H.; Barros, C.; de Castro, M. Vieira; Oliveira, J.; Gamito, P.; Bouchard, S.; Pinto, R. J.
Posttraumatic stress disorder and Physiological Response in First Responders During Virtual Reality Exposure Journal Article
In: Cyberpsychology, Behavior, and Social Networking, 2025, ISSN: 21522715 (ISSN).
Abstract | Links | BibTeX | Tags: adult, electrodermal response, Emergency Responders, female, first responders, Galvanic Skin Response, Heart Rate, human, Humans, male, Middle Aged, pathophysiology, physiological response, physiology, Post-Traumatic, posttraumatic stress disorder, posttraumatic stress disorder (PTSD), psychology, questionnaire, rescue personnel, skin conductance, Stress Disorders, Surveys and Questionnaires, virtual reality, virtual reality exposure therapy, Young Adult
@article{antonio_posttraumatic_2025,
title = {Posttraumatic stress disorder and Physiological Response in First Responders During Virtual Reality Exposure},
author = {H. António and C. Barros and M. Vieira de Castro and J. Oliveira and P. Gamito and S. Bouchard and R. J. Pinto},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105023876769&doi=10.1177%2F21522715251394917&partnerID=40&md5=c3c071b02ee24bd37789dfd06a936fbd},
doi = {10.1177/21522715251394917},
issn = {21522715 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {Cyberpsychology, Behavior, and Social Networking},
abstract = {First responders (FRs) are routinely exposed to traumatic events, increasing risk for posttraumatic stress disorder (PTSD). This study compared heart rate variability (HRV) and skin conductance level (SCL) between FRs with and without probable PTSD at baseline and during a virtual reality (VR) task. Eighty-four FRs completed questionnaires and physiological assessments. Participants with probable PTSD showed significantly lower baseline HRV, indicating reduced parasympathetic modulation. No group differences emerged for HRV during VR or for SCL at either point. The results confirm reduced HRV at rest in PTSD, but further work is needed to clarify why this difference was not observed during the task and why SCL showed no group effects. To advance understanding of these results, future studies should include larger samples, longer baselines, recovery phases, and clinical interviews. © 2025 Mary Ann Liebert, (NY) LLC.},
keywords = {adult, electrodermal response, Emergency Responders, female, first responders, Galvanic Skin Response, Heart Rate, human, Humans, male, Middle Aged, pathophysiology, physiological response, physiology, Post-Traumatic, posttraumatic stress disorder, posttraumatic stress disorder (PTSD), psychology, questionnaire, rescue personnel, skin conductance, Stress Disorders, Surveys and Questionnaires, virtual reality, virtual reality exposure therapy, Young Adult},
pubstate = {published},
tppubtype = {article}
}
First responders (FRs) are routinely exposed to traumatic events, increasing risk for posttraumatic stress disorder (PTSD). This study compared heart rate variability (HRV) and skin conductance level (SCL) between FRs with and without probable PTSD at baseline and during a virtual reality (VR) task. Eighty-four FRs completed questionnaires and physiological assessments. Participants with probable PTSD showed significantly lower baseline HRV, indicating reduced parasympathetic modulation. No group differences emerged for HRV during VR or for SCL at either point. The results confirm reduced HRV at rest in PTSD, but further work is needed to clarify why this difference was not observed during the task and why SCL showed no group effects. To advance understanding of these results, future studies should include larger samples, longer baselines, recovery phases, and clinical interviews. © 2025 Mary Ann Liebert, (NY) LLC.
5.
Onita, C. A.; Matei, D. -V.; Trandafir, L. -M.; Petrescu-Miron, D.; Corciova, C.; Fuior, R.; Manole, L. -M.; Mihai, B. -M.; Dascalu, C. -G.; Tarcea, M.; Bouchard, S.; Mocanu, V.
In: Nutrients, vol. 17, no. 15, 2025, ISSN: 20726643 (ISSN).
Abstract | Links | BibTeX | Tags: Adolescent, adolescent obesity, alpha amylase saliva isoenzyme, alpha-Amylases, amylase, anthropometry, anxiety assessment, appetite, article, Autonomic Nervous System, autonomic nervous system function, chemistry, Child, childhood obesity, clinical article, controlled study, craving, eating behavior, Electrophysiology, emotional eating, emotional stress, exploratory factor analysis, Factor Analysis, feeding behavior, female, Heart Rate, heart rate variability, human, Humans, Hydrocortisone, hypothalamus hypophysis adrenal system, immersive VR game, male, mental stress, metabolism, neuroendocrine system, Neurosecretory Systems, pathophysiology, Pediatric Obesity, physiology, Psychological, psychology, Saliva, salivary alpha-amylase, salivary cortisol, social stress, Statistical, Stress, stress assessment, subjective stress, three-factor eating questionnaire (TFEQ), Three-Factor-Eating-Questionnaire, video game, Video Games, virtual reality, virtual reality exposure therapy, visual analog scale
@article{onita_autonomic_2025,
title = {Autonomic and Neuroendocrine Reactivity to VR Game Exposure in Children and Adolescents with Obesity: A Factor Analytic Approach to Physiological Reactivity and Eating Behavior},
author = {C. A. Onita and D. -V. Matei and L. -M. Trandafir and D. Petrescu-Miron and C. Corciova and R. Fuior and L. -M. Manole and B. -M. Mihai and C. -G. Dascalu and M. Tarcea and S. Bouchard and V. Mocanu},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105013574948&doi=10.3390%2Fnu17152492&partnerID=40&md5=d1e974dae00d424b9f6fae86b8a7cc6a},
doi = {10.3390/nu17152492},
issn = {20726643 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {Nutrients},
volume = {17},
number = {15},
abstract = {Background/Objectives: The aim was to identify patterns of autonomic and neuroendocrine reactivity to an immersive virtual reality (VR) social-emotional stressor and explore their associations with perceived stress and eating behavior. Methods: This one-group pretest–posttest study included 30 children and adolescents with obesity (15 boys and 15 girls), aged 8 to 17 years. The VR protocol consisted of two consecutive phases: a 5 min relaxation phase using the Forest application and a 5 min stimulation phase using a cognitively engaging VR game designed to elicit social-emotional stress. Physiological responses were measured using heart rate variability (HRV) indices and salivary stress biomarkers, including cortisol and alpha amylase. Subjective stress and eating responses were assessed via visual analogue scales (VAS) administered immediately post-exposure. The Three-Factor Eating Questionnaire (TFEQ-R21C) was used to evaluate cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). Results: The cortisol reactivity was blunted and may reflect both the attenuated HPA axis responsiveness characteristic of pediatric obesity and the moderate psychological challenge of the VR stressor used in this study. Two distinct autonomic response patterns were identified via exploratory factor analysis: (1) parasympathetic reactivity, associated with increased RMSSD and SDNN and decreased LF/HF, and (2) sympathetic activation, associated with increased heart rate and alpha-amylase levels and reduced RR intervals. Parasympathetic reactivity was correlated with lower perceived stress and anxiety, but also paradoxically with higher uncontrolled eating (UE). In contrast, sympathetic activation was associated with greater cognitive restraint (CR) and higher anxiety ratings. Conclusions: This study demonstrates that immersive VR game exposure elicits measurable autonomic and subjective stress responses in children and adolescents with obesity, and that individual differences in physiological reactivity are relevantly associated with eating behavior traits. The findings suggest that parasympathetic and sympathetic profiles may represent distinct behavioral patterns with implications for targeted intervention. © 2025 by the authors.},
keywords = {Adolescent, adolescent obesity, alpha amylase saliva isoenzyme, alpha-Amylases, amylase, anthropometry, anxiety assessment, appetite, article, Autonomic Nervous System, autonomic nervous system function, chemistry, Child, childhood obesity, clinical article, controlled study, craving, eating behavior, Electrophysiology, emotional eating, emotional stress, exploratory factor analysis, Factor Analysis, feeding behavior, female, Heart Rate, heart rate variability, human, Humans, Hydrocortisone, hypothalamus hypophysis adrenal system, immersive VR game, male, mental stress, metabolism, neuroendocrine system, Neurosecretory Systems, pathophysiology, Pediatric Obesity, physiology, Psychological, psychology, Saliva, salivary alpha-amylase, salivary cortisol, social stress, Statistical, Stress, stress assessment, subjective stress, three-factor eating questionnaire (TFEQ), Three-Factor-Eating-Questionnaire, video game, Video Games, virtual reality, virtual reality exposure therapy, visual analog scale},
pubstate = {published},
tppubtype = {article}
}
Background/Objectives: The aim was to identify patterns of autonomic and neuroendocrine reactivity to an immersive virtual reality (VR) social-emotional stressor and explore their associations with perceived stress and eating behavior. Methods: This one-group pretest–posttest study included 30 children and adolescents with obesity (15 boys and 15 girls), aged 8 to 17 years. The VR protocol consisted of two consecutive phases: a 5 min relaxation phase using the Forest application and a 5 min stimulation phase using a cognitively engaging VR game designed to elicit social-emotional stress. Physiological responses were measured using heart rate variability (HRV) indices and salivary stress biomarkers, including cortisol and alpha amylase. Subjective stress and eating responses were assessed via visual analogue scales (VAS) administered immediately post-exposure. The Three-Factor Eating Questionnaire (TFEQ-R21C) was used to evaluate cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). Results: The cortisol reactivity was blunted and may reflect both the attenuated HPA axis responsiveness characteristic of pediatric obesity and the moderate psychological challenge of the VR stressor used in this study. Two distinct autonomic response patterns were identified via exploratory factor analysis: (1) parasympathetic reactivity, associated with increased RMSSD and SDNN and decreased LF/HF, and (2) sympathetic activation, associated with increased heart rate and alpha-amylase levels and reduced RR intervals. Parasympathetic reactivity was correlated with lower perceived stress and anxiety, but also paradoxically with higher uncontrolled eating (UE). In contrast, sympathetic activation was associated with greater cognitive restraint (CR) and higher anxiety ratings. Conclusions: This study demonstrates that immersive VR game exposure elicits measurable autonomic and subjective stress responses in children and adolescents with obesity, and that individual differences in physiological reactivity are relevantly associated with eating behavior traits. The findings suggest that parasympathetic and sympathetic profiles may represent distinct behavioral patterns with implications for targeted intervention. © 2025 by the authors.
6.
António, H.; Barros, C.; de Castro, M. Vieira; Oliveira, J.; Gamito, P.; Bouchard, S.; Pinto, R. J.
Posttraumatic Stress Disorder and Physiological Response in First Responders During Virtual Reality Exposure Journal Article
In: Cyberpsychology, Behavior, and Social Networking, vol. 28, no. 12, pp. 787–793, 2025, ISSN: 21522715 (ISSN).
Abstract | Links | BibTeX | Tags: adult, electrodermal response, Emergency Responders, female, first responders, Galvanic Skin Response, Heart Rate, human, Humans, male, Middle Aged, pathophysiology, physiological response, physiology, Post-Traumatic, posttraumatic stress disorder, posttraumatic stress disorder (PTSD), psychology, questionnaire, rescue personnel, skin conductance, Stress Disorders, Surveys and Questionnaires, virtual reality, virtual reality exposure therapy, Young Adult
@article{antonioPosttraumaticStressDisorder2025,
title = {Posttraumatic Stress Disorder and Physiological Response in First Responders During Virtual Reality Exposure},
author = {H. António and C. Barros and M. Vieira de Castro and J. Oliveira and P. Gamito and S. Bouchard and R. J. Pinto},
url = {https://www.scopus.com/pages/publications/105023876769?origin=resultslist},
doi = {10.1177/21522715251394917},
issn = {21522715 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {Cyberpsychology, Behavior, and Social Networking},
volume = {28},
number = {12},
pages = {787–793},
publisher = {SAGE Publications Ltd},
abstract = {First responders (FRs) are routinely exposed to traumatic events, increasing risk for posttraumatic stress disorder (PTSD). This study compared heart rate variability (HRV) and skin conductance level (SCL) between FRs with and without probable PTSD at baseline and during a virtual reality (VR) task. Eighty-four FRs completed questionnaires and physiological assessments. Participants with probable PTSD showed significantly lower baseline HRV, indicating reduced parasympathetic modulation. No group differences emerged for HRV during VR or for SCL at either point. The results confirm reduced HRV at rest in PTSD, but further work is needed to clarify why this difference was not observed during the task and why SCL showed no group effects. To advance understanding of these results, future studies should include larger samples, longer baselines, recovery phases, and clinical interviews. © 2025 SAGE Publications.},
keywords = {adult, electrodermal response, Emergency Responders, female, first responders, Galvanic Skin Response, Heart Rate, human, Humans, male, Middle Aged, pathophysiology, physiological response, physiology, Post-Traumatic, posttraumatic stress disorder, posttraumatic stress disorder (PTSD), psychology, questionnaire, rescue personnel, skin conductance, Stress Disorders, Surveys and Questionnaires, virtual reality, virtual reality exposure therapy, Young Adult},
pubstate = {published},
tppubtype = {article}
}
First responders (FRs) are routinely exposed to traumatic events, increasing risk for posttraumatic stress disorder (PTSD). This study compared heart rate variability (HRV) and skin conductance level (SCL) between FRs with and without probable PTSD at baseline and during a virtual reality (VR) task. Eighty-four FRs completed questionnaires and physiological assessments. Participants with probable PTSD showed significantly lower baseline HRV, indicating reduced parasympathetic modulation. No group differences emerged for HRV during VR or for SCL at either point. The results confirm reduced HRV at rest in PTSD, but further work is needed to clarify why this difference was not observed during the task and why SCL showed no group effects. To advance understanding of these results, future studies should include larger samples, longer baselines, recovery phases, and clinical interviews. © 2025 SAGE Publications.
7.
Onita, C. A.; Matei, D. -V.; Trandafir, L. -M.; Petrescu-Miron, D.; Corciova, C.; Fuior, R.; Manole, L. -M.; Mihai, B. -M.; Dascalu, C. -G.; Tarcea, M.; Bouchard, S.; Mocanu, V.
In: Nutrients, vol. 17, no. 15, 2025, ISSN: 20726643 (ISSN).
Abstract | Links | BibTeX | Tags: Adolescent, adolescent obesity, alpha amylase saliva isoenzyme, alpha-Amylases, amylase, anthropometry, anxiety assessment, appetite, article, Autonomic Nervous System, autonomic nervous system function, chemistry, Child, childhood obesity, clinical article, controlled study, craving, eating behavior, Electrophysiology, emotional eating, emotional stress, exploratory factor analysis, Factor Analysis, feeding behavior, female, Heart Rate, heart rate variability, human, Humans, Hydrocortisone, hypothalamus hypophysis adrenal system, immersive VR game, male, mental stress, metabolism, neuroendocrine system, Neurosecretory Systems, pathophysiology, Pediatric Obesity, physiology, Psychological, psychology, Saliva, salivary alpha-amylase, salivary cortisol, social stress, Statistical, Stress, stress assessment, subjective stress, three-factor eating questionnaire (TFEQ), Three-Factor-Eating-Questionnaire, video game, Video Games, virtual reality, virtual reality exposure therapy, visual analog scale
@article{onitaAutonomicNeuroendocrineReactivity2025,
title = {Autonomic and Neuroendocrine Reactivity to VR Game Exposure in Children and Adolescents with Obesity: A Factor Analytic Approach to Physiological Reactivity and Eating Behavior},
author = {C. A. Onita and D. -V. Matei and L. -M. Trandafir and D. Petrescu-Miron and C. Corciova and R. Fuior and L. -M. Manole and B. -M. Mihai and C. -G. Dascalu and M. Tarcea and S. Bouchard and V. Mocanu},
url = {https://www.scopus.com/pages/publications/105013574948?origin=resultslist},
doi = {10.3390/nu17152492},
issn = {20726643 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {Nutrients},
volume = {17},
number = {15},
publisher = {Multidisciplinary Digital Publishing Institute (MDPI)},
abstract = {Background/Objectives: The aim was to identify patterns of autonomic and neuroendocrine reactivity to an immersive virtual reality (VR) social-emotional stressor and explore their associations with perceived stress and eating behavior. Methods: This one-group pretest–posttest study included 30 children and adolescents with obesity (15 boys and 15 girls), aged 8 to 17 years. The VR protocol consisted of two consecutive phases: a 5 min relaxation phase using the Forest application and a 5 min stimulation phase using a cognitively engaging VR game designed to elicit social-emotional stress. Physiological responses were measured using heart rate variability (HRV) indices and salivary stress biomarkers, including cortisol and alpha amylase. Subjective stress and eating responses were assessed via visual analogue scales (VAS) administered immediately post-exposure. The Three-Factor Eating Questionnaire (TFEQ-R21C) was used to evaluate cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). Results: The cortisol reactivity was blunted and may reflect both the attenuated HPA axis responsiveness characteristic of pediatric obesity and the moderate psychological challenge of the VR stressor used in this study. Two distinct autonomic response patterns were identified via exploratory factor analysis: (1) parasympathetic reactivity, associated with increased RMSSD and SDNN and decreased LF/HF, and (2) sympathetic activation, associated with increased heart rate and alpha-amylase levels and reduced RR intervals. Parasympathetic reactivity was correlated with lower perceived stress and anxiety, but also paradoxically with higher uncontrolled eating (UE). In contrast, sympathetic activation was associated with greater cognitive restraint (CR) and higher anxiety ratings. Conclusions: This study demonstrates that immersive VR game exposure elicits measurable autonomic and subjective stress responses in children and adolescents with obesity, and that individual differences in physiological reactivity are relevantly associated with eating behavior traits. The findings suggest that parasympathetic and sympathetic profiles may represent distinct behavioral patterns with implications for targeted intervention. © 2025 by the authors.},
keywords = {Adolescent, adolescent obesity, alpha amylase saliva isoenzyme, alpha-Amylases, amylase, anthropometry, anxiety assessment, appetite, article, Autonomic Nervous System, autonomic nervous system function, chemistry, Child, childhood obesity, clinical article, controlled study, craving, eating behavior, Electrophysiology, emotional eating, emotional stress, exploratory factor analysis, Factor Analysis, feeding behavior, female, Heart Rate, heart rate variability, human, Humans, Hydrocortisone, hypothalamus hypophysis adrenal system, immersive VR game, male, mental stress, metabolism, neuroendocrine system, Neurosecretory Systems, pathophysiology, Pediatric Obesity, physiology, Psychological, psychology, Saliva, salivary alpha-amylase, salivary cortisol, social stress, Statistical, Stress, stress assessment, subjective stress, three-factor eating questionnaire (TFEQ), Three-Factor-Eating-Questionnaire, video game, Video Games, virtual reality, virtual reality exposure therapy, visual analog scale},
pubstate = {published},
tppubtype = {article}
}
Background/Objectives: The aim was to identify patterns of autonomic and neuroendocrine reactivity to an immersive virtual reality (VR) social-emotional stressor and explore their associations with perceived stress and eating behavior. Methods: This one-group pretest–posttest study included 30 children and adolescents with obesity (15 boys and 15 girls), aged 8 to 17 years. The VR protocol consisted of two consecutive phases: a 5 min relaxation phase using the Forest application and a 5 min stimulation phase using a cognitively engaging VR game designed to elicit social-emotional stress. Physiological responses were measured using heart rate variability (HRV) indices and salivary stress biomarkers, including cortisol and alpha amylase. Subjective stress and eating responses were assessed via visual analogue scales (VAS) administered immediately post-exposure. The Three-Factor Eating Questionnaire (TFEQ-R21C) was used to evaluate cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). Results: The cortisol reactivity was blunted and may reflect both the attenuated HPA axis responsiveness characteristic of pediatric obesity and the moderate psychological challenge of the VR stressor used in this study. Two distinct autonomic response patterns were identified via exploratory factor analysis: (1) parasympathetic reactivity, associated with increased RMSSD and SDNN and decreased LF/HF, and (2) sympathetic activation, associated with increased heart rate and alpha-amylase levels and reduced RR intervals. Parasympathetic reactivity was correlated with lower perceived stress and anxiety, but also paradoxically with higher uncontrolled eating (UE). In contrast, sympathetic activation was associated with greater cognitive restraint (CR) and higher anxiety ratings. Conclusions: This study demonstrates that immersive VR game exposure elicits measurable autonomic and subjective stress responses in children and adolescents with obesity, and that individual differences in physiological reactivity are relevantly associated with eating behavior traits. The findings suggest that parasympathetic and sympathetic profiles may represent distinct behavioral patterns with implications for targeted intervention. © 2025 by the authors.
8.
António, H.; Barros, C.; de Castro, M. Vieira; Oliveira, J.; Gamito, P.; Bouchard, S.; Pinto, R. J.
Posttraumatic stress disorder and Physiological Response in First Responders During Virtual Reality Exposure Journal Article
In: Cyberpsychology, Behavior, and Social Networking, 2025, ISSN: 21522715 (ISSN).
Abstract | Links | BibTeX | Tags: adult, electrodermal response, Emergency Responders, female, first responders, Galvanic Skin Response, Heart Rate, human, Humans, male, Middle Aged, pathophysiology, physiological response, physiology, Post-Traumatic, posttraumatic stress disorder, posttraumatic stress disorder (PTSD), psychology, questionnaire, rescue personnel, skin conductance, Stress Disorders, Surveys and Questionnaires, virtual reality, virtual reality exposure therapy, Young Adult
@article{antonioPosttraumaticStressDisorder2025a,
title = {Posttraumatic stress disorder and Physiological Response in First Responders During Virtual Reality Exposure},
author = {H. António and C. Barros and M. Vieira de Castro and J. Oliveira and P. Gamito and S. Bouchard and R. J. Pinto},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105023876769&doi=10.1177%2F21522715251394917&partnerID=40&md5=c3c071b02ee24bd37789dfd06a936fbd},
doi = {10.1177/21522715251394917},
issn = {21522715 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {Cyberpsychology, Behavior, and Social Networking},
abstract = {First responders (FRs) are routinely exposed to traumatic events, increasing risk for posttraumatic stress disorder (PTSD). This study compared heart rate variability (HRV) and skin conductance level (SCL) between FRs with and without probable PTSD at baseline and during a virtual reality (VR) task. Eighty-four FRs completed questionnaires and physiological assessments. Participants with probable PTSD showed significantly lower baseline HRV, indicating reduced parasympathetic modulation. No group differences emerged for HRV during VR or for SCL at either point. The results confirm reduced HRV at rest in PTSD, but further work is needed to clarify why this difference was not observed during the task and why SCL showed no group effects. To advance understanding of these results, future studies should include larger samples, longer baselines, recovery phases, and clinical interviews. © 2025 Mary Ann Liebert, (NY) LLC.},
keywords = {adult, electrodermal response, Emergency Responders, female, first responders, Galvanic Skin Response, Heart Rate, human, Humans, male, Middle Aged, pathophysiology, physiological response, physiology, Post-Traumatic, posttraumatic stress disorder, posttraumatic stress disorder (PTSD), psychology, questionnaire, rescue personnel, skin conductance, Stress Disorders, Surveys and Questionnaires, virtual reality, virtual reality exposure therapy, Young Adult},
pubstate = {published},
tppubtype = {article}
}
First responders (FRs) are routinely exposed to traumatic events, increasing risk for posttraumatic stress disorder (PTSD). This study compared heart rate variability (HRV) and skin conductance level (SCL) between FRs with and without probable PTSD at baseline and during a virtual reality (VR) task. Eighty-four FRs completed questionnaires and physiological assessments. Participants with probable PTSD showed significantly lower baseline HRV, indicating reduced parasympathetic modulation. No group differences emerged for HRV during VR or for SCL at either point. The results confirm reduced HRV at rest in PTSD, but further work is needed to clarify why this difference was not observed during the task and why SCL showed no group effects. To advance understanding of these results, future studies should include larger samples, longer baselines, recovery phases, and clinical interviews. © 2025 Mary Ann Liebert, (NY) LLC.
9.
Onita, C. A.; Matei, D. -V.; Trandafir, L. -M.; Petrescu-Miron, D.; Corciova, C.; Fuior, R.; Manole, L. -M.; Mihai, B. -M.; Dascalu, C. -G.; Tarcea, M.; Bouchard, S.; Mocanu, V.
In: Nutrients, vol. 17, no. 15, 2025, ISSN: 20726643 (ISSN).
Abstract | Links | BibTeX | Tags: Adolescent, adolescent obesity, alpha amylase saliva isoenzyme, alpha-Amylases, amylase, anthropometry, anxiety assessment, appetite, article, Autonomic Nervous System, autonomic nervous system function, chemistry, Child, childhood obesity, clinical article, controlled study, craving, eating behavior, Electrophysiology, emotional eating, emotional stress, exploratory factor analysis, Factor Analysis, feeding behavior, female, Heart Rate, heart rate variability, human, Humans, Hydrocortisone, hypothalamus hypophysis adrenal system, immersive VR game, male, mental stress, metabolism, neuroendocrine system, Neurosecretory Systems, pathophysiology, Pediatric Obesity, physiology, Psychological, psychology, Saliva, salivary alpha-amylase, salivary cortisol, social stress, Statistical, Stress, stress assessment, subjective stress, three-factor eating questionnaire (TFEQ), Three-Factor-Eating-Questionnaire, video game, Video Games, virtual reality, virtual reality exposure therapy, visual analog scale
@article{onitaAutonomicNeuroendocrineReactivity2025a,
title = {Autonomic and Neuroendocrine Reactivity to VR Game Exposure in Children and Adolescents with Obesity: A Factor Analytic Approach to Physiological Reactivity and Eating Behavior},
author = {C. A. Onita and D. -V. Matei and L. -M. Trandafir and D. Petrescu-Miron and C. Corciova and R. Fuior and L. -M. Manole and B. -M. Mihai and C. -G. Dascalu and M. Tarcea and S. Bouchard and V. Mocanu},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105013574948&doi=10.3390%2Fnu17152492&partnerID=40&md5=d1e974dae00d424b9f6fae86b8a7cc6a},
doi = {10.3390/nu17152492},
issn = {20726643 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {Nutrients},
volume = {17},
number = {15},
abstract = {Background/Objectives: The aim was to identify patterns of autonomic and neuroendocrine reactivity to an immersive virtual reality (VR) social-emotional stressor and explore their associations with perceived stress and eating behavior. Methods: This one-group pretest–posttest study included 30 children and adolescents with obesity (15 boys and 15 girls), aged 8 to 17 years. The VR protocol consisted of two consecutive phases: a 5 min relaxation phase using the Forest application and a 5 min stimulation phase using a cognitively engaging VR game designed to elicit social-emotional stress. Physiological responses were measured using heart rate variability (HRV) indices and salivary stress biomarkers, including cortisol and alpha amylase. Subjective stress and eating responses were assessed via visual analogue scales (VAS) administered immediately post-exposure. The Three-Factor Eating Questionnaire (TFEQ-R21C) was used to evaluate cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). Results: The cortisol reactivity was blunted and may reflect both the attenuated HPA axis responsiveness characteristic of pediatric obesity and the moderate psychological challenge of the VR stressor used in this study. Two distinct autonomic response patterns were identified via exploratory factor analysis: (1) parasympathetic reactivity, associated with increased RMSSD and SDNN and decreased LF/HF, and (2) sympathetic activation, associated with increased heart rate and alpha-amylase levels and reduced RR intervals. Parasympathetic reactivity was correlated with lower perceived stress and anxiety, but also paradoxically with higher uncontrolled eating (UE). In contrast, sympathetic activation was associated with greater cognitive restraint (CR) and higher anxiety ratings. Conclusions: This study demonstrates that immersive VR game exposure elicits measurable autonomic and subjective stress responses in children and adolescents with obesity, and that individual differences in physiological reactivity are relevantly associated with eating behavior traits. The findings suggest that parasympathetic and sympathetic profiles may represent distinct behavioral patterns with implications for targeted intervention. © 2025 by the authors.},
keywords = {Adolescent, adolescent obesity, alpha amylase saliva isoenzyme, alpha-Amylases, amylase, anthropometry, anxiety assessment, appetite, article, Autonomic Nervous System, autonomic nervous system function, chemistry, Child, childhood obesity, clinical article, controlled study, craving, eating behavior, Electrophysiology, emotional eating, emotional stress, exploratory factor analysis, Factor Analysis, feeding behavior, female, Heart Rate, heart rate variability, human, Humans, Hydrocortisone, hypothalamus hypophysis adrenal system, immersive VR game, male, mental stress, metabolism, neuroendocrine system, Neurosecretory Systems, pathophysiology, Pediatric Obesity, physiology, Psychological, psychology, Saliva, salivary alpha-amylase, salivary cortisol, social stress, Statistical, Stress, stress assessment, subjective stress, three-factor eating questionnaire (TFEQ), Three-Factor-Eating-Questionnaire, video game, Video Games, virtual reality, virtual reality exposure therapy, visual analog scale},
pubstate = {published},
tppubtype = {article}
}
Background/Objectives: The aim was to identify patterns of autonomic and neuroendocrine reactivity to an immersive virtual reality (VR) social-emotional stressor and explore their associations with perceived stress and eating behavior. Methods: This one-group pretest–posttest study included 30 children and adolescents with obesity (15 boys and 15 girls), aged 8 to 17 years. The VR protocol consisted of two consecutive phases: a 5 min relaxation phase using the Forest application and a 5 min stimulation phase using a cognitively engaging VR game designed to elicit social-emotional stress. Physiological responses were measured using heart rate variability (HRV) indices and salivary stress biomarkers, including cortisol and alpha amylase. Subjective stress and eating responses were assessed via visual analogue scales (VAS) administered immediately post-exposure. The Three-Factor Eating Questionnaire (TFEQ-R21C) was used to evaluate cognitive restraint (CR), uncontrolled eating (UE), and emotional eating (EE). Results: The cortisol reactivity was blunted and may reflect both the attenuated HPA axis responsiveness characteristic of pediatric obesity and the moderate psychological challenge of the VR stressor used in this study. Two distinct autonomic response patterns were identified via exploratory factor analysis: (1) parasympathetic reactivity, associated with increased RMSSD and SDNN and decreased LF/HF, and (2) sympathetic activation, associated with increased heart rate and alpha-amylase levels and reduced RR intervals. Parasympathetic reactivity was correlated with lower perceived stress and anxiety, but also paradoxically with higher uncontrolled eating (UE). In contrast, sympathetic activation was associated with greater cognitive restraint (CR) and higher anxiety ratings. Conclusions: This study demonstrates that immersive VR game exposure elicits measurable autonomic and subjective stress responses in children and adolescents with obesity, and that individual differences in physiological reactivity are relevantly associated with eating behavior traits. The findings suggest that parasympathetic and sympathetic profiles may represent distinct behavioral patterns with implications for targeted intervention. © 2025 by the authors.
10.
Quintana, P.; Bouchard, S.; Botella, C.; Robillard, G.; Serrano, B.; Rodriguez-Ortega, A.; Ernst, M. Torp; Rey, B.; Berthiaume, M.; Corno, G.
In: Journal of Clinical Medicine, vol. 12, no. 13, 2023, ISSN: 20770383 (ISSN), (Publisher: Multidisciplinary Digital Publishing Institute (MDPI)).
Abstract | Links | BibTeX | Tags: adult, anxiety assessment, article, Canada, clinical article, controlled study, cultural differences, ecological validity, exposure, female, generalized social anxiety, human, immersion, male, multicenter study, psychotherapy, self report, social anxiety, social interaction, social phobia, Spain, virtual reality, virtual reality exposure therapy
@article{quintana_engaging_2023,
title = {Engaging in Awkward Social Interactions in a Virtual Environment Designed for Exposure-Based Psychotherapy for People with Generalized Social Anxiety Disorder: An International Multisite Study},
author = {P. Quintana and S. Bouchard and C. Botella and G. Robillard and B. Serrano and A. Rodriguez-Ortega and M. Torp Ernst and B. Rey and M. Berthiaume and G. Corno},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85165033932&doi=10.3390%2fjcm12134525&partnerID=40&md5=7b0f59b46ff7680611d5a64e18909651},
doi = {10.3390/jcm12134525},
issn = {20770383 (ISSN)},
year = {2023},
date = {2023-01-01},
journal = {Journal of Clinical Medicine},
volume = {12},
number = {13},
publisher = {Multidisciplinary Digital Publishing Institute (MDPI)},
abstract = {The effectiveness of in virtuo exposure-based treatment of performance-only social anxiety disorder (SAD) has been demonstrated in several studies. However, few studies have validated virtual environments with participants suffering from generalized SAD. The goal of this study is to confirm the potential of a virtual environment in inducing anxiety in adults suffering from generalized SAD, compared to adults without SAD, when engaged in awkward social interactions. Differences between participants from two different countries were also explored. The sample consisted of 15 participants with SAD from Canada, 17 participants without SAD from Canada, 16 participants with SAD from Spain, and 21 participants without SAD from Spain. All participants were immersed in a control virtual environment and in an experimental virtual environment considered potentially anxiety-inducing for individuals with generalized SAD. As hypothesized, results showed that the experimental virtual environment induced a higher level of anxiety than the control environment among participants with SAD compared to those without SAD. The impact on anxiety of each socially threatening task performed during the experimental immersion was statistically significant. In terms of anxiety responses, no significant differences were found between participants from Canada and Spain. However, spatial presence and ecological validity were higher in Canadians than in Spaniards. Unwanted negative side effects induced by immersions in virtual reality were higher in the SAD group. This study highlights the importance for therapists to engage people with SAD in clinically relevant tasks while immersed in VR psychotherapeutic applications. © 2023 by the authors.},
note = {Publisher: Multidisciplinary Digital Publishing Institute (MDPI)},
keywords = {adult, anxiety assessment, article, Canada, clinical article, controlled study, cultural differences, ecological validity, exposure, female, generalized social anxiety, human, immersion, male, multicenter study, psychotherapy, self report, social anxiety, social interaction, social phobia, Spain, virtual reality, virtual reality exposure therapy},
pubstate = {published},
tppubtype = {article}
}
The effectiveness of in virtuo exposure-based treatment of performance-only social anxiety disorder (SAD) has been demonstrated in several studies. However, few studies have validated virtual environments with participants suffering from generalized SAD. The goal of this study is to confirm the potential of a virtual environment in inducing anxiety in adults suffering from generalized SAD, compared to adults without SAD, when engaged in awkward social interactions. Differences between participants from two different countries were also explored. The sample consisted of 15 participants with SAD from Canada, 17 participants without SAD from Canada, 16 participants with SAD from Spain, and 21 participants without SAD from Spain. All participants were immersed in a control virtual environment and in an experimental virtual environment considered potentially anxiety-inducing for individuals with generalized SAD. As hypothesized, results showed that the experimental virtual environment induced a higher level of anxiety than the control environment among participants with SAD compared to those without SAD. The impact on anxiety of each socially threatening task performed during the experimental immersion was statistically significant. In terms of anxiety responses, no significant differences were found between participants from Canada and Spain. However, spatial presence and ecological validity were higher in Canadians than in Spaniards. Unwanted negative side effects induced by immersions in virtual reality were higher in the SAD group. This study highlights the importance for therapists to engage people with SAD in clinically relevant tasks while immersed in VR psychotherapeutic applications. © 2023 by the authors.