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.
Sheehy, L.; Finestone, H.; Bouchard, S.; Dezeeuw, K.; Doering, P.; Dunlop, N.; Sveistrup, H.
Immersive Virtual Reality Experiences can Decrease Pain and Distress in Patients Living in Complex Care Journal Article
In: Annual Review of CyberTherapy and Telemedicine, vol. 23, pp. 272–278, 2025, ISSN: 15548716 (ISSN).
Abstract | Links | BibTeX | Tags: adult, aged, article, chronic pain, clinical article, complex care, controlled study, discomfort, distress syndrome, female, human, immersion, male, Mood, nausea, Pain, patient care, quality of life, virtual reality, wound care
@article{sheehy_immersive_2025,
title = {Immersive Virtual Reality Experiences can Decrease Pain and Distress in Patients Living in Complex Care},
author = {L. Sheehy and H. Finestone and S. Bouchard and K. Dezeeuw and P. Doering and N. Dunlop and H. Sveistrup},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105023893911&partnerID=40&md5=cf29113c44db0b13e00df2e34acbc141},
issn = {15548716 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {Annual Review of CyberTherapy and Telemedicine},
volume = {23},
pages = {272–278},
abstract = {Patients living in complex care (CC) frequently experience pain. The study goals were to assess the feasibility of using virtual reality (VR), and the potential for VR to impact pain, mood, and quality of life in two groups of patients living in CC, those experiencing acute pain during wound dressing changes and those experiencing chronic pain. Participants were offered 30 minutes of immersive, passive VR experiences using a Meta Quest 2 headset, 3 times/week for 3 weeks. Pain and mood were assessed pre, during and post each VR session. Pain, mood and quality of life were assessed before and after the 3-week intervention. Feasibility was assessed after each session. Three women (average age 66.3) with wound dressing changes completed an average of 3.7 sessions (25.5 minutes/session). Two-thirds experienced meaningful declines in pain with VR. Seventeen participants (6 men, 11 women, average age 58.4) with chronic pain completed an average of 3.1 sessions (21.4 minutes/session). Pain was significantly decreased from pre to post VR and pre to during VR. Mood and quality of life did not change. Both groups had low levels of discomfort and nausea, and high levels of satisfaction and immersiveness. Most participants enjoyed the experience and appreciated the immersion. It was challenging to adapt the headset to patients in non-seated positions who could not use VR controllers. VR is a promising modality to manage pain in patients living in CC. More work needs to be done to confirm the results and implement VR in clinical settings. © 2025, Interactive Media Institute. All rights reserved.},
keywords = {adult, aged, article, chronic pain, clinical article, complex care, controlled study, discomfort, distress syndrome, female, human, immersion, male, Mood, nausea, Pain, patient care, quality of life, virtual reality, wound care},
pubstate = {published},
tppubtype = {article}
}
Patients living in complex care (CC) frequently experience pain. The study goals were to assess the feasibility of using virtual reality (VR), and the potential for VR to impact pain, mood, and quality of life in two groups of patients living in CC, those experiencing acute pain during wound dressing changes and those experiencing chronic pain. Participants were offered 30 minutes of immersive, passive VR experiences using a Meta Quest 2 headset, 3 times/week for 3 weeks. Pain and mood were assessed pre, during and post each VR session. Pain, mood and quality of life were assessed before and after the 3-week intervention. Feasibility was assessed after each session. Three women (average age 66.3) with wound dressing changes completed an average of 3.7 sessions (25.5 minutes/session). Two-thirds experienced meaningful declines in pain with VR. Seventeen participants (6 men, 11 women, average age 58.4) with chronic pain completed an average of 3.1 sessions (21.4 minutes/session). Pain was significantly decreased from pre to post VR and pre to during VR. Mood and quality of life did not change. Both groups had low levels of discomfort and nausea, and high levels of satisfaction and immersiveness. Most participants enjoyed the experience and appreciated the immersion. It was challenging to adapt the headset to patients in non-seated positions who could not use VR controllers. VR is a promising modality to manage pain in patients living in CC. More work needs to be done to confirm the results and implement VR in clinical settings. © 2025, Interactive Media Institute. All rights reserved.
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.
Bouchard, S.; Forget, H.
Conducting exposure in virtual reality for the treatment of social phobia does lead to change in dysfunctional beliefs Journal Article
In: Annual Review of CyberTherapy and Telemedicine, vol. 23, pp. 258–264, 2025, ISSN: 15548716 (ISSN).
Abstract | Links | BibTeX | Tags: adult, article, clinical article, cognitive behavioral therapy, controlled study, exposure, female, follow up, hospital admission, human, in vivo study, Liebowitz Social Anxiety Scale, male, multiple regression, predictors of outcome, randomized controlled trial, social anxiety disorder, social phobia, Social Phobia Scale, threat, treatment duration, Treatment mechanisms, treatment outcome, virtual reality
@article{bouchard_conducting_2025,
title = {Conducting exposure in virtual reality for the treatment of social phobia does lead to change in dysfunctional beliefs},
author = {S. Bouchard and H. Forget},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105023856314&partnerID=40&md5=db4c4e86d7c32b544fe28c7fb6f9172b},
issn = {15548716 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {Annual Review of CyberTherapy and Telemedicine},
volume = {23},
pages = {258–264},
abstract = {This study used data from a randomized control trial on cognitive behavior therapy for social phobia testing the effectiveness of exposure conducted in virtual reality. Measures of cognitive mechanisms had been collected but never analyzed. The study was motivated by a recent publication mentioning that potential aversive outcomes of being judged in virtual reality and by virtual characters have no objective negative consequence in daily life. A sample of 51 adults completed outcome and cognitive mechanism measures at a pretreatment, after 14 weeks of treatment or being on a waiting list, and at a 6-month follow-up. Results demonstrate that conducting exposure in virtual reality led to reductions in dysfunctional beliefs about the perceived consequences of feared social threats, about the likelihood of these feared threats occurring, as well as an increase in perceived self-efficacy to face social situations. These changes were statistically significant when compared to the waiting list condition, remained stable at the 6-month follow-up, and were no less important than when exposure was conducted in vivo. All predictors significantly correlated (p < .001) with the two measures of treatment outcome. Further analyses of cognitive mechanism measures predicting treatment outcomes revealed that, when controlling for shared variance, changes in perceived likelihood and in self-efficacy contributed significantly to patients’ improvement, whereas the role of perceived consequences was only a predictor of self-efficacy. © 2025, Interactive Media Institute. All rights reserved.},
keywords = {adult, article, clinical article, cognitive behavioral therapy, controlled study, exposure, female, follow up, hospital admission, human, in vivo study, Liebowitz Social Anxiety Scale, male, multiple regression, predictors of outcome, randomized controlled trial, social anxiety disorder, social phobia, Social Phobia Scale, threat, treatment duration, Treatment mechanisms, treatment outcome, virtual reality},
pubstate = {published},
tppubtype = {article}
}
This study used data from a randomized control trial on cognitive behavior therapy for social phobia testing the effectiveness of exposure conducted in virtual reality. Measures of cognitive mechanisms had been collected but never analyzed. The study was motivated by a recent publication mentioning that potential aversive outcomes of being judged in virtual reality and by virtual characters have no objective negative consequence in daily life. A sample of 51 adults completed outcome and cognitive mechanism measures at a pretreatment, after 14 weeks of treatment or being on a waiting list, and at a 6-month follow-up. Results demonstrate that conducting exposure in virtual reality led to reductions in dysfunctional beliefs about the perceived consequences of feared social threats, about the likelihood of these feared threats occurring, as well as an increase in perceived self-efficacy to face social situations. These changes were statistically significant when compared to the waiting list condition, remained stable at the 6-month follow-up, and were no less important than when exposure was conducted in vivo. All predictors significantly correlated (p < .001) with the two measures of treatment outcome. Further analyses of cognitive mechanism measures predicting treatment outcomes revealed that, when controlling for shared variance, changes in perceived likelihood and in self-efficacy contributed significantly to patients’ improvement, whereas the role of perceived consequences was only a predictor of self-efficacy. © 2025, Interactive Media Institute. All rights reserved.
7.
Yee, J.; Matheson, H.; Bogie, B. J. M.; Perron, É. D.; Thérond, A.; Charest, M.; Driel, C.; Goyette, M.; Lei, Y. T.; Noël, C.; Ariaratnam, K.; Collins, G.; Gorman, C.; Cretu, A. -M.; Tremblay, S.; Rivard, M. -C.; Cullwick, C.; Morris, C.; Attwood, D. G.; Baines, A.; Stewart, A.; Bouchard, S.; Bowie, C. R.; Guimond, S.
Cognitive Remediation for Psychosis in Virtual Reality (ThinkTactic VR): Qualitative, Iterative, and User-Centered Codevelopment Study Journal Article
In: JMIR Mental Health, vol. 12, 2025, ISSN: 23687959 (ISSN).
Abstract | Links | BibTeX | Tags: adult, article, clinical article, cognitive defect, Cognitive rehabilitation, Cognitive remediation, Cognitive remediation therapy, community functioning, health care personnel, human, neurocognition, patient engagement, program development, psychosis, qualitative research, social cognition, user-centered approach, user-centered design, virtual reality
@article{yee_cognitive_2025,
title = {Cognitive Remediation for Psychosis in Virtual Reality (ThinkTactic VR): Qualitative, Iterative, and User-Centered Codevelopment Study},
author = {J. Yee and H. Matheson and B. J. M. Bogie and É. D. Perron and A. Thérond and M. Charest and C. Driel and M. Goyette and Y. T. Lei and C. Noël and K. Ariaratnam and G. Collins and C. Gorman and A. -M. Cretu and S. Tremblay and M. -C. Rivard and C. Cullwick and C. Morris and D. G. Attwood and A. Baines and A. Stewart and S. Bouchard and C. R. Bowie and S. Guimond},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105013110717&doi=10.2196%2F69359&partnerID=40&md5=c5daaabcfd92d826b28327a5800609ae},
doi = {10.2196/69359},
issn = {23687959 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {JMIR Mental Health},
volume = {12},
abstract = {Background: Cognitive remediation improves cognition and psychosocial functioning in individuals with psychotic disorders. The use of virtual reality (VR) to deliver cognitive remediation in immersive environments that mimic real cognitively challenging situations has the potential to increase engagement to treatment and further enhance its impact on functioning. Objective: We aimed to codevelop a cognitive remediation program in VR with individuals with psychotic disorders and health care professionals to identify and address their needs. Methods: Individuals with lived experience of a psychosis-spectrum condition (n=11) met 9 times and the health care professionals (n=7) met 3 times. Participants discussed personal and professional opinions on the challenges associated with cognitive difficulties in individuals with psychotic disorders. They also provided feedback on the program development. Results: We discerned 4 themes from the content expert working groups: the need for a program to address cognitive impairments, the key program design elements to support cognitive rehabilitation, the importance of leveraging technology as an intervention tool, and the need to improve community functioning. In total, 3 themes were identified for the health care professionals: the need for a clinically relevant program that addresses the research-to-practice gap, the need to improve patient engagement in services, and the need for a program that addresses the limited resources in health care. The needs of our end-user experts were placed at the center of the program development process. When possible, we also integrated their suggestions, like the incorporation of a virtual coach within the immersive environment. Conclusions: Individuals with lived experience and health care professionals have distinct needs, which have informed the co-design of a novel cognitive remediation program in VR, ThinkTactic VR. To our knowledge, ThinkTactic VR is one of the first co-designed and codeveloped cognitive remediation programs in VR using an iterative, user-centered approach involving both individuals with psychotic disorders and health care professionals. ©Jasmin Yee, Hannah Matheson, Bryce J M Bogie, Émilie Du Perron, Alexandra Thérond, Maëlle Charest, Catheleine van Driel, Marika Goyette, Ya Ting Lei, Chelsea Noël, Kagusthan Ariaratnam, Greg Collins, Chris Gorman, Ana-Maria Cretu, Simon Tremblay, Marie-Christine Rivard, Catherine Cullwick, Crystal Morris, David G Attwood, Alexandra Baines, Angela Stewart, Stéphane Bouchard, Christopher R Bowie, Synthia Guimond.},
keywords = {adult, article, clinical article, cognitive defect, Cognitive rehabilitation, Cognitive remediation, Cognitive remediation therapy, community functioning, health care personnel, human, neurocognition, patient engagement, program development, psychosis, qualitative research, social cognition, user-centered approach, user-centered design, virtual reality},
pubstate = {published},
tppubtype = {article}
}
Background: Cognitive remediation improves cognition and psychosocial functioning in individuals with psychotic disorders. The use of virtual reality (VR) to deliver cognitive remediation in immersive environments that mimic real cognitively challenging situations has the potential to increase engagement to treatment and further enhance its impact on functioning. Objective: We aimed to codevelop a cognitive remediation program in VR with individuals with psychotic disorders and health care professionals to identify and address their needs. Methods: Individuals with lived experience of a psychosis-spectrum condition (n=11) met 9 times and the health care professionals (n=7) met 3 times. Participants discussed personal and professional opinions on the challenges associated with cognitive difficulties in individuals with psychotic disorders. They also provided feedback on the program development. Results: We discerned 4 themes from the content expert working groups: the need for a program to address cognitive impairments, the key program design elements to support cognitive rehabilitation, the importance of leveraging technology as an intervention tool, and the need to improve community functioning. In total, 3 themes were identified for the health care professionals: the need for a clinically relevant program that addresses the research-to-practice gap, the need to improve patient engagement in services, and the need for a program that addresses the limited resources in health care. The needs of our end-user experts were placed at the center of the program development process. When possible, we also integrated their suggestions, like the incorporation of a virtual coach within the immersive environment. Conclusions: Individuals with lived experience and health care professionals have distinct needs, which have informed the co-design of a novel cognitive remediation program in VR, ThinkTactic VR. To our knowledge, ThinkTactic VR is one of the first co-designed and codeveloped cognitive remediation programs in VR using an iterative, user-centered approach involving both individuals with psychotic disorders and health care professionals. ©Jasmin Yee, Hannah Matheson, Bryce J M Bogie, Émilie Du Perron, Alexandra Thérond, Maëlle Charest, Catheleine van Driel, Marika Goyette, Ya Ting Lei, Chelsea Noël, Kagusthan Ariaratnam, Greg Collins, Chris Gorman, Ana-Maria Cretu, Simon Tremblay, Marie-Christine Rivard, Catherine Cullwick, Crystal Morris, David G Attwood, Alexandra Baines, Angela Stewart, Stéphane Bouchard, Christopher R Bowie, Synthia Guimond.
8.
Bouchard, S.; Forget, H.
Conducting exposure in virtual reality for the treatment of social phobia does lead to change in dysfunctional beliefs Journal Article
In: Annual Review of CyberTherapy and Telemedicine, vol. 23, pp. 258–264, 2025, ISSN: 15548716 (ISSN).
Abstract | Links | BibTeX | Tags: adult, article, clinical article, cognitive behavioral therapy, controlled study, exposure, female, follow up, hospital admission, human, in vivo study, Liebowitz Social Anxiety Scale, male, multiple regression, predictors of outcome, randomized controlled trial, social anxiety disorder, social phobia, Social Phobia Scale, threat, treatment duration, Treatment mechanisms, treatment outcome, virtual reality
@article{bouchardConductingExposureVirtual2025,
title = {Conducting exposure in virtual reality for the treatment of social phobia does lead to change in dysfunctional beliefs},
author = {S. Bouchard and H. Forget},
url = {https://www.scopus.com/pages/publications/105023856314?origin=resultslist},
issn = {15548716 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {Annual Review of CyberTherapy and Telemedicine},
volume = {23},
pages = {258–264},
publisher = {Interactive Media Institute},
abstract = {This study used data from a randomized control trial on cognitive behavior therapy for social phobia testing the effectiveness of exposure conducted in virtual reality. Measures of cognitive mechanisms had been collected but never analyzed. The study was motivated by a recent publication mentioning that potential aversive outcomes of being judged in virtual reality and by virtual characters have no objective negative consequence in daily life. A sample of 51 adults completed outcome and cognitive mechanism measures at a pretreatment, after 14 weeks of treatment or being on a waiting list, and at a 6-month follow-up. Results demonstrate that conducting exposure in virtual reality led to reductions in dysfunctional beliefs about the perceived consequences of feared social threats, about the likelihood of these feared threats occurring, as well as an increase in perceived self-efficacy to face social situations. These changes were statistically significant when compared to the waiting list condition, remained stable at the 6-month follow-up, and were no less important than when exposure was conducted in vivo. All predictors significantly correlated (p < .001) with the two measures of treatment outcome. Further analyses of cognitive mechanism measures predicting treatment outcomes revealed that, when controlling for shared variance, changes in perceived likelihood and in self-efficacy contributed significantly to patients’ improvement, whereas the role of perceived consequences was only a predictor of self-efficacy. © 2025, Interactive Media Institute. All rights reserved.},
keywords = {adult, article, clinical article, cognitive behavioral therapy, controlled study, exposure, female, follow up, hospital admission, human, in vivo study, Liebowitz Social Anxiety Scale, male, multiple regression, predictors of outcome, randomized controlled trial, social anxiety disorder, social phobia, Social Phobia Scale, threat, treatment duration, Treatment mechanisms, treatment outcome, virtual reality},
pubstate = {published},
tppubtype = {article}
}
This study used data from a randomized control trial on cognitive behavior therapy for social phobia testing the effectiveness of exposure conducted in virtual reality. Measures of cognitive mechanisms had been collected but never analyzed. The study was motivated by a recent publication mentioning that potential aversive outcomes of being judged in virtual reality and by virtual characters have no objective negative consequence in daily life. A sample of 51 adults completed outcome and cognitive mechanism measures at a pretreatment, after 14 weeks of treatment or being on a waiting list, and at a 6-month follow-up. Results demonstrate that conducting exposure in virtual reality led to reductions in dysfunctional beliefs about the perceived consequences of feared social threats, about the likelihood of these feared threats occurring, as well as an increase in perceived self-efficacy to face social situations. These changes were statistically significant when compared to the waiting list condition, remained stable at the 6-month follow-up, and were no less important than when exposure was conducted in vivo. All predictors significantly correlated (p < .001) with the two measures of treatment outcome. Further analyses of cognitive mechanism measures predicting treatment outcomes revealed that, when controlling for shared variance, changes in perceived likelihood and in self-efficacy contributed significantly to patients’ improvement, whereas the role of perceived consequences was only a predictor of self-efficacy. © 2025, Interactive Media Institute. All rights reserved.
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{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.
10.
Yee, J.; Matheson, H.; Bogie, B. J. M.; Perron, É. D.; Thérond, A.; Charest, M.; Driel, C.; Goyette, M.; Lei, Y. T.; Noël, C.; Ariaratnam, K.; Collins, G.; Gorman, C.; Cretu, A. -M.; Tremblay, S.; Rivard, M. -C.; Cullwick, C.; Morris, C.; Attwood, D. G.; Baines, A.; Stewart, A.; Bouchard, S.; Bowie, C. R.; Guimond, S.
Cognitive Remediation for Psychosis in Virtual Reality (ThinkTactic VR): Qualitative, Iterative, and User-Centered Codevelopment Study Journal Article
In: JMIR Mental Health, vol. 12, 2025, ISSN: 23687959 (ISSN).
Abstract | Links | BibTeX | Tags: adult, article, clinical article, cognitive defect, Cognitive rehabilitation, Cognitive remediation, Cognitive remediation therapy, community functioning, health care personnel, human, neurocognition, patient engagement, program development, psychosis, qualitative research, social cognition, user-centered approach, user-centered design, virtual reality
@article{yeeCognitiveRemediationPsychosis2025,
title = {Cognitive Remediation for Psychosis in Virtual Reality (ThinkTactic VR): Qualitative, Iterative, and User-Centered Codevelopment Study},
author = {J. Yee and H. Matheson and B. J. M. Bogie and É. D. Perron and A. Thérond and M. Charest and C. Driel and M. Goyette and Y. T. Lei and C. Noël and K. Ariaratnam and G. Collins and C. Gorman and A. -M. Cretu and S. Tremblay and M. -C. Rivard and C. Cullwick and C. Morris and D. G. Attwood and A. Baines and A. Stewart and S. Bouchard and C. R. Bowie and S. Guimond},
url = {https://www.scopus.com/pages/publications/105013110717?origin=resultslist},
doi = {10.2196/69359},
issn = {23687959 (ISSN)},
year = {2025},
date = {2025-01-01},
journal = {JMIR Mental Health},
volume = {12},
publisher = {JMIR Publications Inc.},
abstract = {Background: Cognitive remediation improves cognition and psychosocial functioning in individuals with psychotic disorders. The use of virtual reality (VR) to deliver cognitive remediation in immersive environments that mimic real cognitively challenging situations has the potential to increase engagement to treatment and further enhance its impact on functioning. Objective: We aimed to codevelop a cognitive remediation program in VR with individuals with psychotic disorders and health care professionals to identify and address their needs. Methods: Individuals with lived experience of a psychosis-spectrum condition (n=11) met 9 times and the health care professionals (n=7) met 3 times. Participants discussed personal and professional opinions on the challenges associated with cognitive difficulties in individuals with psychotic disorders. They also provided feedback on the program development. Results: We discerned 4 themes from the content expert working groups: the need for a program to address cognitive impairments, the key program design elements to support cognitive rehabilitation, the importance of leveraging technology as an intervention tool, and the need to improve community functioning. In total, 3 themes were identified for the health care professionals: the need for a clinically relevant program that addresses the research-to-practice gap, the need to improve patient engagement in services, and the need for a program that addresses the limited resources in health care. The needs of our end-user experts were placed at the center of the program development process. When possible, we also integrated their suggestions, like the incorporation of a virtual coach within the immersive environment. Conclusions: Individuals with lived experience and health care professionals have distinct needs, which have informed the co-design of a novel cognitive remediation program in VR, ThinkTactic VR. To our knowledge, ThinkTactic VR is one of the first co-designed and codeveloped cognitive remediation programs in VR using an iterative, user-centered approach involving both individuals with psychotic disorders and health care professionals. ©Jasmin Yee, Hannah Matheson, Bryce J M Bogie, Émilie Du Perron, Alexandra Thérond, Maëlle Charest, Catheleine van Driel, Marika Goyette, Ya Ting Lei, Chelsea Noël, Kagusthan Ariaratnam, Greg Collins, Chris Gorman, Ana-Maria Cretu, Simon Tremblay, Marie-Christine Rivard, Catherine Cullwick, Crystal Morris, David G Attwood, Alexandra Baines, Angela Stewart, Stéphane Bouchard, Christopher R Bowie, Synthia Guimond.},
keywords = {adult, article, clinical article, cognitive defect, Cognitive rehabilitation, Cognitive remediation, Cognitive remediation therapy, community functioning, health care personnel, human, neurocognition, patient engagement, program development, psychosis, qualitative research, social cognition, user-centered approach, user-centered design, virtual reality},
pubstate = {published},
tppubtype = {article}
}
Background: Cognitive remediation improves cognition and psychosocial functioning in individuals with psychotic disorders. The use of virtual reality (VR) to deliver cognitive remediation in immersive environments that mimic real cognitively challenging situations has the potential to increase engagement to treatment and further enhance its impact on functioning. Objective: We aimed to codevelop a cognitive remediation program in VR with individuals with psychotic disorders and health care professionals to identify and address their needs. Methods: Individuals with lived experience of a psychosis-spectrum condition (n=11) met 9 times and the health care professionals (n=7) met 3 times. Participants discussed personal and professional opinions on the challenges associated with cognitive difficulties in individuals with psychotic disorders. They also provided feedback on the program development. Results: We discerned 4 themes from the content expert working groups: the need for a program to address cognitive impairments, the key program design elements to support cognitive rehabilitation, the importance of leveraging technology as an intervention tool, and the need to improve community functioning. In total, 3 themes were identified for the health care professionals: the need for a clinically relevant program that addresses the research-to-practice gap, the need to improve patient engagement in services, and the need for a program that addresses the limited resources in health care. The needs of our end-user experts were placed at the center of the program development process. When possible, we also integrated their suggestions, like the incorporation of a virtual coach within the immersive environment. Conclusions: Individuals with lived experience and health care professionals have distinct needs, which have informed the co-design of a novel cognitive remediation program in VR, ThinkTactic VR. To our knowledge, ThinkTactic VR is one of the first co-designed and codeveloped cognitive remediation programs in VR using an iterative, user-centered approach involving both individuals with psychotic disorders and health care professionals. ©Jasmin Yee, Hannah Matheson, Bryce J M Bogie, Émilie Du Perron, Alexandra Thérond, Maëlle Charest, Catheleine van Driel, Marika Goyette, Ya Ting Lei, Chelsea Noël, Kagusthan Ariaratnam, Greg Collins, Chris Gorman, Ana-Maria Cretu, Simon Tremblay, Marie-Christine Rivard, Catherine Cullwick, Crystal Morris, David G Attwood, Alexandra Baines, Angela Stewart, Stéphane Bouchard, Christopher R Bowie, Synthia Guimond.