@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}

}

@article{petrin_maternal_2024,

title = {Maternal childhood emotional abuse increases cardiovascular responses to children’s emotional facial expressions},

author = {R. Pétrin and A. Bérubé and É. St-Pierre and C. Blais},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85192637581&doi=10.1371%2fjournal.pone.0302782&partnerID=40&md5=c464b30fe7cc5b7b0baaf865fdf1f6de},

doi = {10.1371/journal.pone.0302782},

issn = {19326203 (ISSN)},

year  = {2024},

date = {2024-01-01},

journal = {PLoS ONE},

volume = {19},

number = {5 May},

publisher = {Public Library of Science},

abstract = {Parents with a history of childhood maltreatment may be more likely to respond inadequately to their child’s emotional cues, such as crying or screaming, due to previous exposure to prolonged stress. While studies have investigated parents’ physiological reactions to their children’s vocal expressions of emotions, less attention has been given to their responses when perceiving children’s facial expressions of emotions. The present study aimed to determine if viewing facial expressions of emotions in children induces cardiovascular changes in mothers (hypo- or hyper-arousal) and whether these differ as a function of childhood maltreatment. A total of 104 mothers took part in this study. Their experiences of childhood maltreatment were measured using the Childhood Trauma Questionnaire (CTQ). Participants’ electrocardiogram signals were recorded during a task in which they viewed a landscape video (baseline) and images of children’s faces expressing different intensities of emotion. Heart rate variability (HRV) was extracted from the recordings as an indicator of parasympathetic reactivity. Participants presented two profiles: one group of mothers had a decreased HRV when presented with images of children’s facial expressions of emotions, while the other group’s HRV increased. However, HRV change was not significantly different between the two groups. The interaction between HRV groups and the severity of maltreatment experienced was marginal. Results suggested that experiences of childhood emotional abuse were more common in mothers whose HRV increased during the task. Therefore, more severe childhood experiences of emotional abuse could be associated with mothers’ cardiovascular hyperreactivity. Maladaptive cardiovascular responses could have a ripple effect, influencing how mothers react to their children’s facial expressions of emotions. That reaction could affect the quality of their interaction with their child. Providing interventions that help parents regulate their physiological and behavioral responses to stress might be helpful, especially if they have experienced childhood maltreatment. © 2024 Public Library of Science. All rights reserved.},

note = {Publisher: Public Library of Science},

keywords = {adult, alcohol consumption, analysis of variance, article, blood pressure, cardiovascular response, Child, Child Abuse, Childhood, Childhood Trauma Questionnaire, demographics, electrocardiogram, Electrocardiography, emotion, Emotional Abuse, Emotions, Ethnicity, Facial Expression, female, Heart Rate, heart rate variability, human, human experiment, Humans, Likert scale, male, mother, mother child relation, Mother-Child Relations, Mothers, parasympathetic tone, physical activity, physiology, post hoc analysis, psychology, questionnaire, sexual abuse, Surveys and Questionnaires},

pubstate = {published},

tppubtype = {article}

}

@article{bouchard_multisite_2022,

title = {A Multisite Non-Inferiority Randomized Controlled Trial of the Efficacy of Cognitive-Behavior Therapy for Generalized Anxiety Disorder Delivered by Videoconference},

author = {S. Bouchard and M. J. Dugas and G. Belleville and F. Langlois and P. Gosselin and G. Robillard and G. Corno and A. Marchand},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85139777758&doi=10.3390%2fjcm11195924&partnerID=40&md5=52cbc697b3a9705b2f7fb87b7bfdc3eb},

doi = {10.3390/jcm11195924},

issn = {20770383 (ISSN)},

year  = {2022},

date = {2022-01-01},

journal = {Journal of Clinical Medicine},

volume = {11},

number = {19},

publisher = {MDPI},

abstract = {Delivering psychotherapy by videoconference has been studied in a number of clinical trials, but no large controlled trial has involved generalized anxiety disorder (GAD). This multicenter randomized controlled non-inferiority trial was conducted to test if cognitive-behavior psychotherapy delivered by videoconference (VCP) is as effective as cognitive-behavior psychotherapy delivered face-to-face, using a strict margin of tolerance for non-inferiority. A total of 148 adults received a 15-session weekly manualized program. The treatment was based on the intolerance of uncertainty model of GAD. The impact of treatment was assessed using primary (GAD severity), secondary (worry, anxiety, and intolerance of uncertainty) and tertiary (general functioning) variables measured before and after treatment and at 6-month and 12-month follow-ups. Results showed that: (a) the treatment was effective; (b) VCP for GAD was statistically non-inferior to face-to-face psychotherapy on primary, secondary and tertiary measures at all assessment points; (c) change in intolerance of uncertainty significantly predicted change in the primary outcome measure over and above important clinical factors common to all psychotherapies (motivation, working alliance, perceived therapist competence, and client satisfaction). These findings support the use of VCP as a promising treatment option for adults with GAD. Clinical trial registry: ISRCTN#12662027. © 2022 by the authors.},

note = {Publisher: MDPI},

keywords = {adult, Anxiety, article, Beck Depression Inventory, cognitive behavioral therapy, Cognitive-behavior therapy, competence, controlled study, female, follow up, generalized anxiety disorder, Generalized Anxiety Disorder Scale, human, Likert scale, major clinical study, male, motivation, multicenter study, non-inferiority, patient worry, penn state worry questionnaire, predictors of outcome, psychotherapist, quality of life, randomized controlled trial, Structured Clinical Interview for DSM Disorders, treatment outcome, videoconferencing, videoconferencing psychotherapy, World Health Organization},

pubstate = {published},

tppubtype = {article}

}

@article{guitard_exposure_2019,

title = {Exposure to a standardized catastrophic scenario in virtual reality or a personalized scenario in imagination for Generalized Anxiety Disorder},

author = {T. Guitard and S. Bouchard and C. Bélanger and M. Berthiaume},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85073896961&doi=10.3390%2fjcm8030309&partnerID=40&md5=b80f2e6602416c35dd8e36fd8b19c803},

doi = {10.3390/jcm8030309},

issn = {20770383 (ISSN)},

year  = {2019},

date = {2019-01-01},

journal = {Journal of Clinical Medicine},

volume = {8},

number = {3},

publisher = {MDPI},

abstract = {The cognitive behavioral treatment of generalized anxiety disorder (GAD) often involves exposing patients to a catastrophic scenario depicting their most feared worry. The aim of this study was to examine whether a standardized scenario recreated in virtual reality (VR) would elicit anxiety and negative affect and how it compared to the traditional method of imagining a personalized catastrophic scenario. A sample of 28 participants were first exposed to a neutral non-catastrophic scenario and then to a personalized scenario in imagination or a standardized virtual scenario presented in a counterbalanced order. The participants completed questionnaires before and after each immersion. The results suggest that the standardized virtual scenario induced significant anxiety. No difference was found when comparing exposure to the standardized scenario in VR and exposure to the personalized scenario in imagination. These findings were specific to anxiety and not to the broader measure of negative affect. Individual differences in susceptibility to feel present in VR was a significant predictor of increase in anxiety and negative affect. Future research could use these scenarios to conduct a randomized control trial to test the efficacy and cost/benefits of using VR in the treatment of GAD. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.},

note = {Publisher: MDPI},

keywords = {adult, anxiety assessment, article, avoidance behavior, clinical article, cognitive avoidance questionnaire, cognitive behavioral therapy, Cognitive exposure, disease severity, DSM-IV, Exposure in virtual reality, fatigue, female, gatineau presence questionnaire, generalized anxiety disorder, Generalized Anxiety Disorder (GAD), human, human experiment, imagination, immersive tendencies questionnaire, Likert scale, male, Middle Aged, mini international neuropsychiatric interview, penn state worry questionnaire, Personalized scenario, Positive and Negative Affect Schedule, Positive and Negative Syndrome Scale, Presence Questionnaire, psychotherapy, questionnaire, Simulator Sickness Questionnaire, Standardized scenario, task performance, test retest reliability, time series analysis, virtual reality},

pubstate = {published},

tppubtype = {article}

}