@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{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}

}

@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}

}