@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{alessandra_preselected_2026,

title = {Preselected and preferred immersive virtual reality versus narrative alone to induce post-stress relaxation in patients with pulmonary arterial hypertension: A pilot study on perceived stress and heart rate},

author = {G. Alessandra and D. M. Beatrice and C. Sara and M. Roberta and V. Martina and K. Patrycja and B. Maurizio and B. Luca and D. V. Laura Adelaide and B. Stéphane},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105029595132&doi=10.1111%2Fbjhp.70059&partnerID=40&md5=b86f0151066a7923d8854913cbd54318},

doi = {10.1111/bjhp.70059},

issn = {1359107X (ISSN)},

year  = {2026},

date = {2026-01-01},

journal = {British Journal of Health Psychology},

volume = {31},

number = {1},

abstract = {Objectives: Several studies have shown the effectiveness of immersive virtual reality (IVR)-based relaxation techniques in alleviating stress within the general population. However, few data are available on patients, or on the effectiveness of different scenarios in inducing relaxation. This pilot study aims to compare the effectiveness of three relaxation techniques—preselected IVR (IVR-PS), preferred IVR (i.e. chosen by the participant from different alternatives—IVR-PR), and narrative alone (CTR)—in reducing physiological and psychological stress in 16 pulmonary arterial hypertension (PAH) female patients (N = 16, average age: 46 ± 10.66 years; average education: 13.31 ± 3.8 years; mean duration of illness: 8.56 ± 5.24 years) following an acute stress. Methods: Patients performed a mental stress test followed by three different relaxation sessions presented in a randomized order on three separate occasions. Self-perceived stress, level of relaxation, and heart rate (HR) were monitored during the sessions. Participants' ratings of their experiences were also collected. Results: The results indicated that the three relaxation methods were equally effective in reducing perceived stress induced by acute stress and in lowering HR. However, greater cognitive activation was reported in the two IVR conditions compared with the narrative condition. Conclusions: This is the first study to show evidence of the impact of IVR on a rare population. Despite the lack of significant differences between the two IVR and narrative-alone conditions in physiological and subjective relaxation, more than half of the participants expressed a subjective preference for the virtual experience, especially for the preferred one. © 2026 The Author(s). British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.},

keywords = {adult, controlled study, female, Heart Rate, human, Humans, hypertension, Immersive virtual reality, mental stress, Middle Aged, Narration, pathophysiology, physiology, Pilot Projects, pilot study, procedures, Psychological, psychology, Pulmonary, pulmonary arterial hypertension, pulmonary hypertension, randomized controlled trial, rehabilitation, relaxation, Relaxation Therapy, relaxation training, Stress, Therapy, verbal communication, virtual reality},

pubstate = {published},

tppubtype = {article}

}

@article{alessandraPreselectedPreferredImmersive2026,

title = {Preselected and preferred immersive virtual reality versus narrative alone to induce post-stress relaxation in patients with pulmonary arterial hypertension: A pilot study on perceived stress and heart rate},

author = {G. Alessandra and D. M. Beatrice and C. Sara and M. Roberta and V. Martina and K. Patrycja and B. Maurizio and B. Luca and D. V. Laura Adelaide and B. Stéphane},

url = {https://www.scopus.com/pages/publications/105029595132?origin=resultslist},

doi = {10.1111/bjhp.70059},

issn = {1359107X (ISSN)},

year  = {2026},

date = {2026-01-01},

journal = {British Journal of Health Psychology},

volume = {31},

number = {1},

publisher = {John Wiley and Sons Ltd},

abstract = {Objectives: Several studies have shown the effectiveness of immersive virtual reality (IVR)-based relaxation techniques in alleviating stress within the general population. However, few data are available on patients, or on the effectiveness of different scenarios in inducing relaxation. This pilot study aims to compare the effectiveness of three relaxation techniques—preselected IVR (IVR-PS), preferred IVR (i.e. chosen by the participant from different alternatives—IVR-PR), and narrative alone (CTR)—in reducing physiological and psychological stress in 16 pulmonary arterial hypertension (PAH) female patients (N = 16, average age: 46 ± 10.66 years; average education: 13.31 ± 3.8 years; mean duration of illness: 8.56 ± 5.24 years) following an acute stress. Methods: Patients performed a mental stress test followed by three different relaxation sessions presented in a randomized order on three separate occasions. Self-perceived stress, level of relaxation, and heart rate (HR) were monitored during the sessions. Participants' ratings of their experiences were also collected. Results: The results indicated that the three relaxation methods were equally effective in reducing perceived stress induced by acute stress and in lowering HR. However, greater cognitive activation was reported in the two IVR conditions compared with the narrative condition. Conclusions: This is the first study to show evidence of the impact of IVR on a rare population. Despite the lack of significant differences between the two IVR and narrative-alone conditions in physiological and subjective relaxation, more than half of the participants expressed a subjective preference for the virtual experience, especially for the preferred one. © 2026 The Author(s). British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.},

keywords = {adult, controlled study, female, Heart Rate, human, Humans, hypertension, Immersive virtual reality, mental stress, Middle Aged, Narration, pathophysiology, physiology, Pilot Projects, pilot study, procedures, Psychological, psychology, Pulmonary, pulmonary arterial hypertension, pulmonary hypertension, randomized controlled trial, rehabilitation, relaxation, Relaxation Therapy, relaxation training, Stress, Therapy, verbal communication, virtual reality},

pubstate = {published},

tppubtype = {article}

}

@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}

}

@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}

}

@article{alessandraPreselectedPreferredImmersive2026a,

title = {Preselected and preferred immersive virtual reality versus narrative alone to induce post-stress relaxation in patients with pulmonary arterial hypertension: A pilot study on perceived stress and heart rate},

author = {G. Alessandra and D. M. Beatrice and C. Sara and M. Roberta and V. Martina and K. Patrycja and B. Maurizio and B. Luca and D. V. Laura Adelaide and B. Stéphane},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105029595132&doi=10.1111%2Fbjhp.70059&partnerID=40&md5=b86f0151066a7923d8854913cbd54318},

doi = {10.1111/bjhp.70059},

issn = {1359107X (ISSN)},

year  = {2026},

date = {2026-01-01},

journal = {British Journal of Health Psychology},

volume = {31},

number = {1},

abstract = {Objectives: Several studies have shown the effectiveness of immersive virtual reality (IVR)-based relaxation techniques in alleviating stress within the general population. However, few data are available on patients, or on the effectiveness of different scenarios in inducing relaxation. This pilot study aims to compare the effectiveness of three relaxation techniques—preselected IVR (IVR-PS), preferred IVR (i.e. chosen by the participant from different alternatives—IVR-PR), and narrative alone (CTR)—in reducing physiological and psychological stress in 16 pulmonary arterial hypertension (PAH) female patients (N = 16, average age: 46 ± 10.66 years; average education: 13.31 ± 3.8 years; mean duration of illness: 8.56 ± 5.24 years) following an acute stress. Methods: Patients performed a mental stress test followed by three different relaxation sessions presented in a randomized order on three separate occasions. Self-perceived stress, level of relaxation, and heart rate (HR) were monitored during the sessions. Participants' ratings of their experiences were also collected. Results: The results indicated that the three relaxation methods were equally effective in reducing perceived stress induced by acute stress and in lowering HR. However, greater cognitive activation was reported in the two IVR conditions compared with the narrative condition. Conclusions: This is the first study to show evidence of the impact of IVR on a rare population. Despite the lack of significant differences between the two IVR and narrative-alone conditions in physiological and subjective relaxation, more than half of the participants expressed a subjective preference for the virtual experience, especially for the preferred one. © 2026 The Author(s). British Journal of Health Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.},

keywords = {adult, controlled study, female, Heart Rate, human, Humans, hypertension, Immersive virtual reality, mental stress, Middle Aged, Narration, pathophysiology, physiology, Pilot Projects, pilot study, procedures, Psychological, psychology, Pulmonary, pulmonary arterial hypertension, pulmonary hypertension, randomized controlled trial, rehabilitation, relaxation, Relaxation Therapy, relaxation training, Stress, Therapy, verbal communication, virtual reality},

pubstate = {published},

tppubtype = {article}

}

@article{onita_virtual_2025,

title = {Virtual Reality Trier Social Stress and Virtual Supermarket Exposure: Electrocardiogram Correlates of Food Craving and Eating Traits in Adolescents},

author = {C. A. Onita and D. -V. Matei and E. Chelarasu and R. G. Lupu and D. Petrescu-Miron and A. Visnevschi and S. Vudu and C. Corciova and R. Fuior and N. Tupita and S. Bouchard and V. Mocanu},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105026068857&doi=10.3390%2Fnu17243924&partnerID=40&md5=fde16e892b1a18284dc51ac869ba8ee9},

doi = {10.3390/nu17243924},

issn = {20726643 (ISSN)},

year  = {2025},

date = {2025-01-01},

journal = {Nutrients},

volume = {17},

number = {24},

abstract = {Background/Objectives: Acute stress is known to influence food-related motivation and decision-making, often promoting a preference for energy-dense, palatable foods. However, traditional laboratory paradigms have limited ecological validity. This study examined the relationship between stress-induced physiological changes, eating behavior traits, and food cravings using a virtual reality (VR) adaptation of the Trier Social Stress Test (VR-TSST) followed by a VR supermarket task in adolescents. Methods: Thirty-eight adolescents (mean age 15.8 ± 0.6 years) participated in the study. Physiological parameters (HR, QT, PQ intervals) were recorded pre- and post-stress using a portable ECG device (WIWE). Perceived stress and eating behavior traits were evaluated with the Perceived Stress Scale (PSS) and the Three-Factor Eating Questionnaire (TFEQ-R21C), respectively. Immediately after the VR-TSST, participants performed a VR supermarket task in which they rated cravings for sweet, fatty, and healthy foods using visual analog scales (VAS). Paired-samples t-tests examined pre–post changes in physiological parameters, partial correlations explored associations between ECG responses and eating traits, and a 2 × 3 mixed-model Repeated Measures ANOVA assessed the effects of food type (sweet, fatty, healthy) and uncontrolled eating (UE) group (low vs. high) on post-stress cravings. Results: Acute stress induced significant increases in HR and QTc intervals (p < 0.01), confirming a robust physiological stress response. The ANOVA revealed a strong main effect of food type (F(1.93, 435.41) = 168.98, p < 0.001, η2p = 0.43), indicating that stress-induced cravings differed across food categories, with sweet foods rated highest. A significant food type × UE group interaction (F(1.93, 435.41) = 16.49, p < 0.001, η2p = 0.07) showed that adolescents with high UE exhibited greater cravings for sweet and fatty foods than those with low UE. Overall, craving levels did not differ significantly between groups. Conclusions: The findings demonstrate that acute stress selectively enhances cravings for high-reward foods, and that this effect is modulated by baseline uncontrolled eating tendencies. The combined use of VR-based stress induction and VR supermarket simulation offers an innovative, ecologically valid framework for studying stress-related eating behavior in adolescents, with potential implications for personalized nutrition and the prevention of stress-induced overeating. © 2025 by the authors.},

keywords = {acute stress, Adolescent, Adolescents, adult, article, controlled study, craving, decision making, Eating, eating behavior, ecological validity, electrocardiogram, electrocardiogram (ECG) parameters, Electrocardiography, feeding behavior, female, food craving, food preference, Food Preferences, Heart Rate, human, Humans, hyperphagia, male, mental stress, motivation, normal human, overnutrition, pathophysiology, Perceived Stress Scale, personalized nutrition, physiological stress, physiology, PQ interval, Psychological, psychology, QTc interval, questionnaire, reward, simulation, social stress, Stress, supermarket, Surveys and Questionnaires, three-factor eating questionnaire (TFEQ), Three-Factor-Eating-Questionnaire, Trier Social Stress Test, virtual reality, virtual supermarket, visual analog scale},

pubstate = {published},

tppubtype = {article}

}

@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}

}

@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{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}

}