@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{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{quintana_engaging_2023,

title = {Engaging in Awkward Social Interactions in a Virtual Environment Designed for Exposure-Based Psychotherapy for People with Generalized Social Anxiety Disorder: An International Multisite Study},

author = {P. Quintana and S. Bouchard and C. Botella and G. Robillard and B. Serrano and A. Rodriguez-Ortega and M. Torp Ernst and B. Rey and M. Berthiaume and G. Corno},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85165033932&doi=10.3390%2fjcm12134525&partnerID=40&md5=7b0f59b46ff7680611d5a64e18909651},

doi = {10.3390/jcm12134525},

issn = {20770383 (ISSN)},

year  = {2023},

date = {2023-01-01},

journal = {Journal of Clinical Medicine},

volume = {12},

number = {13},

publisher = {Multidisciplinary Digital Publishing Institute (MDPI)},

abstract = {The effectiveness of in virtuo exposure-based treatment of performance-only social anxiety disorder (SAD) has been demonstrated in several studies. However, few studies have validated virtual environments with participants suffering from generalized SAD. The goal of this study is to confirm the potential of a virtual environment in inducing anxiety in adults suffering from generalized SAD, compared to adults without SAD, when engaged in awkward social interactions. Differences between participants from two different countries were also explored. The sample consisted of 15 participants with SAD from Canada, 17 participants without SAD from Canada, 16 participants with SAD from Spain, and 21 participants without SAD from Spain. All participants were immersed in a control virtual environment and in an experimental virtual environment considered potentially anxiety-inducing for individuals with generalized SAD. As hypothesized, results showed that the experimental virtual environment induced a higher level of anxiety than the control environment among participants with SAD compared to those without SAD. The impact on anxiety of each socially threatening task performed during the experimental immersion was statistically significant. In terms of anxiety responses, no significant differences were found between participants from Canada and Spain. However, spatial presence and ecological validity were higher in Canadians than in Spaniards. Unwanted negative side effects induced by immersions in virtual reality were higher in the SAD group. This study highlights the importance for therapists to engage people with SAD in clinically relevant tasks while immersed in VR psychotherapeutic applications. © 2023 by the authors.},

note = {Publisher: Multidisciplinary Digital Publishing Institute (MDPI)},

keywords = {adult, anxiety assessment, article, Canada, clinical article, controlled study, cultural differences, ecological validity, exposure, female, generalized social anxiety, human, immersion, male, multicenter study, psychotherapy, self report, social anxiety, social interaction, social phobia, Spain, virtual reality, virtual reality exposure therapy},

pubstate = {published},

tppubtype = {article}

}

@article{orskov_cognitive_2022,

title = {Cognitive behavioral therapy with adaptive virtual reality exposure vs. cognitive behavioral therapy with in vivo exposure in the treatment of social anxiety disorder: A study protocol for a randomized controlled trial},

author = {P. T. Ørskov and M. B. Lichtenstein and M. T. Ernst and I. Fasterholdt and A. F. Matthiesen and M. Scirea and S. Bouchard and T. E. Andersen},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85140322564&doi=10.3389%2ffpsyt.2022.991755&partnerID=40&md5=1dacd4e05081f4790ccd5e0d7224e0ca},

doi = {10.3389/fpsyt.2022.991755},

issn = {16640640 (ISSN)},

year  = {2022},

date = {2022-01-01},

journal = {Frontiers in Psychiatry},

volume = {13},

publisher = {Frontiers Media S.A.},

abstract = {Background: Social anxiety disorder (SAD) has a high prevalence and an early onset with recovery taking decades to occur. Current evidence supports the efficacy of cognitive behavioral therapy (CBT) with virtual reality (VR) exposure. However, the evidence is based on a sparse number of studies with predominantly small sample sizes. There is a need for more trials investigating the optimal way of applying VR based exposure for SAD. In this trial, we will test the efficacy of CBT with adaptive VR exposure allowing adjustment of the exposure based on real-time monitoring of the participants's anxiety level. Methods: The trial is a randomized controlled, assessor-blinded, parallel-group superiority trail. The study has two arms: (1) CBT including exposure in vivo (CBT-Exp), (2) CBT including exposure therapy using individually tailored VR-content and a system to track anxiety levels (CBT-ExpVR). Treatment is individual, manual-based and consists of 10 weekly sessions with a duration of 60 min. The study includes 90 participants diagnosed with SAD. Assessments are carried out pre-treatment, mid-treatment and at follow-up (6 and 12 months). The primary outcome is the mean score on the Social Interaction Anxiety Scale (SIAS) with the primary endpoint being post-treatment. Discussion: The study adds to the existing knowledge by assessing the efficacy of CBT with adaptive VR exposure. The study has high methodological rigor using a randomized controlled trial with a large sample size that includes follow-up data and validated measures for social anxiety outcomes. Clinical trial registration: ClinicalTrials.gov, identifier: NCT05302518. Copyright © 2022 Ørskov, Lichtenstein, Ernst, Fasterholdt, Matthiesen, Scirea, Bouchard and Andersen.},

note = {Publisher: Frontiers Media S.A.},

keywords = {adult, aged, Alcohol Use Disorders Identification Test, anxiety assessment, Anxiety disorder, article, behavior disorder assessment, cognitive behavioral therapy, comparative effectiveness, controlled study, Depression, Drug Use Disorders Identification Test, electrodermal activity, exposure, Fear of Negative Evaluation, follow up, health economics, Heart Rate, human, Leibowitz Anxiety Scale, Machine learning, major clinical study, psychological distress assessment, psychophysiological measurements, randomized controlled trial, Simulator Sickness Questionnaire, social anxiety, Social Interaction Anxiety Scale, social phobia, Subjective Units of Distress Scale, therapy effect, treatment duration, treatment outcome, virtual reality, virtual reality exposure therapy, Working Alliance Inventory},

pubstate = {published},

tppubtype = {article}

}

@article{lafortune_virtual_2020,

title = {Virtual Reality and Sex Therapy: Future Directions for Clinical Research},

author = {D. Lafortune and L. Dion and P. Renaud},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85075661234&doi=10.1080%2f0092623X.2019.1623357&partnerID=40&md5=217b4082644658823a6c8dd10fea1b7b},

doi = {10.1080/0092623X.2019.1623357},

issn = {0092623X},

year  = {2020},

date = {2020-01-01},

journal = {Journal of Sex and Marital Therapy},

volume = {46},

number = {1},

pages = {1–17},

publisher = {Routledge},

abstract = {Rapidly growing new technologies are revolutionizing the field of mental health, in terms of both understanding and treating mental disorders. Among these, virtual reality (VR) is a powerful tool providing clients with new learning experiences benefiting their psychological well-being. This article offers an overview of the current literature on VR in psychotherapy, highlighting its relevance to sexual dysfunction (SD) treatment. A literature review of PubMed and Google Scholar databases was used to provide a description of the theoretical frameworks and clinical indications associated with VR use in psychotherapy and SD treatment. The effectiveness of VR exposure-based therapy has been empirically validated for several mental disorders, notably anxiety disorders. The emerging combined use of VR and mindfulness tends to focus on chronic pain treatment. Experimental research examining the use of immersive technologies in the treatment of SDs is lacking. Given the shortcomings of conventional SD treatments, exploring and developing specialized VR interventions may prove beneficial. VR offers promising avenues in sex therapy, particularly for the treatment of genital pain disorders or SDs in which anxiety plays a significant etiological role. © 2019, © 2019 Taylor & Francis Group, LLC.},

note = {Publisher: Routledge},

keywords = {human, Humans, Mental health, Physiological, procedures, Psychological, psychosexual disorder, Sexual Dysfunction, Sexual Dysfunctions, virtual reality, virtual reality exposure therapy},

pubstate = {published},

tppubtype = {article}

}

@article{nolet_adoption_2020,

title = {The Adoption of New Treatment Modalities by Health Professionals and the Relative Weight of Empirical Evidence in Favor of Virtual Reality Exposure Versus Mindfulness in the Treatment of Anxiety Disorders},

author = {K. Nolet and G. Corno and S. Bouchard},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85083108852&doi=10.3389%2ffnhum.2020.00086&partnerID=40&md5=e72f1ece3a23c5283e1c9cc954c090bb},

doi = {10.3389/fnhum.2020.00086},

issn = {16625161},

year  = {2020},

date = {2020-01-01},

journal = {Frontiers in Human Neuroscience},

volume = {14},

publisher = {Frontiers Media S.A.},

abstract = {Anxiety disorders are among the most prevalent mental disorders, and cognitive-behavioral therapy (CBT) with exposure exercises is considered as the gold-standard psychological intervention. New psychotherapeutic modalities have emerged in the last decade and, among them, mindfulness has been rapidly adopted by therapists. The adoption rate is slower for the use of virtual reality (VR) to conduct exposure. The goal of the present position paper is to contrast, for the treatment of anxiety disorders, the weight of empirical evidences supporting the use of exposure in VR with the use of mindfulness-based therapy (MBT). Based on the most recent meta-analyses, we found that CBT with exposure conducted in VR was more thoroughly researched and supported than MBT, receiving validation from roughly twice as many studies with high control (i.e., randomized, active controls with clinical samples). However, this conclusion is nuanced by reviewing gaps in the literature for both therapies. Potential factors influencing clinicians’ choice of treatment and suggestions for future research directions are proposed. © Copyright © 2020 Nolet, Corno and Bouchard.},

note = {Publisher: Frontiers Media S.A.},

keywords = {Anxiety disorder, clinical decision making, cognitive behavioral therapy, comparative effectiveness, controlled study, evidence based medicine, human, intermethod comparison, mental health care personnel, mindfulness, randomized controlled trial (topic), review, therapy effect, validation study, virtual reality exposure therapy},

pubstate = {published},

tppubtype = {article}

}

@article{clemmensen_study_2020,

title = {Study protocol: Exposure in virtual reality for social anxiety disorder-a randomized controlled superiority trial comparing cognitive behavioral therapy with virtual reality based exposure to cognitive behavioral therapy with in vivo exposure},

author = {L. Clemmensen and S. Bouchard and J. Rasmussen and T. T. Holmberg and J. H. Nielsen and J. R. Mø. Jepsen and M. B. Lichtenstein},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85078711155&doi=10.1186%2fs12888-020-2453-4&partnerID=40&md5=28b076f10bf189f7c90b8bed4c719200},

doi = {10.1186/s12888-020-2453-4},

issn = {1471244X},

year  = {2020},

date = {2020-01-01},

journal = {BMC Psychiatry},

volume = {20},

number = {1},

publisher = {BioMed Central},

abstract = {Background: Social Anxiety Disorder (SAD) is characterized by an intense fear of negative judgement by others. Cognitive Behavioral Therapy (CBT) is recommended for treatment, but a substantial part of individuals with SAD either do not seek treatment or drop-out. CBT with Virtual Reality (VR)-based exposure has several advantages compared to traditional exposure methods, mainly due to increased control of situational elements. The aim of the current study is to develop a CBT program containing VR-based exposure. The intervention is targeted to adult patients suffering from SAD and treatment effect will be assessed by changes in SAD symptoms. Methods: This article describes the study protocol of a Randomized Controlled Trial with three arms: 1) CBT with VR exposure based on 360° videos 2) CBT with in vivo exposure and 3) VR relaxation therapy. There will be 30 participants in each arm with a crossover at the end of the treatment period during which the participants in the third group will be randomly re-Allocated to one of the two former groups. The treatment program consists of 10 weekly individual sessions with a psychologist, and a six month follow-up consisting of a questionnaire. The primary outcome measure is reduction in SAD symptoms which will be assessed with the Social Interaction Anxiety Scale (SIAS). Discussion: There are currently no published studies on CBT with VR exposure based on 360° videos for SAD treatment. Furthermore, the current study will be the first Danish SAD treatment program that includes VR technology. Trial registration: clinicaltrials.gov (NCT03973541) June 3rd 2019. © 2020 The Author(s).},

note = {Publisher: BioMed Central},

keywords = {adult, Anxiety, article, clinical effectiveness, cognitive behavioral therapy, controlled study, exposure, follow up, health program, human, Humans, in vivo study, outcome assessment, phobia, psychologist, questionnaire, randomized controlled trial, relaxation training, Social, Social Interaction Anxiety Scale, social phobia, treatment outcome, virtual reality, virtual reality exposure therapy, Young Adult},

pubstate = {published},

tppubtype = {article}

}

@article{fernandez-alvarez_deterioration_2019,

title = {Deterioration rates in Virtual Reality Therapy: An individual patient data level meta-analysis},

author = {J. Fernández-Álvarez and A. Rozental and P. Carlbring and D. Colombo and G. Riva and P. L. Anderson and R. M. Baños and A. A. Benbow and S. Bouchard and J. M. Bretón-López and G. Cárdenas and J. Difede and P. Emmelkamp and A. García-Palacios and V. Guillén and H. Hoffman and I. Kampann and R. Moldovan and A. Mühlberger and M. North and P. Pauli and W. Peñate Castro and S. Quero and M. Tortella-Feliu and K. Wyka and C. Botella},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85050381788&doi=10.1016%2fj.janxdis.2018.06.005&partnerID=40&md5=012fdcaa9b8676314cbf22c52c91135b},

doi = {10.1016/j.janxdis.2018.06.005},

issn = {08876185 (ISSN)},

year  = {2019},

date = {2019-01-01},

journal = {Journal of Anxiety Disorders},

volume = {61},

pages = {3–17},

publisher = {Elsevier Ltd},

abstract = {Ample evidence supports the use of Virtual Reality (VR) for anxiety disorders. Nonetheless, currently there is no evidence about moderators or potential negative effects of VR treatment strategies. An Individual Patient Data (IPD) approach was employed with 15 retrieved datasets. The current study sample was composed of 810 patients. Randomized control trials (RCTs) for each primary outcome measure were performed, in addition to moderator analyses of the socio-demographic variables. Deterioration rates were 14 patients (4.0%) in VR, 8 (2.8%) in active control conditions, and 27 (15%) in the WL condition. With regard to receiving treatment, patients in a waiting list control condition had greater odds of deteriorating than in the two active conditions, odds ratios (ORs) 4.87, 95% confidence interval (CI) [0.05, 0.67]. In the case of the socio-demographic variables, none of them were associated with higher or lower odds of deterioration, with the exception of marital status in the WL condition; married people presented a significantly lower probability of deterioration, OR 0.19, 95% CI [0.05, 0.67]. Finally, when comparing pooled effects of VR versus all control conditions, the OR was 0.61 (95% CI 0.31–1.23) in favor of VR, although this result was not statistically significant. This study provides evidence about the deterioration rates of a therapeutic VR approach, showing that the number of deteriorated patients coincides with other therapeutic approaches, and that deterioration is less likely to occur, compared to patients in WL control groups. © 2018 Elsevier Ltd},

note = {Publisher: Elsevier Ltd},

keywords = {Adolescent, adult, aged, Anxiety disorder, Anxiety Disorders, article, demography, deterioration, Deterioration rates, disease association, female, human, Humans, Individual patient data analysis, male, marriage, meta analysis, Middle Aged, Odds Ratio, outcome assessment, Probability, psychology, randomized controlled trial (topic), social status, virtual reality, virtual reality exposure therapy, Young Adult},

pubstate = {published},

tppubtype = {article}

}

@article{tardif_re-examining_2019,

title = {Re-Examining Psychological Mechanisms Underlying Virtual Reality-Based Exposure for Spider Phobia},

author = {N. Tardif and C. -E. Therrien and S. Bouchard},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85060171246&doi=10.1089%2fcyber.2017.0711&partnerID=40&md5=43737ac357efea6e35bd5668eb17e040},

doi = {10.1089/cyber.2017.0711},

issn = {21522715},

year  = {2019},

date = {2019-01-01},

journal = {Cyberpsychology, Behavior, and Social Networking},

volume = {22},

number = {1},

pages = {39–45},

publisher = {Mary Ann Liebert Inc.},

abstract = {The proposed study aims at expanding results from a previous study on mechanisms of change after exposure in virtual reality (VR) and documenting the impact of adding tactile and haptic feedback. It was predicted that change in the severity of spider phobia according to the Fear of Spiders Questionnaire (FSQ) would be significantly predicted by change in dysfunctional beliefs toward spiders and self-efficacy, over and above the variance explained by a physiological measure of fear during exposure (heart rate) and presence during the immersion. Participants (N = 59) were randomly assigned to the presentation of visual stimuli only, visual plus tactile stimuli, or visual, tactile plus haptic feedback stimuli. A standard multiple regression was conducted to predict change on the FSQ using the following predictors: beliefs about spiders, beliefs about one's own behavior when facing spiders, perceived self-efficacy, disgust, presence, and heart rate. Only changes in beliefs about spiders and in perceived self-efficacy significantly predicted the reduction in fear of spiders. This result enhances our understanding of the mechanisms involved in exposure conducted in VR. Analyses of variance also show that participants reported statistically significant changes in their clinical condition, with little added value to the addition of tactile and haptic feedback. The advantages of tactile and haptic stimulation are questioned, at least in the context of only one brief exposure session and the equipment used. © 2019, Mary Ann Liebert, Inc.},

note = {Publisher: Mary Ann Liebert Inc.},

keywords = {animal, Animals, Fear, Heart Rate, human, Humans, phobia, Phobic Disorders, physiology, psychology, questionnaire, spider, Spiders, Surveys and Questionnaires, virtual reality exposure therapy},

pubstate = {published},

tppubtype = {article}

}