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Background Although the Trier Social Stress Test (TSST) constitutes a valid paradigm for social stress induction, less is known about the effects of a virtual reality (VR) TSST on short- and long-term hypothalamic-pituitary-adrenal (HPA) axis and sympathetic-adreno-medullar (SAM) axis responses. Hence, this study set out to evaluate reactivity and habituation of self-reported stress and HPA and SAM reactivity in a real TSST and VR-TSST when compared to a placebo TSST. Method Sixty-eight healthy young adults (50% female) were randomly assigned to either a real TSST, a VR-TSST, or a placebo TSST, all of which were conducted three times (one day and one week post initial exposure). Social presence, self-reported stress, salivary cortisol, heart rate (HR), and heart rate variability (HRV) were analyzed using ANOVAs and multilevel models. Findings On the first exposure, both the real and VR-TSST showed significantly stronger cortisol and cardiovascular responses than the placebo. On the second visit, the cortisol response was still significantly high—and the HRV response low—for the real and VR-TSST. The third visit resulted in HR, HRV, and cortisol responses comparable to the placebo group. Furthermore, the real TSST induced more self-reported stress than the placebo on all three visits, the VR-TSST only on the first two visits. Social presence was stable across conditions and had no association with stress markers. Conclusion These findings imply that the replicability of stress exposures at shorter intervals seems problematic for the traditional TSST, and for the VR-TSST.

Background and objective As social interactions increasingly shift towards digitally mediated communications, understanding the underlying mechanisms of virtually provided support and its effect on stress buffering is of central importance. Thus, this study's objective was to assess, whether a virtual character's (avatar vs. agent) attentive and (non-verbal) emotionally responsive presence during a phase anticipating a real-life social-evaluative stressor would attenuate subsequent stress responses and have a beneficial effect on attentional focus and self-esteem. In addition, social presence and physical presence experiences were assessed. Methods 48 healthy young adults were either supported by a human controlled avatar, a computer agent or received no support prior to a real-life Trier Social Stress Test (TSST). Results Results revealed a moderate stress buffering effect of a virtual character's non-verbal attentive presence preceding a stressor. In particular, the presence of the human controlled avatar led to reduced feelings of tension as well as to a heightened attentional focus on others during the TSST. By trend, avatar support also seemed to protect the participants’ self-esteem. In contrast, unsupported controls showed the tendency to focus more on the self and report more tension. Finally, there were no group differences in social or physical presence. Conclusions The attentive presence of a virtual character seems to be effective in terms of attenuating subjective stress responses, particularly if the user has the impression that the virtual other is controlled by a human. Hence, online stress prevention and treatment may profit from purposefully inserting virtual characters as supporters and motivators.

While ostracism constitutes a social stressor with negative effects on physical and mental health, social inclusion seems to increase resilience. This may be true not only for face-to-face settings, but also for computer-mediated interactions. Hence, this study examined the differences between ostracism and social inclusion in real-life or Virtual Reality (VR) regarding self-reported stress, neuroendocrine and cardiovascular reactivity in a subsequent real-life socio-evaluative task. 84 females were randomly assigned to a 3 (agency: face-to-face/human controlled VR-avatar/computer VR-agent) x 2 (inclusion status: inclusion/exclusion) between-subject design using a Cyberball paradigm. Subsequently, they were exposed to a real-life Trier Social Stress Test (TSST). Results indicate that the experience of ostracism constitutes a threat to fundamental social needs independent of agency. Excluded participants showed cardiovascular reactivity during TSST; also face-to-face and avatar excluded individuals had elevated salivary cortisol levels. Included participants reported more perceived social support during Cyberball and showed a blunted cortisol response to the TSST. These results suggest that face-to-face and avatar-related ostracism provokes responses in the hypothalamic–pituitary–adrenal (HPA) axis and the sympathetic nervous system (SNS). Furthermore, they reveal that social inclusion may act as a stress-protector as it alters HPA- and SNS-related stress responsiveness to subsequent stressors.

Given the increasing use of virtual characters, research is challenged to gain sufficient knowledge on the effects they may have on human cognitions, emotions and behaviors. Thus, this study set out to examine social avoidance tendencies and prosocial behaviors towards human controlled (avatars) and computer controlled entities (agents). A total of N = 95 healthy young adults were randomly assigned to an avatar or agent condition. Participants were exposed to a virtual stranger asking to sit at the table (prosocial behavior) as well as a virtual waiter handing over the false drink (social avoidance). Empathy, interaction anxiety, social and physical presence as well as subjective stress levels were assessed to control for confounding influences. Empathy emerged as a significant predictor of prosocial behavior. Social avoidance, in turn, was not predicted by any of the included variables. Also, there was no effect of agency on social presence, physical presence, social interaction anxiety and stress. Yet, participants showed significantly more social avoidance and prosocial behavior towards avatars. These seemingly contradictory results may be explained by an extension of prior theories: While intuitive responses (e.g., stress) follow the Media Equation Concept (Nass & Moon, 2000), more complex processes (e.g., empathy) may modulate agency dependent responses.

The concept of social exclusion has recently gained more attention in the context of online social interactions. However, there is only little data regarding the impact of virtual social exclusion on subsequent real-life social behaviors. Thus, this study set out to examine a virtual version of the common social exclusion scenario, the Cyberball-Paradigm (Williams & Jarvis, 2006), and test for behavioral consequences in a sample of 45 students. Both the virtual characters' agency and the experience of social presence were controlled for. Findings indicate that ostracized individuals show less prosocial behavior in a helping task and keep more seating distance to a confederate than included participants. Also, virtual social exclusion constitutes a significant threat to fundamental human needs like social control, self-esteem and belonging and causes an increase in uncertainty, sadness and anger as well as a decrease in happiness. Avatars and agents seemed to equally endanger human needs and lead to the same seating distance. However, avatar excluded persons also had higher levels of sadness and were less helpful than avatar included persons, who in turn were more confident. Thus, while the Media Equation Concept (Nass & Moon, 2000) holds true for the immediate reaction to social exclusion (i.e., avatars and agents equally threaten fundamental needs), the delayed emotional and behavioral reactions differ for avatars and agents, possibly because they are preceded by cognitive evaluation (c.f.,Temporal Need-Threat Model; Williams, 2009). Implications of these findings for everyday online social interactions (i.e., in MMORPGs) are discussed. Virtual social exclusion leads to increased anger, sadness and uncertainty.Virtual social exclusion constitutes a significant threat to basic human needs.Participants excluded by avatars showed less real-life prosocial behavior.Excluded participants kept a larger seating distance to a confederate.There was no difference in social presence between avatars and agents.

Public speaking is a well-known psychosocial stress to occur in social-evaluative situations. This study examined self-reported, autonomic and endocrine stress responses to a 5-minźpublic speaking task. Participants were asked to present either in front of i) a real audience, or ii) a virtual audience or iii) an empty virtual lecture hall. Thus, the main objective of this study was to examine the influence of real or virtual social stimuli on stress reactivity. Additionally, possible sex differences in stress responses were evaluated. Sixty-six women and men (20-33 years) underwent a multidimensional assessment of stress including self-reported state anxiety, heart rate, heart rate variability and saliva cortisol secretion. Results showed comparable increases in all stress responses in both the real and the virtual public speaking group. These findings indicate that the Self Preservation Theory is not limited to physically present social entities, but may also be extended to virtual social stimuli; as such this observation is also in line with the so called Media Equation Concept. Implications of the current results for therapy and research are subsequently discussed. Social evaluation (real & virtual) leads to an increase in anxiety, HR and cortisol.Virtual stressors without social cues do not elicit a significant stress response.No sex differences in stress responses during real and virtual social evaluation.Data supports Media Equation Theory and Self-Preservation Theory in virtual reality.

Although social anxiety disorders (SADs) are increasingly treated by means of virtual cue exposure, the mechanisms leading to sufficient anxiety levels and thus to a success of virtual reality exposure therapy are still poorly understood. Also, most studies with SAD participants fail to evaluate social presence, although it may be a more appropriate indicator for virtual social stress scenarios than physical presence. Hence, for the first time, this study sets out to examine the link between social presence, physical presence, and emotional responses to phobogenic virtual social stimuli. A group of n = 12 participants with SAD and n = 12 healthy controls were exposed to three social tasks in an interactive virtual environment (VE). Self-report measures of physical and social presence as well as state anxiety were used alongside heart rate measures to evaluate the virtual experience. Results show significantly higher anxiety levels-both self-report and physiological-in SAD participants than in controls. Also, socially anxious subjects reported to experience more copresence and mutual attention as well as a higher sense of being in the VE than their healthy peers. In sum, social presence experiences may be more predicative of the anxiety response in SAD individuals than physical presence. Especially attentional processes seem to crucially shape the interplay between presence and affective responses.

While virtual humans are increasingly used to benefit the elderly, considerably little is still known about older adults' virtual experiences. However, due to age-related changes, older adults' perceptions of virtual environments (VEs) may be unique. Hence, our objective was to examine possible gender differences in immersion, flow, and emotional states as well as physical and social presence in elderly males and females interacting either with a computer-controlled agent or a human-controlled avatar. Seventy-eight German-speaking older adults were randomly assigned to an avatar or an agent condition and were exposed to a brief social encounter in a virtual café. Results indicate no overall gender differences, but a significant effect of agency on social presence, physical presence, immersion, and flow. Participants in the avatar condition reported higher levels in all measures, except for involvement. Furthermore, significant gender × agency interactions were found, with females showing more social presence, spatial presence, and flow when interacting with a human-controlled avatar and more realism when conversing with an agent. Also, all participants showed significant changes in their affect post exposure. In sum, older adults' virtual experiences seem to follow unique patterns, yet, they do not preclude the elderly from successfully participating in VEs.

Background and objectives Face-to-face and text-based social support have been shown to attenuate stress responses in past studies. Yet as social interactions increasingly take place online by means of virtual humans, our objective was to examine whether different forms of social support (virtual vs. real) prior to the Trier Social Stress Test (TSST) would also decrease stress. Additionally, the effect on subsequent real-life social behaviors (helping and approach) was evaluated while controlling for affective states and social presence. Methods 56 participants were either supported by an avatar, an agent, a real human or received no support before completing the TSST and two subsequent social behavior tasks (pen task and seating task). Results Results show no difference in agency regarding social presence. Yet, participants with agent support and no support had significantly higher heart rates during the TSST and reported to be more worried. Also, they were more irritated and showed significantly slower helping reactions (picking up pens). Limitations A limitation to this study is that only emotional verbal and non-verbal support were provided by a stranger. Different forms of support as well as a different source (i.e., a friend) may have a more pronounced effect on stress buffering. Conclusions Virtual social support is as effective as face-to-face support in terms of stress buffering, as long as the recipient has the impression that it is provided by another human (via an avatar). This has wide ranging implications not only for health-related application in prevention and treatment but also for further research.

Following the idea of using virtual environments (VEs) as mood induction procedures (MIPs), this study set out to examine whether five different virtual park scenarios would each elicit a specific affective state (i.e., joy, sadness, boredom, anger and anxiety). Within this main objective, a subset of two additional goals was identified: first, to analyze whether the sense of presence would differ across emotionally charged VEs, and second, to examine the link between a more objective measure of affective arousal, electrodermal activity (EDA), and presence. Following a between-subject design, 120 students were randomly assigned to one of the five VEs. Results show that almost all of the five virtual park scenarios were able to elicit the intended emotion. Additionally, presence levels were the same across all VEs suggesting that presence did not confound the emotional reaction to the VEs. Furthermore, EDA seems to be a poor indicator of presence as it is not significantly correlated with self-reported presence. The implications of these findings for both future research and practice are addressed in a comprehensive discussion. Four virtual park scenarios elicited the intended emotional states.Presence levels were the same across different virtual environments.Skin conductance level seems to be a poor indicator of presence.

Collaborative virtual environments (CVEs) hold the immense potential of enhancing social inclusion and social support not only in younger but especially also in older people. However, there is still considerably little knowledge about the experiences of elderly when using CVEs. Additionally, there is reason to assume that men and women regardless of their age might also differ in their perceptions of CVEs, with this difference very likely being mediated by empathic abilities. Consequently, the main objective of the current study was to evaluate gender specific experiences of social and physical presence in a group of older (N=62) and younger adults (N=62) with respect to possible mediating influences of empathy. Results indicate no differences in physical and social presence between the two age groups, yet they support past findings that men experience more spatial presence, involvement and a higher sense of being there than women. Also, the empathy scale Fantasy considerably mediated gender differences in spatial presence, thus strengthening the theoretical assumption of a relationship between presence and empathy. Implications and future directions of these findings are discussed in detail.

The link between anxiety and presence in a virtual environment (VE) is still a subject of an unresolved debate, with little empirical research to support theoretical claims. Thus, the current study analyzed presence, self-reported anxiety, and a physiological parameter (heart rate [HR]) in a sample of 30 high anxious and 35 low anxious participants. Both groups delivered a 5 minute speech in a virtual lecture hall. Results indicate no mediating influences of presence on group differences in self-reported state anxiety during the speech, but point toward negative correlations between state anxiety and the iGroup Presence Questionnaire (IPQ) scales "sense of being there" and "realism." Furthermore, HR was found to be unrelated to self-reported presence. Only the IPQ scale "spatial presence" showed a marginally significant influence on group differences in state anxiety. The present results support the assumption that presence and anxiety are logically distinct, meaning that presence does not directly influence the intensity of an emotion felt in a VE. Rather, it constitutes a precondition for an emotion to be at all elicited by a VE. Also, HR has proven to be no adequate substitute measure for presence, since it only assesses anxiety not presence. It may, however, mediate the interplay between trait anxiety and state anxiety. Possible implications of the current findings are discussed alongside the problem of using presence questionnaires that seem to be prone to subjective bias (i.e., participants confusing presence and emotion).

Collaborative virtual environments allow younger and older people to interact over long distances and stay in contact with their families and friends. Thus, these virtual environments are considered to be both, a crucial factor for active and healthy ageing and a great chance for future developments that may enhance and alter communication for specific age groups. Yet, to date there is a lack of studies examining differences between younger and older adults with special regards to technology usage factors, presence related factors as well as anxiety measures and psychophysiological arousal during social interactions in a collaborative virtual environment. Consequently, the objective of the current study was to evaluate the above mentioned factors in a group of 20 younger and 20 older adults using a slightly stressful collaborative virtual environment. The corresponding results indicate that virtual environments could indeed be beneficial tools for the communication of both, younger and older adults. Yet, older adults reported significantly lower levels of social presence during the interaction and were less able to handle the system than younger adults. Interestingly however, both groups did not differ in their technology related anxiety or regarding physiological measures of stress during the experience of the virtual environment.

Collaborative virtual environments and technical possibilities in general are still a growing and more and more important influence on everyday life. According to corresponding studies it seems that context conditions as well as individual factors such as gender play an important role in the experience of virtual environments (i.e. immersion and technology-related anxiety) and in the rating of the used technology (i.e. its perceived usefulness). Thus, the objective of the current study was to evaluate the above mentioned factors in a group of 14 women and 14 men using two different emotionally charged collaborative virtual environments. The corresponding results indicate that there are in fact gender differences: Women reported higher levels of technology-related anxiety and immersion. In general, participants in the rainy condition rated the usefulness of the virtual environment higher. Also, women in the rainy condition rated the perceived usefulness higher than women in the cheerful condition whereas in the group of men it was vice versa.

In this paper we present two studies concerning the application of a virtual environment for public speaking anxiety. We have created a program simulating a virtual lecture room, which can be filled with a large number of listeners behaving in different ways. The purpose of the scene is to train people who are anxious to give talks in front of a large audience. We present the results of two studies, showing the impact of this kind of virtual exposure. Results indicate that people do experience such a situation as realistic, as well as report social insecurity and show heightened psychophysiological arousal (HR). Furthermore, we show that especially curious people, and people with high social insecurity rate the system as useful.