Abstract：
Compared to the in-person Trier Social Stress Test (TSST), virtual reality (VR) variants reduce resource-intensity and improve standardization but induce stress with smaller effect sizes. However, higher cortisol reactivity is given for more immersive TSST-VRs. Immersivity depends on the VR-system, but perceived immersion may be targeted by exposure to, or interaction with the VR. We investigated whether stress reactivity towards the openly accessible OpenTSST VR can be enhanced by prior exposure to a sensorimotor game completed in VR as mediated by increased immersion. Therefore, N = 58 healthy participants underwent the OpenTSST VR or its inbuilt control condition (placebo TSST-VR, pTSST-VR). Beforehand, participants completed a sensorimotor game either in VR or in real life. Stress was measured by means of self-reports, salivary cortisol concentrations, and salivary alpha-amylase (sAA) activity. Perceived immersion was assessed with the Igroup Presence Questionnaire (IPQ). The TSST-VR-group showed higher subjective stress than the pTSST-VR-group. Even though area under the curve measures indicated significant differences in cortisol levels between TSST-VR and pTSST-VR, this effect was not replicated in omnibus-analyses. Likewise, sAA was not responsive to stress. Our data suggests the OpenTSST VR does not reliably trigger physiological stress reactivity. Likewise, participants playing the VR-game before exposure to the TSST-VR did not show enhanced stress reactivity. Importantly, playing the VR-game did not lead to increased immersion (indicated by the IPQ), either. The key question resulting from our study is which manipulation may be fruitful to obtain a comparable stress response toward the TSST-VR compared to the in-person TSST.
摘要：
与面对面的特里尔社会压力测试(TSST)相比，虚拟现实（VR）变体降低了资源强度并改善了标准化，但以较小的效应大小引起了压力。然而,更高的皮质醇反应性给予更多的沉浸式TSST-VRs。沉浸感取决于VR系统，但是感知到的沉浸感可能是暴露于，或与VR互动。我们调查了对开放可访问的OpenTSSTVR的应激反应是否可以通过事先暴露于VR中完成的感觉运动游戏而增强，这是通过增加沉浸感来介导的。因此,N=58名健康参与者接受了OpenTSSTVR或其内置对照条件(安慰剂TSST-VR，pTSST-VR)。事先，参与者在VR或现实生活中完成了感觉运动游戏。压力是通过自我报告来测量的，唾液皮质醇浓度,和唾液α-淀粉酶（sAA）活性。使用Igroup存在问卷（IPQ）评估感知沉浸感。TSST-VR组的主观应激高于pTSST-VR组。即使曲线下面积测量表明TSST-VR和pTSST-VR之间的皮质醇水平存在显着差异，这一效应未在综合分析中得到证实.同样，sAA对压力无反应。我们的数据表明OpenTSSTVR不能可靠地触发生理应激反应。同样，参与者在暴露于TSST-VR之前玩VR游戏没有表现出增强的应激反应性.重要的是,玩VR游戏并没有导致沉浸感增加(由IPQ表示)，要么。我们研究得出的关键问题是，与面对面的TSST相比，哪种操作可能会对TSST-VR产生可比的应激反应。
