Observational studyJournal of medical Internet research2026
Automated Inference of Social Anxiety From Behavior in Social Virtual Reality: Cross-Sectional Observational Study.
Observational study in Journal of medical Internet research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSocial anxiety often manifests through behaviors such as reduced gaze to the eyes and lower speech volume. While these markers have been examined in face-to-face interactions, large-scale assessments remain challenging. Social virtual reality (VR) offers a promising alternative by enabling naturalistic interactions in which behavior can be captured at scale, but it remains unclear if people show naturalistic behavior in such artificial environments.
objectiveWe examined whether behavioral and physiological markers associated with social anxiety in real-life interactions similarly emerge in dyadic social VR. We additionally examined whether these patterns overlap with patterns linked to the broader constructs of psychopathology and verticality.
methodsIn this cross-sectional study, 128 participants (105 females, 22 males, 1 diverse; age 18-51 years; mean age 22.60, SD 3.57 years), recruited from a university student population, engaged in a 30-minute avatar-mediated dyadic conversation in social VR while physically located in separate rooms. We assessed gaze toward the partner's eyes, smiling, and speaking behavior by using the VR headsets' built-in eye trackers, face trackers, and microphones, and assessed high-frequency heart rate variability (HF-HRV) by using an electrocardiogram.
resultsRelationships between traits and behavioral and physiological measures were analyzed using linear mixed-effects models (α=.05). Social anxiety was linked to reduced gaze toward the partner's eyes while speaking (β=-.20, 95% CI -0.35 to -0.04; t
conclusionsIn dyadic interactions in social VR, social anxiety was associated with behavioral and physiological modulations similar to those observed in face-to-face interactions, indicating heightened social stress and submissiveness even in avatar-mediated communication. Patterns were similar for heightened psychopathology and reversed for verticality, indicating that these traits may lie on a shared social-behavioral spectrum. Extending previous research focused on face-to-face interactions or reactions toward artificial agents displayed in VR, this study is the first to provide a comprehensive account of the behavioral and physiological modulations associated with social anxiety in avatar-based human-human interactions. Since social VR setups allow researchers to assess a rich set of behavioral data as a byproduct of the setup's core functionality, the technique opens novel possibilities to detect social stress, track therapeutic progress, or tailor interventions to individual behavior when interactions take place in VR.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.