Evidence map›Paper›PMID 41898011›Full record

ArticleBehavioral sciences (Basel, Switzerland)2026

Human-like, Animal-like, or Object-like? The Impact of LLM-Based Virtual Doctor Avatar Design on User Emotion, Physiology, and Experience.

Han Zhang, Shiyi Wang, Rui Peng

Abstract read
In one paragraph

Article in Behavioral sciences (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Han ZhangIntelligent Design, Platform at the Intersection of Art and Technology, Central China Normal University, Wuhan 430079, China.ORCID 0000-0002-3998-9464
Shiyi WangIntelligent Design, Platform at the Intersection of Art and Technology, Central China Normal University, Wuhan 430079, China.
Rui PengIntelligent Design, Platform at the Intersection of Art and Technology, Central China Normal University, Wuhan 430079, China.

Funding

MOE (Ministry of Education in China) Project of Humanities and Social Sciences 22YJC760044
6 · The paper itself

Abstract

Virtual agents powered by large language models are increasingly deployed in digital mental health services, yet the influence of avatar appearance on users' emotional, cognitive, and physiological responses remains insufficiently understood. This study was conducted between March and April 2024 and examined how three avatar designs-animal-like, human-like, and object-like-shape affective experience, user evaluation, autonomic activity, and attentional allocation during virtual doctor interactions. Forty-two participants completed a within-subjects experiment involving self-reported affect ratings, multidimensional user-experience assessments, heart rate variability (HRV) measures, and eye-tracking indicators. The avatar type did not yield statistically significant differences in changes in positive or negative affect across conditions. However, physiological data revealed clear divergences. The animal-like avatar elicited the strongest parasympathetic activation, reflected by significant increases in the root mean square of successive differences (RMSSD) and high-frequency (HF) power, whereas the object-like avatar produced a sympathetic-dominant response. Across six user-experience dimensions, the animal-like avatar consistently received the highest evaluations. Eye-tracking results showed faster first fixation and a longer face-directed fixation duration for the animal-like avatar, indicating stronger social attention. The human-like avatar demonstrated slightly delayed initial fixation, consistent with subtle yet nonsignificant uncanny-valley tendencies. These findings underscore the critical role of avatar visual design in shaping emotional safety, engagement, and social processing in virtual mental-health interactions.

Indexed as

digital mental healthemotional responseslarge language modelssocial presenceuser experiencevirtual doctor avatars

Identifiers

PMID41898011
PMCPMC13023460

What OpenQuestion holds

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Registered trials

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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.