{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T18:06:07Z","timestamp":1786125967035,"version":"build-2736575974"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002241","name":"Japan Science and Technology Agency","doi-asserted-by":"publisher","award":["JPMJPF2203"],"award-info":[{"award-number":["JPMJPF2203"]}],"id":[{"id":"10.13039\/501100002241","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NTT Digital Computing Research Center"},{"DOI":"10.13039\/501100020963","name":"Moonshot Research and Development Program","doi-asserted-by":"publisher","award":["JPMJMS239F"],"award-info":[{"award-number":["JPMJMS239F"]}],"id":[{"id":"10.13039\/501100020963","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Social anxiety disorder has a considerable negative impact on educational attainment, employment status, and relationship development. Exposure therapy is an established method used to treat social anxiety by getting patients used to talking to other people. However, this procedure requires patients to have conversations with strangers, which may impose a psychological burden. This study aimed to examine whether the burden could be reduced during a first-time face-to-face interaction by using a human digital twin avatar technology that we call \u201cAnother Me.\u201d We conducted an exploratory, randomized, open-label, controlled study with 30 young participants who self-reported nervousness during conversations with strangers. Participants were divided into an intervention group and a control group. The intervention group (n\u2009=\u200915) watched a generated video of a conversation between their Another Me and the Another Me of an assigned interlocutor. After viewing the video, they engaged in an online conversation with the assigned interlocutor. The control group (n\u2009=\u200915) watched a video of a conversation between the avatars of two strangers and then engaged in a conversation with an assigned interlocutor. Results showed that the primary endpoint\u2014the between-group difference in heart rate change from before to after the online conversation\u2014was not statistically significant. However, exploratory secondary analyses suggested that heart rate decreased in the intervention group after viewing the pre-dialogue simulation video and remained relatively stable until the completion of the online conversation. In contrast, the control group exhibited an increase in heart rate before the online conversation. Additionally, the intervention group reported lower anxiety levels and a greater willingness to converse until the end of the face-to-face conversation. These findings should be interpreted as preliminary and hypothesis-generating. Further confirmatory trials with rigorous physiological monitoring are required.<\/jats:p>","DOI":"10.1371\/journal.pone.0353835","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:32:39Z","timestamp":1786123959000},"page":"e0353835","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Investigating \u201cAnother Me\u201d digital twin technology to support the development of human relationships: An exploratory randomized controlled study"],"prefix":"10.1371","volume":"21","author":[{"given":"Ami","family":"Yamasato","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8860-070X","authenticated-orcid":true,"given":"Chihiro","family":"Takayama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichiro","family":"Eitoku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Ishii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Ishii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4992-6918","authenticated-orcid":true,"given":"Lidwina","family":"Andarini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuya","family":"Matsuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Otsuka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Setsukou","family":"Sha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Tamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6928-0432","authenticated-orcid":true,"given":"Emi","family":"Kamono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mizuki","family":"Ohashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Yano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3840-5436","authenticated-orcid":true,"given":"Tomoyuki","family":"Miyazaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"issue":"7","key":"pone.0353835.ref001","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1016\/j.cpr.2004.07.004","article-title":"The nature and expression of social phobia: Toward a new classification","volume":"24","author":"SG Hofmann","year":"2004","journal-title":"Clin Psychol Rev"},{"issue":"3","key":"pone.0353835.ref002","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1177\/0004867414546699","article-title":"DSM-IV and DSM-5 social anxiety disorder in the Australian community","volume":"49","author":"E Crome","year":"2015","journal-title":"Aust N Z J Psychiatry"},{"issue":"4","key":"pone.0353835.ref003","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1176\/appi.ajp.157.4.521","article-title":"Barriers to the treatment of social anxiety","volume":"157","author":"M Olfson","year":"2000","journal-title":"Am J Psychiatry"},{"issue":"9618","key":"pone.0353835.ref004","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1016\/S0140-6736(08)60488-2","article-title":"Social anxiety disorder","volume":"371","author":"MB Stein","year":"2008","journal-title":"Lancet"},{"issue":"1","key":"pone.0353835.ref005","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.brat.2007.10.003","article-title":"Optimizing inhibitory learning during exposure therapy","volume":"46","author":"MG Craske","year":"2008","journal-title":"Behav Res Ther"},{"key":"pone.0353835.ref006","unstructured":"National Institute for Health and Care Excellence. 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