{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:17:53Z","timestamp":1788491873026,"version":"build-2803163510"},"reference-count":71,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Serious Games"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Craving is a diagnostic criterion and predictor of relapse in patients with alcohol dependence (AD) and is induced in cue exposure therapy (CET) to prepare patients for real-life risk situations. The benefits of virtual reality (VR) as an innovative tool within treatment for this highly prevalent disorder include increased practicability, standardization, and personalization of CET. Accurate measurement of craving is essential to develop effective virtual reality cue exposure (VR-CE) scenarios. Despite being relevant for diagnostics and therapy, the psychophysiological reaction to alcohol cues and its relationship to subjective craving has not been sufficiently examined.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to investigate the induction of subjective craving, its physiological correlates, and their relationship in patients with AD during an innovative VR-CE paradigm, including 2 alcohol-associated risk scenarios (bar and living room) and a neutral baseline scenario.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Craving was analyzed by measuring physiological reactions (electrodermal activity, including nonspecific skin conductance responses [NS-SCR] and skin conductance level [SCL]; heart rate [variability] [HR(V)]; brightness-corrected pupil diameter [BCPD]; and respiration rate [RR]) and subjective craving (visual analog scale) in 61 patients with AD. Linear mixed-effects models were conducted to estimate the effects of VR-CE. Correlations between subjective and physiological craving parameters were analyzed using Spearman correlations.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Results showed that alcohol-associated VR scenarios had significant effects on subjective craving (\n \u03b2<\/jats:italic>\n values between 9.48, 95% CI 6.02\u201012.95 and 15.93, 95% CI 12.47\u201019.40, with moderate effect sizes between\n d<\/jats:italic>\n =0.56 and\n d<\/jats:italic>\n =0.72) and on NS-SCR frequency (\n \u03b2<\/jats:italic>\n values between 0.97, 95% CI 0.14\u20101.80 and 3.06, 95% CI 2.23\u20103.89, with small-to-large effect sizes between\n d<\/jats:italic>\n =0.31 and\n d<\/jats:italic>\n =0.91), BCPD (\n \u03b2<\/jats:italic>\n values between 0.03, 95% CI 0.01\u20100.06 and 0.05, 95% CI 0.02\u20100.07, with small effect sizes between\n d<\/jats:italic>\n =0.21 and\n d<\/jats:italic>\n =0.29), and RR (\n \u03b2<\/jats:italic>\n values between 0.67, 95% CI 0.06\u20101.28 and 1.66, 95% CI 1.05\u20102.26, with small effect sizes between\n d<\/jats:italic>\n =0.22 and\n d<\/jats:italic>\n =0.45), but not on SCL and HR(V). Correlation analyses showed significant but weak correlations between subjective craving and electrodermal activity (SCL:\n r<\/jats:italic>\n =0.20,\n P<\/jats:italic>\n =.04; NS-SCR frequency:\n r<\/jats:italic>\n =0.21,\n P<\/jats:italic>\n =.03).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This study showed that subjective and physiological craving (NS-SCR, BCPD, and RR but not SCL and HR[V]) can be successfully induced by VR-CE in patients with AD. These outcomes add to research on the induction of craving using a wide range of psychophysiological and subjective parameters. Furthermore, this study expands the still-limited research on the relationship between subjective and psychophysiological craving in patients with AD. In the long term, this study informs the development of effective VR-CET, which could, by further building on psychophysiological parameters, lead to biofeedback VR-CET as an innovative treatment option for patients with AD.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/84156","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T19:12:37Z","timestamp":1781118757000},"page":"e84156-e84156","source":"Crossref","is-referenced-by-count":1,"title":["Multimodal Psychophysiological Assessment of Craving in Patients With Alcohol Dependence During Virtual Reality Cue Exposure: Exploratory Single-Arm Clinical Study"],"prefix":"10.2196","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5955-8821","authenticated-orcid":false,"given":"Alva","family":"L\u00fctt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2289-1556","authenticated-orcid":false,"given":"Nadja","family":"Ruckser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2479-1198","authenticated-orcid":false,"given":"Alessandro","family":"Turno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1311-2840","authenticated-orcid":false,"given":"Nikolaos","family":"Tsamitros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9371-3242","authenticated-orcid":false,"given":"Julia","family":"Thormann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9415-2555","authenticated-orcid":false,"given":"Daniel","family":"Schulze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9860-3250","authenticated-orcid":false,"given":"Ivan","family":"Nenchev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2943-8949","authenticated-orcid":false,"given":"Thomas","family":"Wolbers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2646-9861","authenticated-orcid":false,"given":"Sofia Marie","family":"Lange Mussons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0149-9122","authenticated-orcid":false,"given":"Robert","family":"Sch\u00f6neck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4831-6097","authenticated-orcid":false,"given":"Jil Zo\u00e9","family":"Fuhrmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3260-6328","authenticated-orcid":false,"given":"Felix","family":"Bermpohl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5405-9065","authenticated-orcid":false,"given":"Andreas","family":"Heinz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6006-3201","authenticated-orcid":false,"given":"Miriam","family":"Sebold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6215-7295","authenticated-orcid":false,"given":"Anne","family":"Beck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7150-6071","authenticated-orcid":false,"given":"Stefan","family":"Gutwinski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"R1","unstructured":"Diagnostic and Statistical Manual of Mental Disorders DSM-5. American Psychiatric Association; 2013. ISBN: 978-0-89042-559-6"},{"key":"R2","unstructured":"International Classification of Diseases, 11th revision (ICD-11). World Health Organization. 2022. URL: https:\/\/icd.who.int\/en\/ [Accessed 10-10-2025]"},{"issue":"2","key":"R3","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1093\/alcalc\/agy093","article-title":"Alcohol craving predicts relapse after residential addiction treatment","volume":"54","author":"Stohs","journal-title":"Alcohol Alcohol"},{"issue":"4","key":"R4","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1016\/j.neubiorev.2009.11.024","article-title":"Craving\u2019s place in addiction theory: contributions of the major models","volume":"34","author":"Skinner","journal-title":"Neurosci Biobehav Rev"},{"issue":"1","key":"R5","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-016-0795-8","article-title":"A randomized controlled study of exposure therapy as aftercare for alcohol use disorder: study protocol","volume":"16","author":"Mellentin","journal-title":"BMC Psychiatry"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2022.107578","article-title":"The efficacy of cue exposure therapy on alcohol use disorders: a quantitative meta-analysis and systematic review","volume":"139","author":"Kiyak","journal-title":"Addict Behav"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2015.00660","article-title":"Virtual reality for enhanced ecological validity and experimental control in the clinical, affective and social neurosciences","volume":"9","author":"Parsons","journal-title":"Front Hum Neurosci"},{"issue":"3","key":"R8","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1007\/s40429-021-00377-5","article-title":"Virtual reality-based treatment approaches in the field of substance use disorders","volume":"8","author":"Tsamitros","journal-title":"Curr Addict Rep"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2019.00074","article-title":"Identifying triggers of alcohol craving to develop effective virtual environments for cue exposure therapy","volume":"10","author":"Ghi\u0163\u0103","journal-title":"Front Psychol"},{"issue":"3","key":"R10","doi-asserted-by":"publisher","first-page":"199","DOI":"10.20882\/adicciones.1958","article-title":"ALCO-VR Project: a randomized clinical trial evaluating virtual reality cue-exposure therapy for treatment-resistant alcohol use disorder patients","volume":"37","author":"Ghi\u0163\u0103","journal-title":"Adicciones"},{"issue":"4","key":"R11","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.1007\/s00213-018-5131-1","article-title":"Pupillary reactivity to alcohol cues as a predictive biomarker of alcohol relapse following treatment in a pilot study","volume":"236","author":"Kvamme","journal-title":"Psychopharmacology (Berl)"},{"issue":"1","key":"R12","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-023-05426-z","article-title":"Effects of virtual reality-based cue exposure therapy on craving and physiological responses in alcohol-dependent patients-a randomised controlled trial","volume":"23","author":"Zhang","journal-title":"BMC Psychiatry"},{"issue":"10","key":"R13","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1007\/s00702-005-0439-5","article-title":"Physiological and subjective responding to alcohol cue exposure in alcoholics and control subjects: evidence for appetitive responding","volume":"113","author":"Reid","journal-title":"J Neural Transm (Vienna)"},{"issue":"3","key":"R14","doi-asserted-by":"publisher","first-page":"354","DOI":"10.15288\/jsa.2005.66.354","article-title":"Alcohol cue reactivity in alcohol-dependent adolescents","volume":"66","author":"Thomas","journal-title":"J Stud Alcohol"},{"key":"R15","doi-asserted-by":"crossref","unstructured":"Grimm P . Social desirability bias. In: Sheth J Malhotra N , editors. Wiley International Encyclopedia of Marketing. John Wiley & Sons; 2010. [doi: 10.1002\/9781444316568]","DOI":"10.1002\/9781444316568.wiem02057"},{"issue":"2","key":"R16","doi-asserted-by":"publisher","first-page":"1572","DOI":"10.1016\/j.addbeh.2012.08.004","article-title":"Measurement of alcohol craving","volume":"38","author":"Kavanagh","journal-title":"Addict Behav"},{"issue":"1","key":"R17","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1111\/j.1530-0277.2006.00019.x","article-title":"Measuring craving: an attempt to connect subjective craving with cue reactivity","volume":"30","author":"Ooteman","journal-title":"Alcohol Clin Exp Res"},{"issue":"4","key":"R18","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1037\/a0015843","article-title":"A meta-analytic investigation of the relationship between attentional bias and subjective craving in substance abuse","volume":"135","author":"Field","journal-title":"Psychol Bull"},{"issue":"16","key":"R19","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10163658","article-title":"Clinical relevance of immersive virtual reality in the assessment and treatment of addictive disorders: a systematic review and future perspective","volume":"10","author":"Langener","journal-title":"J Clin Med"},{"issue":"3","key":"R20","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1016\/j.pbb.2008.08.014","article-title":"Quantitative electroencephalographic (qEEG) correlates of craving during virtual reality therapy in alcohol-dependent patients","volume":"91","author":"Lee","journal-title":"Pharmacol Biochem Behav"},{"issue":"1","key":"R21","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-023-05346-y","article-title":"An explorative single-arm clinical study to assess craving in patients with alcohol use disorder using virtual reality exposure (CRAVE)-study protocol","volume":"23","author":"L\u00fctt","journal-title":"BMC Psychiatry"},{"issue":"2","key":"R22","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)-a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","journal-title":"J Biomed Inform"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: building an international community of software platform partners","volume":"95","author":"Harris","journal-title":"J Biomed Inform"},{"issue":"5","key":"R24","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation","volume":"40","author":"Charlson","journal-title":"J Chronic Dis"},{"issue":"3","key":"R25","first-page":"179","volume":"23","author":"Drobes","journal-title":"Alcohol Res Health"},{"key":"R26","unstructured":"Braithwaite JJ Watson DG Jones R Rowe M . A guide for analysing electrodermal activity (EDA) & skin conductance responses (SCRs) for psychological experiments. University of Birmingham; 2015. URL: https:\/\/www.birmingham.ac.uk\/documents\/college-les\/psych\/saal\/guide-electrodermal-activity.pdf [Accessed 20-05-2026]"},{"issue":"8","key":"R27","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1111\/j.1469-8986.2012.01384.x","article-title":"Publication recommendations for electrodermal measurements","volume":"49","author":"Boucsein","journal-title":"Psychophysiology"},{"issue":"1","key":"R28","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1016\/j.jneumeth.2010.04.028","article-title":"A continuous measure of phasic electrodermal activity","volume":"190","author":"Benedek","journal-title":"J Neurosci Methods"},{"key":"R29","unstructured":"R2024b release highlights \u2013 MATLAB and Simulink version: 24.2. 0.2712019. MathWorks. 2024. URL: https:\/\/www.mathworks.com\/products\/new_products\/release2024b.html [Accessed 20-05-2026]"},{"key":"R30","unstructured":"Pandas-dev\/pandas. GitHub. 2020. URL: https:\/\/github.com\/pandas-dev\/pandas [Accessed 20-05-2026]"},{"key":"R31","doi-asserted-by":"crossref","unstructured":"McKinney W . Data structures for statistical computing in python. Presented at: 9th Python in Science Conference; Jun 28 to Jul 3, 2010; Austin, Texas. [doi: 10.25080\/Majora-92bf1922-00a]","DOI":"10.25080\/Majora-92bf1922-00a"},{"issue":"7825","key":"R32","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1038\/s41586-020-2649-2","article-title":"Array programming with NumPy","volume":"585","author":"Harris","journal-title":"Nature"},{"key":"R33","unstructured":"Gollan B . Sensor-based online assessment of human attention [Dissertation]. Johannes Kepler University Linz; 2017. URL: https:\/\/www.researchgate.net\/publication\/323573930_Sensor-based_Online_Assessment_of_Human_Attention [Accessed 20-05-2026]"},{"key":"R34","unstructured":"Beatty J Lucero-Wagoner B . The pupillary system. In: Cacioppo JT Tassinary LG Berntson CG , editors. Handbook of Psychophysiology. 2nd ed. Cambridge University Press; 2000:142-162. URL: https:\/\/cbcd.bbk.ac.uk\/sites\/default\/files\/cbcd\/files\/interlearn\/Beatty%20&%20Lucero-Wagoner%20(2000).pdf [Accessed 22-05-2026]"},{"key":"R35","doi-asserted-by":"crossref","unstructured":"Kluyver T Ragan-Kelley B P\u00e9rez F Granger B Bussonnier M Frederic J . Jupyter notebooks\u2014a publishing format for reproducible computational workflows. In: Loizides F Schmidt B , editors. Positioning and Power in Academic Publishing: Players, Agents and Agendas. IOS Press; 2016:87-90. URL: https:\/\/eprints.soton.ac.uk\/403913\/1\/STAL9781614996491-0087.pdf [Accessed 22-05-2026]","DOI":"10.3233\/978-1-61499-649-1-87"},{"key":"R36","unstructured":"Anaconda documentation. Anaconda. 2020. URL: https:\/\/www.anaconda.com\/docs\/main [Accessed 20-05-2026]"},{"key":"R37","unstructured":"R: a language and environment for statistical computing. R Foundation for Statistical Computing. 2023. URL: https:\/\/www.R-project.org\/ [Accessed 10-10-2025]"},{"key":"R38","unstructured":"RStudio: integrated development environment for R. The R Project; 2011. URL: https:\/\/www.r-project.org\/conferences\/useR-2011\/abstracts\/180111-allairejj.pdf [Accessed 20-05-2026]"},{"key":"R39","unstructured":"Pinheiro J Bates D DebRoy S Sarkar D . nlme: linear and nonlinear mixed effects models. R Core Team; 2025. URL: https:\/\/cran.r-project.org\/web\/packages\/nlme\/nlme.pdf [Accessed 20-05-2026]"},{"key":"R40","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2024.1430458","article-title":"Update: factors influencing heart rate variability-a narrative review","volume":"15","author":"Sammito","journal-title":"Front Physiol"},{"issue":"Supplement-1","key":"R41","doi-asserted-by":"publisher","first-page":"24","DOI":"10.2478\/v10201-011-0008-6","article-title":"Effects of elevated body temperature on control of breathing","volume":"11","author":"Zila","journal-title":"Acta Med Martin"},{"issue":"1","key":"R42","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1111\/j.1469-8986.2010.01043.x","article-title":"Sigh rate and respiratory variability during mental load and sustained attention","volume":"48","author":"Vlemincx","journal-title":"Psychophysiology"},{"issue":"1","key":"R43","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.emc.2023.06.022","article-title":"Physiologic effects of substance use","volume":"42","author":"Murray","journal-title":"Emerg Med Clin North Am"},{"issue":"3","key":"R44","doi-asserted-by":"publisher","first-page":"1074","DOI":"10.1152\/jappl.2001.90.3.1074","article-title":"Impact of age on breathing and resistive pressure in people with and without sleep apnea","volume":"90","author":"Browne","journal-title":"J Appl Physiol"},{"issue":"2-3","key":"R45","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1016\/j.resp.2005.10.010","article-title":"Does gender affect pulmonary function and exercise capacity?","volume":"151","author":"Harms","journal-title":"Respir Physiol Neurobiol"},{"key":"R46","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.00129","article-title":"Standards in pupillography","volume":"10","author":"Kelbsch","journal-title":"Front Neurol"},{"issue":"2","key":"R47","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/0042-6989(70)90114-8","article-title":"The influence of age and retinal illumination on the pupillary near reflex","volume":"10","author":"Sch\u00e4fer","journal-title":"Vision Res"},{"issue":"3","key":"R48","doi-asserted-by":"publisher","first-page":"202","DOI":"10.3928\/1081597X-20100511-01","article-title":"Dark-adapted pupil diameter as a function of age measured with the NeurOptics pupillometer","volume":"27","author":"Bradley","journal-title":"J Refract Surg"},{"issue":"3","key":"R49","first-page":"1132","volume":"35","author":"Winn","journal-title":"Invest Ophthalmol Vis Sci"},{"issue":"6","key":"R50","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1093\/ageing\/25.6.432","article-title":"Changes in autonomic function with age: a study of pupillary kinetics in healthy young and old people","volume":"25","author":"Bitsios","journal-title":"Age Ageing"},{"key":"R51","doi-asserted-by":"crossref","unstructured":"Wilhelm H . Pupillometrie. In: Katarakt- Und Linsenchirurgie. Springer; 2023:93-94. [doi: 10.1007\/978-3-662-62458-6_19]","DOI":"10.1007\/978-3-662-62458-6_19"},{"issue":"13","key":"R52","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v082.i13","article-title":"lmerTest package: tests in linear mixed effects models","volume":"82","author":"Kuznetsova","journal-title":"J Stat Soft"},{"issue":"5","key":"R53","doi-asserted-by":"publisher","first-page":"368","DOI":"10.3102\/1076998614547577","article-title":"Design-comparable effect sizes in multiple baseline designs: a general modeling framework","volume":"39","author":"Pustejovsky","journal-title":"J Educ Behav Stat"},{"key":"R54","unstructured":"Information matrices for fitted lme and gls models. lmeInfo. 2023. URL: https:\/\/jepusto.github.io\/lmeInfo\/ [Accessed 22-10-2025]"},{"key":"R55","unstructured":"Fox J Weisberg S . An R Companion to Applied Regression. 3rd ed. SAGE Publications, Inc; 2018. URL: https:\/\/us2.sagepub.com\/en-us\/nam\/an-r-companion-to-applied-regression\/book246125 [Accessed 20-05-2026]"},{"key":"R56","doi-asserted-by":"crossref","unstructured":"Cohen J . Statistical Power Analysis for the Behavioral Sciences. Routledge; 1988. [doi: 10.4324\/9780203771587]","DOI":"10.4324\/9780203771587"},{"issue":"1","key":"R57","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1037\/amp0000191","article-title":"Journal article reporting standards for quantitative research in psychology: the APA Publications and Communications Board task force report","volume":"73","author":"Appelbaum","journal-title":"Am Psychol"},{"issue":"6","key":"R58","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1016\/j.addbeh.2007.12.010","article-title":"Assessing reactivity to virtual reality alcohol based cues","volume":"33","author":"Bordnick","journal-title":"Addict Behav"},{"key":"R59","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2020.00124","article-title":"Alcohol craving in heavy and occasional alcohol drinkers after cue exposure in a virtual environment: the role of the sense of presence","volume":"14","author":"Simon","journal-title":"Front Hum Neurosci"},{"issue":"1","key":"R60","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-025-00587-6","article-title":"Virtual reality interventions in the assessment and treatment of alcohol use disorder - a systematic scoping review on methodology","volume":"20","author":"Gaddum","journal-title":"Addict Sci Clin Pract"},{"issue":"1","key":"R61","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-81071-0","article-title":"Craving induction through virtual reality cue-exposure for patients with alcohol dependence in rehabilitation treatment","volume":"14","author":"Tsamitros","journal-title":"Sci Rep"},{"issue":"3","key":"R62","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1046\/j.1360-0443.1999.9433273.x","article-title":"Meta-analysis of cue-reactivity in addiction research","volume":"94","author":"Carter","journal-title":"Addiction"},{"key":"R63","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2016.06.012","article-title":"A psychoengineering paradigm for the neurocognitive mechanisms of biofeedback and neurofeedback","volume":"68","author":"Gaume","journal-title":"Neurosci Biobehav Rev"},{"issue":"6","key":"R64","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1016\/j.bpsc.2019.12.013","article-title":"Heart rate variability, cue-evoked ventromedial prefrontal cortical response, and problem alcohol use in adult drinkers","volume":"5","author":"Wang","journal-title":"Biol Psychiatry Cogn Neurosci Neuroimaging"},{"issue":"1","key":"R65","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1007\/s00213-011-2618-4","article-title":"Cue-elicited heart rate variability and attentional bias predict alcohol relapse following treatment","volume":"222","author":"Garland","journal-title":"Psychopharmacology (Berl)"},{"key":"R66","doi-asserted-by":"publisher","DOI":"10.1016\/j.pbb.2018.12.003","article-title":"Heart rate variability in alcohol use: a review","volume":"176","author":"Ralevski","journal-title":"Pharmacol Biochem Behav"},{"issue":"20","key":"R67","doi-asserted-by":"publisher","first-page":"3685","DOI":"10.1007\/s00213-015-4027-6","article-title":"Cue reactivity and its relation to craving and relapse in alcohol dependence: a combined laboratory and field study","volume":"232","author":"Witteman","journal-title":"Psychopharmacology (Berl)"},{"issue":"6","key":"R68","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1007\/s007020070073","article-title":"Cue exposure in alcohol dependent patients: preliminary evidence for different types of cue reactivity","volume":"107","author":"Szegedi","journal-title":"J Neural Transm"},{"key":"R69","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.108803","article-title":"Alcohol-related attentional biases in recently detoxified inpatients with severe alcohol use disorder: an eye-tracking approach","volume":"225","author":"Bollen","journal-title":"Drug Alcohol Depend"},{"issue":"1","key":"R70","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1111\/add.16333","article-title":"Craving modulates attentional bias towards alcohol in severe alcohol use disorder: an eye-tracking study","volume":"119","author":"Bollen","journal-title":"Addiction"},{"issue":"1","key":"R71","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1037\/a0029626","article-title":"Attentional biases in abstinent alcoholics and their association with craving","volume":"27","author":"Field","journal-title":"Psychol Addict Behav"}],"container-title":["JMIR Serious Games"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/games.jmir.org\/2026\/1\/e84156","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:26:04Z","timestamp":1785536764000},"score":1,"resource":{"primary":{"URL":"https:\/\/games.jmir.org\/2026\/1\/e84156"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,10]]},"references-count":71,"URL":"https:\/\/doi.org\/10.2196\/84156","relation":{},"ISSN":["2291-9279"],"issn-type":[{"value":"2291-9279","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,10]]},"article-number":"v14i2e84156"}}