Objective:

To map VR stress paradigms and examine their engagement of stress-response systems while considering early adversity.

Approach:

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Key Findings:

• Five clusters of VR stress paradigms were identified: social-evaluative, cognitive/performance-based, threat/fear-based, analogue trauma, and complex ecologically valid paradigms.
• VR consistently elicited subjective and autonomic responses, while endocrine and neural responses varied by paradigm type.
• Social-evaluative paradigms showed robust subjective and autonomic activation with variable HPA axis responses.
• Threat-based paradigms elicited strong autonomic and affective responses, whereas cognitive paradigms were associated with performance-related stress and limited endocrine activation.
• Evidence on early adversity suggested differential sensitivity to specific stressor types.

Interpretation:

VR-based stress paradigms selectively engage distinct response systems depending on paradigm characteristics, and integrating early adversity may enhance the precision of VR-based stress research.

Limitations:

• Only a subset of studies directly assessed adverse childhood experiences or childhood trauma.
• The role of early adversity in moderating stress reactivity remains underexplored.

Conclusion:

VR-based stress paradigms do not induce stress as a unitary construct but engage distinct response systems, suggesting potential applications for personalized nutrition and stress-related behaviors.