Into the Woods or a Stroll in the Park: How Virtual Contact with Nature Impacts Positive and Negative Affect

Current methodologies of greenspace exposure and mental health research-a scoping review

Introduction

Greenspaces can provide an important resource for human mental health. A growing body of literature investigates the interaction and the influence of diverse greenspace exposures. In order to gain a comprehensive understanding of the complex connection between greenspace and mental health, a variety of perspectives and methodological combinations are needed. The aim of this review is to assess the current methodologies researching greenspace and mental health.

Methods

A scoping review was conducted. Four electronic databases (Pubmed, Embase, PsycInfo, Web of Science) were searched for relevant studies. A wide range of greenspace and mental health keywords were included to provide a comprehensive representation of the body of research. Relevant information on publication characteristics, types of greenspaces, mental health outcomes, and measurements of greenspace exposure and mental health was extracted and assessed.

Results

338 studies were included. The included studies encompassed a multitude of methods, as well as outcomes for both greenspace and mental health. 28 combinations were found between seven categories each for greenspace and mental health assessment. Some pairings such as geoinformation systems for greenspace assessment and questionnaires investigating mental health were used much more frequently than others, implying possible research gaps. Furthermore, we identified problems and inconsistences in reporting of greenspace types and mental health outcomes.

Discussion

The identified methodological variety is a potential for researching the complex connections between greenspace and mental health. Commonly used combinations can provide important insights. However, future research needs to emphasize other perspectives in order to understand how to create living environments with mental health benefits. For this purpose, interdisciplinary research is necessary.

The impact of virtual reality natural and built environments on affective responses: a systematic review and meta-analysis

This study aims to evaluate the extent to which virtual reality (VR) natural and built settings affect emotional states. Web of Science, SCOPUS, and PubMed were searched for relevant articles prior to February 2022. Of 15 articles identified for systematic review, 6 met the inclusion criteria for meta-analysis (studies with only pre- and post-condition measures of the Positive and Negative Affect Schedule (PANAS) were included). Both positive affect (g = 0.20, p = 0.001) and negative affect (g = - 0.30, p = 0.001) change scores for the VR natural environment were statistically significant. On the other hand, change scores for VR built environment were not significant in both positive affect (g = - 0.08, p = 0.355) and negative affect (g = - 0.08, p = 0.058). The findings revealed that, in addition to a VR natural environment, a VR built environment is capable of providing restorative experiences against negative mood in some circumstances.

Psychophysiological Responses of College Students to Audio-Visual Forest Trail Landscapes

Forest trails provide urban residents with contact with nature that improves health and well-being. Vision and hearing are important forms of environmental perception, and visual and auditory stimuli should not be overlooked in forest trail landscapes. This study focused on the health benefits of the audio-visual perception of forest trail landscapes. Forest density (FD) and forest sounds (FS) in forest trail landscapes were examined as visual and auditory variables, respectively. FD was divided into three levels: high (Hd), medium (Md), and low density (Ld). FS were divided into four levels: quiet natural and anthropogenic sounds (QnQa), quiet natural and loud anthropogenic sounds (QnLa), loud natural and quiet anthropogenic sounds (LnQa), and loud natural and loud anthropogenic sounds (LnLa). The levels of these two variables were combined to create 12 conditions. A total of 360 college students were randomly assigned to 12 groups (mapping onto the 12 conditions; N=30 per group). All subjects performed the same 5-min high-pressure task indoors, followed by a 5-min recovery period of experiencing a simulated forest trail landscape (viewing pictures and listening to sounds). Brain waves, blood pressure, blood oxygen saturation (SpO2, measured with a finger monitor), the pulse rate, and mood indicators were collected to analyse the physiological and psychological responses to the audio-visual forest trail landscapes. The results indicated that higher FD and lower FS improved health benefits. The interaction between FD and FS revealed a pattern of combinations that facilitated stress reduction and positive mood recovery. These results are of theoretical value in that they indicate important audio-visual characteristics of forest trail landscapes. In terms of practical applications, these findings support the construction of urban forest trails to provide health benefits.

Pre-frontal stimulation does not reliably increase reward responsiveness

Depression is the leading cause of disability worldwide and its effects can be fatal, with over 800,000 people dying by suicide each year. Neuromodulatory treatments such as transcranial magnetic stimulation (TMS) are being used to treat depression. Despite its endorsement by two regulatory bodies: NICE (2016) and the FDA (2008), there are major questions about the treatment efficacy and biological mechanisms of TMS. Ahn et al.'s (2013) justified the use of TMS in a clinical context in an important study indicating that excitatory TMS increases reward responsiveness. A pseudo-replication of this study by Duprat et al., (2016) also found a similar effect of active TMS, but only with the addition of an exploratory covariate to the analyses-trait reward responsiveness. Here we replicate Ahn et al.'s (2013) key study, and to test the reliability of the effects, and their dependency on trait reward responsiveness as described by Duprat et al., (2016). Using excitatory and sham TMS, we tested volunteers using the probabilistic learning task to measure their reward responsiveness both before and after stimulation. We also examined affect (positive, negative) following stimulation. Irrespective of TMS, the task was shown to be sensitive to reward responsiveness. However, we did not show TMS to be effective in increasing reward responsiveness and we did not replicate Ahn et al., (2013) or Duprat et al., (2016)'s key findings for TMS efficacy, where we provide evidence favouring the null. Moreover, exploratory analyses suggested following active stimulation, positive affect was reduced. Given our findings, we question the basic effects, which support the use of TMS for depression, particularly considering potential deleterious effects of reduced positive affect in patients with depression.

Brief repeated virtual nature contact for three weeks boosts university students' nature connectedness and psychological and physiological health during the COVID-19 pandemic: A pilot study

The COVID-19 pandemic and its associated uncertainties and restrictions have adverse impacts on university students' mental wellbeing. Evidence shows that virtual nature contact has mental health benefits. However, little is known about the potential beneficial health impacts of virtual nature contact during times of social distancing, when access to the natural environment is restricted. This pilot study aimed to examine the effectiveness of a 3-week virtual nature contact in improving nature connectedness and reducing psychophysiological stress. A sample of 56 university students in Hong Kong was randomly assigned to control and nature interventions using 2-D video played for 15 min three times a week for 3 weeks. Nature connectedness, perceived restorativeness and psycho-physiological wellbeing were measured. Our findings show significant changes in psychological stress levels after nature interventions compared with the baseline, including increased happiness and stronger emotions of comfort and relaxation. When compared with the control group, the results show the nature intervention group has significantly higher levels of nature connectedness, happiness, and positive affect, but no significant effects on other psychological and physiological variables (e.g., cardiovascular responses). Our preliminary findings highlight the potential use of virtual nature contacts in bolstering university students' wellbeing at times of pandemic or when in-person visit to the natural environment is not feasible.

Measuring affect and complex working memory in natural and urban environments

Introduction

Research suggests that spending time in natural environments is associated with cognitive and affective benefits, while increased use of technology and time spent in urban environments are associated with depletion of cognitive resources and an increasing prevalence of mental illness. Attention Restoration Theory suggests that exposure to natural environments can restore depleted attentional resources and thereby improve cognitive functioning and mood. Specifically, recent meta-analyses have revealed that the most improved cognitive abilities after nature exposure include selective attention, working memory, and cognitive flexibility.

Methods

While existing studies examined these cognitive abilities, few have examined the Operation Span (OSPAN), a complex measure of working memory capacity. Therefore, the current study (N = 100) compared performance on the OSPAN and self-reported mood using the Positive and Negative Affect Schedule before and after a 30-min walk in a natural or urban environment.

Results

Results from the study showed that both groups exhibited an increase in positive affect and a decrease in negative affect, suggesting that going outside for a walk can boost mood regardless of environment type. Inconsistent with past work, there were no significant changes in OSPAN scores before and after the walk for either environment type.

Discussion

Future studies should analyze how the length of time spent in the environment, certain characteristics of the environment, and individual differences in connectedness to nature may impact attention restoration to gain insight on nature's ability to improve our affect and cognition.

A Meta-Analysis of Emotional Evidence for the Biophilia Hypothesis and Implications for Biophilic Design

The biophilia hypothesis posits an innate biological and genetic connection between human and nature, including an emotional dimension to this connection. Biophilic design builds on this hypothesis in an attempt to design human-nature connections into the built environment. This article builds on this theoretical framework through a meta-analysis of experimental studies on the emotional impacts of human exposure to natural and urban environments. A total of 49 studies were identified, with a combined sample size of 3,201 participants. The primary findings indicated that exposure to natural environments had a medium to large effect on both increasing positive affect and decreasing negative affect. This finding supported the anticipated emotional dimension of the biophilia hypothesis and lends credibility to biophilic design theory. Evidence was revealed in support of the affective/arousal response model. Immersion in environments indicated a larger effect size than laboratory simulation of environments. Methodological recommendations for future experimental research were few, however the Positive and Negative Affect Schedule (PANAS) outcome measure was recommended as a measure of both positive and negative affect for further studies. A combination measurement of stress related outcome variables was proposed to further explore the affective/arousal response model and its potential relationship to the biophilia hypothesis. The meta-analysis provides evidence for fundamental theories regarding human-nature connection, while revealing gaps in current knowledge.

What Activities in Forests Are Beneficial for Human Health? A Systematic Review

Over the past decade, clinical trials of forest-based interventions have increased, leading to their recognition as preventive medicine. However, little is known about the differences in health effects according to the activity characteristics of interventions. This study aimed to understand the types of activities and their associated health effects to identify differences in health effects between activities. PubMed, PsycINFO, Web of Science, and Scopus databases were searched, and methodological quality was assessed using Cochrane ROB2. A total of 32 randomized controlled trials (RCTs) met the eligibility criteria. Health outcomes were collected from 6264 participants aged 6–98 years, and the sample size was 12–585. The Interventions were walking (n = 21), staying (n = 7), exercise (n = 4), indirect exposure (n = 4), and the activity time was between 10 and 240 min. Overall, walking showed consistent positive health effects, and there were differences in effects on anxiety and depression, cognitive function, stress hormone, and inflammation according to the activity. However, most of the included studies had a high risk of bias, and interventions were limited to specific activities, durations, and frequencies. Although a few limitations remain, the findings in this study are of great significance in providing the basis for the design of forest-based interventions.

Impact of Exposure to Natural and Built Environments on Positive and Negative Affect: A Systematic Review and Meta-Analysis

There is increasing evidence that the natural environment provides substantial benefits to human emotional well-being. The current study synthesized this body of research using the meta-analysis and assessed the positive and negative effects of exposure to both the natural and built environments. We searched four databases and 20 studies were included in the review. The meta-analysis results showed the most convincing evidence that exposure to the natural environment could increase positive affect (standardized mean difference, SMD = 0.61, 95% CI 0.41, 0.81) and decreased negative affect (SMD = -0.47, 95% CI -0.71, -0.24). However, there was extreme heterogeneity between the studies, and the risk of bias was high. According to the subgroup analysis, study region, study design, mean age of the sample, sample size, and type of natural and built environment were found to be important factors during exposure to the natural environment. The implications of these findings for the existing theory and research are discussed. These findings will help convince the health professionals and policymakers to encourage the residents to increase their time spent in the natural environment. These findings of this systematic review also suggested that the creation, maintenance, and enhancement of accessible greenspaces or existing natural environments may form part of a multidimensional approach to increasing emotional well-being of the local populations.

Validating Visual Stimuli of Nature Images and Identifying the Representative Characteristics

This study fills a void in the literature by both validating images of nature for use in future research experiments and examining which characteristics of these visual stimuli are found to be most representative of nature. We utilized a convenience sample of university students to assess 129 different nature images on which best represented nature. Participants (n = 40) viewed one image per question (n = 129) and were asked to rate images using a 5-point Likert scale, with the anchors “best represents nature” (5) and “least represents nature” (1). Average ratings across participants were calculated for each image. Canopies, mountains, bodies of water, and unnatural elements were identified as semantic categories of interest, as well as atmospheric perspectives and close-range views. We conducted the ordinary least squares (OLS) regression and the ordered logistic regression analyses to identify semantic categories highly representative of nature, controlling for the presence/absence of other semantic categories. The results showed that canopies, bodies of water, and mountains were found to be highly representative of nature, whereas unnatural elements and close-range views were inversely related. Understanding semantic categories most representative of nature is useful in developing nature-centered interventions in behavioral performance research and other neuroimaging modalities. All images are housed in an online repository and we welcome the use of the final 10 highly representative nature images by other researchers, which will hopefully prompt and expedite future examinations of nature across multiple research formats.

Exploring the Links Between Biophilic and Restorative Qualities of Exterior and Interior Spaces in Leon, Guanajuato, Mexico

The interactive role of the ecological, architectural, biophilic, and sensory qualities of outdoor and indoor spaces in the restorative experiences of urban inhabitants is little known. We analyzed the restorative influence on mood states and situational stress related to exposure to vegetation proportion, spatial extension, landmark salience, biophilic architecture, people density, street visual access, olfactory pleasantness, and noise of 65 public spaces in a Mexican city. The environmental qualities of these places were analyzed with multidimensional scaling (MDS), leading to eight space categories (e.g., historic squares with biophilic architecture, large parks, street scenes, and interiors with non-biophilic architecture). Ratings of the restorative potential, mood states, situational stress, olfactory pleasantness, and noise annoyance were evaluated on such places and modeled through a structural equation modeling (SEM). The model shows that the restorative influence of the environmental qualities on moods and stress was related to a decrease in experiences of negative moods and perceived stress, and an increase of positive mood states. Based on our findings, we discuss design guidelines, emphasizing the relevance of including vegetation and built elements with biophilic qualities to create restorative environments.

Application of Virtual Environments for Biophilic Design: A Critical Review

Biophilic design as a new design approach promotes the integration of natural elements into the built environment, leading to a significant impact on human health, well-being, and productivity. On the other hand, scholars have explored Virtual Environment (VE) to create virtual nature and provide a complex experience of exposure to natural elements virtually. However, there is a lack of understanding about such studies in general, which use VE as a reliable tool to support biophilic design. Thus, the authors conducted a literature review on the applications, capabilities, and limitations of VE for biophilic design. The literature review shows that VE is capable of supporting critical features of biophilic design studies such as representing combinations of biophilic patterns, providing multimodal sensory inputs, simulating stress induction tasks, supporting required exposure time to observe biophilic patterns, and measuring human’s biological responses to natural environment. However, factors affecting user’s experience of a virtual biophilic environment exist, such as VE experience dimensions, user-related factors, cybersickness, navigational issues, and possible limitations of VE sensory input. Overall, biophilic design studies in VEs are still limited. Nevertheless, there are many opportunities for further research in this field.

Greenspace Interventions, Stress and Cortisol: A Scoping Review

Background: Engaging with nature can profoundly impact psychological and physiological health of persons across the lifespan. Greenspace interventions (GSI) encompass a broad range of strategic, nature-based activities for overall health and wellbeing. Within the past 20 years there has been a growing interest in the access to and management of greenspace to mediate the deleterious impact of acute and chronic stress, particularly, physiologic biomarkers of stress such as cortisol. Objective: This review aims to describe the impact of greenspace interventions on cortisol, to present the current state of the science on GSIs as they impact cortisol, and to uncover any limitations of current research strategies to best inform future research. Methods: A scoping methodology was conducted to systematically study this emerging field and inform future research by mapping the literature based on the GSI category, interventional design, cortisol metrics, and subsequent analysis of cortisol. Conclusion: Considerable heterogeneity in research design, aim(s), interventional strategy, and cortisol metrics were identified from a total of 18 studies on GSIs and cortisol outcomes. While studies demonstrated a potential for the positive association between GSIs and stress relief, more rigorous research is needed to represent GSIs as an intervention to mitigate risks of stress.

Effects of exposure to immersive videos and photo slideshows of forest and urban environments

A large number of studies have demonstrated the benefits of natural environments on people's health and well-being. For people who have limited access to nature (e.g., elderly in nursing homes, hospital patients, or jail inmates), virtual representations may provide an alternative to benefit from the illusion of a natural environment. For this purpose and in most previous studies, conventional photos of nature have been used. Immersive virtual reality (VR) environments, however, can induce a higher sense of presence compared to conventional photos. Whether this higher sense of presence leads to increased positive impacts of virtual nature exposure is the main research question of this study. Therefore, we compared exposure to a forest and an urban virtual environment in terms of their respective impact on mood, stress, physiological reactions, and cognition. The environments were presented via a head-mounted display as (1) conventional photo slideshows or (2) 360[Formula: see text] videos. The results show that the forest environment had a positive effect on cognition and the urban environment disturbed mood regardless of the mode of presentation. In addition, photos of either urban or forest environment were both more effective in reducing physiological arousal compared to immersive 360[Formula: see text] videos.

Comparing the Trail Users with Trail Non-Users on Physical Activity, Sleep, Mood and Well-Being Index

Background: The current study sought to understand whether trail users reported better wellness and health status compared to the non-users, and to recognize the associated factors. Methods: Eight trails from different locations and settings within Indiana were selected to sample trail users for the study. Additionally, areas surrounding these eight trails were included in the study as sample locations for trail non-users. Trail users and non-users were intercepted and asked to participate in a survey including demographics, socioeconomic status, physical activity, mood, smoking, nutrition, and quality of sleep. Information was collected and compared between the trail users and the non-users. Association of self-rated health, age, sex, race, marital status, employment, income, education, smoking, nutrition, sleep, and mood with trail use was evaluated by multivariable linear regression model. Results: The final sample size included 1299 trail users and 228 non-users. Environmental factors (access to nature and scenery) were important incentives for 97% and 95% of trail users, respectively. Age, sex, mood, and sleep quality were significantly associated with using the trail. Mean (SD) self-rated wellness and health out of 10 was 7.6 (1.4) in trail users and 6.5 (1.9) in non-users (p < 0.0001). Importantly, trail users were significantly more physically active outside of the trail compared to the non-users (207 vs. 189 min/week respectively, p = 0.01) and had better sleep qualities and mood scores. Using the trails was significantly associated with higher self-rated wellness and health score. The longer the use of trails, the higher the self-rated wellness and health index (β = 0.016, p = 0.03). Conclusion: Compared to not using the trails, trail use was significantly associated with more physical activity, better sleep quality, and higher self-rated wellness and health.

Exploring the use of Immersive Virtual Reality to enhance Psychological Well-Being in Pediatric Oncology: A pilot randomized controlled trial

PURPOSE

To investigate whether Immersive Virtual Reality (VR) has a greater positive influence on oncology patients' physical and emotional mood states when compared to an iPad attentional control condition. Our secondary objective was to understand what factors influenced VR effectiveness.

METHOD

Participants were 90 oncology inpatients, aged 7-19 years, and their primary parent caregiver. Using a randomized controlled study design patients were allocated to VR (three content groups) or an iPad control condition. Pre-post-intervention self-report state measures were collected using visual analogue scales and an objective measure of physiological arousal (pulse rate). Post-intervention, patients reported on level of immersion, enjoyment and simulator sickness.

RESULTS

Patients benefited from both Immersive VR and novel iPad intervention with no statistically significant differences found between conditions on child outcomes. However, patients accessing Immersive VR consistently reported greater positive shifts in mood state and reductions in negative symptoms when compared with iPad. No change was observed in physiological arousal levels (pulse rate) in either condition before, during or immediately after intervention. Moderation analysis showed that the degree of child illness (PedsQL), sex, age, and level of immersion were important in influencing the magnitude of differences between the VR and iPad conditions on mood, anxiety and pain.

CONCLUSIONS

These preliminary findings support the use of Immersive VR in clinical oncology settings to improve patient well-being. Further studies examining the application of Immersive VR in supporting children adjusting to hospitalization and cancer treatment are therefore warranted. Factors found to moderate VR effectiveness provide important clinical implications.

The impact of green spaces on mental health in urban settings: a scoping review

BACKGROUND

Our planet is currently experiencing the largest wave of urban growth in history, with 55% of the world's population (4.2 billion people) currently living in urban areas, a figure set to rise to 70% by 2050. Primary care is the first point of treatment for most mental health disorders. Since the urban environment and health are intrinsically linked, it is useful to examine the effectiveness of Nature-Based Solutions in addressing mental health.

AIMS

The aim of this scoping review was to examine "How urban green spaces can improve mental health and wellbeing among patients attending general practice and primary care?"

METHODS

The scoping review framework comprised a five-stage process developed by Arksey and O'Malley.

RESULTS

Twenty-five studies were included in the review, mostly cross-sectional studies. A wide range of mental health outcomes were identified. Out of the 25 included studies, 23 showed positive associations between mental health and green space characteristics.

CONCLUSION

Our findings suggest that while green spaces are associated with positive mental health outcomes, most studies were cross-sectional in nature and provided limited evidence for association. Furthermore, the population samples used in most of the studies were taken from national survey data and were not specifically primary care patients. Further studies that assess primary care patients specifically are warranted.

Restorativeness in Natural and Urban Environments: A Meta-Analysis

In recent decades, there has been an increasing volume of research aimed out quantifying the extent to which the natural environment can assist in restoring mental, emotional, and physical well-being. It is commonly assumed that natural environments are more restorative than urban environments. However, studies addressing this issue use a variety of methods for data collection making it difficult to compare the findings of different studies. The research reported here uses a meta-analysis aimed at estimating how much natural environments are perceived as being more restorative than urban environments. We investigated the role of moderator variables such as research design, kind of natural environment, participants, measurement instruments used or the context in which the data were collected. PsycINFO, PsycARTICLES, Scopus, SpringerLINK, Web of Science online databases were used to identity all peer-review articles on restorativeness published to date (k = 167). Reference sections of obtained papers were examined for additional studies. Only 22 studies met inclusion criteria (direct exposure to environment, comparison between one outdoor environment with natural element and one without natural element, and restorativeness measured by self-report scale) and were included in meta-analysis. Results show that natural environments are perceived to be more restorative than urban environments (Cohen's d (confidence interval) = 1.99 (1.38-2.61)). Significant heterogeneity between the study was found (Q(19) = 503.16, p < .001) and variability within studies was very high (I² = 97%). However, subsequent univariate moderator analyses were not significant. Other methodological differences (e.g., lighting conditions) could explain this variability. We concluded that the variability in studies is more likely to be due to individual differences (e.g., age, connections to nature, and environmental attitude) than the methodological differences.

Concepts, Practices and Advantages of Spirituality Among People with a Chronic Mental Illness in Melbourne

There is a relative paucity of literature in the field of spirituality among people who have a lived experience of severe mental illness from Australia. Sixteen individuals with a severe mental illness were interviewed on their experiences of spirituality. The three themes that emerged from the data were concepts of spirituality, benefits of intentional spiritual practices and perceived spiritual benefits of recreational pursuits and physical activity. This paper adds to the relatively sparse literature on spirituality among persons with a mental illness in Australia.

The impact of exposure to films of natural and built environments on state body appreciation

Previous work has shown that exposure to images of nature results in elevated state body appreciation, but static images may lack ecological validity. Here, we examined the impact of exposure to short films of simulated, first-person walks in natural or built environments. Thirty-six university students completed a measure of state body appreciation before and after watching films of either a walk in a natural or a built environment created specifically for the present study. Two weeks later, they completed the same task but watched the other film type. Results indicated that exposure to the film of a natural environment resulted in significantly elevated state body appreciation (d = 0.66). There was no significant change in state body appreciation following exposure to the film of the built environment (d = 0.14). These findings suggest that exposure to films depicting the natural environment may promote immediate, moderate-sized improvements in state body image.