Letter to the editor: Attention restoration in natural environments: Mixed mythical metaphors for meta-analysis

Social prescribing of nature therapy for adults with mental illness living in the community: A scoping review of peer-reviewed international evidence

Social prescribing of nature therapy "green social prescribing" facilitates access to local nature-based activities that improve biopsychosocial wellbeing outcomes, are affordable, accessible, and can be adapted to context. These are becoming increasingly popular and gray literature is emerging, however, peer-reviewed scientific evidence is exiguous. This scoping review aimed to identify and critique peer-reviewed evidence for green social prescribing interventions and develop recommendations for research and clinical practice. Included studies were published in peer-reviewed journals in English on/after 1 January 2000. Participants were community-living adults with mental illness; Intervention was any green social prescribing program; Comparator was not restricted/required; Outcomes were any biopsychosocial measures; and any/all Study Designs were included. Twelve databases were searched on 15 October 2022; these were Academic Search Premier, APA PsycArticles, APA PsycINFO, CINAHL, Cochrane Library, Google Scholar, JSTOR, ProQuest, PubMed, Science Direct, Scopus, and Web of Science. The Mixed Methods Appraisal Tool was used to assess quality. Seven publications describing 6 unique studies (5 UK, 1 Australia) were identified including 3 mixed-methods, 2 qualitative, and 1 RCT. Participants included 334 adults (45% female, aged 35-70 years); sample sizes ranged from 9 to 164. All studies showed improvements in biopsychosocial wellbeing, and participants from most studies (n = 5) reported increased connection to the earth and intention to further access nature. Participant demographics and diagnoses were poorly reported, and intervention activities and assessments varied considerably. However, MMAT scores were good overall suggesting these studies may reliably demonstrate intervention outcomes. We conclude that socially prescribed nature therapy can improve biopsychosocial wellbeing and is a potentially important intervention for mental illness. Recommendations for research and clinical practice are provided.

Influence of Forest Visitors' Perceived Restorativeness on Social-Psychological Stress

This study was conducted to verify the perceived restorativeness of citizens visiting forests on social-psychological stress and psychological resilience according to forest space type. The study involved a questionnaire survey conducted on citizens who visited forests between 1 May and 15 July 2020, when social distancing in daily life was being implemented. Three types of forest spaces (urban forest, national park, and natural recreation forest) were selected for the survey. They used the survey results of 1196 people as analysis data for this study. In this study, the PRS (Perceived Restorativeness Scale) and the PWI-SF (Psychosocial Well-being Index Short Form) were used to evaluate perceived restorativeness and social-psychological stress of citizens visiting forests. In the study, the average score of visitors' perceived restorativeness was 5.31 ± 0.77. Social-psychological stress was found in the healthy group, potential stress group, and high-risk group. These groups made up 8.0%, 82.5%, and 9.5% of the respondents, respectively. Pearson's correlation analysis between perceived restorativeness and social-psychological stress revealed that the higher the perceived restorativeness, the lower the social-psychological stress. "Diversion Mood", "Not bored", and "Coherence", which are the sub-factors of perceived restorativeness according to the forest space type, were found to have meaningful results for psychological resilience. However, there was no significant difference in the forest space type between "Compatibility" and social-psychological stress, which are sub-factors of perceived restorativeness. In conclusion, the forest space type affects the psychological resilience of those who visit the forest. Urban forests, national parks, and natural recreation forests are places to reduce stress.

What is the best way of delivering virtual nature for improving mood? An experimental comparison of high definition TV, 360° video, and computer generated virtual reality

Exposure to 'real' nature can increase positive affect and decrease negative affect, but direct access is not always possible, e.g. for people in health/care settings who often experience chronic boredom. In these settings 'virtual' forms of nature may also have mood-related benefits (e.g. reducing boredom) but it has been difficult to separate effects of nature content from those of delivery mode. The present laboratory-based study explored whether exposure to three different delivery modes of virtual nature could reduce negative affect (including boredom) and/or increase positive affect. Adult volunteer participants (n = 96) took part in a boredom induction task (to simulate the emotional state of many people in health/care settings) before being randomly assigned to view/interact with a virtual underwater coral reef in one of three experimental conditions: (a) 2D video viewed on a high-definition TV screen; (b) 360⁰ video VR (360-VR) viewed via a head mounted display (HMD); or (c) interactive computer-generated VR (CG-VR), also viewed via a HMD and interacted with using a hand-held controller. Visual and auditory content was closely matched across conditions with help from the BBC's Blue Planet II series team. Supporting predictions, virtual exposure to a coral reef reduced boredom and negative affect and increased positive affect and nature connectedness. Although reductions in boredom and negative affect were similar across all three conditions, CG-VR was associated with significantly greater improvements in positive affect than TV, which were mediated by greater experienced presence and increases in nature connectedness. Results improve our understanding of the importance of virtual nature delivery mode and will inform studies in real care settings.

Conceptualizing the Human Health Outcomes of Acting in Natural Environments: An Ecological Perspective

Human-nature interactions have been presented as important for promoting and sustaining wellbeing and health benefits. Research has shown that pictures of nature, interacting with nature, physical activity in nature, immersion in nature and even feeling connected to nature can improve health. While considerable research supports this notion that nature can have positive health impact, theoretical and conceptual frameworks that help explain how the natural environment provides benefits to human health and wellbeing have proved limited. In extreme cases, theoretical approaches reinforce a problematic notion where nature is viewed as a separate entity, as a treatment to be taken as prescribed to remediate health problems that arise. Such approaches are limited as they fail to address how beneficial person-nature relations may be captured in interventions. There is a need for a deeper understanding of the processes underlying the observed benefits of the person-nature link in order to design effective research and interventions. It is especially important to consider the implications of research on person-nature relations for people living in urban contexts. In this paper, we present an ecological perspective building on James Gibson's conceptualization of human behavior. Specifically, we outline a framework that emphasizes the person-environment system as the most appropriate scale of analysis. We present three relevant concepts from the ecological approach: form of life, affordances and niche construction, as helpful for appreciating how acting in natural environments might benefit human health and wellbeing. This approach urges policy makers and urban designers to rethink environmental designs to provide and support a landscape of affordances that makes use of the richness of natural environments.

Psychophysiological Effects of Different Methods of Inducing Restoration Needs

The purpose of this study was to examine the psychophysiological effects of different restoration need-inducing methods and the changes in these effects overtime. This study adopted a randomized controlled trial to assign participants (experiment 1: n = 120, experiment 2: n = 90) to four experimental treatments: control, imagined fatigue, the Stroop task and the binary classification task, and the Markus and Peters arithmetic test. We used self-report scales (The Pleasure-Arousal-Dominance emotion scale, The Well-being Measures, and The Restoration Scale) and an attention test (backward digit span) as pre- and posttests, and a physiological measuring device to continually assess participants' bodily mobilizations. The results showed that the Stroop task and the binary classification task as well as the Markus and Peters arithmetic test more significantly increased the arousal of subjective perception and decreased restoration than the control and imagined fatigue, and the physiological influences of the methods varied overtime with no definitive trend.

Nature and mental health: An ecosystem service perspective

A growing body of empirical evidence is revealing the value of nature experience for mental health. With rapid urbanization and declines in human contact with nature globally, crucial decisions must be made about how to preserve and enhance opportunities for nature experience. Here, we first provide points of consensus across the natural, social, and health sciences on the impacts of nature experience on cognitive functioning, emotional well-being, and other dimensions of mental health. We then show how ecosystem service assessments can be expanded to include mental health, and provide a heuristic, conceptual model for doing so.

The Human-Nature Experience: A Phenomenological-Psychoanalytic Perspective

Drawing upon phenomenology and psychoanalytic concepts, we explore and explicate participants' lived experience of the natural world. The authors draw upon Husserl's description of consciousness as intentionality and his later work on the life-world, in exploring experiences which provide a basis for a psychochoanalytic understanding of the human-nature experience. Unstructured interviews were undertaken with nine participants, each of whom regarded nature as being significant for their sense of wellbeing. The lived experiences were explicated drawing upon the two processes: Giorgi's descriptive phenomenological psychological methodology and psychoanalytic researcher reflexivity. Data analysis and explication involved the following steps: (1) a thorough reading of each interview transcript, (2) breaking data into parts by demarcating meaning units, (3) organizing data by translating meaning units into units of psychological experience through coding, and (4) arriving at a summary of the data which involved organizing and reviewing units of psychological experience. The process of reflection led to the formulation of an essential psychological structure of participants' lived experience of the natural world. We argue that the human-nature relationship can be conceived in terms of psychoanalytic concepts, and in particular, constructs based upon an understanding of the primacy of attachment relationships. The natural world is elucidated as (a) nature being experienced as a primary attachment, (b) nature experienced as a secure base, (c) nature experienced as twinship, (d) nature experienced as containing, and (e) nature experienced as embodied. This paper extends previous empirical descriptions of the human-nature relationship by incorporating psychoanalytic processes and theory into a theoretically informed qualitative methodological stance. Beyond the traditional notion of nature as something 'out there' that we can interact with for cognitive or emotional restoration, participants in this study described the experience of nature as being integral to their sense of self. This study suggests that experiences that facilitate immersion in nature provide opportunities for the development of an integrated sense of self that has a profound impact on a participant's sense of wellbeing. The findings further demonstrate the convergence between phenomenology and psychoanalytic constructs which offers a richness to our understanding the subjectivity of participants and their relationship with nature, a perspective not often attainable through more traditional quantitative research methodologies.

Building mindfulness bottom-up: Meditation in natural settings supports open monitoring and attention restoration

Mindfulness courses conventionally use effortful, focused meditation to train attention. In contrast, natural settings can effortlessly support state mindfulness and restore depleted attention resources, which could facilitate meditation. We performed two studies that compared conventional training with restoration skills training (ReST) that taught low-effort open monitoring meditation in a garden over five weeks. Assessments before and after meditation on multiple occasions showed that ReST meditation increasingly enhanced attention performance. Conventional meditation enhanced attention initially but increasingly incurred effort, reflected in performance decrements toward the course end. With both courses, attentional improvements generalized in the first weeks of training. Against established accounts, the generalized improvements thus occurred before any effort was incurred by the conventional exercises. We propose that restoration rather than attention training can account for early attentional improvements with meditation. ReST holds promise as an undemanding introduction to mindfulness and as a method to enhance restoration in nature contacts.

Attention Restoration Theory II: a systematic review to clarify attention processes affected by exposure to natural environments

Attention Restoration Theory (ART) predicts exposure to natural environments may lead to improved cognitive performance through restoration of a limited cognitive resource, directed attention. A recent review by Ohly and colleagues (2016) uncovered substantial ambiguity surrounding details of directed attention and how cognitive restoration was tested. Therefore, an updated systematic review was conducted to identify relevant cognitive domains from which to describe elements of directed attention sensitive to the restoration effect. Forty-two articles that tested natural environments or stimuli against a suitable control, and included an objective measure of cognitive performance, had been published since July 2013. Articles were subjected to screening procedures and quality appraisal. Random effects meta-analyses were performed to calculate pooled effect sizes across 8 cognitive domains using data from 49 individual outcome measures. Results showed that working memory, cognitive flexibility, and to a less-reliable degree, attentional control, are improved after exposure to natural environments, with low to moderate effect sizes. Moderator analyses revealed that actual exposures to real environments may enhance the restoration effect within these three domains, relative to virtual exposures; however, this may also be due to differences in the typical lengths of exposure. The effect of a participants' restoration potential, based upon diagnosis or fatigue-induction, was less clear. A new framework is presented to qualify the involvement of directed attention-related processes, using examples of tasks from the three cognitive domains found to be sensitive to the restoration effect. The review clarifies the description of cognitive processes sensitive to natural environments, using current evidence, while exploring aspects of protocol that appear influential to the strength of the restoration effect.