Discussion
phobic, agoraphobic, depressive, depression-related low
BLIND
Our findings support both of the general hypotheses that brief exposure to an immersive nature video, relative to an urban comparison condition would (i) reduce stress and improve indices of mental wellbeing in adolescents and (ii) increase nature connection. Our novel hypothesis on increasing nature spirituality (iii) was also supported. The positive findings are consistent with previous research where virtual nature interventions often, but not always, show benefitIn the present study, we first showed that the randomisation to the Nature and Urban conditions was successful, with no significant baseline differences found on any measure. This is an important step, and broader methodological issue, as previous work in this area has shown that both lack of randomisation and lack of the use of a control group can inflate the positive finding rateTo encourage adherence to task in this online remote context, we asked participants a factual checking question specific to each condition. This proved to be helpful given that the majority in each condition answered their respective questions correctly and we suggest continuing to use measures to increase adherence to online interventions in future research.There was a difference between conditions on positive affect which decreased significantly in the urban condition but not in the nature condition, suggesting that rather than improving positive affect, the nature condition was able to buffer it, relative to the deleterious effects in the urban condition. This may be very important when considering future early intervention and prevention strategies for adolescent mental health, especially for those for whom accessing nature is challenging. Buoying mental wellbeing for those at-risk adolescents may mean the difference between sustaining wellness and facing the unfolding of clinical mental health difficulties.An increase in nature spirituality in the virtual nature condition is a novel finding that may also be important for future research directions. As has been pointed out by RyffThe paucity of spirituality considerations in clinical and counselling training programmes is slowly being addressedWe recognise that virtual exposure to natural environments may have value in improving mental wellbeing and even preventing mental illness, and may be appropriate for those struggling to get outside or who are agoraphobic, socially phobic or have depression-related low motivation. However, consistent with other viewsAlthough just a single subjective item explored the effect of nature on attention, participants self-reported feeling more alert and attentive after watching the video. It should be noted that in both virtual experimentsThe majority of the sample reported that the video was too long although we consider it brief, under the average time for virtual exposure (8 min) in a recent review The strengths of this study include remote blind randomisation of participants to experimental or comparison condition, the use of a number of well-validated psychometric instruments and the novel finding of an increase in nature spirituality following brief virtual nature exposure. We acknowledge, however, several limitations. First, in this proof-of-principle study we are unable to determine the precise features of environment that are likely to be beneficial to mental wellbeing. As discussed elsewhere this is an important frontier in the research We were unable to use objective measures of stress (e.g. salivary cortisol) or indices such as heart rate variability collected via wearables, or objective measures of attention or other executive functions. We were also unable to include any follow up measurement time points to test, for example, the potential mid-term effect on reducing depressive symptoms over weeks and months. Clearly in this proof-of-principle, experimental design of a brief intervention we were unable to test effects of prevention of mental health conditions in adolescents but this should be a focus of future research. The sample of adolescents in this study was also overwhelmingly female and ethnically white and so it will be important for future studies to test for effects in males and other ethnic groups.We suggest that future research priorities should focus on augmenting virtual nature interventions to increase their effectiveness and this could be achieved in several ways. First, the intervention could be repeated multiple times over a number of days or weeks and dose-response relationships assessed. Second, more active components could be added, for example, mindful awareness