Daily exposure to virtual nature reduces symptoms of anxiety in college students | Scientific Reports - Nature.com

Exposure to earthy environments tin amended intelligence health. At slightest 17 systematic reviews person summarized the increasing lit connected this topic¹. Across these reviews, hundreds of observational and experimental studies amusement that quality vulnerability tin alteration symptoms of anxiousness and depression, hazard of cognitive diminution (i.e., dementia), and accent portion improving cognitive functioning and development, emotion regulation, mood, and intelligence well-being. Some of the strongest associations betwixt quality vulnerability and wellness are seen for anxiousness and depression, with 33% and 37% little comparative hazard for radical surviving successful greener neighborhoods².

Accessing outdoor earthy environments is not imaginable for each people. Nearly two-thirds of U.S. citizens unrecorded successful cities³, and these areas often deficiency capable densities of well-maintained, safe, and accessible greenspaces⁴. People who unrecorded adjacent "greenspaces" (vegetation-rich areas) whitethorn not sojourn for different reasons, similar being unaware these places exist, facing discrimination, feeling unsafe successful these spaces, and not prioritizing visitation⁵. Some physicians beforehand quality vulnerability by prescribing visits to parks to code intelligence wellness issues⁶. Still, these prescriptions necessitate regular quality "outings" and are constricted to those with the motivation, carnal ability, fiscal means, and clip to visit. Other populations look carnal and intelligence constraints to accessing quality outdoors, specified arsenic immoderate objective populations and radical surviving and moving successful isolated and confined environments (i.e., polar regions, submarines, cargo ships, and outer space)^7,8.

While it is important to code barriers to entree greenspace successful existent life, immoderate of the benefits of quality interaction person been observed successful studies of virtual nature^9,10. Virtual quality involves pictures, videos, oregon immersive media (i.e., virtual world [VR] headsets) presenting audio–video oregon multisensory simulations of earthy environments¹¹. VR headsets are apt to person stronger associated wellness benefits than level screens due to the fact that of their precocious levels of immersion¹². Audiovisual combinations beforehand greater intelligence benefits than audio oregon ocular sensory inputs alone¹³. Correspondingly, researchers are progressively studying simulated quality successful VR headsets alternatively than different media¹¹.

Nearly 40 studies person investigated the short-term wellness outcomes of virtual quality successful VR^14,15. Observed outcomes see galore of those associated with existent quality vulnerability but widen to symptom management, disordered eating, phobias, post-traumatic stress, and cognitive rehabilitation¹⁶. The astir commonly studied outcomes are mood, stress, and perceptions that an situation captures a viewer's attraction without effort and restores cognitive capacities ("perceived restorativeness")¹¹. These outcomes are apt selected owed to the survey design. Interventions with azygous exposures necessitate surveys oregon intelligence measures delicate to abbreviated interventions. However, outcomes similar objective diagnoses oregon symptoms of anxiousness and slump person beardown societal implications owing to their increasing planetary load and attraction challenges^17,18. Examining whether the therapeutic effects of quality connected symptoms of anxiousness and depression, arsenic good arsenic underlying causes (e.g., rumination), widen to VR is required to measure virtual nature’s objective significance^19,20.

Three anterior studies of repeated exposures to virtual quality and anxiousness oregon slump outcomes supply insights into its objective significance. Veling et al. conducted a randomized power proceedings with 50 patients receiving attraction for temper disorders²¹. Comparisons were drawn betwixt 360-degree videos of divers earthy landscapes (i.e., beaches, mountains, and underwater) and a guided meditation information with audio tracks but nary ocular stimuli. The quality videos were created by the institution Atmosphaeres and shown successful a Samsung Gear VR headset utilizing a Samsung Galaxy S6 smartphone (2560 × 1440 px, 60 Hz refresh rate). Both conditions were 10-min successful duration and 10 days successful length. The authors recovered a 10% simplification successful depressive symptoms and a 29% simplification successful anxiousness symptoms for the virtual quality intervention. Depressive symptoms besides decreased successful the power condition. Differences betwixt virtual quality and power conditions approached value for anxiousness but not depressive symptoms.

Lakhani et al. utilized a crossover plan to survey the effects of 3 20-min viewings of earthy landscapes and wildlife successful 360-degree videos²². These were produced by the National Geographic and English broadcaster David Attenborough and shown successful an Oculus Go headset (2560 × 1440 px, 60 Hz refresh rate). Data from 16 participants receiving spinal cord rehabilitation were collected. The power information had nary VR exposure. Participants were randomized to prosecute successful VR oregon the power information successful the archetypal vs. 2nd week of the study. The results indicated reductions successful depressive symptoms for some conditions. Only 1 subgroup of six patients showed important reductions successful symptoms passim the VR intervention.

Reynolds et al. conducted a 3rd crossover proceedings among 38 women with metastatic bosom cancer. Participants saw 1 of 2 virtual quality experiences for an mean of 13-min per time for 1 week²³. These experiences included Ripple VR, which presented 360-degree videos of a beach, waterfall, and upland from Mixt Studio, and Happy Place, a commercially disposable VR exertion with a highly stylized, animated camping country developed by the institution Hjärtat. Ripple VR allowed participants to constitute their names successful the sand, stack rocks, and teleport betwixt mountains and lakes. These experiences were presented successful a Pico Goblin headset (1440 × 1280 px, 70 Hz refresh rate). No power information was used. The authors recovered important decreases successful depressive and anxiousness symptoms from the virtual quality intervention. Subsequent analyses reported these beneficial impacts were lone observed for participants who did not consciousness powerfully "connected" to quality astatine the opening of the study²⁴.

The existent survey was designed successful effect to the constricted and conflicting results for repeated virtual quality vulnerability and intelligence wellness outcomes. We conducted a randomized power proceedings to trial the impacts of regular vulnerability implicit astatine slightest a three-week play connected assemblage students' symptoms of anxiety, depression, and rumination. We chose this colonisation since students whitethorn beryllium peculiarly disposed to utilize quality vulnerability successful VR settings, specified arsenic the "metaverse" (virtual environments that are interactive, immersive, and collaborative)²⁵. Unlike past studies that examined slump oregon anxiousness arsenic unitary phenomena, we measured chiseled dimensions of anhedonic depression, anxious arousal (panic), and anxious apprehension (worry), which disagree successful their psychological, physiological, and neurological characteristics^26,27,28. These measures admit the analyzable but precise symptoms of slump and anxiety. Somatic symptoms are comparatively circumstantial to anxiety, portion debased affirmative impact and anhedonia (lack of pleasure) are much circumstantial to depression²⁹. Anxiety tin beryllium further differentiated betwixt anxious arousal, defined arsenic physiological hyperarousal arsenic good arsenic feelings of panic and tension, and anxious apprehension, defined arsenic chronic interest with verbal dwelling commonly connected imaginable antagonistic outcomes of aboriginal events²⁷. Our regular involution was constricted to 4-min, which whitethorn elicit larger effects than longer durations³⁰. Relatedly, we extended the survey play implicit aggregate weeks to measure longer-term exposures and outcomes. We included a power information with nary assigned involution to find the causal effects of exposure. We also controlled for behavioral changes crossed the survey play that whitethorn interaction intelligence wellness status. Finally, we considered measures related to quality connectedness that mightiness mean the effectiveness of virtual nature²³. Our superior nonsubjective was to measure the impacts of regular virtual quality vulnerability connected symptoms comparative to nary exposure.

Sample characteristics

Table 1 shows the characteristics of the illustration (N = 40). Additional descriptions of prime variables (engagement with quality and outdoor quality experiences) are provided successful Table S1.

Three-quarters of the participants were female. Just implicit fractional of the participants completed the survey during a COVID-19 pandemic semester (i.e., Fall 2022). Ages ranged from 18 to 22 years (M = 19.3, SD = 1.2). Participants identified arsenic non-Hispanic (NH) White (N = 23, 57.5%), NH Asian (N = 11, 27.5%), NH Black (N = 3, 7.5%), NH multiracial (N = 1, 2.5%), oregon Hispanic (N = 2, 5%). On average, the 24 participants who completed the virtual quality information adhered to the attraction 5.4 times/week (SD = 1.1, range = 2.7–7.0). Baseline comparisons for survey outcomes were not antithetic betwixt conditions (worry, p = 0.98; panic, p = 0.19; depressive symptoms, p = 0.63; rumination, p = 0.84).

Data were disposable for an further 37 students who chose not to participate. This illustration was lone a subset of the full fig of invited eligible students (see Methods: Participants). A smaller stock of these non-participants had experienced VR than participants, 43.2% vs. 70.0%, X²(1, N = 77) = 4.58, p = 0.032. Other comparisons did not amusement differences betwixt these 2 groups, including outdoor quality visits and beingness camping experiences, ps = 0.45 and 0.47, respectively.

Effect of virtual quality connected symptoms

Unadjusted values shown successful boxplots suggested that virtual quality decreased worry, panic, and depressive symptoms portion expanding rumination (Fig. 1A–D). In the power condition, depressive symptoms appeared to worsen portion worry, panic, and rumination remained constant. Not each trends successful mean comparisons were statistically significant, however. Decreases successful interest and panic were important for the virtual quality condition, ps = 0.006 and 0.012, respectively. No different changes successful intelligence wellness approached value for either condition, p > 0.10.

Figure 1

Impacts of virtual quality comparative to a power information (no intervention) connected 2 dimensions of anxiousness symptoms (worry (A) and panic (B)), depressive symptoms (C), and an underlying origin of mediocre intelligence health: rumination (D) (N = 40). Greater decreases correspond to stronger benefits of vulnerability for intelligence health. Red lines link median values pre- and post-intervention. The clip betwixt the pre- and post-intervention was 3 weeks for the 18 students (45% of the full sample) who participated earlier the COVID-19 pandemic and 4 weeks for the 22 students (55% of the full sample) who participated during the COVID-19 pandemic.

Adjusted models showed that decreases successful interest with virtual quality vulnerability remained important aft accounting for gender, semester, and changes successful slumber and carnal enactment (Table 2). Worry decreased by an mean of 6.3 points comparative to the power condition, p = 0.018. Given that this measurement ranged from 16 (none of the survey items "being typical" of participants) to 80 (all items being "very typical"), the observed alteration corresponded to a 9.8% mean alteration successful worry.

Adjusted models besides showed that decreases successful panic with virtual quality vulnerability approached significance. Panic decreased by an mean of 5.0 points comparative to the power condition, p = 0.058.

No different important changes successful intelligence wellness were observed successful the adjusted models. Changes successful depressive symptoms and rumination comparative to the power information were non-significant. The last models predicted 16%, 13%, 8%, and 9% of the variance successful worry, panic, depressive symptoms, and rumination changes, respectively.

Gender, VR experience, and outdoor quality acquisition moderated the interaction of virtual quality connected changes successful interest (Fig. 2A–D, Table S2). Female participants showed greater decreases than antheral participants, p = 0.0066. Participants with VR acquisition earlier the survey besides showed greater decreases than caller VR users, p = 0.0070. In addition, participants with much visits to outdoor quality successful the past twelvemonth and beingness camping acquisition showed greater decreases than participants with little outdoor quality exposure, ps = 0.0070 and 0.0066, respectively.

Figure 2

Moderating effects of sex (A), VR acquisition (B), vulnerability to outdoor quality (C, D), and engagement with quality (E, F) for impacts of virtual quality connected changes successful interest (N = 23). Greater antagonistic values correspond to stronger intelligence wellness vulnerability benefits. Red lines amusement changes successful median values betwixt conditions.

Higher levels of engagement with quality besides moderated the interaction of virtual quality connected changes successful interest (Fig. 2E,F, Table S2). Participants with debased baseline levels experienced greater decreases successful interest than those with precocious baseline levels, p = 0.0089. Similarly, participants with debased post-intervention levels experienced greater decreases successful interest than participants with precocious post-intervention levels, p = 0.0074. Engagement with quality values besides changed implicit the survey period. Levels decreased by 8.2% successful the virtual quality information and 9.4% successful the power condition. Differences were important lone successful the virtual quality condition, ps = 0.026 for virtual quality and 0.13 for power (Table S1).

Hundreds of studies papers the benefits of existent oregon virtual vulnerability to quality connected intelligence health^1,11. The beneficial effects of virtual vulnerability are important for radical with constricted carnal capableness oregon who look societal and intelligence barriers to accessing harmless outdoor environments. The expected impacts of virtual quality connected intelligence wellness are mostly drawn from short-term exposures and outcomes, specified arsenic stress, mood, and perceived restorativeness^11,15.

We conducted 1 of the archetypal longitudinal experiments of regular virtual quality vulnerability and objective measures of intelligence health, namely symptoms of anxiousness and slump and a imaginable origin of depression: rumination. Among our illustration of 40 assemblage students, anxious apprehension (worry) decreased with virtual quality vulnerability comparative to nary exposure. These changes remained important aft adjusting for gender, semester, and slumber and carnal enactment changes. Beneficial changes successful anxious arousal (panic) were besides observed and approached value successful adjusted models. No important effects for depressive symptoms oregon rumination were observed.

Our findings are mostly accordant with 3 anterior studies that examined longitudinal vulnerability to virtual quality and objective outcomes. Like the 10-day involution by Veling et al., we recovered stronger effects of 360-degree quality videos connected anxiousness than connected depressive symptoms²¹. The 3-day involution by Lakhani et al. lone measured depressive symptoms²². They did not find robust results for this outcome; lone 1 of their experimental groups experienced drops implicit the involution period. In contrast, the results of a 7-day involution by Reynolds et al. differed from ours since they recovered decreases successful anxiousness and depression^23,24. However, their survey lacked a power information to conclusively ascribe these changes to virtual quality in VR. Reynolds et al. besides recovered clinically important changes successful depressive symptoms and not anxiousness symptoms. The authors suggested these findings resulted from a "floor effect" whereby participants showed comparatively debased anxiousness levels from the onset. The authors besides noted the debased interior reliability of their anxiousness measure.

Research with singular exposures to virtual quality is mostly soundless connected wherefore regular virtual quality vulnerability mightiness interaction anxiousness much than depressive symptoms. The findings of Chin et al. suggest 1 imaginable explanation²⁴. Only women with weaker feelings of quality connectedness showed beneficial effects of virtual quality for depression. Our illustration whitethorn person been dominated by assemblage students with higher levels of connectedness and benefited small from our intervention. We measured engagement with beauty, which is conceptually and empirically chiseled from connectedness to quality but inactive shows beardown affirmative correlations with that measure³¹. Our participants' mean engagement with quality worth was 5.1 connected a 1 (low) to 7 (high) scale. If depressive symptoms lone amended with virtual quality among radical with debased quality connectedness, our illustration was improbable to amusement effects. Meanwhile, virtual quality vulnerability whitethorn interaction anxiousness symptoms careless of people’s quality connectedness levels.

Similarly, our findings for virtual quality not benefiting rumination are hard to recognize with existing research. Several studies amusement outdoor quality vulnerability tin trim this maladaptive signifier of self-referential thought and hazard origin for depression^19,20,32. We are unaware of studies connected repeated virtual quality vulnerability and rumination. One survey of a azygous dose of virtual quality recovered that authorities rumination decreased aft viewing a slideshow of quality images; however, the aforesaid findings were recovered aft viewing a slideshow of municipality images without greenery³³. This uncovering suggests that viewing a slideshow itself produced the desired interaction careless of the environments shown. Given the beardown transportation betwixt slump and rumination²⁰, it is imaginable for the effects of virtual quality connected rumination to beryllium moderated by connectedness to nature. Future probe should trial this proposal since the results whitethorn besides assistance explicate our findings for depressive symptoms.

We recovered that engagement with quality changed crossed our survey period. Significant decreases successful the virtual quality information and decreases that approached value successful the power information were observed. Engagement with quality and quality connectedness are expected to summation with quality interaction and explicate the downstream intelligence benefits of exposure³¹. In past research, a azygous 10-min vulnerability to 360-degree videos of akin landscapes to those presented present (with the objection of rainforests) improved quality connectedness among participants with debased baseline levels³⁴. Investigations of the dose–response curves betwixt concepts related to quality connectedness and repeated exposures to virtual quality are warranted. An ongoing systematic reappraisal that evaluates the capableness of virtual quality to summation quality connectedness whitethorn observe applicable findings³⁵.

Another imaginable mentation for our divergent findings for anxiousness and depressive symptoms relates to the mechanisms of enactment by which virtual quality mightiness interaction intelligence health. Virtual quality is apt to enactment done distraction and/or relaxation pathways³⁶. The lone survey with repeated exposures that recovered accordant benefits for depressive symptoms included virtual quality experiences with interactions, similar penning successful the sand, moving virtual objects around, and teleporting betwixt locations²³. Our survey and others that failed to find benefits of repeated vulnerability provided nary interactive opportunities^21,22. Interactions whitethorn distract participants from antagonistic emotions by refocusing attention. Comparatively, non-interactive and interactive experiences whitethorn activate the parasympathetic tense strategy done relaxation, which whitethorn alleviate anxiousness symptoms.

We recovered that gender, VR use, and outdoor quality acquisition moderated the impacts of virtual quality connected worry. Gendered results could beryllium explained by women tending to payment much than men from quality entree owed to biologic differences, sex roles and norms, and differences successful intelligence relationships with nature³⁷. Meanwhile, results for VR usage and outdoor quality acquisition struggle with immoderate past probe connected singular exposures to virtual nature³⁸. The absorption of these findings suggests that radical acquainted with virtual quality stimuli–both successful presumption of hardware and imagery–may payment much than those who are little familiar.

Further probe is needed to trial these explanations. Participant's lived experiences and affectional connections with quality look to impact their derived benefits of virtual nature²⁵. Data connected clip successful quality outdoors should beryllium collected successful studies of virtual quality to measure however clip outdoors influences adherence and efficacy of clip successful VR. Researchers tin way the fig of minutes participants walk outdoors utilizing mobile apps similar NatureDose™ (NatureQuant LLC, Bend, OR) oregon cipher greenspace entree utilizing residential addresses and remotely sensed data³⁹. Qualitative enquiry could assistance construe differences successful however participants emotionally respond to antithetic types of earthy landscapes–both existent and virtual⁴⁰. Non-interactive and interactive VR experiences could trial the mechanisms underlying wellness benefits of outcome. Brain imaging studies could validate these findings and nexus them to biology neuroscience⁴¹. Exposure to outdoor environments^{20,42,43,44,45} and virtual nature^{44,45,46,47,48,49} tin elicit electrical activation and humor travel changes successful encephalon regions associated with intelligence health. Distinguishing the objective conditions studied present is disposable with functional magnetic resonance imaging (fMRI)²⁸. Repeated encephalon scans would beryllium indispensable to validate our findings contempt their fiscal and logistical challenges. Comparable studies of quality vulnerability and repeated encephalon imaging are rare⁴⁵, but notable exceptions exist^20,43. Importantly, stronger beneficial effects of quality vulnerability utilizing mobile encephalon scanning approaches (i.e., functional near-infrared spectroscopy [fNIRS]) person been shown for outdoor settings than for videos⁴⁸. This uncovering reinforces the request to power for outdoor vulnerability successful virtual quality studies. Mental wellness oregon encephalon imaging changes from outdoor vulnerability whitethorn overwhelm the much subtle changes from virtual exposure.

The findings of this survey reenforce a increasing assemblage of lit that finds virtual quality is an effective, safe, and acceptable involution for intelligence wellness promotion¹⁵. While existent outdoor quality is apt to person stronger effects than virtual nature, virtual quality tin nutrient an array of beneficial effects¹⁰. These widen beyond physiological, affective, and cognitive restoration to social, ecological, and "transcendent" (altered authorities of consciousness, oregon revelations wherever the aforesaid and situation are perceived anew) restoration⁵⁰. Virtual quality should beryllium offered to populations who bash not person harmless entree to outdoor settings owed to psychological, physical, residential, oregon different barriers. In particular, virtual quality could beryllium recommended to objective populations¹⁶ and radical surviving and moving successful isolated and confined environments (i.e., polar regions, submarines, cargo ships, and outer space)^7,8.

Virtual quality interventions should minimize the imaginable for adverse effects. Regarding cybersickness, imaginable participants could beryllium screened utilizing a validated survey artillery for question sickness (i.e., Reason and Brand Motion Sickness Susceptibility Questionnaire [MSSQ]⁵¹; Motion History Questionnaire [MHQ]⁵²). Baseline levels of the Simulator Sickness Questionnaire (SSQ)⁵³ person besides been utilized for this purpose^54,55. We are unaware of virtual quality studies utilizing these susceptibility measures contempt their usage successful the broader VR lit and correlations with cybersickness⁵⁶. Testing susceptibility whitethorn beryllium peculiarly important among populations susceptible to cybersickness, specified arsenic women, radical possessing a neurological upset oregon phobia, and radical with constricted acquisition utilizing technology⁵⁷. Techniques to minimize cybersickness successful the instauration of virtual quality interventions besides exist. When utilizing a 360-degree camera, videos tin beryllium captured exclusively connected a stationary tripod, arsenic we person done here, or, erstwhile question is desired, videos tin beryllium stabilized utilizing an physics handheld gimbal for moving video⁵⁸ with the skyline intelligibly visible⁵⁹. Aside from cybersickness, HMDs tin induce ocular fatigue, besides called eyestrain and describing the physiological strain oregon accent resulting from excessive demands connected the ocular system^60,61. Techniques to trim ocular fatigue whitethorn see presenting monoscopic videos arsenic opposed to stereoscopic videos (different viewing angles presented to each oculus for extent perception); limiting durations of HMD usage to 20 min.; and avoiding VR aft extended usage of different devices that emit bluish airy (i.e., phones, computers)⁶¹. With the expanding prime of HMDs and 360-degree camera technology, cybersickness whitethorn play a decreasing relation successful virtual quality counterindications. Meanwhile, ocular fatigue whitethorn play an expanding relation successful who should beryllium provided virtual quality interventions, fixed galore populations’ progressively precocious levels of surface time^62,63.

Our survey has strengths and limitations. We differentiated betwixt dimensions of anxiousness and depressive symptoms utilizing scales with precocious levels of discriminant validity. We included a power information to relationship for pupil intelligence wellness changes implicit the semester. However, our prime of the power information could beryllium viewed arsenic a weakness since we could not relationship for the imaginable "novelty" effect of VR, whereby newer users whitethorn respond much favorably to VR experiences⁶⁴. We expect specified effects to beryllium minimized by the 15 oregon much exposures our VR radical experienced during the intervention. Our illustration consisted of steadfast undergraduate students crossed aggregate calendar seasons. While results derived from this colonisation whitethorn not generalize to broader populations, assemblage students endure from intelligence wellness issues astatine precocious rates, and their hazard of anxiousness and slump heightened during the COVID-19 pandemic⁶⁵. Students who participated during the pandemic whitethorn person been peculiarly delicate to changes successful intelligence wellness from our intervention. Still, the confounding effects of conducting a survey implicit 3 semesters with aggregate calendar seasons whitethorn person influenced our results⁶⁶. Last, we did not trial for the anticipation of antagonistic affectional responses, specified arsenic boredom oregon fear, from virtual quality exposure. Such findings person been reported successful studies among young adults⁴⁰, including erstwhile quality videos are presented without quality sounds⁴⁷, and among dementia patients⁶⁷. Individual responses to definite landscapes presented successful HMDs could explicate the humble effect sizes for anxiousness symptoms and null results for depressive symptoms. This anticipation warrants aboriginal investigations that measurement scenery preferences and lived experiences alongside intelligence wellness outcomes.

In conclusion, we recovered grounds that regular doses of virtual quality vulnerability tin alteration anxiousness for assemblage students. More probe is needed to separate the mechanisms by which vulnerability impacts intelligence wellness to place erstwhile and for whom it benefits objective outcomes.

Participants

We recruited steadfast young adults from 2 ample nationalist universities successful the U.S. utilizing a convenience sampling approach. Undergraduate students from the University of Illinois astatine Urbana-Champaign (UIUC), Urbana, IL, were recruited successful the autumn of 2019 and aboriginal outpouring of 2020 (before mid-March) semesters portion undergraduate students from Clemson University, Clemson, SC were recruited successful the autumn 2020 semester. A recruitment connection to a screening survey was distributed to the UIUC Department of Psychology Subject Pool and an online undergraduate people with 700 enrolled students. At Clemson University, a recruitment connection was distributed to an in-person people with astir 900 enrolled students. Courses astatine Clemson and UIUC met wide acquisition requirements; therefore, students represented a divers acceptable of world majors. Students completed a screening survey and were eligible if they were betwixt 18 and 29 years old, did not instrumentality regular psychoactive medications, had mean oregon correct-to-normal imaginativeness and hearing, and did not person astigmatism of much than 1 diopter betwixt their eyes. The survey was approved by the UIUC Institutional Review Board (Protocol #19401) with a reciprocal statement astatine the Clemson University Institutional Review Board and carried retired successful accordance with the existent mentation of the Declaration of Helsinki. Informed consent was obtained from each participants.

Sixty students (26 from UIUC and 34 from Clemson) started the study. One UIUC pupil did not ticker videos successful the last week and was excluded. Another UIUC pupil reported 23 h of slumber implicit the past week and was excluded. One Clemson subordinate completed some surveys but provided excessively fewer responses for astatine slightest 1 survey artillery to impute each values. A implicit dataset for the screening survey was unavailable erstwhile information investigation occurred. Missing information resulted from unit changes, organization affiliation changes, and bundle administrative entree limitations. Relatedly, imaginable errors successful participants’ unsocial identifiers successful the screening survey information resulted successful unmatched observations betwixt these information and the pre- and post-intervention survey data. Data from 40 participants (18 from UIUC, 22 from Clemson) were yet disposable for analysis.

Procedure

Participants were randomly assigned to an involution oregon power condition. Both conditions completed online surveys connected VR usage and pre- and post-surveys connected intelligence wellness outcomes. The duration of the survey depended connected the university. Our archetypal docket was a four-week involution period, and we utilized this play for the 2 semesters astatine UIUC. Restrictions connected participants' capableness to prosecute successful probe during the COVID-19 pandemic required that we shorten the survey play astatine Clemson to three-weeks.

Students successful the involution information were loaned VR headsets for the study. Headsets were provided successful idiosyncratic earlier the pandemic and mailed with a prepaid instrumentality shipping statement during the pandemic to debar in-person contact. Students were asked to ticker 1 of six 360-degree videos connected Monday done Saturday of each week (Fig. 3). The videos were 4-min successful length. The power information received nary involution oregon instructions beyond completing the online surveys.

Figure 3

360-degree videos shown successful the virtual quality involution (Courtesy of INVIROVR).

VR content

The 360-degree videos were created by the institution INVIROVR (https://invirovr.com/) utilizing a GoPro Omni camera rig (GoPro, Inc., San Mateo, CA, USA). This framework holds six GoPro Hero4 Black cameras with fisheye lenses facing antithetic directions. The framework was fixed connected a tripod astatine oculus level (2-m) to simulate an on-site experience. Videos were recorded during sunny oregon partially cloudy weather. The idiosyncratic videos were stitched unneurotic to make spherical 360-degree videos.

A aviator survey tested 58 imaginable earthy landscapes with 9 UIUC postgraduate students and module members acquainted with VR research. We defined “natural landscapes” arsenic environments abundant successful features (i.e., plants, water, rocks, and minerals) with small oregon nary evident grounds of quality beingness oregon intervention, successful alignment with erstwhile reviews connected the wellness benefits of quality exposure^68,69. These participants watched 360-degree videos created by INVIROVR, including forests, beaches, deserts, lakes, grasslands, and alpine areas. The videos varied by duration, type, and fig of transitions. Data from absorption groups revealed 3 conclusions. First, 4-min durations were agelong capable to beryllium perceived arsenic restorative but not excessively agelong to induce boredom. Second, beaches and h2o bodies were preferred implicit forested oregon different greenish landscapes, but these types were preferred implicit rocky landscapes. Third, videos with transitions were preferred implicit videos without transitions.

A consequent survey with 95 participants was conducted with six 4-min 360-degree videos utilizing a subsample of the supra landscapes⁴⁰. The locations spanned from Costa Rica, the bluish United States (i.e., Upper Peninsula of Michigan), to the Rocky Mountain West (i.e., Colorado and New Mexico) and constituted a substance of the 3 large components of earthy landscapes–plants, water, and rocks/minerals–with precocious amounts of works biomass, which has been shown to summation the beneficial effects of VR exposure^68,70. Most videos included 4 scenes presented for 1-min each with a 3-s crossfade betwixt scenes. Since our aviator information were constricted successful generalizability, we included 2 videos with a azygous country shown for the full 4-min. A qualitative probe recovered immoderate scenes were preferred much often than others but astatine slightest 1 subordinate "favorited" each of the six videos⁴⁰. Therefore, we elected to usage each six videos (Fig. 3). Locations were expected to beryllium unfamiliar to participants truthful restorative effects were akin crossed the sample⁷¹. Videos were selected to exclude cars, postulation noises, buildings, airplane flyovers, pitchy trails, oregon radical since these elements tin impact preferences and responses to earthy landscapes^11,40,72. After our survey began, we observed that 1 video included a 16-s conception of 3 radical hardly disposable successful the background.

Videos were presented successful Oculus Go headsets (2560 × 1440 px, 60 Hz refresh rate). The dependable was played successful on-ear headphones. Headsets, controllers, and headphones were cleaned betwixt participants according to the shaper and champion signifier guidelines with disinfecting wipes and an ultraviolet (UV) container (CleanBox, Nashville, TN, USA)⁷³.

Measures

We measured anxious apprehension (elsewhere labeled arsenic "worry") with the Penn State Worry Questionnaire⁷⁴. This instrumentality asks respondents 16 items astir their tendencies to worry, inability to power these tendencies, and resulting antagonistic impacts connected a 6-point standard (1 = not astatine each emblematic of me, 6 = very emblematic of me). The standard has shown precocious interior consistency successful past probe and our illustration (Cronbach's alpha = 0.93)^27,74.

We measured anxious arousal ("panic") with items from the Mood and Anxiety Symptom Questionnaire (MASQ)^75,76. These items amusement precocious levels of discriminant validity from different temper disorders and interior consistency, including successful our illustration (Cronbach's alpha = 0.85)²⁷. Participants were asked to complaint their symptoms implicit the past week connected a 5-point standard (1 = not astatine all, 5 = extremely). Examples included being startled easily, trembling oregon shaking, musculus twitches oregon trembles, and feeling dizzy oregon lightheaded. The UIUC Institutional Review Board required 1 point asking astir suicidal thoughts removed. Therefore, information postulation astatine that instauration had 16 items for this index, portion information postulation astatine Clemson had 17 items.

Another 22 items from the MASQ were utilized to measurement depressive symptoms²⁷. The interior consistency successful past probe and our illustration was precocious (Cronbach's alpha = 0.91)²⁷. Participants were asked to complaint symptomology implicit the past week connected the aforesaid 5-point standard (1 = not astatine all, 5 = extremely). Example items included feeling withdrawn from different people, thing is precise enjoyable and cheerful oregon truly blessed (reverse coded).

A main operator of slump and result shown to payment from quality vulnerability was besides measured: rumination^20,77. Rumination is the maladaptive signifier of self-referential thought⁷⁸. The conception was measured with 12 items from the Rumination Reflection Questionnaire (RRQ) connected a 5-point standard (1 = strongly disagree, 5 = strongly agree)⁷⁹, which showed precocious interior consistency successful our illustration (Cronbach’s alpha = 0.77). Example items included "it is casual for maine to enactment unwanted thoughts retired of my mind" and "I often find myself re-evaluating thing I've done" (reverse coded).

Additional variables were measured to recognize the illustration characteristics and power for imaginable confounding effects. Gender and semester of information were collected earlier the survey began. The fig of viewings per week among participants was retrieved from play online surveys by asking participants however galore videos during the past week were watched to completion. Sleep quantity was measured with a azygous item: "how overmuch slumber did you get connected mean during the past week?" Physical enactment was measured with the Godin-Shephard Leisure-Time Physical Activity Questionnaire⁸⁰. This consists of 3 questions astir the frequence of light, moderate, and strenuous workout successful the past week. A summative people was calculated by summing the fig of strenuous workout bouts multiplied by nine, fig of mean workout bouts multiplied by five, and fig of airy workout bouts multiplied by three. The resulting standard has arbitrary units. More physically acceptable radical thin to person ranges astir 150 to 200, portion little acceptable radical thin to scope from 50 to 100⁸⁰.

Potential moderators were selected based connected the results disposable during this study's conception^38,64. The grade to which participants comprehend themselves arsenic emotionally and physiologically responding to quality successful the earthy satellite was measured with the four-item subscale of the Engagement with Beauty Scale⁸¹. Items (i.e., "I announcement quality successful 1 oregon much aspects of nature") were measured connected a 7-point standard (1 = very dissimilar me, 7 = very similar me). Scores were analyzed astatine baseline and the extremity of the involution (week 4 for UIUC participants, week 3 for Clemson participants). The interior consistency was precocious (Cronbach's alpha = 0.80).

Baseline experiences outdoors successful quality were captured with quality visits implicit the past twelvemonth and camping experiences implicit the lifetime. The archetypal point asked however often participants visited a "nature-based park" and provided section examples of metropolis oregon region parks, wood preserves, botanical gardens, and backstage woodlands. Nine effect categories were imaginable (1 = no times successful the past year, 9 = five oregon much times per week for astir weeks successful the past year)⁸². No participants reported the highest effect category. The 2nd point asked participants however often they went camping overnight "in the wilderness." Five effect options were provided (1 = no times successful my life, 5 = more than 10 times successful my life). A implicit listing of effect options is disposable successful Table S1.

We measured past VR usage to seizure the imaginable "novelty effects" of utilizing a headset earlier the study⁶⁴. To bash so, we asked participants whether they had ever experienced virtual reality. Response options included yes and nary arsenic good arsenic "not sure." No participants indicated they were unsure whether they had utilized VR.

Analyses

Survey information were archetypal screened for missing values. Five missing cases were recovered for rumination successful the power information and imputed utilizing anticipation maximization (EM)⁸³. The azygous point measuring suicidal ideation was besides imputed for the UIUC participants. The Clemson information were screened for systematic causes of missingness utilizing Little's trial of missing wholly astatine random (MCAR)⁸⁴. Non-significant results indicated that information were MCAR (χ² = 500.56, DF = 610, p > 0.05). An EM method was employed to impute these data. Rates of missingness ranged from 25 to 28% for intelligence wellness outcomes and 49% for slumber and carnal activity.

Sample characteristics were described based connected the adaptable type. Continuous measures were reported with means and modular deviations oregon medians and interquartile ranges (IQRs) depending connected distribution. Binary measures were reported arsenic counts and frequencies. Differences betwixt pre- and post-interventions were compared with paired illustration t-tests.

We utilized 4 sets of stepwise regressions with changes successful worry, panic, depressive symptoms, and rumination arsenic the outcomes. Base models included gender, semester (during the COVID-19 pandemic oregon not), and slumber and carnal enactment changes. Change scores for time-variant confounders were utilized to simplify the models and optimize statistical power. The last models added the experimental information arsenic a dummy adaptable with the power arsenic the notation group. Statistical value was defined by p < 0.05. Analyses were completed successful R V4.1.2 (R Foundation, Vienna, Austria).

Moderation tests were performed among the subsample of virtual quality participants. We compared the effects of virtual quality among women vs. men, past VR users vs. caller VR users, and debased vs. precocious levels of engagement with beauty, quality visitation, and camping experiences. Participants were categorized betwixt the 3 second variables into debased vs. precocious levels utilizing median splits: debased engagement with beauty ≤ 5; debased quality visits ≤ 4 (6 to 9 times successful the past year); debased camping experiences ≤ 2 (1 clip implicit the lifetime).

The datasets generated and analyzed during the existent survey and the scripts utilized to make the results are disposable connected the Open Science Framework (OSF) astatine https://osf.io/r73x5/ (https://doi.org/10.17605/OSF.IO/R73X5).

References

Authors and Affiliations

1. Virtual Reality and Nature Lab, Clemson University, Clemson, SC, USA

   Matthew H. E. M. Browning, Olivia McAnirlin, Shuai Yuan & Vishnunarayan Girishan Prabhu

2. Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, USA

   Matthew H. E. M. Browning, Olivia McAnirlin, Ryan J. Gagnon & Shuai Yuan

3. Department of Natural Resources and Environmental Sciences, University of Illinois astatine Urbana-Champaign, Urbana, IL, USA

   Seunguk Shin

4. College of Education, University of Illinois astatine Urbana-Champaign, Champaign, IL, USA

   Gabrielle Drong

5. School of Mathematical and Statistical Sciences, Clemson University, Clemson, SC, USA

   Shyam Ranganathan

6. University of North Florida, Jacksonville, FL, USA

   Kailan Sindelar

7. INVIROVR Inc., Santa Fe, NM, USA

   David Hoptman

8. School of Environmental and Forest Sciences, University of Washington, Seattle, WA, USA

   Gregory N. Bratman

9. Systems Engineering and Engineering Management, University of North Carolina astatine Charlotte, Charlotte, NC, USA

   Vishnunarayan Girishan Prabhu

10. Department of Psychology, University of Illinois astatine Urbana-Champaign, Champaign, IL, USA

    Wendy Heller

Contributions

M.B. was liable for the conception and plan of the work, information analysis, mentation of results, and the archetypal draught of the manuscript. S.S., G.D., O.M., D.H., and W.H. assisted with designing the work, collecting data, and revising the manuscript. D.H. was besides liable for the instauration of the VR simulations. K.S. and S.Y. assisted with information postulation and revised the manuscript. R.G., S.R., G.B., and V.P. assisted with information analysis, mentation of results, and revising the manuscript.

Corresponding author

Correspondence to Matthew H. E. M. Browning.

Competing interests

The authors state nary competing interests.

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