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Is decreased exposure to nature causing mental disorders?

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The evidence is mixed.

Summary: Richard Louv, a journalist with no research background, coined the term 'Nature Deficit Disorder' (NDD) to explain possible causes for childhood cognitive disorders. The article, "Have You Got Nature Deficit Disorder?" by Alice Wilkinson uses Louv's terminology to encourage those living in urban areas to spend more time in green spaces. Further investigation of NDD showed that Louv ties NDD to Attention Deficit Disorder (ADD), and Attention Deficit Hyperactivity Disorder (ADHD), while others also include Autism.

Origin and Prevalence

Richard Louv, a journalist, first coined the phrase "Nature Deficit Disorder" in his 2005 book Last Child in the Woods: Saving our Children from Nature-Deficit Disorder. His intent was to create a phrase to explain a possible cause of ADD and ADHD, but did not intend for it to have clinical significance. He is the author of several books on the importance of nature that have been published in 17 countries. He is the co-founder of the Children & Nature Network, an organization established to connect people to nature. Since his introduction of the concept, Louv has been invited to speak at several appearances, to include the US Forest Service and the North Carolina Educational State Forest system. His work also influenced D-RI Senator Jack Reed to introduce the Bill " No Child Left Inside ACT" (2013-2014). The bill has not yet passed. His work has been promoted in over 1000 media outlets including New York Times, Washington Post, USA Today, and The Chicago Tribune.

#BeatNDD has been spreading across social media as companies such as Moving Art offer incentive for sharing your photos with their hashtag. Several Facebook pages, a few of which are BBC News, the Children and Nature Network, and MindUp have featured articles advertising and promoting nature deficit disorder. Tweets by @naturehomeschool, @Richlouv, @FatNatChat, @ParentingTpnews, and many others are spreading the idea through Twitter.

Issues and Analysis

Nature Deficit Disorder is not a recognized medical or diagnostic term. By Louv's definition, symptoms of NDD include diminished senses, attention difficulties, lack of concentration, lethargy, and decreased mood, which are similar to those of Seasonal Affective Disorder (SAD). A recent study by Auburn University, Alabama, has shown that a lack of sunlight does not induce depression. However, this study has several flaws. It used previously collected self-report surveys gathered from random phone calls and analyzed the responses with the recorded weather at the location of the person at the time the phone conversation happened.

There was no subject contact and the subject pool was not formed from medical documentation of those with depressive symptoms, but from whomever decided to stay on the phone with the interviewer. Additionally, studies in the United Kingdom have shown evidence that people do experience depressive symptoms due to "winter blues". These studies centered on empirical evidence such as sleep behavior and reversing the symptoms by using a light box to simulate the light spectrum in summer months. These findings suggest NDD is distinct from SAD or being sensitive to seasonal changes; NDD is described as a disconnection with nature that leads to a decline in mental health that does not change with the seasons.

Wilkinson also links studies in her article that indirectly support NDD as a true disorder. The mentioned studies show evidence that direct sunlight 2-3 times per week for 15 minutes can provide the daily requirement of vitamin D needed for bone and muscle health. Louv uses published studies as an argument for NDD and connects theses studies to ADD and ADHD. For example, a recognized treatment used to alleviate symptoms of depression called Ecotherapy, consists of engaging in outdoor leisure work and is recognized as an effective treatment for depression. A survey of 12,000 people undergoing Ecotherapy was published in Mind, a mental health charity group. The survey found that 69% of people reported increases in wellbeing and 76% had improvements in mood after working outdoors in gardens. Participants also had a decrease in anger, confusion, depression and tension after being outdoors. Evaluation of wellbeing was completed by composite questionnaires designed to measure not only wellbeing, but also social inclusion and connection to nature. Furthermore, studies have found negative effects of urban environment on cognitive health. One study published in Frontiers in Psychology shows that urban environments lead to cognitive fatigue. Additionally, the study showed people in urban environments with constant stimulation showed improvement in attention demanding tasks after spending time in nature.

Several peer-reviewed journals have published articles that demonstrate the benefits of nature, but an intensive literature search in published journals revealed there is no research that shows lack of nature causes ADD, ADHD, or autism. However, some papers have hinted a possible relationship between general health and lack of nature. A paper by Graham, et al., suggested that the gut microbiome is affected from not being in nature. They researched the human gut microbiome and compared bacteria found in nature with that found in urban environments and found them to be significantly different. Their argument is that humans evolved with certain species of gut flora and by living in urban environments with different bacteria, the dynamics of our gut microbiome is changing. Research by Mitchell, et al., also found that negative mental states were more highly correlated with physical activity in urban environments compared to that in nature.

Few studies have been conducted to understand how different environments influence ADHD. However, studies have shown improvement in ADHD symptoms in children after being outdoors in green spaces. Parents have reported improvement in their children's ADHD symptoms following outdoor play in green spaces versus non-green spaces. Research by Taylor, A., et al., 2009, showed that children with ADHD had better concentration after a walk in the park versus a walk downtown or a neighborhood walk. Current studies imply that children and adults benefit equally from being in nature, but further research is needed to understand how environmental preferences differ between adults and children. Also, minor attention has been paid to personal and socio-cultural factors of restorative environments in these studies. Further studies should consider familiarity, time spent outdoors, and developmental stages.

Further Reading

Bruyere, B., Teel, T., & Newman, P. (2009). Response to ''More kids in the woods: Reconnecting Americans with nature.'' Journal of Forestry, 107(7), 378–379. Retrieved from http://www.uky.edu/OtherOrgs/AppalFor/Readings/240%20-%20Reading%20-%20Last%20Kids%203.pdf

Kimbell, A. R., Schuhmann, A., & Brown, H. (2009). More kids in the woods: Reconnecting Americans with nature. Journal of Forestry 107(7), 373–377. Retrieved from http://www.uky.edu/OtherOrgs/AppalFor/Readings/240%20-%20Reading%20-%20Last%20Kids%201.pdf

McKee, B. (2005). Growing up denatured. The New York Times. p. F1. Retrieved from http://www.nytimes.com/2005/04/28/garden/28kids.html

Rook, G. (2013). Regulation of the immune system by biodiversity from the natural environment: An ecosystem service essential to health. PNAS. vol. 110 no. 46; 18360–18367, doi: 10.1073/pnas.1313731110

Vanderwalle, G., Hebert, M., Beaulieu,C., Richard, L., Daneault, V., Garon, M-L., Leblanc, J., Gransjean, D., Maquet, P., Schwartz, S. (2011). Abnormal Hypothalamic Response to Light in Seasonal Affective Disorder. Biological Psychiatry. Volume 70, Issue 10, pp. 954–961. http://ntserver1.wsulibs.wsu.edu:2090/10.1016/j.biopsych.2011.06.022


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