# Motivation and emotion/Book/2020/Nature deficit disorder

* Multimedia presentation (3 min)

## Overview

Imagine you are taking a walk to your local park. It is a warm, spring day and you are surrounded by blossomed flowers, growing fruit trees and a bright blue lake. You think to yourself "it really is the most perfect day to take a stroll". You arrive at your local park and sit down at the wooden bench. The smell of the sweet, musky florals runs through your nose, the sound of chirping cockatoos immerse your ears, and the fresh, spring wind gently blows against your face, all while you observe a bevy of black swans waddle their way through the bright green grass. You are in deep engagement with nature. Your engagement becomes interrupted when you hear a woman raise her voice. You move toward your head toward the voice and notice a young boy sitting on the wooden bench opposite to you. His spine is curled over, his eyes are in focus, and his thumbs are moving rapidly while playing on his smartphone. The woman raises her voice again toward the young boy, telling him to "get off his phone!" and encouraging him to play in the park. The boy ignores the woman and continues engaging with his mobile phone.
Nature Deficit Disorder (NDD) is the idea that humans, particularly children, are becoming alienated from nature and spending less time outdoors (Louv, 2005) (See Figure 1.). For the new generation of children, experiences in nature (whether that is in the backyard, at an outdoor park, or along the beach) are slowly decreasing and becoming replaced by indirect experiences through electrical media (Louv, 2008). The influence of parental fears of nature and increased urbanisation has also contributed to NDD. This effect of nature deficiency has shown links to various psychological effects, such as increased risk of depression, anxiety, and ADHD, as well as physical health detriments (Kuo, 2013; Louv, 2011). Ultimately, it is suggested by researchers that having a strong engagement with nature is vital for our psychological and physical health (Louv, 2005).
This chapter explores NDD, specifically the effects of spending time in nature, the causes of NDD and how NDD can be cured. Psychological theories and case studies are discussed to further explore and understand NDD.
* Focus questions
* What are the effects of NDD?
* What causes NDD?
* How can emotion theories and research help understand NDD?
* What can be done to cure NDD?

## What is nature deficit disorder?

The term "nature deficit disorder" was introduced by Richard Louv in 2005 through the publication of his book, “Last Child in the Woods: Saving Our Children from Nature-Deficit Disorder.” (Louv, 2019). NDD is not yet regarded as a formal diagnosis and has not been recognised in any medical coding schemes, such as the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). However, there has been controversy between researchers about whether NDD should be considered a formal diagnosis (e.g., see Elizabeth Dickinson's 2013 study).
Louv (2005) spent over 10 years travelling around the United States assessing children living in urban environments (i.e. big cities, busy highways, high population of people) against children living closer to natural environments (i.e. the beach, on a farm, along a lake). Louv (2005) proposed children living in urban environments had less knowledge of the environment and their immediate natural surroundings, and had an increased risk of developing depression, anxiety and Attention-Deficit Hyperactivity Disorder (ADHD). Due to this, Louv (2005) had a goal to "reconnect" children with nature.
True or False!
1
Nature deficit disorder is a medically recognised mental disorder featured in the DSM-5.
True
False
2
Elizabeth Dickinson coined the term "nature deficit disorder" in 2005.
True
False :

## The effects of nature

While Louv (2005) examined some of the psychological and physical effects of NDD, limited studies have been conducted by other researchers assessing the effect of nature deficiency in humans. Despite this, various researchers have examined the effects of nature connectedness (spending adequate time in natural environments and having a strong connection with nature). These are explored below.

### Psychological effects

[Provide more detail]

#### Stress

A highly-studied area is the relationship between nature and stress. Many researchers have identified exposure to nature as a mechanism to reduce and potentially buffer stress. Wells and Evan (2003) measured psychological stress in children living in rural areas to examine whether the residential environment might buffer or moderate the impact of stressful life events. The results showed that children living near natural elements in residential settings form protective factors that shields children from stress and ultimately contribute to their resilience (Wells & Evan, 2003). Jo, Song and Miyazaki (2019) also demonstrated physiological indicators of stress, such as blood pressure and heart rate, decreased rapidly when individuals entered, or were shown images of forested settings. The mechanisms involved in why nature alleviates stress are not completely understood and are an ongoing focus of research. Louv (2011) hypothesised that children and adults who are nature deficit may show symptoms of stress, particularly after spending an excessive amount of time in unnatural environments.

#### Depression

While there is limited research about whether depression is a symptom of NDD, exposure to nature has also shown effects in reducing symptoms of depression (see Figure 2.). Alcock et al. (2014) studied people who were diagnosed with depression for five consecutive years and who moved from urban areas and relocated to greener, natural environments. The results showed decreased depressive symptoms, increased happiness, increased physical activity and an overall improved mental health and well-being (Alock et al., 2014). Similar results were presented by Korpela et al., (2016) who studied participants with depression attending an indoor psychoeducation group meeting, as well as an outdoor session consisting of engagement-based psychological tasks (e.g. finding a favourite place in the natural environment), and walking around the area. These sessions were conducted weekly over a 3-month period. After completion of the program, over half of the participants had a "clinically significant" decrease of depressive symptoms (based on the Beck Depression Inventory) (Korpela et al., 2016). These studies indicate a strong relationship between nature exposure and depression prevention and reduction.

#### Cognitive abilities

Researchers have also looked at the effect of nature in increasing attention, promoting attention restoration and decreasing symptoms of ADHD. Recent studies have suggested nature therapy and exposure to green space have decreased ADHD symptoms. In Dineen's (2018) study, kindergarten to year three students that were diagnosed with ADHD or had symptoms of ADHD participated in interactive activities that focused on different aspects of the environment such as "land and seas" and "birds and bees". The program included four daily sessions and assessed the students ADHD levels through verbal tests 15 minutes after each session. The students presented significant reductions in hypervigilance and increased ability to hold attention after each session (Dineen, 2018). Wilson (2015) conducted a similar study and found 30 minutes of playtime in green environments were also effective in restoring attention in ADHD children. It is suggested by Louv (2005), children with ADHD are more likely to be nature deficit.
* Case Study
* Andre is a 5-year-old boy who loves playing outside. Every morning, Andre and his mum, Bec, take a stroll to the local lake and feed the ducks. Some days, it is hard for Bec to get Andre back home because he loves spending time with the ducks. Andre has even named all the ducks and call them his "friends". One day, it was Andre's 6th birthday. Andre was gifted a virtual pad where he can read books and play games. One morning, Andre suddenly did not want to go see the ducks and insisted to play with his virtual pad instead. Bec allowed this for a couple of days, but after the third day of playing on his virtual pad, Bec took it off him and insisted for Andre to go feed the ducks. Andre started crying and throwing himself on the floor. Bec gave the virtual pad back to Andre and he was happy again. Over the next couple of months, Andre hardly went outside. Andre was suddenly becoming restless, had trouble concentrating at school, and was showing symptoms of depression. Andre was taken to the doctor and his results were inconclusive. Based on Louv's (2005) findings, Andre may be showing symptoms of NDD.

### Physical effects

Many of Louv's studies have shown a relationship between nature deficiency and physical health, including increased risk of obesity (Charles & Louv, 2009), increased violence, vitamin D deficiency, and increased risk of disease and mortality (Louv, 2005; Kuo, 2013). However, studies assessing nature deficiency and physical health outside of Louv's (2005) have been very limited. Additionally, researchers have speculated whether these relationships are casual or if it is explained by additional variance (such as physical activity in natural environments) that lead to these results (Dickinson, 2013).
Quiz
Based on what you have learnt so far, who is most likely presenting symptoms of Nature Deficit Disorder?
James who watches the bumble bees take pollen out from his daisy flowers every morning.
Tania who meditates in her backyard every day.
Isabella who watches television every afternoon instead of taking her pet dog for a walk.
Alex who snorkels with the fish in the Great Barrier Reef every summer. :

### Physiological effects

While there is limited research on the physiological effects of nature deficiency, Louv (2005) has introduced his own terms to describe some of the effects children with NDD may experience.

###### Placed blindness

Placed blindness is the idea that humans are losing individualised relationships with the land on which they live. It is believed the digital world has become more real to us than the nature offered outside our homes and workplaces. It begins in childhood when children spend less time outdoors and more time engaging with modern technology. Children ultimately become less aware of their natural environments and are unappreciative and are lacking understanding of the natural world. Louv (2005) suggests place blindness can be relieved through choosing a place outside and sitting in it while observing the environment for ten minutes daily (or as often as possible).

###### Sensory anaesthesia

Sensory anaesthesia describes the disconnection of feedback we receive from nature through our five senses. It is caused by indoor, screen-focused lifestyle and the effects may led to dulled senses. Our senses are vital for various things, such as stimulating learning and language developmenl, fleeing us away from danger, and exploring the world (Louv, 2005). Louv (2005) suggests the antidote to sensory anaesthesia is outdoor meditation. Go to an area surrounded by nature. Take notice of the sounds of water, the smell of fresh air, the sights of blue skies, and the touch of a smooth surface of a stone. Meditation will assist in amplifying your senses and counteracting sensory anaesthesia (Louv, 2005).

###### Species loneliness

Many children do not engage with other species, other than household pets. Species loneliness is the lack of connection with other species of this earth. Having a connection with other species, even the smallest of them, is important for our physical, mental and physiological health. Whether you live in an urban, suburban or rural environments, take notice of the spices present around you. Listen to the sounds of birds in the morning, or watch ants climb a tree. It can be very meaningful to experience a sharing moment with a non-human species (Louv, 2005).

## Causes of nature deficit disorder

Louv (2005; 2011) has proposed various factors that may contribute to the development of NDD. These are discussed below.

### Increased use of electronics

In our modern world, technology dominates almost every aspect of our lives. In 2017, over 66% of Kindergarten to Year 12 students used technology (computers, smartphones and tablets) daily in the classroom from an 8% increase from the year before (Straker, Harris, Joosten & Howie, 2017). Louv (2011) believes children's lives are becoming over-programmed in the virtual world and studies have indicated with each wave of technology, there have been concerns raised about the potential impact on physical, mental and social health outcomes (Straker et al., 2017). The concern is not the technology itself, but rather, our lack of balance between nature and technology. The more time we spend on screens, the less energy and motivation humans have to go outside (See Figure 3.) (Louv, 2011).

### Urbanisation

As of 2008, for the first time in human history, more people lived in cities than in the countryside. In 2016, 55% of the world population lived in urban areas and this is expecting to increase to 68% by 2050 (United Nations, 2018). The barrier is not the city, but the absence of natural environments in the city. This is due to:
* Poor design of cities, neighbourhoods, homes, schools and workplaces in access to nature.
* Loss of urban parkland and the destruction of nearby nature within neighbourhoods.
* Poor transportation systems that bypass communities of different economics and abilities, and bypass natural areas as well (Louv, 2011).
The less we see of nature, the less we value of it. Louv (2011) suggests this disappearance of biodiversity is a major contributor to the development of NDD.

### Parental protectionism and fear

A potentially surprising and unexpected cause of NDD is parental protectionism and fear. While there are some things in our natural environment humans are conditioned to fear, such as falling off a large mountain or a hungry lion chasing you, many fears relating to nature have been amplified and instilled by cultural influences (Louv, 2011). Interestingly, some people have developed biophobia - a fear of nature itself, in which is more prevalent in individuals with limited contact to nature (Olivos-Jara, Segura-Fernández, Rubio-Pérez & Felipe-García, 2020). Parents who experience biophilia tendencies (avoiding nature as much as possible) are more likely to pass these tendencies onto their children as well.
Another fear Louv (2011) suspects is contributing to the development of NDD is fear of strangers. There has been a media-amplified fear of strangers ("stranger danger") in the last two decades, especially from the increased media on terrorism, child trafficking and child murders (Wodda, 2018). While these are real and serious dangers, parents should still not deprive their children from spending time outdoors and accompany them when necessary (Louv, 2011).
Lastly, the fear of social attitudes towards outdoor play and what is considered 'right' and 'wrong' for parents also contributes to NDD (i.e. "children should not play outside because they will get dirty") (Louv, 2011).
Louv (2011) believes the more we experience nature, the more we will know how to avoid natural risks, and the less we will fear it.
Quiz
According to Louv (2011), what are some of the causes of Nature Deficit Disorder?
Increased use of technology.
Household pets.
Parental fear of nature.
Strained relationships with family.
Urbanisation. :

## Psychological theories and nature deficit disorder

Various psychological theories have been examined to further obtain a comprehensive understanding of NDD.

### Biophilia theory hypothesis

Louv's (2005) idea of NDD was heavily based on Wilson's (1993) work and his theory the biophilia theory hypothesis (New South Wales Department of Education, 2013). Wilson proposed that humans are evolutionary hardwired to have a strong connection with nature and all forms of life (see Figure 4). Since the prehistoric era, human survival was based on the ability to understand and be in touch with our natural environments. Our ancestors relied on knowledge of the ecosystems, seasons and resources to hunt for food, build shelters and ultimately survive and reproduce. This evolutionary affiliation presented in our ancestors is suggested to not only account for our tendency to seek connections to nature, but also enhance our emotional and psychological health. This is why many of us may favour natural light over artificial, seek out natural landscapes, and have plants in our homes (Wilson, 1993).
These connections to nature are suggested to be expressed based upon the early experiences children have with nature (Wilson, 1993). This is based on research demonstrating increased human psychological well-being upon exposure in natural features and environments (Gullone, 2000). If children were to separate themselves from natural environments, the ability to learn about and connect to nature is ultimately hindered and may cause biophilia tendencies. These biophilia tendencies are suggested to carry on from generation to generation, thus, it is not only the current child that is affected, but also future generations (Wilson, 1993). This theory may support the idea of NDD and explain why many parents and children in today's generation seperate themselves from nature and may fear particular aspects of the outdoors.

### Stress reduction theory

Stress Reduction Theory (SRT) (Ulrich, 1984) suggests that natural environments facilitate restoration in psychophysiological stress, negative moods, and fatigue that were ultimately caused from excessive amount of time spent in unnatural environments (Joye & Dewitte, 2018). Similar to the biophilia theory hypothesis, SRT is based on an evolutionary perspective and suggests positive psychological responses to natural environments are rooted in humans genes (Jiang, He, Chan & Larsen, 2020). The modern human brain is still wired for the Stone-Age, thus we still produce the same positive effects to the environment to that of our ancestors, which is believed to reduce or even buffer psychophysiological stress (Joye & Dewitte, 2018). Following a stressful environment, being surrounded and connecting with nature promotes calming effects (Jiang, He, Chan & Larsen, 2020).
* Case Study
* Ava, a seven year-old girl, experiences sudden stress from school after learning there will be a pop quiz in her history class after lunch. Using the Stress Reduction Theory, it is suggested Ava should spend quality time outside during her lunch break. Spending time outside may include Ava running around in the grass, finding shapes from clouds, catching butterflies, or simply, just walking around and admiring the natural landscape. From doing this, it is suggested Ava will respond to the natural environment with more positive mental responses, such as relaxation, joy and reduced stress (Jiang et al., 2020). Ava is predicted to approach the pop quiz in a positive and relaxed mindset after spending time in a natural environment.
The SRT can be used to explain the psychological effects in NDD. As many children in today's generation are spending more time in urban environments than in natural environments (Louv, 2011), children are suggested to be overloaded and over-stimulated by noise, movement and visual complexity. These daily interactions can easily overwhelm and increase stress in people, in which are one of the symptoms suggested to be associated with NDD (Louv, 2005). Spending quality time in natural environments and connecting with nature appears to be an antidote to the stress effects of urban living (Louv, 2011).

### Attention restoration theory

The Attention Restoration Theory (ART) is based on a cognitive psychological perspective and proposes exposure in nature helps humans improve mental focus and the ability to concentrate. ART follows the central notion of "directed attention", in which is the process to focus on certain cognitive processes, while at the same time, blocking out distracting stimuli. Directed attention is important for various tasks; from driving a car to writing a book chapter about NDD. However, it is considered a limited resource and can become quickly fatigued. According to ART, an effective way to restore directed attention is from spending time in nature (Joye & Dewitte, 2018). It is hypothesised that nature facilities restoration in directed attention through shifting one’s attention onto soft fascinating stimuli in an automatic, bottom-up way. This minimises the demands on (effortful) directed attention, resulting in the ability to rest and restore itself (Joye & Dewitte, 2018).
ART may be used to understand the link between nature deficiency and the increased rate of ADHD in children. If nature is speculated to restore directed attention, children who do not spend enough time outside may not be able to facilitate attention restoration, thus, in turn, may lead to attention difficulties (Louv, 2005).

## How to cure nature deficiency

To cure nature deficiency, children (and adults) need to ultimately immerse themselves into nature and form a deep connection with the natural world (Louv, 2005). Spending time in nature does not need to involve weekly camping trips or extensive hikes (although of course this is great!); nature is all around us, such as in our backyard, in our gardens or at our local park. Thus, the first step to cure nature deficiency is to realise how we define 'nature' and shifting our mindset to understand we are surrounded by nature. Next, it is not just about going outside, but using all our senses to understand and connect with the environment (Louv 2005; 2011) (see Figure 5.). Below are various ways to reconnect children with nature;

### Immersive nature experience

Every day, set a time for you and/or your child to spend 30 minutes outside. Find your favourite spot where you are surrounded by nature. Notice the smell of fresh air, observe your surroundings, and listen to the sounds presented to you. Engage all of your senses and be present and appreciative of the moment. Allow your children to lay on the grass, to smell the flowers or even play in the mud. Let them engage their senses through playtime (Louv, 2005).

### Encourage play time outside

Leave the tablets at home and allow children to explore their natural surroundings. Let them explore an area that has enough space to run around in, as well as various stimuli that engages all their senses. This might mean climbing a tree, growing a garden in the backyard, or simply kicking a soccer ball! Better yet, find something both the children and parents can do together, such as going on a walk to the local lake and feeding the ducks. While there is no recommended 'dosage' for how much outdoor play children should engage in, more is better (Kuo, 2013)!

### Set time aside for the weekend

For many parents, the weekend may be a time for relaxation after a tough work week. While it is important to have some down-time, immersing yourself in nature, even if it is for only an hour, is very beneficial for you and your children's psychological and physical health (Kuo, 2013). For those who prefer relaxation on the weekend, do some meditation in your background, take a stroll to a local green area or visit a park. For those who like to be more active, go to the beach, visit a national park or go on a day camping trip.

## Conclusion

NDD is a term coined by Richard Louv to describe human disconnection from nature. As NDD is a relatively new phenomenon, very few studies have been conducted on the effects of nature deficiency in humans. However, the studies that have tested the effects of NDD have suggested there is an increased risk of depression, anxiety and ADHD, as well as various physical health detriments, related to human nature deficiency, especially in children.
NDD is suspected to be caused by increased use of technology, urbanisation, and parental protectionism and fear. It is important for parents and children to find a healthy balance between spending time in nature and spending time in our modern world.
Fortunately, NDD can be easily cured. Spending daily time outside and forming a strong connection with nature is the best form of treatment. Encouraging children to play outside instead of watching television or playing on a tablet is an important step. Plan a time each day to spend at least 30 minutes outside. This could be as simple as watering the garden or taking a hike.
On a final note, it is important to remember, at this current time, NDD is not a formal psychological medical condition. Very few psychological studies have assessed NDD and those that have, have presented critiques. Thus, the scope of this chapter is not for self-diagnosis, but to recognise the importance of spending time in nature and the benefits it offers on psychological and physical health.