Virtual Nature as an Intervention for Reducing Stress and Improving Mood in People with Substance Use Disorder

Abstract

Substance use disorder (SUD) afflicts a large percentage of the United States population, with negative implications that cost more than $420 billion annually. This population often experiences negative emotions throughout the recovery process, including anxiety, depression, stress, and negative affect. Currently, evidence-based treatment strategies for SUD include cognitive behavioral therapy, motivational interviewing, 12-step programs, and mindfulness-based treatment. One intervention that has not been studied at length among individuals with SUD is use of the natural environment as treatment. Among other patient populations, nature has been shown to reduce stress and anxiety by regulating autonomic nervous system function, reducing symptoms of depression, and improving mood. The purpose of this study was to investigate whether viewing nature videos could similarly reduce stress and improve mood in individuals with SUD. A crossover design was used to compare viewing a nature scene and practicing mindfulness-based activities for women with SUD at a residential treatment facility. Over four weeks, participants engaged in the two activities for the first 10 minutes of their daily program. Immediately before and after each 10 minute session, measures were taken for heart rate, in beats per minute (BPM); affect, using the Positive and Negative Affect Scale (PANAS); and overall mood, using a 10-point rating scale from “very unpleasant” to “pleasant.” Thirty-six women completed the study. For viewing a nature scene and practicing the mindfulness-based activities, there were statistically significant reductions in mean negative affect scores (p=0.001) and heart rate (p≤0.001). In addition, for participants in both conditions, overall mood improved significantly (p=0.030). The results from this study provide initial evidence that viewing nature has similar benefits to MBT in the treatment of stress and negative mood associated with the SUD recovery process and may be an additional, cost-effective treatment strategy for individuals with SUD.

The Impact of Virtual Nature Therapy on Stress Responses: A Systematic Qualitative Review

“…The VRF appeared to be used in health practice. For example, stress research on patients with dementia [34], cancer [58], and SUD [50] has been respectively conducted, which is a good initiative for further studies covering more psychological conditions.…”

“…Among the most employed methods were the Profile of Mood States (POMS), positive and negative affect scale (PANAS), visual analogue scales (VAS), standard stress scale (SSS), perceived stress scale (PSS), and state and trait anxiety inventory (STAI-S). Along with psychosocial impacts assessment, twelve studies [35,36,[45][46][47][48][49][50][51][52][53][54] examined the effects of forest therapy on physiological health by evaluating heart rate (HR), heart rate variability (HRV), systolic blood pressure (SBP), diastolic blood pressure (DBP), salivary amylase (SA), the standard deviation of R-R intervals (SDRR), blood volume pulse (BVP), and skin conductance levels (SCL).…”

“…In two more studies, HR was used with VAS [54] and PANAS [50] to evaluate the effectiveness of VR in reducing stress. Schebella, Weber, Schultz, and Weinstein [54] use IVEs comprised of visual, auditory, and olfactory stimuli to examine the impacts of biodiversity on stress recovery.…”

“…It was stated that multisensory (visual, auditory, and olfactory) stimulation improved stress recovery and did not impact the immersion sense of the participants when compared to visual-only encounters. In [50], the impact of VR technology on reducing stress and enhancing individuals' moods was investigated using a pulse-oximeter and the PANAS. This study was conducted on 36 women with substance use disorder (SUD) for the first 10 min of their daily programs in a residential treatment program for four weeks, including two activities.…”

“…The effectiveness of nature was not a monopoly of forests, but beaches [45] and seas [46] provide similar positive effects to an extent. In health practice, VR has been proven to mitigate stress among patients with SUD [50], dementia [34], and cancer, during the intravenous procedure [58].…”