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Yoga et santé mentale, mythes ou réalités?

Yoga et santé mentale, mythes ou réalités?

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L’engouement pour le yoga est un phénomène grandissant auprès d’un bon nombre de gens. Les studios, les styles et les festivals de yoga se multiplient à grande vitesse. D’ailleurs, depuis 2015, le 21 Juin a été désignée la journée internationale de yoga par « United Nation General Assembly » (UNGA, 2014). De plus, le premier salon international sur le yoga (expo yoga) s’est tenu au palais des congrès de Montréal en Février dernier. Au sein de notre équipe, Connecte groupe de psychologie Montréal, des psychologues et des professeurs de yoga collaborent régulièrement pour organiser des ateliers de bien-être et de santé mentale.

Lorsqu’on fait une recherche internet avec le terme yoga comme mot-clés, il est facile de s’emballer quant aux bienfaits cités (amélioration de la qualité de vie, gestion du stress, diminution de la détresse psychologique, promouvoir l’activité physique, etc). Toutefois, d’autres sources citent les méfaits (preuves insuffisantes, simple mode, danger de blessures, degré de difficulté, absence des bienfaits promis, etc).

Face à cette situation, j’ai jugé pertinent d’écrire à ce sujet, notamment sur les liens entre le yoga et la santé mentale. Tout d’abord, il importe de préciser que je suis biaisée : je suis une adepte du yoga depuis plusieurs années et ma thèse doctorale portait sur le yoga. Cependant, l’objectif ici est de résumer ce qu’est le yoga, les bienfaits et les limites observés concernant la santé mentale selon des recherches scientifiques et fournir quelques ressources.

Le mot « yoga » est un dérivé de la racine sanskrit « yuj », qui veut dire « unir ». Ultimement, « yoga » signifie l’union du moi individuel avec le moi universel. Le terme renvoie aussi à la discipline pratiquée menant à cette union (Bower et al., 2005). Cette activité vise à améliorer le bien-être physique, émotionnel et spirituel (Bower et al., 2005). Cette activité est pratiquée pour explorer le lien corps-esprit, la conscience du corps, l’importance de la respiration et de la relaxation.

Bon nombre de recherches ont été effectuées auprès de diverses populations (en santé, oncologie, maladies cardiovasculaires, troubles anxieux, troubles dépressifs, etc). Dans l’ensemble, les études suggèrent une amélioration quant à la gestion des symptômes dépressifs, des symptômes anxieux, la détresse psychologique et une amélioration au niveau de la qualité de vie (Buffart et al., 2012; Chong et al., 2011; Jeter et al., 2015; Kirkwood et al., 2005; Li & Goldsmith, 2012; Patel et al., 2012). Cependant, il importe de mentionner que la littérature scientifique révèle une variabilité importante quant à la rigueur méthodologique des recherches menées (petits échantillons, un nombre restreint d’essais randomisés, diverses interventions, etc). Par conséquent, les bénéfices du yoga sont prometteurs mais avant de pouvoir conclure son efficacité à grande échelle, il faut plus d’études bien menées. Heureusement, les recherches à ce niveau se multiplient!

Alors, en attendant les résultats de ces recherches, que faire et quoi dire tant à ceux se méfiant du yoga que ceux ne jurant que par le yoga? Voici ce que je propose: Le yoga est l’une des interventions complémentaires et alternatives (ICA) les plus pratiquées et les plus sollicitées. Les ICA réfèrent à des interventions holistiques, axées sur les produits naturels, n’étant pas considérées comme des interventions standards et souvent nommées « orientales ». À ce jour, les études sur le yoga semblent démontrer des bienfaits importants pour favoriser le bien-être et la santé mentale, il s’agit d’une intervention sécuritaire pouvant être pratiquée par des individus en santé et diverses populations cliniques. Toutefois, il faut plus d’études avant de pouvoir généraliser les bénéfices du yoga. Plus important, le yoga est une stratégie et non pas LA stratégie. Cela signifie donc qu’il est possible d’utiliser cette intervention conjointement avec les interventions standards pour améliorer son bien-être (psychothérapie, traitements pharmacologiques, conditionnement physique, etc).

Pour conclure, je vous invite à visiter les sites de Passeport Santé et Mon Yoga Virtuel afin d’en apprendre davantage sur le yoga.

Bonne exploration!

Namasté


Annélie S. Anestin est une psychologue à la clinique Connecte Groupe de psychologie de Montréal. L’équipe de Connecte aime bien écrire sur les diverses façons d’améliorer notre santé mentale et inclure la psychologie dans notre vie quotidienne. Pour plus de conseils utiles, consultez les blogues de Connecte, les baladodiffusions, suivez-nous sur Instagram @connectepsychology ou aimez notre page sur Facebook.


Références

Bower, J.E., Woolery, A., Sternlieb, B. et Garet, D. (2005). Yoga for cancer patients and survivors. [Review]. Cancer Control: Journal of the Moffitt Cancer Center, 12(3), 165-171.

Buffart, L.M., van Uffelen, J.G., Riphagen, II, Brug, J., van Mechelen, W., Brown, W.J. et Chinapaw, M.J. (2012). Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials. [Meta-Analysis Research Support, Non-U.S. Gov't Review]. BioMed Central Cancer, 12, 559.

Chong, C.S., Tsunaka, M., Tsang, H.W., Chan, E.P., Cheung,W.M. (2011). Effects of Yoga on Stress Management in Healthy Adults: A Systematic Review J Altern Ther Health Med, 17(1), 32-8.

Jeter, P.E., Slutsky, J., Singh, N. et Khalsa, S.B. (2015). Yoga as a Therapeutic Intervention: A Bibliometric Analysis of Published Research Studies from 1967 to 2013. J Altern Complement Med, 21(10), 586-592.

Kirkwood,G., Rampes, H.,Tuffrey, V., Richardson, J., et Pilkington, K. (2005). Yoga for anxiety: a systematic review of the research evidence. Br J Sports Med, 39, 884–891.

Li, A.W. et Goldsmith, C-A.W. (2012). The effects of yoga on anxiety and stress. Altern Med Rev 17(1), 21-35.

Patel, N.K., Newstead, A.H. et Ferrer, R.L. (2012). The Effects of Yoga on Physical Functioning and Health Related Quality of Life in Older Adults: A Systematic Review and Meta-Analysis. J Altern Complement Med, 18(10), 902-917.

United Nations, International Yoga Day (2014)

What’s the big deal about gratitude?

What’s the big deal about gratitude?

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Gratitude refers to being grateful, thankful and appreciative. In the last few years, there has been more and more attention in the media about the benefits of gratitude. Recently, a couple of my clients wanted to know what all the hype surrounding gratitude was, so I thought I’d take the opportunity to share a little with you about the many benefits associated with gratitude and a bit about how to cultivate your own gratitude practice.

In the last ten years or so, there has been a fair amount of research on gratitude. Studies have clearly demonstrated that gratitude is beneficial on a number of levels and that it can have a positive impact on one’s quality of life. It has been proven to have a positive effect on general well-being and other aspects of mental health and, more recently, an attitude of gratitude has also been found to have a positive effect on physical health. Practicing gratitude is something we can all do; it is simple, doesn’t require any sort of equipment or involve any expense and one can incorporate an attitude of gratitude into their life in little time.  Great! What are we waiting for and how do we get started?

Let’s start by examining the benefits of developing an attitude of gratitude. How does gratitude really help? 

Physical benefits

Recent studies have demonstrated that individuals who are more grateful tend to be in better physical health. More specifically, those who are more grateful are less likely to experience pain, and they are more likely to take better care of their health by exercising regularly and scheduling regular medical check-ups (1, 2). It has also been suggested that a simple gratitude practice such as noting what they are grateful for before bed can help to improve duration and quality of sleep (3, 4) increase energy levels and reduce blood pressure.

Benefits on Mental Health

Gratitude has also been found to have a positive impact on our general well-being and mental health. Robert Emmons, PhD (recognized as the world’s leading scientific expert on gratitude and a psychology professor at the University of California) has done a lot of research in this area and his studies have confirmed that gratitude decreases depression (5) and increases overall happiness (6). Studies have also demonstrated that gratitude can help to improve self-esteem (7, 8) and promote resilience and reduce the chances of developing PSTD after experiencing trauma (9). 

How can we incorporate an attitude of gratitude into our lives?

There are many ways to cultivate an attitude of gratitude.  A popular strategy is to keep a gratitude journal and either start or finish the day by taking note of a few things that you feel grateful for. When people do this systematically, it creates a shift towards a greater awareness and appreciation of the positive things around them. There are also a number of popular gratitude apps such as Gratitude Diary App, Gratitude!, Attitude of gratitude, and Happify, which make keeping a gratitude journal easy and practical. A couple of months ago, my husband and I began using the “5 minute Journal” (10) which is a little more elaborate than a simple gratitude journal, but it includes a daily gratitude list as well as other daily entries that help create more awareness of positives in our lives (and we are both really enjoying using it!).

Other ways to express gratitude might be by sending a thank you note or an email to express thanks to someone who you haven’t had a chance to express thanks to, such as a crossing guard or a bus driver. Studies have shown that this sort of exercise will help increase levels of happiness in the person delivering the thanks and also increases happiness in the person receiving the thanks (11).

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Gratitude and children

For those of you with children, you will be interested to learn that there has been some research on gratitude and children. In fact, studies have found that children who are grateful tend to be happier and express greater life satisfaction (12). Gratitude has also been found to related to greater well-being and less negative affect in early adolescents(13). Among older youth (14-19 years) research has demonstrated that grateful teenagers report greater life satisfaction, are more engaged (both at school and in their extracurricular activities) and perform better at school. They also report less depression and are less materialistic (14).

As a parent of young children, I have found myself feeling frustrated at times thinking that they take things for granted or lack appreciation. I did some reading on fostering gratitude in children and began to try taking a few minutes at the end of the day to ask them what they are grateful for. I usually do this either at dinner as a family or at bedtime when tucking them into bed. I tend to opt for asking this at bedtime because I find that it’s a nice way to connect and share one-on-one with each of my little ones.  Doing this encourages us to pause and reflect on our days together and appreciate moments from our day. I’m often really touched by what they come up with, and this has become a precious part of my day, and often something I find myself adding to my own gratitude list. You can also try asking your child to draw something they are grateful for, or to make a gratefulness collage. These are nice options for ways to encourage your child to slow down and take the time to reflect on things they are thankful for. Such practices also offer the opportunity as a parent to model gratefulness by sharing with them what you are grateful for, and it can allow you to learn something from your child.

A nice book to share with young children to help introduce the idea of gratitude is How Full is Your Bucket (15).

I invite you to take a couple of minutes now to think about what you have to be grateful for in your life. I know for myself these days, it’s often something related to my family and friends or the weather that has helped the trees and flowers start to bloom. What are YOU grateful for today? Please share pictures of whatever you are feeling grateful for today on social media (Facebook and Instagram) and don’t forget to tag us at #connetepsychology. We will be grateful to you for sharing!


Andrea Martin is a clinical psychologist in Westmount, Montreal, Quebec, at Connecte Montreal Psychology Group. The team at Connecte loves writing about ways to boost our mental health and bring psychology into our everyday lives. For more helpful tips, check out Connecte’s blogspodcast, follow @connectepsychology on Instagram or @ConnecteMTL on Twitter, or like us on Facebook.


References 

1. Hill, P. L., Allemand, M., & Roberts, B. W. (2013). Examining the pathways between gratitude and self-rated physical health. Personality and Individual Differences, 54, 92-96.

2. Emmons, Robert A.; McCullough, Michael E. (2003).  Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology, 84(2): 377-389.

3. Digdon, N., Koble, A. (2011). Effects of Constructive Worry, Imagery Distraction, and Gratitude Interventions on Sleep Quality: A Pilot Trial. Applied Psychology: Health and Well-Being, 3(2): 193-206.

4. Wood, A.M., Jospeh, S., Lloyd, J., Atkins, S. (2009). Gratitude influences sleep through the mechanism of pre-sleep cognitions. Journal of Psychosomatic Research, 66(1): 43-48.

5. Wood, A. (2010). Gratitude and Well Being: A review and theoretical Integration. Clinical Psychology Review. Wood, A. M., et al., Gratitude and well-being: A review and theoretical integration, Clinical Psychology Review 30(7): 890-905.

6. Emmons,  Robert. A. (2007). Thanks!: How Practicing Gratitude Can Make You Happier.  New York: Houghton Mifflin Books.

7. Lin, C.C. (2015). The relationships among gratitude, self-esteem, depression, and suicidal ideation among undergraduate students. Scandinavian Journal of Psychology, 56(6): 700-707.

8. Chen, L.H., Wu, C-H. (2014). Gratitude Enhances Change in Athletes’ Self-Esteem: The Moderating Role of Trust in Coach. Journal of Applied Sports Psychology, (3): 349-362.

9. Fredrickson, B., Tugade, M.M., Waugh, C.E., Larkin, G.R. (2003). What Good Are Positive Emotions in Crises? A Prospective Study of Resilience and Emotions Following the Terrorist Attacks on the United States on September 11th, 2001. Journal of Personality and Social Psychology, 84(2): 365–376.

10. Ikkon, A., Ramdas, U.J. (2013).  The Five Minute Journal: A Happier You in 5 Minutes a Day.  Intelligent Change Inc.

11. Seligman ME1, Steen TA, Park N, Peterson C. (2005). Positive psychology progress: empirical validation of interventions. American Psychology, 60(5): 410-421.

12. Park. N., Peterson., C. (2006). Character Strengths and Happiness among Young Children: Content Analysis of Parental Descriptions. Journal of Happiness Studies, 7(3): 323-341.

13. Froh, J.J., Sefick, W.J., Emmons, J.A. (2008). Counting blessings in early adolescents: An experimental study of gratitude and subjective well-being. Journal of School Psychology, 46: 213–233.

14. Froh, J. J.,Fan, J., Emmons, R. A., Bono, G., Huebner, E. S., & Watkins, P. (2011). Measuring gratitude in youth: Assessing the psychometric properties of adult gratitude scales in children and adolescents. Psychological Assessment, 23(2): 311-324.

15. Rath, T., Reckmeyer, M. How full is your bucket? For Kids.  Gallup Press.

The Many Benefits of Being in Nature

The Many Benefits of Being in Nature

By: Dr. Lisa Linardatos, Clinical Psychologist
Photos: Sarah Glaser and Lisa Linardatos

I never really articulated my love of nature until relatively recently. I didn’t grow up participating in many organized outdoor activities, and I never considered myself a particularly “outdoorsy” person. I knew when I moved from my rural hometown to the city I missed being able to see the milky way on a summer night, but the diversity and excitement afforded by a big city mostly overshadowed that loss. As I get older though, I find myself more and more drawn to nature, and when I take the time to appreciate it, it feels like a gift. I delight in it.

Inevitably, as a psychologist, I became curious about how being in nature affects people. As a researcher, I did not want to talk about the benefits of nature to my clients unless I felt there was adequate data to support such claims. Sure enough, as I describe below, being in nature not only positively affects our physical and mental health, but the benefits likely reach beyond the individual and have broader environmental and societal implications. Moreover, therapy is unfortunately inaccessible to many given its cost and long waiting lists. I also find therapy somewhat limiting in its usual format of weekly, one-hour sessions, so I’m always on the look-out for how clients can change their everyday environments to improve their mental health, and being in nature is one way to do so. Being in nature is a relatively simple and accessible way to better our well-being and mental health, and in giving it a try we have little to lose.

How is being in nature helpful for us?

Physical Health

I think many of us intuitively know that being in nature is helpful, but what does the science say about how it helps us? In terms of physical health, studies have linked exposure to nature to decreased diseases and a longer life span. Researchers Jolanda Maas and colleagues did a study where they looked at the medical records of 345143 people living in the Netherlands, and found that people living within a one-kilometre radius of a green space were less likely to suffer from various diseases including cardiovascular disease, musculoskeletal disorders, respiratory disease, and neurological disease, as well as other health problems such as diabetes, migraines, asthma, and urinary tract infections (1). Also, at least one study has shown that living near green space is associated with living longer, even if people didn’t use the green space, and possibly has the most benefits for lower income individuals (2).

Mental Health and Cognitive Functioning

In addition to the slew of evidence linking exposure to nature and physical health, much research has found a link between nature and mental health. People living within a one-kilometre radius of green space experienced less anxiety and depression (1). Even just a short walk can affect our thoughts and feelings. For example, in a study done around Stanford, California, 60 participants were randomly assigned to a 50-minute walk either in a natural setting or an urban environment. Those who did the nature walk reported less anxiety, rumination, and negative mood and they were more likely to hang on to their positive mood (3). Similarly, a survey done on of over 10000 people in England has linked living in urban areas with more green space to greater life satisfaction (4).

"There are always flowers for those who want to see them."      
Henri Matisse

Our brains also seem to perform better when we’re exposed to nature. Our working memory is better, and we score higher on tasks that require concentration and “directed attention” (focussing on one specific thing while inhibiting distractions) (5).  Even children with ADHD concentrated better after a 20-minute walk in the park vs. a walk through the city centre or a walk through a neighbourhood (6).

Social and Environmental

There is an abundance of research showing that social support, social cohesion (i.e., shared norms and values and a sense of belonging and feeling accepted by one’s group), and a sense of community are beneficial for mental health (7). Common green spaces have been found to facilitate social contact, and could thereby increase a sense of community (8). That is, if you’re living in a neighbourhood where there’s a park, or an apartment building that has a shared garden or courtyard, you are more likely to have informal social contact with your neighbours. Some health professionals and local residents in London are capitalizing on the therapeutic benefits of gardening, and have created a network of food-growing gardens in various health care and hospital settings, where patients learn how to grow food that is then used to feed the hospital patients. As discussed in the article (check it out here), gardening can be used as way to reduce social isolation, not to mention depression, anxiety, stress, and disease, and may even increase the well-being of patients with dementia.

Being in nature might also make us nicer to others and nicer to the environment. In one study, people who watched a nature video were more cooperative and indicated a greater willingness to engage in environmentally sustainable behaviours compared to people who watched a video on architecture (9). And people who are exposed to nature vs. man-made environments reported valuing community and close relationships more and were more generous with their money (10). We also know that being nice to others increases our own positive emotions, such as happiness (11). I love these findings because it shows how far-reaching the benefits of nature can be. That is, exposure to nature seems to benefit us on a personal level, but also has environmental and societal benefits.

Spirituality and Connectedness

Many people also find that being in nature is a spiritual experience, and can facilitate the feeling of being connected to something greater, thereby decreasing feelings of loneliness. Feelings of awe, which is often elicited during exposure to nature (12), have been linked to an expanded perception of time and a greater wiliness to volunteer one’s time to help others (13). Awe-inspiring moments can also help us keep things in perspective, allowing us to feel like our problems are relatively small and fostering the belief that we can cope. For a dose of “awe”, check out the time lapse video below taken from one of Spain’s highest mountain.

"The clearest way into the Universe is through a forest wilderness."    
John Muir

Being in nature also provides a great opportunity to practice mindfulness, a particular state of present-moment, sensory awareness linked to lots of positive mental and physical health benefits. Check out my colleague Natsumi’s blog post for more on mindfulness: Mindfulness: An Introductory Guide. And here’s a summary of research on mindfulness.

Fun tip: To learn more about my natural surroundings and to facilitate mindful moments, I bought this fun and easy-to-use field guide, Small Adventures Journal. It makes you feel like a kid again!

Why is being in nature beneficial?

What is it about nature that is beneficial for our well-being and health? One theory is based on the idea that in urban settings, we have more social stress, and this frequent processing of social stress may put us at risk for mental health issues (14). For example, it’s probable that in an urban setting we more often experience what is referred to as social evaluative threat - feeling judged and negatively evaluated by others – than in a rural setting.

Attention Restoration Theory (ART), on the other hand, suggests that urban environments cause mental fatigue as we’re often having to control where we direct our attention and filter out irrelevant information (15, 16). According to ART, natural environments and nature scenes (think sunsets, butterflies, and streams) are not overly demanding and easily engage our attention, and promote a sense of “fascination” and “being away” (15), thereby allowing us to rest our attentional resources.

Another theory, the Stress Reduction Theory (SRT), suggests that being in a natural environment reduces stress by activating our parasympathetic nervous system, which is the system responsible for calming us down (17). In support of SRT, studies have shown that viewing photos and videos of nature scenes decrease stress as measured by various physiological indicators, such as heart rate (18), and walking in parks and forests has been shown to reduce cortisol levels (19).

Although more research needs to be done to clarify, for example, how much exposure to nature is needed to make a difference in one’s health, benefits from nature exposure have been found across different mediums (e.g., images, window views, urban parks, rural areas) (5), for a variety of durations of exposure (minutes to hours to days to years) (20) and for a variety of things - mental and physical health, attention, concentration, and working memory (21). One of my favourite articles summarizing some of these findings is from National Geographic: This is Your Brain on Nature (22).

"In every walk with nature one receives far more than he seeks."       
John Muir

Nature in and around Montreal

As many of us have busy schedules and some of us live in urban settings, it can be difficult to access nature. While writing this blog post, I thought it might be helpful to give readers some ideas of where to find nature in the Montreal area. So, I asked my Facebook friends for recommendations of nature spots in and around Montreal. Many graciously replied and below are their responses. I was delighted to read their responses and hear not just about great nature spots, but how nature fuels the imagination.

  • Parc nature de l'ile de la visitation

  • My daughter and I love Lachine rapids in Verdun. Lots of bird species, plants, trees, water stream changes a lot which is so exciting to watch for kids especially.

  • Parc des Rapides

  • Maybe a classic... But I always love a little excursion in Parc Mont Royal.

  • Morgan Arboretum is nice, and always love iles de boucherville and mont. st. hilaire.

  • Dawson college has an amazing peace garden. It's small but it completely lives up to its name! It is gorgeous! Parc lafontaine is nice and in the fall the botanical garden is magnificent (in a groomed kind of way). The absolute outdoor spot is mont saint-sauveur. I can get lost there for days (or I wish I could hehe)

  • Ps: the Dawson peace garden is a great green oasis in the middle of the concrete of the city.

  • Champ des possibles!

  • Canal walks daily keep me sane!

  • I love walks along the canal - and also love the sweet fairyland alleyways of NDG in the spring and summer.

  • Westmount park, Mont-Royal, Lachine canal, Nuns Island at the path along the water

  • Love this! #naturebath

  • The Stereo's back fire escape has one of the most breathtaking sunrises....

  • This may be a little gauche, but I love the cemeteries on the mountain...all of them. The back of the Mont-Royal cemetery (I think) has that new lookout which no one goes to and in the summer the smell of hot wildflowers is intoxicating. And all of the "secret" off-road trails on the mountain.

  • I love to get under the weeping willows at Parc Jarry. If there's people around, I use their trunks as "support for stretches"...but really I just want to pet them and be in contact with them! I will also give a love tap to massive old trees that are slowly uprooting the sidewalk in places. It's fun to just pause and look up up up from the bottom of the trunk and breathe it all in.

  • Oh! Actually, I think I also love the contrast here in Montreal. Like the tiny urban parks or even the cedar hedges in my backyard. Sometimes I feel like the proximity to streets/cars/city-ness makes me really appreciate the green even more. Like the front of our house is on a big-ish street, but when I get to the ruelle out back, I like to pretend that I've transitioned to our cottage.

  • Les îles de Boucherville are super pretty, the Botanical Gardens are lovely, Mont St Bruno parc for a child friendly hike, any of the state parks especially when the fall colours are here...

For more suggestions on how to get to know nature, check out these 10 tips from David Suzuki. You can also learn more about his 30 x 30 nature challenge (30 minutes a day in nature for 30 days) here. Montrealers also have the opening of this “secret garden” to look forward to.

Last but not least, for some added inspiration, check out this audio clip of birds singing recently recorded from a balcony in the heart of Montreal.


Lisa Linardatos is a clinical psychologist in Westmount, Montreal, Quebec, at Connecte Montreal Psychology Group. The team at Connecte loves writing about ways to boost our mental health and bring psychology into our everyday lives. For more helpful tips, check out Connecte’s blogspodcast, follow @connectepsychology on Instagram or @ConnecteMTL on Twitter, or like us on Facebook.


References

1. Maas, J., Verheij, R. A., de Vries, S., Spreeuwenberg, P., Schellevis, F. G., & Groenewegen, P. P. (2009). Morbidity is related to a green living environment. Journal of epidemiology and community health, 63(12), 967-973.

2. Mitchell, R., & Popham, F. (2008). Effect of exposure to natural environment on health inequalities: an observational population study. The Lancet, 372(9650), 1655-1660.

3. Bratman, G. N., Daily, G. C., Levy, B. J., & Gross, J. J. (2015). The benefits of nature experience: Improved affect and cognition. Landscape and Urban Planning, 138, 41-50.

4. White, M. P., Alcock, I., Wheeler, B. W., & Depledge, M. H. (2013). Would you be happier living in a greener urban area? A fixed-effects analysis of panel data. Psychological science.

5. Berman, M. G., Jonides, J., & Kaplan, S. (2008). The cognitive benefits of interacting with nature. Psychological Science, 19(12), 1207–1212. 

6. Taylor, A. F., & Kuo, F. E. (2009). Children with attention deficits concentrate better after walk in the park. Journal of attention disorders,12(5), 402-409.

7. Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: a meta-analytic review. PLoS Med, 7(7).

8. Kuo, F. E., Sullivan, W. C., Coley, R. L., & Brunson, L. (1998). Fertile ground for community: Inner-city neighborhood common spaces. American Journal of Community Psychology, 26(6), 823-851.

9. Zelenski, John M., Raelyne L. Dopko, and Colin A. Capaldi. Cooperation is in our nature: Nature exposure may promote cooperative and environmentally sustainable behavior. Journal of Environmental Psychology, 42 (2015): 24-31.

10. Weinstein, N., Przybylski, A. K., & Ryan, R. M. (2009). Can nature make us more caring? Effects of immersion in nature on intrinsic aspirations and generosity. Personality and Social Psychology Bulletin, 35(10), 1315-1329.

11. Nelson, S. K., Layous, K., Cole, S. W., & Lyubomirsky, S. (2016). Do Unto Others or Treat Yourself? The Effects of Prosocial and Self-Focused Behavior on Psychological Flourishing.

12. Shiota, M.N., Keltner, D., & Mossman, A. (2007). The nature of awe: Elicitors, appraisals, and effects on self-concept. Cognition and Emotion, 21, 944-963.

13. Rudd, M., Vohs, K. D., & Aaker, J. (2012). Awe expands people’s perception of time, alters decision making, and enhances well-being. Psychological science, 23(10), 1130-1136.

14. Lederbogen, F., Kirsch, P., Haddad, L., Streit, F., Tost, H., Schuch, P., ... & Meyer-Lindenberg, A. (2011). City living and urban upbringing affect neural social stress processing in humans. Nature, 474(7352), 498-501.

15. Kaplan, S. (1995). The restorative benefits of nature: Toward an integrative framework. Journal of Environmental Psychology, 15, 169-182.

16. Kaplan, R. & Kaplan, S. (1989). The experience of nature: A psychological perspective. New York: Cambridge.

17. Ulrich, R. S. (1981). Natural versus urban scenes some psychophysiological effects. Environment and behavior, 13(5), 523-556.

18. Gladwell, V. F., Brown, D. K., Barton, J. L., Tarvainen, M. P., Kuoppa, P., Pretty, J., et al. (2012). The effects of views of nature on autonomic control. European Journal ofApplied Physiology, 112(9), 3379–3386.

19. Tyrväinen, L., Ojala, A., Korpela, K., Lanki, T., Tsunetsugu, Y., & Kagawa, T. (2014). The influence of urban green environments on stress relief measures: A field experiment. Journal of Environmental Psychology, 38, 1–9.

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