Examining the role of nature-based activities in the lives of military veterans with post-traumatic stress disorder

Nature-based activities have been shown in previous research to be beneficial to veterans with post-traumatic stress disorder (PTSD) through attendance at group nature-based interventions. Benefits have included improved PTSD symptoms, improved self-esteem and increased social connections. Interventions are diverse in duration, activities and organisation, and more research is needed to understand the mechanisms that lead to benefits. Additionally, little is known about how veterans with PTSD use nature-based activities in their daily lives, outside of organised interventions. Theoretically, attention restoration theory (ART) provides the most prominent theory of how nature is restorative to mental health, suggesting that being around nature improves fatigued attention, which improves wellbeing. Using mixed methods, four research studies investigated how nature-based activities help veterans with PTSD, the role that organised interventions play, and evidence of restoration as proposed by ART. The first study was a mixed method case series design that showed psychosocial improvements mainly occurred in the latter part of a 7-night fishing intervention for a group of eight veterans with PTSD, and showed mixed results in terms of social and attentional benefits. The second, qualitative study showed veterans with PTSD used nature-based activities to counteract their PTSD, allowing them to gain control through the environment and strength through accessing their military identities. This was further evidenced through an online survey in Chapter 4 that showed veterans found nature-based activities more helpful than non-veterans in their recovery from mental health issues, and in helping to manage symptoms of current mental health problems. Finally, a correlational study in Chapter 5 showed veterans were faster at a cognitive task when they had done more recent nature-based activities, but non-veterans were not. Overall, this thesis enhances understanding of how veterans with PTSD benefit from nature and suggests veterans may have a different relationship with nature than non-veterans.