Outdoor play and nature connectedness as potential correlates of internalized mental health symptoms among Canadian adolescents


Engagement with natural environments may provide adolescents with some protection against symptoms of poor mental health

This study explored how outdoor play and perceived importance of nature connectedness related to psychosomatic symptoms in Canadian adolescents. Psychosomatic symptoms are indicators of poor mental health. Earlier studies indicate that spending time outside can potentially reduce the risk of mental health in young people. Previous studies have also shown a positive link between connectedness with nature and mental health. This previous research, however, did not focus on adolescents. This research addresses this gap. Because just being outside doesn’t necessarily mean being connected to nature, this study explored both outdoor time and connectedness to nature in relation to psychosomatic symptoms in adolescents.

Data for this research was based on over 20,000 children (age 11-15) participating in the 2013/2014 Health Behaviour in School-aged Children (HBSC) study which involved students from 377 schools in Canada. An outdoor play measure asked students to report how much time they usually spend playing outdoors outside school hours during the week and on weekends. For nature connectedness, students were asked to respond to two questions: (1) “How important is it for you to feel connected to nature?” and (2) “How important is it for you to care for the natural environment?” Their response options ranged from 1 (“not at all important”) to 5 (“very important”). For psychosomatic symptoms, students were asked to indicate how often they experienced the following symptoms in the past six months: feeling low or depressed, irritability or bad temper, feeling nervous, difficulties in getting to sleep, headache, stomach ache, backache, and feeling dizzy.

Students reported playing outdoors outside of school hours for an average of 15 hours per week. Almost 9% (8.9) reported no time playing outdoors. Boys reported more outdoor time than girls. Almost 60% (59.2) of the participating students considered connection to nature “important,” with slight differences noted between boys and girls (57.2% for boys; 61.0% for girls). Approximately 28% of the students reported high levels of psychosomatic symptoms. These symptoms were found to be associated with various personal and environmental factors: perceived family wealth, ethnicity, urban-rural status, school climate, neighborhood social capital, family support, family communication, and friend support. Data analysis showed that outdoor time and connections to nature related to psychosomatic health. Engagement in outdoor play (even 30 minutes per week) was associated with decreased psychological symptoms of girls. Appreciating the importance of feeling connections with nature was associated with decreased psychosomatic symptoms in both boys and girls.

These findings suggest that engagement with natural environments may provide some protection for adolescents against symptoms of poor mental health. This research also highlights the importance of considering gender differences when developing public mental health initiatives related to outdoor environments.


Piccininni, C., Michaelson, V., Janssen, I., Pickett, W., (2018). Outdoor play and nature connectedness as potential correlates of internalized mental health symptoms among Canadian adolescents. Preventive Medicine, 112, 168-175.



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