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Background: Rates of psychological distress are rising, pressure on mental health services is increasing and currently there is a section of the population who experience psychological distress but are not accessing traditional mental health services. It has been proposed that nature-based interventions can play a role in mental health care. Aims: This thesis firstly aimed to conduct a systematic review to identify, and review randomised controlled trials that measured the effect of a virtual nature intervention on attention and distress. The second part of the thesis consisted of an empirical study that investigated the association between watching a virtual nature video and changes in positive and negative affect, anxiety, and mindfulness in older adults. The study aimed to see if this association could be further enhanced with mindfulness instruction. A correlational relationship between improvements in positive and negative affect, anxiety and nature connectedness aimed to be investigated, as was state mindfulness as a potential mediator in the relationship between contact with virtual nature and improvements in affect and anxiety. METHOD: The systematic review searched four databases using relevant key words for research papers and judged these against inclusion and exclusion criteria. The quality of the final papers was assessed. A three-arm randomised empirical study was conducted recruiting older adults from the general population. Results: The systematic review revealed twenty papers relevant to the research question. A narrative synthesis found evidence for associations between virtual nature contact and improvements in attention and psychological distress. The evidence for attention appeared to be stronger for certain measures. The quality of papers was good however limited by unclear reporting. Findings from the empirical study found support for an association between negative affect and watching a nature video, with no association with any other variables. Mindfulness instruction did not enhance any changes, neither was nature connectedness correlated with benefits. No mediation analysis was conducted as the data did not meet the assumptions of a mediation. Conclusions: The systematic review suggests that virtual nature is associated with improvements in psychological distress and attention in the general population. When it comes to attention this association seems to vary depending on the measurement used. This association of improvements in psychological distress was not replicated in the empirical project which used an older adult sample. Previous established associations seen in the general population using real nature did not extend to this older adult population and virtual nature, suggesting that virtual nature may not hold the same benefits as real nature.

Literature review: Doctoral and Doctor of Philosophy (PhD) students experience various challenges. This literature review explored stressors and coping in doctoral students. Four databases were searched, nine papers met the inclusion criteria and were included in the review. The review included qualitative studies and thematic synthesis was conducted to analyse findings. Four themes were identified under stressors: 1) Social disconnect 2) Institutional support and Academic Factors, 3) Individual factors and View of Self, and 4) Challenges and Uncertainty. Themes identified under coping included: 1) Seeking and feeling supported, 2) University resources, 3) Personal strategies, 4) Organisational factors. Findings suggest the importance of social support for doctoral/PhD students and opportunities for this whilst studying, as well as support in developing organisational and practical skills. Empirical study: This study aimed to explore the wellbeing, symptoms of depression, anxiety and stress including COVID-related stress in a sample of postgraduate students (n=290), to explore possible relationships of these variables with demographic factors and assess any differences in scores between home-based and international students, and between those who had and had not accessed services. A cross-sectional survey was used. Home students scored significantly higher stress and covid-related stress levels than international students with small effect sizes, so may not be of great clinical relevance. Those who reported accessing services scored significantly higher in depression, anxiety and stress scores and lower wellbeing when compared to those who reported they did not access services ,with medium to large effect sizes. Older age and being a Master's student were associated with higher wellbeing, lower stress and COVID-19 related stress. Conclusions should be interpreted cautiously due to limitations. Clinical implications include the possible need for support for both home and international students. Further research is required on understanding reasons for not accessing support.