The Effects of Coloring on Anxiety, Mood, and Perseverance

The impact of arts on prescription on individual health and wellbeing: a systematic review with meta-analysis

Introduction

The evidence-base for the impact of participating in the arts for different aspects of health and wellbeing is growing. Arts on Prescription has gained increasing recognition as a method for fostering connections among individuals and communities, however, to date no systematic review of the impact on individual health and wellbeing has been conducted. This review aims to provide an understanding of individual health and wellbeing outcomes from participation in Arts on Prescription programmes.

Methods

Major electronic databases were systematically searched, including Cochrane Library; Web of Science; ProQuest; CINAHL; Arts & Humanities; Ebsocohost; Pubmed; PsycINFO. Other databases were also used: Google Scholar and websites of specific organizations, e.g., NHS Evidence, Kings Fund, Health foundation, Nuffield Trust and NESTA and University of Florida Arts-in Medicine Repository. The review used PRISMA reporting structures. Critical Appraisal Skills Programme (CASP) templates were used for qualitative and quantitative studies, and the Mixed Methods Appraisal Tool (MMAT) for studies with a mixed methods protocol to assess quality and risk of bias. A narrative review of the qualitative data was conducted. For quantitative outcomes, a meta-analysis for studies that met inclusion criteria was conducted, and a narrative review made of secondary and heterogeneous outcomes and approaches.

Results

7,805 records were identified but only 25 records were included as studies with a focus on the impact on individual health and wellbeing. Studies were conducted in Australia, Denmark, Sweden, United Kingdom, and the United States. Programmes were held in community settings, arts venues, GP surgeries, primary healthcare settings, and one school. Most interventions varied from 8 to 10 weeks and included a wide range of different arts activities. Qualitative themes included social benefits, psychological benefits and progression opportunities. The meta-analysis showed a statistically significant improvement in wellbeing, and the narrative review identified promising outcomes that require further evidential support (e.g., reductions in anxiety and depression).

Discussion

Arts on Prescription programmes are an appropriate intervention for improving psychosocial wellbeing, providing both social and psychological benefits as well as progression opportunities. We discuss the various qualitative and quantitative outcomes, along with potential 'active ingredients' and barriers to participation (physical, psychological and social).

Systematic review registration

PROSPERO, identifier CRD42023408974, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023408974.

The effects of online art therapy on ego functions, emotion regulation, and interpersonal relationship styles in neurotic personality organization

Art therapy, as an effective therapeutic intervention, is used to improve positive self-image and self-awareness, promote insight, and enhance therapeutic communication. This study aimed to evaluate the efficacy of art psychotherapy on ego functions, emotion regulation, and interpersonal relationship styles of individuals with neurotic personality organization. Using a quasi-experimental pretest-posttest design, 60 participants were assigned to intervention and control groups, each further divided into three subgroups (n = 10 per subgroup). The intervention group engaged in online art therapy sessions twice weekly over nine weeks, while the control group received no intervention. Data analysis involved descriptive statistics, paired samples t-tests, and independent t-tests. There was a significant decrease in the intervention group's judgmental subdimensions of the Ego Function Assessment Scale. A significant decrease was found in the intervention group in "awareness" (p < 0.01), "clarity" (p < 0.05), and "impulse" (p < 0.001) subdimensions and total scores of the Difficulties in Emotion Regulation Scale. There was no statistical difference between the intervention and control groups' mean pretests and posttests and comparing those groups with each other concerning IRSQ scores. The online group art therapy led to successful improvements in participants' ego functions and emotion regulations.

The effect of mandala coloring on pregnancy-related anxiety

PURPOSE

In the literature, the efficacy of mandala coloring on pregnancy-related anxiety has been investigated, and no study has been found on its effect on anxiety. This randomized controlled trial was designed to assess the efficacy of mandala coloring application on pregnancy-related anxiety.

METHODS

The study included 77 primiparous pregnant women: 39 in the control group and 38 in the experimental group, and was carried out in an education-research hospital's obstetric clinic. Data for the study were gathered using Information Form, the Pregnancy-related Anxiety Scale, and the State Anxiety Inventory. While the experimental group did mandala coloring during a month twice in a week, and the control group was not do anything. The "Pregnancy-related Anxiety Scale" and "The State Anxiety Inventor" were used to assess anxiety in all groups before and after application. In the statistical analysis of the data, the SPSS 23.0 package program was used. In all tests, p < 0.005 was considered statistically significant.

RESULTS

Immediately post-intervention, the women in the experimental group had a significantly higher reduce pregnancy-related anxiety (p < 0.05). Especially in the mandala group within according to control group were found to have significantly reduced anxiety the application (PrAS-1 82,50 ± 2,47 vs. 84,41 ± 4,12; PrAS-2 77,92 ± 2,16 vs. 83,89 ± 3,80; PrAS-3 72,05 ± 3,97 vs. 84,10 ± 4,35; PrAS-Total 77,49 ± 5,21 vs. 84,13 ± 4,07; STAI-1 52,39 ± 2,50 vs. 51,17 ± 1,16; STAI-2 49,73 ± 0,75 vs. 49,05 ± 1,27; STAI-3 48,84 ± 3,17 vs. 49,02 ± 1,22; STAI-Total 50,32 ± 2,8 vs. 49,75 ± 1,58).

CONCLUSIONS

Mandala coloring is effective in reducing pregnancy-related anxiety.

CLINICAL TRIAL NUMBER

(NCT05534867).

Don't disturb my circles: The effect of fine arts training on visuospatial ability in students

Origami, drawing and colouring are artistic activities that can be beneficial for cognitive abilities or emotional well-being. However, there is a lack of studies that would investigate and compare these activities and their effects within the spatial abilities' domain. The aim of this study was to investigate if and how participating in three artistic activities-colouring, drawing or origami-can enhance spatial abilities. A total of 73 young adults participated in one of the three activities organized as a 7-session training, distributed every third day. Measures of spatial abilities (Spatial Reconstruction Task [SRT]), Mental Rotation Task [MRT]), Santa Barbara Solids Task [SBST]), and Corsi Block Tapping Task [Corsi]) were administered before (pretest) and after (posttest) the training, as well as at the 6-month follow-up). The Intrinsic Motivation Inventory (IMI) was administered at the posttest. The results showed no significant interaction between the training group and the measurement time point for the spatial ability tasks. Nevertheless, effect sizes at posttest favor origami and drawing in enhancing more complex spatial abilities (MRT for origami and drawing; SBST for origami; Corsi for drawing), and colouring in strengthening spatial perception (SRT). Some effects have remained for a longer period of time. Origami led to a greater pressure and tension, and colouring to higher interest and enjoyment. These results suggest that artistic activities can potentially contribute to the strengthening of spatial abilities, but it is advised to presented them in a way that reduces frustration and increase participant's enjoyment.

Why Being 'Stressed' Is 'Desserts' in Reverse-The Effect of Acute Psychosocial Stress on Food Pleasure and Food Choice

The link between acute stress, food pleasure and eating behavior in humans by employing measures of individual reward mechanisms has not been investigated as of yet. Having these insights is key to understanding why many people experience a change in eating behavior when experiencing stress. Thirty-five Danes (mean age 21.71 years) underwent a stress-inducing and relaxation-inducing task based on a randomized cross-over study design. Both tasks were combined with the Leeds Food Preference Questionnaire, to investigate the effect of stress on specific measures of food reward. Furthermore, participants chose a snack, as a covert measure of actual food choice. The study found no effect on explicit liking, explicit wanting or relative preference. For implicit wanting, an effect was detected on high-fat sweet foods, with increasing scores for the stress-induced condition. Moreover, 54% chose a different snack following the stress-inducing condition. Interestingly, 14% chose to change their snack choice to no snack at all. Results suggest acute psychosocial stress can increase cravings for highly palatable foods for some, while for others an experience of loss of appetite prevails. Overall, this study points to a further understanding of why consumers have issues with making healthy food choices, ultimately affecting public health too.

Does an acute bout of moderate exercise reduce alcohol craving in university students?

Craving is considered to be a vital contributor to the onset and maintenance of alcohol misuse. However, there is little known about its potential moderators and there are few interventions that specifically target these cravings. Exercise generates multiple psychological and physiological effects that in theory may reduce craving, and therefore we hypothesised that a short exercise circuit may potentially alter reward circuits. Recent research centred around neuroimaging studies suggests that similar reward circuits in the brain stimulated through exercise are also found to be activated by commonly misused substances such as alcohol. Peripheral levels of dopamine, norepinephrine, and serotonin, as well as the release of endorphins that would otherwise be artificially stimulated using alcohol are hypothesised to increase via alternate substitution induced by exercise. Exercise would thus replace effects of alcohol use to a substantial extent, and therefore was theorised to decrease craving and subsequently reduce hazardous alcohol use. A university student sample who reported hazardous drinking levels participated in either an exercise, colouring (as an active control) or a passive control intervention, and self-reported alcohol craving, mood, anxiety, and positive and negative affect scores were assessed. The present study found that a short exercise circuit significantly reduced alcohol craving, whilst also eliciting beneficial effects on mood and anxiety. This knowledge will help aid the utilisation of exercise as a potential therapeutic tool to reduce alcohol craving, prevent hazardous alcohol use and develop a greater understanding of the mechanisms that underlie addictive behaviour.

Impact of COVID-19 containment zone built-environments on students' mental health and their coping mechanisms

The 2nd wave of COVID-19 in 2021 had put several higher educational institutions in India into complete lockdowns and some were converted into containment zones to prevent the further spread of infection. A study was conducted on a student population (N = 432) in one such institute campus across three different hostel complexes to understand the role of containment zone Built Environments in the prevalence of Anxiety and Depression. The results from the analysis revealed that students living in rooms which have access to qualitative Built Environment aspects such as quality window views overlooking greenery and sky in addition to presence of indoor plants and portrait/artworks, are at lower risk of depression and severity of anxiety. The linear regression results of Built Environment Variable (BEV) Score with CES-D and GAD-7 advocated for an inverted relationship. The multinomial logistic regression revealed that with each 1-unit increase in BEV Score there is a significant decrease of 1.3-unit of likelihood of Depression, 0.779, 0.712 and 0.614-unit decrease in the likelihood of mild, moderate and severe levels of anxiety respectively. For Adverse Effect on Productivity, a 1-unit increase in BEV Score increases the likelihood of No-effect on productivity by 1.277 units. In order to precisely predict the effect of individual aspects of University Campus Built environments on the mental health of students during such containment and quarantine situations, further multidisciplinary investigation is required on the spheres of Built Environment, Psychology, and Epidemiology.

Pilot Study of Videos to Deliver Mindfulness-Based Art Therapy for Adults With Multiple Sclerosis

BACKGROUND

Mindfulness-based art therapy (MBAT) has been shown to provide a strategy for adults with multiple sclerosis (MS) to self-manage their symptoms. There is a need for the use of an MBAT intervention that can be delivered in any setting for adults with MS. The purpose of this pilot feasibility study was to test the feasibility and acceptability of an MBAT intervention delivered via videoconference.

METHODS

We developed an MBAT intervention to be delivered by videoconference to adults with MS recruited from an academic center registry. We also conducted phone interviews to collect acceptability data.

RESULTS

Most of the participants (n = 5) were very positive about the MBAT video sessions and stated content as clear and easy to follow and understand. The time and delivering method were acceptable.

CONCLUSION

Mindfulness-based art therapy sessions delivered through videoconference are acceptable and feasible for adults with MS.

Therapeutic psychological and biological responses to mindfulness-based art therapy

Stress and anxiety pose a threat to college students' academic performance as well as their long-term mental and physical health, but the time constraints of a rigorous academic schedule make it difficult to offer even brief mental health interventions. A convenience sample of full-time students at a public university was recruited for a 5-week study conducted mostly using an online platform. Participants were randomly assigned to a Mindfulness-Based Art Therapy (MBAT) intervention or a Neutral Clay Task (NCT). Anxiety, perceived stress, and salivary cortisol outcomes were measured. A total of n = 77 participants completed the study. The MBAT group experienced significant reductions in anxiety and perceived stress compared to the NCT group. Significant reductions in salivary cortisol were observed, but only time could be identified as a confounding variable. Art making alone is not enough to induce significant positive responses, but this study suggests MBAT can, and that an online intervention could offer feasible and accessible mental health services on college campuses. Further refinement of biological data collection and analysis is needed to determine what the mediating effects MBAT could have, if any, at the molecular level.

The effectiveness of art therapy for anxiety in adults: A systematic review of randomised and non-randomised controlled trials

Background

Anxiety disorders are one of the most diagnosed mental health disorders. Common treatment consists of cognitive behavioral therapy and pharmacotherapy. In clinical practice, also art therapy is additionally provided to patients with anxiety (disorders), among others because treatment as usual is not sufficiently effective for a large group of patients. There is no clarity on the effectiveness of art therapy (AT) on the reduction of anxiety symptoms in adults and there is no overview of the intervention characteristics and working mechanisms.

Methods

A systematic review of (non-)randomised controlled trials on AT for anxiety in adults to evaluate the effects on anxiety symptom severity and to explore intervention characteristics, benefitting populations and working mechanisms. Thirteen databases and two journals were searched for the period 1997 –October 2017. The study was registered at PROSPERO (CRD42017080733) and performed according to the Cochrane recommendations. PRISMA Guidelines were used for reporting.

Results

Only three publications out of 776 hits from the search fulfilled the inclusion criteria: three RCTs with 162 patients in total. All studies have a high risk of bias. Study populations were: students with PTSD symptoms, students with exam anxiety and prisoners with prelease anxiety. Visual art techniques varied: trauma-related mandala design, collage making, free painting, clay work, still life drawing and house-tree-person drawing. There is some evidence of effectiveness of AT for pre-exam anxiety in undergraduate students. AT is possibly effective in reducing pre-release anxiety in prisoners. The AT characteristics varied and narrative synthesis led to hypothesized working mechanisms of AT: induce relaxation; gain access to unconscious traumatic memories, thereby creating possibilities to investigate cognitions; and improve emotion regulation.

Conclusions

Effectiveness of AT on anxiety has hardly been studied, so no strong conclusions can be drawn. This emphasizes the need for high quality trials studying the effectiveness of AT on anxiety.