The effect of adult coloring (mandala pattern) on pain and anxiety associated with dressing changes in burn patients: A randomized controlled trial.

Introduction: The study investigated the effect of mandala coloring on pain and anxiety associated with dressing changes in burn patients. Method: This clinical trial was conducted on 60 patients in two groups. At the beginning of the study [baseline (T1)], anxiety and pain were assessed using the BSPAS and VAS. A mandala pattern with colored pencils was provided to the patients in the intervention group. Each patient was given 30 min to color. Anxiety was measured at the 35th minute (T2). A dressing change was performed and 15 min later, the variables were measured again (T3). The control group received no intervention. Results: The mean anxiety at the baseline (T1), 35th minute (T2), and 15 min after dressing changes (T3) in the intervention and control groups were 38.73 ± 5.55, 26.20 ± 6.08 and 28 ± 8.53, and 39.17 ± 4.17, 41.27 ± 3.68 and 41.63 ± 2.97, respectively. Anxiety at T1 was at the same for both groups. The anxiety in the intervention group decreased (P < 0.001) at T2 and T3 and increased in the control group. The mean pain intensity at the baseline (T1) and 15 min after dressing changes (T2) in the intervention group was 8.47 ± 1.432 and 5.9 ± 1.9, respectively, and in the control group was 8.33 ± 0.802 and 8.77 ± 0.626. Pain intensity at T1 was at the same level for both groups. The pain in the intervention group decreased at T2 (P < 0.001), whilst it increased in the control group. Conclusion: Mandala coloring can reduce pain and anxiety during dressing changes in burn patients. It can be used as adjuvant treatment. Lay Summary: Wound dressing in burn patients is accompanied by pain. This painful experience can lead to wound dressing anxiety in these patients. For this purpose, a study was conducted to check whether coloring before wound dressing can reduce the pain and anxiety of dressing in adults. Two groups of patients were included in the study; before the dressing, one group received a pre-prepared image of mandela designs along with colored pencils and colored the design to their taste. The other group did not receive any intervention. The intensity of pain and the level of anxiety of the two groups were measured before and after the dressing. The results showed that the coloring of the mandela design before dressing reduced the pain and anxiety related to the proceedure.

International Chinese students' experiences of participating in mandala-based art therapy in Korea: a phenomenological study.

Background: Although China and South Korea share a similar East Asian culture, owing to major social and cultural differences, international students encounter several difficulties, which can lead to various psychological problems. Objective: To explore the experiences of eight Chinese doctoral students in South Korea participating in mandala-based art therapy. Method: Data for this phenomenological study were gathered through individual interviews and visual art from April 5 to 20, 2022. The MAXQDA software program was used for data analysis. Results: The data analysis results yielded 355 codes, 53 subcategories, and 17 categories. Five final themes emerged: (a) sealed lips by others' eyes, (b) inner exploration and outward expression, (c) healing power of the mandala, (d) filling the inner space together, and (e) opportunities to understand art therapy. Conclusion: The researchers hope that completing this intervention will enable participants to complete their studies more effectively and achieve their ideals as well as future career goals, helping them ultimately return home safely with both personal and academic growth.

A practical development protocol for evidence-based digital integrative arts therapy content in public mental health services: digital transformation of mandala art therapy.

Introduction: The fundamentals of digital transformation include the conversion of the traditional method into a digital format to develop a standardized system that collects, analyzes, and processes quantitative data. This study aims to provide a comprehensive understanding of the development process and key elements of evidence-based digital integrative arts therapy. Methods: The "Digital Mandala" service in the "Mental Health App" produced as part of a national public mental health project for personalized depression management is adopted to explain how to convert the existing mandala art therapy into digital format. A living lab approach has been applied, which can be used to address the nation's mental health challenges by promoting collaboration, innovation, and evidence-based solutions. Results: Evidence-based digital content requires evidence that covers the structural process, the effects of existing methods, and the components and meanings of each detailed scene. In this section, we provide five stages of the development process, including preliminary research, design, development, commercialization, and advancement. Consequently, clinical elements, integrative arts therapy features, and data factors are defined as the key principles of evidence-based digital integrative arts therapy. Discussion: Based on the data factors found in this study, it will be possible to create an evaluation dataset of digital integrative arts therapy content for managing depression. Additionally, the large-scale public data can be analyzed through artificial intelligence technology, which is expected to be used as a basis for deriving significant results in a new form, going further than the existing evaluation method. This research is significant because it establishes the foundation for digital transformation in the field of art therapy for public mental health services and investigates its potential.

The Effect of the Meditation Based Mandala Programme on Distress, Anxiety and Depression in the Caregivers of Cancer Patients in Palliative Care Unit.

Mental health problems were found to be more common than physical health problems in cancer caregivers in palliative care units. This is a quasi-experimental study planned to determine the effect of the meditation based mandala programme on distress, anxiety and depression in caregivers of cancer patients in a palliative care unit. Planned as a single-group pre-test/post-test design, with a total of 11 caregivers. Data were collected with the Caregiver Diagnosis Form, Distress Thermometer, Beck Depression Inventory, and Beck Anxiety Inventory. Caregivers participated in the Meditation Based Mandala Programme once a week, which lasted 2 hours for 5 weeks. The distress, depression and anxiety levels of the patients were measured before the programme started and at the end of the programme. Meditation based mandala programme is effective in reducing the distress, depression and anxiety levels of caregivers of cancer patients in the palliative care unit.

The effect of mandala art therapy on the comfort and resilience levels of mothers who have children with special needs: A randomized controlled study.

BACKGROUND: The study was conducted in order to determine the effect of mandala therapy applied to mothers who have children with special needs on the mothers' comfort and resilience levels. METHODS: The study was conducted as a randomized controlled study at a special education school in Turkey. The study sample consisted of 51 mothers (24 mothers in the experimental group and 27 mothers in the control group) who had children with special needs. A 16-h mandala therapy was applied to the mothers in the experimental group. Identifying Information Form, General Comfort Questionnaire and Adult Resilience Scale were used as data collection tools. RESULTS: According to the regression analysis performed in order to explain the difference between the first and third measurements of General Comfort Questionnaire, mandala art therapy was found to be effective, and the model established was determined to be statistically significant. It was also determined that the change that occurred between the third and first measurements performed in order to identify the change in the general comfort levels of the individuals was higher in the experimental group in comparison to the control group (P < 0.05). It was seen that the mothers' mean scores obtained from the Adult Resilience Scale total scale and its subscales significantly increased in the second and third measurements (P < 0.05) but that the increase in the mean scores of the control group was not significant (P > 0.05). CONCLUSIONS: Mandala Art Therapy is a method that improves the comfort levels and resilience of mothers who have children with special needs. It might be beneficial for mothers to perform these applications at special education schools in collaboration with nurses.

How flow and mindfulness interact with each other in mindfulness-based augmented reality mandala coloring activities.

Introduction: This study explores the effects of different types of augmented reality (AR) mandala coloring activities on mindfulness and flow in college students. Methods: A total of 76 college students participated in the study and were divided into two groups based on their drawing skills: the high-skilled group (n = 38) and the low-skilled group (n = 38). With the help of AR technology, two groups of subjects carried out three mandala coloring experiments with structured mandala, free mandala and cooperative mandala in order. The measurement evaluation in the experimental program included a pre-test before all the experiments (Time 0) and each post-test after three mandala coloring activities (Time 1, Time 2 and Time 3). The balance dimensions of flow and challenge skills of the two groups were measured. Results: ANOVA results showed that a single 30-min short-term datura coloring activity did not significantly improve mindfulness (f = 2.339, p = 0.074, η2 = 0.031), but did significantly improve flow (f = 11.918, p = < 0.001, η2 = 0.139). Linear regression results found positive correlations between mindfulness and certain dimensions of flow (e.g., focus on a task, unambiguous feedback, sense of control, challenge -- skill balance, and automatic experience). Mindfulness was also found to be negatively correlated with the loss of the self-conscious component of flow. We also found that the free mandala was quite challenging for subjects in the low-skill group, while the teamwork in the cooperative mandala helped them overcome difficulties and cope with challenges. Discussion: Flow can be quickly and effectively improved through short AR mandala coloring exercises. The contribution of this study is to provide inspiration and reference for further exploring how AR mandola coloring can improve subjects' mental state and promote the perfection and development of positive psychological mechanism.

The research focus and development trend of art therapy in Chinese education since the 21st century.

Since the 21st century, art therapy has made great progress and development in China's education. To find out the relationship between art therapy and special children, hundreds of related literatures were analyzed using co-word analysis software, which shows that art therapy is increasingly important in special children and their education. Expressive art therapy has a good development prospect in college students' mental health education and group counseling. The connotation of group painting therapy is constantly enriched. The theme research of mandala painting therapy is closely related, and painting art therapy focuses on the psychological counseling research of different groups, but the two are still in the marginal position in the whole research, and have not been paid attention to. Therefore, in the future research, firstly, we should continue to strengthen the research of art therapy and expressive art therapy in special education and individual mental health education; second, further broaden the depth and breadth of group painting therapy; third, strengthen the study of mandala painting therapy and painting art therapy.

The Effects of Mindfulness-Based Mandala Coloring, Made in Nature, on Chronic Widespread Musculoskeletal Pain: Randomized Trial.

This study aimed to investigate the effects of mindfulness-based mandala coloring made within nature on individuals with chronic widespread musculoskeletal pain (CWP). Thirty-six participants were randomly allocated. In the experimental group, identical interventions and procedures were administered for each experiment. The control group members were untreated and remained in an urban environment. Overall, the experiment showed significant improvements in tender points (f = 8.791, p = 0.006), total stress level (f = 14.570, p = 0.001), depressive symptoms (f = 15.205, p = 0.001), anger symptoms (f = 7.263, p = 0.011) and salivary cortisol (f = 10.619, p = 0.003) in the experimental group. The results reflect that MBMC within nature is effective in reducing pain, psychological stress responses, and cortisol levels in individuals with CWP. The positive results could be a product of the experimental design rather than the treatment itself. A rigorous experimental design provides better understanding of MBMC within nature.

Effects of art-based mandala intervention on distress and anxiety in cancer patients.

OBJECTIVE: This study was planned to determine the effect of art-based mandala intervention on the distress and anxiety experienced by cancer patients. METHODS: This semi-experimental study with a single group pretest-posttest design was performed with 12 breast cancer survival patients. The data were collected through "Patient Diagnostic Form", "Distress Thermometer", "Trait Anxiety Inventory". Patients participated in the "Art-Based Mandala Intervention" for eight weeks, one day a week, 2 h each. The distress and anxiety levels of the patients were measured before starting the program and at the end of the program. RESULTS: Cancer patients experienced moderate level of anxiety (50.66 ± 6.91) and clinically significant distress (4.08 ± 2.74). Anxiety scores of cancer patients decreased significantly after the program compared to before the program (p < 0.05). The distress scores of cancer patients increased after the program compared to before the program (p > 0.05). CONCLUSION: After the art-based mandala intervention program, anxiety scores of breast cancer survival patients decreased, and distress scores increased.

A Mindfulness-Based Brain-Computer Interface to Augment Mandala Coloring for Depression: Protocol for a Single-Case Experimental Design.

BACKGROUND: The regular practice of mindfulness has been shown to provide benefits for mental well-being and prevent depression relapse. Technology-mediated interventions can facilitate the uptake and sustained practice of mindfulness, yet the evaluation of interactive systems, such as brain-computer interfaces, has been little explored. OBJECTIVE: The objective of this paper is to present an interactive mindfulness-based technology to improve mental well-being in people who have experienced depression. The system, Anima, is a brain-computer interface that augments mandala coloring by providing a generative color palette based on the unfolding mindfulness states during the practice. In addition, this paper outlines a multiple-baseline, single-case experimental design methodology to evaluate training effectiveness. METHODS: Adult participants who have experienced depression in the past, have finished treatment within the last year, and can provide informed consent will be able to be recruited. The Anima system, consisting of 2 tablets and a nonintrusive mental activity headband, will be delivered to participants to use during the study. Measures include state and trait mindfulness, depression symptoms, mental well-being, and user experience, and these measures will be taken throughout the baseline, intervention, and monitoring phases. The data collection will take place in the form of a questionnaire before and after each mandala-coloring session and a semistructured interview every 2 weeks. Trial results will be analyzed using structured visual analysis, supplemented with statistical analysis appropriate to single-case methodology. RESULTS: Study results will offer new insights into the deployment and evaluation of novel interactive brain-computer interfaces for mindfulness training in the context of mental health. Moreover, findings will validate the effectiveness of this training protocol to improve the mental well-being of people who have had depression. Participants will be recruited locally through the National Health Service. CONCLUSIONS: Evidence will assist in the design and evaluation of brain-computer interfaces and mindfulness technologies for mental well-being and the necessary services to support people who have experienced depression. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/20819.

Corrigendum: Cooperative and Individual Mandala Drawing Have Different Effects on Mindfulness, Spirituality, and Subjective Well-Being.

[This corrects the article DOI: 10.3389/fpsyg.2020.564430.].

Cooperative and Individual Mandala Drawing Have Different Effects on Mindfulness, Spirituality, and Subjective Well-Being.

Mandala drawing was first practiced by Tibetan buddhists and then developed by Carl Gustav Jung, who felt certain that mandala drawing has the function of integrating psychological division, enhancing psychological harmony, and preserving personality integrity. Previous studies on mandala drawing have mainly focused on alleviating people's negative emotions, such as anxiety and depression. Therefore, this study explored the effect and mechanism of mandala drawing on the improvement of subjective well-being (SWB), mindfulness, and spirituality from positive psychology's viewpoint and compared the different effects of cooperative mandala drawing (CMD) and individual mandala drawing (IMD) on mindfulness, spirituality, and SWB. A total of 76 students were recruited from Chang Gung University, and the aforementioned three main variables were measured before and after the coloring experiment. The results indicated that both CMD and IMD significantly enhanced the subjects' spirituality. Compared with IMD, CMD has a more significant improvement and promotion effect on SWB of subjects by affecting PA, while IMD had no significant effect on PA, and the enhancement effect of SWB was weaker than that of CMD. Mindfulness, spirituality, and SWB all positively correlated with each other. This study highlights the mechanism of mandala drawing and the theoretical understanding of the relationship between mindfulness and SWB. Mandala drawing especially CMD has a positive effect on spirituality and SWB, which may provide individuals with a simple and easy method to improve their happiness.

Effectiveness of mindfulness-based coloring for university students' test anxiety.

Objective: This study compared the effectiveness of mindfulness coloring (mandala), free drawing/coloring, and a noncoloring control activity for university students' test anxiety, and assessed the relationship of dispositional mindfulness and response to intervention on mindfulness and test anxiety states. Participants: University students (n = 167; 81.4% female; Mage = 21.29 years, SD = 4.46) were randomly assigned to a mandala (n = 57), free draw/coloring (n = 58), or noncoloring condition (n = 52). Methods: Participants completed standardized measures assessing test anxiety and state mindfulness pre-postactivity before completing a test, and two dispositional mindfulness measures. Results: Participants in both coloring conditions reported significant decreases in test anxiety and significant increases in state mindfulness pre-postintervention, and participants in the control condition reported significant increases in test anxiety. Reports of preintervention state mindfulness and test anxiety fully mediated relations between dispositional mindfulness and postintervention state mindfulness and test anxiety. Conclusions: Implications for research and practice on mindfulness coloring and test anxiety are discussed.

Effects of Mandala Art Therapy on Subjective Well-being, Resilience, and Hope in Psychiatric Inpatients.

PURPOSE: This study investigated the effects of Mandala art therapy on subjective well-being, resilience, and hope among psychiatric inpatients. METHODS: Recruited 36 people who had been treated as inpatients in a psychiatric ward at a university hospital in Seoul, South Korea, and divided them evenly into experimental and control groups. The experimental group was required to attend a total of 8 sessions of Mandala art therapy, twice per week, between August 11 and October 30, 2015; measures of the three main variables were administered at pre-test and post-test in both groups. RESULTS: Hope significantly increased in both groups, but the overall increase was greater in the experimental group (mean score of 9.5 and 15.3 at pre- and post-test, respectively) than in the control group (10.9 and 11.9). CONCLUSION: These results suggest that Mandala art therapy can have a positive effect on the hope of psychiatric inpatients. However, further research concerning its effects on subjective well-being and resilience, as well as other psychological constructs, is warranted to better understand the effects of Mandala art therapy on psychiatric inpatients.

When Did Coloring Books Become Mindful? Exploring the Effectiveness of a Novel Method of Mindfulness-Guided Instructions for Coloring Books to Increase Mindfulness and Decrease Anxiety.

Mindfulness has been associated with the use of coloring books for adults; however, the question of whether they do increase mindfulness has not been addressed. In two studies, we attempted to identify whether mindfulness is increased, and whether there is a need for ongoing guidance while coloring, similar to mindfulness meditation. In the first randomized controlled experiment, university students (n = 88) were assigned to an unguided mandala coloring group (i.e., described in mainstream literature as a mindfulness practice) or to a free-drawing group. Measurements of state mindfulness and state anxiety were taken pre- and post- experiment. Results indicated no change in mindfulness or anxiety. In the second randomized controlled experiment, university students (n = 72) were assigned to an unguided mandala coloring group (i.e., same as Experiment 1), or, to a mindfulness-guided coloring group (i.e., same as the unguided coloring group with a mindfulness practitioner guiding participants as in mindfulness breathing meditation, with instructions modified and applied to coloring). Results indicated that the mindfulness-guided mandala coloring group performed better in decreasing anxiety, but no change was observed in mindfulness. Exit interviews revealed that some participants did not like the voice guiding them while coloring, which suggested further differing and significant findings. While mindfulness-guided coloring appears promising, guidance or instructions on how to color mindfully may require further development and adjustment to enhance health and wellbeing.

Jung's views on causes and treatments of schizophrenia in light of current trends in cognitive neuroscience and psychotherapy research I. Aetiology and phenomenology.

Jung's writings on schizophrenia are almost completely ignored or forgotten today. The purpose of this paper, along with a follow-up article, is to review the primary themes found in Jung's writings on schizophrenia, and to assess the validity of his theories about the disorder in light of our current knowledge base in the fields of psychopathology, cognitive neuroscience and psychotherapy research. In this article, five themes related to the aetiology and phenomenology of schizophrenia from Jung's writings are discussed:1) abaissement du niveau mental; 2) the complex; 3) mandala imagery; 4) constellation of archetypes and 5) psychological versus toxic aetiology. Reviews of the above areas suggest three conclusions. First, in many ways, Jung's ideas on schizophrenia anticipated much current thinking and data about the disorder. Second, with the recent (re)convergence of psychological and biological approaches to understanding and treating schizophrenia, the pioneering ideas of Jung regarding the importance of both factors and their interaction remain a useful and rich, but still underutilized resource. Finally, a more concerted effort to understand and evaluate the validity of Jung's concepts in terms of evidence from neuroscience could lead both to important advances in analytical psychology and to developments in therapeutic approaches that would extend beyond the treatment of schizophrenia.

Clinical efficacy of Shodhana Karma and Shamana Karma in Mandala Kushtha (Psoriasis).

In India an estimated 0.8% of the population is suffering from Psoriasis. It is a papulo-squamous disorder of the skin, characterized by sharply defined erythemato-squamous lesions. It is chronic and is well known for its course of remissions and exacerbations. The exact etiology is still unknown. This condition is comparable with Mandala Kushtha in Ayurvedic system of medicine. Shodhana procedures are reliable to control the disease. Forty patients, fulfilling the inclusion criteria, were selected and randomly divided into four groups with 10 patients in each group. In Group A, Vamana and Virechana was administered once during the trial period. In Group B, Vamana and Virechana followed by Dermo-care in the dose of 5 g twice a day for the period of 2 months. In Group C, only Dermo-care was administered. In Group D, Tab. Neotrexate (Methotrexate) 7.5 mg/week was given under the supervision of dermatologist. Marked improvement was observed in 10% of the patients in Group B. Moderate improvement was observed in 20% of the patients in Group A, 90% in Group B, and 80% in Group D. Mild improvement was observed in 80% of the patients in Group A, 100% in Group C, and 20% in Group D.