Art Therapy Alleviates the Levels of Depression and Blood Glucose in Diabetic Patients: A Systematic Review and Meta-Analysis

Conceptualizing an antiracist framework for neuroscience research in art therapy: a qualitative pilot study

Introduction

Advances in social cognitive neuroscience research have contributed deeper understanding of neural processes relevant to art therapy, and of social, interrelational phenomena including racism and implicit bias. Confoundingly, emerging critical discourse about neuroscience research design highlighted systemic racism, implicit bias, and inequality perpetuated by imaging technologies, lack of diversity, and funding disparities. Emphasis toward antiracist practices within cognitive neuroscience research and various other fields has grown; however, literature on antiracist research practices within art therapy research is scant.

Methods

The purpose of this qualitative pilot research study was to elicit conceptualizations about antiracist research practices from art therapy researchers in response to relevant literature. Purposive sampling was used to recruit four female art therapy researchers from the United States (U.S.) and Europe. Semi-structured interviews were analyzed using grounded theory coding resulting in three main categories, seven themes, and subthemes. Member-checking and reflexive journaling were employed to enhance credibility.

Results

Core categories revealed points of convergence across participants, areas of concern, and requirements outlining antiracist research practices in art therapy. The first core category, shared beliefs and values, had three themes: neuroscience-informed perspective of art therapy; neuroscience research can strengthen art therapy theories; and infusion of antiracism and neuroscience into art therapy begins with education. The second core category, barriers and challenges, had two themes: potential credibility and legitimacy concerns for art therapy; and difficult conversations about disparities in awareness, diversity, and resources. The third core category, requirements and responsibilities for antiracist research, had two themes: due diligence to build accountability and legitimacy; and inclusion of diversity in art therapy research, and subthemes.

Discussion

Preliminary outcomes revealed ideas aligning current antiracist neuroscience research discourse with art therapy experimental research practices. The small group of neuroscience-focused art therapist researchers provided realistic considerations about amplifying discourse within the art therapy profession and infusing antiracist research into neuro-informed art therapy curriculum, and prioritizing diversity throughout experimental research design. An antiracist art therapy research framework with principles including education, intentionality, and diversity was proposed, along with recommendations for further research using the framework and to implement the framework into graduate art therapy education.

Incorporating Complementary Therapies Into Diabetes Care

CONTEXT

Current diabetes care and education programs and expert clinical diabetes management guidelines focus on diabetes self-care behaviors and have yet to incorporate complementary therapies. Complementary therapies, such as music therapy, yoga, mindfulness, and art therapy, have been used globally for centuries and have positive metabolic and glycemic outcomes. In this mini-review, we describe complementary therapies successfully used in diabetes, identify current evidence-based practice gaps, and provide recommendations for incorporating complementary therapies into diabetes care.

EVIDENCE ACQUISITION

We thoroughly searched relevant PubMed and Google Scholar studies from 2004 to 2024. Our inclusion criteria were clinical trial studies using the search terms "diabetes self-management" OR "metabolic outcomes" OR "diabetes" OR "type of complementary therapy (music therapy, mindfulness, yoga or art therapy) OR population (type 1 diabetes, type 2 diabetes, prediabetes, diabetes)."

EVIDENCE SYNTHESIS

We synthesized the evidence to determine complementary therapies (music therapy, mindfulness, yoga, or art therapy) that benefit individuals with diabetes. Findings showed that complementary therapies support diabetes-related psychological and cardiometabolic outcomes and enhance the Association of Diabetes Care and Education Specialists 7 Self-Care Behaviors for diabetes self-management, specifically healthy coping, monitoring, reducing risks, and problem-solving. Critical gaps included the lack of large-scale randomized controlled trials in North American diabetes self-management education programs.

CONCLUSION

Complementary therapies have positive psychological and physiological health benefits for people living with diabetes, yet more randomized controlled trials are needed to assess their effectiveness on a large scale. In the interim, complementary therapies can be integrated into diabetes education, specifically as adjunctive hands-on therapies to enhance self-management behaviors and meet self-management goals.

Psychological aspects of rehabilitation nutrition: A position paper by the Japanese Association of Rehabilitation Nutrition (secondary publication)

Psychological aspects of rehabilitation nutrition affect physical, cognitive, and social rehabilitation nutrition. When depression is recognized, not only pharmacotherapy and psychotherapy, but also non-pharmacological therapies such as exercise, nutrition, psychosocial, and other interventions can be expected to improve depression. Therefore, accurate diagnosis and intervention without overlooking depression is important. Psychological aspects of preventive rehabilitation nutrition is also important because depression can be partially prevented by appropriate exercise and nutritional management. Even in the absence of psychological negatives, increasing more psychological positives from a positive psychology perspective can be useful for both patients and healthcare professionals. Positive rehabilitation nutrition interventions can increase more psychological positives, such as well-being, through cognitive-behavioral therapy and mindfulness on their own, as well as through interventions on environmental factors. Consequently, physical, cognitive, and social positives are also expected to be enhanced.

ADA-EASD Consensus Report on the Management of Hyperglycaemia in Type 2 Diabetes in an Afro-Asian Context: Broadening the Perspective

The American Diabetes Association and the European Association for the Study of Diabetes consensus statement 2022 effectively captures the changing paradigm of modern diabetes care. As emphasized in the guidelines, a person-centered decision cycle focusing on preventing complications and improving quality of life is the driving principle behind modern diabetes management. Other notable features of the document are its emphasis on self-management education, therapeutic behaviour, sleep hygiene, nonalcoholic fatty liver disease and weight loss. Focus on individualization of care, social determinants of health, and ethnic variations are pertinent from an Afro-Asian perspective. The "language matters" section is a welcome addition that will help to overcome several barriers in diabetes care.

Art Engagement and Risk of Type 2 Diabetes: Evidence From the English Longitudinal Study of Ageing

Objectives: To examine the prospective association between art engagement and the risk of type 2 diabetes. Methods: Adults aged ≥50 from the English Longitudinal Study of Ageing were asked about the frequency of art engagement, including going to the cinema, the art gallery or museum, and the theatre, a concert, or the opera. Cox proportional hazards regression models were used to examine the risk of type 2 diabetes associated with art engagement. Results: During a median follow-up of 12.2 years, we identified 350 cases of type 2 diabetes from 4,064 participants through interviews. After multivariable adjustment, compared with people who never went to the cinema, those going to the cinema frequently had a significantly lower risk of developing type 2 diabetes (HR = 0.61, 95% CI: 0.44-0.86). After further adjustment for socioeconomic factors, the association was slightly attenuated but remained statistically significant (HR = 0.65, 95% CI: 0.46-0.92). Similar results were found for going to the theatre, a concert, or the opera. Conclusion: Frequent art engagement may be associated with a lower risk of type 2 diabetes, which was independent of individuals' socioeconomic factors.

Application of the Non-Enzymatic Glucose Sensor Combined with Microfluidic System and Calibration Readout Circuit

In this research, we proposed a potentiometric sensor based on copper doped zinc oxide (CZO) films to detect glucose. Silver nanowires were used to improve the sensor’s average sensitivity, and we used the low power consumption instrumentation amplifier (UGFPCIA) designed by our research group to measure the sensing characteristics of the sensor. It was proved that the sensor performs better when using this system. In order to observe the stability of the sensor, we also studied the influence of two kinds of non-ideal effects on the sensor, such as the drift effect and the hysteresis effect. For this reason, we chose to combine the calibration readout circuit with the voltage-time (V-T) measurement system to optimize the measurement environment and successfully reduced the instability of the sensor. The drift rate was reduced by about 51.1%, and the hysteresis rate was reduced by 13% and 28% at different measurement cycles. In addition, the characteristics of the sensor under dynamic conditions were also investigated, and it was found that the sensor has an average sensitivity of 13.71 mV/mM and the linearity of 0.998 at a flow rate of 5.6 μL/min.

Trends in Research on Art Therapy Indexed in the Web of Science: A Bibliometric Analysis

Aim: Despite the increase in international research in art therapy, few studies have been developed with a bibliometric approach which describe the situation regarding this area of knowledge. Thus, the aim of this study is to describe and contextualize international scientific production in the visual arts modality in the context of artistic therapies, to offer a broader and more in-depth vision of the structure of this area of knowledge through of a bibliometric analysis of the publications indexed in the core collection of the Web of Science. Methods: This is a retrospective, exploratory and descriptive, cross-sectional study to analyze the bibliographic data retrieved from the databases of the core collection. The analysis parameters included the data corresponding to the production according to type of document, country, journal, and institution. In addition, the main lines of research were located and classified and the subject matter of the most cited articles in each of them was summarized. Four periods were selected, between 1994 and 2020, to facilitate the thematic analysis and offer an evolutionary perspective of art therapy research. Results: A total of 563 works were published, in 250 journals, in the 63 years between 1958, when the first document was published, and April 2021. The annual growth rate was 7.3% with a mean average of 8.7 publications per year, and 83.13% of the published works were articles. A total of 1,269 authors from 56 countries were counted. The mean number of citations per document was 5.6 and the mean number of citations per document and year was 0.6. The main research domains were psychology and/or rehabilitation and the highest production on this topic was concentrated in only three journals. In general, a high degree of variability was observed in the study topics and numerous theoretical and methodological articles. The most used visual arts modalities were in the main drawing, painting and photography. Conclusion: This work did not find previous existence of any bibliometric analysis on the international scientific production in art therapy. In general terms, there has been a substantial growth in the number of publications on the subject over the last decade. However, this research area does not appear to have peaked, but, on the contrary, is still growing and progressing despite its long history in clinical practice.