Assessing the stress-relief impact of an art-based intervention inspired by the broaden-and-build theory in college students

The study addresses rising psychological stress among college students—particularly medical freshmen—during the transition to university. Prior work suggests that structured art activities (e.g., coloring, drawing) can reduce anxiety by promoting focused attention and present-moment engagement. The authors ground their intervention in Fredrickson’s broaden-and-build theory of positive emotions, positing that art-making can elicit positive affect that broadens attention and cognition, builds enduring personal and social resources, and thereby alleviates perceived stress. The research question is whether a four-week, group-based art-making intervention can reduce perceived stress (and related components such as tension and loss of control) among college freshmen compared with a no-intervention control.

The paper reviews evidence that art-based activities (e.g., coloring mandalas, drawing, clay work) reduce anxiety and stress and enhance self-awareness, concentration, and vagal activity (Curry & Kasser, 2005; Sandmire et al., 2016; Cheshure & Van Lith, 2022). Art-making serves as a non-verbal mode of expression facilitating emotional externalization and regulation (Timulak et al., 2017), with demonstrated benefits across populations, including psychiatric patients engaging in clay work (de Morais et al., 2014), cancer patients (Nainis et al., 2006), and medical students via visual journaling (Mercer et al., 2010). The literature also notes the potential physiological bases of color-related interventions and the distinction between coloring and formal art therapy while recognizing the former’s utility for focus and anxiety reduction. In China, most student-focused stress interventions emphasize music and exercise; art-focused interventions are fewer and often limited to mandala coloring. The theoretical framework centers on the broaden-and-build theory: positive emotions counteract negative emotional effects, widen attentional and cognitive scope, enhance coping and creativity, and help build enduring resources (Fredrickson, 1998; Xiaowei, 2013).

Design: Randomized controlled design with pre-test, post-test (week 4), and follow-up (week 8). Groups: Experimental (art-making) vs. control (no intervention). Participants: Recruited 90 first-year medical students (45 male, 45 female; mean age 18 ± 1). After exclusions for <90% task completion/absence, 70 participants completed all phases (experimental n=33; control n=37). Recruitment: Email invitation to eligible freshmen; interested students received study abstract and consent; orientation session followed. Intervention: Four weekly 2.5-hour sessions of group art-making. Session 1: Ultralight clay modeling (kneading preferred shapes). Session 2: Decorating small wooden boards with butterscotch glue and finished clay products. Session 3: Botanical-specimen bookmark making. Session 4: Acrylic painting on canvas bags. Emphases: Enhancing concentration/flow to reduce anxiety; enabling non-verbal expression for emotional release. Measures: Perceived Stress Scale (PSS-14; 5-point Likert; higher scores = greater perceived stress). Positively phrased items (4,5,6,7,9,10,13) reverse-scored. Reliability reported: overall Cronbach’s alpha=0.899; tension alpha=0.854. Data collection: Pre-test administered prior to intervention; post-test at week 4; follow-up at week 8. Valid questionnaires: Pre-test 76 valid (36 experimental, 40 control; validity rate 84.4% of 90 distributed). Post-test 70 valid (33 experimental, 37 control; 100% validity among returned). All 70 completed all three assessments at follow-up (100% validity). Statistical analysis: Baseline comparisons via chi-square (categorical) and independent-samples t-tests (continuous). Repeated-measures ANOVA with Mauchly’s test for sphericity; between-subject factor: group; within-subject factor: time (pre, post, follow-up). Multiple comparisons used LSD adjustment. Alpha=0.05. Software: SPSS v26.

Baseline: No significant group differences in demographics (age, gender, specialization) or stress indicators (stress perception, tension, loss of control; all p>0.05). Week 4 (post-test) between-group: Experimental group showed lower stress perception (M=5.31, SD=0.76) vs. control (M=6.12, SD=0.90); t=4.061, p<0.01. Tension lower in experimental (M=2.55, SD=0.46) vs. control (M=3.20, SD=0.65); t=4.829, p<0.01. Loss of control showed no significant difference (experimental M=2.76, SD=0.50; control M=2.91, SD=0.71; p>0.05). Week 8 (follow-up) between-group: Experimental maintained improvements: stress perception (M=5.49, SD=1.18) vs. control (M=6.09, SD=1.15); t=2.145, p<0.05. Tension (M=2.74, SD=0.55) vs. control (M=3.19, SD=0.58); t=3.307, p<0.01. Loss of control remained non-significant (experimental M=2.75, SD=0.72; control M=2.90, SD=0.75; p>0.05). Within-group (experimental): Significant time effects for stress perception (df=2, F=4.172, p=0.017) and tension (df=2, F=7.615, p=0.001), but not loss of control (df=2, F=0.419, p=0.658). LSD multiple comparisons showed significant decreases from pre to post and pre to follow-up for both tension (p<0.001) and stress perception (p<0.01 to p<0.001), with no significant change from post to follow-up, indicating sustained effects. Interaction effects: Significant time × group interactions for stress perception (df=2, F=6.400, p=0.002) and tension (df=2, F=9.444, p<0.001); non-significant for loss of control (df=2, F=1.225, p=0.297). Subjective feedback: Participants reported enhanced emotional regulation, improved concentration with respite from intrusive thoughts, and increased sense of belonging and mutual support.

The findings support the hypothesis that a brief, structured art-making program can reduce perceived stress and tension in college freshmen relative to no intervention, with effects sustained four weeks post-intervention. This aligns with broaden-and-build theory: art-making likely elicited positive emotions that broadened attention and cognition, enabled flow-like concentration, and built social/psychological resources within the group context. The non-verbal, hands-on nature of the activities may have facilitated emotional expression and regulation, consistent with prior art therapy literature. While loss of control did not significantly change, perceived stress and tension improved, suggesting that the intervention primarily targets affective and attentional components of stress rather than control appraisals. Practically, art-making offers an engaging, aesthetically rich alternative to traditional psychoeducation, potentially enhancing mental health programming for freshmen. The subjective reports corroborate the quantitative findings, highlighting emotional soothing, focused absorption, and social bonding as mechanisms.

Art-making, implemented as a four-session, four-week program, significantly reduced perceived stress and tension among college freshmen and sustained benefits at four-week follow-up. The study contributes empirical support for integrating art-based, non-verbal interventions into university mental health education, grounded in the broaden-and-build framework of positive emotions. Future research should expand samples beyond a single medical college, examine tailoring to diverse skill levels and preferences (including gender differences in receptivity), explore mechanisms (e.g., attentional focus, social connectedness), and consider strategies to impact feelings of loss of control.

- Sample drawn from a single medical college, limiting generalizability. - Variability in students’ aptitude and receptivity to art-making, with noted gender differences, may influence outcomes. - Loss of control did not improve, indicating limited scope across stress dimensions. - Attrition/exclusion between initial recruitment (n=90) and analysis sample (n=70) may introduce selection bias. - Control group did not receive an active comparator, leaving expectancy/placebo effects unaccounted for.