Comparison of the Effectiveness of Theater-Based Art Therapy and Psychosocial Rehabilitation on Illness Perception and Autonomous Arousal Readiness in Patients with Schizophrenia

Authors

    Mona Abolghasemzade Department of Psychology, Go.C., Islamic Azad University, Gorgan, Iran.
    Afsaneh Khajevandkhoshli * Department of Psychology, Go.C., Islamic Azad University, Gorgan, Iran. a.khajevand@iau.ac.ir
    Lilasadat Aziziziabari Department of Nursing, Go.C., Islamic Azad University, Gorgan, Iran
https://doi.org/10.61838/mhlj.3.4.10

Keywords:

Schizophrenia, Theater-based art therapy, Psychosocial rehabilitation, Illness perception, Autonomous arousal readiness

Abstract

The objective of this study was to compare the effectiveness of theater-based art therapy and psychosocial rehabilitation on illness perception and autonomous arousal readiness in male patients with schizophrenia. This applied study employed a semi-experimental pretest–posttest design with a control group and a three-month follow-up. The statistical population consisted of male patients aged 25–55 years with mild schizophrenia under the supervision of Iranmehr Comprehensive Care Center in Qaem Shahr, Iran, in 2024. Using G*Power software, a total sample of 45 participants was selected through purposive sampling based on inclusion and exclusion criteria, and they were randomly assigned to two experimental groups (theater-based art therapy and psychosocial rehabilitation, 15 each) and one control group (15 participants). The Illness Perception Questionnaire (Broadbent et al., 2006) and the Autonomous Arousal Readiness Questionnaire (Korn, 1998) were administered at three stages: pretest, posttest, and follow-up. Data were analyzed using repeated measures ANOVA, Bonferroni, and Tukey post hoc tests in SPSS version 18. The results of mixed repeated measures ANOVA indicated significant main effects of group, treatment stage, and group × stage interaction for both illness perception and autonomous arousal readiness (p < .001). Bonferroni post hoc tests showed that illness perception increased significantly from pretest to posttest and follow-up, while autonomous arousal readiness decreased significantly over the same periods, with no significant differences between posttest and follow-up, suggesting sustained effects. Tukey post hoc comparisons further revealed that psychosocial rehabilitation produced significantly greater improvements than theater-based art therapy in both illness perception (p < .001) and reduction of arousal readiness (p = .03). The findings demonstrate that both theater-based art therapy and psychosocial rehabilitation are effective interventions for enhancing illness perception and reducing autonomous arousal readiness in patients with schizophrenia, with psychosocial rehabilitation showing comparatively stronger effects.

Downloads

Download data is not yet available.

References

1. Ruiz MIR, Aceituno D, Rada G. Art Therapy for Schizophrenia? Medwave. 2017;17(Suppl1):e6845-e. doi: 10.5867/medwave.2017.6845.

2. Luo X, Zhang Z, Zheng Z, Ye Q, Wang J, Wu Q, et al. Art Therapy as an Adjuvant Treatment for Schizophrenia: A Protocol for an Updated Systematic Review and Subgroup Meta-Analysis of Randomized Clinical Trials Following the PRISMA Guidelines. Medicine. 2022;101(40):e30935. doi: 10.1097/md.0000000000030935.

3. Patterson S, Debate J, Anju S, Waller D, Crawford M. Provision and Practice of Art Therapy for People With Schizophrenia: Results of a National Survey. Journal of Mental Health. 2011;20(4):328-35. doi: 10.3109/09638237.2011.556163.

4. Holttum S, Huet V. The MATISSE Trial–A Critique. Sage Open. 2014;4(2). doi: 10.1177/2158244014532930.

5. Frijda NH. Emotion Experience and Its Varieties. Emotion Review. 2009;1(3):264-71. doi: 10.1177/1754073909103595.

6. Lim E, Park S-Y, Jang SH, Bahk WM, Kwon YJ, Yoon B-H, et al. M185. The Effects of Group Arts Therapy Based on Emotion Management Training on the Emotional Expression, Alexithymia, Depression and Quality of Life in Patients With Schizophrenia. Schizophrenia Bulletin. 2020;46(Supplement_1):S206-S7. doi: 10.1093/schbul/sbaa030.497.

7. Lee S-Y. The Effects of Group Arts Therapy Based on Emotion Management Training on the Emotional Expression, Alexithymia, Depression and Quality of Life in Patients With Schizophrenia. Bjpsych Open. 2025;11(S1):S55-S. doi: 10.1192/bjo.2025.10172.

8. Tong J, Yu W, Fan X, Sun X, Zhang JM, Zhang J, et al. Impact of Group Art Therapy Using Traditional Chinese Materials on Self-Efficacy and Social Function for Individuals Diagnosed With Schizophrenia. Frontiers in Psychology. 2021;11. doi: 10.3389/fpsyg.2020.571124.

9. Çataldaş SK, Eren N, Üstün N, Ofluoğlu F, Ayhan CH. Effects of Art Therapy on Quality of Life and Social Functioning in Individuals With Schizophrenia. Journal of Psychosocial Nursing and Mental Health Services. 2025;63(5):49-55. doi: 10.3928/02793695-20250107-02.

10. Chen C-R, Du S-C. Effects of Art Therapy on Positive Symptom, Negative Symptom and Emotion in Schizophrenia. 2024. doi: 10.37766/inplasy2024.3.0021.

11. Syafril S. Idiom-Idiom Estetik Pastiche, Parodi, Kitsch, Camp, Dan Skizofrenia Dalam Karya Teater Postmodern Indonesia Jalan Lurus. Komposisi Jurnal Pendidikan Bahasa Sastra Dan Seni. 2012;9(2). doi: 10.24036/komposisi.v9i2.97.

12. Park N-E, Park J-H, Kim D-E, Kim S-H, Chung D-K. A Case Report of a Schizophrenic Patient Treated With Art Therapy and Korean Traditional Medicine. Journal of Oriental Neuropsychiatry. 2016;27(3):147-55. doi: 10.7231/jon.2016.27.3.147.

13. Ando M, Kira H, Hayashida S. Changes in the Autonomic Nervous System and Moods of Advanced Cancer Patients by Mindfulness Art Therapy Short Version. Journal of Cancer Therapy. 2016;07(01):13-6. doi: 10.4236/jct.2016.71002.

14. Utas-Akhan L, Avcı D, Basak I. Art Therapy as a Nursing Intervention for Individuals With Schizophrenia. Journal of Psychosocial Nursing and Mental Health Services. 2024;62(5):29-38. doi: 10.3928/02793695-20231025-02.

15. Andersen E, Lewis GF, Belger A. Aberrant Parasympathetic Reactivity to Acute Psychosocial Stress in Male Patients With Schizophrenia Spectrum Disorders. Psychiatry Research. 2018;265:39-47. doi: 10.1016/j.psychres.2018.04.009.

16. Constantin C-N. Art-Terapia În Schizofrenie – Aspecte Ale Cercetării Cantitative. Rpsih. 2025;71(1):37-46. doi: 10.59277/rpsih.2025.1.03.

17. Jáuregui OI, Costanzo EY, Achával Dd, Villarreal MF, Chu E, Mora MC, et al. Autonomic Nervous System Activation During Social Cognition Tasks in Patients With Schizophrenia and Their Unaffected Relatives. Cognitive and Behavioral Neurology. 2011;24(4):194-203. doi: 10.1097/wnn.0b013e31824007e9.

18. Ando M, Ito S. Changes in Autonomic Nervous System Activity and Mood of Healthy People After Mindfulness Art Therapy Short Version. Health. 2016;08(04):279-84. doi: 10.4236/health.2016.84029.

19. Reynolds S, Lane SJ, Mullen B. Effects of Deep Pressure Stimulation on Physiological Arousal. American Journal of Occupational Therapy. 2015;69(3):6903350010p1-p5. doi: 10.5014/ajot.2015.015560.

20. Adiba DMF, Paramita H. The Effect of Art Therapy by Painting Technique on Social Function Level in Schizophrenia Patients at Menur Mental Hospital, Surabaya City, East Java, Indonesia. The Int J Of Med Science and Health. 2024;4(3):20-30. doi: 10.70070/2sfc2565.

21. Dzakiya EL, Untari R. PENGARUH TERAPI SENI TIE-DYE TERHADAP KEPUASAN HIDUP PASIEN SKIZOFRENIA DI RSJD Dr. RM. SOEDJARWADI KLATEN. Jurnal Ilmiah Kedokteran. 2024;3(1):32-9. doi: 10.55080/mjn.v3i1.700.

22. Krisniati TR. Exploring the Efficacy of Art-Related Activities Particularly Painting as Adjuvant Therapy in Schizophrenia: An Evidence-Based Case Report. Journal of Psychiatry Psychology and Behavioral Research. 2024;5(1):17-24. doi: 10.21776/ub.jppbr.2024.005.01.4.

23. Kozhyna G, Kryshtal AA. Evaluation of the Influence of Art Therapy on the Dynamics of Social Functioning of Schizophrenic Patients. Inter Collegas. 2017;4(3):150-3. doi: 10.35339/ic.4.3.150-153.

24. Leurent B, Killaspy H, Osborn D, Crawford M, Hoadley A, Waller D, et al. Moderating Factors for the Effectiveness of Group Art Therapy for Schizophrenia: Secondary Analysis of Data From the MATISSE Randomised Controlled Trial. Social Psychiatry and Psychiatric Epidemiology. 2014;49(11):1703-10. doi: 10.1007/s00127-014-0876-2.

25. Feng J, Chen H, Fu L. Effect of Reality Oriented Training Combined With Group Diversified Art Therapy on Social Function of Chronic Schizophrenia. Journal of Clinical Medicine Research. 2024;5(2):269. doi: 10.32629/jcmr.v5i2.2327.

26. Cheng C, Elamin ME, May H, Kennedy M. Drawing on Emotions: The Evolving Role of Art Therapy. Irish Journal of Psychological Medicine. 2021;40(3):500-2. doi: 10.1017/ipm.2021.20.

Downloads

Published

2025-10-04

Submitted

2025-06-01

Revised

2025-09-07

Accepted

2025-09-11

How to Cite

Abolghasemzade, M. ., Khajevandkhoshli, A., & Aziziziabari, L. (2025). Comparison of the Effectiveness of Theater-Based Art Therapy and Psychosocial Rehabilitation on Illness Perception and Autonomous Arousal Readiness in Patients with Schizophrenia. Mental Health and Lifestyle Journal, 3(4), 1-13. https://doi.org/10.61838/mhlj.3.4.10

Similar Articles

1-10 of 96

You may also start an advanced similarity search for this article.