An interventional study of Expressive Arts Therapy in Emotion Dysregulation and Aggressive Behavior in Violent Offenders, sponsored by Shenzhen University. Completed at 1 site in China. Open to male participants aged 20 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-11-03.
Sponsored by Shenzhen University · Not applicable, Interventional, and Supportive care
This randomized controlled trial evaluated whether an 8-week expressive arts therapy (EAT) program can improve emotion regulation and reduce aggression in male violent offenders incarcerated in a Chinese prison. A total of 65 participants were randomly assigned to an EAT intervention group (n=31) or a routine-care control group (n=34). The program used art, clay, and music to help participants express emotions and reinterpret negative experiences.
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This study's enrollment of 65 is below the median of 120 across 1,197 interventional studies indexed under Behavior.
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Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
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Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Participants in the Expressive Arts Therapy (EAT) group received an 8-week group intervention delivered by qualified expressive arts therapists. The 31 participants were divided into three small groups of approximately 10 members each. The intervention consisted of one two-hour session per week, with each week focusing on a specific theme: Body and Emotions, Stress Volcano, Seeing Emotions, Unspoken Words, Self-Awareness, Life Line, Flow of Life, and Review \& Prospect. The therapy integrated multimodal arts-including painting, clay work, and music-to facilitate emotional expression, bypass verbal defenses, and enhance cognitive reappraisal by helping participants externalize and reinterpret emotional experiences.
Behavioral: Expressive Arts Therapy
Participants in the control group (n = 34) received routine prison management only and did not participate in the Expressive Arts Therapy (EAT) intervention. However, the prison's routine psychological services remained available to all participants in this group throughout the study period. They completed the same baseline, mid-treatment (4-week), and post-treatment (8-week) assessments as the intervention group.
The intervention consisted of one two-hour session per week, with each week focusing on a specific theme: Body and Emotions, Stress Volcano, Seeing Emotions, Unspoken Words, Self-Awareness, Life Line, Flow of Life, and Review \& Prospect.
Also known as: EAT
Cognitive Reappraisal Capacity (Picture-Rating Task)
Cognitive reappraisal capacity was assessed using a computerized picture-rating task programmed in E-Prime 3.0, utilizing 40 negative images selected from the Chinese Affective Picture System. The task consisted of two parts: "rating after viewing" and "rating after cognitive reappraisal." In the "rating after viewing" part, participants rated their emotional response to 20 randomly assigned images. In the "rating after cognitive reappraisal" part, participants were instructed to provide positive interpretations of the depicted persons or scenarios for the remaining 20 images before rating their emotional response. Ratings were made on a 9-point scale ranging from 1 (minimal negative emotion) to 9 (strongest negative emotion). For subsequent administrations (mid- and post-treatment), half of the images were replaced with new ones, while both groups viewed the same image sets at each time point.
Time frame: Baseline (before the intervention), mid-treatment (after 4 weeks of intervention), and post-treatment (upon completion of the 8-week intervention).
Implicit Violent Attitudes (Implicit Association Test)
Implicit violent attitudes were measured using the Implicit Association Test (IAT) programmed in E-Prime 3.0, comprising two types of implicit word associations: "self-violence" and "violence-positive." The "self-violence" IAT assessed automatic associations between self-concept and violence by measuring reaction times when pairing self-related words with violence-related attributes, while the "violence-positive" IAT evaluated implicit attitudes toward violence by measuring association speeds between violence-related words and valenced attributes. The test included four critical blocks: block 4 (violence-self + peace-others pairing), block 7 (violence-others + peace-self pairing), block 11 (positive-defend + negative-attack pairing), and block 14 (positive-attack + negative-defend pairing). The "self-violence" IAT effect was calculated by subtracting the mean RT of Block 4 from Block 7, and the "violence-positive" IAT effect by subtracting Block 11's mean RT from Block 14's.
Time frame: Baseline (0-week), mid-treatment (4-week), and post-treatment (8-week).
Mood States (Visual Analogue Mood Scale, VAMS)
Mood states were assessed using the Visual Analogue Mood Scale (VAMS), programmed using NET 8.0, which consists of 18 items across four dimensions: somatic state, psychosomatic state, emotional state, and extraversion. Each item presents a pair of antonymous adjectives, and participants rated their current state by clicking on a 100-point continuum between the two descriptors (e.g., 1 = "extremely drowsy" to 100 = "extremely alert"). The scale includes 13 forward-scored and 5 reverse-scored items, with higher composite scores indicating greater positivity in each respective dimension.
Time frame: Baseline (0-week), mid-treatment (4-week), and post-treatment (8-week).
Plan to share: No — The study was conducted with a vulnerable population-incarcerated violent offenders-within a correctional facility. Participants provided informed consent with the assurance that their individual data would remain confidential and would not be shared outside the research team. Furthermore, the prison administration imposed strict data governance requirements, including that all data remain under institutional control and be used solely for the purposes of this approved study. Therefore, access to the data is restricted to the principal investigators and authorized research personnel, and de-identified data may only be made available to qualified researchers upon reasonable request to the corresponding author, subject to approval from the Ethics Committee of Shenzhen University and the prison administration, and in compliance with applicable privacy and institutional regulations.
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Shenzhen University