118. Visual narrative therapy for emotional regulation in patients with depression: an intervention study based on dynamic color-pattern poster design

Abstract Background Patients with depression generally have problems such as limited emotion recognition, obvious negative cognitive bias, and decreased emotion regulation ability. Traditional psychological intervention still has shortcomings such as low participation and difficulty in abstract understanding in terms of emotional expression and internal experience reshaping. Visual narrative therapy constructs visualized emotional narrative paths through colors, shapes and situational metaphors, which can promote patients’ externalization of emotional experiences and enhance their ability to reevaluate emotions. However, at present, empirical evidence on whether visual narrative design based on dynamic color graphics can further enhance the intervention effect is still relatively scarce. Therefore, this study explores the intervention effect of visual narrative therapy combined with dynamic color graphic posters on the emotional regulation ability of patients with depression, aiming to provide more practical evidence support for the interdisciplinary integration of visual design and psychotherapy. Methods A randomized controlled trial was conducted involving 82 patients diagnosed with depression at the outpatient department of a tertiary hospital. Participants were randomly assigned (1:1) to the control group (n = 41) or the routine psychological support group (n = 41). The intervention lasted 6 weeks. The intervention group received visual narrative therapy incorporating dynamic color-pattern posters, including emotional color mapping, metaphorical graphic narration, visual reconstruction training, and individualized storytelling. The control group received routine psychological support. Assessments were conducted at baseline, Week 3, and Week 6, covering depressive symptoms (PHQ-9), the Difficulties in Emotion Regulation Scale (DERS), and an emotion recognition task (accuracy and reaction time). Repeated-measures ANOVA was used to examine time × group interaction effects. Results After 6 weeks, PHQ-9 scores in the intervention group decreased from 15.37 ± 3.12 to 8.26 ± 2.74 (a reduction of 46.3%), significantly greater than the control group’s decrease from 15.09 ± 3.05 to 11.94 ± 2.88 (a reduction of 20.8%) (p<.001). DERS scores also showed a larger reduction in the intervention group (from 98.42 ± 10.57 to 74.15 ± 9.84) compared with the control group (from 97.26 ± 11.03 to 88.73 ± 10.41) (p=.004). Emotion recognition accuracy increased to 81.6% ± 5.2% in the intervention group, higher than the control group’s 72.4% ± 6.1% (p<.01). Furthermore, dynamic color-pattern posters significantly improved positive emotion priming, as reaction time decreased by 214.6 ms in the intervention group versus 87.4 ms in the control group. Discussion The research results show that the visual narrative therapy integrating dynamic color graphic posters can significantly improve the emotional regulation ability of patients with depression, and its effect is reflected in the alleviation of depressive symptoms and the enhancement of emotional recognition ability, etc. The dynamic changes of visual elements enhance patients’ externalized expression of emotions and internal narrative reconstruction, making it easier for them to obtain positive emotional experiences. The research provides new empirical evidence for the intervention of visual design in mental and psychological therapy, but it is still limited by the sample size and intervention period. Future research can further explore the differential effects of different visual elements on mood improvement.