Colour atmospheres as a non-verbal approach to preferences and behavioural states in forensic psychiatry. A qualitative case study comparing representational nature images and abstract colour compositions in patients with severe communication impairments

Abstract Background: Patients in forensic psychiatric settings with severe cognitive and communicativeimpairments largely elude established diagnostic and participatory procedures. In particular, thereis a lack of valid methods for systematically recording individual preferences and affectivereactions without linguistic mediation. Objective: The aim of the study is to investigate the extent to which non-verbal behaviouralreactions to colour atmospheres can serve as a reliable means of accessing individualpreferences.The central question is whether abstract colour atmospheres trigger comparable affectivephysicalreactions to concrete images of nature, provided that their colour and lighting mood is preserved. Method: A qualitative, idiographic case study (N = 2) was conducted under real-world conditionsin a forensic psychiatric setting.The subjects were presented with 20 archetypal images of nature as well as 20colour-atmospheric abstractions.Non-verbal behavioural responses (facial expressions, body movements, vocalisations, duration of attention) were recorded in two sessions (fixed vs. randomised order) by the researcher and trained nursing staff. Results: Both patients exhibited clear, reproducible and, in some cases, stronglypronounced affective-physical reactions to the stimuli presented. The reaction patterns were highly consistent between representational nature images and the corresponding abstract colour gradients (congruence up to 90%). Open, light and warm colour atmospheres led to approach behaviour, relaxation and longer dwell times, whilst dense, dark and visually complex atmospheres correlated with avoidance and tension. These differentiated reactions were observed in patients who had previously been largely unreachable through attempts at verbal communication. Conclusion: The results provide initial empirical evidence that colour atmospheres can constitutean independent and primary factor influencing emotional experience and behaviour . evenindependently of representational image content. At the same time, the approach opens up a novel way of assessing individual preferences in nonverbal patient groups.Despite the limited sample size, the findings suggest that colour-atmospheric design can bespecifically employed for emotional regulation and to support therapeutic processes.