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arts engagement may affect mental health, organised under the novel \u201carts exposome\u201d framework. Provides the theoretical structure that the present paper proposes to operationalise for empirical mechanism testing."},{"key":"10.1016\/j.copsyc.2026.102460_bib38","unstructured":"Recent meta-analysis of randomised trials of active visual art therapy across health outcomes; supports the case that aggregated \u201carts intervention\u201d effects are real but underlines the need for mechanism-level specification."},{"key":"10.1016\/j.copsyc.2026.102460_bib39","unstructured":"Documents associations between cultural engagement patterns and indices of biological dysregulation in population data; directly relevant to the refined exposome\u2013biomarker linkage proposed here."},{"key":"10.1016\/j.copsyc.2026.102460_bib40","unstructured":"Recent definitional work that begins to address the construct-decomposition problem for arts engagement in public health research; complementary to the operational refinement proposed here."},{"key":"10.1016\/j.copsyc.2026.102460_bib41","unstructured":"Recent meta-analysis showing comparable depression and anxiety effects of group arts interventions across diverse arts modalities and comparator designs; supports the equifinality framing of section 4 and the design recommendations advanced here."},{"key":"10.1016\/j.copsyc.2026.102460_bib42","unstructured":"Applies non-recursive instrumental variable models to UK Household Longitudinal Study data (n = 17,927) to test bidirectional causality between arts engagement and mental health; clarifies how recent causal-inference advances inform total-effect estimation while leaving mechanism inference contingent on exposure specification."},{"key":"10.1016\/j.copsyc.2026.102460_bib43","unstructured":"Personal View identifying the shared principles, processes, and contextual factors linking arts-based leisure engagement and psychological therapies; motivates the head-to-head testing and non-inferiority framing advanced here."},{"key":"10.1016\/j.copsyc.2026.102460_bib44","unstructured":"Randomised non-inferiority trial showing telehealth-delivered music therapy is non-inferior to cognitive behavioural therapy for anxiety in cancer survivors; a concrete instance of the head-to-head, gold-standard-comparator design recommended here."}],"container-title":["Current Opinion in Psychology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2352250X26001983?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2352250X26001983?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T20:40:30Z","timestamp":1791751230000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2352250X26001983"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2027,2]]},"references-count":44,"alternative-id":["S2352250X26001983"],"URL":"https:\/\/doi.org\/10.1016\/j.copsyc.2026.102460","relation":{},"ISSN":["2352-250X"],"issn-type":[{"value":"2352-250X","type":"print"}],"subject":[],"published":{"date-parts":[[2027,2]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Operationalising the arts exposome","name":"articletitle","label":"Article Title"},{"value":"Current Opinion in Psychology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.copsyc.2026.102460","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). 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