Biased emotional recognition in depression: perception of emotions in music by depressed patients.

Abstract Background Depression is a highly prevalent mood disorder, that impairs a person's social skills and also their quality of life. Populations affected with depression also suffer from a higher mortality rate. Depression affects person's ability to recognize emotions. We designed a novel experiment to test the hypothesis that depressed patients show a judgment bias towards negative emotions. Methods To investigate how depressed patients differ in their perception of emotions conveyed by musical examples, both healthy (n = 30) and depressed (n = 79) participants were presented with a set of 30 musical excerpts, representing one of five basic target emotions, and asked to rate each exc…

Validity and reliability of electroencephalographic frontal alpha asymmetry and frontal midline theta as biomarkers for depression

Electroencephalographic (EEG) frontal alpha asymmetry (FAA) and frontal midline (FM) theta have been suggested as biomarkers for depression and anxiety, but have mostly been assessed in small and non-clinical studies. In a clinical sample of 79 adults with depression (ICD-10: F32), resting EEG and scales of depression (MADRS) and anxiety (HADS-A) were measured at intake and after 3 months. FAA and FM theta values were referenced to a normative population database. Internal consistency, test-retest reliability, and correlations with psychiatric tests were examined. Reliability was sufficient. However, FAA and FM theta values were close to the general population, and correlations with psychia…

Enhancing the efficacy of integrative improvisational music therapy in the treatment of depression : study protocol for a randomised controlled trial

Abstract Background Depression is among the leading causes of disability worldwide. Not all people with depression respond adequately to standard treatments. An innovative therapy that has shown promising results in controlled trials is music therapy. Based on a previous trial that suggested beneficial effects of integrative improvisational music therapy (IIMT) on short and medium-term depression symptoms as well as anxiety and functioning, this trial aims to determine potential mechanisms of and improvements in its effects by examining specific variations of IIMT. Methods/design A 2 × 2 factorial randomised controlled trial will be carried out at a single centre in Finland involving 68 adu…

Musical interaction in music therapy for depression treatment

Music therapy is efficacious for the treatment of depression. Compared to other psychotherapeutic forms, it allows for the emergence of various modes of mutual interaction, thus enabling multiple channels for emotional expression and fostering therapeutic alliance. Although musical interaction patterns between client and therapist have been regarded as predictors of therapeutic outcome in depression, this has not yet been systematically investigated. We aim to address this gap by analyzing the possible linkage between musical interaction features and changes in depression score. In a clinical trial, digital piano improvisations from 58 Finnish clients and their therapists were recorded ove…

On Musical Identities, Social Pharmacology, and Intervention Timing in Music Therapy

How do antidepressants or recreational drugs influence the music experience in the context of therapy or during music performance and listening? Using drugs to enhance performance we can describe a complementary interaction between lifestyle, personal identity and drugs, influencing musical identities in creative processes. Treating depressed clients with individual psychodynamic music therapy (MT) worked well with those also taking anti-depressants, but also initiated a process in which the need for medication started to decrease. While antidepressants may help to keep anxiety, energy loss and rumination within limits, MT induces a process in which emotional limitations are likely to becom…

Individual music therapy for depression: randomised controlled trial

BackgroundMusic therapy has previously been found to be effective in the treatment of depression but the studies have been methodologically insufficient and lacking in clarity about the clinical model employed.AimsTo determine the efficacy of music therapy added to standard care compared with standard care only in the treatment of depression among working-age people.MethodParticipants (n= 79) with an ICD–10 diagnosis of depression were randomised to receive individual music therapy plus standard care (20 bi-weekly sessions) or standard care only, and followed up at baseline, at 3 months (after intervention) and at 6 months. Clinical measures included depression, anxiety, general functioning…

Music Therapy for Depression Enhanced With Listening Homework and Slow Paced Breathing: A Randomised Controlled Trial

Introduction: There is evidence from earlier trials for the efficacy of music therapy in the treatment of depression among working-age people. Starting therapy sessions with relaxation and revisiting therapeutic themes outside therapy have been deemed promising for outcome enhancement. However, previous music therapy trials have not investigated this issue.Objective: To investigate the efficacy of two enhancers, resonance frequency breathing (RFB) and listening homework (LH), when combined with an established music therapy model (trial registration number ISRCTN11618310).Methods: In a 2 × 2 factorial randomised controlled trial, working-age individuals with depression were allocated into gr…

sj-docx-1-pom-10.1177_03057356221084368 – Supplemental material for Musical interaction in music therapy for depression treatment

Supplemental material, sj-docx-1-pom-10.1177_03057356221084368 for Musical interaction in music therapy for depression treatment by Martin Hartmann, Anastasios Mavrolampados, Petri Toiviainen, Suvi Saarikallio, Katrien Foubert, Olivier Brabant, Nerdinga Snape, Esa Ala-Ruona, Christian Gold and Jaakko Erkkilä in Psychology of Music

Favouring emotional processing in improvisational music therapy through resonance frequency breathing: a single-case experimental study with a healthy client

Resonance frequency breathing (RFB) is a form of slow breathing at around six breaths/min, whose immediate effects are to substantially increase heart rate variability (HRV) and to reduce stress levels. Since RFB has already been successfully used on its own to treat various emotional disorders, we wanted to evaluate its effect on emotional processing when used as a preparatory intervention in improvisational music therapy. To do so, we performed a single-subject experimental study with a healthy participant. We hypothesised that RFB would serve both as an emotional catalyst and emotional regulator, the actual outcome depending on the client’s current issues and needs. The study consisted o…

The role of music in adolescents' mood regulation

The aim of this study was the exploration and theoretical clarification of the role of music in adolescents' mood regulation. The phenomenon was approached through an inductive theory construction. The data were gathered from eight adolescents by means of group interviews and follow-up forms, and were then analysed using constructive grounded theory methods. The analysis resulted in a theoretical model, which describes mood regulation by music as a process of satisfying personal mood-related goals through various musical activities. The general nature of the mood regulation is described, the goals and strategies of mood regulation are examined, and finally the specific role of music in moo…

Music and speech listening enhance the recovery of early sensory processing after stroke.

Abstract Our surrounding auditory environment has a dramatic influence on the development of basic auditory and cognitive skills, but little is known about how it influences the recovery of these skills after neural damage. Here, we studied the long-term effects of daily music and speech listening on auditory sensory memory after middle cerebral artery (MCA) stroke. In the acute recovery phase, 60 patients who had middle cerebral artery stroke were randomly assigned to a music listening group, an audio book listening group, or a control group. Auditory sensory memory, as indexed by the magnetic MMN (MMNm) response to changes in sound frequency and duration, was measured 1 week (baseline), 3…

The effect of resonance frequency breathing when used as a preparatory exercise in music psychotherapy : A single-case experimental study of a client with anxiety disorder

This study aimed at evaluating the possible benefits of starting Integrative Improvisational Music Therapy (IIMT) sessions with 10 min of Resonance Frequency Breathing (RFB), a type of slow breathing known to be beneficial for stress reduction and emotional regulation. A client diagnosed with anxiety disorder and social phobia attended 12 IIMT sessions. Using an alternating treatments design, RFB was systematically alternated with a control intervention (vibroacoustic therapy, VAT). Therapy processes were assessed through the Session Evaluation Questionnaire (SEQ) and the continuous measurement of heart rate variability (HRV), a biomarker of autonomic nervous system response. RFB was consis…

Effects of maternal singing during kangaroo care on maternal anxiety, wellbeing, and mother-infant relationship after preterm birth: a mixed methods study

Introduction: Preterm birth may disturb the typical development of the mother– infant relationship, when physical separation and emotional distress in the neonatal intensive care unit may increase maternal anxiety and create challenges for early interaction. This cluster-randomized controlled trial examined the effects of maternal singing during kangaroo care on mothers’ anxiety, wellbeing, and the early mother– infant relationship after preterm birth. Method: In the singing intervention group, a certified music therapist guided the mothers (n = 24) to sing or hum during daily kangaroo care during 33–40 gestational weeks (GW). In the control group, the mothers (n = 12) conducted daily kanga…

Mixed Methods Research in Music Therapy

Mixed Methods Research (MMR) combines different research methodologies in the same study with the goals of producing better and more profound knowledge of the phenomenon under investigation than use of a single method would achieve. Typically, both quantitative and qualitative approaches are employed in MMR. Music therapy is an example of a complex research area, where MMR can be considered a suitable way to capture and reflect the complexity of practice. There are many ways to understand and conduct MMR and the field is developing quickly. The chapter briefly describes MMR and its latest developments using examples of music therapy research in which MMR has been applied. Though MMR is a we…

Modelling the relationships between emotional responses to, and musical content of, music therapy improvisations

This article reports a study in which listeners were asked to provide continuous ratings of perceived emotional content of clinical music therapy improvisations. Participants were presented with 20 short excerpts of music therapy improvisations, and had to rate perceived activity, pleasantness and strength using a computer-based slider interface. A total of nine musical features relating to various aspects of the music (timing, register, dynamics, tonality, pulse clarity and sensory dissonance) were extracted from the excerpts, and relationships between these features and participants' emotion ratings were investigated. The data were analysed in three stages. First, inter-dimension correla…

Music therapeutic emotional processing (MEP): Expression, awareness, and pain predict therapeutic outcome

Successful emotional processing is pivotal for the therapeutic change, and music can support emotional processing. However, we know little on how music-based emotional processing actually predicts clinical outcomes. This study investigated music therapeutic emotional processing (MEP) as a predictor of therapeutic outcome in treatment for depression. Data consisted of self-reports of 64 clients (age range 19–57, 74% female) from a clinical trial (12 sessions) of integrative improvisational music therapy (IIMT). A 19-item MEP questionnaire was developed for assessing clients’ experiences after sessions. Emergent MEP factors were correlated with clients’ perceptions of the therapeutic value o…

Rhythmic exercises as tools for rehabilitation following cerebellar stroke: A case study integrating music therapy and physiotherapy techniques

Introduction: This article explores the use of music and multisensory stimuli in the construction of compensatory neural networks for motoric functioning in a patient recovering from cerebellar strokes (CS). This study aimed to address the real-world clinical concern of patients having a passive role in therapy, by arousing the client’s interest and self-motivation in rehabilitation. Method: The article presents a case study of a CS survivor, using data derived from rehabilitation sessions combining music therapy techniques with physiotherapy techniques to improve the fluency and accuracy of his motor performance. Qualitative and quantitative data are used to identify, describe, and evaluat…

Enhancing improvisational music therapy through the addition of resonance frequency breathing : Common findings of three single-case experimental studies

One core characteristic of active music therapy is the facilitation of emotional expression through the creation of music improvisations. In an attempt to further develop this approach, we created an enhanced form of integrative improvisational music therapy by including 10 minutes of resonance frequency breathing (RFB) at the beginning of the sessions. RFB is a type of slowbreathing known for its ability to reduce stress and support emotional regulation. This paper summarizes the common findings of three single-case experimental studies and introduces a provisional model to explain the observed effects of RFB. During the breathing itself, all three clients (two of them healthy and one diag…

Musiikin merkityksiä, vaikutuksia ja käyttötapoja musiikkipsykoterapiassa

Predicting Music Therapy Clients’ Type of Mental Disorder Using Computational Feature Extraction and Statistical Modelling Techniques

Background. Previous work has shown that improvisations produced by clients during clinical music therapy sessions are amenable to computational analysis. For example, it has been shown that the perception of emotion in such improvisations is related to certain musical features, such as note density, tonal clarity, and note velocity. Other work has identified relationships between an individual’s level of mental retardation and features such as amount of silence, integration of tempo with the therapist, and amount of dissonance. The present study further develops this work by attempting to predict music therapy clients’ type of mental disorder, as clinically diagnosed, from their improvisat…

Professional freedom : A grounded theory on the use of music analysis in psychodynamic music therapy

Although music is the fundamental element of music therapy, music analysis methods are a particularly under-researched area. This study investigates how and when psychodynamically orientated music therapists employ the analysis of musical material in both clinical work and research. Constructivist grounded theory was employed in the collection and analysis of the data. Eight participants, all highly experienced in psychodynamic music therapy, were recruited using referral sampling. In-depth interviews focused on therapists’ experiences of working with different client groups, and the applicability of different assessment methods. Strauss and Corbin’s coding paradigm was used to determine ca…

Shifting effects in randomised controlled trials of complex interventions: a new kind of performance bias?

Gold C, Erkkila J, Crawford MJ. Shifting effects in randomised controlled trials of complex interventions: a new kind of performance bias? Objective:  Randomised controlled trials (RCTs) aim to provide unbiased estimates of treatment effects. However, the process of implementing trial procedures may have an impact on the performance of complex interventions that rely strongly on the intuition and confidence of therapists. We aimed to examine whether shifting effects over the recruitment period can be observed that might indicate such impact. Method:  Three RCTs investigating music therapy vs. standard care were included. The intervention was performed by experienced therapists and based on …

Music therapy or music medicine?

Letter to the editor En kritisk kommentar til en artikel af V. Brandes et al (2010), som omtaler en undersøgelse som msuikterapi, selvom der tydeligvis er tale om musikmedicin. Brevet forsøger at præcisere begreberne i en international forksningskontekst.

The effect of improvisational music therapy on the treatment of depression: protocol for a randomised controlled trial

Abstract Background Music therapy is frequently offered to individuals suffering from depression. Despite the lack of research into the effects of music therapy on this population, anecdotal evidence suggests that the results are rather promising. The aim of this study is to examine whether improvisational, psychodynamically orientated music therapy in an individual setting helps reduce symptoms of depression and improve other health-related outcomes. In particular, attention will be given to mediator agents, such as musical expression and interaction in the sessions, as well as to the explanatory potential of EEG recordings in investigating emotion related music perception of individuals w…

Kun sanat eivät riitä – luovat terapiat

Keskitymme artikkelissamme kolmeen Suomessakin hyvin tunnettuun luovaan terapiaan: musiikki-, kuvataide- ja tanssi-liiketerapiaan. Tarkastelunäkökulmana on ilmaisu, toisin sanoen se, miten näissä terapioissa perustellaan musiikillisen, kuvallisen ja liikkeellisen ilmaisun käyttöä terapeuttisessa vuorovaikutuksessa. Luovilla terapioilla on paljon yhteistä, ja ne kaikki suhtautuvat lähestymistavan taustalla olevaan taiteeseen samantyyppisesti. Taiteelliset ilmaisukielet nähdään ennen sanoja olevana, kokonaisvaltaisena kehon ja mielen aktivoijana. Ne stimuloivat, rikastavat ja monin tavoin hyödyttävät terapeuttista työskentelyä. Ne eivät sulje sanallisen vuorovaikutuksen käyttöä pois vaan tuov…

sj-docx-1-pom-10.1177_03057356221084368 – Supplemental material for Musical interaction in music therapy for depression treatment

Supplemental material, sj-docx-1-pom-10.1177_03057356221084368 for Musical interaction in music therapy for depression treatment by Martin Hartmann, Anastasios Mavrolampados, Petri Toiviainen, Suvi Saarikallio, Katrien Foubert, Olivier Brabant, Nerdinga Snape, Esa Ala-Ruona, Christian Gold and Jaakko Erkkilä in Psychology of Music

Improvisaatiopohjainen yksilömusiikkiterapia masennuksen hoidossa : kontrolloitu, satunnainen tutkimus

Masennus on yleinen sairaus, joka vaikuttaa ihmisen elämään laaja-alaisesti, heikentäen muun muassa yksilön sosiaalisia taitoja ja vaikeuttaen kykyä tunnistaa ja ilmaista tunteita. Masennukseen liitetään myös vaikeudet ilmaista ja säädellä negatiivisia tunteita kuten vihaa. Tässä tutkimuksessa selvitettiin kliiniseen improvisaatioon perustuvan lyhytkestoisen musiikkiterapia-intervention lisäarvoa Käypä hoidon mukaiseen masennuksen hoitoon (engl. standard care, jatkossa Se) lisättynä verrattuna pelkkään se hoitoon. Psykiatriset arviot toteutettiin sekä koe- että kontrolliryhmille lähtötilanteessa ennen satunnaistamista, sekä kolmen kuukauden (musiikkiterapiaintervention jälkeen) ja kuuden ku…

The effect of improvisational music therapy on the treatment of depression: protocol for a randomised controlled trial

Background. Music therapy is frequently offered to individuals suffering from depression. Despite the lack of research into the effects of music therapy on this population, anecdotal evidence suggests that the results are rather promising. The aim of this study is to examine whether improvisational, psychodynamically orientated music therapy in an individual setting helps reduce symptoms of depression and improve other health-related outcomes. In particular, attention will be given to mediator agents, such as musical expression and interaction in the sessions, as well as to the explanatory potential of EEG recordings in investigating emotion related music perception of individuals with depr…