A Brief Music App to Address Pain in the Emergency Department: Prospective Study

Abstract courtesy of Neuromusic News, Fondazione Mariani
J Med Internet Res 2020 May 20;22(5):e18537
A brief music app to address pain in the emergency department: prospective study
Chai PR1,2,3,4, Schwartz E5, Hasdianda MA6, Azizoddin DR2, Kikut A6, Jambaulikar GD6, Edwards RR5, Boyer EW1,4, Schreiber KL5
1 Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, USA; 2 Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, USA; 3 The Koch Institute for Integrated Cancer Research, Massachusetts Institute of Technology, Boston, MA, USA; 4 The Fenway Institute, Boston, MA, USA; 5 Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, USA; 6 Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, USA

Emergency physicians face the challenge of relieving acute pain daily. While opioids are a potent treatment for pain, the opioid epidemic has ignited a search for nonopioid analgesic alternatives that may decrease the dose or duration of opioid exposure. While behavioral therapies and complementary medicine are effective, they are difficult to deploy in the emergency department. Music is a potential adjunctive therapy that has demonstrated effectiveness in managing pain. Our objective was to understand the feasibility and potential for an effect of a novel music app to address acute pain and anxiety in patients admitted to an emergency department observation unit. This prospective cohort study enrolled patients admitted to an emergency department observation unit with pain who had received orders for opioids. We gathered baseline pain and psychosocial characteristics including anxiety, sleep disturbance, and pain catastrophizing using validated questionnaires. Participants received a smartphone-based music intervention and listened to the music in either a supervised (research assistant-delivered music session 3 times during their stay) or unsupervised manner (music used ad lib by participant). The app collected premusic and postmusic pain and anxiety scores, and participants provided qualitative feedback regarding acceptability of operating the music intervention. We enrolled 81 participants and randomly assigned 38 to an unsupervised and 43 to a supervised group. Mean pain in both groups was 6.1 (1.8) out of a possible score of 10. A total of 43 (53%) reported previous use of music apps at home. We observed an overall modest but significant decrease in pain (mean difference -0.81, 95% CI -0.45 to -1.16) and anxiety (mean difference -0.72, 95% CI -0.33 to -1.12) after music sessions. Reduction of pain and anxiety varied substantially among participants. Individuals with higher baseline pain, catastrophizing (about pain), or anxiety reported greater relief. Changes in pain were correlated to changes in anxiety (Pearson ρ=0.3, P=.02) but did not vary between supervised and unsupervised groups. Upon conclusion of the study, 46/62 (74%) reported they liked the music intervention, 57/62 (92%) reported the app was easy to use, and 49/62 (79%) reported they would be willing to use the music intervention at home. A smartphone-based music intervention decreased pain and anxiety among patients in an emergency department observation unit, with no difference between supervised and unsupervised use. Individuals reporting the greatest reduction in pain after music sessions included those scoring highest on baseline assessment of catastrophic thinking, suggesting there may be specific patient populations that may benefit more from using music as an analgesic adjunct in the emergency department. Qualitative feedback suggested that this intervention was feasible and acceptable by emergency department patients.
and for our Italian friends…
I medici di emergenza affrontano la sfida di alleviare il dolore acuto ogni giorno. Nonostante gli oppioidi siano un potente trattamento per il dolore, l’epidemia di oppioidi ha dato il via alla ricerca di alternative analgesiche che possano ridurre la dose o la durata dell’esposizione agli oppioidi. Se da un lato le terapie comportamentali e la medicina complementare sono efficaci, dall’altro sono difficili da implementare nei dipartimenti di emergenza. La musica è una potenziale terapia aggiuntiva che ha dimostrato efficacia nella gestione del dolore. L’obiettivo degli Autori era comprendere la fattibilità e il potenziale di effetto di una nuova app musicale per affrontare il dolore acuto e l’ansia nei pazienti ricoverati in un’unità di osservazione del dipartimento di emergenza. Questo studio prospettico di coorte ha arruolato pazienti ricoverati in un’unità di osservazione del pronto soccorso con dolore che avevano ricevuto prescrizioni di oppioidi. Gli Autori hanno raccolto dati sul dolore di base e le caratteristiche psicosociali tra cui ansia, disturbi del sonno e dolore catastrofico usando questionari validati. I partecipanti hanno ricevuto un intervento musicale basato su smartphone e hanno ascoltato la musica in modo supervisionato (fornito da un assistente di ricerca 3 volte durante il loro soggiorno) o in modo non supervisionato (musica utilizzata a piacere dal partecipante). L’app raccoglieva i punteggi di dolore e ansia pre-musica e post-musica e i partecipanti fornivano un feedback qualitativo sull’accettabilità dell’utilizzo dell’intervento musicale. Gli Autori hanno arruolato 81 partecipanti e assegnati casualmente 38 a un gruppo non supervisionato e 43 a un gruppo supervisionato. Il dolore medio in entrambi i gruppi era 6,1 (1,8) su un possibile punteggio di 10. Un totale di 43 (53%) ha riferito di un precedente utilizzo di app musicali a casa. Gli Autori hanno osservato una riduzione complessivamente modesta ma significativa del dolore (differenza media da -0,81, 95% Cl da -0,45 a -1,16) e dell’ansia (differenza media da -0,72, 95% Cl da -0,33 a -1,12) dopo le sessioni di musica. La riduzione del dolore e dell’ansia variava sostanzialmente tra i partecipanti. Gli individui con dolore basale più elevato, pensiero catastrofico (riguardo al dolore) o ansia hanno riportato un maggiore sollievo. I cambiamenti nel dolore erano correlati ai cambiamenti dell’ansia (Pearson p=0,3, P=.02), ma non variavano tra gruppi supervisionati e non supervisionati. Al termine dello studio, 46/62 (74%) hanno riferito di apprezzare l’intervento musicale, 57/62 (92%) hanno riferito che l’app era facile da usare e 49/62 (79%) hanno riferito che sarebbero stati disposti a usare l’intervento musicale a casa. Un intervento musicale basato su smartphone ha ridotto il dolore e l’ansia tra i pazienti in un’unità di osservazione del dipartimento di emergenza, senza alcuna differenza tra l’uso supervisionato e non supervisionato. Gli individui che hanno riportato la maggiore riduzione del dolore dopo le sessioni di musica includevano quelli che hanno ottenuto il punteggio più alto nella valutazione basale del pensiero catastrofico, suggerendo che potrebbero esserci popolazioni specifiche di pazienti che potrebbero trarre maggiori benefici dall’uso della musica come aggiunta analgesica nel dipartimento di emergenza. Il feedback qualitativo ha suggerito che questo intervento era fattibile e accettabile dai pazienti del pronto soccorso.

Full article access

Published on 20.05.20 in Vol 22, No 5 (2020): May

Chai PR, Schwartz E, Hasdianda MA, Azizoddin DR, Kikut A, Jambaulikar GD, Edwards RR, Boyer EW, Schreiber KL
A Brief Music App to Address Pain in the Emergency Department: Prospective Study
J Med Internet Res 2020;22(5):e18537
URL: https://www.jmir.org/2020/5/e18537
DOI: 10.2196/18537
PMID: 32432550
PMCID: 7270860

Music as a Regulator of Emotion: Three Case Studies

Happy to share my first academic publication from the July issue of Music & Medicine! Article includes my work from UC San Diego on musical intensity and self-harming behaviors as well as 3 case studies illustrating how music can be used in life-preserving ways. Conducting this research was one of the most challenging and meaningful endeavors of my life, and I’m honored to see these individuals’ powerful stories shared.

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Music and dementia: individual differences in response to personalized playlists

Abstract courtesy of Neuromusic News, Fondazione Mariani

Music and dementia: individual differences in response to personalized playlists
Journal of Alzheimers Disease 2018 Jun 23

Garrido S, Stevens CJ, Chang E, Dunne L, Perz J
MARCS Institute for Brain, Behaviour & Development, Western Sydney University, Sydney, Australia

Personalized music playlists are increasingly being used in health-care contexts to address the psychological and behavioral symptoms in people with dementia. However, there is little understanding of how people with different mental health histories and symptoms respond differently to music. A factorial experiment was conducted to investigate the influence of depression, anxiety, apathy, and cognitive decline on affective response to music. Ninety-nine people with dementia listened to three music playlists based on personal preferences. Activation of facial action units and behavioral observation were measured continuously. Results demonstrated that people with high levels of depression and with symptoms of Alzheimer’s type dementia demonstrated increased levels of sadness when listening to music. People with low depression but high levels of apathy demonstrated the highest behavioral evidence of pleasure during music listening, although behavioral evidence declined with severity of cognitive decline. It is concluded that as well as accounting for personal preferences, music interventions for people with dementia need to take mental health history and symptoms into account.

And for our Italian friends:

Una playlist di musica personalizzata è un metodo sempre più utilizzato nei contesti di cura per risolvere problemi di natura psicologica o comportamentale in persone con demenza. Tuttavia, non è chiaro come persone con differenti storie di malattia mentale rispondano in modo diverso alla musica. È stato condotto un esperimento fattoriale per investigare il ruolo della depressione, dell’ansia, dell’apatia e del declino cognitivo nella risposta emotiva alla musica. 99 soggetti affetti da demenza sono stati esposti all’ascolto di tre diverse playlist musicali basate sulle preferenze personali. L’attivazione di unità di azione facciale e l’osservazione comportamentale sono state misurate di continuo. I risultati evidenziano che le persone con alti livelli di depressione e con segni tipici della demenza di Alzheimer mostravano un incremento dei segni di tristezza quando ascoltavano la musica. Le persone con basso punteggio di depressione, ma con alto livello di apatia mostravano la più significativa evidenza di piacere durante l’ascolto della musica, sebbene gli indici comportamentali declinassero con l’aumento del declino cognitivo. Gli Autori concludono che, oltre a considerare le preferenze personali, gli interventi musicali per i pazienti affetti da Alzheimer debbano tenere in considerazione anche la loro storia clinica e i sintomi.

Full article access

DOI: 10.3233/JAD-180084
Journal: Journal of Alzheimer’s Disease, vol. 64, no. 3, pp. 933-941, 2018

SMPC 2017 Photo Recap

 

SMPC2017 LOGO

This year, I had the privilege of serving as event photographer and social media chair for the annual meeting of the Society for Music Perception and Cognition. I am happy to share that the official #SMPC2017 flickr is now online! Feel free to download, tag, and share your memories from this year’s conference. Link for sharing: https://flic.kr/s/aHsm5Qgj2M

Here’s the slideshow I put together of the conference photos. If you were in attendance, it was the video shown during the banquet Wednesday night.

Hope everyone had a blast at SMPC 2017! Happy viewing!

 

SMPC official logo

Abstract: Nonmusician with severe Alzheimer’s dementia learns a new song

Via Fondazione Mariani, from Neurocase 2017 Feb;23(1):36-40

A nonmusician with severe Alzheimer’s dementia learns a new song

Baird A, Umbach H, Thompson WF 
Australian Research Council Centre of Excellence in Cognition and its Disorders and Psychology Department, Macquarie University, Sydney, Australia

The hallmark symptom of Alzheimer’s Dementia (AD) is impaired memory, but memory for familiar music can be preserved. We explored whether a non-musician with severe AD could learn a new song. A 91 year old woman (NC) with severe AD was taught an unfamiliar song. We assessed her delayed song recall (24 hours and 2 weeks), music cognition, two word recall (presented within a familiar song lyric, a famous proverb, or as a word stem completion task), and lyrics and proverb completion. NC’s music cognition (pitch and rhythm perception, recognition of familiar music, completion of lyrics) was relatively preserved. She recalled 0/2 words presented in song lyrics or proverbs, but 2/2 word stems, suggesting intact implicit memory function. She could sing along to the newly learnt song on immediate and delayed recall (24 hours and 2 weeks later), and with intermittent prompting could sing it alone. This is the first detailed study of preserved ability to learn a new song in a non-musician with severe AD, and contributes to observations of relatively preserved musical abilities in people with dementia.

For our Italian friends:

Il sintomo caratteristico della demenza senile di Alzheimer (AD) è la memoria compromessa, ma i ricordi di melodie familiari possono essere preservati. Gli Autori hanno indagato se un non-musicista affetto da una grave forma di AD potesse imparare una nuova canzone. A una donna di 91 anni (NC) malata gravemente di AD è stata insegnata una canzone che non conosceva. I ricercatori hanno valutato il tempo di recupero differito della canzone (24 ore e 2 settimane), la cognizione della musica, il richiamo di due parole (presentate all’interno del testo di una canzone a lei familiare, in un proverbio famoso oppure come la radice di una parola da completare), e la capacità di completare un testo e un proverbio. La cognizione musicale di NC (percezione dell’altezza e del ritmo, riconoscimento di una musica familiare, completamento del testo delle parole) si è dimostrata relativamente conservata. La paziente ha recuperato 0 parole su 2 presentate nel testo della canzone o nei proverbi, ma è riuscita a richiamare 2 su 2 radici delle parole, suggerendo quindi funzioni intatte della memoria implicita. Ha potuto cantare sia eseguendo sul momento la canzone appena imparata, sia dopo un richiamo ritardato (24 ore e 2 settimane dopo) e, con un prompt intermittente, è riuscita a cantare da sola. Questo è il primo studio dettagliato sull’abilità conservata di imparare una nuova canzone nei non musicisti affetti da severe forme di AD, e fornisce un contributo alle osservazioni relative alle preservate abilità musicali nelle persone affette da demenza.

Full article may be found here.

Baird, A., Umbach, H., & Thompson, W. F. (2017). A nonmusician with severe Alzheimer’s dementia learns a new song. Neurocase, 23(1), 36-40.

ICMPC Poster: Musical Intensity in Affect Regulaton: Interventons in Self-Harming Behavior

In partial fulfillment of my graduate thesis, this poster represents the findings of my study conducted at the University of California, San Diego. Presented July 5, 2016 at the 14th International Conference on Music Perception and Cognition in San Francisco.

For full study, see chapter 2 of my thesis.

For PDF, see HERELD poster ICMPC.

Abstract:

Prior research associates listening to heavy music with reduced suicide risk, especially among teenage girls when utilized for vicarious release. Nevertheless, few studies consider the active use of heavy music in self-regulation for those who suffer from thoughts of self-harm and/or mental illness. In order to to better understand the mechanisms by which engaging with heavy and intense music may circumvent self-harming behavior, a pilot study is presented of 283 subjects. The majority of those surveyed report suffering from thoughts of self-harm or mental disorders. To examine the use of affect regulation via both generic (non-specified) and heavy, intense, and highly emotive music, we created the Music in Affect Regulation Questionnaire (MARQ), utilizing music in mood regulation (MMR) strategies from the work of Saarikallio. We identify heavy music by the presence of capacious, distorted riffs; loud, pervasive percussion; or an overall feeling of ‘raw power,’ emotion, and affective intensity stemming from the instrumental or vocal parts. Our findings collectively show that heavy music listeners (and those who have thoughts of self-harm, in particular) interact with definitively heavy, intense, or highly emotive music differently than with generic music, especially in the use of modulating negative mood. These findings seem less related to genre-specific categories than certain musical commonalities collectively understood as intensity, and provide significant evidence for heavy music’s ability to circumvent self-destructive impulses, especially when applied in tandem with specific listening strategies of affect-regulation. Additional evidence from prior case studies further suggests the value of deeper investigation of the conscientious use of heavy music as a potential intervention for those suffering from affect dysregulation and self-harm.

HERELD ICMPC

Musical Intensity in Affect Regulaton: Interventons in Self-Harming Behavior

Help Fund My Thesis Research in Music, Mind, and the Brain

1511649_10100770379146070_1472478529_oHello all! Sincerest apologies for the severe lack of content over the past year or so. I have been tucked away studying music and psychology at UCSD, and who knew: grad school can be time-consuming! Luckily, I’m unwaveringly passionate about what I have been privileged to research, and I’ve enjoyed…well, many moments 🙂

To come to the point, I’d like to ask a bit of support in order to finish my thesis. In 2011, I received generous support from you all to attend my first conference surrounding music and the brain. Five years later, I find myself again in need of assistance to conduct research in my field. This time, however, your help will fund the final steps for completion of my thesis: broadly approaching how music might be used to combat and intervene in young people who struggle with self-destructive behavior. I have an immense faith in music’s capacity to heal, transform, and even save lives.

Taking place in 3 weeks, I have been invited to participate and present my research in the UK in Epigenesis and Philosophy: A Workshop on the Work of Catherine Malabou. This event brings together scholars in both the humanities and natural sciences. We will engage in critical discussion regarding our work in tandem with the work of the aforementioned French philosopher widely known for her ideas which merge philosophy, neuroscience, and psychoanalysis. Some of you may recall my enthusiasm for her work on plasticity as the catalyst for my decision to pursue graduate studies in how music may be used as a healing tool. I have since been lucky enough to converse with Catherine on a number of occasions, and she remains a primary source of inspiration and critical analysis in the wake of her timely question “What Should We Do With Our Brain?”

As a graduate student, I have been obscenely blessed with a fellowship that allows me to study in a wonderful program. Last year, I was awarded graduate travel stipends that allowed me to present my work locally and abroad. Unfortunately, the financial situation in my department is quite different this year, and it seems what few resources were available have been exhausted. Participation in the upcoming workshop would be a tremendous aid in research for the thesis (which must be completed by May of this year for graduation in June). The budget including air travel, ground transportation, food and lodging comes to around $1,700. 

Funding this vital research not only supports completion of my graduate thesis — it furthers investigation of the transformative healing, powers I believe music can have on the mind. Please consider joining others who have donated here and help us make the largest impact possible.

Give to this research

 

For information on the types of research I do, please feel free to contact me at dhereld@ucsd.edu or visit any of the sites below:

Abstract – Recovering the Voice Through Sonic Gesture: Contending the Annihilation of Self

Paper – Heavy and Light: Uncovering resilience and positive affect in extreme music

As The Spirit Wanes, or The Hope of Plasticity

Thank you so much for your support!

 

 

The change of music preferences following the onset of a mental disorder

Mental Illness 2015 Jun 18;7(1):5784
The change of music preferences following the onset of a mental disorder

Gebhardt S (1), von Georgi R (2)

1 Department of Psychiatry and Psychotherapy, University of Marburg, Germany; 2 Department of Music Science and Music Education, University of Giessen, Germany ; International Psychoanalytic University of Berlin, Germany

A psychiatric population (n=123) was examined on how music preferences had changed after the onset of a mental disorder. Most patients did not change their previous music preference; this group of patients considered music helpful for their mental state, showed more attractivity and enforcement as personality traits and used music more for emotion modulation. Patients who experienced a preference shift reported that music had impaired them during the time of illness; these patients showed less ego-strength, less confidence and less enforcement and used music less for arousal modulation. A third subgroup stopped listening to music completely after the onset of the mental disorder; these patients attribute less importance to music and also reported that music had impaired their mental state. They showed more ego-strength and used music less for emotion modulation. The results suggest that the use of music in everyday life can be helpful as an emotion modulation strategy. However, some patients might need instructions on how to use music in a functional way and not a dysfunctional one. Psychiatrists and psychotherapists as well as music therapists should be aware of emotion modulation strategies, subjective valence of music and personality traits of their patients. Due to the ubiquity of music, psychoeducative instructions on how to use music in everyday life plays an increasing role in the treatment of mental illness.

Versione Italiana

Una popolazione psichiatrica di 123 persone è stata esaminata per indagare il modo in cui le loro preferenze musicali sono cambiate dopo l’insorgenza della patologia mentale. La maggior parte dei pazienti considerava la musica di aiuto al proprio stato mentale, mostravano più tratti di personalità di attrattività e applicazione, usavano la musica soprattutto per la modulazione delle emozioni. I pazienti che sperimentavano un cambiamento delle preferenze riportavano che la musica li aveva in qualche modo toccati negativamente nel momento della malattia. Questi pazienti riportavano minore autostima e fiducia e usavano meno la musica per la modulazione delle emozioni. Il terzo gruppo riferiva di aver interrotto l’ascolto della musica dopo l’inizio della malattia mentale e attribuivano meno importanza alla musica che a loro avviso aveva influenzato negativamente lo stato mentale. I risultati suggeriscono che l’uso della musica nella vita di tutti i giorni possa essere utile come strategia di modulazione delle emozioni. In ogni caso, alcuni pazienti necessitano di essere indirizzati sul modo in cui devono usare la musica in un modo funzionale e non disfunzionale. Gli psichiatri e gli psicoterapisti così come i musicoterapisti dovrebbero essere informati circa le strategie di controllo e modulazione delle emozioni, della valenza soggettiva della musica e dei tratti della personalità dei loro pazienti. Dal momento che la musica è ubiquitaria, una guida psicoeducativa su come utilizzarla è sempre più necessaria per il trattamento delle patologie psichiatriche.

For full article, please visit NCBI online.

Gebhardt, S., & von Georgi, R. (2015). The Change of Music Preferences Following the Onset of a Mental Disorder. Mental Illness, 7(1), 5784. doi:10.4081/mi.2015.5784

Call for Papers: “Atrocity Exhibition”: A two day symposium on Joy Division

This just in, under “It doesn’t get any cooler than this” …

The Society for Enthnomusicology recently announced a two day symposium revolving around Joy Division. Call for abstracts found below, taken directly from the SEM website.

Kevin Cummins, Getty Images

Ian Curtis in Manchester, 1979. Kevin Cummins, Getty Images.

“Atrocity Exhibition”:

A two day symposium on Joy Division

Wednesday & Thursday, 25th -26th November 2015, University of Limerick, Ireland

Following on from successful international symposia on The Smiths, Morrissey, Riot Grrrl, David Bowie, and Songs of Social Protest, the research cluster ‘Popular Music and Popular Culture’, at the University of Limerick, Ireland, is convening a two day symposium to examine the significant contribution of Joy Division to popular music and culture.

In addition, we are pleased to announce that our research cluster in association with Dolans, Limerick, presents A “JOY DIVISION” CELEBRATION: Peter Hook and The Light performing Unknown Pleasures & Closer, and featuring an opening set of New Order material in Dolans Warehouse, Limerick on Thursday, November 26th 2015.

This is an open-call for papers. We invite scholars working across a range of disciplines and approaches (such as, cultural studies, ethnomusicology, musicology, media studies, popular music studies, urban studies, fan studies and sociology) to propose papers on the lasting cultural / musical legacy of Joy Division. Papers for example might consider:

• Joy Division and the creation of a distinct Manchester Soundscape • Styling and Iconography (Album and single sleeves, promotional photographs etc) • The lyrical / musicological / performance analysis of specific songs • Fandom and the ‘cult’ of Ian Curtis • Influences on and legacy of Joy Division • The visual analysis of specific videos / live performances

Please submit a Word document containing your paper title, a 250 word abstract, and author information including full name, institutional affiliation, email address, and a 50-word bio to popmusicandculture@ul.ie by 31st July 2015. A maximum of 30 minutes will be allocated to each conference paper (20 minutes for presentation and 10 minutes for questions). Panel proposals (three presenters – 90 minutes) should include a 150 word overview and 250 word individual abstracts (plus author information listed above). We also welcome proposals for workshops, film screenings, performances etc. Notifications regarding acceptance will be sent byAugust17th 2015.

Planned Academic Outputs:

It is intended to publish an edited and refereed book based on a selection of the symposium’s papers.

Symposium Conveners:

Dr. Martin Power, Dept. of Sociology, University of Limerick.

Dr. Eoin Devereux, Dept. of Sociology, University of Limerick.

Dr. Aileen Dillane, Irish World Academy of Music and Dance, University of Limerick.

For further information please see the events page on www.ul.ie/pmpc or contactpopmusicandculture@ul.ie ‘Popular Music and Popular Culture’ is an interdisciplinary research cluster based at the University of Limerick, Ireland, which provide a platform for researchers working within sociology, ethnomusicology, cultural studies, sociolinguistics, to come together to advance their shared interest in the critical analysis of popular music and popular culture and the elucidation of their social meaning, significance and material impacts.