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Abera M, Hanlon C, Daniel B, Tesfaye M, Workicho A, Girma T, Wibaek R, Andersen GS, Fewtrell M, Filteau S, Wells JCK. Effects of relaxation interventions during pregnancy on maternal mental health, and pregnancy and newborn outcomes: A systematic review and meta-analysis. PLoS One 2024; 19:e0278432. [PMID: 38271440 PMCID: PMC10810490 DOI: 10.1371/journal.pone.0278432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/23/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Stress during pregnancy is detrimental to maternal health, pregnancy and birth outcomes and various preventive relaxation interventions have been developed. This systematic review and meta-analysis aimed to evaluate their effectiveness in terms of maternal mental health, pregnancy and birth outcomes. METHOD The protocol for this review is published on PROSPERO with registration number CRD42020187443. A systematic search of major databases was conducted. Primary outcomes were maternal mental health problems (stress, anxiety, depression), and pregnancy (gestational age, labour duration, delivery mode) and birth outcomes (birth weight, Apgar score, preterm birth). Randomized controlled trials or quasi-experimental studies were eligible. Meta-analyses using a random-effects model was conducted for outcomes with sufficient data. For other outcomes a narrative review was undertaken. RESULT We reviewed 32 studies comprising 3,979 pregnant women aged 18 to 40 years. Relaxation interventions included yoga, music, Benson relaxation, progressive muscle relaxation (PMR), deep breathing relaxation (BR), guided imagery, mindfulness and hypnosis. Intervention duration ranged from brief experiment (~10 minutes) to 6 months of daily relaxation. Meta-analyses showed relaxation therapy reduced maternal stress (-4.1 points; 95% Confidence Interval (CI): -7.4, -0.9; 9 trials; 1113 participants), anxiety (-5.04 points; 95% CI: -8.2, -1.9; 10 trials; 1965 participants) and depressive symptoms (-2.3 points; 95% CI: -3.4, -1.3; 7 trials; 733 participants). Relaxation has also increased offspring birth weight (80 g, 95% CI: 1, 157; 8 trials; 1239 participants), explained by PMR (165g, 95% CI: 100, 231; 4 trials; 587 participants) in sub-group analysis. In five trials evaluating maternal physiological responses, relaxation therapy optimized blood pressure, heart rate and respiratory rate. Four trials showed relaxation therapy reduced duration of labour. Apgar score only improved significantly in two of six trials. One of three trials showed a significant increase in birth length, and one of three trials showed a significant increase in gestational age. Two of six trials examining delivery mode showed significantly increased spontaneous vaginal delivery and decreased instrumental delivery or cesarean section following a relaxation intervention. DISCUSSION We found consistent evidence for beneficial effects of relaxation interventions in reducing maternal stress, improving mental health, and some evidence for improved maternal physiological outcomes. In addition, we found a positive effect of relaxation interventions on birth weight and inconsistent effects on other pregnancy or birth outcomes. High quality adequately powered trials are needed to examine impacts of relaxation interventions on newborns and offspring health outcomes. CONCLUSION In addition to benefits for mothers, relaxation interventions provided during pregnancy improved birth weight and hold some promise for improving newborn outcomes; therefore, this approach strongly merits further research.
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Affiliation(s)
- Mubarek Abera
- Department of Psychiatry, Faculty of Medical Science, Jimma University, Jimma, Ethiopia
| | - Charlotte Hanlon
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Beniam Daniel
- School of Nursing, College of Medicine and Health Sciences, Arbaminch University, Arbaminch, Ethiopia
| | - Markos Tesfaye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Abdulhalik Workicho
- Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Tsinuel Girma
- Department of Pediatrics, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | - Rasmus Wibaek
- Clinical Epidemiology Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Gregers S. Andersen
- Clinical Epidemiology Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Mary Fewtrell
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Suzanne Filteau
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jonathan C. K. Wells
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
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Korošec K, Osika W, Bojner-Horwitz E. "It is more Important than food sometimes"; Meanings and Functions of Music in the Lives of Autistic Adults Through a hermeneutic-phenomenological Lense. J Autism Dev Disord 2024; 54:366-378. [PMID: 36323990 DOI: 10.1007/s10803-022-05799-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
Subjective experiences of autistic adults remain under-researched, especially in the field of art. To learn more about their uses and functions of music, we interviewed 13 autistic adults and through a hermeneutic-phenomenological analysis found four overarching themes: Well-being, Identity and self-development, Connectedness, and Negative experiences. Findings show a broad and deep meaning of music in their lives, spanning from seemingly trivial functions such as making chores more enjoyable, to existential questions, such as choosing to stay alive. We discuss the often-overlooked negative effects or experiences of music, noting that positive and negative effects must always be addressed together if we are to use music to lower stress and support well-being.
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Affiliation(s)
- Kaja Korošec
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Norra stationsgatan 69, plan 7, 113 64, Stockholm, Sweden.
- Department of Music, Pedagogy and Society, Royal College of Music, Stockholm, Sweden.
- Center for Social Sustainability, Institution of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
| | - Walter Osika
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Norra stationsgatan 69, plan 7, 113 64, Stockholm, Sweden
- Center for Social Sustainability, Institution of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Eva Bojner-Horwitz
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institute, Norra stationsgatan 69, plan 7, 113 64, Stockholm, Sweden
- Department of Music, Pedagogy and Society, Royal College of Music, Stockholm, Sweden
- Center for Social Sustainability, Institution of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Head JH, Orme WH. Applying Principles of Mentalizing Based Therapy to Music Therapy Methods. ARTS IN PSYCHOTHERAPY 2023. [DOI: 10.1016/j.aip.2023.102017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
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Christensen J, Slavik L, Nicol JJ, Loehr JD. Alpha oscillations related to self-other integration and distinction during live orchestral performance: A naturalistic case study. PSYCHOLOGY OF MUSIC 2023; 51:295-315. [PMID: 36532616 PMCID: PMC9751440 DOI: 10.1177/03057356221091313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Ensemble music performance requires musicians to achieve precise interpersonal coordination while maintaining autonomous control over their own actions. To do so, musicians dynamically shift between integrating other performers' actions into their own action plans and maintaining a distinction between their own and others' actions. Research in laboratory settings has shown that this dynamic process of self-other integration and distinction is indexed by sensorimotor alpha oscillations. The purpose of the current descriptive case study was to examine oscillations related to self-other integration and distinction in a naturalistic performance context. We measured alpha activity from four violinists during a concert hall performance of a 60-musician orchestra. We selected a musical piece from the orchestra's repertoire and, before analyzing alpha activity, performed a score analysis to divide the piece into sections that were expected to strongly promote self-other integration and distinction. In line with previous laboratory findings, performers showed suppressed and enhanced alpha activity during musical sections that promoted self-other integration and distinction, respectively. The current study thus provides preliminary evidence that findings from carefully controlled laboratory experiments generalize to complex real-world performance. Its findings also suggest directions for future research and potential applications of interest to musicians, music educators, and music therapists.
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Affiliation(s)
| | - Lauren Slavik
- Department of Psychology, University of Saskatchewan, Saskatoon, Canada
| | - Jennifer J Nicol
- Department of Educational Psychology and Special Education, University of Saskatchewan, Saskatoon, Canada
| | - Janeen D Loehr
- Department of Psychology, University of Saskatchewan, Saskatoon, Canada
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J L, E P, X Z, QN L, A G, F L, Y W, M F. A Cross-Cultural Randomized Pilot Trial of Western-based and Five Elements Music Therapy for Psychological Well-being. Explore (NY) 2022:S1550-8307(22)00205-1. [DOI: 10.1016/j.explore.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/22/2022] [Accepted: 11/01/2022] [Indexed: 11/11/2022]
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Brancatisano O, Baird A, Thompson WF. Why is music therapeutic for neurological disorders? The Therapeutic Music Capacities Model. Neurosci Biobehav Rev 2020; 112:600-615. [PMID: 32050086 DOI: 10.1016/j.neubiorev.2020.02.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 02/04/2020] [Accepted: 02/08/2020] [Indexed: 12/19/2022]
Abstract
Music has cognitive, psychosocial, behavioral and motor benefits for people with neurological disorders such as dementia, stroke, Parkinson's disease (PD) and Autism Spectrum Disorder (ASD). Here we discuss seven properties or 'capacities' of music that interact with brain function and contribute to its therapeutic value. Specifically, in its various forms, music can be engaging, emotional, physical, personal, social and persuasive, and it promotes synchronization of movement. We propose the Therapeutic Music Capacities Model (TMCM), which links individual properties of music to therapeutic mechanisms, leading to cognitive, psychosocial, behavioral and motor benefits. We review evidence that these capacities have reliable benefits for people with dementia, stroke, PD and ASD when employed separately or in combination. The model accounts for the profound value that music affords human health and well-being and provides a framework for the development of non-pharmaceutical treatments for neurological disorders.
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Affiliation(s)
- Olivia Brancatisano
- Department of Psychology and Centre for Ageing, Cognition, and Wellbeing, Macquarie University, Sydney, Australia
| | - Amee Baird
- Department of Psychology and Centre for Ageing, Cognition, and Wellbeing, Macquarie University, Sydney, Australia
| | - William Forde Thompson
- Department of Psychology and Centre for Ageing, Cognition, and Wellbeing, Macquarie University, Sydney, Australia.
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Kishita N, Backhouse T, Mioshi E. Nonpharmacological Interventions to Improve Depression, Anxiety, and Quality of Life (QoL) in People With Dementia: An Overview of Systematic Reviews. J Geriatr Psychiatry Neurol 2020; 33:28-41. [PMID: 31203712 DOI: 10.1177/0891988719856690] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This overview aimed to systematically synthesize evidence from existing systematic reviews to signpost practitioners to the current evidence base on nonpharmacological interventions to improve depression, anxiety, and quality of life (QoL) in people with dementia and to discuss priorities for future research. The databases MEDLINE, PsycINFO, Scopus, and Cochrane Central Register of Controlled Trials were searched in August 2017 with an updated search in January 2019. Fourteen systematic reviews of randomized controlled trials of nonpharmacological interventions were identified. Dementia stage was rated moderate or severe in the majority of the reviews and type of dementia varied. Interventions reported to be effective were cognitive stimulation (QoL: standardized mean difference [SMD] = 0.38), music-based therapeutic interventions (depression: SMD = -0.27, anxiety: SMD = -0.43, QoL: SMD = 0.32), and psychological treatments (mainly cognitive behavior therapy; depression: SMD = -0.22, anxiety: MD = -4.57). Although health-care professionals are recommended to continue using these approaches, future research needs to focus on the type and form of interventions that are most effective for different stages and types of dementia.
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Affiliation(s)
- Naoko Kishita
- School of Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Tamara Backhouse
- School of Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Eneida Mioshi
- School of Health Sciences, University of East Anglia, Norwich, United Kingdom
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The effects of music therapy on the interaction of the self and emotions-An interim analysis. Complement Ther Med 2018; 41:61-66. [PMID: 30477866 DOI: 10.1016/j.ctim.2018.08.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 08/27/2018] [Accepted: 08/31/2018] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES Music therapy is a well-established non-verbal treatment method in psychiatry and psychosomatic medicine. However, empirical data of its impact on emotion modulation processes and personality dimensions are still sparce. An interesting concept is the use of music for emotion modulation in everyday life. The purpose of this interim study was to assess the interplay of personality dimensions and emotion modulation strategies in patients treated with music therapy versus patients without music therapy. DESIGN A cross-sectional design was used. SETTING The study was conducted during the course of inpatient treatment in a general psychiatric hospital. Data from n = 137 patients was included in the analysis. MAIN OUTCOME MEASURES According to the mediator model a regression analysis was performed using personality variables as potential predictors and emotion modulation variables as outcome criteria. RESULTS In the music therapy group, insecurity predicted the use of music for both cognitive problem solving and positive stimulation in everyday life. In the non-music therapy group, cooperation and insouciance predicted the use of music for reduction of negative activation. CONCLUSIONS Specific personality dimensions predict greater targeted emotion modulation strategies if music therapy is applied than without it. That is, music therapy helps patients acquire more conscious (i.e. cognitive-related strategies) emotion modulation techniques by means of including their individual personality, whereas patients without music therapy simply "vent" their negative emotions (i.e. non-cognitive strategies). Conversely, the data suggest that music therapy can contribute to modify personality dimensions through the development of these emotion modulation strategies. This could be a plausible explanation for beneficial long-term effects of music therapy.
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Chang BH, Chen BW, Beckstead JW, Yang CY. Effects of a music-creation programme on the anxiety, self-esteem, and quality of life of people with severe mental illness: A quasi-experimental design. Int J Ment Health Nurs 2018; 27:1066-1076. [PMID: 29222834 DOI: 10.1111/inm.12414] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2017] [Indexed: 01/29/2023]
Abstract
Many studies have shown that music therapy improves patients' symptoms. However, interventions using music creation as their core await further development for patients with severe mental illness (SMI). The current study investigated the effect of a music-creation programme on the anxiety, self-esteem, and quality of life of patients with SMI. A quasi-experimental design using convenience sampling was adopted to recruit patients with SMI from a psychiatric day care centre. Participants were grouped based on their willingness to undergo an intervention (26 patients in the experimental group and 23 patients in the control group). The control groups participated in conventional mental rehabilitation therapy activities. The experimental group participated in a music-creation session for 90 min every week over a 32-week period. The outcome indicators before and after the intervention were assessed using the Hamilton Anxiety Rating Scale (HAM-A), Rosenberg Self-Esteem Scale (RSES), and World Health Organization Quality of Life-BREF (WHOQOL-BREF). Finally, the intervention effect was determined using generalized estimating equations (GEEs). After 32 weeks of intervention activities, the experimental group showed significant improvements in their HAM-A total scores (P < 0.001) and RSES total scores (P = 0.005). Regarding quality of life, the improvements of the experimental group in terms of the psychological (P = 0.016) and social relationship domains (P = 0.033) were superior to those of the control group. Music-creation programmes are recommended for inclusion in the routine rehabilitation activities of patients with SMI.
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Affiliation(s)
- Beh-Huan Chang
- RN/HN Department of Nursing, Taipei City Hospital, Songde Branch, Taipei, Taiwan
| | - Bo-Wei Chen
- Department of Psychology, Fu Jen Catholic University, New Taipei, Taiwan
| | - Jason W Beckstead
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Chiu-Yueh Yang
- Department of Nursing, National Yang Ming University, Taipei, Taiwan
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