Comparing live to recorded music and stories using multiple psychoneuroendocrine and

426 Pages·2017·7.22 MB·English

Edith Cowan University
Research Online
Theses: Doctorates and Masters Theses
2018
Comparing live to recorded music and stories using multiple
psychoneuroendocrine and psychological measures
Ronniet Orlando
Edith Cowan University
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Recommended Citation
Orlando, R. (2018). Comparing live to recorded music and stories using multiple psychoneuroendocrine
and psychological measures. https://ro.ecu.edu.au/theses/2136
This Thesis is posted at Research Online.
https://ro.ecu.edu.au/theses/2136
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Comparing live to recorded music and stories using multiple
psychoneuroendocrine and psychological measures

This thesis is presented for the degree of
Doctor of Philosophy

Ronniet Orlando

Edith Cowan University

School of Arts and Humanities

2018
Declaration

I certify that this thesis does not, to the best of my knowledge and belief:

i. incorporate without acknowledgment any material previously submitted for a
degree or diploma in any institution of higher education;

ii. contain any material previously published or written by another person
except where due reference is made in the text of this thesis; or

iii. contain any defamatory material

Ronniet ORLANDO

Ronniet Orlando PhD Thesis i
Abstract

Listening to music brings health benefits, according to an expanding opus of
empirical research. Studies to date cover a wide range of music interventions
and outcome measures. Music has been applied to healthy participants, as well
as clinical populations to target anxiety and pain. But little is known about
whether live music is more effective than recorded music as an intervention for
these common symptoms.

This exploratory study sought answers with the emerging science of saliva
analysis, which focuses on biomarkers that indicate stress and immune function.
In this case salivary cortisol, alpha-amylase, immunoglobulin-A, interleukin-
1beta, and pH levels were measured. Saliva samples from 50 university students
and 23 palliative care and surgical patients were compared before and after
each participant listened to a live (ML), audiovisual (MAV) or audio recorded
(MA) standardised program of classical music played on a solo violin, viola or
cello. Live (SL) or audio (SA) story readings were added as interventions to
control for psychosocial variables. Saliva’s non-invasive, repeatable, objective
psychoneuroendocrine (PNE) snapshots were supplemented with subjective
visual analogue scales for anxiety (VASA) and pain (VASP), and self-report affect
scales to rate liking, perceived and felt emotion, and absorption. Participants
were also asked for a one-word summary of their listening experience.

It was anticipated that ML would reduce anxiety and pain, as well as boost the
immune markers, more than MAV and MA, and that music overall would
demonstrate stronger benefits than the story readings.

No single outcome measure provided sufficient data to draw conclusions, but
trends in the melange of both objective and subjective instruments revealed
that overall more positive health indicators arose from live music than recorded
music, particularly in the clinical settings. Stories were also shown to have some
Ronniet Orlando PhD Thesis ii
moderating effects on pain and anxiety. This study demonstrated the
therapeutic values of music as well as story readings, and the superior benefits
of live music and stories compared to audio recordings of the same
presentations.

The PNE methodology had some limitations, particularly with the clinical
population, resulting in gaps in the patients’ biomarker data. Some differential
results highlighted the value of using a kaleidoscope of both objective and
subjective outcome measures to gain a fuller understanding of the complex
cognitive, emotional, neural, hormonal, and biopsychosocial processes involved
in music’s beneficial effects.

Ronniet Orlando PhD Thesis iii
Acknowledgements

It may take a village to raise a child, but it takes a world

— and coffee — to create a PhD!

Ronniet Orlando

To all those who have supported me along the way: my supervisors, fellow
students and staff at Edith Cowan University; willing mentors I have called on
for guidance; staff and patients at Bethesda Hospital, Perth; and all participants
and presenters, for their enthusiasm and cooperation in facilitating this
ambitious project.

To my family and friends: for advice and practical help, for keeping me
grounded, feeding me, listening to me, jamming with me, travelling with me, and
loving me.

To my lifelong companion music: you have helped me find my voice and
navigated me through rough waters; nourished my soul and intellect and made
my heart dance; fed and clothed me; given me wings to fly to distant lands; laid
paths and highways to friends and mentors; and accompanied rich relationships
with fellow travellers through life, sharing joyful dances to sultry songs, and
sweet lullabies to sorrowful laments.

Thank you all!

Ronniet Orlando PhD Thesis iv
TABLE OF CONTENTS

Declaration ................................................................................................................................. i
Abstract ...................................................................................................................................... ii
Acknowledgements ............................................................................................................... iv
TABLE OF CONTENTS ........................................................................................................... v
List of Tables .................................................................................................................. xi
List of Figures ................................................................................................................ xi
Abbreviations ......................................................................................................................... xv
Dedication ............................................................................................................................ xviii
Prelude .....................................................................................................................................xix
Overture ..................................................................................................................................... 1
Chapter 1: THEMATIC EXPOSITION - A Review of the Literature ...................... 4
Music and the arts as therapeutic tools ..................................................................... 5
Music in history .............................................................................................................. 5
Arts and science ............................................................................................................. 6
Engagement with the creative arts......................................................................... 6
Music therapy and music in medicine ................................................................... 8
What is music? ................................................................................................................. 10
A Westernised perspective ..................................................................................... 10
A more functional perspective .............................................................................. 11
Multimodal complexities ......................................................................................... 11
Meaningful, structured and patterned sound ................................................. 12
Characteristics of music ............................................................................................... 13
Musical structure ........................................................................................................ 13
Rhythm and tempo .................................................................................................... 14
Ronniet Orlando PhD Thesis v
Dynamics and the sounds of silence ................................................................... 15
Timbre, pitch and harmony .................................................................................... 16
Musical genre and musical preferences ............................................................ 18
Song, lyrics, and the meaning of music .............................................................. 21
Aesthetics, music and noise ................................................................................... 23
Modes of presentation: live versus recorded music ..................................... 26
Clinical applications of music ..................................................................................... 31
Music as a low-risk intervention .......................................................................... 31
Music for the control of pain .................................................................................. 32
Pain in the palliative care setting ......................................................................... 37
Pain and surgery ......................................................................................................... 40
Assessment of pain .................................................................................................... 41
Anxiolytic effects of music ...................................................................................... 43
Anxiety and palliative care ..................................................................................... 45
Anxiety in surgical patients .................................................................................... 46
Measuring anxiety ...................................................................................................... 48
Are pain and anxiety really measurable as separate constructs? ........... 51
Music and the immune system.............................................................................. 53
Music in non-clinical settings ..................................................................................... 56
Music and wellbeing .................................................................................................. 56
Students and stress ................................................................................................... 57
Chapter 2: BRIDGE - Purpose and Conceptual Framework ................................ 59
Biomedical model ........................................................................................................... 60
Music and the physiology of stress ...................................................................... 61
The biomedical model of pain ............................................................................... 66
Music and neurology ................................................................................................. 68
Neurology, music, pain and anxiety .................................................................... 69
Ronniet Orlando PhD Thesis vi
Cognitive – emotional model ...................................................................................... 72
Emotions and cognition: an intermeshed relationship ............................... 72
How does music evoke emotions? ....................................................................... 75
Summary of cognitive-emotional framework of music ............................... 83
Biopsychosocial model ................................................................................................. 85
Music, pain and the biopsychosocial model ..................................................... 85
Psychosocial implications of cancer ................................................................... 86
Music as a social facilitator ..................................................................................... 86
Illness identity ............................................................................................................. 88
Music versus noise ..................................................................................................... 89
Ecological approach .................................................................................................. 90
Psychoneuroendocrine approach ............................................................................. 92
Natural and acquired immune responses......................................................... 92
The immune system, stress, and the brain-gut connection ....................... 93
Music and the immune system.............................................................................. 94
Saliva and biomarkers .............................................................................................. 96
Summary ..........................................................................................................................103
What is known so far ..............................................................................................103
What are the gaps ....................................................................................................103
Why do this study? How will it contribute? ...................................................104
Aims of this study .....................................................................................................106
Chapter 3: DEVELOPMENT - Methodology..............................................................107
Some limitations of previous research methodologies ..................................107
Confounds and bias .................................................................................................107
Study designs .............................................................................................................108
Participants and settings .......................................................................................110
Recruitment of participants .................................................................................113
Ronniet Orlando PhD Thesis vii