Influence of Music Therapy on Coping Skills and Anger Management in Forensic Psychiatric Patients: An Exploratory Study

Effectiveness of mind-body medicine for Hwa-Byung (a Korean cultural diagnosis of suppressed anger): A systematic review of interventional studies

OBJECTIVE

This systematic review analysed the effectiveness of mind-body modalities (MBMs) in Hwa-byung (HB).

METHODS

Ten electronic databases were searched. Intervention studies using MBMs for individuals with HB, published up to July 2023, were included. The methodological quality of the included studies was assessed using the Cochrane RoB and ROBINS-I tools. Meta-analysis of continuous variables was presented as mean differences (MDs) and their 95% confidence intervals (CIs).

RESULTS

Nine studies including five randomized controlled clinical trials, were included. The MBM types were meditation, relaxation, biofield therapy, art therapy, and forest-based MBM, and comprehensive HB programs. Most studies used an MBM group, with 5-6 sessions delivered during an average of 4-5 weeks. As a result of the meta-analysis, art therapy showed a statistically significantly better effect on improving the Hwa-Byung Scale (HB-S) score compared to the waitlist control (MD = -7.74; 95% CI = -9.81 to -5.66). In the before-and-after comparison, MBMs were frequently reported to have significant benefits for improving the HB-S total score (7/7, 100%), depressive mood (4/5, 80%), and state anxiety (6/8, 75%). Some methodological flaws were identified in the included studies, including the reliability of diagnosis, non-implementation of assessor blinding, and inappropriate control groups.

CONCLUSIONS

This review identified potentially promising MBMs that were not previously recommended in the current HB clinical practice guidelines. In the future, high-quality clinical studies that include the use of standardized HB diagnostic criteria, homogeneous interventions, appropriate control groups, standard assessment tools such as the HB-S, and assessor blinding are needed.

Banging the drum: evolutionary and cultural origins of music and its implications for psychiatry

SUMMARY

There is growing interest in music-based therapies for mental/behavioural disorders. We begin by reviewing the evolutionary and cultural origins of music, proceeding then to discuss the principles of evolutionary psychiatry, itself a growing a field, and how it may apply to music. Finally we offer some implications for the role of music and music-based therapies in clinical practice.

Effectiveness and mechanisms of the arts therapies in forensic care. A systematic review, narrative synthesis, and meta analysis

Introduction

Mental health care provided to offenders with psychiatric problems in forensic settings mainly consists of verbal oriented treatments. In addition, experience-based therapies are used such as (creative) arts therapies: (visual) art therapy, music therapy, drama therapy and dance (movement) therapy. There are indications for effectiveness of arts therapies, but a systematic overview of effect studies of all arts therapies in forensic care is lacking.

Methods

First, we performed a systematic review. Second, Thematic Analysis was used to synthesize the qualitative narrative results and define the hypothesized mechanisms of change. Third, we performed a meta-analysis to investigate the effects of arts therapies in reducing psychosocial problems of offenders. Twenty-three studies were included in the review. Quality and risk of bias was assessed using EPHPP (Effective Public Health Practice Project).

Results

The included studies were heterogeneous in type of outcome measures and intervention characteristics. Synthesis of mechanisms of change involved in the methodical use of the arts in arts therapies resulted in a description of regulatory processes which are stimulated in arts therapies: perceptive awareness (interoceptive and exteroceptive), the regulation of emotions, stress, impulses, cognitions, social regulation, and self-expression. These processes play a role in developing prevention, coping and self-management skills. Eighteen studies were included in the meta-analyses (11 RCTs/CCTs; 7 pre-post studies). The meta-analyses indicated significant effects on both risk factors (psychiatric symptoms and addiction) and protective factors for criminal behavior (social functioning and psychological functioning). Effects on criminal and/or antisocial behavior were not significant, but this outcome measure was scarcely used among the studies.

Discussion

The analyses in this study should be considered explorative. More research is needed to gain more solid conclusions about effectiveness and mechanisms of change of arts therapies in forensic institutions. However, the results of this first systematic review, synthesis of mechanisms and meta-analysis in this field are promising and show effects of arts therapies on risk and protective factors in individuals in forensic institutions.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020217884, identifier: CRD42020217884.

Analysis of music-exposure interventions for impacting prosocial behaviour via behaviour change techniques and mechanisms of action: a rapid review

The aim of the study is to evaluate the interventions examining music exposure’s effects on prosocial behaviour, to identify the behaviour change techniques (BCTs) through which they change it, and to examine the mechanisms of action (MoAs) that mediate the relationship between music exposure and prosocial behaviour. The review identified 15 research articles, comprising 19 relevant studies. The results revealed that, though many of the included studies did not provide enough information to code them adequately, the BCTs “Instruction on how to perform a behaviour”, “Salience of consequences”, “Reduce negative emotions” and “Identification of self as role model” were the most commonly utilized techniques. Additionally, “Emotion” was the most significant MoA in the intervention-behaviour relationship in this context, but too few BCTs were able to be coded to make conclusions about any BCT-MoA relationships.

Effect of educational music intervention on college students' aggressive behaviour

BACKGROUND

Students' aggressive behavior and its negative implications have continued to intrigue researchers. Thus, the present study examined the effect of educational music intervention in reducing aggressive behavior among college students.

METHOD

Quantitative data were collected from 30 college student participants in the treatment group and 30 college student participants in the control group using the teacher-rating of students' aggressive behaviors and self-rated aggression scale instruments. This study adopted the IBM SPSS version 25 program and JASP statistical program for data analysis.

RESULTS

The result of the study indicated that college students in the educational music group showed considerable mean decline in aggressive behavior at posttest compared to their counterparts in the control group. At follow-up, it was revealed that educational music intervention consistently reduced the college students' aggressive behavior.

CONCLUSION

Educational music intervention proved to be a helpful intervention in reducing Nigerian college students' aggressive behavior. In light of this, it would be beneficial to implement educational music intervention to reduce aggressive behavior among college students in other localities.

The Mental Effect of Music on the Personal State in Terms of Depressive Personality Disorders

The use of music as a basis for overcoming depressive personality disorders is possible only if the individual is ready for this therapy. Music therapy affects, first of all, the very structure of personality, its dynamic filling with current social and political tendencies, and allows to highlight problem areas, which are often viewed as complex in the structure of other psychological problems. The purpose of the current study was the determination and justification of the corresponding criteria in relation to this, as well as the methodology for diagnosing the studied phenomenon. The diagnostics involved five groups of psychologists (in general, 438 persons). The preparedness of therapists for preventive and remedial work with patients with depressive conduct disorder was evaluated. To test the truth of the statistical hypothesis the Wilcoxon-Mann-Whitney criterion was used. The novelty of the article is determined by the fact that the use of music is considered only as a therapeutic measure, and not associated with the use of medication or sedation. The developed system of the use of music therapy can be implemented only under the condition of applying special factors and principles. These factors include, first of all, the ability to respond to the personality and, if necessary, adjust the therapy strategy.

The "Ifs" and "Hows" of the Role of Music on the Implementation of Emotional Regulation Strategies

Music is believed to aid the implementation of emotion regulation strategies like distraction or reappraisal, but empirical studies have shown null results. However, the moderating role of one’s relation with music (musical sophistication) and/or executive functioning skills has not been considered yet. In addition, little is known about how music acts. In the present study, we induced anger in a group of participants characterized by musical sophistication and executive functioning. We asked them to regulate their emotional state and measured regulation efficacy. Participants were split into four groups, defined by regulation strategy (distraction vs. reappraisal) and music (with vs. without). Results indicated music effects in higher, but not in lower musical sophistication participants. In the former, music benefitted from reappraisal but was an impaired distraction. Two different executive functions—working memory and affective flexibility—had opposite effects: higher, but not lower working memory participants benefited from music; lower, but not higher, effective flexibility participants took advantage of music. Reports of subjective experience suggested that music favors more empathic reappraisals, and that these may be more long-lasting. Our findings support the idea that music effects depend on listeners’ characteristics, and they raise new hypotheses concerning the specificity of emotional regulation aided by music.

The effect of acceptance and commitment therapy orientated anger management training on anger ruminations and impulsivity levels in forensic psychiatric patients: A randomized controlled trial

PURPOSE

This study aimed at determining the effect of acceptance and commitment therapy (ACT) orientated anger management training on levels of anger rumination and impulsivity in people receiving forensic mental healthcare.

DESIGN AND METHODS

This was a randomized controlled study. The research data were collected between July 2018 and February 2019. The personal information form, Anger Rumination Scale, and Barratt Impulsiveness Scale were used for data collection.

FINDINGS

Total scores on the Barratt Impulsiveness and Anger Rumination Scales were significantly lower in the experimental group than in the control group (p < 0.001).

PRACTICE IMPLICATIONS

This study adds to existing evidence on the provision of anger management training, offering an evidence-based solution along with necessary knowledge and skills for use by forensic psychiatric nurses.

Effects of progressive muscle relaxation training with music therapy on sleep and anger of patients at Community Mental Health Center

OBJECTIVE

The objective is to examine the effects of progressive muscle relaxation training and music therapy applied to chronic psychiatric patients attending the Community Mental Health Center (CMHC) on their anger level and sleep quality.

METHODS

The sample of the study consisted of 66 chronic psychiatric patients (n = 32 in the control group; n = 34 in the intervention group). Progressive muscle relaxation training with music therapy were implemented in the intervention group as 2 sessions per week for 3 months.

RESULTS

A statistically significant difference was found between the pre-test and post-test mean scores of the intervention group (p ≤ .001). After the intervention, a statistically significant difference was found between the PSQI, anger-in, anger-out, anger-control, and trait anger scale scores of the two groups (p ≤ .001).

CONCLUSION

Relaxation training and music therapy are effective in controlling anger and increasing sleep quality in chronic psychiatric patients.

CLINICAL TRIAL NUMBER

NCT04620122.

Psychological interventions for antisocial personality disorder

BACKGROUND

Antisocial personality disorder (AsPD) is associated with poor mental health, criminality, substance use and relationship difficulties. This review updates Gibbon 2010 (previous version of the review).

OBJECTIVES

To evaluate the potential benefits and adverse effects of psychological interventions for adults with AsPD.

SEARCH METHODS

We searched CENTRAL, MEDLINE, Embase, 13 other databases and two trials registers up to 5 September 2019. We also searched reference lists and contacted study authors to identify studies.

SELECTION CRITERIA

Randomised controlled trials of adults, where participants with an AsPD or dissocial personality disorder diagnosis comprised at least 75% of the sample randomly allocated to receive a psychological intervention, treatment-as-usual (TAU), waiting list or no treatment. The primary outcomes were aggression, reconviction, global state/functioning, social functioning and adverse events.

DATA COLLECTION AND ANALYSIS

We used standard methodological procedures expected by Cochrane.

MAIN RESULTS

This review includes 19 studies (eight new to this update), comparing a psychological intervention against TAU (also called 'standard Maintenance'(SM) in some studies). Eight of the 18 psychological interventions reported data on our primary outcomes. Four studies focussed exclusively on participants with AsPD, and 15 on subgroups of participants with AsPD. Data were available from only 10 studies involving 605 participants. Eight studies were conducted in the UK and North America, and one each in Iran, Denmark and the Netherlands. Study duration ranged from 4 to 156 weeks (median = 26 weeks). Most participants (75%) were male; the mean age was 35.5 years. Eleven studies (58%) were funded by research councils. Risk of bias was high for 13% of criteria, unclear for 54% and low for 33%. Cognitive behaviour therapy (CBT) + TAU versus TAU One study (52 participants) found no evidence of a difference between CBT + TAU and TAU for physical aggression (odds ratio (OR) 0.92, 95% CI 0.28 to 3.07; low-certainty evidence) for outpatients at 12 months post-intervention. One study (39 participants) found no evidence of a difference between CBT + TAU and TAU for social functioning (mean difference (MD) -1.60 points, 95% CI -5.21 to 2.01; very low-certainty evidence), measured by the Social Functioning Questionnaire (SFQ; range = 0-24), for outpatients at 12 months post-intervention. Impulsive lifestyle counselling (ILC) + TAU versus TAU One study (118 participants) found no evidence of a difference between ILC + TAU and TAU for trait aggression (assessed with Buss-Perry Aggression Questionnaire-Short Form) for outpatients at nine months (MD 0.07, CI -0.35 to 0.49; very low-certainty evidence). One study (142 participants) found no evidence of a difference between ILC + TAU and TAU alone for the adverse event of death (OR 0.40, 95% CI 0.04 to 4.54; very low-certainty evidence) or incarceration (OR 0.70, 95% CI 0.27 to 1.86; very low-certainty evidence) for outpatients between three and nine months follow-up. Contingency management (CM) + SM versus SM One study (83 participants) found evidence that, compared to SM alone, CM + SM may improve social functioning measured by family/social scores on the Addiction Severity Index (ASI; range = 0 (no problems) to 1 (severe problems); MD -0.08, 95% CI -0.14 to -0.02; low-certainty evidence) for outpatients at six months. 'Driving whilst intoxicated' programme (DWI) + incarceration versus incarceration One study (52 participants) found no evidence of a difference between DWI + incarceration and incarceration alone on reconviction rates (hazard ratio 0.56, CI -0.19 to 1.31; very low-certainty evidence) for prisoner participants at 24 months. Schema therapy (ST) versus TAU One study (30 participants in a secure psychiatric hospital, 87% had AsPD diagnosis) found no evidence of a difference between ST and TAU for the number of participants who were reconvicted (OR 2.81, 95% CI 0.11 to 74.56, P = 0.54) at three years. The same study found that ST may be more likely to improve social functioning (assessed by the mean number of days until patients gain unsupervised leave (MD -137.33, 95% CI -271.31 to -3.35) compared to TAU, and no evidence of a difference between the groups for overall adverse events, classified as the number of people experiencing a global negative outcome over a three-year period (OR 0.42, 95% CI 0.08 to 2.19). The certainty of the evidence for all outcomes was very low. Social problem-solving (SPS) + psychoeducation (PE) versus TAU One study (17 participants) found no evidence of a difference between SPS + PE and TAU for participants' level of social functioning (MD -1.60 points, 95% CI -5.43 to 2.23; very low-certainty evidence) assessed with the SFQ at six months post-intervention. Dialectical behaviour therapy versus TAU One study (skewed data, 14 participants) provided very low-certainty, narrative evidence that DBT may reduce the number of self-harm days for outpatients at two months post-intervention compared to TAU. Psychosocial risk management (PSRM; 'Resettle') versus TAU One study (skewed data, 35 participants) found no evidence of a difference between PSRM and TAU for a number of officially recorded offences at one year after release from prison. It also found no evidence of difference between the PSRM and TAU for the adverse event of death during the study period (OR 0.89, 95% CI 0.05 to 14.83, P = 0.94, 72 participants (90% had AsPD), 1 study, very low-certainty evidence).

AUTHORS' CONCLUSIONS

There is very limited evidence available on psychological interventions for adults with AsPD. Few interventions addressed the primary outcomes of this review and, of the eight that did, only three (CM + SM, ST and DBT) showed evidence that the intervention may be more effective than the control condition. No intervention reported compelling evidence of change in antisocial behaviour. Overall, the certainty of the evidence was low or very low, meaning that we have little confidence in the effect estimates reported. The conclusions of this update have not changed from those of the original review, despite the addition of eight new studies. This highlights the ongoing need for further methodologically rigorous studies to yield further data to guide the development and application of psychological interventions for AsPD and may suggest that a new approach is required.

Psychological and psychosocial interventions offered to forensic mental health inpatients: a systematic review

OBJECTIVE

To examine the evidence for the use of psychological and psychosocial interventions offered to forensic mental health inpatients.

DESIGN

CINAHL, MEDLINE, PsycINFO, ScienceDirect and Web of Science databases were searched for research published in English between 1 January 1990 and 31 May 2018.

OUTCOME MEASURES

Disturbance, mental well-being, quality of life, recovery, violence/risk, satisfaction, seclusion, symptoms, therapeutic relationship and ward environment. There were no limits on the length of follow-up.

ELIGIBILITY CRITERIA

We included randomised controlled trial (RCT) studies of any psychological or psychosocial intervention in an inpatient forensic setting. Pilot or feasibility studies were included if an RCT design was used.We restricted our search criteria to inpatients in low, medium and high secure units aged over 18. We focused on interventions considered applicable to most patients residing in forensic mental health settings.

DATA EXTRACTION AND SYNTHESIS

Two independent reviewers extracted data and assessed risk of bias.

RESULTS

17 232 citations were identified with 195 full manuscripts examined in detail. Nine papers were included in the review. The heterogeneity of the identified studies meant that meta-analysis was inappropriate. The results were presented in table form together with a narrative synthesis. Only 7 out of 91 comparisons revealed statistically significant results with no consistent significant findings. The most frequently reported outcomes were violence/risk and symptoms. 61% of the violence/risk comparisons and 79% of the symptom comparisons reported improvements in the intervention groups compared with the control groups.

CONCLUSIONS

Current practice is based on limited evidence with no consistent significant findings. This review suggests psychoeducational and psychosocial interventions did not reduce violence/risk, but there is tentative support they may improve symptoms. More RCTs are required with: larger sample sizes, representative populations, standardised outcomes and control group interventions similar in treatment intensity to the intervention.

PROSPERO REGISTRATION NUMBER

CRD42017067099.

Music increase altruism through regulating the secretion of steroid hormones and peptides

Music is well known for its effect on human behavior especially of their bonding and empathy towards others. Music provokes one's emotion and activates mirror neurons and reward system. It also regulates social hormones such as steroid hormones or peptides, and increases empathy, pro-sociality and altruism. As a result, it improves one's reproductive success.