Choir versus Solo Singing: Effects on Mood, and Salivary Oxytocin and Cortisol Concentrations

The psychophysiology of music-based interventions and the experience of pain

In modern times there is increasing acceptance that music-based interventions are useful aids in the clinical treatment of a range of neurological and psychiatric conditions, including helping to reduce the perception of pain. Indeed, the belief that music, whether listening or performing, can alter human pain experiences has a long history, dating back to the ancient Greeks, and its potential healing properties have long been appreciated by indigenous cultures around the world. The subjective experience of acute or chronic pain is complex, influenced by many intersecting physiological and psychological factors, and it is therefore to be expected that the impact of music therapy on the pain experience may vary from one situation to another, and from one person to another. Where pain persists and becomes chronic, aberrant central processing is a key feature associated with the ongoing pain experience. Nonetheless, beneficial effects of exposure to music on pain relief have been reported across a wide range of acute and chronic conditions, and it has been shown to be effective in neonates, children and adults. In this comprehensive review we examine the various neurochemical, physiological and psychological factors that underpin the impact of music on the pain experience, factors that potentially operate at many levels - the periphery, spinal cord, brainstem, limbic system and multiple areas of cerebral cortex. We discuss the extent to which these factors, individually or in combination, influence how music affects both the quality and intensity of pain, noting that there remains controversy about the respective roles that diverse central and peripheral processes play in this experience. Better understanding of the mechanisms that underlie music's impact on pain perception together with insights into central processing of pain should aid in developing more effective synergistic approaches when music therapy is combined with clinical treatments. The ubiquitous nature of music also facilitates application from the therapeutic environment into daily life, for ongoing individual and social benefit.

Dedalo Vola project: The effect of choral singing on physiological and psychosocial measures. An Italian pilot study

Several studies have been conducted that show the crucial role of active participation in music in health promotion (e.g. Dingle et al., 2021; Sheppard & Broughton, 2020); however, little research has focused on the biopsychosocial effects of choral singing. The present study aims to evaluate the effectiveness, in terms of improving physiological and psychosocial factors, of a choral program for middle-aged and older individuals. We integrated our study with qualitative observations of the atmosphere and flow state experienced by the choristers. The data were collected before and after 12 weeks of training, with 23 participants took part in the study. They experienced significant improvements in weight, oxygen saturation, heart rate, and satisfaction of psychological needs. A beneficial trend, although not statistically significant, were observed for blood pressure, cholesterol, triglycerides, stress, psychological needs, and mental health. The observations progressively revealed a more cohesive and focused group. Our findings support the potential for cross-disciplinary collaboration between healthcare and arts policy to promote and enhance health and well-being throughout the lifespan.

Biological principles for music and mental health

Efforts to integrate music into healthcare systems and wellness practices are accelerating but the biological foundations supporting these initiatives remain underappreciated. As a result, music-based interventions are often sidelined in medicine. Here, I bring together advances in music research from neuroscience, psychology, and psychiatry to bridge music's specific foundations in human biology with its specific therapeutic applications. The framework I propose organizes the neurophysiological effects of music around four core elements of human musicality: tonality, rhythm, reward, and sociality. For each, I review key concepts, biological bases, and evidence of clinical benefits. Within this framework, I outline a strategy to increase music's impact on health based on standardizing treatments and their alignment with individual differences in responsivity to these musical elements. I propose that an integrated biological understanding of human musicality-describing each element's functional origins, development, phylogeny, and neural bases-is critical to advancing rational applications of music in mental health and wellness.

Human sweat contains oxytocin

BACKGROUND

Oxytocin (OT) has been detected in various body fluids, including blood, urine, saliva, breastmilk, and spinal fluid. Consistent with models that regard skin as a social organ and in line with studies demonstrating that skin cells express both OT and its receptor, our study sought to examine the presence of OT in human sweat.

METHODS

Overall, 553 individuals participated in a pilot study and three experiments. Firstly, 50 participants provided sweat after engaging in various sports for different durations. Secondly, 26 participants provided sweat from forehead, upper-chest, forearm, and underarm, including 11 in natural setting and 15 following OT administration and a 30-minute exercise. Thirdly, of 435 volunteers, 97 provided sufficient axillary sweat for assaying. Of these, 84 participated in a naturalistic experiment that involved saliva and sweat collection in response to physical activity in either solitary or social settings. OT and testosterone (TS) were assayed in sweat and saliva.

RESULTS

Intense activity for at least 25 min was required to produce sufficient sweat for OT analysis. Highest OT levels were found in axillary sweat compared to sweat from the forehead, upper-chest, and forearm. Salivary OT and TS increased after both solitary and social physical activity; however, higher sweat OT was found after solitary sports. Post-hoc preliminary findings indicate that highly extroverted individuals exercising in solitary environments showed the highest sweat OT levels.

CONCLUSIONS

Findings demonstrate, for the first time, the presence of OT in human sweat and show the feasibility of its measurement. Much further research is required to illuminate how sweat OT is impacted by personality and social context and to uncover the role of the skin in OT production.

The positive effects of online group singing on psycho-physiological variables during the COVID-19 pandemic-A pilot randomized controlled trial

The psychological variables that were particularly influenced by social distancing during the COVID-19 pandemic-stress, loneliness, social participation, and well-being-correspond closely to variables that can also be influenced by music. The present study is a pilot randomized controlled trial examining the effects of online group singing on psycho-physiological variables during the pandemic. Over 4 weeks, an online singing group sang together once a week, for 1 h, under the guidance of a professional voice coach. In a first control group, participants also met for 60 min per week but only discussed and exchanged personal experiences about music. A second control condition consisted of a waiting list group. Across all variables studied (positive and negative affect, life satisfaction, stress, loneliness, social participation, self-efficacy, and body perception), positive effects were revealed in the singing group and in the discussion group, but not in the waiting list group. The effects of the variables self-efficacy, social participation, loneliness, and life satisfaction were markedly stronger in the singing group than in the discussion group. The results demonstrate the effectiveness of group singing on a number of psycho-physiological variables, which can be used profitably in and outside of times of crisis, in both clinical and non-clinical settings.

Monitoring oxytocin signaling in the brain: More than a love story

More than any other neuropeptide, oxytocin (OXT) is attracting the attention of neurobiologists, psychologists, psychiatrists, evolutionary biologists and even economists. It is often called a "love hormone" due to its many prosocial functions described in vertebrates including mammals and humans, especially its ability to support "bonding behaviour". Oxytocin plays an important role in female reproduction, as it promotes labour during parturition, enables milk ejection in lactation and is essential for related reproductive behaviours. Therefore, it particularly attracts the interest of many female researchers. In this short narrative review I was invited to provide a personal overview on my scientific journey closely linked to my research on the brain OXT system and the adventures associated with starting my research career behind the Iron Curtain.

Endogenous oxytocin and human social interactions: A systematic review and meta-analysis

While there has been an increase in studies investigating the relationship between endogenous oxytocin (OXT) concentrations and human social interactions over the past decades, these studies still seem far from converging, both in methodological terms and in terms of their results. This systematic review and meta-analysis were aimed at a comprehensive evaluation and synthesis of empirical evidence on the relationship between endogenous OXT concentrations and human social interactions by reviewing studies published between 1970 and July 2020 and addressing various related methodological and analytical limitations. Sixty-three studies were included in the qualitative synthesis, and results from 51 studies were pooled in a meta-analysis (n = 3,741 participants). The results indicated that social interaction did not lead to an expected hormonal response in causal designs, either in a pre-post design (g = 0.079) or when comparing experimental conditions with and without social interaction (g = 0.256). However, in correlational designs, the overall mean effect size (ES) of the correlations between indicators of social interaction and OXT concentrations was significantly different from zero (z = 0.137). In both designs, subgroup analyses revealed that studies involving either parent-child interactions, or the utilization of the enzyme-linked immunosorbent assay method for OXT analysis, or unrestricted eating, drinking, or exercise before biofluid collection showed significantly higher than zero mean ESs. This review exposes the observed inconsistencies and suggests that standardized, replicable, and reliable approaches to assessing social interaction and measuring OXT concentrations need to be developed to study neurochemical mechanisms of sociality in humans. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Wearable Artificial Intelligence Feedback Tool (Wrist Angel) for Treatment and Research of Obsessive Compulsive Disorder: Protocol for a Nonrandomized Pilot Study

BACKGROUND

Obsessive compulsive disorder (OCD) in youth is characterized by behaviors, emotions, physiological reactions, and family interaction patterns. An essential component of therapy involves increasing awareness of the links among thoughts, emotions, behaviors, bodily sensations, and family interactions. An automatic assessment tool using physiological signals from a wearable biosensor may enable continuous symptom monitoring inside and outside of the clinic and support cognitive behavioral therapy for OCD.

OBJECTIVE

The primary aim of this study is to evaluate the feasibility and acceptability of using a wearable biosensor to monitor OCD symptoms. The secondary aim is to explore the feasibility of developing clinical and research tools that can detect and predict OCD-relevant internal states and interpersonal processes with the use of speech and behavioral signals.

METHODS

Eligibility criteria for the study include children and adolescents between 8 and 17 years of age diagnosed with OCD, controls with no psychiatric diagnoses, and one parent of the participating youths. Youths and parents wear biosensors on their wrists that measure pulse, electrodermal activity, skin temperature, and acceleration. Patients and their parents mark OCD episodes, while control youths and their parents mark youth fear episodes. Continuous, in-the-wild data collection will last for 8 weeks. Controlled experiments designed to link physiological, speech, behavioral, and biochemical signals to mental states are performed at baseline and after 8 weeks. Interpersonal interactions in the experiments are filmed and coded for behavior. The films are also processed with computer vision and for speech signals. Participants complete clinical interviews and questionnaires at baseline, and at weeks 4, 7, and 8. Feasibility criteria were set for recruitment, retention, biosensor functionality and acceptability, adherence to wearing the biosensor, and safety related to the biosensor. As a first step in learning the associations between signals and OCD-related parameters, we will use paired t tests and mixed effects models with repeated measures to assess associations between oxytocin, individual biosignal features, and outcomes such as stress-rest and case-control comparisons.

RESULTS

The first participant was enrolled on December 3, 2021, and recruitment closed on December 31, 2022. Nine patient dyads and nine control dyads were recruited. Sixteen participating dyads completed follow-up assessments.

CONCLUSIONS

The results of this study will provide preliminary evidence for the extent to which a wearable biosensor that collects physiological signals can be used to monitor OCD severity and events in youths. If we find the study to be feasible, further studies will be conducted to integrate biosensor signals output into machine learning algorithms that can provide patients, parents, and therapists with actionable insights into OCD symptoms and treatment progress. Future definitive studies will be tasked with testing the accuracy of machine learning models to detect and predict OCD episodes and classify clinical severity.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05064527; https://clinicaltrials.gov/ct2/show/NCT05064527.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/45123.

Testosterone, oxytocin and co-operation: A hypothesis for the origin and function of music

Since the time of Darwin, theories have been proposed on the origin and functions of music; however, the subject remains enigmatic. The literature shows that music is closely related to important human behaviours and abilities, namely, cognition, emotion, reward and sociality (co-operation, entrainment, empathy and altruism). Notably, studies have deduced that these behaviours are closely related to testosterone (T) and oxytocin (OXT). The association of music with important human behaviours and neurochemicals is closely related to the understanding of reproductive and social behaviours being unclear. In this paper, we describe the endocrinological functions of human social and musical behaviour and demonstrate its relationship to T and OXT. We then hypothesised that the emergence of music is associated with behavioural adaptations and emerged as humans socialised to ensure survival. Moreover, the proximal factor in the emergence of music is behavioural control (social tolerance) through the regulation of T and OXT, and the ultimate factor is group survival through co-operation. The "survival value" of music has rarely been approached from the perspective of musical behavioural endocrinology. This paper provides a new perspective on the origin and functions of music.

Similar behavioral but different endocrine responses to conspecific interactions in hand-raised wolves and dogs

Domestication has altered dogs' conspecific social organization compared to their closest, non-domesticated relatives, gray wolves. Wolves live in packs whose survival depends on coordinated behavior, but dogs rely less on conspecifics, which predicts greater cohesiveness in wolf than dog packs. Endocrine correlates such as oxytocin and glucocorticoids modulate group cohesion resulting in species-specific differences in social interactions. We found that although wolves' and dogs' observable behavioral reactions to a territorial threat and separation from the pack were similar, hormonal responses differed. Wolves' but not dogs' oxytocin and glucocorticoid concentrations correlated positively with territorial behaviors and only wolves showed increased glucocorticoid concentrations after separation from their pack. Together, results suggest stronger emotional activation to threats to group integrity in wolves than dogs, in line with their socio-ecology.

Choir Singers Without Rehearsals and Concerts? A Questionnaire Study on Perceived Losses From Restricting Choral Singing During the Covid-19 Pandemic

BACKGROUND

Choir singing is an activity that engages individuals all over the world with a broad demographic representation. Both qualitative and quantitative studies have examined the benefits of the activity but very few have examined the effects when someone loses access to it and stops singing.

OBJECTIVES

Examining the governmental and organisational responses precipitated by the COVID-19 pandemic, we asked what happens when a choir singer loses all of their routines associated with regular participation in choir singing.

MATERIALS AND METHODS

One national choir organization in Sweden (n = 3163) and one in Norway (n = 1881) were approached with a short survey. This comprised questions relating to the issue "what do you as a choir singer misses the most?" Each participant was asked to rate the importance of a number of elements that pertain to the experience of choir singing.

RESULTS

The social aspect of singing emerged as having the strongest weight in terms of perceived loss that is, it was the element that the participants missed the most. Professional singers report that they miss the aesthetic experiences, flow, and all the physical aspects (physical training, voice training, and breathing training) to a greater degree as compared to reports from the amateurs. The importance of aesthetic experiences and physical components appeared to rise with increasing number of years that an individual had engaged with choir singing.

CONCLUSION

In the Scandinavian setting, the social aspect has a stronger weight than the other components and this seemed to be more significant in Norway compared to Sweden.

Infant Stimulation Induced a Rapid Increase in Maternal Salivary Oxytocin

Oxytocin (OT) is a neuropeptide involved in human social behaviors and reproduction. Non-invasive OT levels in saliva have recently roused interest as it does not require a specialized medical setting. Here, we observed one woman’s basal serum and saliva OT from pregnancy to 1 year postpartum to track OT concentration changes over this period. We examined the changes in salivary OT levels over time in response to maternal physiological and behavioral responses. The fluctuation of saliva OT levels is well correlated with serum OT during pregnancy and breastfeeding. However, while salivary OT increased rapidly during direct interaction (social interaction tests) with the infant and/or when the mother was watching her own infant’s video (video tests), no increase was observed in serum. We used social interaction and video tests on a group of mothers (nine mothers for social interaction and six for the video test) to clarify these single-subject results. In both tests, the mothers had increased OT in their saliva but not serum. Our study may suggest that salivary samples reflect not only the physical but also the emotional state and that saliva samples may be useful for monitoring women’s OT levels during pre- and postpartum periods. Further studies with larger sample numbers are necessary to confirm the rapid changes in salivary OT levels in response to maternal physiological and behavioral responses.

Endogenous oxytocin, cortisol, and testosterone in response to group singing

Humans have sung together for thousands of years. Today, regular participation in group singing is associated with benefits across psychological and biological dimensions of human health. Here we examine the hypothesis that a portion of these benefits stem from changes in endocrine activity associated with affiliation and social bonding. Working with a young adult choir (n = 71), we measured changes salivary concentrations of oxytocin, cortisol, and testosterone from before and after four experimental conditions crossing two factors: vocal production mode (singing vs. speaking) and social context (together vs. alone). Salivary oxytocin and cortisol decreased from before to after the experimental manipulations. For oxytocin the magnitude of this decrease was significantly smaller after singing compared to speaking, resulting in concentrations that were significantly elevated after singing together compared to speaking together, after controlling for baseline differences. In contrast, the magnitude of the salivary cortisol decreases was the same across experimental manipulations, and although large, could not be separated from diurnal cycling. No significant effects were found in a low-powered exploratory evaluation of testosterone (tested only in males). At a psychological level, we found that singing stimulates greater positive shifts in self-perceived affect compared to speaking-particularly when performed together-and that singing together enhances feelings of social connection more than speaking together. Finally, measurements of heart rate made for a subset of participants provide preliminary evidence regarding physical exertion levels across conditions. These results are discussed in the context of a growing multidisciplinary literature on the endocrinological correlates of musical behavior. We conclude that singing together can have biological and psychological effects associated with affiliation and social bonding, and that these effects extend beyond comparable but non-musical group activities. However, we also note that these effects appear heavily influenced by broader contextual factors that shape social dynamics, such as stress levels, the intimacy of interactions, and the status of existing relationships.

The Psychological and Biological Impact of "In-Person" vs. "Virtual" Choir Singing in Children and Adolescents: A Pilot Study Before and After the Acute Phase of the COVID-19 Outbreak in Austria

Psychobiological responses to music have been examined previously in various naturalistic settings in adults. Choir singing seems to be associated with positive psychobiological outcomes in adults. However, evidence on the effectiveness of singing in children and adolescents is sparse. The COVID-19 outbreak is significantly affecting society now and in the future, including how individuals engage with music. The COVID-19 pandemic is occurring at a time when virtual participation in musical experiences such as singing in a virtual choir has become more prevalent. However, it remains unclear whether virtual singing leads to different responses in comparison with in-person singing. We evaluated the psychobiological effects of in-person choral singing (7 weeks, from January to March 2020, before the COVID-19 outbreak) in comparison with the effects of virtual choral singing (7 weeks, from May to July 2020, after schools partly re-opened in Austria) in a naturalistic pilot within-subject study. A group of children and young adolescents (N = 5, age range 10-13, female = 2) from a school in Salzburg, Austria were recruited to take part in the study. Subjective measures (momentary mood, stress) were taken pre- and post-singing sessions once a week. Additionally, salivary biomarkers (cortisol and alpha-amylase) and quantity of social contacts were assessed pre- and post-singing sessions every second week. Psychological stability, self-esteem, emotional competences, and chronic stress levels were measured at the beginning of in-person singing as well as at the beginning and the end of the virtual singing. We observed a positive impact on mood after both in-person and virtual singing. Over time, in-person singing showed a pre-post decrease in salivary cortisol, while virtual singing showed a moderate increase. Moreover, a greater reduction in stress, positive change in calmness, and higher values of social contacts could be observed for the in-person setting compared to the virtual one. In addition, we observed positive changes in psychological stability, maladaptive emotional competences, chronic stress levels, hair cortisol, self-contingency and quality of life. Our preliminary findings suggest that group singing may provide benefits for children and adolescents. In-person singing in particular seems to have a stronger psychobiological effect.

Singing at 0.1 Hz as a Resonance Frequency Intervention to Reduce Cardiovascular Stress Reactivity?

Slow breathing at 6 breaths per min (corresponding to ~ 0.1 Hz) has been found to benefit psychological and physical health. In this study, we aimed to examine if paced singing at 0.1 Hz has beneficial acute effects on physiological function as compared to slow breathing. Participants were randomized to one of four experimental interventions prior to performing a mental stress task: paced breathing at 0.1 Hz (n = 26), paced singing at 0.1 Hz (n = 26), spontaneous breathing (n = 24), or spontaneous singing (n = 25). Heart rate, heart rate variability in the low (LF-HRV) and high frequency (HF-HRV) domain, blood pressure and affective wellbeing were assessed. As expected, both paced breathing and paced singing resulted in elevated LF-HRV. Moreover, both singing groups evidenced increases in heart rate, blood pressure and positive affect, thus indicating elevated sympathetic activation. Breathing and singing at 0.1 Hz had no robust effect on cardiovascular stress reactivity. Findings suggest that paced singing could constitute a promising alternative to slow paced breathing as it increases cardiovascular coherence, although more studies are needed to elucidate whether slow breathing and/or singing could ameliorate acute stress responses.

SHAPER-PND trial: clinical effectiveness protocol of a community singing intervention for postnatal depression

INTRODUCTION

Postnatal depression (PND) affects approximately 13% of new mothers. Community-based activities are sought after by many mothers, especially mothers that prefer not to access pharmacological or psychological interventions. Singing has shown positive effects in maternal mood and mother-child bonding. The Scaling-Up Health-Arts Programmes: Implementation and Effectiveness Research-Postnatal Depression study will analyse the clinical and implementation effectiveness of 10-week singing sessions for PND in new mothers. This protocol paper will focus on the clinical effectiveness of this trial.

METHODS AND ANALYSIS

A total of 400 mothers with PND (with a score of at least 10 on the Edinburgh Postnatal Depression Scale) and their babies will be recruited for this hybrid type II randomised controlled trial. The intervention group will attend 10 weekly singing sessions held at community venues or online, facilitated by the arts organisation, Breathe Arts Health Research (Breathe). A control group will be encouraged to attend non-singing sessions in the community or online for 10 weeks. A package of assessments will be collected from participants for clinical, mechanistic and implementation outcomes, at different stages of the trial. Clinical assessments will include questionnaires and interviews for demographics, mental health and social measures, together with biological samples for measurement of stress markers; the study visits are at baseline, week 6 (mid-trial) and week 10 (end of trial), with follow ups at weeks 20 and 36. Multiple imputation will be used to deal with possible missing data and multivariable models will be fitted to assess differences between groups in the outcomes of the study.

ETHICS AND DISSEMINATION

Ethical approval has been granted by the London-West London and GTAC Research Ethics Committee, REC reference: 20/PR/0813.

TRIAL REGISTRATION NUMBER

NCT04834622; Pre-results.

Oxytocin as an allostatic agent in the social bonding effects of music

Despite acknowledging that musicality evolved to serve multiple adaptive functions in human evolution, Savage et al. promote social bonding to an overarching super-function. Yet, no unifying neurobiological framework is offered. We propose that oxytocin constitutes a socio-allostatic agent whose modulation of sensing, learning, prediction, and behavioral responses with reference to the physical and social environment facilitates music's social bonding effects.

How Do Music Activities Affect Health and Well-Being? A Scoping Review of Studies Examining Psychosocial Mechanisms

Background: This scoping review analyzed research about how music activities may affect participants' health and well-being. Primary outcomes were measures of health (including symptoms and health behaviors) and well-being. Secondary measures included a range of psychosocial processes such as arousal, mood, social connection, physical activation or relaxation, cognitive functions, and identity. Diverse music activities were considered: receptive and intentional music listening; sharing music; instrument playing; group singing; lyrics and rapping; movement and dance; and songwriting, composition, and improvisation.

Methods: Nine databases were searched with terms related to the eight music activities and the psychosocial variables of interest. Sixty-three papers met selection criteria, representing 6,975 participants of all ages, nationalities, and contexts.

Results: Receptive and intentional music listening were found to reduce pain through changes in physiological arousal in some studies but not others. Shared music listening (e.g., concerts or radio programs) enhanced social connections and mood in older adults and in hospital patients. Music listening and carer singing decreased agitation and improved posture, movement, and well-being of people with dementia. Group singing supported cognitive health and well-being of older adults and those with mental health problems, lung disease, stroke, and dementia through its effects on cognitive functions, mood, and social connections. Playing a musical instrument was associated with improved cognitive health and well-being in school students, older adults, and people with mild brain injuries via effects on motor, cognitive and social processes. Dance and movement with music programs were associated with improved health and well-being in people with dementia, women with postnatal depression, and sedentary women with obesity through various cognitive, physical, and social processes. Rapping, songwriting, and composition helped the well-being of marginalized people through effects on social and cultural inclusion and connection, self-esteem and empowerment.

Discussion: Music activities offer a rich and underutilized resource for health and well-being to participants of diverse ages, backgrounds, and settings. The review provides preliminary evidence that particular music activities may be recommended for specific psychosocial purposes and for specific health conditions.

Group singing improves both physical and psychological wellbeing in people with and without chronic health conditions: A narrative review

The aim of this narrative review was to establish a link between psychological and physical wellbeing in people with and without chronic health conditions who participated in group singing. Four databases were searched (PubMed, WoS, MEDLINE, and Scopus) using a systematic search method. Articles were screened, yielding 19 suitable articles. In most studies that were included group singing led to an increase in both psychological and physiological wellbeing. The major impacts were on affect and depression and anxiety.Group singing positively affects both physical and psychological wellbeing in people with and without chronic health conditions. No direction of causality could be established.

Singing Together, Yet Apart: The Experience of UK Choir Members and Facilitators During the Covid-19 Pandemic

The Covid-19 induced United Kingdom-wide lockdown in 2020 saw choirs face a unique situation of trying to continue without being able to meet in-person. Live networked simultaneous music-making for large groups of singers is not possible, so other "virtual choir" activities were explored. A cross sectional online survey of 3948 choir members and facilitators from across the United Kingdom was conducted, with qualitative analysis of open text questions, to investigate which virtual choir solutions have been employed, how choir members and facilitators experience these in comparison to an "in-person" choir, and whether the limitations and opportunities of virtual choir solutions shed light on the value of the experience of group singing as a whole. Three virtual choir models were employed: Multi-track, whereby individuals record a solo which is mixed into a choral soundtrack; Live streamed, where individuals take part in sessions streamed live over social media; Live tele-conferencing, for spoken interaction and/or singing using tele-conferencing software. Six themes were identified in the open text responses: Participation Practicalities, encompassing reactions to logistics of virtual models; Choir Continuity, reflecting the responsibility felt to maintain choir activities somehow; Wellbeing, with lockdown highlighting to many the importance of in-person choirs to their sense of wellbeing; Social Aspects, reflecting a sense of community and social identity; Musical Elements, whereby the value of musical experience shifted with the virtual models; Co-creation through Singing, with an overwhelming sense of loss of the embodied experience of singing together in real-time, which is unattainable from existing virtual choir models. The experiences, activities and reflections of choir singers during lockdown present a unique perspective to understand what makes group singing a meaningful experience for many. Co-creation through Singing needs further investigation to understand the impact of its absence on virtual choirs being able re-create the benefits of in-person choirs.

[Can Stress Interact with SARS-CoV-2? A Narrative Review with a Focus on Stress-Reducing Interventions that may Improve Defence against COVID-19]

OBJECTIVE

The COVID-19 pandemic is on the rise and causes many concerns and fears in the population as well as among medical care givers. This raises the question as to how psychosocial stress associated with the pandemic can be managed, and also if certain forms of stress can contribute to an increase in infections and critical illnesses.

METHODS

Against the background of the current state of research on stress and the immune response, we provide a narrative review of studies addressing the question as to how stress can influence the immune defence against viral diseases.

RESULTS

Excessive stress can compromise the barrier function of the airways and alter neuroendocrine control of immune function, which can create a virus-permissive immune response.

DISCUSSION

Because certain forms of stress can play a role in the successful immune defence against viral respiratory disease, it is important to identify people with high psychosocial stress and to help them manage their stress. Conclusion Psychosocial measures that contribute to improved stress management may have a positive effect on the immune response against viral respiratory infections.

Participatory Art Activities Increase Salivary Oxytocin Secretion of ASD Children

Autism spectrum disorder (ASD) occurs in 1 in 160 children worldwide. Individuals with ASD tend to be unique in the way that they comprehend themselves and others, as well as in the way that they interact and socialize, which can lead to challenges with social adaptation. There is currently no medication to improve the social deficit of children with ASD, and consequently, behavioral and complementary/alternative intervention plays an important role. In the present pilot study, we focused on the neuroendocrinological response to participatory art activities, which are known to have a positive effect on emotion, self-expression, sociability, and physical wellbeing. We collected saliva from 12 children with ASD and eight typically developed (TD) children before and after a visual art-based participatory art workshop to measure the levels of oxytocin, a neuropeptide involved in a wide range of social behaviors. We demonstrated that the rate of increase in salivary oxytocin following art activities in ASD children was significantly higher than that in TD children. In contrast, the change rate of salivary cortisol after participatory art activities was similar between the two groups. These results suggest that the beneficial effects of participatory art activities may be partially mediated by oxytocin release, and may have therapeutic potential for disorders involving social dysfunction.

Social Feedback During Sensorimotor Synchronization Changes Salivary Oxytocin and Behavioral States

In humans and animal models, oxytocin increases social closeness, attachment and prosocial behaviors, while decreasing anxiety and stress levels. Efficiently triggering the release of endogenous oxytocin could serve as a powerful therapeutic intervention for disorders of social behavior and for anxiety. We designed a new version of a social sensorimotor synchronization task to investigate the role of social approval in inducing biochemical and psychological changes following behavioral synchrony in a sample of 80 college students. Social approval in the form of real time positive feedback increased well-being only in women, while increasing social closeness in both genders. Social disapproval in the form of real time negative feedback prevented a decrease in stress levels that otherwise women reported following engagement in either social or non-social synchronization. Surprisingly, for certain personality traits, negative social feedback during sensorimotor synchronization was psychologically beneficial irrespective of gender. Salivary oxytocin levels increased only in women after the social but not the non-social synchronization tasks. Oxytocin dynamics were independent of the type of real time feedback that subjects received, indicating the existence of distinct mechanisms for hormonal versus behavioral changes following synchronization. Nevertheless, changes in salivary oxytocin after positive social feedback correlated with changes in well-being and predicted changes in prosocial attitudes. Our findings show evidence of distinct mechanisms for behavioral versus hormonal changes following social sensorimotor synchronization, and indicate that gender and personality traits should be carefully considered when designing behavioral therapies for improving social attitudes and for stress management.

Links Between the Neurobiology of Oxytocin and Human Musicality

The human species possesses two complementary, yet distinct, universal communication systems—language and music. Functional imaging studies have revealed that some core elements of these two systems are processed in closely related brain regions, but there are also clear differences in brain circuitry that likely underlie differences in functionality. Music affects many aspects of human behavior, especially in encouraging prosocial interactions and promoting trust and cooperation within groups of culturally compatible but not necessarily genetically related individuals. Music, presumably via its impact on the limbic system, is also rewarding and motivating, and music can facilitate aspects of learning and memory. In this review these special characteristics of music are considered in light of recent research on the neuroscience of the peptide oxytocin, a hormone that has both peripheral and central actions, that plays a role in many complex human behaviors, and whose expression has recently been reported to be affected by music-related activities. I will first briefly discuss what is currently known about the peptide’s physiological actions on neurons and its interactions with other neuromodulator systems, then summarize recent advances in our knowledge of the distribution of oxytocin and its receptor (OXTR) in the human brain. Next, the complex links between oxytocin and various social behaviors in humans are considered. First, how endogenous oxytocin levels relate to individual personality traits, and then how exogenous, intranasal application of oxytocin affects behaviors such as trust, empathy, reciprocity, group conformity, anxiety, and overall social decision making under different environmental conditions. It is argued that many of these characteristics of oxytocin biology closely mirror the diverse effects that music has on human cognition and emotion, providing a link to the important role music has played throughout human evolutionary history and helping to explain why music remains a special prosocial human asset. Finally, it is suggested that there is a potential synergy in combining oxytocin- and music-based strategies to improve general health and aid in the treatment of various neurological dysfunctions.

The "Managed" or Damaged Heart? Emotional Labor, Gender, and Posttraumatic Stressors Predict Workplace Event-Related Acute Changes in Cortisol, Oxytocin, and Heart Rate Variability

Vital to the everyday operation of police services, police communicators (911 call-takers and dispatchers) are persistently subject to imminent challenges in the workplace; they must always be prepared to engage and deal with a wide variety of circumstances that provoke various intense emotions and physiological stress responses. Acute changes in cortisol, oxytocin, and heart rate variability are central to adaptive responses in stressful complex social interactions, but they might also be indicative of physiological dysregulation due to long-term psychosocial stress exposures. Thus, we examine acute stress-induced release of peripheral oxytocin and cortisol along with changes in heart rate variability, and how each relates to persistent workplace stressors and symptoms of posttraumatic stress. Findings indicate chronic forms of gendered workplace stress such as emotional labor, gender role stress and, posttraumatic stress each have differential associations with, and predict physiological responses to, acutely stressful events in the workplace. These associations suggest potential mechanisms through which communicators become more vulnerable to developing stress-related disorders such as posttraumatic stress injuries, especially after cumulative traumatic exposures in this context. The results also suggest potential pathways for the biological embedding of stressful gendered workplace experiences.

Oxytocin & well-being as promoters of affect regulation and homeostasis: a neuroscientific review

Neurohormone oxytocin release affects mood and behavior in humans, regulating emotional and physiologic aspects.  Neuroscience associates well-being to oxytocin to characterize a general positive-valenced emotional state.  However, the terms well-being and oxytocin are absent, or present in a limited way, in most indexes of psychological terminology and health science descriptors.  This study aimed at studying how this association occurs in literature, based on a systematic review on oxytocin and well-being in the last five years.  Main results: the neuroscientific context seemed to be the most adequate to the study between oxytocin and well-being; association between psychological and neuroendocrine aspects was unusual; medical templates predominated over psychological references;  oxytocin release and feelings of well-being were associated to stimuli of the affective-sensorial type, to psychiatric interventions, to familiarity; results varied according to age, gender, context and personality.  

Why is music therapeutic for neurological disorders? The Therapeutic Music Capacities Model

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.

The Effects of Essential Oil on Salivary Oxytocin Concentration in Postmenopausal Women

Objectives: The aim of this study was to find essential oils that have increased the oxytocin concentration in postmenopausal women. Methods: Fifteen postmenopausal women participated in this study and the effects of 10 different essential oils were investigated. The essential oils included rose otto, sweet orange, lavender, neroli, frankincense, jasmine absolute, ylang ylang, roman chamomile, clary sage, and Indian sandalwood. The subjects were exposed to the control first for 20 min, followed by exposure to an essential oil for 20 min. Each subject received exposure to only a single kind of essential oil per day. Saliva was collected four times for each patient: immediately before and immediately after control exposure, and immediately before and immediately after essential oil exposure. The oxytocin concentration in the saliva was measured using a competitive ELISA kit. Results: The results showed that salivary oxytocin concentrations increased significantly more after exposure to lavender, neroli, jasmine absolute, roman chamomile, clary sage, and Indian sandalwood than after exposure to the control odor. Conclusions: The aroma of certain essential oils may elicit increased secretion of oxytocin in postmenopausal women. This study suggests that olfactory stimulation with any of a number of essential oils increases salivary oxytocin concentrations, which may inhibit aging-induced reduction in muscle mass and function in women.

Experimental empathy induction promotes oxytocin increases and testosterone decreases

Oxytocin and testosterone coordinate adaptive social behaviors with stimuli in the environment. Administration of oxytocin and testosterone is associated with increased and reduced indicators of empathy, respectively, but how levels of these hormones are jointly affected by naturalistic empathy-inducing stimuli remains unclear. In this study, salivary oxytocin and testosterone levels were measured in 173 healthy adults before and after watching a video involving a gravely ill child. Participants also completed questionnaires to assess psychological variables predicted to affect oxytocin reactivity (Autism-Spectrum Quotient, Interpersonal Reactivity Index, Empathy and Systemizing Quotients). On average, there was a 14% increase in oxytocin (p = 0.003) and 4% decrease in testosterone (p = 0.001) pre- to post-video. Opposite directional changes in hormone levels occurred together, as supported by a chi-square test (p < 0.001) and a circular statistics test (p < 0.05). Considered separately, psychological traits did not predict hormone levels or changes to any appreciable degree. However, oxytocin and testosterone changes were linked with empathy relative to systemizing such that: (1) 'Empathy Bias' was associated with a large oxytocin increase but little change in testosterone, while (2) 'Systemizing Bias' and 'Balance' between empathy and systemizing were associated with a decrease in testosterone but little change in oxytocin. These findings suggest that participants were divisible into 'high oxytocin responders' (relatively empathetic) and 'high testosterone responders' (balanced or systemizing-biased). These findings support a model of joint, opposite changes in oxytocin and testosterone under experimental empathy induction, with high, somewhat predictable, diversity in individual responses.

Enhancing mental health recovery by joining arts-based groups: a role for the social cure approach

BACKGROUND

. Even though emerging evidence suggests that participation in arts-based group programs are helpful in supporting mental health, the field lacks an established theorical framework. This study explored the extent to which participants' experiences of singing or creative writing groups aligned with theorising proposed by the social cure approach.

METHODS

. Semi-structured interviews were conducted with 25 choir members, and 23 creative writing group members with chronic mental health conditions at two time points. Transcripts of the interviews were examined by four coders using thematic analysis.

RESULTS

. Consistent with social cure theorising, participation in the choir and creative writing group facilitated meeting participants' needs for belonging, support, self-efficacy, purpose, and positive emotions.

CONCLUSIONS

. This study demonstrated the psychosocial mechanisms by which participation in arts-based groups can enhance mental health. We conclude that engagement with the social cure framework may be useful to structure practice in this field.

Effects of group singing versus group music listening on hospitalized children and adolescents with mental disorders: A pilot study

Background

There is an emerging view that music-related interventions (MuRI) may play an important role for youth with mental disorders. Here, we assessed the potential neuroendocrine (cortisol), immune (IgA) and psychological (mood state, health-related quality of life (HRQOL), well-being) efficacy of a brief program of MuRI (group singing versus group music listening) in children and adolescents with mental disorders in a clinical setting.

Methods

We performed this observational pilot study with 17 patients (aged 11-18; 11 female) admitted to the Department for Child and Adolescent Psychiatry/PMU Salzburg, Austria between March 2015 and April 2016. Patients participated in either a singing program or a music listening program, delivered through five daily, consecutive 45-minute sessions in one week.

Outcomes

Saliva samples for cortisol and IgA, and subjective measures of mood were taken daily, pre- and post-MuRI. HRQOL and well-being were measured pre- and post-5-day-program of MuRI. The program in singing led to a significantly larger mean drop in cortisol than in music listening (mean difference: -0·32; 95% CI -0·57 to -0·07), while listening led to a significantly higher mean positive change in the dimension calmness (mean difference: -2·66, 95%CI -4·99 to -0·33) than singing. Moreover, singing was associated with an improvement in HRQOL, and listening with an improvement in well-being.

Interpretation

Our preliminary findings suggest that MuRI may provide benefits for children and adolescents with mental disorders. The differences in psychobiological responses to singing and music listening invite further investigations. A larger, suitably powered study is now needed to provide a precise estimate of the effects of MuRI for mental health promotion, both on psychological and biological experiences. Funding: Salzburg Festival, Austria, and Focus Area 'Science and Art', Salzburg, Austria.

An Analysis of Endocannabinoid Concentrations and Mood Following Singing and Exercise in Healthy Volunteers

The euphoric feeling described after running is, at least in part, due to increased circulating endocannabinoids (eCBs). eCBs are lipid signaling molecules involved in reward, appetite, mood, memory and neuroprotection. The aim of this study was to investigate whether activities other than running can increase circulating eCBs. Nine healthy female volunteers (mean 61 years) were recruited from a local choir. Circulating eCBs, haemodynamics, mood and hunger ratings were measured before and immediately after 30 min of dance, reading, singing or cycling in a fasted state. Singing increased plasma levels of anandamide (AEA) by 42% (P < 0.05), palmitoylethanolamine (PEA) by 53% (P < 0.01) and oleoylethanolamine (OEA) by 34% (P < 0.05) and improved positive mood and emotions (P < 0.01), without affecting hunger scores. Dancing did not affect eCB levels or hunger ratings, but decreased negative mood and emotions (P < 0.01). Cycling increased OEA levels by 26% (P < 0.05) and tended to decrease how hungry volunteers felt, without affecting mood. Reading increased OEA levels by 28% (P < 0.01) and increased the desire to eat. Plasma AEA levels were positively correlated with how full participants felt (P < 0.05). Plasma OEA levels were positively correlated with positive mood and emotions (P < 0.01). All three ethanolamines were positively correlated with heart rate (HR; P < 0.0001). These data suggest that activities other than running can increase plasma eCBs associated with changes in mood or appetite. Increases in eCBs may underlie the rewarding and pleasurable effects of singing and exercise and ultimately some of the long-term beneficial effects on mental health, cognition and memory.

Sex Differences in Salivary Oxytocin and Cortisol Concentration Changes during Cooking in a Small Group

Background: Oxytocin (OT), a neuropeptide, has positive effects on social and emotional processes during group activities. Because cooking is an integrated process in the cognitive, physical, and socio-emotional areas, cooking in a group is reported to improve emotion and cognition. However, evidence for efficacy in group cooking has not been well established at the biological level. Methods: To address this shortcoming, we first measured salivary levels of OT and cortisol (CORT), a biomarker of psychological stress, before and after group cooking for approximately 1 h by people who know each other in healthy married or unmarried men and women. We then compared the initial OT and CORT concentrations with those during individual non-cooking activities in isolation. Results: Baseline OT concentrations before group and non-group sessions did not significantly differ and OT levels increased after both types of activity in men and women. In men, however, the percentage changes of OT levels in the first over the second saliva samples were significantly small during cooking compared with those in individual activities. In women, however, such a difference was not observed. In contrast, the mean salivary CORT concentrations after group cooking were significantly decreased from the baseline level in both sexes, though such decreases were not significant after individual activity sessions. The sex-specific differences were marital-status independent. Conclusion: These results indicate that OT and CORT concentrations after two activity sessions by a familiar group changed in opposite directions in a sex-specific manner. This suggests that, because cooking is experience-based, we need to consider the sex-specific features of group cooking if we apply it for intervention.

Psychobiological Effects of Choral Singing on Affective State, Social Connectedness, and Stress: Influences of Singing Activity and Time Course

Previous studies have suggested that there are complex psychobiological effects of amateur choral singing on well-being. Here, we investigate the influences of singing vs. non-singing on psychological and biological measurements, reflecting current positive and negative affect, perceived social connectedness, and physiological stress. We hypothesized that active singing leads to significant increases in these measurements compared to participating without singing. Amateur choristers (Exp. 1: N = 54, age range 18–85 years and Exp. 2: N = 49, age range 18–85 years) were tested in two experiments in which approximately half of the group was asked not to sing over periods of 30 (Exp. 1) and 60 min (Exp. 2), while the other half of the group sang. Dependent measures included scales for positive and negative affect and perceived social connectedness. In addition, saliva samples were collected to assess cortisol and alpha-amylase. The results revealed that singing activity had positive influences on affect measurements. However, significant increases in perceived social connectedness for singing were found only in Exp. 2. Biomarker changes were not significant across the experiments. Together, our findings suggest that both singing activity and duration of singing modulate psychological effects, with perceived social connectedness evolving over larger time spans than 30 min. Findings support the notion of beneficial psychological effects also for individuals, who report lower levels of general social support. The unexpected absence of biological effects warrants further investigation.

Immunological and Quality-of-Life Profiles in Women with Breast Cancer: Complementary versus Conventional Care

BACKGROUND

Previous studies showed that women with breast cancer treated in anthroposophic clinic versus conventional care had increased quality of life (QoL) parameters, fighting spirit, and anxiety coping. We have now analyzed immune and QoL factors in these 2 groups for possible differences during the first 6 months after admission, prompted by anthroposophic studies, including mistletoe extracts, showing beneficial immune system effects.

PATIENTS AND METHODS

Fourteen immunological variables, including leukocyte count, lymphocyte count, activated T cells (CD4+ and CD8+), NK cells, B cells, IL1β, IL6, IL10, and oxytocin, were longitudinally analyzed in both groups (n = 2 × 26). A panel of QoL parameters were analyzed using 3 different instruments. Statistical evaluation included that each patient was its own control.

RESULTS

Cytotoxic CD8+ T cell frequency (percent of lymphocytes analyzed by flow-cytometry) significantly decreased over time in the anthroposophic group versus the conventional group (repeated measures ANOVA, p = 0.05). No major differences were observed in other immunological parameters, whereas QoL variables, anxiety decreased and physical symptoms increased/improved significantly in the anthroposophic group (p = 0.04 and p = 0.05, respectively).

CONCLUSION

Overall, women with breast cancer in anthroposophic or conventional therapy did not differ in their immune profiles over time, with exception of decreased cytotoxic T cells in the anthroposophic group. Improvement in physical symptoms along with less anxiety in this group may have influenced the brain-immune axis resulting in lower frequency of CD8+ T cells, a feature associated with less aggressive cancer stages. To evaluate whether this observation is associated with good or bad prognosis, further detailed analyses of memory and naïve CD8+ T cells at tumor site and in blood circulation are essential.

Music and the Meeting of Human Minds

Over tens of thousands of years of human genetic and cultural evolution, many types and varieties of music and language have emerged; however, the fundamental components of each of these modes of communication seem to be common to all human cultures and social groups. In this brief review, rather than focusing on the development of different musical techniques and practices over time, the main issues addressed here concern: (i) when, and speculations as to why, modern Homo sapiens evolved musical behaviors, (ii) the evolutionary relationship between music and language, and (iii) why humans, perhaps unique among all living species, universally continue to possess two complementary but distinct communication streams. Did music exist before language, or vice versa, or was there a common precursor that in some way separated into two distinct yet still overlapping systems when cognitively modern H. sapiens evolved? A number of theories put forward to explain the origin and persistent universality of music are considered, but emphasis is given, supported by recent neuroimaging, physiological, and psychological findings, to the role that music can play in promoting trust, altruistic behavior, social bonding, and cooperation within groups of culturally compatible but not necessarily genetically related humans. It is argued that, early in our history, the unique socializing and harmonizing power of music acted as an essential counterweight to the new and evolving sense of self, to an emerging sense of individuality and mortality that was linked to the development of an advanced cognitive capacity and articulate language capability.

Salivary Oxytocin Concentration Changes during a Group Drumming Intervention for Maltreated School Children

Many emotionally-disturbed children who have been maltreated and are legally separated from their parents or primary caregivers live in group homes and receive compulsory education. Such institutions provide various special intervention programs. Taiko-ensou, a Japanese style of group drumming, is one such program because playing drums in a group may improve children’s emotional well-being. However, evidence for its efficacy has not been well established at the biological level. In this study, we measured salivary levels of oxytocin (OT), a neuropeptide associated with social memory and communication, in three conditions (recital, practice, and free sessions) in four classes of school-aged children. Following the sessions, OT concentrations showed changes in various degrees and directions (no change, increases, or decreases). The mean OT concentration changes after each session increased, ranging from 112% to 165%. Plasma OT concentrations were equally sensitive to drum playing in school-aged boys and girls. However, the difference between practice and free play sessions was only significant among elementary school boys aged 8–12 years. The results suggest that younger boys are most responsive to this type of educational music intervention.