Impaired Maintenance of Interpersonal Synchronization in Musical Improvisations of Patients with Borderline Personality Disorder

Interpersonal synchronization: An overlooked factor in development, social cognition, and psychopathology

Intact social functioning relies on a combination of explicit and implicit behavioral, attentional, and interpersonal processes referred to as "social cognition". Characterizing these interpersonal processes forms a critical underpinning to understanding and treating psychopathology, particularly in disorders where deficits in social functioning do not emerge as a secondary symptom but rather as an essential feature of the disorder. Two of such disorders are autism spectrum disorders (ASD) and schizophrenia spectrum disorders (SZ). However, despite the substantial overlap in the features of social dysfunction between ASD and SZ, including social cognitive deficits in theory of mind, perspective-taking, and empathy, there is a limited understanding of the mechanisms underlying those shared deficits, and how to treat them. We suggest that disruptions of interpersonal functioning emerge over the course of development, and that interpersonal synchronization, a phenomenon in which behavioral and physiological cues align between interacting partners, forms a critical component of social cognition that underlies the disruption in social functioning in ASD and SZ. We present a conceptual review of typical and atypical development of social processes and highlight the role of interpersonal synchronization across the course of development. Then, we review the existing evidence suggesting impairments in both the intentional and spontaneous synchronization of interpersonal processes in ASD and SZ, as well as studies suggesting that interpersonal synchronization and clinical symptoms may be improved through body-oriented interventions within these disorders. Finally, we suggest potential mechanisms that may underpin typical and atypical development of interpersonal synchronization.

De-sync: disruption of synchronization as a key factor in individual and collective creative processes

Creativity is a key skill for the twenty-first century, where the individual and collective imperative to adapt is omnipresent. Yet, it is still unclear how to put creativity theories into practice, which signals a lacuna in our understanding of the pragmatic means by which we get creative. This paper starts from the identification of a number of gaps in the literature. In particular, individual and group creativity are usually treated separately, and the emphasis on the search for novelty seems to overshadow the importance experts give to the disruption of their habitual patterns of behavior. To overcome these gaps, we propose foundations for a unifying framework that takes the perspective of dynamical systems. Specifically, we suggest that de-synchronization, a hallmark of disruption, is an integral part of the creative processes that operate across individual and collective levels of analysis. We show that by conjuring uncertainty, de-synchronized states provide opportunities for creative reorganization. In order to ground this framework, we survey and discuss existing literature, and focus on group improvisation practices (in particular, music and dance improvisation), where partners use the dynamics of their interaction to bring forth a collective performance in real-time. In these practices, disruption by de-synchronization, termed here as 'problematization of coordination', is a pragmatic approach used to push the creative process forward. We suggest that this approach might also be relevant in other types of individual and collective creative processes.

Intra- and inter-brain coupling and activity dynamics during improvisational music therapy with a person with dementia: an explorative EEG-hyperscanning single case study

Objective

Real-life research into the underlying neural dynamics of improvisational music therapy, used with various clinical populations, is largely lacking. This single case study explored within-session differences in musical features and in within- and between-brain coupling between a Person with Dementia (PwD) and a music therapist during a music therapy session.

Methods

Dual-EEG from a music therapist and a PwD (male, 31 years) was recorded. Note density, pulse clarity and synchronicity were extracted from audio-visual data. Three music therapists identified moments of interest and no interest (MOI/MONI) in two drum improvisations. The Integrative Coupling Index, reflecting time-lagged neural synchronization, and musical features were compared between the MOI and MONI.

Results

Between-brain coupling of 2 Hz activity was increased during the MOI, showing anteriority of the therapist's neural activity. Within-brain coupling for the PwD was stronger from frontal and central areas during the MOI, but within-brain coupling for the therapist was stronger during MONI. Differences in musical features indicated that both acted musically more similar to one another during the MOI.

Conclusion

Within-session differences in neural synchronization and musical features highlight the dynamic nature of music therapy.

Significance

The findings contribute to a better understanding of social and affective processes in the brain and (interactive) musical behaviors during specific moments in a real-life music therapy session. This may provide insights into the role of such moments for relational-therapeutic processes.

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.

A Systematic Review of Scientific Studies on the Effects of Music in People with Personality Disorders

Personality Disorders (PDs) are psychiatric conditions involving maladaptive personality traits and behaviours. Previous research has shown that musical preferences and the use of music may be related to personality traits. Additionally, music therapy is increasingly being used as a treatment option for people with PDs. Using the PRISMA guidelines, a systematic literature search was undertaken using three databases: PubMed, Web of Science, and PsycInfo. The following search terms were used: PubMed: "personality disorder" AND (music OR "music therapy"); Web of Science (advanced search): TS = (personality disorder) AND TS = (music or "music therapy"); PsycInfo: "personality disorder" AND (music OR "music therapy"). A total of 24 studies were included in this review and summarised into four categories: music preference, music therapy, music performance, and music imagery, all in relation to PDs or traits associated with PDs. The analysis found that individuals with personality traits associated with PDs may prefer different types or genres of music or interact with music differently than those without these traits. Additionally, music therapy (MT) was found to offer a potentially useful treatment option for PDs. The power of these findings was limited by the small number of included studies. This review offers a useful foundation upon which further research looking at MT as a potential treatment option for PDs can be built.

Inter-brain plasticity as a biological mechanism of change in psychotherapy: A review and integrative model

Recent models of psychopathology and psychotherapy highlight the importance of interpersonal factors. The current review offers a biological perspective on these interpersonal processes by examining inter-brain synchrony-the coupling of brain activity between people interacting with one another. High inter-brain synchrony is associated with better relationships in therapy and in daily life, while deficits in the ability to achieve inter-brain synchrony are associated with a variety of psychological and developmental disorders. The review suggests that therapy improves patients' ability to achieve such synchrony through inter-brain plasticity-a process by which recurring exposure to high inter-brain synchrony leads to lasting change in a person's overall ability to synchronize. Therapeutic sessions provide repeated situations with high inter-brain synchrony. This can lead to a long-term increase in the ability to synchronize, first with the therapist, then generalized to other interpersonal relationships, ultimately leading to symptom reduction. The proposed inter-brain plasticity model offers a novel biological framework for understanding relational change in psychotherapy and its links to various forms of psychopathology and provides testable hypotheses for future research. Understanding this mechanism may help improve existing psychotherapy methods and develop new ones.

Interpersonal Synchronization Protects Against the Antisocial Outcomes of Frustration

Prosociality improves with interpersonal synchronization-the temporal coordination of movement across individuals. We tested whether the benefits of interpersonal synchronization extend to temporary circumstances of induced frustration, where negative changes in prosociality are expected as a result. Participants performed two joint tasks-synchronization versus non-synchronization. Each task was performed twice, with high versus low induced frustration. After each joint task, prosociality was measured both with explicit tests, in which participants were aware of the test goal, and implicit ones, where they were less aware. Frustration levels per task were also reported. Results showed that increase in frustration led to decrease in implicit prosociality after the non-synchronization task, but not after synchronization, suggesting that interpersonal synchronization attenuates the antisocial outcomes of frustration. In addition, our study highlights the advantages of implicit measures of prosociality, among which the test we created (Interpersonal Trust Test) may stand as a useful resource in future experimental research.

Music Therapy During COVID-19: Changes to the Practice, Use of Technology, and What to Carry Forward in the Future

In recent years, the field of music therapy (MT) has increasingly embraced the use of technology for conducting therapy sessions and enhancing patient outcomes. Amidst a worldwide pandemic, we sought to examine whether this is now true to an even greater extent, as many music therapists have had to approach and conduct their work differently. The purpose of this survey study is to observe trends in how music therapists from different regions around the world have had to alter their practice, especially in relation to their use of technology during the COVID-19 pandemic, because of limited options to conduct in-person therapy due to social distancing measures. Further, the findings aim to clarify music therapists’ perspectives on the benefits and limitations of technology in MT, as well as online MT. In addition, this survey investigated what changes have been necessary to administer MT during COVID-19, in terms of virtual therapy and online tools, and how the changes made now may affect MT in the future. We also explored music therapists’ views on whether special technology-focused training might be helpful to support the practice of MT in the future. This is the first survey, to our knowledge, to break down opinions of and trends in technology use based on geographical region (North America, Europe, and Asia), and several noteworthy differences were apparent across regions. We hope our findings provide useful information, guidance, and a global reference point for music therapists on effectively continuing the practice of MT during times of crisis, and can encourage reflection and improvement in administering MT.

The role of impairments in self-other distinction in borderline personality disorder: A narrative review of recent evidence

Impairments in maintaining a differentiated sense of "self" and "other" are thought to be a central feature of borderline personality disorder (BPD). However, studies directly focusing on self-other distinction (SOD) in BPD are scarce, and these findings have not yet been integrated with novel insights into the neural mechanism involved in SOD. Here, we present a narrative review of recent behavioral and neuroimaging findings focusing on impairments in SOD in BPD. Behavioral findings of SOD at the embodied level provide preliminary evidence for impairments in multisensory integration in BPD. Furthermore, both behavioral and neuroscientific data converge to suggest that SOD impairments in BPD reflect an inability to shift between self and other representations according to task demands. Research also suggests that disruptions in infant-caregiver synchrony may play a role in the development of these impairments. Based on these findings, we present a new, integrative model linking impairments in SOD to reduced neural and behavioral synchrony in BPD. The implications of these findings for future research and clinical interventions are outlined.