Article

The Effect of Mindfulness-Based Music Therapy on Attention and Mood in Women Receiving Adjuvant Chemotherapy for Breast Cancer: A Pilot Study

May 2015
Oncology Nursing Forum 42(3):276-82

DOI:10.1188/15.ONF.276-282

Source
PubMed

Authors:

University of Miami

To explore the efficacy of mindfulness- based music therapy (MBMT) to improve attention and decrease mood distress experienced by women with breast cancer receiving adjuvant chemotherapy. . Quantitative, descriptive, longitudinal approach. . A comprehensive cancer hospital and a university in southern Florida. . 15 women with a diagnosis of breast cancer, stages I-III, receiving adjuvant chemotherapy. . Participants individually received MBMT for one hour per week for four weeks. The sessions consisted of varied music activities accompanied by mindfulness attitudes, or mental strategies that enhance moment-to-moment awareness, and weekly homework. Demographic information was collected at baseline. . Attention was measured using Conners' Continuous Performance Test II. Mood was measured using the Profile of Mood States-Brief Form. Narrative comments collected from the homework assignments served to reinforce quantitative data. . Repeated measures analysis of variance showed that attention improved significantly over time. Although all mood states significantly improved from the beginning to the end of each MBMT session, the mood state of fatigue decreased significantly more than the other mood states. . MBMT enhances attention and mood, particularly the mood state of fatigue, in women with breast cancer receiving adjuvant chemotherapy. . A preferred music listening and mindfulness exercise may be offered to women with breast cancer who experience attention problems and mood distress. .

Integrative perspectives on mindfulness, music and music therapy: A literature review

Article

Full-text available

Aug 2021

Mi hyang Hwang

With increasing recognition of the advantage of working within a multidisciplinary team and interdisciplinary study for health, the incorporation of music and mindfulness across healthcare disciplines has become more common. The aim of this study was to explore the integrating theory and practice, key principles, and psychodynamic perspectives with respect to music therapy and mindfulness. Thirty articles were selected from electronic databases and grey literature. Conference abstracts and informal literature reviews were excluded. The articles were categorised and analysed according to methods, interventions, outcome measures and key messages. Key outcomes from the studies revealed that integrating mindfulness and music can enhance the musical experience, facilitate the music therapy process (e.g. Guided Imagery and Music), and contribute to mental wellness (e.g. stress reduction, emotional support, and self awareness). Based on the data analysis, two core themes were identified: a) psychodynamic perspectives of mindfulness and music therapy; and b) here and now, letting go, nonself, nonattachment and being non-judgmental. The link between music and mindfulness has been recognised during recent decades, and combining music and mindfulness demonstrated positive outcomes in the literature. The findings revealed several key perspectives and approaches between mindfulness-based practice (MBP) and music therapy. These findings can offer a new outlook to the therapeutic relationship and can give a practical and theoretical framework of combining mindfulness and music therapy.

Mindfulness-based interventions and cognitive function in cancer survivors: a systematic review and meta-analysis

Article

Full-text available

Feb 2023

Deterioration in cognitive function is common among cancer survivors undergoing treatment. These problems may persist for several years after completion of treatment and can adversely affect cancer survivors' treatment adherence and quality of life. The cause of cognitive changes in cancer survivors is unclear, although it is likely a complex interaction of disease-related, treatment-related, and psychological factors. Mindfulness-based interventions (MBIs) are one promising intervention for cancer survivors to alleviate unwanted and burdensome side effects, including disruptions in cognitive function. The aim of the current review was to synthesize the literature on MBIs and cognitive function in cancer survivors. We searched five databases from inception on May 27, 2021 (original search), and May 4, 2022 (updated search): PubMed, MEDLINE Ovid, EMBASE Ovid, PsycInfo Ovid, CINAHL EBSCO, and Web of Science. Articles were screened at the abstract and full-text level by two reviewers. A total of 1916 records were retrieved, and 24 unique studies met the inclusion criteria. There was significant variability across studies regarding type of MBIs investigated, types of cognitive outcome measures used, and study assessment timelines. Eleven studies were included in a meta-analysis of self-reported cognitive function, significantly favoring MBIs over inactive controls (ie, usual care) (standardized mean difference = 0.86; 95% confidence interval = 0.32–1.41). A similar model, including four studies, compared MBIs with active controls (ie, music listening, metacognition treatment, fatigue education and support, walking program); this model also demonstrated a statistically significant pooled effect (standardized mean difference = 0.61; 95% confidence interval = 0.23–0.99). Owing to a small number of studies, meta-analysis could not be completed for objectively assessed cognitive function; a narrative summary for this outcome revealed mixed results. MBIs demonstrated evidence for improving cognitive function among cancer survivors and particularly self-reported cognitive function. However, most studies demonstrated a high risk of bias and significant concerns regarding study quality. Further research is needed to determine the effects of MBIs on both self-reported and objectively assessed cognitive function for cancer survivors, as well as optimal intervention structure and timing.

Music and mindfulness meditation: Comparing four music stimuli composed under similar principles

Article

Nov 2020

Mindfulness meditation has frequently used sound and music as an important component. However, research on effective music stimuli is scarce. After a series of studies evaluating the most effective, useful, and preferred auditory stimuli, we were interested in exploring whether these effective musical features were transferred to new music. In this study, we evaluate our original music stimuli with three new stimuli composed under similar principles. Non-musician and musician participants (N = 114) in a multisite study evaluated their mindfulness state after listening to four music stimuli, and rated their usefulness and preference. Results from a repeated-measures analysis of variance (ANOVA) at each site indicated no significant difference in mindfulness effectiveness. Friedman’s ANOVAs for the usefulness of the music stimuli showed similar non-significant results in both sites. A mixed model among sites did not show significant differences among groups. Preference rankings were not significantly different for non-musicians, but musicians did show a statistically significant preference of the Original stimuli over Stimulus 2, probably due to sound quality. These results indicate the feasibility of transferring previously researched and effective musical features to new stimuli. Identifying the effective “active ingredients” of music interventions may be one way of supporting evidence-based practice in music therapy.

Music Stimuli for Mindfulness Practice: A Replication Study

Article

Oct 2020

Mindfulness is a natural human capacity to be aware of the present moment, without judgment, rejection, or attachment to it. Cultivating a mindful state has been related to improvements in mood and stress management. Mindfulness practices may be enhanced with music. The purpose of this study was to replicate a previous study regarding the effectiveness, preference, and usefulness of different auditory stimuli for mindfulness practice. Undergraduate nonmusicians (N = 53) listened to 4 different auditory stimuli of increasing complexity, guiding them in a mindfulness experience. Participants rated their mindfulness experience, provided data on their absorption in music, and ranked auditory stimuli according to preference and usefulness for mindfulness practice. A within-subjects design was used to compare the four conditions, counterbalanced, and randomized across participants. Similar to the original study, Friedman analysis of variances (ANOVAs) and post hoc analyses indicated that participants ranked the Melody and Harmony conditions as most preferred and useful. Different from the original results, the repeated-measures ANOVA of the Mindful Attention Awareness Scale scores did not reveal significant differences among auditory stimuli for mindfulness experience. These results provide support for the use of music in mindfulness experiences with a mildly complex stimulus (script, beat, harmony, and melody). However, partially replicated results indicate the need to investigate the discrepancy between participants’ effectiveness ratings and preference/usefulness rankings.

Mindfulness-based Arts Interventions for Cancer Care: A Systematic Review of the Effects on Wellbeing and Fatigue

Article

Feb 2021

Objective: Upon receiving a cancer diagnosis, life irrevocably changes and complex experiences of emotional distress often occur. There is a growing interest in mindfulness-based arts interventions (MBAIs) to ameliorate the distress many patients experience. Our review objective was to synthesize the evidence on the effectiveness of MBAIs on psychological wellbeing and fatigue. Method: Relevant quantitative articles were identified through a systematic search of the grey literature and online databases including MEDLINE, CINAHL, Cochrane CENTRAL, Art Full Text, ART bibliographies Modern, PsycINFO, Scopus, and EMBASE. Two independent reviewers screened titles/abstracts against predetermined inclusion criteria, read full-text articles for eligibility, conducted quality appraisals of included articles, and extracted pertinent data with a standardized data extraction form. The heterogeneity of the included studies precluded a meta-analysis and a narrative synthesis of study outcomes was conducted. Results: Our systematic search retrieved 4,241 titles/abstracts, and 13 studies met our inclusion criteria (8 RCTs and 5 quasi-experiments). Most of the studies focused on patients with cancer (92.3%). There is a growing interest in MBAIs over time and significant heterogeneity in the types of interventions. A significant effect was found on several outcomes that are important in psychosocial oncology: quality of life, psychological state, spiritual wellbeing, and mindfulness. The effect on fatigue was equivocal. Conclusions: This novel intervention demonstrates promise for the psychosocial care of patients with cancer. These findings are an essential antecedent to the continued implementation, development, and evaluation of MBAIs in oncology. This article is protected by copyright. All rights reserved.

Impact of a Music Intervention on Quality of Life in Breast Cancer Patients Undergoing Chemotherapy: A Randomized Clinical Trial

Article

Full-text available

Jul 2020
INTEGR CANCER THER

Background: Music can influence human behavior and may be used as a complementary therapy in health care. Objectives: To assess the effect of music interventions on symptoms, adverse events, and quality of life (QoL) of breast cancer patients undergoing chemotherapy (CT). Design: Nonblinded, randomized clinical trial. Women with breast cancer undergoing adjuvant CT were randomized into 2 groups—Group Music (GM) or Group Control (GC)—and followed during the first 3 cycles of treatment. Measurements: Sociodemographic data, WHOQOL-BREF, BDI-II, BAI, and Chemotherapy Toxicity Scale were assessed. Patients were evaluated after each session of the first 3 CT cycles. GM underwent a 30-minute musical intervention before CT. There was no intervention in the GC. Continuous data were analyzed by Student’s t test, and χ ² test was used to compare qualitative variables. Results: Higher QoL scores on functional scales were observed for the GM in comparison to the GC after the first and third sessions of CT. Depression ( P < .001) and anxiety scores ( P < .001) and vomiting ( P < .01) incidence were lower for the GM in the third session of CT. All the participants in the GM reported positive changes in life in the Subjective Impression of the Subject questionnaire, as well as improvement in fatigue and reduced stress levels. Conclusions: Improvements in QoL, anxiety, depression, and incidence of vomiting were associated with the music intervention, suggesting a positive effect of the music intervention on adverse events of cancer CT.

Effect of music therapy on symptoms, adverse events, and quality of life of breast cancer patients undergoing chemotherapy: A randomized clinical trial.

Article

May 2020

e24140 Background: Music can influence human behavior and may be used as complementary therapy in health care. Objective: To assess the effect of music therapy on symptoms, adverse events and quality of life (QoL) of breast cancer patients undergoing chemotherapy (CT). Methods: Non-blinded, randomized clinical trial. Patients were randomized into two groups: musical group (MG) or control group (CG), and followed during the first 3 cycles of CT. Sociodemographic data, WHOQOL-BREF, BDI-II, BAI and Chemotherapy Toxicity Scale were assessed. Patients were evaluated after each of the first three CT cycles. MG underwent a 30-minute musical intervention prior to CT. There was no intervention in the CG. Results: Higher QoL scores on functional scales were observed for the MG in comparison to the CG after the first and third sessions of chemotherapy. Depression (p < 0.001) and anxiety scores (p < 0.001) and vomiting (p 0.01) incidence were lower for the MG in the third CT session. All participants in the MG reported positive changes in life in the Subjective Impression of the Subject questionnaire, as well as improvement in fatigue and reduced stress levels. Conclusions: Improvements in QoL, anxiety, depression, and incidence of vomiting were associated with music therapy intervention, suggesting a positive effect of music therapy on adverse events of cancer CT. Clinical trial information: RBR-88r347 .

Outcomes of music therapy interventions in cancer patients. A review of the literature

Article

Apr 2019
CRIT REV ONCOL HEMAT

Background Effectiveness of music-based interventions (MI) on cancer patients’ anxiety, depression, pain and quality of life (QoL) is a current research theme. MI are highly variable, making it challenging to compare studies. Objective and methods: To summarize the evidence on MI in cancer patients, 40 studies were reviewed following the PRISMA statement. Studies were included if assessing at least one outcome among anxiety, depression, QoL and pain in patients aged ≥ 18, with an active oncological/onco-haematological diagnosis, participating to any kind of Music Therapy (MT), during/after surgery, chemotherapy or radiotherapy. Results A positive effect of MI on the outcomes measured was supported. Greater reductions of anxiety and depression were observed in breast cancer patients. MI involving patients admitted to a hospital ward were less effective on QoL. Conclusion The increasing evidence about MI effectiveness, tolerability, feasibility and appreciation, supports the need of MI implementation in Oncology, Radiotherapy and Surgery wards, and promotion of knowledge among health operators.

A Mindfulness-Based Music Intervention to Decrease Anxiety and Depression in Cancer Patients

Thesis

Full-text available

Jan 2017

John Britton

The purpose of this paper is to outline and describe the development and implementation of a mindfulness-based music intervention (MBM) for decreasing depression and anxiety in patients with a cancer diagnosis. The development of the intervention is based on a translation of mindfulness practices, research, and function of particular musical elements within mindfulness practice. Initial client responses and comments about the MBM intervention are also provided. The use of mindfulness-based interventions is a prevalent offering for cancer patients in oncology settings often addressing the distress of depression and anxiety. Mindfulness helps decrease symptoms of anxiety and depression by decreasing mental rumination through acceptance of present-moment experience. Music listening and playing can facilitate mindfulness, whereby music assists with improving attention and memory, and increasing positive emotions, acceptance, and motivation. Development and limitations of the outlined intervention, recommendations for future studies, and additional clinical applications are explored.

The Development of a Mindfulness-Based Music Therapy (MBMT) Program for Women Receiving Adjuvant Chemotherapy for Breast Cancer

Article

Full-text available

Aug 2016

Teresa Lesiuk

Problems with attention and symptom distress are common clinical features reported by women who receive adjuvant chemotherapy for breast cancer. Mindfulness practice significantly improves attention and mindfulness programs significantly reduce symptom distress in patients with cancer, and, more specifically, in women with breast cancer. Recently, a pilot investigation of a music therapy program, built on core attitudes of mindfulness practice, reported significant benefits of enhanced attention and decreased negative mood and fatigue in women with breast cancer. This paper delineates the design and development of the mindfulness-based music therapy (MBMT) program implemented in that pilot study and includes clients’ narrative journal responses. Conclusions and recommendations, including recommendation for further exploration of the function of music in mindfulness practice are provided.

Probabilistic dynamic brain response to live Indian classical vocal stimulus

Preprint

Full-text available

Apr 2023

p>Numerous studies have been conducted on the connection between music and the brain, and it has been established that listening to music directly affects brain activity and stimulation. The potential benefits of music therapy, which uses music as a tool for healing and fostering well-being, have come to light in a number of circumstances. However, there is a gap in understanding the effects of Indian classical music (ICM) on the brain and its therapeutic applications. In this work, the authors propose a systematic approach for identifying brain regions evoked to live ICM stimuli, considering input and output uncertainties. The brain responses are captured through 24 channel Electroencephalogram (EEG) cap, which is utilized to allocate electrodes to different regions of the brain. The proposed region specific near-automated framework based on eigen perturbation framework provides a measure to capture the time evolution of brain activity for the melodic transition or transition from a raga to relaxation triggered by Indian classical music. This identification is relevant in understanding dynamic changes in brain responses during musical experiences providing a more comprehensive perception and processing of ICM in the human brain. This automated approach can help integrate it into evidence-based music therapy for cognitive, emotional, and psychological conditions. Probabilistic analysis based on extensive experimental studies with live Indian classical vocal stimuli brings forth many interesting results that are worth delving into for future directions in music therapy. The findings of this study provides evidence indicating ragas activate different brain regions based on listener's musical knowledge.</p

Probabilistic dynamic brain response to live Indian classical vocal stimulus

Preprint

Full-text available

Apr 2023

Effect of Mindfulness Based Cognitive Therapy on the Mental Health and Quality of Life in Patients with Breast Cancer

Article

Full-text available

Jan 2020
Indian J Pharmaceut Sci

Benefits of music therapy as an integrative option in oncological treatment | Beneficios de la musicoterapia como opción integrativa en el tratamiento oncológico

Article

Full-text available

Sep 2020

Objetivo: Identificar la eficacia de los tratamientos musicoterapéuticos que aborden la sintomatología en pacientes con cáncer y que constaten algún tipo de beneficio psicológico, fisiológico, espiritual, social o intelectual. Método: Se realizó un análisis documental que supuso un estudio comparativo de evidencias científicas. Resultados: La musicoterapia minimiza los efectos fisiológicos de tratamientos específicos oncológicos como la quimioterapia, se usa como complemento de la morfina o el sufentanilo disminuyendo el dolor e influye en la vida emocional del paciente. Conclusiones: Es una disciplina que demuestra evidencias positivas en situaciones de tipo emocional reduciendo la depresión, la ansiedad y el estrés, ayudando en la relajación y mejorando el umbral del dolor, postulándose como una opción no-farmacológica que debiera conducir a una implantación cada vez más normalizada en los centros hospitalarios.

Indian Classical music with incremental variation in tempo and octave promotes better anxiety reduction and controlled mind wandering – a randomised controlled EEG study

Article

Mar 2020
EXPLORE-NY

Studies have reported the benefits of music-listening in stress-reduction using musical pieces of specific scale or ‘Raaga’. But the influence of lower-level musical properties (like tempo, octave, timbre, etc.) lack research backing. Carnatic music concerts use incremental modulations in tempo and octave (eg: ‘Ragam-Tanam-Pallavi’) to elevate the mood of audiences. Therefore, the current study aimed to examine the anxiolytic effect of this musical property. A randomized controlled cross-over study with 21 male undergraduate medical students was followed. 11 participants listened to ‘Varying music’ (VM: instrumental music with incremental variations in tempo and octave) and 10 listened to ‘Stable music’ (SM: instrumental music without such variations), thrice daily for 6 days, both clips recorded in Raaga-Kaapi and silence being the control intervention. Electroencephalography (EEG) and Electrocardiography (for heart rate variability or HRV) were done on all 6 days. Beck's Anxiety inventory and State-trait anxiety scale were administered on Day-1 and Day-6. A significant anxiety score reduction was seen only in VM. VM showed marked decrease in lower frequency EEG power in bilateral temporo-parieto-occipital regions compared to silence, whereas SM showed increase in higher frequencies. Relatively, VM showed more midline power reduction (i.e., lower default mode network or DMN activity) and SM showed greater left-dominant alpha/beta asymmetry (i.e., greater right brain activation). During both music interventions HRV remained stable, unlike silence intervention. We speculate that, gradual transition between lower-slower and higher-faster music portions of VM induces a ‘controlled-mind wandering’ state involving balanced switching between heightened mind wandering (‘attention to self’) and reduced mind wandering (‘attention to music’) states, respectively. Therefore, music-selection has remarkable influence on stress-management and warrants further research.

The effectiveness of mindfulness-based arts interventions on psychological wellbeing and fatigue in adults with a physical illness: A systematic review protocol.

Article

Jul 2018

Review question/objective: The objective of this review is to synthesize evidence on the effectiveness of mindfulness-based arts interventions on psychological wellbeing and fatigue in adults with a physical illness.

Effect of a Single Live Group Music Therapy Intervention on Anxiety-State and Well-Being Levels During Chemotherapy: A Multicenter Randomized Clinical Trial Protocol

Article

Full-text available

Dec 2024

Introduction Many cancer patients experience high levels of anxiety during chemotherapy, which can negatively impact their mental health and their physiological, emotional, and spiritual well-being. Different complementary therapies aim to attenuate these effects, including music therapy. Although there is preliminary evidence on the positive effects of music therapy and music-based interventions in chemotherapy wards, few studies report live group interventions delivered by accredited music therapists. Objective To determine the effect of a single live group music therapy intervention on state anxiety and well-being levels of adult cancer patients during chemotherapy. Methodology This study protocol follows the SPIRT guidelines and reports a two-arm multicenter randomized clinical trial (RCT). The intervention group will receive standard care + a live group music therapy session and the control group will receive standard care only. The primary outcome is state anxiety, measured with the six-item State-Trait Anxiety Inventory (STAI-6). The secondary outcome is well-being, measured with the Well-being Numerical Rating Scales (WB-NRSs). The scales will be applied before and after each intervention. Sample size calculation resulted in a total of 102 participants. Conclusions This study seeks to contribute to the improvement of psycho-emotional health and well-being of cancer patients during chemotherapy. It is the first multi-center RCT on music therapy with cancer patients in [country, de-identified for peer review] and aims to gather knowledge about music’s role to improve patients’ mental health during acute treatment. Trial Registration clinicaltrials.gov (NCT06577324, submission date August 21 st , 2024).

Mindfulness's moderating role applied on online SEL education

Article

Full-text available

Nov 2024

Introduction Mild to moderate depression, anxiety, and stress imbalances are prevalent emotional issues among college students and are primary factors leading to deficiencies in social-emotional skills within this population. Without timely intervention, these mild to moderate emotional issues may escalate into more severe conditions. Social-Emotional Learning (SEL) programs are effective for building social-emotional skills. However, current research on SEL programs has not adequately addressed the issue of high-quality teacher-student interactions for students who suffer emotional problems. To tackle this issue, this study proposes a curriculum approach that integrates mindfulness with rhythmic music? and evaluated the emotional changes of students after mindfulness with rhythmic music curriculum. Methods This study adopted a pre-post experimental design. Two hundred and ninety-four firefighting universities students participated in a one-semester “online mindfulness combined with music rhythm SEL course”. The study used the Beck Anxiety Inventory, Center for Epidemiologic Studies Depression Scale and Perceived Stress Scale to measure the anxiety, depression and stress levels of the participants before and after the course, and used the participants' self-reflection reports as a method to explore the students' emotional transformation patterns. Results The research findings indicate that: (1) eighth-note, quarter-note, and sixteenth-note rhythmic music significantly improve the emotional wellbeing of students with depression, anxiety, and stress imbalances, respectively. (2) The degree of emotional improvement has a certain impact on academic performance. (3) Students with anxiety require more instructional support focused on attention concentration during the early phases of the course; students with depression should not be scheduled for social skills learning modules in the short term and need long-term instructional guidance; individuals experiencing stress imbalances require attention to their personal music preferences and benefit from additional listening activities and exercise. Discussion These findings assist teachers in accurately identifying emotional changes among students with emotional problems and managing the patterns of these emotional transitions, thereby providing effective instructional support and promoting high-quality interactions between teachers and students.

Research Progress on Negative Emotions Influencing the Incidence of Breast Cancer

Article

Full-text available

Oct 2024

At present, breast cancer is the largest malignant tumor endangering women’s health, and has become one of the most common cancer types in the world. In recent years, the relationship between psychosocial factors and the incidence of breast cancer has attracted extensive attention. Traditional Chinese medicine research of the motherland suggests that emotional disorder is an important factor leading to breast cancer, and emotional theory and negative emotional accumulation have something in common in some aspects. This article reviews the impact of negative emotions on the risk of breast cancer and the current research progress and explores the possibility of reducing the progress of breast cancer and improving the quality of life of breast cancer patients through negative emotion intervention.

Exploring anxiety as an influencing factor of the impact of exercise and mind-body prehabilitation on cognitive functioning among women undergoing breast cancer surgery

Article

Dec 2023
J PSYCHOSOC ONCOL

Effects and Feasibility of a Mindfulness-Based Guqin Music Intervention During Pregnancy on Postpartum Anxiety and Depression: A Pilot Randomized Controlled Trial

Article

Full-text available

Oct 2023
Mindfulness

Objectives This study aimed to test the effects and feasibility of a mindfulness-based Guqin music intervention (MBGI), administered during pregnancy, on postpartum anxiety and depression. Method Eighty-seven pregnant women, each identified with anxiety and depression, were randomly allocated to one of three groups: 4-week MBGI, Guqin music intervention, or a control group. The participants completed questionnaires on mindfulness, anxiety, depression, and sleep quality at baseline, postintervention, and 6 weeks after delivery. We assessed the feasibility of the intervention by evaluating participant adherence, satisfaction, and any potential difficulties post-intervention. Results The results of the linear mixed model showed that there was a significant treatment-by-time interaction effect in mindfulness (F = 15.658, p < 0.001), anxiety (F = 14.883, p < 0.001), and depression (F = 27.795, p < 0.001) but no significant effects on sleep quality (F = 1.239, p = 0.297). Moreover, decreases in anxiety (b = -0.426, p < 0.001) and depression (b = -0.134, p < 0.001) were significantly correlated with the improvement in mindfulness. Conclusions MBGI, applied during pregnancy, contributes to a decrease in postpartum anxiety and depression, potentially by enhancing mindful attention and awareness. Feasibility outcomes illustrate that MBGI as an intervention for postpartum negative emotions is feasible and well accepted. This study thus proposes a brief, clinically applicable, mindfulness-based music intervention. Preregistration The pilot trial was registered with the Chinese Clinical Trial Registry (ChiCTR2000035242; 4/8/2020).

Exploring Influencing Factors of Anxiety Improvement Following Mindfulness-Based Music Therapy in Young Adults with Cancer

Article

Feb 2023
J MUSIC THER

The purpose of this secondary analysis was to explore physiological, psychological, and situational influencing factors that may affect the impact of a mindfulness-music therapy intervention on anxiety severity in young adults receiving cancer treatment. Young adults receiving cancer treatment for ≥ eight weeks were recruited from adult and pediatric oncology outpatient centers at Dana-Farber Cancer Institute. Participants were asked to attend up to four, in-person (offered virtually via Zoom video conference after the onset of the COVID-19 pandemic) 45-min mindfulness-based music therapy sessions over twelve weeks with a board-certified music therapist. Participants completed questionnaires about anxiety, stress, and other cancer treatment-related outcomes before and after participating in the intervention. Changes in anxiety (i.e., PROMIS Anxiety 4a) over time were compared among baseline physiological (e.g., age or sex), psychological (e.g., stress), and situational influencing (i.e., intervention delivery format) factors using Wilcoxon-rank sum tests. Thirty-one of the 37 enrolled participants completed the baseline and post-intervention measures and were eligible for inclusion in the secondary analysis. Results revealed that higher baseline physical functioning (median change = −6.65), anxiety (median change=-5.65), fatigue (median change = −5.6), sleep disturbance (median change = −5.6), female sex (median change = −5.15), or virtual intervention delivery (median change = −4.65) were potential physiological, psychological, or situational influencing factors associated with anxiety improvement following mindfulness-based music therapy. Additional investigation into physiological, psychological, or situational influencing factors associated with anxiety response will help to tailor the design of future mindfulness-music therapy interventions to decrease psychological distress and address the unique psychosocial concerns among young adults receiving cancer treatment. Trial Registration ClinicalTrials.gov Identifier: NCT03709225

The effect of mindfulness and metacognition on anxiety symptoms: a case-control study

Article

Full-text available

Nov 2022

Background Anxiety disorders (ADs) are associated with numerous psychiatric disorders; despite the efforts in psychotherapy models targeting their etiology, novel treatment strategies are still developing. We aimed to assess whether mindfulness and metacognition differ between patients with ADs and healthy controls (HCs) and whether the symptom severity of ADs is related to mindfulness and metacognition among patients. Two-hundred participants were enrolled in this study. Structured clinical interview, sociodemographic form, Five Facet Mindfulness Questionnaire-Short Form, Metacognition Questionnaire-30, and Hamilton Anxiety Rating Scale were administered. Multivariate analysis of covariance was conducted to compare the groups in terms of mindfulness and metacognition. Correlation and multiple linear regression analyses were performed to measure the association between the variables. Results The main finding indicates that positive beliefs about worry are associated with reduced symptom severity of ADs. Furthermore, HCs have more positive beliefs about worry and nonjudging of inner experience compared to patients with ADs, who utilize negative beliefs about uncontrollability and danger and need to control thoughts to a greater extent. Conclusions This study demonstrates that dysfunctional metacognitive beliefs may influence the anxiety severity of adult patients. We suggest that focusing on reducing maladaptive metacognitions may be supportive of AD improvement.

A Relação entre Música e Atenção: Fundamentos, evidências neurocientíficas e reabilitação

Article

Full-text available

Jun 2021

O presente artigo apresenta um levantamento sobre a relação entre atenção e música, a partir de uma revisão de estudos nas áreas da musicologia cognitiva, neurociências e musicoterapia no campo de música e atenção. O texto divide-se em três seções que agrupam uma revisão de estudos afins: (a) Fundamentos teóricos sobre atenção e música; (b) Evidências neurocientíficas sobre atenção e música; (c) Aplicações terapêuticas da música na atenção. Os estudos da musicologia cognitiva demonstram que agrupamentos perceptivos e expectativas são fatores determinantes para o recrutamento das diversas dimensões da atenção. Exames de neuroimagem, testes neuropsicológicos e estudos sobre a sincronicidade rítmica acrescentam evidências neurocientíficas sobre a forte relação entre música e atenção. As evidências relatadas neste estudo demonstram que música pode ser utilizada em contexto terapêutico com efeitos benéficos para pessoas com prejuízos na atenção ou como um recurso para desviar a atenção de sensações dolorosas ou situações estressantes.

PROPOSIÇÃO DE UMA METODOLOGIA PARA AVALIAÇÃO PADRONIZADA DA ATENÇÃO

Thesis

Full-text available

Nov 2019

Verônica Magalhães Rosário

Os testes de habilidades são instrumentos fundamentais para a avaliação cognitiva. Sua aplicação permite a coleta e análise de dados essenciais tanto para a prática clínica quanto para a pesquisa científica. Dentre as diversas habilidades mensuradas por meio de testes, a atenção apresenta-se como uma competência básica. A atenção é um fenômeno complexo, multidimensional, que permite a interação eficaz do indivíduo com o seu ambiente, subsidiando a organização dos processos mentais. Embora o campo de avaliação padronizada tenha evoluído sobremaneira no que se refere à testagem da atenção, ainda é possível observar uma carência de instrumentos apropriados para a avaliação de populações com necessidades especiais, principalmente no que tange às dificuldades de comando, como é o caso de pessoas com deficiência intelectual (DI) ou transtorno do espectro autista (TEA). Por outro lado, a Musicoterapia tem desenvolvido técnicas de reabilitação atencional que utilizam a música como elemento mediador, de forma a fomentar respostas em pessoas com dificuldades de comando. Tais recursos poderiam ser transferidos para uma metodologia de avaliação padronizada que aplica a música como ferramenta de comunicação dos comandos, facilitando o engajamento e a cooperação dos testandos e oferecendo uma variabilidade de estímulos capaz de mobilizar grupos com níveis heterogêneos de habilidades cognitivas, motoras e de linguagem. Desta forma, o presente trabalho propõe a elaboração de uma metodologia que utiliza a música como estímulo em avaliações padronizadas, construindo um teste de atenção aplicável a crianças e adolescentes com dificuldades de respostas a comandos, como é o caso de pessoas com DI e/ou TEA. O primeiro estudo desta Tese apresenta uma revisão sistemática da literatura sobre a testagem da atenção em pessoas com DI ou TEA, com o intuito de investigar: (1) se existem testes adequados à avaliação desta população, (2) quais seriam as adaptações requeridas e (3) quais os limites e necessidades envolvidos. Os artigos selecionados são apresentados e discutidos a partir de duas categorias de análise: (a) testes, habilidades de atenção e população estudada; (b) procedimentos e adaptações no setting de testagem. São discutidas as principais estratégias empregadas para a compreensão das tarefas, comunicação dos comandos, engajamento durante os procedimentos e formas de emissão de respostas. O segundo estudo da Tese apresenta um levantamento sobre a relação entre atenção e música, a partir de uma revisão de estudos nas áreas da musicologia cognitiva, neurociências e musicoterapia no campo de música e atenção. O texto divide-se em três seções que agrupam uma revisão de estudos afins: (a) Fundamentos teóricos sobre atenção e música; (b) Evidências neurocientíficas sobre atenção e música; (c) Aplicações terapêuticas da música na atenção. Os estudos da musicologia cognitiva demonstram que agrupamentos perceptivos e expectativas são fatores determinantes para o recrutamento das diversas dimensões da atenção. Exames de neuroimagem, testes neuropsicológicos e estudos sobre a sincronicidade rítmica acrescentam evidências neurocientíficas sobre a forte relação entre música e atenção. As evidências relatadas neste estudo demonstram que música pode ser utilizada em contexto terapêutico com efeitos benéficos para pessoas com prejuízos na atenção ou como um recurso para desviar a atenção de sensações dolorosas ou situações estressantes. Por fim, o terceiro estudo da Tese descreve uma proposta de aplicação dos conhecimentos adquiridos nos estudos anteriores para o desenvolvimento de estratégias que possam ser empregadas em uma metodologia para avaliação padronizada da atenção e apresenta o Teste Musical de Atenção Focalizada (TMAF). O TMAF é um teste que utiliza o estímulo musical para avaliar a atenção focalizada em crianças de 4 a 18 anos de idade. Formulado especialmente para atender às necessidades de pessoas com dificuldades acentuadas de comando e/ ou emissão de respostas, é composto por cinco tarefas interativas que empregam o canto e a manipulação de instrumentos musicais. Também são apresentados os estudos de validade de conteúdo do TMAF a partir de duas etapas: a) análise teórica das tarefas; (b) análise semântica das tarefas. A análise teórica foi realizada por 6 juízes especialistas que avaliaram a exequibilidade das tarefas e a validade de conteúdo do teste. A análise semântica foi realizada através da entrevista com 10 familiares de crianças e adolescentes com transtornos do neurodesenvolvimento. Espera-se que essa Tese e as ações propostas favoreçam a aplicação da música como um recurso para avaliação de pessoas com DI e/ ou TEA, colaborando com a prática clínica e a pesquisa baseada em evidências direcionada a tais populações.

PROPOSIÇÃO DE UMA METODOLOGIA PARA AVALIAÇÃO PADRONIZADA DA ATENÇÃO

Thesis

Nov 2019

Verônica Magalhães Rosário

Individualized Piano Instruction for Improving Cognition in Breast Cancer Survivors

Article

Sep 2019

Purpose: To evaluate the use of individualized piano instruction (IPI) for improving cognition among breast cancer survivors. Participants & setting: Six participants were included in an eight-week piano program with three data collection time points at baseline, midpoint, and postintervention. Participants were recruited from the breast cancer clinic of a university cancer center in South Florida. Methodologic approach: Neurocognitive, psychosocial, and self-report assessments were conducted to determine potential benefits and program feasibility, including the NIH Toolbox® Cognition Battery, the Functional Assessment of Cancer Therapy (FACT)-Cognitive Function, the FACT-Breast, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, and a participant questionnaire. Findings: Results related to potential benefits suggest that IPI may significantly improve overall cognition in breast cancer survivors, with fluid cognition showing improvement. In addition, IPI may improve quality of life and self-reported measures of depression and anxiety, with large to moderate effect sizes, respectively. Implications for nursing: Nurses should explore different treatment options for chemotherapy-related cognitive impairment and consider including IPI in survivorship care plans.

One-week exposure to South Indian Classical music clip having incremental variation in tempo and octave promotes better anxiety reduction among medical students - an EEG based study

Preprint

Full-text available

Jun 2019

[Read at: https://www.biorxiv.org/content/10.1101/656777v1.full] Several scientific studies using Western classical music and some using Indian classical music have reported benefits of listening to musical pieces of specific ‘genre’ or ’Raga’, in terms of stress reduction and mental well-being. Within the realm of a Raga, presentation of musical pieces varies in terms of low-level musical components (like tempo, octave, timbre, etc.), and yet there is hardly any research on their effect. A commonly preferred musical pattern in Carnatic classical music is to have incremental modulations in tempo and octave (‘Ragam-Tanam-Pallavi’), and we wanted to examine whether this could have better anxiolytic effect than music without such modulations. Accordingly, in the current study, we exposed 21 male undergraduate medical students to a custom recorded South Indian classical music clip for 1 week (8 minutes clip; Raaga ‘Kaapi’; only two instruments – ‘Violin’ and ‘Mridangam’; listened thrice daily for 6 days). One set of the participants (Varying Music; n=11) listened to a version that had the incremental variations, whereas the other set (Stable Music; n=10) listened to a version without such variations. On all 6 days, one of the music listening sessions was conducted in the lab while collecting electroencephalography (EEG; 32 channels) and electrocardiography (ECG; 1 channel) data. Psychological assessment for anxiety (State-Trait Anxiety Inventory - STAI and Beck Anxiety Inventory - BAI) was conducted before (day 1) and after (day 6) the intervention. Physiological parameters studied included power spectrum across the scalp in delta, alpha, beta, theta and gamma bands from EEG and heart rate variability (HRV) from ECG, during the baseline recordings of day 1 and day 6 of intervention. Our results show that participants when exposed to varying music showed significant reduction in anxiety, in contrast to stable music or silence intervention. A global examination of power spectral changes showed a stark contrast between stable and varying music intervention in comparison to silence - former showing greater increase in higher frequencies whereas latter showing prominent decrease especially in lower frequencies, both in bilateral temporo-parieto-occipital regions. A more detailed spectral analysis in frontal region revealed that both music intervention showed greater left-dominant alpha/beta asymmetry (i.e., greater right brain activation) and decrease in overall midline power (i.e., lower default mode network or DMN activity), when compared to silence intervention. Interestingly, stable music resulted in more left asymmetry, whereas, varying music showed more midline power reduction. Both music intervention also didn’t show the reduction in HRV parameters that was associated with silence intervention. We speculate that, the enhancement in ‘mind calming effect’ of Kaapi raaga when presented with incremental variations, could be brought about by a balanced switching between a heightened mind wandering state with ‘attention to self’ during the lower-slower portions and a reduced mind wandering state with ‘attention to music’ during the higher-faster portions of the music. Such a ‘dynamic mind wandering’ exercise would allow training one’s creative thinking as well as sustained attention, during the respective high and low mind wandering states - both helping prevent ruminating thoughts. Therefore, musical properties such as tempo and octave have non-trivial influence on the various neurological and psychological mechanisms underlying stress management. Considering the impact of this finding in selection of music clips for music therapy, further studies with larger sample size is warranted.

Participants’ experiences of music, mindful music, and audiobook listening interventions for people recovering from stroke: MELLO trial participant experiences

Article

May 2018

Existing research evidence suggests that both music listening and mindfulness interventions may have beneficial effects on mood and cognition poststroke. This mixed‐methods study, nested within a pilot randomized controlled trial investigating the feasibility and acceptability of combining music listening and brief mindfulness training poststroke, explored study participants’ experiences of engaging in the interventions. Fifty‐six stroke survivors who were randomized to receive an 8‐week intervention of mindful music listening (n = 15), music listening (n = 21), or audiobook listening (n = 20, control) using self‐selected material participated in a postintervention individual semistructured interview with a researcher not involved in their intervention delivery. Interview questions focused on affective, cognitive, and physical experiences. Data were coded and analyzed using thematic analysis. Across groups, listening was associated with positive distraction from thoughts and worries. Mindful music listening was most strongly associated with relaxation and concentration, improved attentional control, and emotion regulation, as well as enjoyment. Music listening was most strongly associated with increased activity, memory reminiscence, and improved mood. In addition, participants provided valuable feedback on intervention feasibility and acceptability. The findings suggest that the interventions were feasible and enjoyable for people recovering from stroke.

A Rationale for Music Training to Enhance Executive Functions in Parkinson’s Disease: An Overview of the Problem

Article

Full-text available

Apr 2018

Music listening interventions such as Rhythmic Auditory Stimulation can improve mobility, balance, and gait in Parkinson’s Disease (PD). Yet, the impact of music training on executive functions is not yet known. Deficits in executive functions (e.g., attention, processing speed) in patients with PD result in gait interference, deficits in emotional processing, loss of functional capacity (e.g., intellectual activity, social participation), and reduced quality of life. The model of temporal prediction and timing suggests two networks collectively contribute to movement generation and execution: the basal ganglia-thalamocortical network (BGTC) and the cerebellar-thalamocortical network (CTC). Due to decreases in dopamine responsible for the disruption of the BGTC network in adults with PD, it is hypothesized that rhythmic auditory cues assist patients through recruiting an alternate network, the CTC, which extends to the supplementary motor areas (SMA) and the frontal cortices. In piano training, fine motor finger movements activate the cerebellum and SMA, thereby exercising the CTC network. We hypothesize that exercising the CTC network through music training will contribute to enhanced executive functions. Previous research suggested that music training enhances cognitive performance (i.e., working memory and processing speed) in healthy adults and adults with cognitive impairments. This review and rationale provides support for the use of music training to enhance cognitive outcomes in patients with Parkinson’s Disease (PD).

The energy-enhancing potential of participatory performance-based arts activities in the care of people with a diagnosis of cancer: an integrative review

Article

Mar 2018

Background Cancer in all its forms and stages is accompanied by a range of emotional, social and spiritual impacts. Pharmacological interventions have limited success with these issues and a range of interventions are needed to support people with a cancer diagnosis. We seek to understand the benefits of participatory performance-based arts activities, such as music, singing, drama and dance, in the care of people with cancer. We use the emerging Energy Restoration Framework, based on Kaplan’s Attention Restoration Theory to explore the potentially energy-enhancing aspects of participation in such activities. Methods An integrative review is used to explore existing research on the use of participatory performance-based arts in cancer care. Existing research is summarized and critically appraised. Results are analysed thematically and mapped to the attributes of the Energy Restoration Framework. Results Eight studies (four qualitative, three quantitative and one mixed-methods study) published between 2001 and 2016 met the search criteria. Findings from the thematic analysis resonated with the attributes of the Energy Restoration Framework. Conclusions Research on the topic is very limited. When examined through the lens of the Energy Restoration Framework, the literature hints at the potential value of participatory performance-based arts activities for enhancing energy in the cancer care context.

Terapias artísticas y creativas en la mejora del malestar psicológico en mujeres con cáncer de mama. Revisión sistemática

Article

Full-text available

Oct 2017

Objective: To know the current state of the effectiveness of artistic and creative therapies (ACTs) over psychological distress of women with breast cancer and to delimit it according to the type of CT and the therapeutic moment of the patient. Method: The search was performed using Pubmed, Web of Science, Psychinfo and Google Academic databases for the period 2010-2016. Results: nine controlled RTC and quasi-experimental studies (2 of Dance movement therapy, 1 of Art Therapy, 1 of Music therapy and 5 of Musical Listening) were obtained, including 680 participants. Methodological quality, risk of bias and measures of therapeutic efficacy are discussed. Conclusions: ACT scans seem to be short-term complementary aid during the treatment phase in breast cancer. However, more trials are needed to clarify the mechanisms underlying the improvement as well as to delimit the effectiveness of each modality. © 2017, Spanish Association of Anglo-American Studies. All rights reserved.

Curcumin reduces mitomycin C resistance in breast cancer stem cells by regulating Bcl-2 family-mediated apoptosis

Article

Full-text available

Sep 2017
Canc Cell Int

Background Curcumin, a natural compound derived from the turmeric rhizome Curcuma longa Linn, has anticancer and chemoresistance reduction biological activities. We evaluated the efficacy of curcumin in sensitizing chemotherapy drugs through regulation of Bcl-2-mediated apoptosis in breast cancer stem-like cells (BCSCs). Methods Cell survival was measured using MTT assay. Apoptosis-related proteins were observed using western blot analysis. Apoptosis was detected with flow cytometric analysis and by Hoechst 33258 staining. The mitochondrial membrane potential was observed with flow cytometric analysis. ResultsThe ability of BCSCs to propagate decreased gradually along the passages and was completely lost at the fifth passage [0.1 μmol/L mitomycin C (MMC) with 5 μmol/L curcumin in MCF-7 and 0.5 μmol/L MMC with 5 μmol/L curcumin in MDA-MB-231 cells]. Curcumin combined with MMC treatment significantly decreased the levels of antiapoptotic Bcl-2 and Bcl-w expression, increased the levels of proapoptotic Bax, Bak, Bad, Bik, and Bim expression, and activated caspase-3 and caspase-9 in MCF-7 BCSCs. In the presence of Bcl-2 siRNA, the apoptosis rate increased by 15% in cells treated with curcumin and MMC. The mitochondrial membrane potential decreased by approximately 20% in MCF-7 BCSCs undergoing the combination treatment of curcumin and MMC. The combination-induced decrease in Bcl-2 was regulated by the presence of the Wnt-specific inhibitor PFK115-584 and PI3k inhibitor LY294002. Conclusions Our study indicates that curcumin might represent a novel therapeutic agent for treating breast cancer chemoresistance induced by MMC.

Being Mindful as a Phenomenological Attitude

Article

Aug 2017

Lena Wiklund Gustin

Purpose: The purpose of this article is to reflect on being mindful as a phenomenological attitude rather than on describing mindfulness as a therapeutic intervention. I will also explore the possibilities that being mindful might open up in relation to nursing research and holistic nursing. Design and method: I will describe and interpret mindfulness as a state of being by means of van Manen's phenomenological method, using the language of phenomenology rather than the language of reductionist science. Thus, this article can be considered a reflective narrative, describing both the process of orienting to the phenomenon, making preunderstandings-including own experiences of mindfulness-visible, and a thematic analysis of nine scientific articles describing the phenomenon. Findings: Being mindful as a phenomenological attitude can be described as a deliberate intentionality, where the person is present in the moment and open to what is going on, bridling personal values and accepting the unfamiliar, thus achieving a sense of being peacefully situated in the world, and able to apprehend one's being-in-the-world. Conclusions: Being mindful as a phenomenological attitude can contribute not only to phenomenological nursing research but also support nurses' presence and awareness.

The effects of music intervention on burn patients during treatment procedures: A systematic review and meta-analysis of randomized controlled trials

Article

Full-text available

Mar 2017
BMC Compl Alternative Med

Background The treatment of burn patients is very challenging because burn injuries are one of the most severe traumas that can be experienced. The effect of music therapy on burn patients has been widely reported, but the results have been inconsistent. Thus, we performed a systematic review and meta-analysis of randomized controlled trials in burn patients to determine the effect of music during treatments. Methods We searched a variety of electronic databases, including MEDLINE (via PubMed), EMBASE, Cochrane Library, Psychinfo, VIP Database for Chinese Technical Periodicals (VIP) and China National Knowledge Infrastructure (CNKI) for relevant trials on the basis of predetermined eligibility criteria. from their first available date through February 2016. Our search focused on two key concepts: music interventions (including music, music therapy and music medicine) and physical activity outcomes (including pain, anxiety, burn characteristics, dressing changes, wound care, debridement and rehabilitation). Two reviewers independently screened records and extracted data from all eligible studies. Statistical heterogeneity was determined using Q-test and the I2 statistic. The endpoints included standardized mean differences (SMDs) and 95% confidence intervals (CIs). Publication bias was tested by Begg’s funnel plot and Egger’s test. ResultsA total of 17 studies met the inclusion criteria, for a total of 804 patients. A statistically significant difference in pain relief was demonstrated between music and non-music interventions (SMD = −1.26, 95% CI [−1.83, −0.68]), indicating that music intervention has a positive effect on pain alleviation for burn patients. The results indicated that music interventions markedly reduced anxiety in individuals compared to non-music interventions (SMD = −1.22, 95% CI [−1.75, −0.69]). Correspondingly, heart rate decreases were found after treatments that included music interventions (SMD = −0.60, 95% CI [−0.84, −0.36]). Conclusion In summary, a positive correlation was found between treatments including music interventions and pain alleviation, anxiety relief, and heart rate reduction in burn patients. However, additional high-quality studies with carefully considered music interventions for burn patients are still needed.

Music therapy and art therapy: Functional neurobiology and applications in oncology

Chapter

Jan 2024

Real-time dynamic analysis of EEG Response for Live Indian Classical Vocal Stimulus with Therapeutic Indications

Article

Jun 2024

eHealth mindfulness-based music therapy for patients undergoing allogeneic hematopoietic stem cell transplantation: A pilot randomized controlled trial protocol

Article

May 2024
CONTEMP CLIN TRIALS

Terapias alternativas, factores clave y su relación con las sesiones de Musicoterapia

Article

Full-text available

Dec 2023

Antonio Garrido Muñoz

La forma en la que se lleva a cabo una sesión de Musicoterapia es muy diferente si se realiza en una UCI, en un aula de Educación Especial o en un geriátrico. Por ello, se pretende hacer una diferenciación entre la forma de abordar una sesión de Musicoterapia en los ámbitos hospitalario, educativo y social. Para esto, se ha seguido una metodología de revisión narrativa de literatura especializada en torno al tema, donde se comparan las diferentes actividades que se llevan a cabo en estos lugares para poder concluir cuál es la manera más adecuada a la hora de dirigirse a los diferentes pacientes que se pueden encontrar, siendo las variables más comunes: el tono de voz, el vocabulario usado, el repertorio elegido, la duración de las sesiones y la metodología. Además, se muestra que el uso de terapias alternativas como la naturopatía o el Mindfulness potencia los resultados obtenidos.

Estímulos musicales para la atención plena (mindfulness): Investigación emergente e implicaciones clínicas

Article

Full-text available

Feb 2023

Eugenia Hernandez-Ruiz

La atención plena (mindfulness) se ha vuelto cada vez más popular en espacios terapéuticos y no terapéuticos como una manera de abordar el estrés, el cambio y la incertidumbre. Aquí compartimos nuestra comprensión de la práctica de la atención plena y un resumen de los hallazgos de cuatro estudios exploratorios sobre los estímulos musicales originales que pueden respaldar estas prácticas. Compartimos las características musicales específicas que los participantes en nuestros cuatro estudios iniciales prefirieron y encontraron efectivas y útiles. Todavía es necesario realizar más investigación para determinar resultados clínicos. Sin embargo, esta información puede proporcionar un punto de partida para que los musicoterapeutas exploren la creación de su propia música para la práctica de la atención plena. Se proporcionan referencias a los reportes de investigación publicados para el profesional interesado.

АРТ-ТЕРАПІЯ ЯК МЕТОД ДУХОВНОЇ ПІДТРИМКИ ПАЦІЄНТІВ У КЛІНІЧНІЙ ПРАКТИЦІ

Article

Full-text available

May 2022

Мета. У статті визначається місце духовної підтримки пацієнтів методами арт-терапії в системі професійної допомоги в клінічних умовах. Важливими завданнями є аналіз останніх досліджень щодо духовної підтримки пацієнтів в клінічній практиці; узагальнення та систематизація основних методологічних підходів та огляд прикладних досліджень із заявленої проблематики; експлікація категоріального апарату; обґрунтування контепоральних моделей духовної підтримки пацієнтів в арт-терапевтичній взаємодії; визначення психотерапевтичних мішеней духовної підтримки пацієнтів в арт-терапевтичному процесі. Методи. Дана стаття має характер теоретико-методологічної розвідки. Основні методи дослідження – аналіз останніх досліджень щодо духовної підтримки пацієнтів в клінічній практиці за допомогою інструментів арт-терапії; синтез, узагальнення та систематизація основних методологічних підходів та прикладних досліджень; експлікація категоріального апарату; теоретико-методологічне моделювання. Результати. Огляд зарубіжних та вітчизняних наукових публікацій дає можливість зробити висновки про те, що духовна підтримка пацієнтів в період одужання в умовах клініки є фундаментальною умовою швидкого одужання пацієнтів незалежно від діагнозу та перебігу захворювань. Арт-терапія як метод духовної підтримки пацієнтів у клінічних умовах має високий потенціал застосування та вимагає подальшого вивчення, апробування та впровадження в умови стаціонару. Висновки. Ми визначили духовну підтримку як терапевтичну допомогу пацієнтам знайти смисли, надію та цілісність у їх житті та стосунках, відчути свій зв’язок з собою, іншими та Всесвітом, а також дати їм відчуття турботи, співчутливої присутності та безумовного прийняття, готовності бути разом у складні часи, вислухати та поважати їх індивідуальні духовні переконання та вірування. Ми виокремили психотерапевтичні мішені, для яких духовно орієнтована арт-терапія є ефективною: самореалізація та саморозвиток, самопізнання, прийняття реальності, пошук сенсу і мети існування та усвідомлення самоцінності. Проведений мета аналіз наукових джерел дозволив визначити основні моделі сучасної арт-терапії заснованої на духовній підтримці: Модель континууму експресивної терапії; Модель відновлення; Модель тіла і розуму в арт-терапії. Важливим завданням сьогодні є віднайдення ефективних інструментів арт-терапевтичної роботи та створення програм духовної підтримки пацієнтів, що, безумовно, є перспективним напрямком подальших досліджень.

Investigating the effect of background music on cognitive and skill performance: A cross-sectional study

Article

Mar 2022
Work

Background: Existing studies on the impact of background music in the workplace have reported varying results, from improving production and performance to being known as an annoying factor. Given the lack of evidence of the background music influence on the cognitive factors in the work place in previous studies and the lack of study on the effect of background music on skill performance when gender and personality type is considered, research in this area seems necessary. Objective: The purpose of the present study is to investigate the influence of background music on cognitive and skill performance in the work place with regard to gender and personality type. Methods: This study was conducted with the participation of 52 students (26 males and 26 females) aged between 18-30 years old. Sustained attention, working memory, fine finger and gross manual dexterity skills and personality type were assessed. Participants were randomly tested once when being exposed to classical instrumental music and once again when faced with complete silenceRESULTS:Playing background music improved students working memory but had no significant effect on sustained attention. Music also improved skill performance.Overall, memory performance and fine finger dexterity were found significantly better in extroverts when compared to introverts during playing background music. Conclusion: Background music improves working memory and speeds up performance in skill tasks, however the role of personality type in influencing background music on cognitive and skill performance needs further investigation.

Music interventions for improving psychological and physical outcomes in people with cancer

Article

Oct 2021

Background: This is an update of the review published on the Cochrane Library in 2016, Issue 8. Having cancer may result in extensive emotional, physical and social suffering. Music interventions have been used to alleviate symptoms and treatment side effects in people with cancer. This review includes music interventions defined as music therapy offered by trained music therapists, as well as music medicine, which was defined as listening to pre-recorded music offered by medical staff. Objectives: To assess and compare the effects of music therapy and music medicine interventions for psychological and physical outcomes in people with cancer. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2020, Issue 3) in the Cochrane Library, MEDLINE via Ovid, Embase via Ovid, CINAHL, PsycINFO, LILACS, Science Citation Index, CancerLit, CAIRSS, Proquest Digital Dissertations, ClinicalTrials.gov, Current Controlled Trials, the RILM Abstracts of Music Literature, http://www.wfmt.info/Musictherapyworld/ and the National Research Register. We searched all databases, except for the last two, from their inception to April 2020; the other two are no longer functional, so we searched them until their termination date. We handsearched music therapy journals, reviewed reference lists and contacted experts. There was no language restriction. Selection criteria: We included all randomized and quasi-randomized controlled trials of music interventions for improving psychological and physical outcomes in adults and pediatric patients with cancer. We excluded patients undergoing biopsy and aspiration for diagnostic purposes. Data collection and analysis: Two review authors independently extracted the data and assessed the risk of bias. Where possible, we presented results in meta-analyses using mean differences and standardized mean differences. We used post-test scores. In cases of significant baseline difference, we used change scores. We conducted separate meta-analyses for studies with adult participants and those with pediatric participants. Primary outcomes of interest included psychological outcomes and physical symptoms and secondary outcomes included physiological responses, physical functioning, anesthetic and analgesic intake, length of hospitalization, social and spiritual support, communication, and quality of life (QoL) . We used GRADE to assess the certainty of the evidence. Main results: We identified 29 new trials for inclusion in this update. In total, the evidence of this review rests on 81 trials with a total of 5576 participants. Of the 81 trials, 74 trials included adult (N = 5306) and seven trials included pediatric (N = 270) oncology patients. We categorized 38 trials as music therapy trials and 43 as music medicine trials. The interventions were compared to standard care. Psychological outcomes The results suggest that music interventions may have a large anxiety-reducing effect in adults with cancer, with a reported average anxiety reduction of 7.73 units (17 studies, 1381 participants; 95% confidence interval (CI) -10.02 to -5.44; very low-certainty evidence) on the Spielberger State Anxiety Inventory scale (range 20 to 80; lower values reflect lower anxiety). Results also suggested a moderately strong, positive impact of music interventions on depression in adults (12 studies, 1021 participants; standardized mean difference (SMD): -0.41, 95% CI -0.67 to -0.15; very low-certainty evidence). We found no support for an effect of music interventions on mood (SMD 0.47, 95% CI -0.02 to 0.97; 5 studies, 236 participants; very low-certainty evidence). Music interventions may increase hope in adults with cancer, with a reported average increase of 3.19 units (95% CI 0.12 to 6.25) on the Herth Hope Index (range 12 to 48; higher scores reflect greater hope), but this finding was based on only two studies (N = 53 participants; very low-certainty evidence). Physical outcomes We found a moderate pain-reducing effect of music interventions (SMD -0.67, 95% CI -1.07 to -0.26; 12 studies, 632 adult participants; very low-certainty evidence). In addition, music interventions had a small treatment effect on fatigue (SMD -0.28, 95% CI -0.46 to -0.10; 10 studies, 498 adult participants; low-certainty evidence). The results suggest a large effect of music interventions on adult participants' QoL, but the results were highly inconsistent across studies, and the pooled effect size was accompanied by a large confidence interval (SMD 0.88, 95% CI -0.31 to 2.08; 7 studies, 573 participants; evidence is very uncertain). Removal of studies that used improper randomization methods resulted in a moderate effect size that was less heterogeneous (SMD 0.47, 95% CI 0.06 to 0.88, P = 0.02, I2 = 56%). A small number of trials included pediatric oncology participants. The findings suggest that music interventions may reduce anxiety but this finding was based on only two studies (SMD -0.94, 95% CI -1.9 to 0.03; very low-certainty evidence). Due to the small number of studies, we could not draw conclusions regarding the effects of music interventions on mood, depression, QoL, fatigue or pain in pediatric participants with cancer. The majority of studies included in this review update presented a high risk of bias, and therefore the overall certainty of the evidence is low. For several outcomes (i.e. anxiety, depression, pain, fatigue, and QoL) the beneficial treatment effects were consistent across studies for music therapy interventions delivered by music therapists. In contrast, music medicine interventions resulted in inconsistent treatment effects across studies for these outcomes. Authors' conclusions: This systematic review indicates that music interventions compared to standard care may have beneficial effects on anxiety, depression, hope, pain, and fatigue in adults with cancer. The results of two trials suggest that music interventions may have a beneficial effect on anxiety in children with cancer. Too few trials with pediatric participants were included to draw conclusions about the treatment benefits of music for other outcomes. For several outcomes, music therapy interventions delivered by a trained music therapist led to consistent results across studies and this was not the case for music medicine interventions. Moreover, evidence of effect was found for music therapy interventions for QoL and fatigue but not for music medicine interventions. Most trials were at high risk of bias and low or very low certainty of evidence; therefore, these results need to be interpreted with caution.

Effect of Music on a Mindfulness Experience: An Online Study

Article

Jun 2021
ART PSYCHOTHER

Mindfulness has become increasingly common in therapeutic and non-therapeutic venues as a way to address stress, change, and uncertainty, such as in the COVID-19 pandemic. The use of music in mindfulness is apparent in several traditional and Western practices but has little research regarding its effect in novice practitioners. In an online course-based research experience, a group of student researchers, a graduate research assistant and two faculty members recruited 54 healthy participants within their social networks, to investigate the effect of a music stimulus on one mindfulness exercise and the feasibility of implementing this intervention in virtual sessions. Participants attended two virtual group sessions where student researchers and a faculty member/research assistant provided online questionnaires and links to a 20-minute meditation recording, either with or without music, as the two conditions. Potential moderators of the intervention included stress in the previous month and absorption in music. A repeated-measures ANCOVA indicated no significant differences among conditions, and no interaction with stress or absorption in music. Although contrary to our expectations, the lack of significant differences between conditions indicate that music did not distract from a mindfulness meditation, and that the music and guided mindfulness stimulus was as efficacious as the guided mindfulness alone. Given the potential for music to become a distractor for novice practitioners, this finding is important and in line with our theoretical framework. Online delivery of this intervention was feasible and apparently effective. Suggestions for implementation of online research and intervention delivery are included.

Features of brainwave induced by 3D auditory stimulation

Conference Paper

Oct 2020

Effect of Exercise Training on Exercise Tolerance and Level of Oxidative Stress for Head and Neck Cancer Patients Following Chemotherapy

Article

Full-text available

Aug 2020

Background Chemotherapy decreases fitness performance via repression of cardiopulmonary function and oxidative stress. This study was designed to investigate whether exercise intervention could improve exercises capacity and reduce systemic oxidative stress in patients with head and neck (H&N) cancer receiving chemotherapy.Methods This is a single-center study. Forty-two H&N cancer patients who were undergoing chemotherapy were recruited in this study. An 8-week exercise intervention was performed by conducting the combination of aerobic and resistance exercise 3 days a week. The exercise training was conducted by a physiotherapist. The exercise capacity and exercise responses were measured from blood pressure (BP) and heart rate (HR). Oxidative stress markers from human plasma, such as total antioxidant capacity, 8-hydroxy-2′-deoxyguanosine, malondialdehyde, and carbonyl content, were tested by activity kits.ResultsWe provide compelling evidence that exercise training ameliorated exercise responses and increased exercise capacity by repressing resting BP and increasing 1- and 3-min BP recovery. We also found the resting HR was reduced, and the 1- and 3-min HR recovery was increased after exercise training. In addition, the rating of perceived exertion after the peak exercise was reduced after exercise intervention. We also found that exercise training repressed oxidative stress markers by elevation of total antioxidant capacity and suppression of 8-OHd and carbonyl content in plasma.DiscussionWe clearly demonstrate that exercise can promote exercise capacity and reduce oxidative stress in H&N cancer patients receiving chemotherapy, which might guide new therapeutic approaches for cancer patients, especially those undergoing chemotherapy.

Cognition and Wound Healing

Chapter

Aug 2018

Vahid Rakhshan

https://link.springer.com/chapter/10.1007/15695_2018_134 Wound healing is a complex process formed of various overlapping stages, namely, clot formation, inflammation, proliferation, and remodeling, which depend on the systemic health and a competent immune system. Negative cognitive processes such as pain and stress can induce the stress response, which delays wound healing by deteriorating health and modulating the immune function through the activation of the hypothalamus-pituitary-adrenal and sympathetic-adrenal-medullary axes. Hence, it seems that practices capable of mitigating stress or pain might accelerate wound healing. This chapter reviews the effects of relaxation and meditation, music therapy, expressive writing, hypnosis, and placebo on physiological health and wound recovery.

Use of Complementary Therapies for Side Effect Management in Breast Cancer: Evidence and Rationale

Article

Aug 2016

Women diagnosed with breast cancer can experience chronic side effects after curative treatment concludes, negatively impacting survivorship. The most prevalent side effects addressed in the medical and nursing literature include symptoms such as hot flashes, fatigue, myalgias/arthralgias and cognitive impairment. Complementary therapies, particularly natural products including herbs, dietary supplements, vitamins, minerals, and probiotics, and mind–body techniques that include such modalities as yoga, meditation, massage, acupuncture, relaxation, tai chi and hypnosis show promise for treatment of some of these symptoms associated with cancer care. However, the research in this area is nascent and much more work is needed to understand symptom physiology and mechanisms of action of complementary therapies. The purpose of this paper was to summarize key evidence from Phase II and III randomized clinical trials in order to provide guidance to distinguish promising versus nonpromising interventions for sympt...

Non-pharmacological interventions for cognitive impairment due to systemic cancer treatment: Reviews

Article

Aug 2016

Background: It is estimated that up to 75% of cancer survivors may experience cognitive impairment as a result of cancer treatment and given the increasing size of the cancer survivor population, the number of affected people is set to rise considerably in coming years. There is a need, therefore, to identify effective, non-pharmacological interventions for maintaining cognitive function or ameliorating cognitive impairment among people with a previous cancer diagnosis. Objectives: To evaluate the cognitive effects, non-cognitive effects, duration and safety of non-pharmacological interventions among cancer patients targeted at maintaining cognitive function or ameliorating cognitive impairment as a result of cancer or receipt of systemic cancer treatment (i.e. chemotherapy or hormonal therapies in isolation or combination with other treatments). Search methods: We searched the Cochrane Centre Register of Controlled Trials (CENTRAL), MEDLINE, Embase, PUBMED, Cumulative Index of Nursing and Allied Health Literature (CINAHL) and PsycINFO databases. We also searched registries of ongoing trials and grey literature including theses, dissertations and conference proceedings. Searches were conducted for articles published from 1980 to 29 September 2015. Selection criteria: Randomised controlled trials (RCTs) of non-pharmacological interventions to improve cognitive impairment or to maintain cognitive functioning among survivors of adult-onset cancers who have completed systemic cancer therapy (in isolation or combination with other treatments) were eligible. Studies among individuals continuing to receive hormonal therapy were included. We excluded interventions targeted at cancer survivors with central nervous system (CNS) tumours or metastases, non-melanoma skin cancer or those who had received cranial radiation or, were from nursing or care home settings. Language restrictions were not applied. Data collection and analysis: Author pairs independently screened, selected, extracted data and rated the risk of bias of studies. We were unable to conduct planned meta-analyses due to heterogeneity in the type of interventions and outcomes, with the exception of compensatory strategy training interventions for which we pooled data for mental and physical well-being outcomes. We report a narrative synthesis of intervention effectiveness for other outcomes. Main results: Five RCTs describing six interventions (comprising a total of 235 participants) met the eligibility criteria for the review. Two trials of computer-assisted cognitive training interventions (n = 100), two of compensatory strategy training interventions (n = 95), one of meditation (n = 47) and one of physical activity intervention (n = 19) were identified. Each study focused on breast cancer survivors. All five studies were rated as having a high risk of bias. Data for our primary outcome of interest, cognitive function were not amenable to being pooled statistically. Cognitive training demonstrated beneficial effects on objectively assessed cognitive function (including processing speed, executive functions, cognitive flexibility, language, delayed- and immediate- memory), subjectively reported cognitive function and mental well-being. Compensatory strategy training demonstrated improvements on objectively assessed delayed-, immediate- and verbal-memory, self-reported cognitive function and spiritual quality of life (QoL). The meta-analyses of two RCTs (95 participants) did not show a beneficial effect from compensatory strategy training on physical well-being immediately (standardised mean difference (SMD) 0.12, 95% confidence interval (CI) -0.59 to 0.83; I(2)= 67%) or two months post-intervention (SMD - 0.21, 95% CI -0.89 to 0.47; I(2) = 63%) or on mental well-being two months post-intervention (SMD -0.38, 95% CI -1.10 to 0.34; I(2) = 67%). Lower mental well-being immediately post-intervention appeared to be observed in patients who received compensatory strategy training compared to wait-list controls (SMD -0.57, 95% CI -0.98 to -0.16; I(2) = 0%). We assessed the assembled studies using GRADE for physical and mental health outcomes and this evidence was rated to be low quality and, therefore findings should be interpreted with caution. Evidence for physical activity and meditation interventions on cognitive outcomes is unclear. Authors' conclusions: Overall, the, albeit low-quality evidence may be interpreted to suggest that non-pharmacological interventions may have the potential to reduce the risk of, or ameliorate, cognitive impairment following systemic cancer treatment. Larger, multi-site studies including an appropriate, active attentional control group, as well as consideration of functional outcomes (e.g. activities of daily living) are required in order to come to firmer conclusions about the benefits or otherwise of this intervention approach. There is also a need to conduct research into cognitive impairment among cancer patient groups other than women with breast cancer.

Trajectories of Terminally Ill Patients' Cardiovascular Response to Receptive Music Therapy in Palliative Care

Article

Apr 2016
J PAIN SYMPTOM MANAG

Context: Relaxation interventions are frequently used to promote symptom relief in palliative care settings, but little is known about the underlying mechanisms. Objectives: The present analysis aimed at examining the psychophysiological pathways of terminally-ill patients' cardiovascular response to a live music therapy versus prerecorded mindfulness exercise. Methods: Eighty-four patients of a palliative care unit were randomly assigned to either of the two interventions. Multilevel modeling was used to analyze trajectories of physiological change. Vagally-mediated heart rate variability (VM-HRV) and blood volume pulse amplitude (BVP-A) served as indices of autonomic nervous system response. Participants' gender, age, baseline scores, self-rated pain, and assignment to treatment were entered to the models as predictors. Results: Both VM-HRV and BVP-A showed significant linear and quadratic trends over time, as well as substantial heterogeneity among individuals' trajectories. Baseline scores, pain and treatment significantly accounted for random variation in VM-HRV intercepts. BVP-A levels were significantly higher in women than in men. Moreover, assignment to treatment significantly accounted for differences in the linear slopes of peripheral blood flow. Conclusion: Higher levels of VM-HRV in the music therapy group highlight the importance of a therapeutic relationship for the effectiveness of relaxation interventions in end-of-life care settings. Music therapy caused significantly stronger reductions of vascular sympathetic tone and, therefore, may be indicated in the treatment of pain and stress-related symptoms in palliative care. Initial self-ratings of pain moderated patients' physiological response and need to be taken into account in clinical practice and future theory building.

The Ramp Archetype and the Maintenance of Passive Auditory Attention

Article

Full-text available

Oct 1992

David Huron

Research on physiological aspects of attention has shown an asymmetry in neurological arousal with respect to the direction of stimulus change. Increases of stimulus intensity level are more effective than equivalent decreases in evoking listeners' attention. Where musical resources limit a continual escalation of intensity level over the course of a work, it is theoretically possible to maintain attention by structuring the work as a sequence of stimulus "ramps"—where intensity increases are small and incremental, but stimulus decreases are large and abrupt. Scorebased studies of dynamics in homophonic music and voice entries and exits in polyphonic music show such an asymmetry. It would appear that for a large body of works of western art music, compositional practices are consistent with a theoretical strategy for maintaining passive auditory attention.

Perceived Cognitive Function in Breast Cancer Survivors: Evaluating Relationships With Objective Cognitive Performance and Other Symptoms Using The Functional Assessment of Cancer Therapy Cognitive Scale (FACT-Cog).

Article

Full-text available

Sep 2014
J PAIN SYMPTOM MANAG

Context: Perceived cognitive impairment (PCI) has been shown to be one of the most common symptoms after breast cancer treatment. However, this symptom does not always correlate with objective cognitive performance and is often highly associated with other patient-reported symptoms. Objectives: Using a sample of breast cancer survivors (BCS), this study examined relationships among the Functional Assessment of Cancer Therapy-Cognitive (FACT-Cog) scale, a self-report questionnaire that measures PCI; impact on quality of life (QoL); comments from others (other); perceived cognitive ability (PCA); objective cognitive performance on tests of verbal memory, speed of processing, and executive functioning; and other symptoms (fatigue, depression, anxiety, and sleep disturbance). Methods: The BCS who were aged 40 years or older and at least one year post-chemotherapy treatment were enrolled. Participants completed questionnaires and a brief neuropsychological assessment. Results: A total of 88 BCS who were on average 56.7 (SD 8.5) years old and 5.3 (SD 4.1) years post-treatment participated; 94% reported clinically significant PCI. The PCI was significantly correlated with some objective measures of immediate and delayed verbal memory and executive function, whereas PCA was associated with all these measures. The PCI and PCA were both significantly associated with depressive symptoms, fatigue, and anxiety, but only PCI was related to poor global sleep quality. Conclusion: The PCA was highly correlated with objective neuropsychological performance and may be clinically useful in identifying problems with verbal memory and executive functioning in BCS.

Meta-Analysis of Cognitive Functioning in Breast Cancer Survivors Previously Treated With Standard-Dose Chemotherapy

Article

Full-text available

Aug 2012
J CLIN ONCOL

Purpose: Evidence is mixed regarding long-term cognitive deficits in patients treated with chemotherapy. Previous meta-analyses have not focused specifically on the postchemotherapy period and have not incorporated several recent studies. The goal of the current study was to conduct a meta-analysis of cognitive functioning in breast cancer survivors who were treated with chemotherapy ≥ 6 months previously. Methods: A search of PubMed, PsycInfo, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library yielded 2,751 abstracts, which were independently evaluated by pairs of raters. Meta-analysis was conducted on 17 studies of 807 patients previously treated with standard-dose chemotherapy for breast cancer. Neuropsychological tests were categorized according to eight cognitive domains: attention, executive functioning, information processing, motor speed, verbal ability, verbal memory, visual memory, and visuospatial ability. Results: Deficits in cognitive functioning were observed in patients treated with chemotherapy relative to controls or prechemotherapy baseline in the domains of verbal ability (g = -0.19; P < .01) and visuospatial ability (g = -0.27; P < .01). Patients treated with chemotherapy performed worse than noncancer controls in verbal ability and worse than patients treated without chemotherapy in visuospatial ability (both P < .01). Age, education, time since treatment, and endocrine therapy did not moderate observed cognitive deficits in verbal ability or visuospatial ability (all P ≥ .51). Conclusion: Results indicate that, on average, observed cognitive deficits in patients with breast cancer previously treated with chemotherapy are small in magnitude and limited to the domains of verbal ability and visuospatial ability. This information can be used to inform interventions to educate patients with breast cancer regarding the long-term impact of chemotherapy on cognitive functioning.

Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review

Article

Full-text available

Jul 2003

Ruth Baer

Interventions based on training in mindfulness skills are becoming increasingly popular. Mindfulness involves intentionally bringing one's attention to the internal and external experiences occurring in the present moment, and is often taught through a variety of meditation exercises. This review summarizes conceptual approaches to mind-fulness and empirical research on the utility of mindfulness-based interventions. Meta-analytic techniques were incorporated to facilitate quantification of findings and comparison across studies. Although the current empirical literature includes many methodological flaws, findings suggest that mindfulness-based interventions may be helpful in the treatment of several disorders. Methodologically sound investigations are recommended in order to clarify the utility of these interventions.

Mindfulness: A Proposed Operational Definition

Article

Full-text available

Oct 2004

There has been substantial interest in mindfulness as an approach to reduce cognitive vulnerability to stress and emotional distress in recent years. However, thus far mindfulness has not been defined operationally. This paper describes the results of recent meetings held to establish a consensus on mindfulness and to develop conjointly a testable operational definition. We propose a two-component model of mindfulness and specify each component in terms of specific behaviors, experiential manifestations, and implicated psychological processes. We then address issues regarding temporal stability and situational specificity and speculate on the conceptual and operational distinctiveness of mindfulness. We conclude this paper by discussing implications for instrument development and briefly describing our own approach to measurement.

Neurocognitive Dimensions of Breast Cancer and Its Treatment

Article

Full-text available

Jan 2011
NEUROPSYCHOPHARMACOL

Neuropsychopharmacology, the official publication of the American College of Neuropsychopharmacology, publishing the highest quality original research and advancing our understanding of the brain and behavior.

The Benefits of Being Present: Mindfulness and Its Role in Psychological Well-Being

Article

Full-text available

Apr 2003

Mindfulness is an attribute of consciousness long believed to promote well-being. This research provides a theoretical and empirical examination of the role of mindfulness in psychological well-being. The development and psychometric properties of the dispositional Mindful Attention Awareness Scale (MAAS) are described. Correlational, quasi-experimental, and laboratory studies then show that the MAAS measures a unique quality of consciousness that is related to a variety of well-being constructs, that differentiates mindfulness practitioners from others, and that is associated with enhanced self-awareness. An experience-sampling study shows that both dispositional and state mindfulness predict self-regulated behavior and positive emotional states. Finally, a clinical intervention study with cancer patients demonstrates that increases in mindfulness over time relate to declines in mood disturbance and stress.

High levels of untreated distress and fatigue in cancer patients

Article

Full-text available

Jul 2004

The purpose of the study was to assess a large representative sample of cancer patients on distress levels, common psychosocial problems, and awareness and use of psychosocial support services. A total of 3095 patients were assessed over a 4-week period with the Brief Symptom Inventory-18 (BSI-18), a common problems checklist, and on awareness and use of psychosocial resources. Full data was available on 2776 patients. On average, patients were 60 years old, Caucasian (78.3%), and middle class. Approximately, half were attending for follow-up care. Types of cancer varied, with the largest groups being breast (23.5%), prostate (16.9%), colorectal (7.5%), and lung (5.8%) cancer patients. Overall, 37.8% of all patients met criteria for general distress in the clinical range. A higher proportion of men met case criteria for somatisation, and more women for depression. There were no gender differences in anxiety or overall distress severity. Minority patients were more likely to be distressed, as were those with lower income, cancers other than prostate, and those currently on active treatment. Lung, pancreatic, head and neck, Hodgkin's disease, and brain cancer patients were the most distressed. Almost half of all patients who met distress criteria had not sought professional psychosocial support nor did they intend to in the future. In conclusion, distress is very common in cancer patients across diagnoses and across the disease trajectory. Many patients who report high levels of distress are not taking advantage of available supportive resources. Barriers to such use, and factors predicting distress and use of psychosocial care, require further exploration.

Impact of Mindfulness-Based Stress Reduction (MBSR) on sleep, mood, stress and fatigue symptoms in cancer outpatients

Article

Full-text available

Feb 2005

Sleep disturbance is a very common problem for cancer patients that has largely not been addressed in the clinical intervention literature. Mindfulness meditation has demonstrated clinical benefits for a variety of patient populations in other areas of functioning. This study examined the effects of an 8-week Mindfulness-Based Stress Reduction (MBSR) program on the sleep quality of a heterogeneous sample of 63 cancer patients. Overall sleep disturbance was significantly reduced (p < .001) and participants reported that their sleep quality had improved (p .001). There was also a significant reduction in stress (p < .001), mood disturbance (p = .001), and fatigue (p < .001). The associations among these changes and implications for improving quality of life of cancer patients are discussed.

A randomized, controlled trial of mindfulness-based art therapy (MBAT) for women with cancer

Article

Full-text available

May 2006

The purpose of this study was to gather data on the efficacy of a newly developed psychosocial group intervention for cancer patients, called mindfulness-based art therapy (MBAT). One hundred and eleven women with a variety of cancer diagnoses were paired by age and randomized to either an eight-week MBAT intervention group or a wait-list control group. Ninety-three participants (84%) completed both the pre- and post-study measurements. As compared to the control group, the MBAT group demonstrated a significant decrease in symptoms of distress (as measured by the Symptoms Checklist-90-Revised) and significant improvements in key aspects of health-related quality of life (as measured by the Medical Outcomes Study Short-Form Health Survey). This investigation of MBAT provides initial encouraging data that support a possible future role for the intervention as a psychosocial treatment option for cancer patients.

Distress Reduction from a Psychological Intervention Contributes to Improved Health for Cancer Patients

Article

Full-text available

Oct 2007

Psychological interventions are efficacious in reducing emotional distress for cancer patients. However, it is not clear whether psychological improvements are, in turn, related to improved health. A clinical trial tests whether a psychological intervention for cancer patients can do so, and also tests two routes to achieve better health: (a) reducing patients' Emotional Distress, and/or (b) enhancing their functional immunity. Post-surgery, 227 breast cancer patients were randomized to intervention or assessment only Study Arms. Conducted in small groups, intervention sessions were offered weekly for 4 months and followed by monthly sessions for 8 months. Measures included psychological (distress), biological (immune), and health outcomes (performance status and evaluations of patient's symptomatology, including toxicity from cancer treatment, lab values) collected at baseline, 4 months, and 12 months. A path model revealed that intervention participation directly improved health (p<.05) at 12 months. These effects remained when statistically controlling for baseline levels of distress, immunity, and health as well as sociodemographic, disease, and cancer treatment variables. Regarding the mechanisms for achieving better health, support was found for an indirect effect of distress reduction. That is, by specifically lowering intervention patients' distress at 4 months, their health was improved at 12 months (p<.05). Although the intervention simultaneously improved patients' T-cell blastogenesis in response to phytohemagglutinin (PHA), the latter increases were unrelated to improved health. A convergence of biobehavioral effects and health improvements were observed. Behavioral change, rather than immunity change, was influential in achieving lower levels of symptomatology and higher functional status. Distress reduction is highlighted as an important mechanism by which health can be improved.

Mindfulness training modifies subsystems of attention

Article

Full-text available

Jul 2007

Mindfulness is defined as paying attention in the present moment. We investigate the hypothesis that mindfulness training may alter or enhance specific aspects of attention. We examined three functionally and neuroanatomically distinct but overlapping attentional subsystems: alerting, orienting, and conflict monitoring. Functioning of each subsystem was indexed by performance on the Attention Network Test. Two types of mindfulness training (MT) programs were examined, and behavioral testing was conducted on participants before (Time 1) and after (Time 2) training. One training group consisted of individuals naive to mindfulness techniques who participated in an 8-week mindfulness-based stress reduction (MBSR) course that emphasized the development of concentrative meditation skills. The other training group consisted of individuals experienced in concentrative meditation techniques who participated in a 1-month intensive mindfulness retreat. Performance of these groups was compared with that of control participants who were meditation naive and received no MT. At Time 1, the participants in the retreat group demonstrated improved conflict monitoring performance relative to those in the MBSR and control groups. At Time 2, the participants in the MBSR course demonstrated significantly improved orienting in comparison with the control and retreat participants. In contrast, the participants in the retreat group demonstrated altered performance on the alerting component, with improvements in exogenous stimulus detection in comparison with the control and MBSR participants. The groups did not differ in conflict monitoring performance at Time 2. These results suggest that mindfulness training may improve attention-related behavioral responses by enhancing functioning of specific subcomponents of attention. Whereas participation in the MBSR course improved the ability to endogenously orient attention, retreat participation appeared to allow for the development and emergence of receptive attentional skills, which improved exogenous alerting-related process.

Short Term Meditation Training Improves Attention and Self-Regulation

Article

Full-text available

Nov 2007

Recent studies suggest that months to years of intensive and systematic meditation training can improve attention. However, the lengthy training required has made it difficult to use random assignment of participants to conditions to confirm these findings. This article shows that a group randomly assigned to 5 days of meditation practice with the integrative body-mind training method shows significantly better attention and control of stress than a similarly chosen control group given relaxation training. The training method comes from traditional Chinese medicine and incorporates aspects of other meditation and mindfulness training. Compared with the control group, the experimental group of 40 undergraduate Chinese students given 5 days of 20-min integrative training showed greater improvement in conflict scores on the Attention Network Test, lower anxiety, depression, anger, and fatigue, and higher vigor on the Profile of Mood States scale, a significant decrease in stress-related cortisol, and an increase in immunoreactivity. These results provide a convenient method for studying the influence of meditation training by using experimental and control methods similar to those used to test drugs or other interventions.

Mindfulness: A Proposed Operational Definition

Article

Aug 2004

Orienting to the Present Moment

Article

Feb 2013

Lori Brotto

Randomized Controlled Trial of Mindfulness-Based Cancer Recovery Versus Supportive Expressive Group Therapy for Distressed Survivors of Breast Cancer (MINDSET)

Article

Aug 2013
J CLIN ONCOL

PURPOSETo compare the efficacy of the following two empirically supported group interventions to help distressed survivors of breast cancer cope: mindfulness-based cancer recovery (MBCR) and supportive-expressive group therapy (SET). PATIENTS AND METHODS This multisite, randomized controlled trial assigned 271 distressed survivors of stage I to III breast cancer to MBCR, SET, or a 1-day stress management control condition. MBCR focused on training in mindfulness meditation and gentle yoga, whereas SET focused on emotional expression and group support. Both intervention groups included 18 hours of professional contact. Measures were collected at baseline and after intervention by assessors blind to study condition. Primary outcome measures were mood and diurnal salivary cortisol slopes. Secondary outcomes were stress symptoms, quality of life, and social support.ResultsUsing linear mixed-effects models, in intent-to-treat analyses, cortisol slopes were maintained over time in both SET (P = .002) and MBCR (P = .011) groups relative to the control group, whose cortisol slopes became flatter. Women in MBCR improved more over time on stress symptoms compared with women in both the SET (P = .009) and control (P = .024) groups. Per-protocol analyses showed greater improvements in the MBCR group in quality of life compared with the control group (P = .005) and in social support compared with the SET group (P = .012). CONCLUSION In the largest trial to date, MBCR was superior for improving a range of psychological outcomes for distressed survivors of breast cancer. Both SET and MBCR also resulted in more normative diurnal cortisol profiles than the control condition. The clinical implications of this finding require further investigation.

Cognitive function and breast cancer: Promise and potential insights from functional brain imaging

Article

Oct 2012
BREAST CANCER RES TR

Altered cognitive function can be a distressing side effect of cancer and its treatment. Women diagnosed and treated for breast cancer often report problems with memory, concentration, and other cognitive abilities that can pose significant barriers to full resumption of family, job, and social roles. Despite considerable neuropsychological research, many unanswered questions remain about cancer-related cognitive deficits and the underlying neural bases. Functional magnetic resonance imaging (fMRI) measures brain activation associated with different mental states and has significantly advanced our understanding of cognitive function and dysfunction in healthy and clinical populations. However, to date the application of fMRI to the study of cognitive function in breast cancer is limited. The current review addresses the potential importance of this method for understanding the neurocognitive effects of breast cancer disease and treatment. Along with reviewing published fMRI studies on breast cancer to date, we discuss potential major contributions of this method which include: (a) delineating components of cognitive function and underlying neural processes most affected by cancer and its treatment, (b) uncovering compensatory processes and their limits, (c) identifying altered resting state networks that may relate to subjective complaints and longer term outcomes, and (d) clarifying the relationship between pre-treatment alterations in brain activity and longer term neural and behavioral outcomes. Finally, we pose questions for future research that can be optimally addressed by integrating fMRI and other imaging modalities to clarify the nature and causes of "chemo brain" and guide interventions to improve cognitive function and the quality of breast cancer survivorship.

Does Mindfulness Training Improve Cognitive Abilities? A Systematic Review of Neuropsychological Findings

Article

Dec 2010

Mindfulness meditation practices (MMPs) are a subgroup of meditation practices which are receiving growing attention. The present paper reviews current evidence about the effects of MMPs on objective measures of cognitive functions. Five databases were searched. Twenty three studies providing measures of attention, memory, executive functions and further miscellaneous measures of cognition were included. Fifteen were controlled or randomized controlled studies and 8 were case-control studies. Overall, reviewed studies suggested that early phases of mindfulness training, which are more concerned with the development of focused attention, could be associated with significant improvements in selective and executive attention whereas the following phases, which are characterized by an open monitoring of internal and external stimuli, could be mainly associated with improved unfocused sustained attention abilities. Additionally, MMPs could enhance working memory capacity and some executive functions. However, many of the included studies show methodological limitations and negative results have been reported as well, plausibly reflecting differences in study design, study duration and patients' populations. Accordingly, even though findings here reviewed provided preliminary evidence suggesting that MMPs could enhance cognitive functions, available evidence should be considered with caution and further high quality studies investigating more standardized mindfulness meditation programs are needed.

Mindfulness meditation improves cognition: evidence of brief mental training. Consciousness and Cognition: An International Journal, 19, 597-605

Article

Apr 2010
CONSCIOUS COGN

Neurocognitive Changes in Cancer Survivors

Article

Nov 2008

This article provides an overview of the most recent literature on the cognitive adverse effects of chemotherapy in patients with breast cancer. The prevalence of cognitive dysfunction in patients treated with chemotherapy was variable in studies using a cross-sectional design. More recent prospective studies detected cognitive difficulties in subgroups of patients, mostly at short-term follow-ups, but other studies found no evidence of impairment. Studies using neuroimaging techniques and animal models have begun to examine structural and functional correlates of cognitive changes associated with chemotherapy. A review of the literature suggests that considerable progress has been made in the investigation of chemotherapy-related cognitive dysfunction in recent years, and highlights the importance of a multidisciplinary approach to further elucidate the mechanisms that may underlie treatment-related toxicity.

Cognitive Function in Breast Cancer Patients Receiving Adjuvant Chemotherapy

Article

Jul 2000

Breast cancer patients receiving chemotherapy have complained of difficulties in their ability to remember, think, and concentrate. This study assessed whether there are differences in cognitive function between breast cancer patients treated with standard-dose adjuvant chemotherapy compared with healthy controls. The High Sensitivity Cognitive Screen and the Profile of Mood States (POMS) were used to assess cognitive function and mood in a group of 107 women. The women consisted of 31 breast cancer patients receiving adjuvant chemotherapy (group A), 40 breast cancer patients who had completed adjuvant chemotherapy a median of 2 years earlier (group B), and 36 healthy controls (group C). Univariate analysis showed statistically significant differences (P =.009) in overall cognitive function scores between groups A and C, with poorer function in patients receiving adjuvant chemotherapy. These differences remained significant (P =.046) when controlling for age, education level, and menopausal status. More patients had moderate or severe cognitive impairment in groups A and B than in controls (P </=.002). There were no significant differences in POMS scores between the groups, suggesting that the differences seen in cognitive scores were unlikely to be because of mood disturbance. Cognitive differences were observed in breast cancer patients receiving adjuvant chemotherapy compared with healthy controls. These differences did not seem to be caused by significant differences in mood disturbance between the two groups. If confirmed, these results have substantial implications for informed consent, counseling, and psychosocial support of patients receiving adjuvant chemotherapy for breast cancer.

A Randomized, Wait-List Controlled Clinical Trial: The Effect of a Mindfulness Meditation-Based Stress Reduction Program on Mood and Symptoms of Stress in Cancer Outpatients

Article

Sep 2000

The objective of this study was to assess the effects of participation in a mindfulness meditation-based stress reduction program on mood disturbance and symptoms of stress in cancer outpatients. A randomized, wait-list controlled design was used. A convenience sample of eligible cancer patients enrolled after giving informed consent and were randomly assigned to either an immediate treatment condition or a wait-list control condition. Patients completed the Profile of Mood States and the Symptoms of Stress Inventory both before and after the intervention. The intervention consisted of a weekly meditation group lasting 1.5 hours for 7 weeks plus home meditation practice. Ninety patients (mean age, 51 years) completed the study. The group was heterogeneous in type and stage of cancer. Patients' mean preintervention scores on dependent measures were equivalent between groups. After the intervention, patients in the treatment group had significantly lower scores on Total Mood Disturbance and subscales of Depression, Anxiety, Anger, and Confusion and more Vigor than control subjects. The treatment group also had fewer overall Symptoms of Stress; fewer Cardiopulmonary and Gastrointestinal symptoms; less Emotional Irritability, Depression, and Cognitive Disorganization; and fewer Habitual Patterns of stress. Overall reduction in Total Mood Disturbance was 65%, with a 31% reduction in Symptoms of Stress. This program was effective in decreasing mood disturbance and stress symptoms in both male and female patients with a wide variety of cancer diagnoses, stages of illness, and ages. cancer, stress, mood, intervention, mindfulness.

A metaanalysis of studies of the effects of cancer chemotherapy on various domains of cognitive function

Article

Nov 2005

Little is known about the effects of chemotherapy on cognitive function. The purposes of this metaanalysis were to estimate the effect sizes for the effect of chemotherapy on each domain of cognitive function and to differentiate effect sizes by each method of comparison of effects (i.e., normative data, control group, or baseline data). Sixteen studies that evaluated cognitive function in chemotherapy patients were included in the study. DSTAT metaanalysis software was used to calculate an effect size and confidence intervals for each neuropsychologic test. Tests were assigned to a specific cognitive domain, and an average effect size was determined for each domain. Only one domain of cognitive function (i.e., visual memory) had significant chemotherapy-induced impairment across all comparison types. However, when the neuropsychologic test scores of chemotherapy patients were compared with normative data, significant effect sizes were found for four domains of cognitive function (i.e., executive function, information processing speed, verbal memory, visual memory). In addition, significant, albeit small, effect sizes were found for language and verbal memory when chemotherapy patients' test scores were compared with test scores of healthy matched controls. All significant averaged effect sizes were in the negative direction, indicating that mean scores on neuropsychologic tests for patients who had received chemotherapy were on average lower than comparison scores. Data from this metaanalysis supported the hypothesis that chemotherapy can have a negative impact on cognitive function. However, most deficits in this study ranged from small to moderate and were nonsignificant.

Renaming “Chemobrain”

Article

Oct 2007

A subset of breast cancer survivors are reporting cognitive impairment after cancer treatment, which has commonly been attributed to the receipt of chemotherapy and colloquially termed "chemobrain." For some, a fear of this side effect enters into their decision regarding therapy. Our review of the literature reveals that so-called "chemobrain" is complex and that factors other than chemotherapy may affect cognitive function, including the impact of surgery and anesthesia, hormonal therapy, menopause, anxiety, depression, fatigue, supportive care medications, genetic predisposition, comorbid medical conditions, or possibly paraneoplastic phenomenon. Studies to date have differed in their assessment and definition of cognitive impairment, thus, making comparisons between studies difficult. In addition, most studies have been limited by a small sample size, and there has been a general lack of focus on older patients despite their high concentration within the cancer population. Large, multicenter studies are needed to better understand the magnitude and mechanism of cognitive changes in cancer survivors and to assess the impact of cognitive changes on the patient's daily lives. We propose that the phenomenon commonly referred to as "chemobrain" would be more accurately labeled "cancer- or cancer-therapy-associated cognitive change."

The Effect of Mindfulness-Based Music Therapy on Attention and Mood in Women Receiving Adjuvant Chemotherapy for Breast Cancer: A Pilot Study

Abstract

No full-text available

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