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Effects of Choir Singing or Listening on Secretory Immunoglobulin A, Cortisol, and Emotional State

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Effects of Choir Singing or Listening on Secretory Immunoglobulin A, Cortisol, and Emotional State

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The present study investigates the effects of choir music on secretory immunoglobulin A (S-IgA), cortisol, and emotional states in members of a mixed amateur choir. Subjects participated in two conditions during two rehearsals 1 week apart, namely singing versus listening to choral music. Saliva samples and subjective measures of affect were taken both before each session and 60 min later. Repeated measure analyses of variance were conducted for positive and negative affect scores, S-IgA, and cortisol. Results indicate several significant effects. In particular, singing leads to increases in positive affect and S-IgA, while negative affect is reduced. Listening to choral music leads to an increase in negative affect, and decreases in levels of cortisol. These results suggest that choir singing positively influences both emotional affect and immune competence. The observation that subjective and physiological responses differed between listening and singing conditions invites further investigation of task factors.
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Journal of Behavioral Medicine, Vol. 27, No. 6, December 2004 (
C
2004)
Effects of Choir Singing or Listening
on Secretory Immunoglobulin A,
Cortisol, and Emotional State
Gunter Kreutz,
1,3
Stephan Bongard,
2
Sonja Rohrmann,
2
Volker Hodapp,
2
and Dorothee Grebe
1
Accepted for publication: November 11, 2003
The present study investigates the effects of choir music on secretory im-
munoglobulin A (S-IgA), cortisol, and emotional states in members of a mixed
amateur choir. Subjects participated in two conditions during two rehearsals
1 week apart, namely singing versus listening to choral music. Saliva samples
and subjective measures of affect were taken both before each session and 60
min later. Repeated measure analyses of variance were conducted for positive
and negative affect scores, S-IgA, and cortisol. Results indicate several sig-
nificant effects. In particular, singing leads to increases in positive affect and
S-IgA, while negative affect is reduced. Listening to choral music leads to an
increase in negative affect, and decreases in levels of cortisol. These results sug-
gest that choir singing positively influences both emotional affect and immune
competence. The observation that subjective and physiological responses dif-
fered between listening and singing conditions invites further investigation of
task factors.
KEY WORDS: singing; S-IgA; cortisol; emotion.
1
Department of Music Education, Johann Wolfgang Goethe-University Frankfurt am Main,
Frankfurt, Germany.
2
Department of Psychology, Johann Wolfgang Goethe-University Frankfurt am Main,
Frankfurt, Germany.
3
To whom correspondence should be addressed at Department of Music Education, J. W.
Goethe-University Frankfurt am Main, Sophienstrasse 1-3, D-60487 Frankfurt am Main,
Germany; e-mail: G.Kreutz@em.uni-frankfurt.de.
623
0160-7715/04/1200-0623/0
C
2004 Springer Science+Business Media, Inc.
624 Kreutz, Bongard, Rohrmann, Hodapp, and Grebe
INTRODUCTION
Since the times of Plato, artists and scientists alike have been intrigued
by the power of music to elicit strong emotional responses in humans and
animals. The Greek philosophers were among the first in the Western culture
to speculate about specific effects of music on bodily chemistry, and subjec-
tive feelings (Levman, 2000). For example, they were convinced that music
benefited health and specific recommendations were formulated for using
music therapeutically against mental and physical illness (Bruhn, 2000).
Empirical research over the past decades has addressed the psychophys-
iological effects of music listening with some emphasis on the responses of
the autonomous nervous system (ANS) (e.g., Goldstein, 1980; Kreutz et al.,
2002a,b; Panksepp, 1995). In general, this research suggests that listeners’
subjective experience is at least in part mediated by physiological responses
to music stimuli (Bartlett, 1996). However, few studies were able to relate
peripheral ANS responses to emotional experiences of music (Krumhansl,
1997; Nyclicek et al., 1997). To date, this research did not yet provide re-
liable evidence for associations between music and health related ANS
variables.
It appears well established that the ANS profoundly affects immune
functions (Ader et al., 1991). Most of the studies reviewed below have
used secretory IgA (S-IgA) as a marker of immune competence (Stone
et al., 1987b). S-IgA is a protein considered as the body’s first line of de-
fense against bacterial and viral infections of the upper respiratory pathway
(Tomasi, 1972). In particular, S-IgA was found more strongly influenced via
the sympathetic rather than the parasympathetic branch of the ANS (Ring
et al., 1999). There is general consensus that S-IgA is specifically responsive
to an individual’s emotional state (Rein and McCraty, 1995). Increases of
S-IgA were often observed in the context of positive and/or relaxing experi-
ences (e.g., Green and Green, 1987; Stone et al., 1987a), whereas S-IgA often
decreased in studies on the emotional impact of stressful events (Martin and
Dobbin, 1988) and intense physical effort (Mackinnon and Hooper, 1994).
Research on the effects of music listing on immune system and emo-
tional stress are receiving increasing attention in behavioral medicine (Pratt
and Spintge, 1996). Several studies have specifically looked at the relation-
ship between music listening, subjective mood, and immune competence.
Music listening may significantly influence immune functions via the ANS
(McCraty et al., 1996). In particular, S-IgA increased in the context of music
listening and relaxation (Tsao et al., 1992; see also Van Rood et al., 1993).
Individual music preferences and context factors appear to be important in
mediating these effects. Therefore, music may benefit patients in individ-
ual treatment formats (e.g., McKinney et al., 1997a). McCraty et al. (1996)
Effects of Choir Singing or Listening on Secretory Immunoglobulin A 625
concluded that music listening may enhance the benecial effects of self-
induced positive mood on immunity.
McKinney et al. (1997b) found that the combination of classical music
and spontaneous imagery led to signicant decreases in beta-endorphin, a
hormone which is believed to be related to emotional stress (Panksepp et al.,
1979). Gerra et al. (1998) extended these ndings using classical and techno
music. They found correlations between personality traits such as novelty-
seeking or harm avoidance and musically-induced endocrine responses, also
including beta-endorphin.
In lieu of increasing evidence that music listening may inuence immune
competence and physiological stress in adult listeners (Pratt and Spintge,
1996), there is no comparable research on the conceivably enhancing effects
of more active musical behaviors than listening. For example, the emotional
effect of singing on the organism of the singer is yet poorly understood, al-
though singing is probably the most common everyday musical activity ob-
servable in all cultures (Nettle, 2000). In a pioneering study, Beck et al. (1999)
looked at the endocrine effects of singing in professional chorale singers. The
authors were interested in the effects of three singing conditions (two dif-
ferent rehearsals and one performance) on changes of S-IgA and cortisol.
Cortisol is a hormone associated with emotional stress (Kirschbaum and
Hellhammer, 1994). Beck et al. (1999) found strong increases of S-IgA in
each condition. For instance, during the performance S-IgA levels went up
by more than 350% in nearly 25% of the singers. Levels of cortisol, by con-
trast, were found to decrease in the rehearsal conditions only, but increased
signicantly during the performance. These results suggested different ef-
fects of singing on S-IgA and cortisol. A further nding of the Beck et al.
study was that according to a multiple regression analysis several subjective
measures associated with positive attitudes toward singing predicted changes
in S-IgA. To explain these ndings it was speculated that breathing patterns
induced by singing as well as positive mood change might contribute to the
observed S-IgA increases.
More recent studies tend to corroborate subjective positive mood ef-
fects and health benets of singing in groups (Clift and Hancox, 2001; Grape
et al., in press; Unwin et al., 2002; Valentine and Evans, 2001). However, it
is yet not clear whether and to what extent the observed effects could be
attributed to mere passive exposure to musical sound, rather than active
physical engagement in singing. As shown above, listening to music alone
may induce a variety of signicant endocrine effects, even irrespective of
subjectsmusical training (Bartlett, 1996; McCraty et al., 1996).
On the basis of these previous ndings, the purpose of the present
study was to compare subjective and physiological responses produced by
group singing with those elicited by listening to music and to establish any
626 Kreutz, Bongard, Rohrmann, Hodapp, and Grebe
differences as subjects processed the same musical materials in these con-
ditions. It was hypothesized that both singing and listening enhance specic
immune functions as well as they lead to positive changes of affective states.
Therefore, we expected signicant increases in S-IgA and subjective positive
emotional state as well as signicant decreases of cortisol and negative emo-
tional state after singing and after listening to choral music, but that these
effects were more pronounced in the singing condition.
METHODS
Participants
Thirty-one members (23 female) of an amateur choir participated in
this study. Participants age ranged from 29 to 74 years (M = 56.9 years,
SD = 14.8 years). As assessed by a questionnaire, none of the participants
reported smoking more than 10 cigarettes per day or drinking more than
5 alcoholic drinks per week. On a questionnaire, subjects did not indicate
acute health problems with respect to respiration or cardiovascular system.
All subjects gave informed consent individually.
Design and Procedure
After informed consent was obtained from all participants, the exper-
imental conditions for this study were realized in two sessions at the same
location in the rehearsal room of a church at the regular time of that choirs
rehearsal between 6 and 7 p.m. The sessions were conducted 1 week apart
and lasted for 60 min each. Participants were instructed not to take in any
meals, or alcoholic drinks, and refrain from smoking within 1 h before the
start of the rehearsal.
Before the rst session started, each participant lled in a demographic
questionnaire. Moreover, before each of the two sessions, a psychometric
scale for the measurement of emotional state (Positive and Negative Affect
Schedule, PANAS; Krohne et al., 1996; Watson et al., 1988) was completed.
The PANAS consists of 20 items, 10 representing positive affect (e.g., I feel
ne), and 10 items representing negative affect (e.g., I feel depressed).
Participants were asked to mark each of the items on a scale from 1 (very
little or not at all)to5(extremely) according to their current feeling.
The PANAS was lled in once again at the end of each session. Also, at
the beginning and at the end of each session, saliva was collected using a
standard procedure (see next section).
Effects of Choir Singing or Listening on Secretory Immunoglobulin A 627
Singing Condition
The singing condition was initiated by a 10-min warm-up phase, in which
various breathing, stretching, and vocalization exercises were performed.
For the rest of the session, sections and pieces from Mozarts Requiem were
rehearsed, and instructions by the conductor were given to the choir. Par-
ticipants stood during the warm-up, whereas they remained seated for the
rest of the time. Times of interruptions by the conductor were measured and
approximated 10 min of the rehearsal time.
Listening Condition
During the second session 1 week later, the pieces from Mozarts Re-
quiem were presented from CD, and articles on singing from an eighteenth
century encyclopedia of the arts (Sulzer, 1967) were read aloud. Participants
were seated during the entire session. When music was played, they were
instructed to listen to the music attentively as if they were engaged in singing.
Moreover, it was ensured that listening to speech and music under the lis-
tening condition had the same proportion as singing and listening to the
conductor under the singing condition.
Saliva Collection and Assaying
Saliva was collected with Sarstedt Salivettes
®
. This device consists of
a plastic tube containing a cotton wool swab. Subjects were asked to insert
the swab into their mouth and were instructed not to swallow saliva for a
5-min period. Afterwards this cotton wool swab was placed back into the
tube. Saliva samples were centrifuged at 4000 × g for 10 min and then were
kept at 30
C until assayed.
Measured parameters in saliva samples were immunoglobulin A, al-
bumin, and cortisol. Albumin levels served both as an exclusion criterion
for blood contaminated saliva samples and for correcting the S-IgA mea-
sures for effects of saliva ow density. Because albumin leaks passively into
saliva from systemic sources, its concentration reects mucosal membrane
permeability. The ratio of S-IgA to albumin thus provides an indication of
the local secretory immune response controlling for any serum leakage of
IgA (Cripps et al., 1991; Drummond and Hewson-Bower, 1996).
After thawing, saliva was analyzed for concentrations of S-IgA and
albumin by use of a fully automated nephometric analyses (BN100, Dade
Behring, Marburg, FRG). The assay protocol has been adapted to the ex-
pected range for saliva concentrations of S-IgA between 0 and 120 mg/dL
628 Kreutz, Bongard, Rohrmann, Hodapp, and Grebe
and albumin (027 mg/dL), respectively using highly specic monoclonal
antibodies for human S-IgA and albumin (Dade Behring). Previous mea-
sures revealed extremely high intra- and interassay precision which can be
expected in general for protein analysis and which justies single measure-
ments of samples in clinical practice.
Saliva cortisol was determined using a commercial luminescence-
immuno assay (IBL, Hamburg, FRG) especially designed for saliva sam-
ples and approved by the Food and Drug Administration (FDA). Pipetting
of standards, samples, and reagents was performed by a fully automated
system (Labotech, Freiburg, FRG).
Luminescence units were read by use of an automatic luminometer
(Beckmann, FRG). All samples were measured in duplicates with sufcient
intra-assay precision (coefcient of variance, CV < 6%). All samples were
analyzed with assays obtained from the same charge to reduce interassay
variation, which was lower than 10%.
Saliva analyses were conducted at the lab of Prof. Dr. J. Hennig at the
Department of Psychology, Justus-Liebig-University Giessen, Germany (for
more details see: Hennig et al., 1999).
Data Analysis
Positive and negative affect sum scores were calculated for the two con-
ditions. To determine any signicant changes of positive and negative affect,
two repeated measures analyses of variance (ANOVA) were conducted for
each of the two scores. Similarly, S-IgA/albumin and cortisol values were
submitted to two separate repeated measures ANOVAs. In all analyses,
condition (singing versus listening) and time (baseline and after treatment)
served as independent variables. In addition, to determine statistical rela-
tionships between subjective and physiological changes, Pearsons product
moment correlations were calculated.
RESULTS
Psychological Measures
Mean scores of positive and negative affect ratings before and after the
two conditions are presented in Table I. Data from three subjects were not
included due to large proportions of missing values.
An ANOVA for positive affect values indicated no signicant main
effect of condition, F(1, 27) = 3.08, p = 0.09, or time, F(1, 27) = 1.30,
Effects of Choir Singing or Listening on Secretory Immunoglobulin A 629
Table I. Means (and Standard Deviations) of Positive and Negative Affect Ratings for
the Two Experimental Conditions at Baseline and After Treatment
Positive affect Negative affect
Baseline After treatment Baseline After treatment
Singing 2.86 (0.51) 3.15 (0.64) 1.31 (0.4) 1.18 (0.24)
Listening 2.85 (0.67) 2.79 (0.81) 1.23 (0.25) 2.20 (0.31)
Note. Scores of each scale were divided by the number of items.
p = 0.26. However, there was a signicant interaction between time and
conditions, F(1, 27) = 6.41, p < 0.02. Follow-up Tukeys HSD tests of sim-
ple effects revealed that positive affect increased signicantly after singing
(p < 0.05), but not after listening. An ANOVA which addressed nega-
tive affects scores revealed highly signicant main effects for condition,
F(1, 27) = 95.71, p < 0.001, time, F(1, 27) = 113.57, p < 0.001, and a signif-
icant interaction between the two factors, F(1, 27) = 145.91, p < 0.001. Post
hoc Tukeys HSD-Tests of simple effects indicated a signicant decrease of
negative affect after singing ( p < 0.05), and a signicant increase of negative
affect after listening (p < 0.05).
Physiological Measures
Table II presents mean S-IgA/albumin and cortisol values at baseline
and after treatment.
An ANOVA of S-IgA/albumin values revealed a highly signicant main
effect of condition, F(1, 30) = 10.41, p < 0.005, but no signicant main
effect of time, F(1, 30) = 0.24, p = 0.62. As predicted, there was a signicant
interaction between time and condition, F(1, 30) = 4.32, p < 0.05 on S-
IgA/albumin. Follow-up Tukeys HSD-Tests of simple effects indicated a
highly signicant increase of S-IgA/albumin for the singing condition (p <
Table II. Means (and Standard Deviations) of S-IgA/Albumin and Cortisol Values Before
and After Treatment for the Two Experimental Conditions
S-IgA/albumin Cortisol [ng/mL]
Baseline After treatment Baseline After treatment
Singing 3.66 (3.15) 5.28 (5.26) 0.75 (0.67) 0.59 (0.48)
Listening 4.10 (4.20) 4.49 (3.78) 0.81 (0.61) 0.48 (0.27)
Note. S-IgA/albumin is without unit because the units for both parameters are identical
(mg/dL).
630 Kreutz, Bongard, Rohrmann, Hodapp, and Grebe
Fig. 1. Means and standard errors of S-IgA/albumin values before and after singing choral
music and listening to choral music respectively.
0.005), but no signicant changes for the listening condition (p = 0.79).
Figure 1 illustrates the signicant condition by time interaction on mean
S-IgA/albumin values.
An ANOVA, which addressed cortisol values, revealed a signicant
main effect of time, F(1, 30) = 10.30, p < 0.005, but no further effects.
However, since we had specic hypotheses considering different effects
of singing versus listening on cortisol responses, we did pairwise compar-
isons of baseline and after treatment values for both conditions separately.
These analyses indicated that cortisol decreased signicantly from baseline
to after treatment in the listening condition, F(1, 28) = 12.14; p < 0.001,
but did not change signicantly in the singing condition, F(1, 30) = 2.56;
p > 0.1.
Pearson correlations between changes in subjective and physiological
measures were calculated separately for the two conditions. Out of eight
coefcients, only one turned out to be signicant: changes of positive mood
during listening correlated signicantly with changes of cortisol levels, r =
0.40, p < 0.05.
Effects of Choir Singing or Listening on Secretory Immunoglobulin A 631
DISCUSSION
This study demonstrated psychophysiological effects of choral singing
and listening to choral music. We found different patterns of changes for
S-IgA, cortisol, and subjects emotional state with respect to the two ex-
perimental conditions. Singing led to a decrease in negative mood and an
increase in positive mood and S-IgA, but did not affect cortisol responses.
Listening on the other hand led to an increase in negative mood, a decrease
in cortisol, and no signicant changes in positive mood and S-IgA.
These results support the hypothesis, that choir singing inuences posi-
tive emotions as well as immune functions in humans. They conrm previous
ndings which showed that singing inuences subjective emotional states
positively (Unwin et al., 2002) and enhances the immune defence (Beck
et al., 1999). These studies corroborate the notion that musically-induced
changes of S-IgA are mediated by subjective mood (McCraty et al., 1996;
Rein and McCraty, 1995).
Contrary to expectations, we observed a decrease of cortisol only for
the listening condition but not for the singing condition. On one hand, de-
creases of cortisol levels suggest psychological deactivation, relaxation, and
stress reduction. On the other hand, it is known that cortisol levels decrease
during the waking hours of human subjects (Kirschbaum and Hellhammer,
1994). This decrease is relatively steep in the morning but slows down in the
afternoon. Given the fact that in the present study all measures were taken
between 6 and 7 p.m. it is rather unlikely that the observed decrease of about
60% within 60 min in the listening condition is only due to the diurnal ef-
fect. The observation that listening also led to an increase in negative mood
suggests that the listening condition was at least partly experienced as un-
exciting, boring, and deactivating by our participants. This interpretation is
very reasonable given the fact that the main objective for these amateur cho-
risters is the production but not the reception of music. The singing condition
on the other hand may have prevented against deactivation and decrease in
cortisol. Moreover, Beck et al. (1999) showed that the performance situation
(rehearsal versus public concert) inuenced the direction of changes of cor-
tisol levels, which decreased during the rehearsals but increased during the
public performance. The authors reasoned that the latter were emotionally
more demanding than rehearsals.
The observed decrease of cortisol levels following the listening period,
while participants reported increased negative mood in the same condition,
is consistent with previous work (Davis and Thaut, 1989), which indicated
that music listeners can present contradictory responses on psychological
and physiological measures. One possible explanation for this dissociation
632 Kreutz, Bongard, Rohrmann, Hodapp, and Grebe
is that music expressing negative emotions, e.g., grief or sadness, is often
experienced as relaxing and soothing (V¨astfj¨all, 2002).
Positive emotions increased after singing, and negative emotions in-
creased after listening. Why did listening to the music not result in the same
subjective responses as singing? Many people report that they enjoy listen-
ing to music in a group setting such as attending a public concert. But again,
it must be kept in mind, that the primary goal of a regular choir rehearsal is
to practice singing. The experimental intervention required by the listening
condition, therefore, was in conict with the routine rehearsal procedure,
and with the intensions and expectations of the individual choristers. In ad-
dition, choristers are more focused on vocal control, watching the music
sheet and the conductor, and listening to their fellow singers during singing
than during listening. Finally, previous studies have addressed the affective
impact of lyrics (Stratton and Zalanowski, 1994), but it is unclear, whether
and to what extent the contents of the lyrics are differentially perceived
during listening as compared to singing. We assume, that the emotionally
negative connotations of the requiem might have had a stronger impact on
affective responses during listening than during singing.
Limitations of the present study should be noted. First, in this study,
there was only one large piece of classical music included. Thus it remains
to be seen, whether our ndings can be generalized across different styles
and genres of music as well as across the selection method of the musical
materials (Thaut and Davis, 1993). Second, as this study was conducted with
choral singers in a group setting, questions arise as to whether similar effects
may be found in solo singing (Valentine and Evans, 2001). Third, we did not
control for physical activity, which is known to inuence mucosal immune
system responses (Mackinnon and Hooper, 1994). For our subjects singing
was physically more demanding than just listening. Future research should
investigate whether and to what degree the observed effect of singing on
S-IgA might be explained by different degrees of physical activity.
Finally, it seems worth to note that humans are not the only species
to exhibit relationships between singing and immune functions (Duffy and
Ball, 2002). One might speculate, that similar relationships as in this study
may be detected in other primates, as vocal production in these species is
directly related to emotional affect and stress-regulation (Grossmann, 2000;
Hauser, 2000).
In sum, the present study shows that amateur group singing leads to
increases in both positive affect and the production of salivary immunoglob-
ulin A, a protein considered as the rst line of defense against respiratory
infections. It replicates previous work demonstrating an association between
singing and immune function, and suggests a possible inuence of musical
behavior on well-being and health.
Effects of Choir Singing or Listening on Secretory Immunoglobulin A 633
ACKNOWLEDGMENTS
This study was supported by a grant of the Deutscher S ¨angerbund e. V.
(German Singers Association). We are grateful to two anonymous reviewers
for their valuable suggestions.
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... Group singing has been found to be beneficial for various biological, psychological, and social reasons (as reviewed in Gick, 2011;Reagon, Gale, Enright, Mann, & Van Deursen, 2016). Many empirical studies have found that group singing enhances peoples' overall psychological well-being (Clift et al., 2010;Judd & Pooley, 2014;Stewart & Lonsdale, 2016), including things like their mental health-related quality of life (Coulton, Clift, Skingley, & Rodriguez, 2015), positive psychophysiological outcomes (Kreutz, Bongard, Rohrmann, Hodapp, & Grebe, 2004), and a reduction of negative feelings (Fancourt et al., 2016;Unwin, Kenny, & Davis, 2002). ...
... Additionally, this result is consistent with prior studies that look at the mood enhancement properties of group music activities among children (Kawase & Ogawa, 2020). Furthermore, the mood-improving effects of singing itself (Coulton et al., 2015;Fancourt et al., 2016;Gick, 2011;Kreutz et al., 2004;Reagon et al., 2016;Unwin et al., 2002) could also have contributed to the overall mood improvement effect of these sessions. 15 Overall, our findings suggest that group singing programs, that use specifically designed song orders, increase participants' sense of unity and improved their overall mood. ...
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Group singing sessions have been observed to result in positive mood changes. One reason for this mood enhancement property is the sense of unity generated by the resulting group cohesion. Based on this sense of unity, the concept of group flow is then likely related the overall group’s cohesion to a certain degree. However, a question remains surrounding the time changes in the factors of group cohesion and flow during sessions in accordance with the therapist’s expectations. To investigate this, quasi-therapeutic group singing sessions were employed. The present study conducted a time series analysis to examine changes in group cohesion, group flow, and participants’ moods by examining the influence of the song orders that a therapist used for effective mood enhancement. The main findings were that (1) group singing sessions enhanced group cohesion and flow between members; (2) group cohesion and group flow of participants was altered in accordance with the order of the presentation of songs, as per our original expectation. We found that group singing sessions enhance participants’ positive mood through the resulting changes to the group cohesion and flow. These results are applicable for those involved in the organizing of the structures of music therapy sessions, as well as future research into this therapeutic mode.
... 42,43 Such high percentage is somewhat unexpected as choir singing is a leisure activity that has shown to reduce stress and positively affect the emotional state of the singers. 5,44 However, an important note here is that the competitive setting of the current study, ie the World Choir Games, can be seen as a stress-inducing situation and might have contributed to this high number. When interpreting the results, it should be taken into account that the high stress levels might have negatively affected voice quality. ...
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Background The voice use of choir singers is understudied despite the imbalance of high vocal demands versus low vocal education, and consequently increased risk for voice problems. Also, there is a lack of information on the effects of a performance on choristers’ voices. Available studies included performances of at least one hour. To date, no studies investigated the effects of a choir performance with a duration resembling vocal warm-ups. Purpose The first purpose of this study was to determine the voice quality, capacities, symptoms and voice-related quality of life of choir singers. Secondly, the effect of a short choir performance, resembling warm-up duration (15 minutes), on the choristers’ voices was investigated. Methods A randomized controlled trial was used. Thirty adult choir singers (25 women, 5 men; mean age: 32 years) were assigned randomly to an experimental group or a control group. Participants in the experimental group sung in choir for 15 minutes immediately after their pre voice assessment, whereas the control group was instructed to have standard voice use (one-on-one conversation with the investigator, no singing) across that time span. A second voice assessment was repeated afterwards. Results The choir singers showed excellent voice quality and capacities with mean scores on the Dysphonia Severity Index and Acoustic Voice Quality Index of 7.5 and 2.0, respectively. Auditory-perceptually, the mean grade score was 5/100 corresponding with a normal to mildly deviant voice quality. Patient-reported outcome measures showed mean deviant scores, indicating a considerable singing voice handicap. The choir singers seem vulnerable for stress with a high occurrence rate of 76.7% (23/30). Compared with the control group, the Dysphonia Severity Index significantly improved, whereas the self-perceived presence of vocal fatigue and complaints increased after 15 minutes of choir singing. Fundamental frequency increased in both groups, being more outspoken in the experimental group. Conclusions Choir singers show excellent voice quality and capacities, that further improve after a short choir performance of 15 minutes. Vocal fatigue and complaints, on the other hand, already increased after that short time span. Realizing that vocal load is much higher in real-life rehearsals, competitions and performances, choristers deserve and need a qualitative voice training and a strict follow-up. Future research should focus on effective vocal warm-up and cool-down programs for this population.
... The results of the study on the effect of music on human stress response by Thoma et al. (2013) may help to understand the positive effects of music on the human body. Kreutz et al. (2004) studied the effects of choral singing on secretory immunoglobulin A, cortisol, and emotional state. As with all other studies, the outcome was favourable in favour of singing, as the results suggest that choral singing positively affects both emotional affect and immune defence. ...
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This article discusses the impact that the Covid-19 pandemic has had on singing with children in schools by providing a descriptive analysis of a comparative look at children's experiences of their singing habits and emotional well-being during the first Covid-19 lockdown. Covid-19 has established itself as (for now) an ever-present variable in our daily lives. This paper offers a descriptive analysis of a comparative study of the Covid-19 lockdown(s) influence on children's singing habits and emotional well-being in Italy, Austria, and Finland. A survey was carried out on children and young people aged 10-20 from Austria, Finland, and Italy on how the Coronavirus lockdown has impacted their everyday lives and their general well-being. Attributes analysed are age, gender, emotional response on the change of singing habits, singing habits before and after Covid-19 lockdown. Until it is certain that rehearsals and communal singing can take place without health risks, alternative options should be explored to effectively plan online teaching in the future. It is the hope that this research, which is only but a start, will spark further research into the matter and contribute to the development of systems and platforms where children can continue their educational and music educational growth by ensuring an uninterrupted singing experience.
... The superior effect of active music therapy on depression seems to be multifactorial, which is possibly due to its active form that helps to connect participants with a therapist or other people and to express difficult feelings. A specific method of active music therapy such as singing has been shown to improve emotional status as well as immunity, 44 well-being, physical and physiological performance, 45 and quality of life. 46 It has been suggested that the use of musical instruments provides opportunities for the expression of emotions among participants, induces positive mood states, and improves psychological and physical quality of life. ...
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... Asimismo, cantar eleva los niveles de inmunoglobulina A (IgA) y del cortisol (Kreutz 2004) sustancias que juegan un papel importante en el sistema inmunológico (Corthésy 2013) y para hacer frente al estrés. ...
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This chapter examines results of a workshop held to discuss experiments conducted to study secretary immunoglobulins. The secretory workshop focused mainly on two general aspects of the secretory immune system: (1) the structure and immunology of IgA, both serum and secretory; and (2) the biological properties of IgA. The first part of the workshop discussed the structure of the IgA molecule. Much of the discussion centered about the discovery in secretory IgA molecules of a fourth type of polypeptide chain. It was shown that the secretory component has now been identified in several other species including the cow, sheep, goat, horse, and dog. Free secretory component, either human or bovine, binds in vitro to polymeric IgA or IgG. The observation that secretory component binds in vitro only to polymeric molecules such as IgA and IgM, raised considerable discussion concerning the possibility that J chain might play a role in binding.
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