Stress
Conditions
Keywords
Mental health, Youth, Singing, Music, Stress, Cortisol, Alpha Amylase, Immunoglobulin A
Brief summary
Interventional, three-armed, open, monocentric, medium-term follow-up, pre-test-post-test design, controlled, parallel group study to investigate the effects of a group singing intervention on neuroendocrine (hair cortisol, salivary cortisol, salivary alpha amylase), immune (salivary immunoglobulin A/s-IgA), and psychological (psychological stress, mood, social contacts, emotional and social competence, self-esteem, and quality of life) responses in mentally ill and healthy children and adolescents (N=135, age range 10 -18). Additionally, the child and adolescent psychiatry group (age range 13-18) takes part in three hour creative workshops every two weeks.
Detailed description
Background: Biopsychological responses to music-related activities (MRA) were examined in various naturalistic settings in adults. Group singing in particular seems to be associated with positive biopsychological outcomes. There is also an emerging view that MRA may play an important role for youth with mental disorders. However, longitudinal research on biopsychological responses to MRA in different clinical and healthy populations among children and adolescents is lacking. Method: Children and adolescents (age range 10-18) under psychiatric treatment at the Department of Child and Adolescents Psychiatry in Salzburg (n=45), healthy children and adolescents from a school in Salzburg (n=45), and members from the Vienna Boys Choir (n=45) in Austria will be recruited to take part in the study. Subjective measures (mood, stress experience) will be taken pre- and post singing sessions once a week throughout six months. Additionally, salivary biomarkers (cortisol, alpha amylase and IgA), social contacts, and quality of life are assessed. Emotional competence, social competence, self-esteem, and chronic stress levels are measured at the beginning, after three months, at the end, and in a follow-up of the study. The group of child and adolescent psychiatry taking part in the creative workshops will be additionally assessed via questionnaires regarding emotional regulation, self-esteem, and art experience before and after every workshop. Furthermore, some individuals of the child and adolescent psychiatry group will undergo fMRI evaluation of the brain before and after completion of all creative interventions. Conclusion: Singing and other creative activities are suggested to benefit mental and physical health in children and adolescents. However, despite the current knowledge, the researchers must better understand the biopsychological mechanisms underlying choral singing in order to determine its full potential, particularly for vulnerable populations. This is the first study to investigate this issue in this population.
Interventions
BEHAVIORALAmateur Group Singing
45-minute singing session led by a professional choirmaster without a therapeutic background once a week
BEHAVIORALProfessional Group Singing
120-minute singing session led by a professional choirmaster without a therapeutic background three times a week. Assessments take place twice a week.
Sponsors
Universität Mozartuem Salzburg
Salzburger Landeskliniken
Paracelsus Medical University
University of Vienna
University of Salzburg
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
10 Years to 18 Years
Healthy volunteers
Yes
Inclusion criteria
(Clinical N): * Written consent to study participation; * Gender: male, female, different; * Age: children and adolescents aged ≥ 10 and ≤ 18 years; * Diagnosis of a psychiatric disorder according to ICD-10; * Patients are admitted regardless of medication status and are allowed to the medication will continue to be used during the study; * Additional therapies and medication are recorded and are not an exclusion criterion; * Musical skills or a certain musical background are not required Inclusion Criteria (Healthy N): * Written consent to study participation; * Gender: male, female, different; * Age: children and adolescents aged ≥ 10 and ≤ 18 years; * Musical skills or a certain musical background are not required
Exclusion criteria
(Clinical N): * Age: children and adolescents aged \<10 years and \> 18 years; * Criteria that prevent an application: hearing loss, states of confusion, inability to verbalize; * Patients with acute externalizing behavior or self-harm/suicidality; * Existing alcohol addiction or abuse of illegal drugs;
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change Short-Term Neuroendocrine Stress (Hypothalamic-Pituitary-Adrenal Axis) from pre- to post singing session over six months | every two weeks pre- and post singing sessions for six months | Biological Stress Marker: Salivary Cortisol |
| Change Short-Term Immune Function from pre- to post singing session over six months | every two weeks pre- and post singing sessions for six months | Biological Marker: Salivary Immunoglobulin A |
| Change from Baseline Chronic Neuroendocrine Stress (Hypothalamic-Pituitary-Adrenal Axis) at three and six months | at the beginning of the study, after three months, at the end of the study after six months, at a follow-up after three months, at a follow up after six months | Biological Stress Marker: Hair Cortisol |
| Change Short-Term Neuroendocrine Stress (Autonomic Nervous System) from pre- to post singing session over six months | every two weeks pre- and post singing sessions for six months | Salivary Alpha-Amylase |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Life Quality | once a month for six months | Pediatric Quality of Life Inventory (PEDsQL; Varni, 2001) |
| Performance Anxiety | once at the beginning of the study, once after 6 months | Das State-Trait-Angstinventar (STAI-T adapted; Laux, Glanzmann, Schaffner, & Spielberger 1981) |
| Social Skills | at the beginning of the study, after three months, at the end of the study after six months, at a follow-up after three months, at a follow up after six months | Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997) |
| Evaluation of the choir session | every week post singing sessions for six months | Liking of the session, liking of the songs, familiarity with the songs (5-point Likert scale; Higher scores mean a better outcome) |
| Chronical Stress | at the beginning of the study, after three months, at the end of the study after six months, at a follow-up after three months, at a follow up after six months | Fragebogen zu chronischem Stress im Kindesalter (CSiK; Richartz, Hoffmann, & Sallen, 2009) |
| Stress Perception | every week pre- and post singing sessions for six months | Visual Analogue Scale (VAS; 0-100; higher score means a worse outcome) |
| Psychological Stress | at the beginning of the study, after three months, at the end of the study after six months, at a follow-up after three months, at a follow up after six months | Stress and Coping Questionnaire for Children and Adolescents (SSKJ 3-8 R; Lohaus, Eschenbeck, Kohlmann, & Klein-Heßling, 2018) |
| Psychological Stability (parents view) | at the beginning of the study, after three months, at the end of the study after six months, at a follow-up after three months, at a follow up after six months | Child Behavior Checklist (CBCL; Achenbach & Arbeitsgruppe Deutsche Child Behavior Checklist, 1994) |
| Psychological Stability (children view) | at the beginning of the study, after three months, at the end of the study after six months, at a follow-up after three months, at a follow up after six months | Youth Self-Report (YSR; Achenbach & Arbeitsgruppe Deutsche Child Behavior Checklist, 1994) |
| Emotional Control | at the beginning of the study, after three months, at the end of the study after six months, at a follow-up after three months, at a follow up after six months | Fragebogen zur Erhebung der Emotionsregulation bei Kindern und Jugendlichen (FEEL-KJ; Grob & Smolenski, 2005) |
| Specific personality and character traits such as curiosity, reward dependency, cooperativity, and self-steering ability | At the beginning of creative workshops, and at a follow-up after three months in the group of children and adolescents with psychiatric disorders | JTCI Junior Temperament and Character Inventory in Children and Adolescents Psychiatry Group Questionnaire |
| Current emotional state | Pre and post every creative workshop in the group of children and adolescents with psychiatric disorders | Positive and negative affect schedule (PANAS) |
| Prosocial Behavior | every two weeks post singing sessions for six months | Social Network Map (Tracey & Whittaker, 1990) |
| Mood | every week pre- and post singing sessions for six months | Multidimensional Mood State Questionnaire (MDBF, short version; Steyer, Notz, Schwenkmezger, & Eid, 1997) |
| Self-Esteem | at the beginning of the study, after three months, at the end of the study after six months, at a follow-up after three months, at a follow up after six months | Selbstwertinventar für Kinder und Jugendliche (SEKJ; Schöne & Stiensmeier-Pelster, 2016) |
| Emotional Skills | at the beginning of the study, after three months, at the end of the study after six months, at a follow-up after three months, at a follow up after six months | Emotional Competence Questionnaire (EKF; Rindermann, 2009) |
Countries
Austria
Contacts
Primary ContactKatarzyna Grebosz-Haring, Dr.
Outcome results
None listed