Music-instruction intervention for treatment of post-traumatic stress disorder: a randomized pilot study

L E Pezzin, E R Larson, W Lorber, E L McGinley, Timothy R Dillingham, L E Pezzin, E R Larson, W Lorber, E L McGinley, Timothy R Dillingham

Abstract

Background: Post-traumatic Stress Disorder (PTSD) is a common sequelae of severe combat-related emotional trauma that is often associated with significantly reduced quality of life in afflicted veterans. To date, no published study has examined the effect of an active, music-instruction intervention as a complementary strategy to improve the psychological well-being of veterans with PTSD. The purpose of this study was to examine the feasibility and potential effectiveness of an active, music-instruction intervention in improving psychological health and social functioning among Veterans suffering from moderate to severe PTSD.

Methods: The study was designed as a prospective, delayed-entry randomized pilot trial. Regression-adjusted difference in means were used to examine the intervention's effectiveness with respect to PTSD symptomatology (primary outcome) as well as depression, perceptions of cognitive failures, social functioning and isolation, and health-related quality of life (secondary outcomes).

Results: Of the 68 Veterans who were self- or provider-referred to the program, 25 (36.7%) were ineligible due to (i) absence of a PTSD diagnosis (n = 3); participation in ongoing intense psychotherapy (n = 4) or inpatient substance abuse program (n = 2); current resident of the Domiciliary (n = 8) and inability to participate due to distance of residence from the VA (n = 8). Only 3 (4.4%) Veterans declined participation due to lack of interest. The mean age of enrolled subjects was 51 years old [range: 22 to 76]. The majority was male (90%). One-quarter were African American or Black. While 30% report working full or part time, 45% were retired due to disability. Slightly over one-quarter were veterans of the OEF/OIF wars. Estimates from regression-adjusted treatment effects indicate that the average PTSD severity score was reduced by 9.7 points (p = 0.01), or 14.3% from pre- to post-intervention. Similarly, adjusted depressive symptoms were reduced by 20.4% (- 6.3 points, p = 0.02). There were no statistically significant regression-adjusted effects on other outcomes, although the direction of change was consistent with improvements.

Conclusions: Our findings suggest that the active, music-instruction program holds promise as a complementary means of ameliorating PTSD and depressive symptoms among this population.

Trial registration: Trial registered at ClinicalTrials.gov with protocol number Medical College of Wisconsin PRO00019269 on 11/29/2018 (Retrospectively registered).

Keywords: Depression; Post-traumatic stress disorder; Randomized trial.

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Institutional Review Board of the Clement J. Zablocki Veterans Administration (VA) Hospital (PRO00019269). All participants provided written consent to participate in the study.

Consent for publication

The manuscript does not include details, images or videos of any individual person.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Study Design
Fig. 2
Fig. 2
CONSORT Figure

References

    1. Price J. Findings from the National Vietnam Veterans' readjustment study - factsheet. In: National Center for PTSD: United States Department of Veterans Affairs. 2010.
    1. Breslau N, Lucia VC, Davis GC. Partial PTSD versus full PTSD: an empirical examination of associated impairment. Psychol Med. 2004;34:1205–1214. doi: 10.1017/S0033291704002594.
    1. Whisman Marital dissatisfaction and psychiatric disorders: results from the National Comorbidity Survey. J of Abn Psych. 1999;108:701–706. doi: 10.1037/0021-843X.108.4.701.
    1. Jordan BK, Marmar CR, Fairbank JA, Schlenger WE, Kulka RA, Hough RL, et al. Problems in families of male Vietnam veterans with posttraumatic stress disorder. J Consult Clin Psychol. 1992;60:916–926. doi: 10.1037/0022-006X.60.6.916.
    1. Cahill SP, Foa EB. A glass half empty or half full? Where we are and directions for future research in the treatment of PTSD. In: Taylor S, editor. Advances in the treatment of posttraumatic stress disorder: cognitive-behavioral perspectives. New York: Springer; 2004. pp. 267–313.
    1. Seidler GH, Wagner FE. Comparing the efficacy of EMDR and trauma-focused cognitive-behavioral therapy in the treatment of PTSD: a meta-analytic study. Psychol Med. 2006;36(11):1515–1522. doi: 10.1017/S0033291706007963.
    1. Devilly GJ, Spence SH. The relative efficacy and treatment distress of EMDR and a cognitive-behavior trauma treatment protocol in the amelioration of posttraumatic stress disorder. J Anxiety Disord. 1999;13(1–2):131–157. doi: 10.1016/S0887-6185(98)00044-9.
    1. American Psychiatric Association . Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. Arlington, VA: American Psychiatric Association Practice Guidelines; 2004.
    1. Ursano RJ, Bell C, Eth S, et al. Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. Am J Psychiatry. 2004;161(11 Suppl):3–31.
    1. Committee on Treatment of Posttraumatic Stress Disorder, Institute of Medicine . Treatment of posttraumatic stress disorder: an assessment of the evidence. Washington: national academies press; 2008.
    1. Bisson JI, Ehlers A, Matthews R, Pilling S, Richards D, Turner S. Psychological treatments for chronic post-traumatic stress disorder. Systematic review and meta-analysis. Br J Psychiatry. 2007;190:97–104. doi: 10.1192/bjp.bp.106.021402.
    1. Maratos A. Music therapy for depression (Review). In: The Cochrane Collaboration: John Wiley and Sons, Ltd; 2009.
    1. Bormann JE, Thorp S, Wetherell JL, Golshan S. A spiritually based group intervention for combat veterans with posttraumatic stress disorder: feasibility study. J Holist Nurs. 2008;26:117–118. doi: 10.1177/0898010107311276.
    1. Chen X. (1992) active music therapy for senile depression. Chinese Journal of Neurology and Psychiatry. 1992;25:208–210.
    1. Walker J, Boyce-Tillman J. Music lessons on prescription? The impact of music lessons for children with chronic anxiety problems. Health Educ. 2002;102(4):172–179. doi: 10.1108/09654280210434246.
    1. Bensimon M. Drumming through trauma: music therapy with post-traumatic soldiers. Arts Psychother. 2008;35(1):34–48. doi: 10.1016/j.aip.2007.09.002.
    1. Weathers FW, Litz BT, Herman DS, Huska JA, Keane TM. The PTSD checklist (PCLC): reliability, validity, and diagnostic validity. Paper presented at the annual meeting of the International Society for Traumatic Stress Studies. TX: San Antonio; 1993.
    1. Vasterling JJ, Proctor SP, Amoroso P, Kane R, Heeren T, White RF. Neuropsychological outcomes of army personnel following deployment to the Iraq war. JAMA. 2006;296:519–529. doi: 10.1001/jama.296.5.519.
    1. Beck AT, Ward CH. Mendelson M et al. (1996) an inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561–571. doi: 10.1001/archpsyc.1961.01710120031004.
    1. Broadbent DE, Cooper PF, Fitzgerald P, et al. The cognitive failures questionnaire and its correlates. Br J Clin Psychol. 1982;21:1–16. doi: 10.1111/j.2044-8260.1982.tb01421.x.
    1. Russell DW. UCLA loneliness scale (version 3): reliability, validity, and factor structure. J of Personality Assessment. 1996;66(1):20–40. doi: 10.1207/s15327752jpa6601_2.
    1. Brooks R, with the EuroQol group EuroQol: the current state of play. Health Policy. 1996;37(1):53–72. doi: 10.1016/0168-8510(96)00822-6.
    1. Gelman A, Hill J. Data analysis using regression and multilevel/hierarchical models. New York: Cambridge University Press; 2007.
    1. Lee LGMM. 2SLS estimation of mixed regressive models. J Econ. 2007;137:489–514. doi: 10.1016/j.jeconom.2005.10.004.
    1. NIH “Notice of Intent to Publish a Funding Opportunity Announcement for Promoting Research on Music and Health: Phased Innovation Award for Music Interventions (R61/R33 Clinical Trial Optional)” Accessed 10/15/2018.
    1. Vedantam S. "A Political Debate On stress disorder: as claims rise, VA Takes Stock".: Washington Post; 2005.
    1. Higginson IJ, Vivat B, Silber E, et al. Study protocol: delayed intervention randomised controlled trial within the Medical Research Council (MRC) framework to assess the effectiveness of a new palliative care service. BMC Palliat Care. 2006;5:7. doi: 10.1186/1472-684X-5-7.
    1. Olanow CW, Hauser RA, Jankovic J, Langston W, Lang A, Poewe W, Tolosa E, Stocchi F, Melamed E, Eyal E, Rascol O. A randomized, double-blind, placebo-controlled, delayed start study to assess rasagiline as a disease modifying therapy in Parkinson's disease (the ADAGIO study): rationale, design, and baseline characteristics. Movement Disorders: official journal of the Movement Disorder Society. 2008;23(15):2194–2201. doi: 10.1002/mds.22218.

Source: PubMed

3
Suscribir