How group singing facilitates recovery from the symptoms of postnatal depression: a comparative qualitative study

Rosie Perkins, Sarah Yorke, Daisy Fancourt, Rosie Perkins, Sarah Yorke, Daisy Fancourt

Abstract

Background: Previous research has demonstrated that making music can enhance positive emotions as well as support positive psychological functioning. However, studies tend to be limited by lack of comparison with other psychosocial interventions. This study builds on a three-arm randomised controlled trial (RCT) that demonstrated that group singing for mothers and babies, but not group creative play, can lead to faster recovery from moderate-severe symptoms of postnatal depression than usual care. The aim was to elucidate the mechanisms of the group singing intervention in order to account for its recovery properties.

Methods: Qualitative research was conducted with 54 mothers who had experienced symptoms of postnatal depression. Mothers completed a 10-week programme of either group singing or group creative play as part of the wider RCT study. Data were collected via a series of 10 semi-structured focus groups conducted at the end of each 10-week programme. These were designed to elicit subjective and constructed experiences of the singing and play interventions and were analysed inductively for emergent themes.

Results: Five distinctive features of the group singing emerged: (i) providing an authentic, social and multicultural creative experience, (ii) ability to calm babies; (iii) providing immersive 'me time' for mothers; (iv) facilitating a sense of achievement and identity; (v) enhancing mother-infant bond.

Conclusions: Community group singing interventions may reduce symptoms of postnatal depression through facilitating a functional emotional response rooted in the needs of new motherhood. These features are of relevance to others seeking to implement creative interventions for maternal mental health.

Trial registration: NCT02526407 . Registered 18 August 2015.

Keywords: Community; Focus groups; Music; Postnatal depression; Qualitative; Singing.

Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the National Health Service South East Scotland Research Ethics Committee (15/SS/016). Women provided written informed consent to participate.

Consent for publication

Women provided written informed consent for their anonymised data to be published.

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.

References

    1. Boath E, Henshaw C. The treatment of postnatal depression: a comprehensive literature review. J Reprod Infant Psychol. 2001;19:215–248. doi: 10.1080/02646830120073224.
    1. Morrell C, Warner R, Slade P, Dixon S, Walters S, Paley G, et al. Psychological interventions for postnatal depression: cluster randomised trial and economic evaluation. The PoNDER trial Health Technol Assess. 2009;13 10.3310/hta13300.
    1. Cooper P, Murray L. Postnatal depression. Br Med J. 1998;316:1884–1886. doi: 10.1136/bmj.316.7148.1884.
    1. Junge C, Garthus-Niegel S, Slinning K, Polte C, Simonsen TB, Eberhard-Gran M. The impact of perinatal depression on Children’s social-emotional development: a longitudinal study. Matern Child Health J. 2016; 10.1007/s10995-016-2146-2.
    1. Kingston D, Tough S, Whitfield H. Prenatal and postpartum maternal psychological distress and infant development: a systematic review. Child Psychiatry Hum Dev. 2012;43:683–714. doi: 10.1007/s10578-012-0291-4.
    1. Nilova V, Ward L, Hall P. Women’s experiences of parenting toddlers following postnatal depression: experiences of parenting following PND. Aust J Psychol. 2016; 10.1111/ajpy.12138.
    1. Beestin L, Hugh-Jones S, Gough B. The impact of maternal postnatal depression on men and their ways of fathering: an interpretative phenomenological analysis. Psychol Health. 2014;29:717–735. doi: 10.1080/08870446.2014.885523.
    1. Dennis C-L, Dowswell T. Psychosocial and psychological interventions for preventing postpartum depression. Cochrane Database Syst Rev. 2013; 10.1002/14651858.CD001134.pub3.
    1. Honey KL, Bennett P, Morgan M. A brief psycho-educational group intervention for postnatal depression. Br J Clin Psychol. 2002;41:405–409. doi: 10.1348/014466502760387515.
    1. Perry C, Thurston M, Osborn T. Time for me: the arts as therapy in postnatal depression. Complement Ther Clin Pract. 2008;14:38–45. doi: 10.1016/j.ctcp.2007.06.001.
    1. Feeley N, Bell L, Hayton B, Zelkowitz P, Carrier M-E. Care for Postpartum Depression: what do women and their partners prefer? Perspect Psychiatr Care. 2016;52:120–130. doi: 10.1111/ppc.12107.
    1. Bungay H, Munn-Giddings C, Boyce M, Wilson C. The value of the arts in therapeutic and clinical interventions: a critical review of the literature: Anglia Ruskin University; 2014.
    1. Staricoff RL. Arts in health: the value of evaluation. J R Soc Promot Heal. 2006;126:116–120. doi: 10.1177/1466424006064300.
    1. The RSPH Working Group on Arts, Health and Wellbeing. Arts, Health and Wellbeing Beyond the Millennium: How far have we come and where do we want to go? Royal Society for Public Health and the Philipp Family Foundation; 2013.
    1. Crawford P, Lewis L, Brown B, Manning N. Creative practice as mutual recovery in mental health. Ment Health Rev J. 2013;18:55–64. doi: 10.1108/MHRJ-11-2012-0031.
    1. MacDonald R, Kreutz G, Mitchell L, editors. Music, health, & wellbeing. Oxford: Oxford University Press; 2012.
    1. Fancourt D, Ockelford A, Belai A. The psychoneuroimmunological effects of music: a systematic review and a new model. Brain Behav Immun. 2014;36:15–26. doi: 10.1016/j.bbi.2013.10.014.
    1. Perkins R, Williamon A. Learning to make music in older adulthood: a mixed-methods exploration of impacts on wellbeing. Psychol Music. 2014;42:550–567. doi: 10.1177/0305735613483668.
    1. Creech A, Hallam S, Varvarigou M, McQueen H, Gaunt H. Active music making: a route to enhanced subjective well-being among older people. Perspect Public Health. 2013;133:36–43. doi: 10.1177/1757913912466950.
    1. Bräuninger I. Dance movement therapy group intervention in stress treatment: a randomized controlled trial (RCT) Arts Psychother. 2012;39:443–450. doi: 10.1016/j.aip.2012.07.002.
    1. Quiroga Murcia C, Kreutz G, Clift S, Bongard S. Shall we dance? An exploration of the perceived benefits of dancing on well-being. Arts Health. 2010;2:149–163. doi: 10.1080/17533010903488582.
    1. Slayton SC, D’Archer J, Kaplan F. Outcome studies on the efficacy of art therapy: a review of findings. Art Ther. 2010;27:108–118. doi: 10.1080/07421656.2010.10129660.
    1. Roberts S, Camic PM, Springham N. New roles for art galleries: art-viewing as a community intervention for family carers of people with mental health problems. Arts Health. 2011;3:146–159. doi: 10.1080/17533015.2011.561360.
    1. Judd M, Pooley JA. The psychological benefits of participating in group singing for members of the general public. Psychol Music. 2014;42:269–283. doi: 10.1177/0305735612471237.
    1. Clift S, Morrison I. Group singing fosters mental health and wellbeing: findings from the East Kent “singing for health” network project. Ment Health Soc Incl. 2011;15:88–97. doi: 10.1108/20428301111140930.
    1. Dingle GA, Brander C, Ballantyne J, Baker FA. “To be heard”: the social and mental health benefits of choir singing for disadvantaged adults. Psychol Music. 2013;41:405–421. doi: 10.1177/0305735611430081.
    1. von Lob G, Camic P, Clift S. The use of singing in a group as a response to adverse life events. Int J Ment Health Promot. 2010;12:45–53. doi: 10.1080/14623730.2010.9721818.
    1. Kreutz G. Does singing facilitate social bonding? Music Med. 2014;6
    1. Weinstein D, Launay J, Pearce E, Dunbar RIM, Stewart L. Singing and social bonding: changes in connectivity and pain threshold as a function of group size. Evol Hum Behav. 2016;37:152–158. doi: 10.1016/j.evolhumbehav.2015.10.002.
    1. Pearce E, Launay J, Dunbar RIM. The ice-breaker effect: singing mediates fast social bonding. R Soc Open Sci. 2015;2:150221. doi: 10.1098/rsos.150221.
    1. Robertson E, Grace S, Wallington T, Stewart DE. Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry. 2004;26:289–295. doi: 10.1016/j.genhosppsych.2004.02.006.
    1. Fancourt D, Perkins R. Effect of singing interventions on symptoms of postnatal depression: three-arm randomised controlled trial. Br J Psychiatry. 2018;212:119–121. doi: 10.1192/bjp.2017.29.
    1. Clift S, Hancox G, Morrison I, Hess B, Kreutz G, Stewart D. Choral singing and psychological wellbeing: quantitative and qualitative findings from English choirs in a cross-national survey. J Appl Arts Health. 2010;1:19–34. doi: 10.1386/jaah.1.1.19/1.
    1. MacDonald R, Kreutz G, Mitchell L. What is music, health, and wellebing and why it is important? In: music, health, & wellbeing. Oxford: Oxford University Press; 2012.
    1. DeNora T, Ansdell G. What can’t music do? Psychol Well-Being. 2014;4 10.1186/s13612-014-0023-6.
    1. Peters S. Qualitative research methods in mental health. Evid Based Ment Health. 2010;13:35–40. doi: 10.1136/ebmh.13.2.35.
    1. Byng R, Norman I, Redfern S, Jones R. Exposing the key functions of a complex intervention for shared care in mental health: case study of a process evaluation. BMC Health Serv Res. 2008;8 10.1186/1472-6963-8-274.
    1. Fancourt D, Perkins R. Creative interventions for symptoms of postnatal depression: a process evaluation of implementation. Arts Health. in press
    1. Sandelowski M. Whatever happened to qualitative description? Res Nurs Health. 2000;23:334–340. doi: 10.1002/1098-240X(200008)23:4<334::AID-NUR9>;2-G.
    1. Beck CT. Predictors of postpartum depression: an update. Nurs Res. 2001;50:275–285. doi: 10.1097/00006199-200109000-00004.
    1. Leahy-Warren P, McCarthy G, Corcoran P. First-time mothers: social support, maternal parental self-efficacy and postnatal depression: first-time mothers. J Clin Nurs. 2012;21:388–397. doi: 10.1111/j.1365-2702.2011.03701.x.
    1. Rossiter C, Fowler C, Mcmahon C, Kowalenko N. Supporting depressed mothers at home: their views on an innovative relationship-based intervention. Contemp Nurse. 2012;41:90–100. doi: 10.5172/conu.2012.41.1.90.
    1. Dennis C-L. Psychosocial and psychological interventions for prevention of postnatal depression: systematic review. BMJ 2005;331:15–0.
    1. Jorm AF, Morgan AJ, Hetrick SE. Relaxation for depression. In: the Cochrane collaboration, editor. Cochrane database of systematic reviews. John Wiley & Sons, Ltd: Chichester, UK; 2008.
    1. Baker F, Mackinlay E. Sing, soothe and sleep: a lullaby education programme for first-time mothers. Br J Music Educ. 2006;23:147. doi: 10.1017/S0265051706006899.
    1. Dissanayake E. Motherese is but one part of a ritualized, multimodal, temporally organized, affiliative interaction. Behav Brain Sci. 2004;27 10.1017/S0140525X0432011X.
    1. Falk D. Prelinguistic evolution in early hominins: whence motherese? Behav Brain Sci. 2004;27:491–503.
    1. Pelaez M, Virués-Ortega J, Gewirtz JL. Contingent and noncontingent reinforcement with maternal vocal imitation and Motherese speech: effects on infant vocalizations. Eur J Behav Anal. 2011;12:277–287. doi: 10.1080/15021149.2011.11434370.
    1. Nakata T, Trehub SE. Infants’ responsiveness to maternal speech and singing. Infant Behav Dev. 2004;27:455–464. doi: 10.1016/j.infbeh.2004.03.002.
    1. Shenfield T, Trehub SE, Nakata T. Maternal singing modulates infant arousal. Psychol Music. 2003;31:365–375. doi: 10.1177/03057356030314002.
    1. Moehler E, Brunner R, Wiebel A, Reck C, Resch F. Maternal depressive symptoms in the postnatal period are associated with long-term impairment of mother–child bonding. Arch Womens Ment Health. 2006;9:273–278. doi: 10.1007/s00737-006-0149-5.
    1. Mualem O, Klein PS. The communicative characteristics of musical interactions compared with play interactions between mothers and their one-year-old infants. Early Child Dev Care. 2013;183:899–915. doi: 10.1080/03004430.2012.688824.
    1. Juslin PN. Sloboda JA. Handbook of Music and Emotion: Theory, Research, Applications. Oxford University Press; 2010.
    1. Meyer LB. Emotion and meaning in music. Chicago: University of Chicago Press; 1956.
    1. Sloboda JA, Juslin PN. At the interface between the inner and outer world: Psychological perspectives. In: Handbook of Music and Emotion: Theory, Research, Applications. Oxford: Oxford University Press; 2010. p. 73–97.
    1. Ryan RM, Deci EL. On happiness and human potentials: a review of research on hedonic and Eudaimonic well-being. Annu Rev Psychol. 2001;52:141–166. doi: 10.1146/annurev.psych.52.1.141.
    1. Fancourt D, Perkins R. The effects of mother–infant singing on emotional closeness, affect, anxiety, and stress hormones. Music Sci. 2018;1:205920431774574. doi: 10.1177/2059204317745746.

Source: PubMed

赞助者和合作者

医疗条件

药物干预

3
订阅