The Use of Music often Has a Crucial Role in the Everyday Life of Patients with Mental Disorders

Background: Until now little has been known about the relationship between emotion modulation through music listening habits and personality dimensions, especially in patients with mental disorders.

Objective: To explore relations between the use of music in everyday life and personality dimensions in patients with mental disorders.

Methods: A population of patients suffering from mental disorders (n=190) was examined using one inventory on emotion modulation by music (IAAM) and another assessing personality dimensions (SKI).

Results: Patients with high ego-strength used music less for relaxation, cognitive problem solving or for reduction of negative activity, similarly patients with high orderliness used it less for cognitive problem solving or for reduction of negative activity, but patients with high confidence used music more for fun stimulation. Patients who reported that they listened to music which improved their symptoms of mental illness showed more ego-strength and orderliness than patients who listened to music that worsened their emotional condition.

Conclusions: The study suggests that the personality variables confidence, ego-strength and orderliness are variables for the use of music in a helpful way for emotion modulation.

Music is a communication medium with a strong emotional influence on the mortal being. thus, it is, not dubious to hypothecate a relationship between personality traits and the individual relating to music. The existent’s geste towards music develops especially during youth and nonage (1), accompanying and interacting with the process of socialization and development of personality traits. In cases with internal diseases or other conditions music has been studied generally on a remedial base (2- 4), but nearly no methodical scientific data exists on the use of music in everyday life (UofM) of individualities suffering from internal diseases. 

 The term UofM refers to the actuality of a learned geste  or active action strategy which is applied purposely by individualities who use music to impact being everyday countries (e.g., positive or negative feelings, affects, thrill, attention, alert or processes of social attachment)(,6). In everyday life of cases with internal diseases the UofM frequently has a pivotal part. For illustration, cases with frame personality complaint consider music veritably important in their life; using it to affect regulation as a cover fornon-suicidal tone- harming geste (7). In our former report we could show that cases with internal diseases use music in order to reduce negative feelings (6). Thereby the UofM was appreciatively identified with the inflexibility of the complaint. In another disquisition (8), music remedy showed a transfer effect of remedy leading into a changed geste 

 The end of the current disquisition was to explore the relationship between the UofM in everyday life and personality confines in cases suffering from internal diseases. 

 Three main motifs were explored in thiscross-sectional designed study 

1. Analysis of correlation between variables of the UofM and personality confines. 

 2. Influence of age and gender on SKI/ IAAM scales. 

 3. Differences in SKI/ IAAM scales with respect to the following variables emotion modulation of internal condition before and after onset of the internal complaint; musicality; individual value of music; active listening to musicvs. unresistant hail of music in the background. 

Subjects 

 Of n = 312 asked cases n = 190 cases( 61; 111 womanish and 79 joker; mean age37.4 ±13.3 times, range 18- 82 times) admitted at the Department for Psychiatry and Psychotherapy of the University of Marburg, Germany, shared in the study carried out in 2005 until 2007. No case of the study was treated with music remedy during the factual outpatient treatment. The cases suffered from mood affective diseases (36.4), neurotic diseases (24.2), diseases of adult personality and geste (17.9), schizophrenia diapason diseases (12.2), psychoactive substance use (6.3), and others. Gender and age within the study group didn't relate significantly. Cases gave written informed concurrence; the study was approved by the Ethics Committee of the University of Marburg, Germany. 

 Assessment and instruments 

        Cases entered tone- assessment questionnaires. The" force for the assessment of Activation and Arousal modulation through Music"(IAAM) with 62 particulars on a 5- point- scale showing high trust ability and validity (13) measured the situation dependent everyday life UofM according to the parameters Rela- xation (RX), Cognitive Problem working (CP), Reduction of negative Activation (RA), Fun Stimulation (FS) and Arousal Modulation (AM). Personality confines were assessed by means of the tone- conception force (SKI (14)). The SKI is designed to register that part of the personality which results substantially from interpersonal commerce. The 5 scales, each containing 8 bipolar particulars on a 7- point- scale, cover the following confines with sufficient trustability portions (Cronbach’s nascence) in the present sample pride- strengthvs. Insecurity (EI) (sense of particular and empirical security together with the lack of passions of anxiety; α = 0.79), attractivenessvs. marginality(A-M) (tone- assessment of own worth in social groups; α = 0.90), confidencevs. Reserve (C- R) (attachment capacity and closeness; α = 0.85), orderlinessvs. Nonchalance (O- I)( degree of structuring in particular terrain; α = 0.78) and enforcementvs. cooperation(E-C) ( tone- assessment of fierceness in social groups; α = 0.74). Another short questionnaire gathered data on private prints on emotion modulation by UofM before and after onset of the internal complaint. Sociodemographic data and data on the internal complaint were taken from the medical records. The Global Assessment of Functioning Scale (GAF) (15) was used to assess the performing position of the cases. 

Statistical procedures 

      As statistical procedures Pearson’s correlations were used to explore connections between the IAAM and SKI scales, two- tagged Student’s t- tests and chi- quadrat- tests to find out group differences,e.g., in gender. In this exploratory study the term" significant" was used for results with a p- value of ≤0.05. The data were anatomized using Statistical Package of the Social lores (SPSS18.0 for Windows) software.

Assessing the correlation analysis, we set up the ensuing results (see Table 1) the SKI scaleE-I identified negatively with the IAAM scales RX (r = -0.174; p = 0.031), CP (r = -0.215; p = 0.008) and RA (r = -0.222; p = 0.006). This suggests that cases with a high pride- strength use music less to relax, to break problems or to reduce negative activation than cases characterized by further instability. Further, C- R identified appreciatively with FS (r = 0.331; p<0 xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed>

Table 1: Results of the correlation analysis between IAAM and SKI scales. 

 Correlation analysis of the SKI/ IAAM scales with age revealed the ensuing results the aged the cases were, the more pronounced were the variables pride- strength(E-I; r = 0.210; p = 0.006) and orderliness( O- I; r = 0.237; p = 0.002), but the less pronounced was the UofM for reduction of negative exertion( RA; r = -0.276; p<0 xss=removed xss=removed xss=removed xss=removed xss=removed xss=removed>

 T- tests with SKI/ IAAM scales as dependent variables and gender as independent variable displayed significant differences for pride- strength(E-I), which was stronger in the manly case group (mean difference3.8 ±1.3 points; p = 0.004) and as a trend in relaxation (RX), which was stronger in the womanish case group (mean difference2.7 ±1.5 points; p = 0.071). 

 Likewise, we delved using t- tests differences in SKI/ IAAM scales (1) between cases who consider themselves musical (n = 97) compared to cases who don't (n = 84)( 2) between cases who give harkening to music a great impact in their life( n = 132) compared to those who don't( n = 52), and( 3) between cases who reported active listening to music( n = 72) versus unresistant hail of music in the background( n = 58) during the time after the onset of the internal complaint. 

 1. It could be revealed that cases who consider themselves musical show simply advanced values in attractiveness (A-M; mean difference3.4 ±1.7 points; p = 0.042) and – as trends – in RX (trend; mean difference2.9 ±1.5 points; p = 0.056) und RA (trend; mean difference2.7 ±1.6 points; p = 0.096) compared to cases who don't consider themselves as musical. 

 2. Cases for whom the UofM has a great impact in their life consider themselves more seductive(A-M; mean difference3.9 ±1.8 points; p = 0.035), but with further instability(E-I; mean difference-3.6 ±1.4 points; p = 0.012) and show advanced values in all IAAM scales( all p<0>

 3. Cases who reported active listening to music showed increased values in the IAAM scales RX (p = 0.013; mean difference3.9 ±1.6), CP (p = 0.034; mean difference3.5 ±1.6) and as a trend RA (p = 0.095; mean difference2.9 ±1.7) compared to cases who reported unresistant hail of music in the background. also, in a chi quadrat test we set up significant further people who reported both that they've heeded laboriously to music and that music have helped them compared to cases who have heard music in the background and who didn't benefit from music (p = 0.001). still, in another item about the question whether music has harmed the cases, we set up no significant difference between cases who heeded laboriously to music and those with music in the background. therefore, music which is heeded laboriously – similar to awareness training – can be judged as useful, while music in the background doesn't help, but – in our sample – has not harmed moreover. 

In the SKI scales there were no differences between the two groups. Further, correlation analysis between SKI scales and the GAF score revealed no significant correlations. 

To our knowledge this is the first study probing relations between the UofM and personality confines in a psychiatric population. The study shows that these relations are quantifiable. First exploratory results are handed. 

 The results of the correlation analysis on relations between variables concerning the UofM and similar on personality confines suggest that pride- strength and orderliness are connected with lower UofM for relaxation, cognitive problem working, reduction of negative exertion and thrill modulation. 

One could hypothecate that pride- strength and orderliness might represent a lack of interest in music. still t- tests showed no significant difference in these variables between cases who reported harkening to music to be of great impact on their life and those who did not. 

 We thus supposed that pride- strength and order- liness might represent adaptability personality traits which help to establish the right mood stabilizing ways indeed when global functioning is formerly low. The farther result that cases with further pride- strength and orderliness use the appropiate music to ameliorate their mood, falls in line with this supposition. still, the used mood stabilizing ways mustn't only be UofM, but also other ways of emotion modulation. therefore, people with increased pride- strength and orderliness might have a high degree of structuring capacities, so that they intimately hear to that kind of music which they consider helpful. This thesis is also supported by the result that high confidence is connected with lesser fun stimulation by means of music. Interestingly, we set up positive correlations of age with both pride- strength and orderliness as well with the cases’ print that music during the illness has harmed them. therefore, cases who have advanced scores in pride- strength and orderliness feel to have generally the print that they use helpful music and don't need to reduce negative feelings through music, but when they get aged, they witness music during the illness as further dangerous. It can't be barred that cases with advanced scores in pride- strength and orderliness can use music appreciatively as long they're healthy together with other strategies, but that they fail to use music as a fashion to reduce negative feelings, when they've fallen ill, especially as aged cases.

 To our knowledge, no studies have delved the influence of personality confines on the UofM in internal diseases so far. Some studies have just examined the influence of music preferences on internal diseases. For illustration, one study set up an association between popular music exposure and major depression while reading print media similar as books were negatively associated with depression (22). We interpret this miracle as a result of not harkening laboriously to music, whereas in our current study we delved in particular UofM as an active strategy of harkening to for emotion modulation. 

 For music therapists it might be intriguing to know which personality confines their cases have. Cases with high scores in confidence do clearly profit from music which stimulates fun dogging, presumably also cases with high egostrength and orderliness. These cases might intimately choose the right UofM in order to modulate their emotional state. still, aged cases with increased pride- strength and orderliness scores might have problems using music for the reduction of negative feelings during a phase of internal complaint, so that they need specific instruction how to deal with music. Cases with high scores of instabilities might in particular profit from music remedy because they've a strong private relation to UofM, but have obviously underrepresented strategies how to use music in the right manner in order to reduce negative feelings (rather of enhancing negative feelings by music). 

 Farther impact on the modulation of emotion have the individual orders, which we've bandied in our former report (6). 

The use of music frequently has a pivotal part in the everyday life of cases with internal diseases. For music is a cognitive-emotional reality which both portrays and influences cerebral processes, psychiatric pathomechanisms might be also unraveled by this approach. This study shows first exploratory data on relations between emotion modulation strategies by means of the use of music in everyday life and personality confines. 

 Overall, results suggest that certain personality confines, in particular instability and nonchalance (lack of structuring capabilities), are connected with the increased use of music to manage with negative affective countries. still, it's also instability and nonchalance which feel to avoid successful managing with cerebral torture, ending up in a negatively tone- buttressing system, which might reflect a pathomechanism of the internal complaint. adding knowledge about the influence of music on internal diseases might help in leading to a lesser relief from internal torture by a more specific running of music and should also be useful in music remedy. farther studies on the clinical impact of music on the base of this approach are warranted.       

Competing interests

The authors declare that they have no competing interests.