Changing the Cadence from Military to Community through Music
PTSD symptoms among military veterans is a common response to traumatic events. Diagnostic criteria for PTSD include intrusive, avoidant, negative cognitions and mood, and increased arousal symptoms. Often these symptoms are associated with a sense of loss of personal control and a decreased ability to regulate physiologic, cognitive, and emotional responses to traumatic reminders. In general, Emotional Processing Theory focuses on the negative triggers associated with PTSD and Broaden and Build theory focuses on the potential for positive triggers associated with resilience. Music can be an effective medium for increasing a sense of personal control and impact physiologic (e.g., heart rate variability), cognitive, and emotional responses in the context of passive listening and/or active participation. Examples of physiologic, cognitive, and emotional responses to music will be discussed. In addition, clinical contexts (e.g., self-help, adjunctive treatment) will be presented in which music may assist military veterans in their response to traumatic events.
Breslau N, Kessler RC. The stressor criterion in DSM-IV posttraumatic stress disorder: an empirical investigation. Biological psychiatry. 2001;50(9):699-704.
Copeland WE, Keeler G, Angold A, Costello EJ. Traumatic events and posttraumatic stress in childhood. Archives of general psychiatry. 2007;64(5):577-584.
Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB. Posttraumatic stress disorder in the National Comorbidity Survey. Archives of general psychiatry. 1995;52(12):1048-1060.
McLaughlin KA, Koenen KC, Hill ED, et al. Trauma exposure and posttraumatic stress disorder in a national sample of adolescents. Journal of the American Academy of Child and Adolescent Psychiatry. 2013;52(8):815-830.e814.
Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. American journal of preventive medicine. 1998;14(4):245-258.
Kazlauskas E. Challenges for providing health care in traumatized populations: barriers for PTSD treatments and the need for new developments. Global health action. 2017;10(1):1322399.
Hoge CW, Castro CA, Messer SC, McGurk D, Cotting DI, Koffman RL. Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med. 2004;351(1):13-22.
Kulka RA, Schlenger WA, Fairbanks JA, et al. Trauma and the Vietnam War Generation: Report of Findings from the National Vietnam Veterans Readjustment Study. New York, NY: Brunner/Mazel, Inc; 1990.
Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery. Santa Monica, CA: RAND Corporation; 2008.
Foa EB, Hembree EA, Rothbaum BO. Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences. Therapist Guide. New York City: Oxford University Press; 2007.
Schiraldi GR. The post-traumatic stress disorder sourcebook : a guide to healing, recovery, and growth. New York, NY: McGraw-Hill; 2009.
Association AP. Diagnostic and Statistical Manual of Mental Disorders. 5 ed. Arlington, VA: Psychiatric Publishing; 2013.
Dalgleish T, Power MJ. Emotion-specific and emotion-non-specific components of posttraumatic stress disorder (PTSD): implications for a taxonomy of related psychopathology. Behaviour research and therapy. 2004;42(9):1069-1088.
Herman JL. Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress. 1992;5(3):377-391.
Rasmussen AM, Shalev AY. Integrating the neuroendocrinology, neurochemistry, and neuroimmunology of PTSD to date and the challenges ahead. In: Friedman MJ, Keane TM, Resick PA, eds. Handbook of PTSD: Science and Practice. 2 ed. New York, NY: Guilford Press; 2014:275-299.
Association AP, Adults GDPftToPi. Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults. Washington, DC: American Psychological Association; 2017.
Steenkamp MM, Litz BT, Hoge CW, Marmar CR. Psychotherapy for Military-Related PTSD: A Review of Randomized Clinical Trials. JAMA. 2015;314(5):489-500.
Jaycox LH, Foa EB, Morral AR. Influence of emotional engagement and habituation on exposure therapy for PTSD. Journal of Consulting and Clinical Psychology. 1998;66(1):185-192.
Kalebasi N, Kuelen E, Schnyder U, et al. Blunted responses to reward in remitted post-traumatic stress disorder. Brain and behavior. 2015;5(8):e00357.
Benight CC, Bandura A. Social cognitive theory of posttraumatic recovery: the role of perceived self-efficacy. Behaviour research and therapy. 2004;42(10):1129-1148.
Fredrickson BL. The broaden-and-build theory of positive emotions. Philosophical transactions of the Royal Society of London Series B, Biological sciences. 2004;359(1449):1367-1378.
Cacioppo JT, Priester JR, Berntson GG. Rudimentary determinants of attitudes. II: Arm flexion and extension have differential effects on attitudes. Journal of personality and social psychology. 1993;65(1):5-17.
Davidson RJ. The neuropsychology of emotion and affective style. In: Lewis M, Haviland JM, eds. Handbook of emotions. New York, NY: Guilford Press; 1993:143-154.
Frijda N. Emotions are functional, most of the time. In: Ekmon P, Davidson R, eds. The nature of emotion: Fundamental questions. New York, NY: Oxford University Press; 1994:112-122.
Carver C, Scheier M. Origins and Functions of Positive and Negative Affect: A Control-Process View. Vol 971990.
Clore GL. Why emotions are never unconsciouos. In: Ekman P, Davidson RJ, eds. The nature of emotions: Fundamental questions. New York, NY: Oxford University Press; 1994:285-290.
Rajendra Acharya U, Paul Joseph K, Kannathal N, Lim CM, Suri JS. Heart rate variability: a review. Medical & biological engineering & computing. 2006;44(12):1031-1051.
Tsuji H, Larson MG, Venditti FJ, Jr., et al. Impact of reduced heart rate variability on risk for cardiac events. The Framingham Heart Study. Circulation. 1996;94(11):2850-2855.
Thayer JF, Hansen AL, Saus-Rose E, Johnsen BH. Heart rate variability, prefrontal neural function, and cognitive performance: the neurovisceral integration perspective on self-regulation, adaptation, and health. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine. 2009;37(2):141-153.
Thayer JF, Friedman BH, Borkovec TD. Autonomic characteristics of generalized anxiety disorder and worry. Biological psychiatry. 1996;39(4):255-266.
Friedman BH, Thayer JF. Autonomic balance revisited: panic anxiety and heart rate variability. Journal of psychosomatic research. 1998;44(1):133-151.
Cohen H, Kotler M, Matar MA, Kaplan Z, Miodownik H, Cassuto Y. Power spectral analysis of heart rate variability in posttraumatic stress disorder patients. Biological psychiatry. 1997;41(5):627-629.
Chalmers JA, Quintana DS, Abbott MJ, Kemp AH. Anxiety Disorders are Associated with Reduced Heart Rate Variability: A Meta-Analysis. Frontiers in psychiatry. 2014;5:80.
Thayer JF, Smith M, Rossy LA, Sollers JJ, Friedman BH. Heart period variability and depressive symptoms: gender differences. Biological psychiatry. 1998;44(4):304-306.
Thayer JF, Lane RD. A model of neurovisceral integration in emotion regulation and dysregulation. Journal of Affective Disorder. 2000;61(3):201-216.
Porges SW, Furman SA. The Early Development of the Autonomic Nervous System Provides a Neural Platform for Social Behavior: A Polyvagal Perspective. Infant and child development. 2011;20(1):106-118.
Porges SW. The polyvagal perspective. Biol Psychol. 2007;74(2):116-143.
Beauchaine TP, Thayer JF. Heart rate variability as a transdiagnostic biomarker of psychopathology. Int J Psychophysiol. 2015.
Cooper TM, McKinley PS, Seeman TE, Choo TH, Lee S, Sloan RP. Heart rate variability predicts levels of inflammatory markers: Evidence for the vagal anti-inflammatory pathway. Brain Behav Immun. 2014.
Newton-Cheh C, Guo CY, Wang TJ, O'Donnell CJ, Levy D, Larson MG. Genome-wide association study of electrocardiographic and heart rate variability traits: The Framingham Heart Study. BMC Medical Genetics. 2007;8(Suppl 1):S7.
Jarczok MN, Kleber ME, Koenig J, et al. Investigating the associations of self-rated health: heart rate variability is more strongly associated than inflammatory and other frequently used biomarkers in a cross sectional occupational sample. PloS one. 2015;10(2):e0117196.
Ginsberg JP, Berry ME, Powell DA. Cardiac coherence and posttraumatic stress disorder in combat veterans. Altern Ther Health Med. 2010;16(4):52-60.
Kim HG, Cheon EJ, Bai DS, Lee YH, Koo BH. Stress and heart rate variability: A meta-analysis and review of the literature. Psychiatry Investigation. 2018;15(3):235-245.
Minassian A, Maihofer AX, Baker DG, Nievergelt CM, Geyer MA, Risbrough VB. Association of Predeployment Heart Rate Variability With Risk of Postdeployment Posttraumatic Stress Disorder in Active-Duty Marines. JAMA Psychiatry. 2015;72(10):979-986.
Pyne JM, Constans JI, Wiederhold MD, et al. Heart rate variability: Pre-deployment predictor of post-deployment PTSD symptoms. Biological Psychology. 2016;121(Pt A):91-98.
Thayer JF, Ahs F, Fredrikson M, Sollers JJ, III, Wager TD. A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and health. Neurosci Biobehav Rev. 2012;36(2):747-756.
Etkin A, Wager TD. Functional neuroimaging of anxiety: a meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia. The American journal of psychiatry. 2007;164(10):1476-1488.
Thayer JF, Yamamoto SS, Brosschot JF. The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. International journal of cardiology. 2010;141(2):122-131.
Lehrer PM, Gevirtz R. Heart rate variability biofeedback: how and why does it work? Frontiers in psychology. 2014;5:756.
Gevirtz R. The Promise of Heart Rate Variability Biofeedback: Evidence-Based Applications. Biofeedback. 2015;41(3):110-120.
Diamond LM, Hicks AM, Otter-Henderson KD. Individual differences in vagal regulation moderate associations between daily affect and daily couple interactions. Pers Soc Psychol Bull. 2011;37(6):731-744.
McCraty R, Zayas MA. Cardiac coherence, self-regulation, autonomic stability, and psychosocial well-being. Frontiers in psychology. 2014;5:1090.
Vickhoff B, Malmgren H, Astrom R, et al. Music structure determines heart rate variability of singers. Frontiers in psychology. 2013;4:334.
Huron D. Is music an evolutionary adaptation? Annals of the New York Academy of Sciences. 2001;930:43-61.
Kemp AH, Quintana DS, Kuhnert RL, Griffiths K, Hickie IB, Guastella AJ. Oxytocin increases heart rate variability in humans at rest: implications for social approach-related motivation and capacity for social engagement. PloS one. 2012;7(8):e44014.
Grippo AJ, Trahanas DM, Zimmerman RR, 2nd, Porges SW, Carter CS. Oxytocin protects against negative behavioral and autonomic consequences of long-term social isolation. Psychoneuroendocrinology. 2009;34(10):1542-1553.
Srikanth S, Latha R, Roja ED, Sairaman H, Janani B, Susiganeshkumar E. Effect of music on stress and academic performance of undergraduate medical students. The National medical journal of India. 2014;27(6):351-352.
Kachanathu SJ, Verma SK, Khanna GL. Effect of Music Therapy on Heart Rate Variability: A Reliable Marker to Pre-competition Stress in Sports Performance. Journal of Medical Sciences 2013;13(6):418-424.
Assoication AMT. Music Therapy and Military Populations: A Status Report and Recommendations of Music Therapy Treatment, Programs, Research, and Practice Policy. American Music Therapy Association; 2014.
Janata P, Tomic ST, Rakowski SK. Characterization of music-evoked autobiographical memories. Memory (Hove, England). 2007;15(8):845-860.
Bensimon M, Amir D, Wolf Y. Drumming through trauma: Music therapy with post-traumatic soldiers. The Arts in Psychotherapy. 2008;35(1):34-48.
Carr C, d'Ardenne P, Sloboda A, Scott C, Wang D, Priebe S. Group music therapy for patients with persistent post-traumatic stress disorder--an exploratory randomized controlled trial with mixed methods evaluation. Psychology and Psychotherapy: Theory, Research, and Practice. 2011:1-24.
Gaston ET. Music in therapy. New York, NY: Macmillan; 1968.
van Gelderen MJ, Nijdam MJ, Vermetten E. An Innovative Framework for Delivering Psychotherapy to Patients With Treatment-Resistant Posttraumatic Stress Disorder: Rationale for Interactive Motion-Assisted Therapy. Frontiers in psychiatry. 2018;9:176.
Garrido S, Baker FA, Davidson JW, Moore G, Wasserman S. Music and trauma: the relationship between music, personality, and coping style. Frontiers in psychology. 2015;6:977.
Landis-Shack N, Heinz AJ, Bonn-Miller MO. Music Therapy for Posttraumatic Stress in Adults: A Theoretical Review. Psychomusicology. 2017;27(4):334-342.
Vaudreuil R. Working with active military: A progressive music therapy curriculum. San Diego, CA: MusicWorx, Inc; 2011.
Pezzin LE, Larson ER, Lorber W, McGinley EL, Dillingham TR. Music-instruction intervention for treatment of post-traumatic stress disorder: a randomized pilot study. BMC psychology. 2018;6(1):60.
Bormann JE, Thorp SR, Smith E, et al. Individual Treatment of Posttraumatic Stress Disorder Using Mantram Repetition: A Randomized Clinical Trial. The American journal of psychiatry. 2018;175(10):979-988.