The effect of specific music instrumentation on anxiety reduction in university music students: A feasibility study

Accepted Manuscript Title: The Effect Of Specific Music Instrumentation On Anxiety Reduction In University Music Students: A Feasibility Study Authors: Bill Matney Ph.D., MT-BC PII: DOI: Reference:

S0197-4556(16)30167-8 http://dx.doi.org/doi:10.1016/j.aip.2017.02.006 AIP 1429

To appear in:

The Arts in Psychotherapy

Received date: Revised date: Accepted date:

23-9-2016 8-2-2017 17-2-2017

Please cite this article as: Matney, B.,The Effect Of Specific Music Instrumentation On Anxiety Reduction In University Music Students: A Feasibility Study, The Arts in Psychotherapy (2017), http://dx.doi.org/10.1016/j.aip.2017.02.006 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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EFFECT OF INSTRUMENTATION ON ANXIETY

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THE EFFECT OF SPECIFIC MUSIC INSTRUMENTATION ON ANXIETY REDUCTION IN UNIVERSITY MUSIC STUDENTS:

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A FEASIBILITY STUDY

Bill Matney, Ph.D., MT-BC

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Division of Music Education and Music Therapy

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The University of Kansas

Abstract Word Count: 150

Word Count (not including references): 6387 Keywords: music therapy, relaxation, anxiety, instrumentation, percussion, strings, piano

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Abstract Researchers note the use of recorded music for anxiety reduction, but have rarely studied effects of instrumentation. The investigator asked two questions: (a) Do string music, piano music, and

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marimba music each promote a reduction in anxiety, and (b) Is there a difference among these instrument types regarding their ability to facilitate anxiety reduction? Prior to giving a

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classroom presentation, university student participants (N = 54) listened to a version of Bach Air

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from Orchestra Suite No. 3 in D. Major, BWV 1068, using strings, piano, or marimba. Results indicated a significant difference for anxiety reduction from pretest to posttest when all

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participants were included as one group, or when in their separate respective groups. Analysis indicated no significant difference among the three groups for anxiety reduction. This feasibility

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study therefore offers preliminary indications that particular types of percussion instrumentation

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may be as effective as other instrumentation for anxiety reduction.

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Introduction Music therapists commonly use receptive methods in their practice. Clinicians note the use of live and recorded receptive methods for relaxation and anxiety reduction in clinical

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practice, both in books (Bonde & Wigram, 2001; Davis, Gfeller, & Thaut, 2008; Grocke & Wigram, 2007) and in journal articles (Scheffel & Matney, 2014; Wolfe & Woolsey, 2003).

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Furthermore, journal articles have studied and described music characteristics for their

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stimulative and sedative effects through receptive methods (Bonny & McCarron, 1984; Borling, 1981; Updike & Charles, 1987). Prior literature has discussed the use of voice, woodwinds,

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strings, piano, and flute to promote anxiety reduction, while questioning or dismissing the use of percussion instruments or “percussive music” (Elliott, Polman, & McGregor, 2011; Gaston,

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1951; Gaston, 1958; Grocke & Wigram, 2007). Other articles suggest the potential to use percussion instrumentation for relaxation (Canga, Hahm, Lucido, Grossbard, & Loewy, 2012;

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Gadberry, 2011; Hoeft and Kern, 2007; Koenig, J., Oelkers, Kaess, Parzer, Lenzen, Hillecke, &

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Resch, 2013; Maurer, Kumar, Woodside, & Pekala, 1997). Few articles have studied and compared particular types of instrumentation, using similar music characteristics, for the purpose of anxiety reduction. To address the gap in knowledge, this feasibility study measures both the within-group and between-group effects of different instrumentation on anxiety reduction in university students. The author discusses anxiety, the participant population, receptive music methods, and instrumentation below. Anxiety

Authors define anxiety as a state of inner discomfort often accompanied by nervous behaviors. Authors also differentiate anxiety from fear. Where fear is understood as inner

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discomfort due to a clearly perceived threat, anxiety results when the threat is more diffuse (Seligman & Rosenham, 1989). People experience anxiety to differing degrees and for varying reasons. While anxiety

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can naturally occur in everyday situations, there exist some cases where anxiety may detrimentally affect vocational performance, social functioning, or sleeping patterns. The

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Diagnostic and Statistical Manual of Mental Disorders (5th ed.) (American Psychiatric

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Association, 2013) described specific anxiety disorders, including generalized anxiety disorder, phobic disorder, and panic disorder. Other publications have described or studied common

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anxiety experiences, including existential anxiety (Kesibir, 2014), anxiety related to hospital stays and medical procedures (Guo, East, & Arthur, 2012), social anxiety (Hofmann & Dibartolo,

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2010; de Lima Osorio, 2013), test and performance anxiety (Acka, 2011), and presentation

Wilhelm, Gruber, & Roth, 2001).

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anxiety as a type of trait social anxiety (Feldman, Cohen, Hamrick, & Lepore, 2004; Gerlach,

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People seek to reduce anxiety through many means. In some cases, authors refer to anxiety-reduction approaches as “relaxation techniques” (Seligman & Rosenham, 1989). Approaches to anxiety reduction include but are not limited to mental health treatment, prescription medication, yoga (Smith, Hancock, Blake-Mortimer, & Eckert, 2007), meditation (Miller, Fletcher, & Kabat-Zinn, 1995), progressive muscle relaxation techniques (Seligman & Rosenham, 1989), exercise (Byrne & Byrne, 1993), and hobbies. Some people also listen to recorded music to reduce anxiety, either by themselves or with the assistance of a music therapist or health care professional (Bradt, Dileo, & Potvin, 2013; de Niet, Tiemens, Lendemeijer, & Hutschemackers, 2009).

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Anxiety in University and College Students Researchers have differentiated anxiety in university and college students from other populations, identifying specific stressors and health outcomes below their non-college peers

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(Aselton, 2012; Mungas & Silverman, 2014; Stewart-Brown et al, 2000). Researchers have recorded an increasing incidence of university student anxiety as related to transition from home,

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school demands, financial stressors, and career stressors (Aselton, 2012; Stewart-Brown et al.,

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2000). Stress can distract from learning and decrease performance (Schwabe & Wolf, 2010). Health care professionals seek to assist clients in anxiety reduction to promote overall health and

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performance.

Anxiety Reduction. People seek to reduce anxiety through many means. In some cases,

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authors refer to anxiety-reduction approaches as “relaxation techniques” (Seligman & Rosenham, 1989). Approaches to anxiety reduction include but are not limited to mental health treatment,

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prescription medication, yoga (Smith, Hancock, Blake-Mortimer, & Eckert, 2007), meditation

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(Miller, Fletcher, & Kabat-Zinn, 1995), progressive muscle relaxation techniques (Seligman & Rosenham, 1989), exercise (Byrne & Byrne, 1993), and hobbies. Some people also listen to recorded music to reduce anxiety, either by themselves or with the assistance of a music therapist or health care professional (Bradt, Dileo, & Potvin, 2013; de Niet, Tiemens, Lendemeijer, & Hutschemackers, 2009). University students diagnosed with depression use various coping strategies, including music listening (Aselton, 2012). Music and Relaxation

Differentiating Music Medicine and Music Therapy. Music medicine is understood as music affecting change to promote health; music medicine does not rely upon a therapeutic relationship. Music medicine is therefore differentiated from music therapy, where music and a

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relationship with a qualified therapist both play a role in health promotion (American Music Therapy Association, 2016; Bruscia, 2016; Gold, Erkillä, Bonde, Trondalen, Maratos, & Crawford, 2011). In many cases, music is used in conjunction with a therapist’s verbal guidance

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to promote progressive muscle relaxation, general relaxation, or imagery. Furthermore, a client’s prior relationship with a piece of music may also play a role in its ability to promote relaxation

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(Tan, Yowler, Super, & Fratianne, 2012); a music therapist can use this information to help

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customize receptive relaxation methods. At the same time, music characteristics can play an important role in the music therapy process, and therefore play a role in receptive methods

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(Hanson-Abromeit, 2015). Instrumentation that uses the same tonal framework and volume can be differentiated by timbre. Furthermore, timbre plays a major role in differences between

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percussion instruments.

Researchers have explored the effect of music listening on university students’ anxiety

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levels. Results in Davis & Thaut (1989) suggested that state anxiety was reduced through the use

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of preferred music that is perceived as relaxing. Walworth (2003) studied the effect of music genres on anxiety reduction. Results suggested no change in anxiety. These studies focused on the potential value of music preference and musical style; neither of these studies focused on music instrumentation or music characteristics Methods and characteristics. Bruscia defined receptive methods as those events where “the client listens to music and responds to the experience silently or in another modality” (1998, p. 120). Authors have historically noted the importance of music characteristics to promote relaxation. In the mid 1800s, Florence Nightingale (2007) described the effect of different types of music on soldiers injured in the Crimean War. Instrumental music with continuous sounds generally provided a beneficial result for patients, but instrumentation that did not produce

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continuous sounds had a negative effect. Latter descriptions classified music as either stimulative or sedative. Gaston (1951) described stimulative music as (a) most often instrumental, (b) emphasizing a “percussive quality” (p. 42), (c) employing staccato sounds, and (d)

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predominantly using brass and percussion instruments (Gaston, 1968, p. 139). In contrast, sedative music uses (a) primarily legato sounds; (b) quiet and simple rhythms; and (c)

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instrumentation including voice (Gaston, 1951), strings, and woodwinds (Gaston, 1968).

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Gaston’s categorizations of stimulative and sedative instrumentation set a particular tone for the field; however, his descriptions were not based on systematic research.

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Stimulative and sedative categories. Studies have supported stimulative and sedative categories, with sedative music historically placing an emphasis on melody, harmony, and

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rhythm (Bonny & McCarron, 1984; Borling, 1981; Updike & Charles, 1987). Authors have summarized the characteristics of both sedative and stimulative music, as related to tempo,

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rhythm, pitch, melody, dynamics, harmony, tone, volume, and the levels of variation and

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complexity within each (Robb, Nichols, Rutan, Bishop, & Parker, 1995; Staum & Brotons, 2000; Tan et al., 2012; Wolfe, O’Connell, & Waldon, 2002). Music characteristics and relaxation. More recently, researchers have conducted systematic reviews in order to better understand the effect of music on emotional regulation, relaxation, and anxiety reduction. Results of Sena Moore (2013) suggested that predictable, consonant, and pleasing music promote emotional regulation. Bradt et al. (2013) studied the use of music for relaxation in people with coronary disease. Results suggested that music with a lack of sharp timbres promoted relaxation. de Niet et al. (2009) studied the effect of music-assisted relaxation on sleep quality. The authors stated that “slow rhythm music, without a heavy beat” and preferred music was considered relaxing (p. 1358). Nilson (2008) reviewed literature

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regarding music interventions for anxiety and pain reduction. The author noted that studies used a tempo between 60 and 80 bpm, and either preferred music, or researcher-selected music from a varying range of genres. Regarding instrumentation, Nilson specifically mentioned piano and

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pan flute. However, the above systematic reviews have generally provided limited information regarding the effect of particular music instrumentation on anxiety reduction.

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Researchers have explored the effects of music listening on university students’ anxiety

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levels. Results in Davis and Thaut (1989) suggested that state anxiety was reduced through the use of preferred music that is perceived as relaxing. Walworth (2003) studied the effect of music

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genres on anxiety reduction. Results suggested no change. While informed by prior literature, these studies did not focus on music instrumentation or music characteristics.

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Instrumentation and relaxation. In some cases, authors have discussed instrumentation regarding music listening, relaxation, and anxiety reduction. Wolfe et al. (2002) briefly described

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musical instrumentation as either “enhancing” or “distracting,” but did not discuss specific

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instrumentation. Robb et al. (1995), Robb (2000), and Tan et al. (2012) all noted the importance of strings, flutes, and piano for relaxation. Notably, Grocke and Wigram (2007) stated that music for relaxation is likely to include strings and woodwinds, and to exclude percussion instruments (p. 46). Elliott et al. (2011) noted that piano, classical string instruments, and voice were each described as relaxing. The least relaxing compositions included guitars, bass, and percussion, but musical qualities related to these instruments were not discussed. The literature therefore appears to more commonly acknowledge string instrumentation for relaxation, while acknowledging the use of piano and flute; this literature also questions the use of percussion entirely, or to not discuss percussion at all.

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Percussion Instrumentation Percussion may be argued as the largest set of music instrumentation in existence. While instruments are often struck, they may also be shaken, scraped, brushed, rubbed, plucked,

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or triggered through electronic means (Matney, 2007). Idiophones produce sound through vibration of the complete body (e.g., triangle). Membranophones produce sound through

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vibration of a skin (e.g., bass drum). Sachs (1940) classified different types of percussion

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instruments. Chordophones produce sounds through the vibration of strings (e.g., hammer dulcimer). Aerophones produce sound through air columns or by moving an object through the

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air (e.g., bull roarer). Lamellophones create sound through plucked, vibrating bodies as a part of a larger system (e.g., mbira). Electronic percussion may be triggered through various devices.

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Pitched percussion may use the European tempered tonal system, or use other tonal systems (Matney, 2007). Percussion instruments may create staccato sounds with sharp timbres, (e.g., a

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struck snare drum), legato sounds with no punctuation and soothing timbres (e.g., the rolling

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sound of an ocean drum, or somewhere in between (e.g., a marimba, or handpan). Each percussion instrument therefore demonstrates different manifestations of music characteristics, including but not limited to pitch, timbre, volume, tempo, note duration and connectivity, and melodic and harmonic capabilities. The ways that percussion instruments are played, in conjunction with the music characteristics they demonstrate, result in percussion as a vast, diverse set of instrumentation (Matney, 2007). Piano, string instruments, and marimba represent some of the impulse-generated vibrating sound systems in Western tonal music (Hajda, 1995). While the three instruments traditionally belong to separate instrumental categories, one could also argue the existence of “family resemblances” between them. A piano has a string generator like a violin, but most often

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excites sound through hammering, not unlike a marimba. The classical marimba was derived from African instruments such as the gyil and bala, and the intermediary Central American marimbas (Hartenburger, 2016). Timbre can include the level of attack and decay of a sound, as

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the combination of fundamental tone, overtones, and white noise created by an instrument.

Keefe, 1992).

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Percussion and Receptive Experiences in Clinical Practice

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Marimba generally demonstrates a sharper attack and decay than a string instrument (Goad &

Scheffel and Matney (2014) conducted a survey of music therapists regarding their

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percussion education and clinical use of percussion. Forty three point seven percent of participants stated that they use percussion to facilitate receptive music experiences. The authors

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did not explore if, or to what extent, such receptive experiences included relaxation or anxiety reduction outcomes. Matney (2015) conducted a content analysis, and then discussed the

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therapeutic applications of percussion. He found that less than four percent of studies discussed

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the use of percussion in receptive methods. Some receptive experiences focused on stimulation and organization, while other experiences were applied to promote relaxation, subjective experiences, or imagery. The two above articles suggest that percussion has been applied in receptive methods within clinical practice, but with limited research evidence to support such application.

The current body of literature therefore provides limited sets of conflicting information. On one hand, particular articles and studies dating back to the early years of music therapy have suggested that the use of percussive elements and percussion instruments, are stimulative in nature, and are therefore likely contraindicated for relaxation and anxiety reduction. On the other hand, some studies suggest that percussion instruments can be used in receptive methods for

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relaxation and anxiety reduction. The current body of literature lacks studies that compare different types of instrumentation that including percussion instruments, to promote anxiety reduction.

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Percussion instrumentation for relaxation. The investigator located five studies that discuss the use of percussion used in some capacity in receptive experiences for relaxation.

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Gadberry (2011) used steady beat, performed on a sub-contra C bass tone bar at 66 bpm, to

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significantly reduce state anxiety in participants. Reinforcing ideas of tempo and predictability, the study implies that the qualities of music provided, even when devoid of melody, harmony, or

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commonly used instrumentation, may also promote anxiety reduction. Maurer et al. (1997) explored the potential for repetitive drumming to promote relaxation and the potential for

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hypnotizability. Results suggested higher subjective trance levels, and participants reported feeling more relaxed. Hoeft and Kern (2007) measured the use of recorded drum and percussion

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music on mood, relaxation, energy level, and focus level. Authors reported significant increases

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in relaxation for participants listening to two of the three percussion-driven pieces. Canga et al. (2012) conducted a pilot study, using client-selected listening to a duet of live improvised instruments of their choice, potentially including ocean drum; the instrumentalists reflected current sounds in the environment to promote anxiety reduction in a chemotherapy suite. Through analysis of self-report statistics, results suggested the potential for anxiety reduction. Koenig et al. (2013) studied the use of live receptive music, which included gongs, pitched percussion, drums and shakers, to promote headache reduction, body awareness, tension release, and relaxation. Results noted no difference between the experimental and control groups. The above studies imply the potential for percussion instruments to be used in relaxation. These studies therefore provide demonstrations that potentially counter prior theory (Gaston,

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1951; Grocke & Wigram, 2007) and studies (Elliott et al, 2011; Robb et al., 1995; Robb 2000) that suggest against the use of percussion instruments. However, no study has compared percussion with commonly used instrumentation.

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The current body of literature therefore suggests limited sets of conflicting information. On one hand, book chapters, articles, and studies dating back to the early years of music therapy

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have largely promoted strings, piano, and flute for anxiety reduction. Furthermore, authors have

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suggested that the use of percussive elements and percussion instruments are stimulative in nature, and are therefore likely contraindicated for relaxation and anxiety reduction. On the other

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hand, some studies suggest that percussion instruments can be used in receptive methods for relaxation and anxiety reduction. The current body of literature lacks studies that compare

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different types of instrumentation that including percussion instruments, to promote anxiety reduction.

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The purpose of this feasibility study was to ascertain the limited-efficacy of different

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types of instrumentation on anxiety reduction in university students. The investigator sought to answer the following questions to better understand if various types of instrumental music could be further studied with clinical populations. Research Question: 1.

Do string music, piano music, and marimba music each demonstrate a significant decrease in anxiety from pretest to postest?

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Is there a difference among the three treatment groups (recorded string music, piano music, or marimba music) regarding their ability to facilitate anxiety reduction in university students?

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Method Feasibility Studies A feasibility study exists as “a preliminary study to determine the practicability of study

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components” (Lagasse, 2013, p. 306; Porta, 2008). An investigator may conduct a feasibility study in order to understand whether further, more rigorous study may be warranted; in this

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particular case, the study would provide a greater understanding of implementation, and limited

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efficacy (Bowen et al., 2009). An implementation-focused feasibility study inquires about whether an intervention can be “fully implemented as planned and proposed, often in an

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uncontrolled design” (Bowen et al., 2009, p. 453). When introducing a new idea, a researcher can check implementation potential. Limited-efficacy feasibility testing promotes studies that

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test an intervention in a limited way, which may include the use of convenience samples, with intermediate outcomes, and with limited statistical power. Such studies allow the researcher to

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understand whether or not the new idea shows promise of being successful with expanded

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populations, therefore promoting the potential for stronger efficacy testing or greater transferability toward clinical practice. Knowledge Framework

Epistemology is the branch of philosophy that inquires about knowledge. Authors have discussed the importance of clarifying one’s epistemological position, or the presuppositions about “how we know what we know,” within research studies (Edwards, 2012; Hiller, 2016). More specifically, Crotty (1998) provided researchers a way to explain their knowledge framework within a study, including four levels: (a) epistemological position, (b) theoretical perspective, (c) methodology, and (d) methods. This study employs an objectivist epistemology, in that it inquires about the effect of instrumental music on anxiety reduction. This study asserts

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a post-positivist theoretical perspective, implying the potential to both contribute to and falsify past theories regarding instrumentation in anxiety reduction. The methodology can be described as a quasi-experimental feasibility study. The methods for this study will be described below.

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Participants The investigator chose to work with a non-clinical population that may be prone to a type

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of state anxiety due to stressors (Acka, 2011; Stewart-Brown et al., 2000). Participants included

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undergraduate and graduate students in music therapy, music education, and fine arts music degree programs from a large Mid-Western public university. Before beginning this study, the

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investigator received permission through a university Internal Review Board. Selection criterion required that participants were already assigned to give a graded presentation in one of their

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university courses on the day they were assigned to participate in the study; depending on the classroom setting, participants were presenting either on an assigned group topic on music and

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human development, or giving a mock professional music therapy presentation. The investigator

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requested permission from university professors to recruit potential participants. Participants signed up for ten-minute time periods that occurred within an hour before their scheduled classroom presentation. The investigator did not establish any exclusion criteria for participation. Fifty-seven prospective participants signed up for the study, and were given an assigned date and time to participate. Three prospective participants did not show up at their assigned participation time. Therefore, fifty four (n = 54) participants completed the study. The investigator assigned participation times using convenience samples, ranging from one to six people at a time. The investigator identified participant documents by letter and number (e.g., “P1” for participant one who listened to the piano piece), maintaining anonymity for each participant while providing consistent identification across the demographic survey, pretest, and posttest.

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Design The investigator implemented a pretest/posttest design, using the State and Trait Anxiety Inventory (STAI), form Y-1 to indicate levels of state anxiety before and after the interventions

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(Spielberger, Gorsuch, Lushene, Vagg, & Jacobs, 1983). The investigator only measured state anxiety, as form Y-1 focuses on how one feels in the moment. The investigator conducted three

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treatment interventions: (a) recorded string music, (b) recorded piano music, and (c) recorded

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marimba music. Each participant received one treatment intervention according to random assignment.

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Materials

The investigator chose Bach Air from Orchestra Suite No. 3 in D. Major, BWV 1068, for

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this study because it is has been noted as suitable for relaxation with adults (Bruscia, 1996; Grocke & Wigram, 2007; Pelletier, 2004; Suzuki, 1998; Zimny & Weidenfeller, 1963), and

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because this particular Bach work had been arranged for strings, piano, and marimba. For the

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string orchestra piece, the investigator chose the recording from the compact disc Bach: Violin Concerto No. 1 in A Minor – Air on the G String – Vivaldi: Concertos – Pachelbel: Canon in D Major – Albinoni: Adagio – Beethoven: Fur Elise, Moonlight Sonata – Schubert: Ave Maria – Mendelssohn: Wedding March – Vol. 1 (J. S. Bach Orchestra, 2011). For the piano piece, the investigator selected the version from the compact disc Classical Piano Chillout - Various Artists (Various Artists, 2009). For the marimba piece, the investigator located a video of Marimba: Arranged for Marimba by R. Bauer, performed by Rudi Bauer (Bauer, 2011), and created an audio recording of the video. The use of marimba provided the investigator an opportunity to compare string, piano, and percussion instrumentation with a specific music work, to ensure that the primary difference

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between music pieces would be instrumentation (Madsen & Madsen, 1970). In order to eliminate confounding variables, the investigator sought to create similar tempos and piece lengths between the three pieces. The string and piano piece demonstrated similar average tempos at

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approximately 57 bpm. The investigator modified the tempo and length of the marimba arrangement, while maintaining the same pitch, using a Superscope PSD430. The investigator

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then recorded the modified tempo onto a new compact disc (CD) through a Fostex VF160

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portable studio. The investigator decreased the tempo from approximately 64 bpm to approximately 57 bpm. Tempo reduction also resulted in lengthening the piece. Lengths of the

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respective pieces in minutes and seconds were as follows: strings, 3:27; piano, 3:27; marimba, 3:25.

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While clinical practice and research both support the use of recorded music with scripted guidance from the clinician to promote anxiety reduction (Hernandez-Ruiz, 2005; Robb, 2000),

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the investigator of this feasibility study focused on instrumental music without verbal guidance

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in order to ascertain the potential effect of the instrumentation itself. Procedure

The study occurred in a research room on campus, near the classrooms from which the students would be presenting. The investigator measured the room at 16 feet and10 inches long at its longest point by 18 feet and 11 inches wide at its longest point. Wall materials of the research room included white-painted drywall, white-painted cinderblock, or sound muffling material. Furniture in the room included three small conference tables and ten chairs. Tables were placed on the perimeter of the room, and were made available for participants to complete study documents. Some chairs were situated near the tables, while others were placed near the center of the room, facing the compact disc player.

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The investigator implemented the intervention music sequence with the strings recording for the first group that participated, followed by piano for the second and marimba for the third. The investigator maintained the string, piano, and marimba sequence up through the final

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participant group, ending with marimba. This sampling process resulted in seventeen participants (n = 17) in the strings treatment group, nineteen (n = 19) in the piano treatment group, and

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eighteen (n = 18) in the marimba treatment group.

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After signing an informed consent form, participants completed a demographic questionnaire, which included questions about their (a) gender, (b) university major, (c) year at

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university, (d) primary instrument, (e) preferred approaches to assist in self-relaxation, (f) genre preferences for musical relaxation, and (g) instrumental preferences for musical relaxation (see

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appendix for demographic questionnaire). The investigator, using a script, then asked participants to “Complete the pretest STAI, form Y-1, by answering each question as related to

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“how you are feeling at the moment.”

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Once the pretest was completed, the investigator informed participants that they would be listening to an instrumental piece for approximately three minutes and thirty seconds. The investigator also invited participants to make their own personal choices regarding (a) comfortable seating posture, (b) closed or open eyes, and (c) breathing focus while listening to the music. The investigator used a lamp to provide a more relaxed lighting to the room, with the primary fluorescent lighting turned off after the demographic information was completed and the investigator had informed the participants. The investigator played each respective music CD through an Emerson ES30 stereo system. Each piece reached its maximum amplitude at below 70 decibels, as measured through a smartphone decibel application program. After the music recording was completed, the investigator invited those participants who had their eyes closed to

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open them, and alerted them to the primary lights being turned back on. The investigator then asked participants to complete the STAI posttest. Results

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Demographic analysis suggested particular trends regarding (a) gender, (b) year of college, and (c) primary instrument. Results indicated that forty-seven (n = 47, 87%) participants

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were female, and seven (n = 7, 13%) participants were male. Participant majors included music

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therapy (n = 40, 74.1%), music education (n = 13, 24.07%), and bachelor of fine arts (n =1, 1.9%). A plurality of participants identified as freshmen (n = 16, 29.6%), followed by graduate

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students (n = 13, 24.07%), sophomores, (n = 11, 20.4%), juniors (n = 10, 18.5%), and seniors (n = 4, 7.4%). Participants reported primary instrumentation as voice (n = 25, 46.3%), keyboard

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instrument, (n = 8, 14.8%), woodwind instrument (n = 8, 14.8%), brass instrument (n = 6,

reporting guitar (n = 0, 0%).

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11.1%), classical string instrument (n = 6, 11.1%), percussion (n = 1, 1.9%), with no participants

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Participants also answered questions about the ways they help themselves relax, with which they were able to choose multiple answers (see appendix). Results indicated that listening to music (n = 50, 92.6% of participants), sleep (n = 45, 83.3%) playing music (n = 43, 79.6%), physical activity (n = 34, 70.0%), meditation (n = 12, 22.2%), and yoga (n = 8, 14.8%). Other responses included watching television or movies (n = 6, 11.1%), talking and social interaction (n = 5, 9.3%), reading (n = 2, 3.7%), knitting and craftwork (n = 1, 1.9%), petting a cat (n =1, 1.9%), taking pictures (n =1, 1.9%), dancing (n =1, 1.9%), cooking (n = 1, 1.9%), cleaning room (n = 1, 1.9%), eating (n = 1, 1.9%) and drinking tea (n = 1, 1.9%). Participants also answered questions about their preferred music for relaxation (see appendix). In some cases, participants offered one answer per question, as per the survey

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instructions, while other participants responded with multiple answers per question. One respondent provided no answer to either question six or question seven. Regarding music genres for respondents who provided only one answer (n = 37, the

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following results were calculated: Western classical (n = 5, 13.89%), showtunes (n = 4, 11.11%), popular (n = 4, 11.11%), religious/spiritual (n = 4, 11.11%), jazz (n = 3, 8.33%), country (n = 3,

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8.33%), rock (n = 3, 8.33%) and new age (n = 2, 5.56%). Responses to “other” (n = 9, 25%)

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music genres included independent music, piano ballads, soundtracks, industrial music, Korean, alternative, Kenny G., big band, Sara Bareilles, and “instrumental.”

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For those participants who provided multiple answers regarding genre preferences (n = 16), there were a total of 49 responses. The following results were calculated: Western classical

M

(n = 8, 16.33%), popular (n = 8, 16.33%), jazz (n = 7, 14.29%), new age (n = 5, 10.20%), country (n = 4, 8.16%), rock (n = 4, 8.16%), religious/spiritual (n = 3, 6.12%), showtunes (n = 2,

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4.08%). Responses to other music genres (n = 8, 16.33%)

Ac ce pt e

Regarding instrumental preferences, analysis of respondents who provided a single answer (n = 37) are provided as follows: piano (n = 12, 32.43%), full orchestra (n = 5, 13.51%), guitar (n = 4, 10.81%), orchestral string instruments (n = 3, 8.11%), electronic string instruments (n = 3, 8.11%), concert band (n = 2, 5.41%), wind instruments (n = 2, 5.41%), nature sounds (n = 1, 2.70%), pitched percussion (n = 1, 2.70%), and non-pitched percussion (n = 0, 0.00%). Those who answered “other” (n = 4, 10.81%) replied with vocal church/chant music, acoustic guitar and voice, choral music, saxophone, and string quartets. For those participants who provided multiple answers (n = 16) regarding instrumental preferences, analysis of 60 responses resulted in the following: piano (n = 14, 23.33%), guitar (n = 12, 20.00%), nature sounds (n = 9, 15.00%), orchestral string instruments (n = 8, 13.33%), full

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EFFECT OF INSTRUMENTATION ON ANXIETY

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orchestra (n = 6, 10.00%), wind instruments (n = 3, 5.00%) electronic instruments (n = 3, 5.00%), concert band (n = 2, 3.33%), pitched percussion (n = 2, 3.33%), and non-pitched percussion (n = 1, 1.67%). Two respondents provided the answer “other,” referring to “vocals,” and “not

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clarinet.” The investigator calculated descriptive statistics on STAI responses in order to measure

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variability for both pretest and posttest. Pretest results for study participants (n = 54)

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demonstrated a broad range of variability in responses, M = 48.68, SD = 11.99, minimum = 24, maximum = 75. Posttest results for all participants demonstrated a smaller range of variability in

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comparison, M = 37.55, SD = 8.62, minimum = 22, maximum = 56.

The investigator conducted three tests to measure equality amongst groups. Levene’s Test

M

for Equality of Variances did not yield any significant differences among the three groups on total pretest anxiety scores, F(2,51) = .47, p = .63. Results confirmed the assumption that

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variances for each group were equal. Additionally, the Box’s M value (F = 2.94) demonstrated

Ac ce pt e

that the homogeneity of the variance-covariance matrix assumption was met (p = .84). Thus, the. Lastly, the investigator completed a one-way ANOVA to compare the groups on the STAI at the pretest and postest. Results confirmed that groups were essentially the same at pretest (F(2, 51) = 1.05, p = .36.

In order to find out if there was a difference among the three treatment groups regarding their ability to promote anxiety reduction, the investigator conducted a one-way repeated measures ANOVA. The within subjects factor (repeated measures) was the STAI pretest and posttest. The between subjects factor (two independent variables) was the specific recording being listened to. Mean differences, standard deviation differences, and standard error of the mean differences are presented in Table 1. When all participants were examined as a combined

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group, the effect of scores on the STAI from pretest to posttest was statistically significant, Wilks’s L = .326, F(1, 51) = 105.518, p < .01, partial η2 = .674. The results also showed there was no statistically significant interaction (see Figure 1) between the different types of recording

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heard and the pretest or posttest scores on the STAI, Wilks’s Λ = .955, F(1, 51) = 1.191, p = .312, partial η2 = .045.

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Regarding the ability for each individual intervention to promote a reduction in anxiety,

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the investigator ascertained the following results through analysis. Results of paired samples t tests (Table 1) indicated a significant change for each group at the p < .01 level, after using a

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Bonferonni correction (p = .003). Cohen’s d calculations (see Table 1) suggested strong effect sizes for each individual group.

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Discussion

Researchers have various methods of anxiety induction at their disposal, and must

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consider both the reliability and the ethical considerations of each choice. This particular study

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employed a naturally occurring event that may induce anxiety: a presentation occurring in a classroom within an hour after the study intervention (Feldman, Cohen, Hamrick, & Lepore, 2004, 2004; Gerlach, Wilhelm, Gruber, & Roth, 2001). The resulting range of pretest scores indicate that participants responded to their pending presentation with varying levels of selfreported test or presentation anxiety, as measured by their state anxiety. Do string music, piano music, and marimba music each demonstrate a significant decrease in anxiety from pretest to postest?

Results suggest that recorded instrumental music reduced anxiety, as measured by the STAI self report (Figure 1). When examining the means for each group, scores demonstrated a statistically significant decrease in anxiety across each group. This particular work, as played by

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three separate sets of instrumentation, used particular music characteristics supported by prior research, including tempo (de Niet et al., 2009; Nilson, 2008), legato sound productions (Gaston, 1951), volume levels (Staum & Brotons, 2000), a lack of abrupt changes (Sena Moore, 2013), a

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lack of sharp timbres (Bradt et al., 2013), and consonant harmonies and melodies (Sena Moore, 2013).

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Is there a difference among the three treatment groups (recorded string music, piano music,

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or marimba music) regarding their ability to facilitate anxiety reduction in university students?

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Study results also indicated no difference between groups on anxiety reduction. These results highlight an instance where accepting the null hypothesis is uniquely informative. The

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marimba group was as effective as the strings and piano groups in terms of anxiety reduction. These findings suggest that particular music characteristics are more important to anxiety

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reduction than to the general instrumentation chosen. The distinction between percussive

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elements and percussion instruments requires further clarification. When Gaston categorized stimulative and sedative music, he associated ‘percussive type’ and ‘percussive quality’ (1951, p. 42) with staccato sounds, describing such as the stimulative nature of percussive music. However, such generalizations lack nuance; many percussion instruments provide sound qualities along a continuum of staccato and legato sounds. While marimba is a percussion instrument, it also demonstrates a set of music characteristics common to sedative music. Furthermore, particular percussion instruments, such as marimba, vibraphone, balafon, mbira, kalimba, hang, tank drum, hammer dulcimer, and steel drum emphasize melodic and harmonic qualities in instances where such are desired. Results therefore challenge prior article assertions regarding the inappropriateness of “percussion” instrumentation for relaxation (Gaston, 1951, 1968; Grocke &

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Wigram, 2007; Tan et al., 2012). Both Dileo and Bradt (2007) and Bradt et al. (2013) provide descriptions more specific to the therapeutic functions of musical qualities, potentially eliminating generalizations about instrumental groups.

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Limitations Several limitations existed in this study, including: (a) lack of randomization, (b) limited

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pool sampling, (c) inconsistent group sizes, (d) differing environmental contexts for anxiety,

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(e) lack of control group, (f) no measurement of participants’ familiarity with the work, and (g) challenges interpreting demographic information for further analysis. First, the investigator used

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convenience samples for specific classrooms that required in-class presentations. While this decision promoted efficiency, it also eliminated the possibility of randomization. Second, the

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investigator limited sampling to a particular pool of university students, with each participant pursuing a music degree. Third, the nature of the students’ presentations and their timelines

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resulted in inconsistent convenience group sizes, ranging from one to six people at a time. Fourth,

Ac ce pt e

multiple classroom settings, and therefore multiple presentation contexts, mean that anxiety stimuli may have been inconsistent. Fifth, this study lacked a control group, and therefore eliminated the ability to compare the effectiveness of music to a non-music intervention. Sixth, the investigator did not gage participants’ familiarity with the piece of music used for the intervention. Seventh, inconsistent group sizes may have acted as a confounding variable; there is no way to know whether participants were affected positively or negatively by their shared or individual experience in this particular study. Lastly, challenges with survey question answers left the investigator unable to identify or control for potential influences related to familiarity or preference. The study would have benefitted from clearer instructions about demographic questions. Due to these limitations, results should be interpreted with strong caution.

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Future Research Researchers may wish to understand how specific types of instrumental music affect

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anxiety levels. Future studies may (a) choose different instrumentation, (b) compare music characteristics, (c) measure anxiety through different tools, or (d) study different populations.

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Percussion instrumentation other than marimba may also demonstrate musical qualities

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conducive to relaxation. Furthermore, other types of percussion music, outside of the Western classical tradition, may be studied. Hoeft and Kern’s (2007) use of recorded hand drums and

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auxiliary percussion suggest that such may also be used for anxiety reduction. Lastly, studies may seek to further measure how cultural considerations, familiarity with certain types of

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instrumental music, and musical preferences may play a role in promoting anxiety reduction. Prospective studies may also employ more rigorous methods and use different tools to

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measure anxiety. The use of a control group, randomization will seek to minimize potential bias.

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Consistent group sizes, or individual exposure, during interventions may eliminate the influence of social response. Verbal survey instructions and quick survey checks may allow for easier identification of covariates, as well as control for such variables during statistical analysis. While this study focused on university music students, upcoming studies may examine the use of instrumental music with other populations, including but not limited to (a) a broader range of university students, (b) particular clinical populations, and (c) health-care professionals. Larger sample sizes will help to further substantiate study significance and power. In the case of university students, the study may take into account any diagnoses as covariates, and may seek to correlate anxiety results with other outcomes such as presentation performance. In the case of

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clinical populations, studies may consider correlating anxiety results with other outcomes such as sleeping patterns. Conclusion

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This study contributes to the current literature base in three primary areas: (a) the effect of instrumental music on anxiety reduction in university students, (b) the effect of particular

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types of instrumentation on anxiety reduction, and (c) the effect of particular music

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characteristics on anxiety reduction. The investigator examined the effect of different types of instrumentation in recorded music on state anxiety. Prior to a potentially stressful classroom

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presentation, participants listened to a piece of recorded music using a particular type of instrumentation. No statistical differences among the three treatment groups existed prior to the

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intervention. Results suggest (a) a significant reduction in anxiety when all treatment groups were combined as one group, (b) no significant difference in anxiety reduction among the three

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treatment groups, and (c) a significant reduction in anxiety for each specific treatment group

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(strings, piano, marimba). The results of this study provide a preliminary challenge to commonly held assumptions about recorded percussion music and anxiety reduction. Furthermore, this study contributes to the limited body of knowledge regarding percussion, receptive experiences, and relaxation.

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n

MD

SDD

SEMD

t

p

Strings Piano Marimba

17 19 18

13.53 9.52 10.56

8.15 8.68 7.08

1.98 1.99 1.67

6.85 4.75 6.33

< .001** < .001** < .001**

Cohen's d 1.66 1.10 1.49

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Group

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Table 1: Comparison of STAI pretest and posttest scores via paired samples t test for strings, piano, and marimba groups.

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Note. **Each group demonstrates significance at the .01 level using Bonferroni correction (.01/3 groups=.003).

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Figure 1. Mean STAI score changes due to music listening by instrumental group.

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Appendix

Gender: 1. Male 2. Female

2.

My university major is: 1. Music 2. Other (please state your major)

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1.

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Survey Questions:

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__________________________________________________________ I am a: 1. Freshman 2. Sophomore 3. Junior 4. Senior 5. Graduate Student

4.

(For music majors only) My primary instrument is (choose one): 1. voice 2. keyboard instrument 3. guitar 4. woodwind instrument 5. brass instrument 6. classical string instrument 7. percussion

5.

I do the following to help me relax (circle all that apply): 1. Meditation 2. Music 3. Physical Activity 4. Other (please describe)

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3.

______________________________________________________

6.

If you use music to relax, your music preference for relaxation is (choose one): 1. Western classical 2. jazz 3. popular 4. rock 5. “new age” 6. other (please describe)

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If you do use music to relax, your preferred instrumentation/sounds for relaxation music is (choose one): 1. full orchestra 2. strings 3. piano 4. guitar 5. electronic 6. nature sounds 7. percussion

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7.

37

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