[Polyvagal theory and emotional trauma]. / Polyvagaalinen teoria ja emotionaalinen trauma.

According to the polyvagal theory, the autonomic nervous system can, in deviation from the conventional theory, be divided in three distinct parts that are in hierarchical relationship with each other. The most-primitive autonomic control results in depression of vital functions, the more evolved one in fighting or escape and the most evolved one in social involvement. Practical application of the polyvagal theory has resulted in positive results above all in the treatment of emotional trauma. in Finland, therapy of complex trauma is founded on the theory of structural dissociation of the personality, which together with the polyvagal theory forms a practical frame of reference for psychotherapeutic work.

Individual music therapy for depression: randomised controlled trial.

BACKGROUND: Music therapy has previously been found to be effective in the treatment of depression but the studies have been methodologically insufficient and lacking in clarity about the clinical model employed. Aims To determine the efficacy of music therapy added to standard care compared with standard care only in the treatment of depression among working-age people. METHOD: Participants (n = 79) with an ICD-10 diagnosis of depression were randomised to receive individual music therapy plus standard care (20 bi-weekly sessions) or standard care only, and followed up at baseline, at 3 months (after intervention) and at 6 months. Clinical measures included depression, anxiety, general functioning, quality of life and alexithymia. TRIAL REGISTRATION: ISRCTN84185937. RESULTS: Participants receiving music therapy plus standard care showed greater improvement than those receiving standard care only in depression symptoms (mean difference 4.65, 95% CI 0.59 to 8.70), anxiety symptoms (1.82, 95% CI 0.09 to 3.55) and general functioning (-4.58, 95% CI -8.93 to -0.24) at 3-month follow-up. The response rate was significantly higher for the music therapy plus standard care group than for the standard care only group (odds ratio 2.96, 95% CI 1.01 to 9.02). CONCLUSIONS: Individual music therapy combined with standard care is effective for depression among working-age people with depression. The results of this study along with the previous research indicate that music therapy with its specific qualities is a valuable enhancement to established treatment practices.

The effect of improvisational music therapy on the treatment of depression: protocol for a randomised controlled trial.

BACKGROUND: Music therapy is frequently offered to individuals suffering from depression. Despite the lack of research into the effects of music therapy on this population, anecdotal evidence suggests that the results are rather promising. The aim of this study is to examine whether improvisational, psychodynamically orientated music therapy in an individual setting helps reduce symptoms of depression and improve other health-related outcomes. In particular, attention will be given to mediator agents, such as musical expression and interaction in the sessions, as well as to the explanatory potential of EEG recordings in investigating emotion related music perception of individuals with depression. METHODS: 85 adults (18-50 years of age) with depression (ICD-10: F 32 or F33) will be randomly assigned to an experimental or a control condition. All participants will receive standard care, but the experimental group will be offered biweekly sessions of improvisational music therapy over a period of 3 months. A blind assessor will measure outcomes before testing, after 3 months, and after 6 months. DISCUSSION: This study aims to fill a gap in knowledge as to whether active (improvisational) music therapy applied to people with depression improves their condition. For the first time in this context, the mediating processes, such as changes in musical expression and interaction during the course of therapy, will be objectively investigated, and it is expected that the results will provide new insights into these processes. Furthermore, the findings are expected to reveal whether music related emotional experiences, as measured by EEG, can be utilized in assessing a depressive client's improvement in the therapy. The size and the comprehensiveness of the study are sufficient for generalizing its findings to clinical practice as well as to further music therapy research. TRIAL REGISTRATION: ISRCTN84185937.

Biased emotional recognition in depression: perception of emotions in music by depressed patients.

BACKGROUND: Depression is a highly prevalent mood disorder, that impairs a person's social skills and also their quality of life. Populations affected with depression also suffer from a higher mortality rate. Depression affects person's ability to recognize emotions. We designed a novel experiment to test the hypothesis that depressed patients show a judgment bias towards negative emotions. METHODS: To investigate how depressed patients differ in their perception of emotions conveyed by musical examples, both healthy (n=30) and depressed (n=79) participants were presented with a set of 30 musical excerpts, representing one of five basic target emotions, and asked to rate each excerpt using five Likert scales that represented the amount of each one of those same emotions perceived in the example. RESULTS: Depressed patients showed moderate but consistent negative self-report biases both in the overall use of the scales and their particular application to certain target emotions, when compared to healthy controls. Also, the severity of the clinical state (depression, anxiety and alexithymia) had an effect on the self-report biases for both positive and negative emotion ratings, particularly depression and alexithymia. LIMITATIONS: Only musical stimuli were used, and they were all clear examples of one of the basic emotions of happiness, sadness, fear, anger and tenderness. No neutral or ambiguous excerpts were included. CONCLUSIONS: Depressed patients' negative emotional bias was demonstrated using musical stimuli. This suggests that the evaluation of emotional qualities in music could become a means to discriminate between depressed and non-depressed subjects. The practical implications of the present study relate both to diagnostic uses of such perceptual evaluations, as well as a better understanding of the emotional regulation strategies of the patients.