Music interventions with children, adolescents and emerging adults in mental health settings: a scoping review.

BACKGROUND: Music is increasingly used with youths in health and psychosocial interventions. We conducted a scoping review with the aim to provide an overview of the current available evidence on music intervention for youth in mental health settings, to inform practice and further research. METHODS: Three databases (PsycINFO, PubMed and CINAHL) were surveyed. Using the PRISMA review method, 23 studies met inclusion criteria. RESULTS: Young people aged from 4 to 25 years old with various mental health conditions participated in music interventions. Music therapy was the most investigated (71%). Improving social skills was the most frequent therapeutic aim addressed. Music interventions are mostly appreciated by the participants, but it is difficult to make conclusions about their effectiveness because of the heterogeneity of research designs and the limited current state of research. CONCLUSION: Music interventions appear to represent a promising complementary approach to usual psychiatric care, but further standardised research is necessary to continue investigating their therapeutic effects.

A thorough investigation of the bifactor model of psychopathology in a representative birth cohort: Testing internal and predictive validity to inform models of comorbidity.

This study used symptom dimensions reflecting DSM-V internalizing, externalizing, eating disorders, and substance use (SU) and related problems to thoroughly investigate the structure of psychopathology in mid-adolescence (15 and 17 years, N = 1,515, 52% female). Compared to other hierarchical configurations (unidimensional, correlated factors, or higher-order model), a bifactor model of psychopathology wherein all first-order symptom dimensions loaded onto a second-order general psychopathology factor (P factor) and one of three, second-order specific internalizing, externalizing, or SU factors, best captured the structure of the psychopathology in mid-adolescence. This bifactor model was then used to predict several distinct mental health disorders and alcohol use disorder (AUD) at 20 years, via a structural equation model (SEM). The P factor (bifactor model) was associated with all but one outcome (suicidal ideation without an attempt), at 20 years. Controlling for the P factor, there were no additional, positive, temporal cross-associations (i.e., between mental health (mid-adolescence) and AUD at 20 years, or between SU (mid-adolescence) and mental health problems at 20 years). These results are bolstered by findings from a well-fitting correlated factors model. Namely, when mid-adolescent psychopathology was modeled using an adjusted correlated factors model, associations with outcomes at 20 years were largely masked, with no significant partial, temporal cross-associations. Thus, collectively, findings indicate that comorbidity between SU and mental health in youth may be largely attributable to an underlying liability to experience both problems (i.e., P factor). Ultimately, results support targeting the common liability to psychopathology in the prevention of later mental health problems and AUD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

CDDO-Me Alters the Tumor Microenvironment in Estrogen Receptor Negative Breast Cancer.

The tumor microenvironment (TME) is an essential contributor to the development and progression of malignancy. Within the TME, tumor associated macrophages (TAMs) mediate angiogenesis, metastasis, and immunosuppression, which inhibits infiltration of tumor-specific cytotoxic CD8+ T cells. In previous work, we demonstrated that the synthetic triterpenoid CDDO-methyl ester (CDDO-Me) converts breast TAMs from a tumor-promoting to a tumor-inhibiting activation state in vitro. We show now that CDDO-Me remodels the breast TME, redirecting TAM activation and T cell tumor infiltration in vivo. We demonstrate that CDDO-Me significantly attenuates IL-10 and VEGF expression but stimulates TNF production, and reduces surface expression of CD206 and CD115, markers of immunosuppressive TAMs. CDDO-Me treatment redirects the TAM transcriptional profile, inducing signaling pathways associated with immune stimulation, and inhibits TAM tumor infiltration, consistent with decreased expression of CCL2. In CDDO-Me-treated mice, both the absolute number and proportion of splenic CD4+ T cells were reduced, while the proportion of CD8+ T cells was significantly increased in both tumors and spleen. Moreover, mice fed CDDO-Me demonstrated significant reductions in numbers of CD4+ Foxp3+ regulatory T cells within tumors. These results demonstrate for the first time that CDDO-Me relieves immunosuppression in the breast TME and unleashes host adaptive anti-tumor immunity.

Feasibility and preliminary effectiveness of a drum circle activity to improve affect in patients, families and staff of a pediatric hospital.

Background: Children, families and staff in pediatric hospitals often experience elevated psychological distress. Art-based initiatives, such as group drumming, have been proposed as strategies to support well-being in this context. Methods: This study evaluated the feasibility and potential benefits of a drum circle activity designed to improve the affective experience of patients, families and staff in a large pediatric hospital. A total of 48 patients, 16 employees and 15 visitors completed questionnaires before and after up to 12 joint drum circle sessions. A total of 12 respondents took part in semi-structured interviews. Results: Quantitative analyses showed significant pre-post-session increases in positive affect (beta = .48; p < .001) and decreases in negative affect (beta = -.29; p < .001). Qualitative results corroborated these findings, in addition to suggesting the safety of the activity as well as other potential benefits. Conclusions: This preliminary study supports the usefulness of group drumming to enhance the well-being of pediatric hospital patients, families and staff.

MAP: A Personalized Receptive Music Therapy Intervention to Improve the Affective Well-being of Youths Hospitalized in a Mental Health Unit.

The MAP is an innovative receptive music therapy intervention derived from psychomusical relaxation methods that aims to foster the well-being and recovery of youths with mental health problems by providing them with an adaptive and effective music-assisted means to regulate their mood states. In this quasi-experimental pilot study, we assessed the mood-enhancing potential of participation in MAP sessions delivered by a music therapist in an in-patient mental health facility for children and adolescents. Using short standardized self-reported questionnaires, 20 participants aged 9-17 years old (M = 14, SD = 2.4), mainly girls (13 = 65%), rated their affective state immediately before and after two to four MAP sessions and a similar number of regular unit activity sessions used as comparison. This created a 2 × 2 (Time × Condition) single-group within-individual design. We analyzed pre-post session changes in affect using multilevel mixed models and found participation in MAP sessions to be associated with systematic reductions in self-reported general negative affect and state anxiety. These variations were of modest-to-large magnitude and significantly greater than those associated to participation in regular unit activities. While only a first step towards the validation of the MAP as an effective intervention to foster more adaptive and effective day-to-day mood regulation in youths with mental health problems, this study supports its specific potential to alleviate negative affects and provides a rare demonstration of the putative benefits of music therapy in a pediatric mental health inpatient context.

[Art-based rehabilitation program training: a transfer of knowledge]. / Formation pour une intervention de réadaptation par les arts : un transfert de connaissances.

OBJECTIVES: To evaluate the implementation, processes and perceived efficacy of a pilot project of knowledge transfer in public health, which involves the training/supervision of new practitioners in an art-based rehabilitation program. This innovative evidence-based intervention seeks to promote the well-being of youth with mental disorders through circus and theater workshops. The purpose of this study is to provide a formative evaluation of this pilot project in order to improve the intervention and the knowledge transfer practices in public health. METHODS: This research is based on a participatory and mixed approach, with a ?triangulation-convergence? design, integrating a thematic analysis of qualitative data (semi-structured interviews and Focus Groups), a descriptive analysis of quantitative data (questionnaire of reaction) and a documentary compliance analysis (grid of activity monitoring). RESULTS: The results show that the knowledge transfer strategy has resulted in the training of practitioners who feel ready to take charge of the project, despite implementation gaps. The main barrier was the prolonged and unforeseen absence of project leaders, for reasons out of their control. Nevertheless, the motivation and commitment of the team members acted as a catalyst in this pilot project, which became a setting for discussion and experimentation of the knowledge transfer strategy. CONCLUSION: This study demonstrates the benefits of adopting a participatory approach and mixed method in the evaluation of knowledge transfer in public health, which would better capture the inherent complexity of social interventions.

Reciprocal prospective associations between depressive symptoms and perceived relationship with parents in early adolescence.

OBJECTIVE: Adolescent depressive symptoms are associated with difficult family relationships. Family systems and interpersonal theories of depression suggest that this association could reflect a circular process in which symptoms and family functioning affect each other over time. Few longitudinal studies have tested this hypothesis, and the results of these studies have been equivocal. In this study, we examine reciprocal prospective associations in early adolescence between depressive symptoms and 2 important aspects of parent-child relationships: communication and conflict. METHODS: Participants were 3862 students who annually filled out self-reports. Path analysis was used to examine prospective associations between depressive symptoms and perceived communication and conflict with parents from the age of 12 to 13 and 14 to 15 years. Independence of these associations was assessed by controlling for family context (parental separation and family socioeconomic status) and adolescent behaviour problems (delinquent behaviours and substance use). Sex differences were evaluated with multiple group analysis. RESULTS: Reciprocal prospective associations were found between depressive symptoms and perceived conflict with parents, but not between depressive symptoms and communication with parents. Depressive symptoms were found to predict poorer communication with parents over time, but communication was not predictive of lower depressive symptoms in subsequent years. All paths were sex-invariant and independent from family context and behaviour problems. CONCLUSION: This study highlights the importance of considering the potential impact of adolescent symptomatology on parent-child relationships and suggests that reciprocity may characterize the association between depressive symptoms and negative aspects of parent-child relationships. The role of adolescent perceptions in the interplay between depressive symptoms and family relationships remains to be clarified.