This thesis presents the development and implementation of a proof-of-concept study testing music listening’s capacity to reduce subjective and physiological symptoms of anxiety in a situation analogous to an anxiety disorder. This interdisciplinary thesis draws on both clinical psychology and music psychology literature to present a conceptualisation for music listening in the treatment of anxiety disorders. In preparation for the proof-of-concept study, criteria for optimal stimuli were synthesised from the music psychology literature, two optimal stimuli were selected, and an anxiety induction protocol was developed to model the worry-based nature of an anxiety disorder. The two stimuli selected were ‘The Swan’, from Carnival of the Animals, by Camille Saint-Saëns, and a combination of ‘Dawn’ and ‘The Secret’, by Dario Marianelli, from the 2005 film Pride and Prejudice. In the anxiety induction protocol, participants were told that they would be asked to give a presentation in front of other participants and experimenters (whom they had not yet seen), and that this presentation would be assessed. While they awaited the presentation, participants were asked to do a mental visualisation exercise, which involved thinking about any previous public speaking experience that had made them feel nervous. Participants were given headphones with either music or white noise while they completed this exercise. The proof-of-concept study was conducted with a general population, with participants (n = 58) randomised to listen to either music or white noise during the anxiety induction protocol. Subjective anxiety (as per the short form of the state scale of the State Trait Anxiety Inventory, or STAI-SF) and physiological arousal (as per pulse rate and skin resistance) were measured. Physiological arousal measures were taken for one minute at baseline (time 1), for one minute when the participant had been introduced to the task and were reading through the mental visualisation exercise (time 2), and while the participants completed the mental visualisation exercise, and music or white noise was playing (time 3). Subjective anxiety scores were obtained immediately after each physiological time point. Results showed that subjective anxiety and physiological arousal rose significantly in response to the anxiety induction protocol, and that subjective anxiety and pulse rate decreased significantly in response to the music but remained the same for those who listened to white noise.

The purpose of this study was twofold: to critically review existing systematic reviews and meta-analyses on the topic of music and pain; and to systematically review and conduct a meta-analysis of clinical trials investigating the effect of music on pain encompassing a wide range of medical diagnoses, settings, age groups, and types of pain. For the review of systematic reviews, the author conducted a comprehensive search and identified 14 systematic reviews and meta-analyses. These studies were critically analyzed to present a comprehensive overview of findings, to evaluate methodological quality of the reviews, to determine issues or gaps in the literature, and to generate research questions for the following meta-analysis. For the meta-analysis, the author conducted electronic searches of 12 databases and a handsearch of related journals and reference lists of relevant systematic reviews, with partial restrictions on design (i.e., randomized controlled trials); language (i.e., English, German, Korean, and Japanese); year of publication (i.e., 1995 to 2014) and intervention (i.e., music therapy and music medicine). Analyzed studies included 87 music medicine (MM) and 10 music therapy (MT) trials; eighty-nine of the included studies involved adults and eight trials focused on children. In terms of the types of pain, there were 51 trials on acute, 34 on procedural, and 12 on cancer or chronic pain; the trials were conducted in over 20 different medical specialty areas. For the assessment of study quality, I used the risk of bias tool developed by the Cochrane collaboration, and pooled data from the included studies were analyzed using the Revman 5.3 software according to the effects of music on levels of pain intensity, amount of analgesic use, and changes in vital signs. The results indicated that music interventions resulted in a significant reduction of 1.13 units on 0-10 scales and a small to moderate pain reducing effect on other scales (SMD = -0.39). Participants in the music group experienced a significantly lower level of emotional distress from pain (MD = -10.8), and required significantly fewer anesthetics (SMD = -0.56), opioids (SMD = -0.24), and non-opioid medications (SMD = -0.54). Moreover, the music group showed statistically significant decreases in heart rate of 4.25 bpm, systolic blood pressure of 3.34 mmHg, diastolic blood pressure of 1.18 mmHg, and respiration rate of 1.46 breaths per minute. Findings from several analyses of moderator variables suggest: MT has a stronger effect in reducing self-rated pain intensity than MM; MT is more effective in reducing chronic/cancer pain than other types of pain, but MM seems to be more effective in managing procedural pain; children benefit more from music interventions than do adults, and more from MT than MM; providing different levels of choices in the selection of music yields different outcomes for MM; having a rationale for selection of music greatly improves the treatment outcome for MM; and an active MT approach is more effective in relieving perceived levels of pain than a passive MT approach. The results from the current meta-analysis demonstrate that music interventions may have beneficial effects on pain, emotional distress from pain, use of anesthetics and pain killers, and vital signs including heart rate, systolic blood pressure, diastolic blood pressure and respiration rate. However, these results need to be interpreted with caution due to highly heterogeneous outcomes among the included studies. Considering all the possible benefits, music interventions may provide an effective complimentary approach for the relief of acute, procedural and cancer/chronic pain in the medical setting. / Music Therapy

It is the teacher's responsibility to guide students in building an effective and injury-free piano technique. Improper technique, poor training and bad posture at the instrument all may cause problems such as lack of muscle control, weakness, or tension in the hands. Many teachers are interested in finding information about specific exercises dealing with finger strengthening, stretching, and warm-up strategies, as well as guidelines for safe practicing. It is therefore important for both teachers and students to understand how to build a technique from the earliest years of instruction. Carl Tausig (1841-1871) and Alfred Cortot (1877-1962) both contributed to the development of piano technique by writing books that include a significant number of exercises and excerpts. Their books incorporate detailed instructions on how to play each exercise effectively and without fatigue. Subsequently, Heinrich Ehrlich (1822-1899) collected and systematically arranged Tausig's notes, complementing them with detailed information on how to play Tausig's exercises without causing injury. This dissertation compares and contrasts the exercises found in Alfred Cortot's book, Rational Principles of Pianoforte Technique, and Carl Tausig's book, Daily Studies for the Pianoforte. The latter is based on the practical guidebook, How to Practise on the Piano: Reflections and Suggestions, written by Heinrich Ehrlich. Included in this study are references to the performing arts medical literature dealing with pianists' injuries. By comparing two different historical piano methods and considering their effectiveness in light of modern medical performance research, this dissertation aims to help teachers to determine which methods might be better for students to build a solid piano technique without injuring themselves.