The Cognitive Mechanisms in Music Listening Interventions for Pain: A Scoping Review

Abstract

Music interventions have been introduced in a range of pain management contexts, yet considerable inconsistencies have been identified across evaluation studies. These inconsistencies have been attributed to a lack of clarity around the prospective cognitive mechanisms of action underlying such interventions. The current systematic scoping review was conducted to examine the theoretical rationales provided in the literature for introducing music listening interventions (MLIs) in pain contexts. 3 search terms (music, listening, and pain) were used in four electronic databases, and 75 articles were included for analysis. Content analysis was used to identify that more intensive listening schedules were associated with chronic and cancer pain compared with procedural pain. The degree to which patients had a choice over the music selection could be categorized into 1 of 5 levels. Thematic synthesis was then applied to develop 5 themes that describe the cognitive mechanisms involved in MLIs for pain. These mechanisms were brought together to build the Cognitive Vitality Model, which emphasizes the role of individual agency in mediating the beneficial effects of music listening through the processes of Meaning-Making, Enjoyment, and Musical Integration. Finally, content analysis was used to demonstrate that only a small proportion of studies were explicitly designed to examine the cognitive mechanisms underlying MLIs and we have suggested ways to improve future practice and empirical research. We call on researchers to design and evaluate MLIs in line with the Cognitive Vitality Model of music listening interventions for pain.

Music listening does not inoculate the stress response in young and older adults.

“…The importance of intention is further supported by a recent scoping review on the cognitive mechanisms in music listening interventions for pain. Using a descriptive-analytical approach, Howlin and Rooney (2020) reported cognitive agency as a significant theme across the 75 studies reviewed. Specifically, cognitive agency, or the specific reasons by which people choose the music they listen to is one important factor, or underlying mechanism by which music may reduce pain (Howlin & Rooney, 2020).…”

“…Using a descriptive-analytical approach, Howlin and Rooney (2020) reported cognitive agency as a significant theme across the 75 studies reviewed. Specifically, cognitive agency, or the specific reasons by which people choose the music they listen to is one important factor, or underlying mechanism by which music may reduce pain (Howlin & Rooney, 2020). Investigation of such specific cognitive mechanisms that may mediate the benefits of music listening in the context of stress inoculation is necessary for future research.…”

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“…Perioperative Music Medicine decreased pinprick pain, repeated (conditioned) pain stimulus, and also increased the threshold for pressure pain (19). As a distracting stimulus it shifts attention away from competing noxious stimuli (20). Perioperative Music Medicine is especially effective in patients with depression (21), increasing emotional activity centered in the limbic system of the brain which feeds into the common pain pathways (18), produces endogenous opioids (18) and oxytocin (18,22) as well as decreases cortisol (22) and catecholamines (22,23).…”

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