The Effects of Reading, Interactive Live Music Making, and Recorded Music on Auditory Hallucinations: A Pilot Study

Abstract

ABSTRACT: The purpose of this study is to quantitatively evaluate the effects of reading, interactive live music making, and recorded music on four aspects of auditory hallucinations (clarity, threat, amplitude, and duration). An ABACA research design (N = 7) was used, with A being reading a magazine, B being interactive live music making, and C being listening to recorded music via headphones. Although both interactive live music making and recorded music were able to suppress all four evaluated aspects of auditory hallucinations more than reading, no statistically significant results were found. Additionally, although not statistically significant, the live music making was more effective than recorded music in controlling auditory hallucinations. Results from a post-test indicated that participants would continue to use active music playing and recorded music to suppress auditory hallucinations in the future. Future research is warranted and necessary to further evaluate the differences and effects of interactive live music making and recorded music on auditory hallucinations. Review of Literature Auditory hallucinations (AH) occur frequently among psychiatric patients, but most commonly in individuals with schizophrenia (Shergill, Murray, & McGuire, 1998). AH may also occur in normal individuals, with surveys estimating lifetime prevalence rates of 10-39% in the general population (Bentall & Slade, 1985; McKellar, 1968; Posey & Losch, 1983; Tien, 1991). AH are a type of reality distortion (Sukhwinder & Murray, 2001), and patients usually describe them as distressing (Nyani & David, 1996). Western society has considered AH abnormal since the Middle Ages (Falloon & Talbot, 1981 ). These 'voices' can threaten, distract, command, or even amuse patients. Medical research has given some insight into what causes AH. It is believed that AH are associated with abnormalities in the left hemisphere of the brain (Green, Hugdahl, & Mitchell, 1994). Silbersweig et al. (1995) found that the occurrence of AH was associated with increased regional cerebral blood flow (rCBF) in the medial temporal lobe (hippocampus and parahippocampal gyrus), ventral striatum, thalamus, and orbital frontal cortex. AH are usually treated with anti-psychotic medications, but these treatments are ineffective in 25-30% of cases (Kane, Honigfeld, Singer, & Meltzer, 1988; Meltzer, 1992). Anti-psychotics have been found to lower the level of dopamine in the brain resulting in the reduction of fear, agitation, thought disorders, delusions, and hallucinations (Costello & Costello, 1992). Unfortunately, 20-40% of people with schizophrenia and/or AH receive little to no relief from anti-psychotic medications (Tamminga, 1997). Although they can produce a calming effect, these drugs can reduce clients to a 'zombielike' state. Possible side effects are constipation, dry mouth, muscle rigidity, tremors, and blurred vision. The worst side effect is tardive dyskinesia, a muscle disorder causing uncontrollable grimacing and lip smacking. It is not treatable by other drugs as are most other side effects. Twenty to thirty percent of individuals taking anti-psychotics are estimated to have tardive dyskinesia (Celenberg, 1991). Medication noncompliance is a major problem when treating psychosis. Noncompliance is particularly likely when the treatment goal is to prevent symptom reoccurrence or illness relapse (Perkins, 2002). Most persons on medication are noncompliant due to unpleasant side effects or the belief that, because their psychotic symptoms have been alleviated, they do not need medication any longer. Medication noncompliance is the most common reason for hospital admission in patients with schizophrenia (Jeffreys et al., 1997). Treatments based on the stress-vulnerability-coping skills model have made recent considerable progress in treating individuals with schizophrenia (Mueser, Liberman, & Glynn, 1990). …