Indigenous music therapy theory building through grounded theory research: The developing indigenous theory framework

There are diverse understandings within music therapy about what constitutes theory. Also, there is debate about whether research methodology, developed outside of the field of music therapy, is able to support the development of music therapy theory that is indigenous to the profession. In this paper, a framework, called the developing indigenous theory (DIT) framework, which allows for the development of indigenous theory through the use of grounded theory research methodology, is presented. A new definition of indigenous music therapy theory is provided. Here, indigenous music therapy theory refers to knowledge emergent from music therapy relationships which are able to be plausibly generalised across settings and time, allowing for the development of theory that is idiosyncratic to the field of music therapy. The difference between “precursors to theory” and actual “theory” are examined, and the outcomes of numerous studies are considered through the use of the framework. The distinction between complete and modified grounded theory studies is discussed. It is suggested that the DIT framework may hold relevance for the development of theory in other human relationship-based arts therapies.     

Videopolygraphic and functional MRI study of musicogenic epilepsy. A case report and literature review

A 36-year-old right-handed man, who had experienced partial seizures since the age of 24 every time he played or listened to music with a strong emotional charge, underwent videopolygraphic recording, including autonomic variables, and brain fMRI study during which he listened to both “neutral” and “emotionally charged” music. Three right temporal seizures recorded during videopolygraphic monitoring were elicited by listening to the triggering song. The fMRI study disclosed activation in right acoustic areas during “neutral music,” whereas an “emotionally charged melody” provoked widespread activation over the right fronto-temporo-occipital area before seizure onset. The literature review disclosed 110 published cases of musicogenic epilepsy that seemed to suggest a right-sided predominance of the epileptogenic zone. Our results support the role of the right temporal lobe in musicogenic epilepsy and demonstrate that the cerebral areas activated during the period of strong emotion leading to the seizures encompass the auditory cortex activated by neutral music.     

Discourse analysis reframes oncologic music therapy research findings

Constructivism informed an investigation into music therapy's relevance in a cancer hospital, that is, what did the music therapy do and did it help? Thematic findings, emergent from separate group data analyses (representing patients, visitors, staff, and a researcher's reflections), were contrasted and compared. While some perceptions about music therapy's relevance were shared, discrepancies were also evident. A discourse analysis provides a framework for examining how social reality is produced, acknowledging how multiple meanings can emerge through disparate dialogues informing individual life histories. A discourse analysis on this music therapy research extended the researchers’ reflexivity, provided a rationale for discrepant interpretations about music therapy's efficacy, and enabled alternate interpretations of some of the data and findings. Consequences of endeavouring to “hear” the multiplicity of meanings on discourses that serve to maintain music therapy professionalism, inevitable when examining subjective human experiences, are considered.     

Leisure activity patterns and their associations with overweight: A prospective study among adolescents

We examined longitudinal associations between individual leisure activities (television viewing, video viewing, computer games, listening to music, board games, musical instrument playing, reading, arts, crafts, socializing, clubs or scouts, sports, outdoor activities) and being overweight using logistic regression and latent class analysis in a cohort of Finnish twins responding to self-report questionnaires at 11–12 (N = 5184), 14, and 17 years. We also studied activity patterns (“Active and sociable”, “Active but less sociable”, “Passive but sociable”, “Passive and solitary”) thought to represent different lifestyles. Among boys, activity patterns did not predict becoming overweight, but sports and playing an instrument reduced the risk and arts and listening to music increased it. Among girls, few individual leisure activities predicted becoming overweight. However, girls in the “Passive and solitary” cluster carried the greatest risk of becoming overweight in late adolescence. Studying leisure activities related to overweight may help focus specific interventions on high risk groups.     

Assessing the opinions and experiences of German-speaking psychiatrists regarding necessary changes for the 11th revision of the mental disorders chapter of the international classification of disorders (ICD-11)

We performed an Internet-based questionnaire survey of the opinions of German-speaking psychiatrists regarding the experiences with the 10th revision of the international classification of mental disorders (chapter F of ICD-10). We received 304 completed questionnaires including more than 500 free-text comments. The responding group was characterized by professionally experienced middle-aged psychiatrists. German-speaking psychiatrists were comparatively content with ICD-10. Most diagnostic categories received a “satisfied” or “very satisfied” rating by the majority of respondents. Negative “goodness of fit” ratings – a possible indicator of the need for revision – were not higher than 50% for any category. Based on free-text entries, neurasthenia was the single diagnostic category most often suggested for deletion in ICD-11. Changes were considered necessary mainly for dementias and personality disorders. Adult attention deficit disorder and narcissistic personality disorder were the two diagnostic categories most frequently suggested to be added as new categories. This study provides valuable information related to perceived clinical utility of the classification, though with a narrow sample. Information about clinicians’ experiences should be combined with scientific evidence for the revision process of ICD-11.     

Interobserver reliability of ICSD–R minimal diagnostic criteria for the parasomnias

Objective To estimate the interobserver reliability (IR) of the minimal diagnostic criteria for the parasomnias provided in the International Classification of Sleep Disorders Revised (ICSD–R).Methods Fifty consecutive subjects underwent a structured interview by three doctors based on the ICSD–R minimal criteria for the diagnosis of 13 parasomnias at any time in life. IR was calculated by Kappa statistics and interpreted according to conventional categories.Results In the group of Arousal Disorders, IR was “substantial” (kappa 0.74) for confusional arousals, “slight” (kappa 0.36) for sleepwalking, “fair” (kappa –0.02) for sleep terrors. In the group of Wake–Sleep Transition Disorders, IR was “substantial” to “almost perfect”, but “moderate” for sleep starts (kappa 0.41). In the group of Parasomnias usually associated with REM Sleep, IR was “substantial” (kappa 0.69) for sleep paralysis, “moderate” (kappa 0.46) for RBD, “fair” (kappa 0.25) for nightmares. In the group of Other Parasomnias, IR was “substantial” to ”almost perfect” (kappa between 0.73 and 0.93).Conclusions When the clinical diagnosis of parasomnias is based on the ICSD–R: 1) the majority of Arousal Disorders and REM sleep parasomnias showed only a “fair” to “moderate” IR; 2) all of the other parasomnias showed a ”substantial” to “almost perfect” IR. Nosological entities with unsatisfactory IR share complex motor phenomenology associated with a mental state difficult for the patient to define. The source of disagreement probably lies in the difficulty in interpreting patients’ reports. For these parasomnias IR must be verified and possibly improved with training.     

Neonatal lipopolysaccharide and adult stress exposure predisposes rats to anxiety-like behaviour and blunted corticosterone responses: Implications for the double-hit hypothesis

The double-hit hypothesis posits that an early life genetic or environmental insult sets up a neural predisposition to psychopathology, which may emerge in the presence of a subsequent insult, or ‘second hit’ in later life. The current study assessed the effect of neonatal lipopolysaccharide (LPS) exposure on anxiety-like behaviours in the adult Wistar rat. Rats were administered either LPS (Salmonella enterica, serotype enteritidis, 0.05 mg/kg, ip) or saline (equivolume) on days 3 and 5 of life (birth = day 1). In adulthood (85 days), subjects were allocated to either “stress” or “no stress” treatment groups. For the “stress” group, subjects were exposed to a three-day stress protocol consisting of a 30 min period of restraint and isolation. The “no stress” group was left unperturbed but were handled during this period to control for handling effects between adult “stress” and “no stress” conditions. All animals then underwent behavioural testing using standardised tests of anxiety-like behaviour, including either the Hide Box/Open Field, Elevated Plus Maze (EPM) or Acoustic Startle Response (ASR). Time and event measures for restraint and isolation, the Hide Box/Open Field and EPM were recorded using automated tracking software. Startle amplitude and habituation across time was measured in the ASR test. Prior to and following behavioural test sessions, peripheral blood was collected to assess serum corticosterone and ACTH levels. Data analysis indicated that LPS-treated animals exposed to stress in adulthood exhibited increased anxiety-like behaviour across all behavioural tests compared to controls. Sexually dimorphic effects were observed with males exhibiting increased anxiety-related behaviours compared to females (p < .05). Neonatal LPS exposure induced a significant increase in corticosterone compared to controls (p < .05), whereas corticosterone responses to stress in adulthood were associated with a significantly blunted HPA axis response (p < .05). No differences in ACTH were observed. These results lend support to the double-hit hypothesis of anxiety-related behaviour, demonstrating that neonatal immune activation produces an enhanced propensity toward anxiety-related behaviour following stress in adulthood, and that this susceptibility is associated with alterations to HPA axis ontogeny.     

Serial dependencies and markov properties of neuronal interspike intervals from rat cerebellum

Using three different approaches, each with different theoretical assumptions, we showed that mammalian neuronal spike trains contain serial ordering. We demonstrated that: (1) when intervals are categorized according to whether their durations are short, medium, or long, sequential groupings of adjacent interval categories exhibit Markov dependencies, extending to at least the 4th order; (2) the observed incidence of specified patterns of these groups of adjacent interval categories differs from the independent case, based on Chi square goodness-of-fit tests, and by using similar procedures; (3) there is divergence from independence when adjacent interval patterns are described in terms of relative lengths of adjacent intervals. The statistical indicators of serial dependence were significantly greater when applied to the original data than when applied to the same data after shuffling. Each of these approaches leads to the notion that “information” is carried in clusters of adjacent intervals (“bytes” or “words”) and moreover, we can identify which specific patterns of interspike intervals contribute most to the statistical significance (i.e., those clusters that are potential candidates for “information carriers”). In most of the ten neurons, the “memory” of the system appears to be at least 36–45 msecs.     

Associative and non-associative changes in unit activity of the rat hippocampus

Two main types of neurons of the dorsal hippocampus were recorded in chronic rats during the classical conditioning of an arousal phenomenon (neocortical EEG desynchrony). The relative importance of the associative and non-associative factors was assessed by a differentiation procedure. In naive rats, during the “acquisition” session most type-I neurons rapidly acquired an “inhibitory” response closely parallel to the EEG response. Neither of these responses showed differentiation. Some type-II neurons acquired an “excitatory” response which was independent of the EEG response and which had a significant tendency to differentiation. These data were confirmed in rats submitted to several “retention” sessions. All the type-I neurons were undifferentiated while 11 out of 41 type-II neurons were differentiated. Type-I neurons were characterized by a bursting mode of discharge. Their activity was higher during slow wave sleep (SWS) than during wakefulness (W) or paradoxical sleep (PS). Most of the differentiated type-II neurons were more active during W and/or PS than during SWS.     

Changing Physician Attitudes Toward the Ketogenic Diet: A "Parent-Centered" Approach to Physician Education about a Medication Alternative

Alternative medical therapies such as the ketogenic diet are often dismissed by the medical community. We used a “parent-centered” approach to make physicians aware of the ketogenic diet, an alternative therapy for difficult-to control seizures in children. Parents became aware of the diet through national TV and film. Written and video information was made available to them and they were encouraged to ask their physicians about the potential usefulness of the ketogenic diet for their child. Between 1994 and 1999 we assessed the success of this approach with three surveys of all U.S. child neurologists. This “parent-centered” approach increased physician knowledge about the diet, but had little effect on its use. Despite evidence of its effectiveness, physicians continued to reserve its use until children had failed most new anticonvulsants. Physicians say they would use it more often if “it worked better” and if they “had a dietitian with more experience.”     

Latent class analysis of the Child Behavior Checklist Obsessive-Compulsive Scale

The Obsessive-Compulsive Scale (OCS) of the Child Behavior Checklist (CBCL) predicts obsessive-compulsive disorder and is highly heritable. Latent class analysis (LCA) of the OCS was used to identify profiles within this 8-item scale and to examine heritability of those profiles. The LCA was performed on maternal CBCL reports of their 6- to 18-year–old children from 2 US nationally representative samples from 1989 (n = 2475, 50% male) and 1999 (n = 2029, 53% male) and from Dutch twins in the Netherlands Twin Registry at ages 7 (n = 10 194, 49.3% male), 10 (n = 6448, 48.1% male), and 12 (n = 3674, 48.6% male) years. The heritability of the resultant classes was estimated using odds ratios of twin membership across classes. A 4-class solution fitted all samples best. The resulting classes were a “No or Few Symptoms” class, a “Worries and Has to Be Perfect” class, a “Thought Problems” class, and an “OCS” class. Within-class odds ratios were higher than across-class odds ratios and were higher for monozygotic than dizygotic twins. We conclude that LCA identifies an OCS class and that class is highly heritable using across-twin comparisons.     

Evaluation of two automated metrics for analyzing partner preference tests

The partner preference test (PPT) is commonly used to examine sexual and social preferences in rodents. The test offers experimental subjects a choice between two stimulus animals, and time spent with each is used to calculate a preference score. In monogamous prairie voles (Microtus ochrogaster), the PPT has been paramount to the study of pair bonding. Although powerful, use of the PPT in voles has depended primarily on human manual scoring. Manual scoring is time-consuming and is susceptible to bias and fatigue, limiting the use of the PPT in high-throughput studies. Here we compared manual scoring (real-time and 16×) and two automated scoring metrics: “social proximity” and “immobile social contact”. We hypothesized that “immobile social contact” would provide data most comparable to manually scored “huddling”, and thus be the most sensitive measure of partner preference in prairie voles. Each automated metric produced data that highly correlated with manual scoring (R > 0.90); however, “immobile social contact” more closely reflected manually scored huddling (R = 0.99; P < 0.001). “Social proximity” and “immobile social contact” were then used to detect group partner preferences in four data sets that varied by cohabitation length and sex. “Immobile social contact” revealed a significant partner preference in each data set; “social proximity” detected partner preferences in only three of the four. Our results demonstrate the utility of automated systems in high-throughput PPTs, and further confirm that automated systems capable of scoring “immobile social contact” yield results indistinguishable from manual scoring.     

Perceived social support and dysfunctioning in “clinical” and “normal” adolescents

The purpose of this study was to examine the extent to which inpatient and non-patient samples of youngsters differ from each other with regard to prevalence and co-occurrence of emotional and behavioural problems and negative perceptions of family, school and peers. The sample comprised 202 12–21-year-old adolescents: 101 psychiatric inpatients and 101 matched “community-based” youngsters. Possible differences between the subgroups were tested by means of multi-variate analysis of variance and relative risk ratios.All specific problems and combination patterns were reported significantly more often by the “inpatient” than by the “non-patient” youngsters. However, after correcting for differences in base rates, only the combination of emotional and/or behavioural problems and family problems remained significant. The combination of emotional and family problems was reported about 12 times more often and the combination of behavioural and family problems even about 21 times more often by adolescents in the “clinical” sample than by those in the “normal” sample.Two important conclusions were drawn: (1) co-occurrence in itself did not appear to be the distinguishing factor between the “clinical” and the “normal” sample; and (2) a dominant role of negatively perceived family support in adolescent functioning was suggested. The implications of these findings are discussed.     

Reaching and grasping movements in infants at risk: A review

Although the influence of intrinsic and extrinsic factors on the development of reaching and grasping skills in typical infants has been extensively described in the literature, the effect of such factors on at-risk infants is still poorly understood. Therefore, the aims of the present study were to analyze the scientific publications, from 1980 to 2008, about factors influencing reaching and grasping movements in infants at risk and to describe methodological procedures used in the studies under review. A bibliographical review on empirical studies indexed on Medline, Lilacs and Science Direct data bases was done, using as keywords the terms: “reaching movements”, “grasping”, “catching”, “prehension”, “infants”, “children”, “risk”, “deficit”, “impairment” and “delay”. 127 articles were identified, and 11 were selected. The following risk conditions were assessed in the papers: prematurity, cerebral palsy, Down syndrome, intrauterine cocaine exposure and agenesis of corpus callosum. Methodological issues as well as the intrinsic and extrinsic factors manipulated in the experiments are discussed in the light of changes in theoretical approach to motor behavior.     

The ovarioleukodystrophy

The “ovarioleukodystrophies” comprise a group of rare leukodystrophies associated with primary or premature ovarian failure. Some of the patients have a variant of “vanishing white matter disease” with mutations in subunits of eukaryotic initiation factor 2B (EIF2B). A 32-year-old woman who developed neurological signs related to an extensive leukoencephalopathy on magnetic resonance imaging (MRI) in the context of amenorrhea since the age of 18 years was found to be homozygous for a mutation in the EIF2B5 gene: c.338G>A/p.Arg113His. She had a progressive disease with development of tetraparesia in less than 6 years. Our observation confirms that ovarian failure in the context of a leukodystrophy warrants mutational analysis of the genes encoding the subunits of EIF2B.     

Effectiveness of Intensive Behavioral Intervention in a large, community-based program

Although the efficacy of Intensive Behavioral Intervention (IBI) for young children with Autism Spectrum Disorders (ASD) has been well documented in small model programs, IBI's effectiveness (i.e., does it work in the “real world”?) has been less studied and may not be as impressive, e.g. Bibby, Eikeseth, Martin, Mudford, and Reeves (2002). This study reports on the outcomes of 332 children, aged 2–7 years, enrolled in a large, community-based, publicly funded IBI Program in Ontario, Canada. File review data at intake and exit were compared on a group basis as well as on an individual basis. Results indicated statistically significant and clinically significant improvements: reduction in autism severity, gains in cognitive and adaptive levels, as well as a doubling of children's rate of development. There was a considerable heterogeneity in outcome, as expected, and children were classified into seven categories of progress/outcome. The majority of children (75%) showed some gains during IBI and 11% achieved average functioning. Although the study has clear methodological limitations (chiefly the lack of a comparison group), it suggests that IBI can be implemented effectively in a large, community-based program.     

Increased intra-individual reaction time variability in attention-deficit/hyperactivity disorder across response inhibition tasks with different cognitive demands

One of the most consistent findings in children with ADHD is increased moment-to-moment variability in reaction time (RT). The source of increased RT variability can be examined using ex-Gaussian analyses that divide variability into normal and exponential components and Fast Fourier transform (FFT) that allow for detailed examination of the frequency of responses in the exponential distribution. Prior studies of ADHD using these methods have produced variable results, potentially related to differences in task demand. The present study sought to examine the profile of RT variability in ADHD using two Go/No-go tasks with differing levels of cognitive demand. A total of 140 children (57 with ADHD and 83 typically developing controls), ages 8–13 years, completed both a “simple” Go/No-go task and a more “complex” Go/No-go task with increased working memory load. Repeated measures ANOVA of ex-Gaussian functions revealed for both tasks children with ADHD demonstrated increased variability in both the normal/Gaussian (significantly elevated sigma) and the exponential (significantly elevated tau) components. In contrast, FFT analysis of the exponential component revealed a significant task × diagnosis interaction, such that infrequent slow responses in ADHD differed depending on task demand (i.e., for the simple task, increased power in the 0.027–0.074 Hz frequency band; for the complex task, decreased power in the 0.074–0.202 Hz band). The ex-Gaussian findings revealing increased variability in both the normal (sigma) and exponential (tau) components for the ADHD group, suggest that both impaired response preparation and infrequent “lapses in attention” contribute to increased variability in ADHD. FFT analyses reveal that the periodicity of intermittent lapses of attention in ADHD varies with task demand. The findings provide further support for intra-individual variability as a candidate intermediate endophenotype of ADHD.     

Premorbid personality aspects in mood and schizophrenic disorders

This study examines premorbid personality traits from a self-reported and family-reported perspective on a group of unipolar major depression (n = 27), bipolar (n = 21), and schizophrenic (n = 16) recovered inpatients, and a control group (n = 21). Using the Munich Personality Test (MP-T Scales) of von Zerssen for self-reporting and family-reporting personality traits, and the Kischkel scale for the measurement of “intolerance of ambiguity,” we found more “rigidity,” less “esoteric tendencies,” and more “intolerance of ambiguity” patng unipolar depressive patients. Schizophrenic patients showed more esoteric tendencies and less “extraversion.” Results confirm the hypothesis supported by many authors regarding a particular personality structure in unipolar major depression characterized by ridigity and ambiguity intolerance. This personality pattern for unipolar depressives seems to be different from the depressive personality disorder proposed by DSM-IV. Schizophrenic individuals differ by means of their self- and family-reported extraversion. Clinical and theoretical implications of these findings are discussed.     

Validation of the Hypomania Checklist (HCL-32) in a nonclinical sample of German adolescents

We tested the psychometric properties of the Hypomania Checklist (HCL-32) in a sample of nonclinical adolescents, examined the association with current psychopathology, and tested if “hypomanic” adolescents differ from other participants regarding HCL-scores and psychopathology. A total of 294 students completed the HCL-32 and the SDQ, a screening for psychopathology. In adolescence, the internal structure of hypomania seems to be represented by a triple structure. The first factor “active-elated” is an indicator of symptoms related to energy and activity. The adult factor “irritable-risk taking” is better reflected by two separate factors (“disinhibited/stimulation-seeking” and “irritable-erratic”). These factors were associated with externalizing problems. “Hypomanic” adolescents showed higher HCL total and disinhibited/stimulation-seeking scores and reported more conduct problems than “non-hypomanic” youngsters. The internal structure of the HCL in adolescents mirrors the association of juvenile bipolarity with substance use and symptoms of ADHD and conduct disorder and presents preliminary evidence for its validity.