playing music to relieve stress in a college classroom environment

PLAYING MUSIC TO RELIEVE STRESS IN A COLLEGE CLASSROOM ENVIRONMENT

E ileen FerrerSchool o f Kinesiology and Nutrition Science, California State University

P olong LewLos Angeles Chinatown Senior Citizen Center

Sarah M. J ungSchool o f Kinesiology and Nutrition Science, California State University

Emilia JanekeSchool o f Kinesiology and Nutrition Science, California State University

M ichelle GarciaSchool o f Kinesiology and Nutrition Science, California State University

C indy PengSchool o f Kinesiology and Nutrition Science, California State University

George P oonLos Angeles Chinatown Senior Citizen Center

VlNISHA RATHODSharon B eckwith

Chick F. TamSchool o f Kinesiology and Nutrition Science, California State University

Music therapy can be an effective treatment that prevents stress from contributing to the etiology of disease. For this study, the participants, college students enrolled in an annual Alternative Nutrition class at California State University, Los Angeles, were instructed to select a song to present during class. After listening to each song selection, participants provided written feedback based on a 9-question survey. Self-perceived stress was measured using a Likert scale from 1 to 10, with 10 being the highest level of stress. Microsoft Excel 2007 Data Analysis, was used to calculate t-Test: Paired Two Sample for Meansat a 5% significance level (a

482 / College Student Journal

Introduction

Time spent in college can be a priceless experience, but it can also be a stressful one. In recent years, the academic circle has noted stress to be an important topic of interest, due to the many stresses of daily life (Agolla & Ongori, 2009). There are a variety of reasons students experience stress, which may include: being away from home for the first time; trying to balance the demands of classes, work, extracurricular activities, and a social life; the pressure to perform well academically. Even though some of these may be perceived as positive changes, any departure from a familiar routine can bring about some degree of stress (Richlin-Klon- sky & Hoe, 2003).

Some students may not know how to effectively cope with the demands of college life. As a result, having severe and/or prolonged stress may lead to reduced academic performance. This type of stress can potentially hinder a students level of contribution and participation in campus life, and increases the likelihood of substance abuse and other destructive behaviors (Ross, Neibling & Hecker, 1999). Coping with unhealthy stress begins with recognizing the signs of building stress levels and the stressors that cause them. While stress can be caused by external events, the events themselves may not necessarily be stressful. In fact, it is the way in which an individual interprets and reacts to a stressor that is responsible for producing stress (Bu- sari, 2012). Consequently, although various methods exist to help college students cope with stress, the appropriate method must be selected for the individual.

According to Romano (1992), the interactions between an individuals perception and reaction to stressors are what result in stress. While many may be unaware of the danger of stress, the American Institute of Stress (2012) claimed stress to be the number one health problem for Americans.

While stress itself can be debilitating, its main effect on public health involves increasing risk for diseases such as cancer, diabetes mellitus, and cardiovascular disease. Stress can also lead to depression and its related conditions. Moreover, overall health and wellness is a matter of concern among populations with elevated levels of stress. College students, subject to pressure from many areas, fit into this category.

Music TherapyInterventions for HealthMusic therapy (MT) is defined by the

American Music Therapy Association (2011) as the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. According to the American Music Therapy Association (2011), music therapy is a well-established health program and it is used therapeutically to address an individuals physical, emotional, cognitive, and social needs. Furthermore, a study by Lu and colleagues (2010) defined MT as a form of psychotherapy that is safe, enjoyable, and inexpensive.

The goal and purpose of this study was to examine the role of music as a potentially stress-alleviating therapy among college students. The correlation between music therapy and stress was examined, and research was conducted to investigate the effectiveness of stress reduction via music within an academic population in classroom settings.

Statement of the Problem

What is Stress and how does it function?Emerging scientific evidence suggests that

psychosocial factorswhich are the interrelation of social factors, individual thought, and behavior from emotional states, behavior dispositions, and psychosocial stresscan

Seth ZamoraHighlight


Playing Music to Relieve Stress in a College Classroom Environment / 483

directly influence both physiologic function and health outcomes (Rozanski, Blumen- thal, & Kaplan, 1999; Kiecolt-Glaser, 1999; Baum & Posluszny, 1999). Additionally, if adequate coping skills are lacking, a somatic or psychological dysfunction may be expressed in the form of chronic pain and illness, gastrointestinal distress (GI), sleep disturbances, fatigue, high blood pressure, headaches, or stress emotions, such as anger, anxiety and panic, fright, guilt, shame, sadness, and depression (Yehuda, 2011).

Stress has also been known to affect the immune system through an intricate route of neural and hormonal pathways (Besedovsky & DelRey 1991; Maier & Watkins, 1998). Furthermore, behavior can be affected by stress, manifested by acting impulsively, making poor exercise and nutritional choices, excessive use or abuse of alcohol and/or drugs, and withdrawal from relationships or social situations (MedicineNet, Inc., 2011). Therefore, it can be strongly argued that stress contributes to the etiology of disease.

The main organ responsible for the stress response is the brain, which determines what constitutes as stressful, along with determining the behavioral and physiological responses to specific stressors (McEwen, 2008). McEwen and Stellar (1993) also stated that the brain is the main target of stress and it is structurally and chemically changed by acute and chronic stress.

The chief hormones involved in the stress response are glucocorticoids and catecholamines. Glucocorticoids are steroid hormones produced in the adrenal cortex in response to adrenocorticotropic hormone (ACTH) from the pituitary gland (McEwen, 2008). A specific glucocorticoid, cortisol, is the main stress hormone that becomes elevated during stress. Cortisol manages stressful situations by preparing the body and the fight-or-flight response (Yehuda, 2011). Catecholamines are hormones produced

by the adrenal glands, which are released into the blood during times of stress. The key catecholamines are dopamine, norepinephrine, and epinephrine. These hormones increase during the fight-or-flight response as the body requires stored energy, glucose and fat to be immediately available to cells.

Additionally, the immunological system that responds to stress releases stress markers that provide the body with the energy it needs to escape from the real or perceived danger (Yehuda, 2011; American Diabetes Association on Stress, 2011). Understanding the mechanism of stress provides a backdrop for the effectiveness of mind-body therapies (MBT) as a treatment for stress reduction.

Techniques and Therapies for Stress Management

There are various helpful techniques and therapies for individuals who require stress management. Music is known to be an effective therapeutic treatment. Music therapy is a treatment most commonly applied during a form of complementary and alternative medicine (CAM), a practice that involves using the mind to improve health. As defined by the National Center for Complementary and Alternative Medicine (NCCAM) (2008), mind and body practices focus on interactions among the brain, mind, body, and behavior, with the intent to use the mind to affect physical functioning and promote health (para. 9). Lu and colleagues (2010) stated that stress in early life can affect the biochemistry of the immune system. Therefore, health can be directly influenced by emotional, mental, social, spiritual, experiential, and behavioral factors with the use of a wide range of healing practices known as mind-body therapies (MBT) to support immune functions as shown in Figure 1.


Figure 1. An interrelationship among genetic self, immunity, and environment (epigenetic factors)

Research has proven that music therapy can produce ameliorative effects upon immune systems that have been negatively affected by stress. Lu and colleagues (2010) found that stress increased serum corticosterone and interleukin-4 levels in rats. With exposure to music, the stress-induced elevations in these immune system biomarkers became normalized, proving that music therapy can produce a clinical effect (Lu et al., 2010). Decreased levels of immune system reactants are associated with decreased stress and increased relaxation.

It is an unfortunate fact that while relaxation is critical for stress relief; many individuals do not spend an adequate amount of time relaxing. This is common among college students, who are constantly on-the-go or dealing with stressors involving academic concerns. Academic stress has been defined as the product of a combination of academic related demands that exceed the adaptive

resources available to an individual (Wilks, 2008). The amount of stress a student may experience is something that should not be taken for granted, which may result in adverse effects to a students overall adjustment (Hussain, Kumar & Husain, 2008).

Purpose of the Project

The purpose of this study is therefore to investigate the effectiveness of music therapy, and demonstrate how different forms of music influence stress levels before and after a musical selection in a college classroom environment. Specifically, this study aims to investigate how music can affect stress by observing changes in levels of stress among students before and after listening to a music selection. It is hypothesized that music self-selected by the participant will reduce stress levels. The experimental design was a qualitative descriptive study.


Materials and Methods

Design of the Project

Participants

Participants consisted of college students attending California State University, Los Angeles, enrolled in an annual Alternative Nutrition class designed to study mind and body medicine, as well as stress management using music therapy and nutritional supplementation. This nutritional science course requires a general nutrition class as an academic prerequisite to qualify as a participant, and to be a student enrolled in an Alternative Nutrition class from the years 2008 to 2012. Participants were separated by cohort for the respective year they were enrolled into this class. All student participants remained anonymous and strictly confidential.

Procedures

As a required project of this class, participants were to select any song, and present it to their cohort during the class period (3 hours, 50 minutes). All participants were informed of the procedures by the Instructor, and were provided a handout on the procedures of the project. Songs varied in genre, from classical, pop, altemative/rock, to cul- tural/ethnic music and more.

Participants were asked to listen to each song, and provide written feedback at the end. Feedback was provided with the use of a measurement tool, a 9-question survey, provided by the Instructor. The Music Therapy Survey Form was created and provided by the Instructor. A sample of the survey form is presented in Figure 2.

Figure 2. Music therapy survey form

MUSIC THERAPY SURVEY FORM1. AGE__________YRS

2. GENDER__________

3. WEIGHT__________LBS HEIGHT__________ FT/INS

4. MAJOR____________________

5. SUBJECTIVELY, WHAT IS YOUR CURRENT STRESS LEVEL (WITH 10 BEING THE HIGHEST LEVEL)?CIRCLE ONE: 1 2 3 4 5 6 7 8 9 10

6. DID YOU LIKE THE MUSIC?CIRCLE ONE: VERY MUCH [1] GOOD [2] SOMEWHAT [3] DISLIKE [4]

7. DID YOU FIND ANY MEANING IN THE SONG?CIRCLE ONE: HAS MEANING [1] NO MEANING [2] DONT KNOW [3]

8. DO YOU FEEL HAPPIER AFTER LISTENING TO THE SONG?CIRCLE ONE: YES [1] NO [2] DONT KNOW [3]

9. SUBJECTIVELY, WHAT IS YOUR STRESS LEVEL AFTER THE SONG (WITH 10 BEING THE HIGHEST LEVEL)?CIRCLEONE:! 2 3 4 5 6 7 8 9 1 0




Questions ranged from demographics to the feelings participants had about individual songs. Self-perceived stress was measured using a Likert scale, from 1 to 10, with 10 being the highest level of stress. The two main questions utilized for this experiment were question 5, and question 9, which asked to subjectively choose current stress level before and after listening to each song. It is important to mention, participant data was omitted if a survey was not completed, in which either question 5 or question 9 were not answered or there was no information on means. Next, participants collected completed surveys after presenting their song, and were required to compute question 5 and question 9 for the mean value. To examine individual cohorts, the pre-calculated means for questions 5 and question 9 provided by each participant was collected, and computed to determine the overall mean value. A summary of each cohort is shown in Table 1.

These procedures were also repeated using songs provided by the Instructor. Four songs, chosen by the instructor were: Musical Selection 1 (contemporary Latin jazz); Musical Selection 2 (1970s soul); Musical Selection 3 (1990s pop rock); Musical Selection 4 (1950s pop).Data was collected from partcipants during the years of 2008 to 2012.

Data Analysis

Microsoft Excel 2007 Data Analysis, was used to calculate t-Test: Paired Two Sample for Means at a 5% significance level (a


standard deviation of 0.61 after various songs being played for 2011. The final year 2012, had a mean of 5.22 and a standard deviation of 0.30 before, and after the mean is 3.94 with a standard deviation of 0.41. Overall, for each cohort, the p-values of most results were highly significant (0.0000 being highly significant), which confirmed a decrease in stress for all songs played during an entire class period.

The results from the second part of the experiment, (Table 2 to Table 5), utilized songs

Table 2. Summary for Musical Selection 1

chosen by the Instructor, also demonstrated an overall reduction in stress with the four different songs in all five cohorts. However, there was only one song, Musical Selection 1 for the year 2010 cohort that had no significance in stress reduction. The p-value was 0.27, which is greater than a = 0.05; not statistically significant. However, the decrease of the mean value from 4.27 to a mean of 4 after the song was played indicates there was a small decrease in stress levels.

2008 2009 2010 2011 2012

(n = 48) (n = 36) (n = 45) ( = 61) (" = 54)

Before After Before After Before After Before After Before AfterMean 5.08 4.21 6.06 4.86 4.27 4.00 6.62 5.23 5.59 4.50

Variance 5.18 4.08 4.34 5.44 3.75 3.77 3.64 4.48 3.60 3.46

Correlation 0.71 - 0.69 - 0.67 - 0.69 - 0.74 -

df 47 - 35 - 44 - 60 - 53 -

P(T


Table 4. Summary for Musical Selection 32008 2009 2010 2011 2012

(n = 47) (n = 54) (n == 46) ( = 57) ( = 55)

Before After Before After Before After Before After Before After

Mean 5.47 4.62 6.20 5.06 4.61 4.07 6.0 4.36 5.91 4.69

Variance 4.43 5.89 5.34 4.85 3.84 5.80 3.50 5.41 3.79 3.48

Correlation 0.58 0.75 - 0.76 - 0.55 - 0.75 -

df 46 53 - 45 - 56 - 54 -

P(T


Hochrein, 1994). Thus, music is an easily accessible and efficient therapy to utilize for college students that is also cost-effective. Listening to music does not require a licensed musical therapist, and can be done at the time and location that is convenient to the individual. The only requirement is equipment for playing music, which is already accessible to many students.

In some study participants, listening to music did not produce any effect. Among individual responses, there were some songs that appeared to have caused participant stress levels to increase or have no effect at all. But as the results show, for the overall study population, self-perceived stress levels were reduced in multiple categories from the pre-selected songs to the songs chosen by the instructor. One possible explanation for this reduction in stress levels is that music therapy utilizes the power of the mind to express emotions, potentially influencing all aspects of health and well-being. As it shows in the results, listening to personally selected music had the most impact on stress levels following each song, ft could be that hearing the various types of music provided an emotional response.

There were a few limitations for this music therapy intervention. Because this was a self-administered experiment, the length of the experimental period for listening to all individual songs was limited to only a couple of class meeting days. Due to time constraints, each participant had to introduce and play their songs consecutively with minimal breaks in between, which could have prohibited full focus on each musical selection. Limiting the amount of songs to be played per day to approximately ten or less could provide additional time to respond to each participants choice of music before reflecting on ones own self-perceived levels of stress; fewer songs played per day may also allow for additional time to prepare for the next

song to be played. Conducting a longer study on a single population during the entire length of the academic quarter would demonstrate musics effectiveness over a period of time, and possibly provide a more truthful perception of stress level from participants.

In addition, the effect of music genre was not specifically explored in depth for this intervention. It was mentioned briefly that music genre did not have much influence; however, most studies have demonstrated that soothing, pleasant music, such as classical, has shown to reduce stress levels the most. Further study assessing music genre would provide insight as to which genre is most effective against stress and anxiety or to prove if genre selection makes any difference at all within the same study population. These limiting factors present an opportunity for future studies to be conducted.

Overall, listening to music is a functional, inexpensive, and effortless intervention to utilize in various stressful situations. As this intervention has evidently proven to be successful amongst college students, research has sufficiently established the efficacy and benefit of music for diverse populations in varying age groups. As more people and healthcare professionals become aware and accepting of mind-body therapies and other CAM treatments, music can be widely utilized as a complement to all areas of conventional healthcare.

The Body s Response to Music

The use of music therapy has been closely associated with alleviating stress, anxiety, pain, and a myriad of other physical and/or mental health diseases or disorders. Relieving such health issues is attributable to how the inherent patterns and structures of music in its entirety convey meaning to the brain (Miell, MacDonald, & Hargreaves, 2005). Building upon the basic understanding that the left brain is the thinking side and the right brain is


the feeling side, the left part of the brain was found to be more stimulated during cognitive analysis of music or during sad or unharmoni- ous sounds, such as single predicable chords, whereas the right part of the brain is stimulated more with happy and pleasurable sounds (Salimpoor, 2013).

The region of the brain involved with conveying meaning and emotions is the limbic system. It is located deep within the cerebrum, near the auditory cortex where music and sound are processed, and is composed of several brain structures, which include the amygdala, hippocampus, and hypothalamus (Office of Population Affairs, 2012; Lemonick & Bjerklie, 2003). In addition, the limbic system processes the intuitive, creative, and imaginative information that induces the bodys psychophysiological responses (Guzzetta, 1989).

Thaut (1990) stated that feelings of reward, pleasure, punishment, and pain also occur in the limbic system. Therefore, listening to music becomes an instant reward, releasing enkephalins and endorphins to change moods, evoke relaxation, and alter pain perception. Understanding the role of the limbic system provides insight as to how relaxation comes about, and where emotions are processed when listening to music. Furthermore, when the mesolimbic system (amygdala, hippocampus) recalls a memory triggered by the sound stimulus, the message is eventually delivered to the forebrain, which then sends neurochemicals throughout the entire body to produce tension or relaxation (Brattico & Pearce, 2010).

According to Bunt (1994), there are three essential elements to music that create its patterns and structures: rhythm, melody, and harmony. Each of these elements is important in producing different responses in the body; both the physiological and psychological responses of a listener can be affected (Chian & Tracy, 1999). Furthermore, music is unique in

that it can act as a powerful sensory stimulus, engaging the brain in retraining neural and behavioral functions that can be applied to non-musical context in everyday life, such as therapeutic needs (Yehuda, 2011). Emotional states are developed through music that allows an individual to achieve relaxation.

Music Therapy and Relaxation Response

Music therapy produces a relaxation response, in which Maranto (1993) states music promotes relaxation by physiological and/or psychological entrainment. Entrainment, a principle of physics, occurs where two objects vibrate at similar frequencies causing a mutual sympathetic resonance that vibrate at same frequencies. This concept of entrainment is realized with the direct use of music to generate relaxation (Maranto, 1993). Changes to the bodys physiologic processes due to entrainment, are the result of specific musical stimuli, such as rhythms and tempos that act as synchronizers to cause the change (Saper- ston, 1995). Such responses include release of endorphins, and changes in catecholamine levels, facilitating pain relief as well as lowering blood pressure, heart and respiratory rate, oxygen consumption, and serum lactic acid levels (Guzzetta, 1989; Gardner, 1990; Mc- Cafifery & Beebe, 1994; Pert &Chopra, 1999).

Rhythm is an essential element to music because rhythm is the order in which music moves; it is the most dynamic part (Bunt, 1994). When utilizing music for relaxation under the entrainment principle, the tempos from the music should not exceed a resting heart rate (


the body to slow down and go along with the musics slower beats, producing a relaxation response regardless of genre and duration (Chian, 2009; Lee et al., 2012).

Evidence o f a Positive Effect between Choosing a Musical Selection and a Reduction o f the Perception o f Stress and Anxiety

A 2002 study was performed by physicians Wang, Kulkami, Dolev, and Kain to test music as a method for reducing anxiety in pre-operative patients. The research results indicated a positive effect between music of choice and the reduction of the feeling of stress and anxiety. The pre-operative patients could listen to music of their choice for a time span of 30 minutes. Patients were evaluated at three different times including before, during and after treatment. Blood samples were taken to measure levels of cortisol and catecholamines as bioindicators of stress. Despite the fact that no differences were reported in the hormones released during stress, including epinephrine, norepinephrine and cortisol, patients required decreased levels of propofol to be sedated before the operation. There were no positive effects exhibited between music and stress in all pre-operative patients.

Importance o f Music Preference

Music preference also produces a significant effect on its relationship with stress. Various studies have shown the extra benefit of self-selected music by individuals. A study conducted by Lai and Li (2011), examined the association between music and stress while paying close attention to music preferences. Newly employed nurses were able to choose a song from the six pre-selected songs by the study team (Lai & Li, 2011). Participants showed lower perceived stress levels, as well as lower cortisol, heart rate, mean arterial pressure, and higher finger temperatures when listening to music (< 30 minutes), especially with a song selected by

the participants themselves (Lai & Li, 2011). Lowered stress levels were also exhibited among patients undergoing day surgery, especially when patients were able to select music of their choice (Leardi et al., 2007). Therefore, the therapeutic power of music, as evidenced by these clinical trials, may provide an outlet for stress and anxiety relief among populations subject to high amounts of stress, for instance, college students.

Beyond Treatment for Anxiety: Singing as Form o f Music Therapy

Previous studies of music therapeutic caregiving involving singing have found that persons with dementia may sing along with the caregiver, interfering with eating. In a 2012 study by Hammar, Williams, Swall, and Engstrom, the caregiver was instructed to use humming as opposed to singing in order to observe its influence upon mealtime situations. The elderly female subject with dementia appeared to eat and drink more during the intervention sessions. She also appeared more focused on the food and the caregiver, and in general appeared to be more alert during the interventions. Furthermore, in the palliative and/or hospice setting, MT has the ability to improve quality of life for dying patients (Halstead & Roscoe, 2002; Hilliard, 2003).

Beyond Treatment for Anxiety: Music and Plant Physiology

The physical effects produced by music can be observed in plants as well as in humans. A 2004 study by Creath and Schwartz used seed germination as an objective biomarker, to find that musical sound produced a highly statistically significant effect on the number of seeds sprouted compared to the untreated control over all five experiments. Seeds exposed to musical sound sprouted significantly faster than the untreated control. Musical sound had a significant effect compared to noise and an untreated control as a function of


time (/K0.03) while there was no significant difference between seeds exposed to noise and an untreated control. Musical sound is defined as being dynamically organized to contain variations, as opposed to noise, which is constant. The noise used in this study had a fixed frequency band that was invariant over long time periods.

Sonic Bloom, a new type of plant fertilizer incorporating music, consists of a sound generator CD and a nutrient spray combining 55 trace minerals, amino acids, and seaweed. The sound generator produces tones in the four to six kilohertz range, the same range as many song birds. Photomicrographs of plant leaf surfaces taken using a scanning electron microscope show that the stomata of plants treated with Sonic Bloom are more numerous, more developed, and better defined than the stomata of untreated plants. Radioactive isotopes were utilized to record an increase in nutrient absorption exceeding 700%. This increase in plant nutrient absorption is relevant to human health, as it produces healthier plants and fruit with higher concentrations of complex sugar chains, which may act as communicators for the bodys defense systems (Oliver, 2002).

Future Study

To further investigate the relationship between music and stress, a possible future study might investigate how distinct categories of stress levels reported by college students prior to listening to music can be affected by specific musical selections.


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