This study plans to combine questionnaires, scales, electrophysiological and neuroimaging methods to comprehensively evaluate the effectiveness of music therapy for children and adolescents with emotional disorders and NSSI, and explore the potential neural mechanisms of its effectiveness.
The subjects will be randomly divided into the conventional treatment group (TAU) and the music therapy group (MT). The conventional treatment group will receive DBT group therapy 5 times a week, 1 hour each time, and individual personalized therapy twice a week; the music therapy group will receive individual music therapy twice a week, 30 minutes each time, for a total of 3 weeks on top of conventional treatment. During each intervention, near-infrared brain functional imaging, electrodermal and electrocardiographic equipment will be used to synchronously collect multimodal data from therapists and patients. The heart rate variability, electrodermal conductance response of therapists and patients, and the relative concentrations of oxygenated hemoglobin (oxy-Hb), deoxyhemoglobin (deoxy-Hb) and total hemoglobin in the brain tissue of the subjects and therapists were monitored during the treatment process.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
54
Each music therapy session will include 5 stages. In stage 1, an emotional assessment is conducted to observe the patient's current emotional experience and feelings (provide a VAD score), which lasts about 1 minute. In stage 2, relaxation exercises (breathing relaxation, progressive muscle relaxation, and imaginary relaxation) are conducted under the guidance of the therapist to the music corresponding to the relaxation target VAD, which lasts about 8 minutes. In stage 3, the patient independently selects the music and discusses it with the therapist, which lasts about 10 minutes. In stage 4, the patient listens to resource and positive-oriented music and discusses specific topics with the therapist, which lasts about 10 minutes. Finally, in stage 5, the therapist again conducts an emotional assessment of the patient and observes the patient's current emotional experience and feelings, which lasts about 1 minute.
The conventional treatment group received DBT group therapy 5 times a week, each session lasting 1 hour, and also received individual personalized therapy twice a week.
Shanghai Mental Health Center
Shanghai, Shanghai Municipality, China
RECRUITINGpsychological scale measurement：Screen for Child Anxiety Related Emotional Disorders (SCARED)
Before and after the entire music intervention course, Screen for Child Anxiety Related Emotional Disorders (SCARED) scale is administered to the subjects as baseline and final data. The minimum value is 0. The maximum value is 82. Higher scores means a worse result(the more anxious the person is). A total score of ≥ 25 may indicate the presence of an Anxiety Disorder. Scores higher than 30 are more specific.
Time frame: before and after three weeks of music intervention
psychological scale measurement：Beck Depression Inventory-II (BDI-II)
Before and after the entire music intervention course, Beck Depression Inventory-II (BDI-II) scale is administered to the subjects as baseline and final data. This scale is used to assess the severity of depressive symptoms in the past two weeks, and contains 21 items, each item is scored on a level of 0\~3, and the total score of the scale is the sum of the scores of 21 items. According to the cut-off score provided by the original scale such as Beck, the total score of 0\~13 is no depression, 14\~19 is mild depression, 20\~28 is moderate depression, and 29\~63 is severe depression. The minimum value is 0. The maximum value is 63. Higher scores means a worse result.
Time frame: before and after three weeks of music intervention
psychological scale measurement：Beck Scale for Suicide Ideation (BSS)
Before and after the entire music intervention courseBeck Scale for Suicide Ideation (BSS) scale is administered to the subjects as baseline and final data. There are 3 options for the scale answers, and the corresponding scores from left to right are 1, 2, and 3, with the higher the score, the stronger the desire to die. All visitors complete the first 5 questions first, and if the answer to the 4th and 5th items is "no", then they are considered to have no suicidal ideation and complete this questionnaire; If any one of the 4th or 5th items is "weak" or "moderate to strong", then it is considered suicidal ideation and you need to continue to complete the next 14 items. The higher the score, the greater the intensity of suicidal ideation. Higher scores means a worse result.
Time frame: before and after three weeks of music intervention
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psychological scale measurement：Children's Depression Inventory (CDI)
Before and after the entire music intervention course, Children's Depression Inventory (CDI) scale is administered to the subjects as baseline and final data. The minimum value is 0. The maximum value is 54. Higher scores means a worse result.
Time frame: before and after three weeks of music intervention
psychological scale measurement：Fear of Negative Evaluation Scale (FNE)
Before and after the entire music intervention course, Fear of Negative Evaluation Scale (FNE) scale is administered to the subjects as baseline and final data. The scale is scored from 12 to 60. The opposite of a high FNE is the absence of concern about the evaluation of others, as opposed to the expectation or need for a positive evaluation.
Time frame: before and after three weeks of music intervention
psychological scale measurement：Emotion Regulation Questionnaire (ERQ)
Before and after the entire music intervention course, Emotion Regulation Questionnaire (ERQ) scale is administered to the subjects as baseline and final data. The Emotion Regulation Questionnaire is designed to assess individual differences in the habitual use of two emotion regulation strategies: cognitive reappraisal and expressive suppression. There are 2 parts of the score, the higher of each score means the more the person use this strategy.
Time frame: before and after three weeks of music intervention
psychological scale measurement：Alexian Brothers Urge to Self-Injure Scale (ABUSI)
Before and after the entire music intervention course, Alexian Brothers Urge to Self-Injure Scale (ABUSI) scale is administered to the subjects as baseline and final data. The Alexian Brothers Urge to Self-Injure Scale (ABUSI) assesses the motivation of an individual to engage in self-injury. The minimum value is 0. The maximum value is 35. Higher scores means a worse result.
Time frame: before and after three weeks of music intervention
psychological scale measurement：Difficulties in Emotion Regulation Scale (DERS)
Before and after the entire music intervention course, Difficulties in Emotion Regulation Scale (DERS) scale is administered to the subjects as baseline and final data. The DERS is a brief, 36-item self-report questionnaire designed to assess multiple aspects of emotional dysregulation. The measure yields a total scorev(SUM) as well as scores on six sub-scales: 1. Non-acceptance of emotional responses (NONACCEPT); 2. Difficulties engaging in goal directed behaviour (GOALS ); 3. Impulse control difficulties (IMPULSE); 4. Lack of emotional awareness (AWARE); 5. Limited access to emotion regulation strategies (STRATEGIES); 6. Lack of emotional clarity (CLARITY). Higher scores suggest greater problems with emotion regulation.
Time frame: before and after three weeks of music intervention
psychological scale measurement：Center for Epidemiologic Studies Depression Scale (CES-D)
Before and after the entire music intervention course, Center for Epidemiologic Studies Depression Scale (CES-D) scale is administered to the subjects as baseline and final data. The minimum value is 0. The maximum value is 20. Higher scores means a worse result. The total score of ≤15 points is no depressive symptoms, 16\~19 points are possible depressive symptoms, and ≥ 20 points are definitely depressive symptoms.
Time frame: before and after three weeks of music intervention
DBT-Ways of Coping Checklist (DBT-WCCL)
The Dialectical Behavior Therapy Ways of Coping Checklist (DBT-WCCL) was designed to assess participants' use of DBT skills (e.g., acceptance, cognitive reappraisal, problem-solving) and maladaptive coping responses (e.g., avoidance, denial, self-blame). This is a 59-item self-report scale where participants rate their use of the scale with a four-point scale, resulting in two subscales: a DBT Skills Subscale (DSS) and a Dysfunctional Coping Subscale (DCS). The scoring is the average of relevant items for each subscale. The score for the skills use scale is the average of these items: 1, 2, 4, 6, 9, 10, 11, 13, 16, 18, 19, 21, 22, 23, 26, 27, 29, 31, 33, 34, 35,36, 38, 39, 40, 42, 43, 44, 47,49, 50, 51, 53, 54, 56, 57, 58,59 The dysfunctional coping scale 1 (general dysfunctional coping factor) has these items: 3,5, 8, 12, 14,17, 20, 25, 32, 37, 41, 45, 46,52, 55 and the dysfunctional coping scale 2 (blaming others factor) has these items: 7,15, 24, 28, 30,48
Time frame: before and after three weeks of music intervention