Verification of Effect of Music and Animal Therapy on

Psychiatric Care by using a Nonlinear Analysis of

Pulse Waves

Junji Kojima

and Mayumi Oyama-Higa

Rakuwakai Kyoto Music Therapy Research Laboratory, Rakuwakai Otowa Hospital

2, Otowachinji-cho, Yamashina-ku, Kyoto, 607-8062, Japan

Department of Integrated Psychological Science, Kwansei Gakuin University

1-1-155,Uegahara, Nishinomiya, Hyogo, 662-8501, Japan

Abstract. This study examines the psychiatric effectiveness of music therapy

and animal therapy. Unlike previous research into these modalities, the present

study relies on scientifically valid measurements of actual somatic reaction ra-

ther than on subjective reports. Earlier work by the current authors defined

fluctuation in plethysmogram readings in terms of a Lyapunov exponent de-

rived from activity in the sympathetic nervous system related to the preserva-

tion of mental health. Drawing on the previous findings, this study measured

changes in the Lyapunov exponent as a function of therapy. Results demon-

strated that the Lyapunov exponent reflected the therapeutic effect of these

treatments. Specifically, an increase in the lyapunov exponent indicated nerve

activation within the sympathetic nervous system. On this basis, the authors

recommend that traditional formulation regarding a “healing effect” (i.e., thera-

peutic benefit) be reconsidered.

1 Introduction

This study examines the psychiatric effectiveness of music therapy and animal ther-

apy. Unlike previous research into these modalities, the present study relies on scien-

tifically valid measurements of actual somatic reaction rather than on subjective re-

ports. Earlier work by the current authors defined fluctuation in plethysmogram read-

ings in terms of a Lyapunov exponent derived from activity in the sympathetic nerv-

ous system related to the preservation of mental health. Drawing on the previous

findings, this study measured changes in the Lyapunov exponent as a function of

therapy. Results demonstrated that the Lyapunov exponent reflected the therapeutic

effect of these treatments. Specifically, an increase in the lyapunov exponent indi-

cated nerve activation within the sympathetic nervous system. On this basis, the au-

thors recommend that traditional formulation regarding a “healing effect” (i.e., thera-

peutic benefit) be reconsidered.

Kojima J. and Oyama-Higa M. (2008).

Veriﬁcation of Effect of Music and Animal Therapy on Psychiatric Care by using a Nonlinear Analysis of Pulse Waves.

In Proceedings of the 2nd International Workshop on e-Health Services and Technologies, pages 15-24

DOI: 10.5220/0001881000150024

 SciTePress

2 What is Therapy?

Music therapy is a type of therapy that uses music for the purpose of psychiatric

treatment. It is very different from simple recreation. Indeed, it begins with an as-

sessment process that includes goal-setting, treatment program design, an initial ses-

sion, a documented evaluation, and a treatment conference [3], [4].

Potential participants include psychiatric patients, children, senior citizens, and those

with terminal illnesses. Target diagnoses include physical handicaps, autism, devel-

opmental disabilities, symptoms of ageing, and responses to imminent death. Group

music therapy may also be indicated.

There are two subtypes of music therapy: passive music therapy, and active music

therapy. Passive music therapy involves having patients listen to, sing with, and per-

form body movements in response to music that has been selected by the therapist on

the basis of individual needs and goals. Active music therapy entails the application

of treatment techniques to the aforementioned situation; these techniques are em-

ployed for the purpose of achieving mental health goals.

Brain activation accompanies the behaviors involved in active music therapy. In addi-

tion, the deep breathing that enables singing has a positive effect on the respiratory

state of singers. Moreover, the experience of rhythm in music helps to stabilize the

behavioral rhythms of daily living. Adequate sleep, tasty food, good defluxion, and

balanced bodily cycles promote health.

Brain activation accompanies the behaviors involved in active music therapy. In addi-

tion, the deep breathing that enables singing has a positive effect on the respiratory

state of singers. Moreover, the experience of rhythm in music helps to stabilize the

behavioral rhythms of daily living. Adequate sleep, tasty food, good defluxion, and

balanced bodily cycles promote health.

Yet, claims regarding the efficacy of music therapy must be qualified until studies

using methods that meet the standards of evidence-based-medicine (EBM) demon-

strate such efficacy. It is not enough to recommend music therapy on the basis of

qualitative research alone. The availability of research that validates the efficacy of

music therapy using methodologies accepted by EBM will be of great importance to

individuals who are involved in this treatment and who may benefit from this modal-

ity in the future [5].

Therapy (i.e., psychotherapy) is a treatment method that is employed to achieve a

healing/curative goal for individuals suffering from psychiatric

conditions. It should

be possible to determine the effect of a treatment by the degree to which the goal is

achieved.

2.1 Music Therapy

Music therapy is a type of therapy that uses music for the purpose of psychiatric

treatment. It is very different from simple recreation. Indeed, it begins with an as-

sessment process that includes goal-setting, treatment program design, an initial ses-

sion, a documented evaluation, and a treatment conference [3], [4].

Potential participants include psychiatric patients, children, senior citizens, and those

with terminal illnesses. Target diagnoses include physical handicaps, autism, devel-

opmental disabilities, symptoms of ageing, and responses to imminent death. Group

music therapy may also be indicated.

There are two subtypes of music therapy: passive music therapy, and active music

therapy. Passive music therapy involves having patients listen to, sing with, and per-

form body movements in response to music that has been selected by the therapist on

the basis of individual needs and goals. Active music therapy entails the application

of treatment techniques to the aforementioned situation; these techniques are em-

ployed for the purpose of achieving mental health goals.

Brain activation accompanies the behaviors involved in active music therapy. In addi-

tion, the deep breathing that enables singing has a positive effect on the respiratory

state of singers. Moreover, the experience of rhythm in music helps to stabilize the

behavioral rhythms of daily living. Adequate sleep, tasty food, good defluxion, and

balanced bodily cycles promote health.

Brain activation accompanies the behaviors involved in active music therapy. In addi-

tion, the deep breathing that enables singing has a positive effect on the respiratory

state of singers. Moreover, the experience of rhythm in music helps to stabilize the

behavioral rhythms of daily living. Adequate sleep, tasty food, good defluxion, and

balanced bodily cycles promote health.

Yet, claims regarding the efficacy of music therapy must be qualified until studies

using methods that meet the standards of evidence-based-medicine (EBM) demon-

strate such efficacy. It is not enough to recommend music therapy on the basis of

qualitative research alone. The availability of research that validates the efficacy of

music therapy using methodologies accepted by EBM will be of great importance to

individuals who are involved in this treatment and who may benefit from this modal-

ity in the future [5].

2.2 Animal Therapy

Animal therapy uses the positive impact of the physical affection that attends contact

with a specially trained animal in the service of the treatment of psychiatric disorders.

Anecdotal accounts abound with stories of institutionalized children and senior citi-

zens who visibly brighten when an

animal arrives to visit. Yet, studies examining the

impact of animal therapy have produced inconsistent

results. Several experiments,

however, provide encouragement for the efficacy of animal therapy. For example,

Mugford & M'Comisky (1975) found a positive relationship between keeping a bird

and measures of mental health among senior citizens

[6]. Similar results have

emerged for cats and dogs, underscoring the need for additional research employing

methods that are consistent with EBM.

This effect has been investigated by measuring the physiological state associated with

looking at a dog. Friedmann, Katcher, Thomas, Lynch, & Messent (1983), using a

sample of children, found a clear positive relationship between the presence of a dog

on the one hand, and lowered cardiac rates and blood pressure on the other [7]. This

may be termed the “stillness effect” of being in canine company.

This effect has been investigated by measuring the physiological state associated with

looking at a dog. Friedmann, Katcher, Thomas, Lynch, & Messent (1983), using a

sample of children, found a clear positive relationship between the presence of a dog

on the one hand, and lowered cardiac rates and blood pressure on the other [7]. This

may be termed the “stillness effect” of being in canine company.

3 Calculation of the Lyapunov Exponent

Figure 1 shows the flow diagram showing the procedure from the measurement of

pulse waves to calculation of the Lyapunov exponent [1]. To construct the attractor,

we set a delay time and the number of embedding dimensions according to Tarkens

theory. We used four embedding dimensions and a delay time of 50 msec. Right fig-

ure illustrates the method of embedding in three-dimensional phase space. Although

effective information can be obtained from the shape of the four-dimensional attrac-

tor, we calculated the Lyapunov exponent, which is an index of trajectory instability

and a characteristic of chaos.

Fig. 1. Flow diagram showing the procedure from the measurement of pulse waves to calcula-

tion of the Lyapunov exponent.

By the measurement of pulse of one minute, 43 Lyapunov exponents is obtained. We

performed comparison of each condition using average of these values [2], [3].

4 Methods of Music Therapy and Measurement of Effectiveness

4.1 Study Subjects

The subjects were 7 elderly people who ranged in age from 73 to 88 years (mean 82.9

years old).

4.2 Study Location

The experiment was conducted at A nursing home in Shiga, Japan.

4.3 Study Period

The study was conducted in February 2008.

4.4 Measurement Detail and Methods

Pulse waves were measured for one minute both before and after music therapy.

Therapy session lasted slightly less that one hour. Room temperature was set at the

presumably optimal 25 degrees.

Contents of music therapy :

Therapists: 4 members. Therapy time: about one hour

1. All the subjects hear a chorus of therapists.

2. All subjects hear a chorus of therapists.

3. An exercise vocalizing a musical scale: "Do-Re-Mi;"

4. Physical exercises for the purpose of relaxing muscles (e.g., putting an arm up

while taking a deep breath);

5. A participant accompanies the music with a tambourine, a bell so on

6. Breathing: Using both hands and the rhythm of abdominal breathing;

7. Singing seasonal songs as a group;

8. A song to end the session: "Today's good day;"

4.5 Results Regarding the Efficacy of Music Therapy

Fig. 2 shows the results of music therapy: an increase in the Lyapunov exponent,

reflecting a positive impact on cardiac functioning among six out of seven subjects.

These results confirm that music therapy produced a strong positive effect.

5 Methods of Animal Therapy and Measurement of Effectiveness

5.1 Study Subjects

The sample consisted of 15 students (five males, ten females) with an average age of

19.5 years (range: 18-26).

Subjects were divided into two groups according to attitude toward the animal.

The “positive group” consisted of seven subjects (three males, four females) who

expressed liking for the animal. The “negative group” consisted of eight subjects (two

males, six females) who disliked the animal.

Both groups participated in preliminary investigations and elected to continue the

study [9]. The experiment was explained, consent was obtained, and simulations

(including touching the animal) were performed, but subjects were not informed of

their group membership.

Fig. 2. The effect of music therapy.

5.2 Study Location

O-Laboratory. Room temperature was set at a presumably optimal level.

5.3 Study Period

Observations were made on November 13-16, 2006, 9:00 a.m. to 7:00 p.m.

5.4 Measurement Details and Methods

Contents of animal therapy:

This experiment used a four-year-old female miniature Dachshund, who was ap-

propriate for this research by virtue of her training and quiet disposition.

This experiment examined the effect of canine contact on the digital pulse wave of

the subject. The latter was measured, for 2 minutes, with and without canine contact,

respectively. Baseline readings of body temperature and blood pressure were obtained

at the start of the procedures.

The experimental condition involved the subject gently touching the dog for 2 mi-

nutes, followed by pulse wave measurement. Although the ideal experimental condi-

tion would have entailed simultaneous canine contact and pulse wave measurement,

this was deemed impractical in view of the confounding effects of the vibrations

caused by the touching. A third measurement was taken after a 1-minute break, dur-

ing which the dog was separated from the subject.

Under the control condition, subjects took a break of 2 minutes after the first meas-

urement. The control group was given an equal number of pulse wave measurements,

after equivalent breaks, for 2 minutes apiece, but in the absence of canine contact.

Six pulse wave measurements were obtained for each subject.

Figure 3 shows the experimental procedure.

Fig. 3. Experimental Flow.

Six sets of pulse waves, each of 2 minutes duration (see Figure. 3), were measured:

EM1, EM2, EM3 (under the experimental condition), CM1, CM2, CM3 (under the

control condition).

5.5 Results of Animal Therapy

Fig. 4 shows the effect of animal therapy. All subjects belonging to a positive group

show that a value of Lyapunov exponent increased at the time of EM3 from time of

EM1.

Fig 4. The effect of animal therapy; ○ indicates positive-group subjects; ■ indicates negative-

group subjects.

It is clear that animal therapy produced a significant effect.

Figures 5 and 6 graph the mean Lyapunov exponents of each group under the con-

trol condition. The longitudinal axis expresses the mean Lyapunov exponent, and the

first cross axis expresses the second or third measurement.

No change was found between the first and second measurements in the positive

or negative groups. However, the positive group showed increases in the third meas-

urement and under the experimental condition (see Figure. 5, Left), whereas the nega-

tive group showed corresponding decrements. This accords with the graph in Figure.

5 ,Right).

Fig. 5. Change in the Lyapunov exponent under the experimental condition(Left) and Change

in the Lyapunov exponent under the control condition(Right).

The foregoing demonstrates a change in the Lyapunov exponent as a function of

canine contact. We show an example of attractor of the first measurement and tertiary

measurement of positive group in an experiment condition in Figure 6. Attractor is

drawn in three dimensions. Width of attractor opens, and in comparison with M1

before touching a dog. M3 after having been felt understands that chaous characteris-

tics rise.

Fig. 6. Attractor of pulse waves of subject A.

6 Conclusions

This study examined the effect of music therapy and animal therapy. The effect was

measured by identifying changes in the Lyapunov exponent as calculated by non-

linear analysis of pulse waves. The Lyapunov exponent was chosen due to its associa-

tion with human adaptability and sanity.

This study had the pleasure of scientifically validating the smile of a lonely old

man and the joyful look of an abused child. It provides evidence that meets EBM

standards regarding the efficacy of treatments that use music and animals to deal with

psychiatric conditions.

A psychometric analysis of stress will be made possible by the innovative meth-

odologies employed by the present study.

Acknowledgements

We thank Tomomi Yugichi of the Oyama laboratory, Kwansei Gakuin University

which cooperated with making of experimental data of animal therapy.

References

1. Oyama-Higa, M., Miao, T. (2006). Discovery and application of new index for cognitive

psychology. 2006 IEEE Conference on Systems, Man, and Cybernetics 2006, 2040-2044.

2. Oyama-Higa, M., Miao, T. , Tsujino J., Imanishi A., (2007). Possibility of mental health

self-checks using divergence of pulse waves. 2007 IEEE Conference on System, Man, and

Cybemetics 2006, 3952-3960

3. Oyama-Higa, M., Miao, T., Mizuno-Matsumoto, Y. (2006). Analysis of dementia in aged

subjects through chaos analysis of fingertip pulse waves. 2006 IEEE Conference on Sys-

tems, Man, and Cybernetics 2006, 2863-2867.

4. Tomoaki Shinoda supervision (2001),written by Shigeaki Hinohara, Tomoaki Shinoda et

al. A proposal from the new music therapy practice spot, Friend Corporation of Music

5. Tetsuya Kosaka & Hiroaki Tateishi Compilation (2006), "A hint from the advice practice

spot of music therapy" Minerva Bookshop

6. Donald Michelle & Joseph Pinzon (2007), Practice it with a principle of music therapy,

Friend Corporation of Music

7. Mugford, R. A., & M’Comisky, J. G. (1975). Some recent work on the psychotherapeutic

value of cage birds with old people. London: Pet Animal Society.

8. Friedmann, E., Katcher, A. H., Thomas, S. A., Lynch, J. J., & Messent, P. R. (1983). Social

interaction and blood pressure. Influence of animal companions. Journal of Nervous and

Mental Disease, 171, 461-46

9. Yousyutu Sugita (2003), General Social Surveys Study Memoirs for Japan, 2, 127 - 143.

10. Templer, D., Salter, C. A., Dickey, S., Baldwin, R., & Veleber, D. M. (1981). The con-

struction of a pet attitude scale. Psychological Record, 31, 343-348.