Identifying the Cognitive Mechanisms that Mediate the Analgesic Benefits of Music Listening Interventions

Overall, this thesis presents a theoretical model of the cognitive mechanisms involved in analgesic MLIs, followed by three empirical studies. The scoping review presented in Chapter 2 introduces a comprehensive overview of five cognitive mechanisms and how they fit together to form the Cognitive Vitality Model. Initially, at a lower level, music captures our attention. Following this a person uses their Cognitive Agency to actively engage with the music listening experience. Processes of Enjoyment and Meaning Making, contribute to an intrinsically rewarding experience which motivates the person to continue listening until they become completely absorbed in the music. When patients become fully immersed they integrate the music with their pain, which makes it less unpleasant and less intense. Instead the person becomes more connected with aspects of their self that are reflected in the music, which leads to a strengthened sense of self, and ultimately a greater level of Cognitive Vitality. The development of the Cognitive Vitality Model helped to generate testable hypotheses in relation to the relative impact of each specific mechanism. Based on the findings from the scoping review presented in Chapter 2, empirical methods were to explore three specific mechanisms (Automated Attention, Cognitive Agency and Enjoyment and Meaning Making). The impact of Cognitive Agency was demonstrated in the audio feature analysis presented in Chapter 3 which identified that people choose music with different intramusical features compared to music chosen by experimenters. Subsequently, the limit of Automated Attention was highlighted in the behavioural experiment presented in Chapter 4 which highlighted that intramusical features alone cannot account for the analgesic effects of music listening. Importantly this was the first study to isolate the role of making a choice on the analgesic benefits of music listening, independently but alongside the benefits attributable to Enjoyment. Accordingly, top-down processes in music interventions should be continued to be explored in the context of music-based pain management strategies. Lastly the field study presented in Chapter 5 was used to examine the external validity of the Cognitive Vitality Model with a clinical population. Chronic pain patients were in agreement that musical absorption mediates the analgesic benefits of self-chosen music, and helps to elicit a strengthened sense of self. While one of the main strengths of this thesis is that it provides an overarching evidence-based model of the cognitive mechanisms involved in MLIs it is important to recognize some of the methodological limitations including the validity of using Spotify audio features from a psychological perspective. Areas for future research in this area were dutifully considered in light of current conceptualisations of enjoyment and the potential for additional behavioural experiments. Overall, these findings contribute greater insight into the cognitive mechanisms involved in mediating the analgesic benefits of self-chosen music.