Listening to music is associated with reduced physiological and subjective stress in people with mild intellectual disabilities: A biofeedback study

Background: Many people with mild intellectual disabilities are at increased risk to experience stress. Reducing stress is important because experiencing prolonged and elevated stress can have detrimental effects on mental and physical health and it is associated with aggressive behaviour and self-harm. Aims: This preliminary study investigated whether an intervention combining biofeedback with listening to music is effective and whether a personalized music playlist is more effective than self-selected music in reducing physiological and subjective stress in participants with mild intellectual disabilities. Methods: We collected 103 music listening sessions over a period of 2–4 weeks for 11 participants throughout their daily routines. They listened to music when they received biofeedback on their increased stress level (as measured by wearable biosensor Nowatch) or when they themselves felt stressed. Participants listened either to self-selected music or to a personalised playlist compiled with X-system, music technology that predicts the effect of a song on levels of autonomic arousal. Pulse rate (PR) and skin conductance level (SCL) were measured with the EmbracePlus and subjective feelings of stress and mood were measured with two scale questions. After the intervention phase, participants and their caregivers completed a short questionnaire to evaluate their experiences with using the X-system playlist. Results: Mixed regression analyses showed reductions in PR and SCL during listening to music, and indications were found for reductions in subjective stress and improvement of mood after intervention. Listening to music compiled with X-system was not more effective than listening to self-selected music. However, lower combined arousal values (a feature of X-system) from self-selected and X-system music predicted lower PR and SCL, indicating that these indices can be used to select songs that have a relaxing or energizing effect. Conclusions and implications: The present study suggests that music listening is associated with both subjective and physiological stress reduction. Listening to music might be an accessible, inexpensive and empowering strategy for stress reduction and improving emotion regulation, which could also benefit mental and physical health. Several challenges were encountered while implementing the intervention and suggestions for future research are given.