Journal of Psychiatric and Mental Health Nursing, 1998, 5, 403^408

Objective measurement of mood change induced by contemporary

music
J. L. SMITH 1 B N ( H o n s ) R N & J . N O O N 2 B S c ( H o n s ) P h d R N R M
1
Douglas Bennett 2, The Maudsley Hospital, Denmark Hill, London, UK and 2School of Nursing, University of
Nottingham, Medical School, Queen's Medical Centre, Nottingham UK

Correspondence: SMITH J. L. & NOON J. (1998) Journal of Psychiatric and Mental Health Nursing 5,
Dr Joe Noon 403±408
School of Nursing Objective measurement of mood change induced by contemporary music
University of Nottingham
Medical School (A Floor) A myriad of previous studies from a variety of disciplines has shown several e€ects of
Queen's Medical Centre
music on mind and body. This study investigated the relationship between di€erent
Nottingham
categories of contemporary music (n = 6) and the mood states of a group of students (n
NG7 2UH
UK
= 12), using the Pro®le of Mood States (POMS), to measure mood before and after
exposure to these di€erent pieces of music. When analysed together, all six pieces of
music produced an overall change in mood (P = 0.008) as measured by 2-way repeated
measures analysis of variance (ANOVA). When each category was examined individually,
four categories of music produced highly signi®cant changes in mood: the tense category
(score ± 4.0 + 1.8 POMS Units; P 5 0.001); depressed category ( + 0.5 + 0.2; P 5
0.001); angry category (+ 0.9 + 1.6; P 5 0.03); and the all moods category (1.6 + 0.3; P
5 0.04). One piece of dance music produced changes in all mood categories, giving the
largest positive mean mood change. By contrast, the popular/independent music,
associated with the tense category, produced the largest negative mean mood change.
The ®ve POMS mood states were analysed separately for each piece of music. These
®ndings are consistent with previous work. In addition, the ®nding of the e€ects of
speci®c music categories on mood may have important implications for therapy in
mental health and mental health nursing.

Keywords: empirical study, mental health, mood, music

Accepted for publication: 28 June 1998

purpose of the present study was to investigate the

Introduction
e€ects of di€erent types of music on mood, albeit on a
The e€ects of music on mood and the use of music as small scale. Therefore, using the Pro®le of Mood States
therapy have been studied previously (Andsell 1995, (POMS) (McNair et al. 1992), we aimed to investigate the
Aldridge 1996). If, as has been suggested, mood a€ects e€ects of six categories of contemporary music on mood.
judgement about the frequency of various risks in daily As music often plays an important role in acute mental
life (Atkinson et al. 1993), any stimulus a€ecting mood health inpatient wards as part of the background noise
might have important rami®cations for mental health and general entertainment, and also sometimes has a
nursing practice. However, much of the current evidence therapeutic role, the present ®ndings have important
does not take account of the range of contemporary implications for clinical practice.
music, and thus does not investigate in any depth the Listening to music evokes a conscious response to the
e€ects of speci®c categories of music on mood. The patterns of sound at some structural level, either to the

# 1998 Blackwell Science Ltd 403

Smith & Noon

piece of music in its entirety, that is, the general sound of music, or the music may have very little uniformity of
the whole piece, or to each individual aspect of how the rhythm.
music ®ts together (Dowling 1993). This process of music Smith & Morris (1976) tested 66 college students under
cognition and attention suggests that the listener is likely, conditions of stimulative music, sedative music or no
consciously or subconsciously, to be developing certain music. One of ®ve types of music (classical, jazz and
expectancies concerning the piece. The transmission of blues, easy-listening, country bluegrass, and rock/rock
messages in lyrics might be dependent on the individual and roll) was played for the two groups exposed to
perceptions of the receiver, and could be in¯uenced by music. Their results showed that stimulative music
previous musical training and exposure, personality, and signi®cantly increased both worry and emotionality,
attitudes (Hargreaves 1986). In addition, e€ects on mood while sedative music had no e€ect on anxiety, relative to
might depend on the key in which the music is played that of the control group. Test performance was not
(Storr 1993). However, the overall feeling of a particular a€ected by the music. However, it would be dicult to
song might be transmitted regardless of these attributes repeat this study, as the speci®c pieces of music used were
(Hargreaves 1986). not stated. Smith and Morris assumed that a subject's
Wintersgill (1994), in his article on great composers, musical preferences would enhance or inhibit the e€ect of
suggested that these composers' mood swings were a musical selection on his mental state, but noted that
associated with periods of intense composition, immedi- such was not the case in their study.
ately following a depressive phase; an advantage to a Despite the con¯icting results highlighted by Biley
creative artist. Suggesting an alternative to the Velten (1992), numerous studies have investigated the e€ects of
technique for inducing a change in mood (Velten 1968), music as a therapeutic tool. The main music category
Pignatiello et al. (1986) found that music induced sig- described in many studies is easy-listening music, used to
ni®cant di€erences in mood states between three groups bring about relaxation. For example, music has been
of 10 participants. The groups consisted of eight women shown to induce physiological changes such as altering
and two men, each listening to 20 minutes of either blood pressure, pulse rate and breathing (Aldridge 1994).
elated, neutral or depressed music, and their moods Its uses have also been documented in cancer care,
changed according to whichever music they were neurological problems and in learning diculties
exposed to. Another study, in women, of the selective (Aldridge 1994). Some have used music in the reduction
e€ects of exciting and calm music, showed that exciting of anxiety after surgical operations (Zimmerman et al.
music produced more anxiety and aggression than calm 1988, Guzzetta 1989, Barnason et al. 1995). Others
music or no music, and that calm music produced less simply have stated, through observation and questioning,
anxiety than exciting music or no music (Fisher & that it increases an overall feeling of well-being in a
Greenberg 1972). Among the research tools used in this hospital setting (Stevens 1990, Lindsay 1993), and in a
study was the Nowlis Mood Scale (Nowlis & Green nurse-managed clinic for the homeless (Peden 1993).
1957), which was later used to develop the POMS test. A Estimation of the validity of some of these studies is
further study using the POMS test, by Hanser & dicult; however, an accumulation of agreement over a
Thompson (1994), showed that music improved levels of large amount of literature appears to have built up a case
depression, distress, self-esteem, and mood. for music as therapy over the years (for reviews see Cook
While engaged in a cognitive learning task, a group of (1981) and Aldridge (1994, 1996) and for books see
subjects had a signi®cant mood state-dependent recall Hargreaves (1986), Storr (1993), and Andsell (1995)).
compared to a control group performing the task without In general, much literature agrees that there is a
music (Thaut & de l'Etoile 1993). These authors con- therapeutic use for music. However, this area is
cluded that music, when used as a mood-encoding device, complex, and there is an absence of research on the
created a particular emotional context with the learner. types of music a€ecting mood. Thus, the present study
Rhythm is the primitive, dynamic, driving factor in aimed to investigate the e€ect of six categories of
music, stimulating muscular action (Gaston 1951). contemporary music on mood states.
Gaston suggests two types of music: short, sharp, percus-
sive types, and longer, more sustained types. These types
were labelled staccato and legato respectively. Staccato Methodology
music was associated with primitive dancing, unrest-
Subjects and sampling
rained and very physical, whilst legato was associated
with romance and dreamlike fantasies. However, To form the basis for future studies in patients with
musical rhythm may fall between these two `speeds' of mental health problems, the current study investigated

404 # 1998 Blackwell Science Ltd, Journal of Psychiatric and Mental Health Nursing 5, 403±408
 Effects of music on mood states

12 subjects (6 male, 6 female; mean age 21.9 + 1.1 were asked to rate the pieces of music (from 0 to 4) using
years, range 20±23) who, in an attempt to eliminate a simple questionnaire. From this study, the 5 pieces of
di€erences in demographics such as age and social music which had the highest mean scores for a speci®c
environment, were all undergraduate students of the mood category were chosen, and a 6th piece was chosen,
University of Nottingham (UK). Subjects were inter- for which scores were so varied that it could have
viewed individually, in a quiet room. The protocol was represented all moods. These ®nal pieces of music are
explained, verbally, to the subjects, and they retained shown in Table 1.
an information sheet. All studies took part at the same Firstly, to record their `baseline' mood, volunteers
time of the day, i.e. late afternoon. Participation was were asked how they had felt for the past week. Using
gained by asking two nursing students who were the POMS questionnaire checklist before listening to the
willing to participate in the study to inform the piece of music, they gave a list of adjectives rating from
researcher (JLS) of any others willing to be involved, `not at all' to `extremely', adapted from the POMS
a technique known as snowballing. This was a con- adjective list. These were then scored from 0 to 4,
venience sample, involving only those who were respectively.
available. Secondly, they listened to one of the six selected pieces
Access and approval was gained from the respective of music through headphones to eliminate most of the
heads of academic departments. The study's aims and background noise. The order of musical pieces was
method of investigation were explained to each indivi- assigned randomly through a single blind method using
dual subject. Participation was entirely voluntary and a standard table. Immediately after listening to the music,
subjects could withdraw at any time. Informed consent the subject was asked how s/he felt using a further POMS
was obtained. As a result of these considerations, and the scale. Each subject then repeated the study on a di€erent
fact that patients were not studied, no formal ethical day (at one-week intervals) using a di€erent piece of
approval was sought. music for six weeks.

Study design and protocol Statistical analysis

Musical taste is a highly subjective area. Thus, the study Sums of scores for each piece of music from the pre- and
used an objective method to quantify mood before and post-music questionnaires were calculated. To gain a
after exposure to an individual piece of music: the Pro®le mood-change score, the post-music score was subtracted
of Mood States test (McNair et al. 1992). This instrument from the pre-music score. The adjectives were then
has been well validated and used in previous studies grouped into their appropriate mood category. The
(Penetar et al. 1993, Rhoades et al. 1993, Hanser & adjectives in the `vigorous' mood category, as well as the
Thompson 1994, Chlan 1995), and was chosen because adjectives `relaxed' and `ecient', were then negatively
it tests all mood states, not just one type of mood, which weighted to give an overall mood score (McNair et al.
can be measured by state/trait anxiety tests. 1992). That is, those scores which were positive became
Initially, 13 di€erent pieces of popular music were negative and those which were initially negative became
chosen from a range of music types: classical, jazz and positive. These adjectives were essentially positive emo-
blues, easy-listening, country bluegrass, and rock/ tions, whereas the other adjectives such as `angry',
rock and roll. To narrow down the number of pieces so `exhausted', `depressed', etc., were regarded as negative
that they corresponded to one of the 5 POMS categories emotions. The more negative the overall score the more
(tense, depressed, angry, fatigued, vigorous), a pilot negative the overall mood change became and vice
study was performed whereby lecturers at the university versa.

Table 1
The final pieces of music chosen, categorized according to the 5 mood groups of the POMS test
Category Artist T|tle Type Record company Length
(min)
1 V|gorous Boney M Brown Girl In The Ring Disco Pop Telstar 4:00
2 Fatigued Suede Sleeping Pills Independent (Indie) Polygram Music Ltd. 3:51
3 Angry Rage Against The Machine Killing In The Name Heavy rock/Rap Sony Music Entertainment Inc. 5:14
4 Depressed Depeªche Mode In Your Room Indie/Heavy rock Mute Records 6:26
5 Tense BjÎrk Enjoy Indie/Pop One Little Indian Ltd. 3:57
6 All moods DJ Misjah & DJ T|m Access Hard-core House London Records (90) Ltd. 3:35

# 1998 Blackwell Science Ltd, Journal of Psychiatric and Mental Health Nursing 5, 403±408 405
Smith & Noon

4
These sums of scores were then averaged and
expressed as mean + SEM. Statistical analysis of mood 3
before vs. after music was by a two-way repeated
measures analysis of variance (ANOVA). If the overall 2
ANOVA test was signi®cant, factorial analysis was per-
formed for individual pieces of music. 1

0
Results

Vigorous

All moods
Angry

Tense
Depressed
Fatigued
Subjects co-operated with the data collection and there º1
were no withdrawals from the study. However, through
subject error, some questionnaires were not ®lled out
Musical piece
completely. One subject only rated ®ve pieces of music
instead of six. These factors were accounted for in the Figure 1
statistical analysis. Towards the end of the 6-week study Mean mood changes (using the POMS scoring system) of the 12
subjects for each of the 6 musical pieces (MPs). Error bars represent
period, levels of enthusiasm and co-operation dwindled. SEM.
This probably did not create more negative mean mood-
change score results, because POMS is designed to A positive mean mood-change score denotes a positive
include pre- and post-music scores in the ®nal analysis. change in the mood. For example a positive change in
Table 2 shows the academic disciplines of the subjects. `fatigue' shows a decrease in feelings of fatigue and
Taken together, all 6 musical pieces (MPs) produced a lethargy, and a positive change in `vigour' shows an
change in mood (P = 0.008) (Fig. 1). On closer inspection increase in energy and cheerfulness. Table 3 shows the
of the individual pieces, it was clear that musical piece 1 greatest positive and negative mean mood-change scores
(MP 1) (Brown Girl In The Ring ± 1993 remix by Boney for those pieces of music which caused signi®cant
M), in the `vigorous' category, evoked the greatest changes in mood.
positive mean mood change, and MP 5 (Enjoy by BjoÈrk),
in the `tense' category, was the only piece which created a
negative mean mood change in the 12 subjects. Discussion
When analysed individually by one way ANOVA, mood This small-scale study has demonstrated, using an objec-
changes in response to MPs 1 and 2 were not signi®cant tive scale, the e€ects of speci®c categories of music in
(P 4 0.05), whereas responses to MPs 3 and 6 (P 5 0.05), changing mood. Overall, the pieces of music caused
and MPs 4 and 5 (P 5 0.01) were statistically signi®cant. signi®cant changes in mood in all 12 subjects. Individu-
ally, each of the pieces of music caused some change in
mood, and this was statistically signi®cant for 4 of the
Table 2
Breakdown of subjects' pieces (MPs 3, 4, 5 and 6). These changes were mainly
academic disciplines positive (Fig. 1). Out of the 4 individual pieces that
Academic n changed mood signi®cantly, MP 6 consistently produced
discipline the greatest positive mean mood change (Fig. 1). MP 5
Mathematics 1 (tense) evoked the greatest negative mean mood-change
Law 1
Medicine 2
score (Fig. 1), yet had the greatest positive mean mood-
Nursing 3 change score for the `friendliness' mood category (Table
Engineering 5 3). Subjects' baseline mood may have varied from one
Total 12
day to the next over the course of the study. However, a

Table 3 Greatest positive mean change Greatest negative mean change

Greatest positive and negative mean Mood category Musical piece Mean score Musical piece Mean score
mood change scores for those musical
pieces (3, 4, 5 and 6) which, Tension/anxiety 3 2.3 5 71.5
individually, produced highly Depression/dejection 6 0.5 5 74.8
significant mood changes Anger/hostility 6 1.2 4 71.4
V|gour 6 2.5 4 73.8
Fatigue 4 2.3 5 1.6
Confusion 6 1.1 5 71.9
Friendliness 5 8.3 3 4.7

406 # 1998 Blackwell Science Ltd, Journal of Psychiatric and Mental Health Nursing 5, 403±408
 Effects of music on mood states

mood-change score measures the di€erence between pre- the reason lecturers were chosen in the pilot study was to
and post-music mood states, which should have obtain critical feedback on the instrument, rather than to
accounted for any variability in pre-music mood scores. examine their scores. A further limitation included the
Factors other than the music may have in¯uenced the small numbers of subjects and the fact that they con-
outcome of the study. The length of pieces associated stituted a homogenous middle-class group. Associated
with tension and anxiety, for example, might have with this was a lack of control. We would like to have
potentiated the e€ects of the music itself. This is consis- compared the e€ects of alternative therapies on mood.
tent with the ®nding of Smith & Morris (1976) that Although standardization of conditions could have been
stimulative music increases levels of worry in individuals. more consistent, we ensured that pre- and post-music
In addition, familiarity with a record may play a part in scores were recorded in the same setting for each piece of
the subject's response. When familiarity is plotted against music.
favourability, a U-shaped function curve appears to exist
(Hargreaves 1986). Thus, there is a crossover point at
Implications for mental health nursing
which familiarity touches liking. Straying away from this
crossover point in either direction produces increased By recognizing that music has measurable e€ects on
dislike of the piece of music. Another factor which may mood, mental health nurses may want to consider how
have in¯uenced scores was the lyrical content of the some types of music may a€ect clients' well-being. Music
pieces (Campinha-Bacote & Allbright 1992). Because is being used as therapy more widely now in the ®eld of
lyrics in the contemporary pieces used in the present mental health. For example, music therapy may aid
study were closely intertwined with the rhythm and psychological rehabilitation and behavioural growth
tempo (clearly musical properties), we regarded lyrics (Thaut 1989). Music therapy may augment Roy's Adap-
and music as an entity. tation Model to change ine€ective and adaptive beha-
As we were able to measure a signi®cant negative viours (Hamer 1991), and may have a use in treating
change in mood, i.e. towards anger and hostility, and restrained patients (Janelli et al. 1995). In studies of
towards depression, we suggest that choice of music in ethnomusic, a majority of blues lyrics deals with situa-
mental health settings may require careful consideration. tions and problems with which African-Americans can
The subjects in the present study were healthy young identify (Campinha-Bacote & Allbright 1992). Further-
adults. It is conceivable that some types of music could, more, the importance of lyrical content also may improve
in some less well individuals, induce aggressive emotions response to psychoanalysis by increasing the level of
or may even provoke abusive situations and manic attention and receptivity to this form of treatment
behaviour. In our study, qualitative measures to assess (Peterson 1988). Fewer violent outbursts by psychiatric
feedback from subjects were not investigated. Such inpatients may be associated with background dinner
inclusion may have highlighted other emotions not music (Courtright et al. 1990). In patients su€ering from
revealed by POMS. Anecdotal evidence suggested, for schizophrenia, music therapy signi®cantly diminished
example, that some music (such as MP 4) created feelings negative symptoms, increased ability to converse with
of loneliness, bitterness or desperation. By contrast, some others, reduced social isolation, and increased the level of
music was able to lift depression and induce friendliness interest in external events (Tang et al. 1994).
and happiness, and this may be of particular therapeutic In a medium secure unit for mentally disordered
value in mental health inpatient settings. o€enders, a music workshop strengthened ego, boosted
socialization and decreased symptoms in those described
as `disturbed and inaccessible', and was responsible for
Limitations of the study
increased activity in apathetic patients (Yates & Wil-
Although some consideration was given to factors a€ect- liams 1996). Further evidence for the success of these
ing mood other than music, the emphasis was on the workshops was reported by Gillam (1996) running
overall e€ect musical pieces had on changing mood. similar groups for mental health clients aged between 18
Contemporary music varies in its content too greatly to and 30. However, although properly guided music pro-
have examined these factors on such a small scale. The grams may promote mental health, they also may have
main aim of this study was to measure the e€ect of the exact opposite e€ect on mental health (Charlesworth
contemporary music on mood. Other limitations of this 1982). Two literature reviews of music therapy were
study include preliminary piloting in a slightly older age clearly in favour of its use (Cook 1981, Aldridge 1994).
group, although the range of music used might have been The review by Cook (1981) provides a history of the
sucient to produce similar results. More importantly, importance of music from as far back as Plato and

# 1998 Blackwell Science Ltd, Journal of Psychiatric and Mental Health Nursing 5, 403±408 407
Smith & Noon

Pythagoras. For example, Homer recommended the use Hanser S.B. & Thompson L.W. (1994) E€ects of a music strategy
of music in avoiding negative emotions such as anger, on depressed older adults. Journal of Gerontology 49, 265±
269.
sorrow, worry, fear, and fatigue which, interestingly, Hargreaves D.J. (1986) The Developmental Psychology of Music.
correspond to the ®ve named categories of POMS. This Press Syndicate of the University of Cambridge, CUP, Cam-
preliminary study in healthy young adults might stimu- bridge.
late the development of further studies in mental health Janelli L.M., Kanski G.W., Jones H.M. & Kennedy M.C. (1995)
patients. Exploring music intervention with restrained patients. Nursing
Forum 30, 12±18.
Lindsay S. (1993) Musical care. Nursing Standard 7, 20±21.
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