Abstract
Purpose: Adults have frequently been concerned about the adverse influence that music may have on teenagers. This study was designed to examine the relationship between the intensity of emotional response to music and health risk-taking behavior in adolescents.
Methods: Consecutive participants from the University of California, San Diego, Adolescent Medicine Clinics completed a written survey about music preference, emotional response to music using the Positive Affect Negative Affect Schedule (PANAS), and a variety of health-risk behaviors. For each participant, the PANAS scores were summed to give a positive, negative, and total affect score, and health-risk behaviors were assigned a point value based on the level of risk and then summed to give a risk score.
Results: Health-risk behavior was found to be correlated with increasing emotional response to music (r = 0.23), whether those emotions were positive (r = 0.19) or negative (r = 0.24). Strong negative emotional response to music in particular was correlated with a history of greater risk behavior, particularly among whites (risk score = 10.1) and fans of rock or heavy metal music (risk score = 14.0).
Conclusions: Our study indicates that subjects who experience strong negative emotions to music are at an increased risk of participating in a variety of risk-taking behaviors. Further evaluation of the link between emotional response to music and health-risk behaviors will be useful in clarifying the nature of this relationship.
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Adults have frequently been concerned about the influences that music may have on adolescents and their behaviors. To at least some extent, these concerns may be valid because there is evidence that adolescents who engage in risky behaviors (cheating, stealing, smoking, sexual intercourse, etc.) watch more television and listen to the radio more often than their peers [1]. In addition, certain types of music such as heavy metal and punk rock have been linked to suicidal thoughts, self-harm, substance abuse, and alienation from authority figures [1, 2, 3 and 4]. There is also evidence that removing music videos from a hospital milieu can decrease aggressive behavior [5]. The American Academy of Pediatrics has issued a statement reflecting their concern over the effects of music lyrics and videos on youths, and recent reviews of our current knowledge regarding teens and music have appeared in the literature [6 and 7].
A teenager's choice of music and the corresponding response may vary in accordance with ethnic, cultural, age, and gender factors. For instance, rock music is predominantly a listening choice of white males, while black adolescents tend to prefer rap or soul groups [1]. Studies have consistently found correlations between music and emotion regardless of subject age or gender [8 and 9]. Moreover, music itself has been found to directly influence mood and affect [10]. These emotional effects of music can be modulated though by the method of presentation of the music and a person's preconceived ideas about the music [11, 12 and 13]. Although younger subjects experience more intense emotional responses to stimuli than do adults, there is no difference in emotional composition between adults and adolescents [14 and 15]. Also, adolescent males experience a broader range of emotions at a lower intensity, while females experience fewer emotions but at a greater intensity [16].
Since different pieces of music can elicit different emotional responses and different types of music have been associated with risk-taking behaviors, it is possible that risk-taking teens also have a greater intensity of emotional response to music stimuli. It may be that emotional responsiveness is also a marker of risk-taking behaviors and may be more predicative of risk behavior than musical preference. To help clarify the relationships among intensity of emotional response, music preference, and health-risk behavior, we surveyed a group of adolescents in the San Diego metropolitan area.
Methods
Sample
Between November 19, 1996, and February 4, 1997, consecutive patients from the University of California, San Diego, Adolescent Medicine Clinics in Hillcrest (primarily Medicaid) and La Jolla (primarily managed care) were recruited. The University of California, San Diego, Committee on Investigations Involving Human Subjects approved the study protocol. Requirements for this study were: (a) parental or guardian informed consent for patients younger than 18 years old. Participants 18 or older gave their own consent and (b) English literacy. A total of 142 subjects were asked to participate. Thirteen declined and two returned incomplete surveys, which left a total of 127 completed, usable surveys.
Reasons for declining included not having time to complete the survey (two subjects), not feeling well enough to answer a survey (two subjects), parental concerns about the nature of the questions (three subjects), and simple refusals for unspecified reasons (two adolescents, four parents).
The anonymous and confidential nature of the survey was discussed with each subject and his parent or guardian, and appropriate informed consent was obtained. Brief verbal instructions about completion of the questionnaire were given. Those adolescents who agreed to participate were placed in a private, quiet room or area to complete the survey.
Measures
Demographics
Age, gender, and ethnicity were compiled for each subject.
Music preference
Subjects were asked to choose their favorite type of music from a list of eight categories ("alternative," "classical," "country," "heavy metal," "jazz," "rap," "rock," and "other"). For the "other" category, subjects wrote in their selection. Many of the subjects in our study who listed multiple favorite types of music checked off both rock and heavy metal among other choices. Given this observation and the small number of respondents in our sample who selected only rock [10] or heavy metal (three), we combined the two categories as "rock/metal," as this was most consistent with the fact that many listened to both types of music. From the write-in selections, rhythm and blues ("R&B") and "oldies" were selected frequently, and so they were chosen as new separate categories. A third new category was created, termed "multiple" for persons who chose more than one favorite selection. Finally, the categories classical, country, and jazz were selected so infrequently (one response each) that they were grouped together with remaining write-in selections as "other."
Emotional response
Subjects reported how they felt when listening to their favorite music by completing the Positive Affect Negative Affect Schedule (PANAS) [17]. The PANAS scale consists of 10 positive affects (interested, excited, strong, enthusiastic, proud, alert, inspired, determined, attentive, and active) and 10 negative affects (distressed, upset, guilty, scared, hostile, irritable, ashamed, nervous, jittery, and afraid). Affects are rated on a scale from 1 to 5, based on the intensity of emotion (1 = "very slightly or not at all," 5 = "extremely"). This scale has been shown to be a valid and reliable way to measure mood in a college-aged population in the context of such questions as "How do you feel right now?" as well as "How have you generally felt in the past (year, month, week, day, etc.)?" [17]. The ratings for each subject were summed to give three measures of emotional response to music: positive affect, negative affect, and total affect. The possible ranges for these measures were 10–50 for either positive affect or negative affect, and 20–100 for total affect. We coded affectivity scores as continuous variables and dichotomized them into high and low if they were above or below the 75th percentile of our sample, respectively.
Risk-taking behaviors
Subjects completed a series of 18 questions relating to whether they engaged in a variety of risk-taking behaviors. The questions covered seat belt use, helmet use, cliff diving (a regional behavior), violating curfew, physical fights and weapons, fire setting, animal abuse, stealing, alcohol use, drug use, and sexual activity including number of partners and condom use. Low-risk responses (not engaging in a behavior) were assigned a zero, and higher-risk responses (engaging in a behavior) were assigned a 1. Questions related to number of sexual partners ("none," "1–2," or ">2") and condom use ("never had sex," "always use," "sometimes/never use") were scored between zero and 2. These values were then summed for each subject to give a risk score ranging from a possible zero (low risk) to 19 (high risk). Ethnic groups were separately evaluated for variation in risk score by music preference.
Analysis of data
All statistical analyses were performed using StatView II Version 1.04. The two-tailed Student's t-test was used to compare risk score and affect scores between genders. One-way analysis of variance (ANOVA) was used to compare risk score and affect scores by ethnicity and music preference. Two-way ANOVA was used to analyze risk score by ethnicity and high/low affects as well as music preference by high/low affect scores. Simple correlation was used to analyze the interaction between risk score and each of the affect scores. Finally, we used stepwise multiple regression to examine how risk score was affected by age, positive affect, negative affect, and total affect. Data for risk score and affect scores were also log normalized to control for any skewness in the distributions.
Results
Demographics
One hundred twenty-seven teenagers completed the survey. Participants ranged in age from 11 to 21 years, with a mean age of 15.7 years [standard deviation (SD) 2.2], and 35.7% (45 of 126) were male. Whites accounted for 36% (45 of 126) of the sample, blacks 24% (30 of 126), Hispanics 19% (24 of 126), Asians 10% (12 of 126), and the remaining 12% from a variety of other ethnic backgrounds.
Risk behavior
The mean risk score for all subjects was 5.9 (SD 3.7). Using a simple correlation model, risk score was shown to increase with age (r = 0.52, p = 0.0001), accounting for an estimated 27% of the variability in risk score. Gender (p = 0.19), ethnicity (F = 1.60; p = 0.18), and music preference (F = 1.15; p = 0.34) did not correlate with risk score.
Emotional response
The mean positive affect rating for all subjects was 33.2 (SD 8.6). For negative affect, the mean score was 14.6 (SD 7.7). The total affect score had a mean of 47.8 (SD 13.7). None of the affective responses to music, whether measured continuously or dichotomized, varied with gender, ethnicity, or music preference. The intensity of a participant's emotional response to music as measured by positive affect, negative affect, and total affect did correlate with an increasing risk score by simple correlation.
Interactions between risk score and affect are summarized in Table 3. There were significant interactions between high/low negative affect and ethnicity on risk score (F = 3.19; p = 0.016) and between high/low negative affect and music preference on risk score (F = 3.70; p = 0.0022). Whites who reported a negative affect >75th percentile had a risk score more than double that of whites reporting a negative affect <75th percentile when listening to their favorite music. No other ethnic group showed a statistically significant variation in risk score with high/low negative affect. There were no similar interactions with either positive affect or total affect and ethnicity on risk score. There was also a significant interaction for negative affect and music preference on risk score, but no interactions with positive affect or total affect and music preference on risk score. Subjects who reported negative affect in the upper 75th percentile and listened to rock/metal had higher risk score that those with negative affect below the 75th percentile. However, the majority of rock/metal listeners were white. There was a significant increase in risk score in the high negative affect whites among both those who listened to rock/metal music (p = 0.0003) and those who listened to all other types of music (p = 0.0013).
The factors associated with risk score (age, positive affect, negative affect, and total affect) were entered into a stepwise regression model. Age entered as the most strongly correlated variable (r 2 = 0.26), and negative affect made an additional significant and independent contribution to the model. Together, these two variables predicted 36.3% of the differences in risk score. Neither positive affect nor total affect made an additional contribution to the model.
Log normalization of the data did not significantly affect any of the results.
Discussion
Our sample of San Diego area adolescents found that apart from age, the best predictor of increased health risk score was the teens' self-report of strong negative emotions when listening to their favorite music. This effect was particularly prominent for whites and those who listened to rock/metal music. Even though strong negative emotions were correlated with greater health-risk behavior, any strong emotional reaction to music whether positive or negative was associated with increased risk behaviors. Thus, it may be that a teenager's emotional response to music may be a better indicator of health-risk behaviors than preference for a particular type of music.
Perhaps the link between emotional response to music and risk-taking behaviors is related to underlying personality dimensions. Studies have shown that subjects who score high on the sensation-seeking personality trait tend to engage in more risk behaviors than other subjects [18, 19 and 20]. In addition, personality dimensions have been associated with the enjoyment of various types of music [21]. Music preference, risk-taking behaviors, and emotional responsiveness may all be related to personality dimensions. An individual's underlying personality may make him more likely to gravitate toward and emotionally respond to a specific type of music and predispose him to greater risk-taking behavior. This subject will require further research to elucidate these interrelationships between personality, emotion, music preference, and risk behaviors.
Our data agree with other studies which have found that health-risk behaviors increase with age, but we were unable to find previously described associations between music preference and risk behaviors [1, 3, 4 and 5]. In Klein's survey of the risk behaviors and mass media use of a large group of adolescents, high-risk white adolescents were more likely to listen to heavy metal than were low-risk white adolescents. Our study did not confirm these results, and this may relate to differences in the power of the two studies where ours was relatively smaller and may not have been able to distinguish differences among our music categories. Alternatively, Klein's study was performed 10 years ago and measured a cohort from the southeastern United States. Since our cohort is more recent and from a different region of the country, perhaps cultural changes or geographic variations can account for the observed differences.
As with previous studies, we found an association between negative emotional response to music and risk-taking behavior [2]. Our study found, however, that white adolescents who reported strong negative emotions when listening to music had increased risk behaviors whether or not they listened to rock/metal groups or some other type of music. Teenagers of other ethnic groups did not demonstrate similar correlations between emotion and risk behaviors. It is unclear why white adolescents would show an increase in risk behavior with negative emotions while other ethnic groups would not. The white adolescents in our sample may have come predominantly from a single clinic site and thus may represent a different socioeconomic strata than the sampled adolescents from other ethnic groups. Unfortunately, we did not keep track of which clinic each patient came from. It is possible, then, that differences in socioeconomic environment may underlie the changes in risk behavior that we described in white adolescents reporting strong negative emotions to music. Also, teens attending an adolescent medicine clinic may be a different subset of teenagers from teens who do not receive their care through adolescent medicine clinics, but one would expect that these differences would hold across ethnic groups.
Besides the interaction between extreme negative emotions and rock/metal music, there was also a statistically significant association with the "multiple" and "other" music categories in our study. Given the wide variation of music types represented by these two selections, it is unclear what this result means with regard to music preference. Perhaps if the subjects responding with multiple selections had been forced to choose a single favorite music, the results might have revealed other effects of music choice and high negative affect on risk-taking behavior. A larger sample with more respondents to the diverse selections in the "other" category might better elucidate this portion of the data.
In our sample, rock/metal preference alone was not associated with higher reported negative emotions or risk behavior, but the combination of high negative emotion and rock/metal music was associated with greater risk-taking behavior. Additional unmeasured listener variables may predispose this subgroup to more risk-taking behavior. The majority of participants who listened to rock/metal were white, and whites in our sample who reported strong negative emotions had increased risk-taking behaviors. This may account for some of the observed increase in risk behaviors reported by fans of rock/metal music who experienced strong negative emotions.
This study is limited in its sample size. Some of the effects noted may be owing to a relatively small number of respondents rather than larger trends. Also, the subject pool chosen may have introduced some biases. We did have a high response rate (89%, 127 of 142) from the eligible clinic patients, but the two clinics themselves varied from each other in both socioeconomic and ethnic composition. Adolescents who are referred to an adolescent medicine clinic may be different from the general teenage population. Our ethnic background was skewed, with a higher percentage of blacks in our sample and a lower percentage of whites relative to the San Diego metropolitan area population of 12–21-year-olds [22]. The proportion of all other ethnic groups in our sample roughly approximated that of San Diego county. In addition, the self-report questionnaire may not have adequately captured the participants' true emotional state while listening to music. Although participants completed the survey in private, some may have been reluctant to truthfully answer all of the risk behavior questions.
Despite these limitations, we do feel that our study has captured an important relationship between health-risk behavior and a person's emotional response to music. Future research should examine a larger cohort of adolescents. Because the fans of rock/metal music in our sample were predominantly white, it may be useful to collect a sample of nonwhite adolescents who listen to rock/metal music and see if there is a similar increase in risk behavior in subjects reporting high levels of negative emotions. Subjects who are emotionally responsive to music may also express stronger emotions in other life situations, and such observations may help elucidate the relationship between emotions and risk behavior. It will also be important to examine the converse relationship: Does engaging in risk behaviors alter a person's level of emotional responsiveness to a variety of life situations including listening to music?
Rogier van der Peijl
REAL SCOTSMEN WEAR KILTS because sheep can hear a zipper at 500 yards!
Originally posted by Cady Goldfield
Ah, what a cutie, Rogier. I'll bet a lot of ladies in Netherlands are mourning because you are out of circulation now!
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