Standardized Tunable Music Medicine for Depression (STAMM-D): Development & Feasibility - Major Depressive Disorder (MDD) is a common mental health disorder that affects 8% of US adults, including more than 18% of young adults between the ages of 18 and 29. Decades of research indicate that music-based treatments are broadly effective against depression, but their impact remains tightly restricted by a shortage of trained practitioners and a lack of readily deployed standard protocols. Our overall objective here is to develop and test the feasibility of a new “Standardized Tunable Music Medicine for Depression” as one such protocol. STAMM-D integrates progress across music therapy, neuroscience, and technology within a compact, personalized, mobile health (mHealth) treatment protocol designed to leverage music’s core effects on emotion and reward against MDD’s core symptoms of low mood and anhedonia. Our hypothesis is that we can feasibly develop STAMM-D as an engaging mHealth intervention that will be attractive to a large proportion of young adults with MDD diagnoses (e.g., 75%), a disproportionately affected demographic that also exhibits peak engagement with music, listening for an average of four hours per day. Aim 1 is to develop STAMM-D around three specific innovations, each designed to address a key design principle derived from literature review. These innovations are: (1) “iso music” for mood elevation, adapted from industry wellness applications to MDD treatment; (2) a protocol for creating therapeutically-appropriate individually-tuned music playlists on the basis of a combination of patient-facing music preference interviews and modern music recommendation algorithms; and (3) easy-to-use digital “musical agency” controls that give listeners the power to modulate key musical features (e.g., tempo and spectrum), encouraging behavioral engagement towards affective synchronization. Aim 2 is to deploy STAMM-D alongside a therapeutically credible control condition (Relaxation Music; RM) in a small-scale feasibility trial (N=68) aimed at evaluating recruitment rates, retention rates, treatment fidelity, and acceptability, ahead of a follow-on efficacy trial. Feasibility trial protocol details (dosage, duration, outcomes, etc.) are thus designed to closely match those required to test STAMM-D’s capacity to effectively treat MDD in an appropriately powered and rigorously controlled future trial. Finally, trial operations are designed to generate as much data towards STAMM-D refinement as possible, deriving extensive quantitative and qualitative feedback directly from young adults with MDD (i.e., stakeholders). The significance of this work lies in developing and establishing STAMM-D as a first-in-kind musical treatment with the capacity to radically expand access to music-based treatment for depression. More broadly, we expect this work to outline a template for developing other standardized musical treatments at the intersection of music therapy, neuroscience, and technology—e.g., targeting anxiety and insomnia—thus making an important practical contribution to ongoing efforts to expand the role for music in medicine. Key Personnel include one interdisciplinary neuroscientist (PhD), one music therapist (MT-BC), an academic psychiatrist (MD), two clinical psychiatrists (MDs), and one biostatistician (PhD).
