The mediating role of stress for the effects of the music listening style on pain

Objective Music listening is effective in pain and stress management and can be modulated by the music listening style (MLS): Music empathizers (ME) focus on emotional aspects of music, and music systemizers (MS) focus on structural aspects. This study aimed to investigate if the MLS influences pain and stress, and if the effect of MLS on pain is mediated by stress. Methods Healthy participants (N = 61; age: M = 24.2, SD = 3.89; female/male ME/MS) listened to stimuli during a cold pressor test (CPT) on three days (1: participant-selected music, 2: researcher-selected music, 3: lapping water; random order). Pain intensity, subjective stress, heart rate (HR), heart rate variability parameter RMSSD, salivary alpha-amylase (sAA) and salivary cortisol (sCort) were repeatedly measured. Data were analysed with multilevel and mediation analyses. Results In interaction with gender and condition, MLS influenced reactions in pain intensity and HR, but not subjective stress, RMSSD, sAA or sCort. The effect of MLS on pain intensity was mediated by stress-related parameters: in ME – compared to MS – higher levels of subjective stress at the CPT and lower sCort levels at baseline and CPT were observed, which in turn was associated with higher perceived pain intensity at the CPT and a stronger increase in pain intensity from baseline to CPT. Conclusion Our findings suggest that the MLS can influence specific pain- and stress-related parameters. The effect of the MLS on pain is mediated by endocrine activity and subjective stress. The study provides novel information on individual differences in coping with pain and stress.