Abstract/Summary

Persons with dementia (PwD) with comorbid depression or anxiety face increased risk of cognitive decline, hospitalisation, and institutionalisation. Music-based interventions, e.g., music listening, are used in dementia-care to alleviate depression and anxiety due to a lack of side-effects. Although music can affect two key processes in the development and maintenance of depression and anxiety, attentional biases (AB) (the tendency to attend to, or avoid, certain types of information) and rumination (repetitive, self-focused thoughts), these processes are overlooked within music research/interventions involving PwD. Moreover, an intervention used to alter AB and rumination levels, attentional bias modification (ABM), was yet to be explored with PwD. Hence, this thesis explored for PwD the reliability of rumination scales, and the relationship between depression, anxiety, rumination, and AB as steps toward identifying potential treatment targets to improve outcomes. The feasibility of conducting remotely-delivered AB measures using webcam-based eye-tracking (WBET) within music and ABM research/interventions involving PwD was examined, alongside the reliability of WBET measures of AB. A lab-based gaze-contingent musical ABM (GCM-ABM) paradigm was developed for use with PwD and was piloted with students. The Cognitive Emotional Regulation Questionnaire, Ruminative Thought Style Questionnaire, and Ruminative Response Scale demonstrated adequate to good reliability for PwD. The positive relationship between depression, anxiety, and rumination demonstrated for PwD aligned with literature. These findings, alongside the variance in depression and anxiety accounted for by rumination suggests that rumination is a viable intervention target. Clinically-relevant reductions in depression, anxiety, and rumination were indeed found post music with ABM and GCM-ABM interventions. Single and multi-session WBET measures of AB were feasible with PwD, with single-session measures demonstrating literature-based gaze-location failure rates and lab-based eye tracker reliability levels.