Perceived pleasantness mediates the effects of high-arousal and emotionally complex music on pain.

Music effectively reduces pain, yet the mechanisms underlying music-induced hypoalgesia remain poorly understood. We investigated how latent perceptual dimensions of music influence pain by examining both stimulus properties and subjective evaluations of those properties in 2 experiments. One hundred thirty-four participants listened to unfamiliar musical excerpts during thermal pain stimulation. Musical stimuli were systematically selected using the validated Arousal, Valence, Depth (AVD) model, which quantifies 3 key latent perceptual dimensions of music based on groups of descriptors such as "forceful" or "calming." Study A (n = 74) demonstrated that high arousal music increased pain unpleasantness, whereas high depth music provided relief, but crucially, these effects were completely mediated by participants' subjective ratings of musical pleasantness. Study B (n = 60) replicated the beneficial effect of musical depth and confirmed that participants' perceptions aligned with loadings of the AVD model dimensions. Individual differences in trait systemizing moderated the analgesic effect of depth in one study. Complete mediation by pleasantness ratings indicates that experiences of reward and subjective aesthetic evaluation, rather than perceived musical dimensions themselves, drives music-induced hypoalgesia. This suggests that musical pain interventions should prioritize deep and relaxing music that is well liked by the participant.