Anxiety Disorders and Phobias: A Cognitive Perspective

Context and aims: Many musicians suffer for their art, and health is often compromised during training. The Health Promotion in Schools of Music (HPSM) project has recommended that health education should be included in core curricula, although few such courses have been evaluated to date. The aim of the study was to design, implement and evaluate a compulsory health education course at a UK conservatoire of music.

Methods: The course design was informed by a critical appraisal of the literature on musicians' health problems and their management, existing health education courses for musicians, and the HPSM recommendations. It was delivered by a team of appropriately-qualified tutors over 5 months to 104 first-year undergraduate students, and evaluated by means of questionnaires at the beginning and end of the course. Thirty-three students who had been in their first year the year before the course was introduced served as a control group, completing the questionnaire on one occasion only. Items concerned: hearing and use of hearing protection; primary outcomes including perceived knowledge and importance of the topics taught on the course; and secondary outcomes including physical and psychological health and health-promoting behaviors. The content of the essays written by the first-year students as part of their course assessment served as a guide to the topics they found most interesting and relevant.

Results: Comparatively few respondents reported using hearing protection when practicing alone, although there was some evidence of hearing loss, tinnitus, and hyperacusis. Perceived knowledge of the topics on the course, and awareness of the risks to health associated with performing music, increased, as did self-efficacy; otherwise, there were negative effects on secondary outcomes, and few differences between the intervention and control groups. The topics most frequently covered in students' essays were managing music performance anxiety, and life skills and behavior change techniques.

Conclusion: There is considerable scope for improving music students' physical and psychological health and health-related behaviors through health education, and persuading senior managers, educators and students themselves that health education can contribute to performance enhancement.

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Health Education for Musicians.

Background Music performance anxiety (MPA) is understood as a sub-type of social anxiety and is characterised by fears of a musical presentation. Objective To carry out a critical literature review on clinical and etiological aspects, perceived causes, coping strategies and treatment of MPA. Methods Electronic databases PubMed, PsycINFO and Lilacs as well as specific periodicals were used based on the key-words symptoms, diagnosis, aetiology, perceived causes, coping strategies and treatment. Results MPA is highly prevalent among musicians (> 16%), regardless of culture and formation. Cognitive, behavioural and physiological factors are associated with the aetiology of MPA, including biological and psychological predispositions. In addition, one should highlight factors related to the individual, aspects related to tasks and musical situation as perceived causes and/or predictor variables of MPA. As for the coping strategies, one can also highlight the use of breathing/relaxing techniques, increased musical practice, use of homeopathy and substances without medical prescription. Discussion MPA is impacting in the musician’s life. Despite the increasing interest in its study, it is necessary to better understand this complex phenomenon, mainly in the therapeutic context, in addition to the publicising and offering of services for prevention and treatment of MPA.

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Music performance anxiety: a critical review of etiological aspects, perceived causes, coping strategies and treatment

Classical performing musicians have command of a wide range of cognitive, physiological and musical skills. However, the literature on facilitating optimal music performance has tended to focus on ...

Music performance skills: A two-pronged approach – facilitating optimal music performance and reducing music performance anxiety:

Recent studies have provided empirical support for the suggestion that there is an antithetical relationship between music performance anxiety (MPA) and flow, and that this antithetical relationshi...

Flow and music performance anxiety: The influence of contextual and background variables:

Music performance anxiety (MPA) is characterised by fears related to performing music. It may result in damages to personal life and professional career, so treatment and prevention are very important. Objective To undertake a systematic literature review on the effectiveness/efficacy of MPA interventions and to integrate these findings to those in the literature reviewed previously. Methods We used PubMed, PsycINFO and SciELO databases and keywords music*, performance anxiety, treatment, therapy and intervention and manual research. We selected articles published between October-2002/July-2016. Results Out of 97 articles, 23 were reviewed. Sixteen studies presented inter-group experimental design, and seven presented pre-post experimental design. The intervention modalities reviewed were cognitive behavioural therapy (CBT), virtual reality exposure, biofeedback, yoga, meditation, music therapy and the Alexander technique. Although the interventions presented some indicators of efficacy in the MPA outcomes and improvement in performance quality, important methodological limitations were observed: low number of individuals and non-specific criteria for their inclusion/exclusion. This reinforces previous findings regarding methodological fragilities associated with this context. Discussion CBT is the most frequently studied modality and with the greatest number of effectiveness indicators. The remaining modalities indicate tendencies in positive outcomes that require further and efficient investigation in more rigorous studies with greater methodological control

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Interventions for music performance anxiety: results from a systematic literature review

Introduction Music performance anxiety (MPA) is characterized by long-lasting, high intensity apprehension associated with performing music in public. At extreme levels, MPA can impair the career and quality of life. Our goal is to describe the clinical profile, perceived causes and coping strategies associated with MPA. Methods In this cross-sectional study, several self-assessment instruments were administered to a sample of 214 Brazilian musicians (68% male, 53.3% classical/46.7% popular musicians). Data were analyzed using descriptive and parametric statistics, based on the variables of musical training and level of MPA. Results Percentages of indicators of pathology were high (40% high MPA levels, 37% social anxiety, 12.5% depression, 13.5% alcohol abuse), and musicians with high MPA levels were the most affected. A wide variety of situations were associated with MPA, especially those related to the individual (pressure from self/concern about audience). Emotion-focused coping and internal resources were prominent among the resources used for coping with MPA (breathing, increased practice, familiarization with performance venue), although they were not always effective. It was relatively uncommon for musicians to seek specialized resources and treatments. Conclusions The results demonstrate the vulnerability of the targeted professional groups and the need for preventive strategies and behavioral, environmental, educational, and pharmacological interventions to change this scenario.

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Ana Beatriz Burin

Papers

Music performance anxiety: a critical review of etiological aspects, perceived causes, coping strategies and treatment

Interventions for music performance anxiety: results from a systematic literature review

Music performance anxiety: perceived causes, coping strategies and clinical profiles of Brazilian musicians