Music performance anxiety: perceived causes, coping strategies and clinical profiles of Brazilian musicians / Ansiedade de performance musical: causas percebidas, estratégias de enfrentamento e perfil clínico de músicos brasileiros

Abstract 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.

Resumo Introdução Ansiedade de performance musical (APM) é definida como uma condição de apreensão duradoura e intensa, associada ao desempenho musical em público. Em níveis extremos é prejudicial à carreira e qualidade de vida do músico. Objetiva-se descrever o perfil clínico, as causas percebidas e estratégias de enfrentamento da APM. Métodos Neste estudo transversal, vários instrumentos de autoavaliação foram administrados a 214 músicos brasileiros (68% do sexo masculino, 53,3% clássicos/ 46,7% populares). Os dados foram analisados por estatística descritiva e paramétrica, com base nas variáveis formação musical e nível de APM. Resultados Encontrou-se um percentual elevado de indicadores de psicopatologia (40% altos níveis de APM, 37% ansiedade social, 12,5% depressão, 13,5% abuso de álcool), sendo os músicos com altos níveis de APM aqueles com maior comprometimento. Uma ampla variedade de situações foi associada à APM, com destaque para aquelas relacionadas ao próprio indivíduo (pressão de si próprio/preocupação com a plateia). Entre os recursos utilizados para enfrentamento da APM destacaram-se aqueles focados na regulação emocional e no uso de recursos internos dos músicos (respiração, aumento do treino, familiarização com a prática no local da apresentação), embora nem sempre tenham sido eficazes. Mostrou-se pouco comum a busca por recursos e tratamentos especializados. Conclusões Evidencia-se a condição de vulnerabilidade desse grupo profissional e a necessidade de estratégias preventivas e intervenções comportamentais, ambientais, educativas e farmacológicas que permitam mudanças neste cenário.

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

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.

Elimination testing with adapted scoring reduces guessing and anxiety in multiple-choice assessments, but does not increase grade average in comparison with negative marking.

BACKGROUND AND HYPOTHESES: This study is the first to offer an in-depth comparison of elimination testing with the scoring rule of Arnold & Arnold (hereafter referred to as elimination testing with adapted scoring) and negative marking. As such, this study is motivated by the search for an alternative for negative marking that still discourages guessing, but is less disadvantageous for non-relevant student characteristics such a risk-aversion and does not result in grade inflation. The comparison is structured around seven hypotheses: in comparison with negative marking, elimination testing with adapted scoring leads to (1) a similar average score (no grade inflation); (2) students expressing their partial knowledge; (3) a decrease in the number of blank answers; (4) no gender bias in the number of blank answers; (5) a reduction in guessing; (6) a decrease in self-reported test anxiety; and finally (7) students preferring elimination testing with adapted scoring over negative marking. METHODOLOGY: To investigate the above hypotheses, this study implemented elimination testing with adapted scoring and negative marking in real exam settings in two courses in a Faculty of Medicine at a large university. Due to changes in the master of medicine the same two courses were taught to both students of the 1st and 2nd master in the same semester. Given that both student groups could take the same exam with different test instructions and scoring methods, a unique opportunity occurred in which elimination testing with adapted scoring and negative marking could be compared in a high-stakes testing situation. After receiving the grades on the exams, students received a questionnaire to assess their experiences. FINDINGS: The statistical analysis taking into account student ability and gender showed that elimination testing with adapted scoring is a valuable alternative for negative marking when looking for a scoring method that discourages guessing. In contrast to traditional scoring of elimination testing, elimination testing with adapted scoring does not result in grade inflation in comparison with negative marking. This study showed that elimination testing with adapted scoring reduces blank answers and finds strong indications for the reduction of guessing in comparison with negative marking. Finally, students preferred elimination testing with adapted scoring over negative marking and reported lower stress levels in elimination testing with adapted scoring in comparison with negative marking.

Association between temporomandibular disorders and music performance anxiety in violinists.

BACKGROUND: Professional violin playing has been associated with a predisposition to develop temporomandibular disorder (TMD). There are a number of risk factors, including physical trauma from the playing posture and the presence of parafunctional habits. Music performance anxiety (MPA) may also be a factor, as it has been associated with playing-related musculoskeletal disorders (PRMD). AIMS: To evaluate a possible association between the presence of TMD and the level of MPA in violin players. METHODS: An observational study using a written questionnaire that retrieved data related to TMD symptoms (Fonseca Anamnestic Questionnaire), MPA level (Kenny Music Performance Anxiety Inventory, K-MPAI), instrument practice time, chinrest type, sex and age. Descriptive, bivariate and logistic regression analyses were conducted. RESULTS: Ninety-three professional or semi-professional violinists performing in and around Lisbon, Portugal, completed the questionnaire (73% response rate). TMD was present in 50 violinists (58%). There was a statistically significant association between the presence of TMD and high MPA levels (P < 0.001) and the most anxious violinists were six times (95% confidence interval 2.51-15.33; P < 0.001) more likely to report TMD symptoms when compared with the least anxious players. CONCLUSIONS: Violin players had a high prevalence of reported TMD symptoms, which was significantly associated with high MPA levels. It may therefore be necessary to address psychological and physical factors simultaneously in musicians who do not improve with physical therapy alone.

A Psychophysiological Case Study of Orchestra Conductors.

The psychological and physiological effects of performance were investigated in two professional orchestral conductors, with data collected prior to, during, and after a rehearsal and a public performance. The participants were given a battery of psychological self-report tests (anxiety, dissociation, health inventory, fantasy proneness, shame, and flow). Ambulatory physiological monitoring (Vivometric LifeShirt® system) was conducted during both a rehearsal and public performance to gather information about the autonomic nervous system and heart rate variability (HRV). One conductor had a history of asthma and anxiety, and the second conductor had coronary artery disease. The results revealed within-subject and between-subject differences in autonomic nervous system responses and HRV during several conditions (pre-performance rest, stair-climbing, rehearsal, and performance). Based on heart rate, the physiological demands of professional conducting are reflective of work intensities considered "hard." Both conductors experienced high flow states. Anxiety and coronary artery disease may have attenuated HRV resilience in this study. It is recommended that noninvasive methods be implemented to assess cardiac autonomic activity in professional conductors, particularly during engagement in their professional activities. The findings suggest a need to further study anxiety, respiratory conditions, and cardiovascular risks for conductors.

Exploring the factorial structure of the Sport Anxiety Scale-2: invariance across language, gender, age and type of sport.

BACKGROUND: This study evaluates the metric and scalar invariance of the Sport Anxiety Scale-2 (SAS-2), which is considered one of the best sport performance anxiety assessment tools for child and adolescent athletes, across four sampling variables: language, gender, age and type of sport. METHOD: The participants were 842 athletes (Mage = 11.73, SD = 2.20) from Spain, Belgium and Portugal, each of whom completed the language-adapted version of the SAS-2. Confirmatory factor analysis was used to test the invariance of the measurement model, and the relative importance of the sampling variables was assessed using a multiple indicator multiple causes model (MIMIC). RESULTS: The results revealed metric and scalar invariance across all sampling variables and null to modest effects of gender, age and type of sport as covariates for the factors of the SAS-2. However, there was a marked effect (ß = -.56) of language on worry, which reflected lower scores on this factor for the Flemish sample. CONCLUSIONS: The results of this study provide evidence of the invariance of the SAS-2 across samples, thereby endorsing the reliability of its factorial structure for future multi-group research.

Treatment and prevention of music performance anxiety.

Music performance anxiety (MPA) regularly occurs when musicians present themselves before an audience in performance situations, and thus, it plays an important role in the careers of professional musicians. MPA is expressed on the emotional and physical level, as well as on the levels of thinking and behavior, and extends along a continuum of varying severity. Its performance-impairing, afflicting form is considered to be a specific type of social phobia, which requires therapy. There are different psychological theories, which contribute to the understanding of the phenomenon of MPA and provide basic principles for the various treatment approaches. Current "best practice," in our clinical experience, is a personal- and problem-oriented approach within a multimodal therapy model, including the range of psychoanalytic and cognitive behavioral therapies, body-oriented methods, and mental techniques. In order to avoid severe MPA, prevention in the field of music pedagogic is very important. Thus, the concepts of dealing positively with MPA should be implemented very early into the instrumental and vocal education of musicians.

Mild test anxiety influences neurocognitive performance among African Americans and European Americans: identifying interfering and facilitating sources.

The current study examined ethnic/racial differences in test-related anxiety and its relationship to neurocognitive performance in a community sample of African American (n = 40) and European American (n = 36) adults. The authors hypothesized the following: (a) Test-anxiety related to negative performance evaluation would be associated with lower neurocognitive performance, whereas anxiety unrelated to negative evaluation would be associated with higher neurocognitive performance. (b) African American participants would report higher levels of anxiety about negative performance evaluation than European Americans. (c) European Americans would report higher levels of anxiety unrelated to negative performance evaluation. The first two hypotheses were supported: Ethnic/racial differences in test-taking anxiety emerged such that African Americans reported significantly higher levels of negative performance evaluation, which was associated with lower cognitive performance. The third hypothesis was not supported: African Americans and European Americans reported similar levels of test-anxiety unrelated to negative evaluation.

Acute and chronic stress increase salivary cortisol: a study in the real-life setting of a national examination undertaken by medical graduates.

Spanish medical graduates who apply for a medical specialty training position (MIR) must take an examination that will shape their future personal and professional lives. Preparation for the test represents an important stressor that persists for several months. The aim of this study was to elucidate the stress pattern of this group and evaluate possible changes in the circadian rhythm of cortisol release in medical graduates preparing for this test. A repeated-measures longitudinal study was performed, measuring the salivary cortisol concentrations in 36 medical graduates (13 males and 23 females; mean age of 24.2 years) on five sampling days. Five cortisol samples were collected from 07:00 to 21:00 h in order to monitor changes in the circadian rhythm. On all sampling days (except on the day of the official examination), anxiety and psychological stress were evaluated with the Spanish versions of the State-Trait Anxiety Inventory (STAI) and the Perceived Stress Scale (PSS). During the study period, participants showed higher levels of anxiety than the Spanish reference population as well as a progressive increase in self-perceived stress. A significant increase in salivary cortisol concentration was observed in both chronic (study and examination preparation) and acute (examinations) situations. Our results suggest that the cortisol awakening response (CAR) may be a good indicator of anticipatory stress but is unaffected by long-term examination preparation. Comparison of results between the official examination day and the mock examination days yielded evidence that learning may modulate the behavior of the hypothalamic-pituitary-adrenal axis.