Performance anxiety in professional musicians: a systematic review on prevalence, risk factors and clinical treatment effects

Abstract

Music performance anxiety (MPA) is one of the most common disorders among professional musicians, nevertheless, little is known about the disease. With this systematic review, prevalence, risk factors and treatment procedures for MPA were assessed, and for the first time, quality assessments were carried out for all studies using standardized assessment tools. A systematic literature search was conducted via search algorithms in the databases MEDLINE, EMBASE, CINAHL, PsycArticles, PsycInfo and ERIC. Included were case reports, case–control, cohort, cross-sectional and intervention studies examining professional musicians with MPA. For quality assessment, adapted tools of the National Heart, Lung, and Blood Institute were used. A total of 43 studies were included (10 case reports, 21 intervention, 11 cross-sectional, one cohort study). Quality ratings ranged from −11 to 6 out of a maximum of 15/16 points for cross-sectional/cohort studies and −4 to 11 out of 18 points for intervention studies. The prevalence of MPA was between 16.5% and 60%. More women than men were affected and musicians older than 45–50 years reported less MPA than younger musicians. Regarding treatment cognitive behavioural therapy (CBT) and β-blockers were most often researched with beneficial results for CBT. However, studies with adequate control groups for CBT interventions are needed to clarify its efficacy. Studies showed methodological weaknesses, especially in the selection of participants, recording of influencing factors, blinding of interventions, randomization of participants and analysis of comorbidity. Recommendations for further research are made.

“A Bed of Nails”: Professional Musicians’ Accounts of the Experience of Performance Anxiety From a Phenomenological Perspective

“…The majority of research in the field has maintained a clinical approach to the study of performance anxiety, focusing on its etiology, prevalence and treatment (see, for example, the systematic reviews of Burin and Osorio, 2017;Fernholz et al, 2019). Most published studies with adult musicians have employed quantitative methodologies, for example: intervention studies and experimental research (e.g., James and Savage, 1984;Gates et al, 1985;Gates and Montalbo, 1987;Nagel et al, 1989;Montello et al, 1990;Brotons, 1994;Brodsky and Sloboda, 1997;Chang et al, 2003;Kim, 2005.…”

“…Studies with adult orchestral and choral musicians, for example, have reported a prevalence of between 15 and 70% (Schulz, 1981;Gustafson and Rawson, 1983;Fishbein et al, 1988;Marchant-Haycox and Wilson, 1992;Steptoe, 2001;Brugués, 2009;Ryan and Andrews, 2009;Medeiros Barbar et al, 2014). Recently, a systematic review of MPA in professional musicians concluded similarly that prevalence rates range between 16.5 and 60% (Fernholz et al, 2019).…”

Musical Performance Anxiety (MPA)

“…These data indicate that women are significantly less confident and more anxious and show less self-efficacy (attitude) in contexts such as jazz improvising learning. In women over 45 years old, the MPA prevalence is even bigger and can achieve up to 60% depending on the context [11]. However, there is a great relation between MPA and age increase among susceptible individuals, independently of the gender.…”

Respiratory Variability, Sighing, Anxiety, and Breathing Symptoms in Low- and High-Anxious Music Students Before and After Performing

“…] which is manifested through combinations of affective, cognitive, somatic and behavioral symptoms" (Kenny, 2010, p. 433). MPA is a major issue for professionals and students (Fernholz et al, 2019).…”