Why are some performers exhilarated and energized about performing in public, while others feel a crushing sense of fear and dread, and experience public performance as an overwhelming challenge that must be endured? What are the factors that produce such vastly different performance experiences? Why have consummate artists like Frederic Chopin, Sergei Rachmaninoff, Pablo Cassals, Tatiana Troyanos, and Barbra Streisand experienced such intense music performance anxiety? This is a disorder that can affect musicians across a range of genres and of all standards. Some of the ‘cures’ musicians resort to can be harmful to their health and detrimental to their playing. This book is an exposition of music performance anxiety. It draws on a range of disciplines including psychology, philosophy, phenomenology, psychoanalysis, and performance theory in order to explain the many facets of music performance anxiety that have emerged in the empirical and clinical literature. It identifies some unifying guiding principles that will enhance our understanding of the condition and guides in the development of effective treatments. The book provides a detailed conceptual framework for the study of music performance anxiety and a review of the empirical and clinical research on the anxiety disorders. In addition, it presents a thorough analysis of the concepts related to music performance anxiety, its epidemiology, and theories and therapies that may be useful in understanding and treating the condition. The voices of musicians are clearly heard throughout the book and in the final two chapters, we hear directly from musicians about how they experience it and what they do to manage it.

We report the major findings from the psychosocial questionnaire component of a cross-sectional population survey of the musicians in Australia’s eight full-time professional symphonic and pit orchestras. The response rate was 70% (n = 377). Female musicians reported significantly more trait anxiety, music performance anxiety, social anxiety, and other forms of anxiety and depression than male musicians. The youngest musicians (<30 years) were significantly more anxious compared with the oldest musicians (51+). The youngest female musicians were most affected by music performance anxiety. Music performance anxiety was lowest for the older musicians (51+ years). Thirty-three per cent of musicians may meet criteria for a diagnosis of social phobia. Twenty-two per cent answered in the affirmative to a question screening for post-traumatic stress disorder. Thirty-two per cent returned a positive depression screen; this subgroup had higher scores on the anxiety measures. Linear regression analysis identified the State-Trait Anxiety Inventory (STAI-T), the Social Phobia Inventory (SPIN), the Anxiety and Depression Detector (ADD) and age as independent predictors of music performance anxiety severity. Significant numbers of musicians drank alcohol in a manner outside the National Health and Medical Research Council (NHMRC) alcohol guidelines (2009); only 6% were current smokers. This study has identified a significant pattern of anxiety, depression and health behaviours that require attention in occupational health and safety policies and programmes for this workforce.

Boys diagnosed with ADHD by specialist pediatricians and stabilized on medication were randomly assigned to a 20-session yoga group (n = 11) or a control group (cooperative activities; n = 8). Boys were assessed pre- and post-intervention on the Conners’ Parent and Teacher Rating Scales-Revised: Long (CPRS-R:L & CTRS-R:L; Conners, 1997), the Test of Variables of Attention (TOVA; Greenberg, Cormna, & Kindschi, 1997), and the Motion Logger Actigraph. Data were analyzed using one-way repeated measures analysis of variance (ANOVA). Significant improvements from pre-test to post-test were found for the yoga, but not for the control group on five subscales of the Conners’ Parents Rating Scales (CPRS): Oppositional, Global Index Emotional Lability, Global Index Total, Global Index Restless/Impulsive and ADHD Index. Significant improvements from pre-test to post-test were found for the control group, but not the yoga group on three CPRS subscales: Hyperactivity, Anxious/Shy, and Social Problems. Both groups improved significantly on CPRS Perfectionism, DSM-IV Hyperactive/Impulsive, and DSM-IV Total .For the yoga group, positive change from pre- to post-test on the Conners’ Teacher Rating Scales (CTRS) was associated with the number of sessions attended on the DSM-IV Hyperactive-Impulsive subscale and with a trend on DSM-IV Inattentive subscale. Those in the yoga group who engaged in more home practice showed a significant improvement on TOVA Response Time Variability with a trend on the ADHD score, and greater improvements on the CTRS Global Emotional Lability subscale. Results from the Motion Logger Actigraph were inconclusive. Although these data do not provide strong support for the use of yoga for ADHD, partly because the study was under-powered, they do suggest that yoga may have merit as a complementary treatment for boys with ADHD already stabilized on medication, particularly for its evening effect when medication effects are absent. Yoga remains an investigational treatment, but this study supports further research into its possible uses for this population. These findings need to be replicated on larger groups with a more intensive supervised practice program.

Childhood maltreatment has diverse, lifelong impact on morbidity and mortality. The Childhood Trauma Questionnaire (CTQ) is one of the most commonly used scales to assess and quantify these experiences and their impact. Curiously, despite very widespread use of the CTQ, scores on its Minimization-Denial (MD) subscale—originally designed to assess a positive response bias—are rarely reported. Hence, little is known about this measure. If response biases are either common or consequential, current practices of ignoring the MD scale deserve revision. Therewith, we designed a study to investigate 3 aspects of minimization, as defined by the CTQ’s MD scale: 1) its prevalence; 2) its latent structure; and finally 3) whether minimization moderates the CTQ’s discriminative validity in terms of distinguishing between psychiatric patients and community volunteers. Archival, item-level CTQ data from 24 multinational samples were combined for a total of 19,652 participants. Analyses indicated: 1) minimization is common; 2) minimization functions as a continuous construct; and 3) high MD scores attenuate the ability of the CTQ to distinguish between psychiatric patients and community volunteers. Overall, results suggest that a minimizing response bias—as detected by the MD subscale—has a small but significant moderating effect on the CTQ’s discriminative validity. Results also may suggest that some prior analyses of maltreatment rates or the effects of early maltreatment that have used the CTQ may have underestimated its incidence and impact. We caution researchers and clinicians about the widespread practice of using the CTQ without the MD or collecting MD data but failing to assess and control for its effects on outcomes or dependent variables.

We examined self-reported frequency and severity of performance-related musculoskeletal pain disorder (PRMD), trigger point pain (TPP) and depression, social phobia (SPIN) and music performance anxiety (MPA) using the Kenny Music Performance Anxiety Inventory (K-MPAI) in a cross-sectional survey of 377 professional orchestral musicians. Most (84%) musicians had experienced performance-impairing pain; 50% reported current pain. Females reported more performance-impairing pain and more current pain than males. Cluster analysis indicated a complex relationship between depression and PRMD severity. Three clusters showed the hypothesized relationship (i.e., more depression, more pain). Musicians in the fourth cluster denied depression but reported the most severe pain, suggesting a group who somatize their psychological distress. Cluster analysis also revealed a strong relationship between PRMD severity and MPA. Clusters with higher scores on K-MPAI reported higher scores on PRMD severity. TPP was not associated with self-reported PRMD frequency or severity. There was a significant linear relationship between TPP and MPA for females, but males scoring the highest MPA reported lower TPP than those with milder MPA. Neither SPIN nor beta blocker use was associated with PRMD frequency or severity. The complex relationships identified between PRMD, TPP, depression and MPA may have important implications for PRMD management in professional musicians.