Music performance anxiety (MPA) is a common problem in musicians of all ages, genders, socio-economic backgrounds, and levels of performance experience. The intensity of symptoms associated with the condition range from mild to debilitating. Even at lower levels, chronic MPA is associated with stress-related illnesses and maladaptive coping behaviors, such as self-medication with licit (cigarettes and alcohol) and illicit or off-label drugs. Acute MPA is known to destroy musical careers.
Faced with the pervasiveness and potential gravity of MPA, clinicians have developed a number of nonpharmacologic treatment protocols, some of which have been studied for efficacy. Most of the outcome studies have reported pairwise comparisons (experimental versus control) of measures taken of small samples of performing musicians. The robustness of the treatment was determined by tests of statistical significance of observed differences on outcome measures or by the calculation of effect size.
Previous narrative reviews of outcome studies have provided summary descriptions of their characteristics and findings. However, these analyses do not provide quantitative evidence of the efficacy of different treatments for ameliorating MPA.
Since it was first employed in psychological research by Smith and Glass in 1977, meta-analysis has become the gold standard for synthesizing quantitative research findings across studies. The method involves integration of standardized treatment effect estimates from different studies. It can provide comparisons of the effectiveness of subgroups of therapies (approaches), characterize a therapeutic approach in terms of an outcome profile, and determine whether a particular psychotherapeutic intervention is effective. The present review is the first to use meta-analysis to integrate the findings of research studies in the literature on nonpharmacologic psychotherapies for MPA and to compare their effectiveness.
An exhaustive search of the literature identified 46 efficacy studies. Of these, 29 met the criteria for inclusion in the meta-analysis. The accumulated data represents autonomic, self-report, and observational measures of MPA for 852 advanced music students and professional musicians. Each measure was coded for type (autonomic, self-report or observational) and for therapeutic approach (cognitive, behavioral, complementary and alternative, and combined). Analysis of the synthesized data indicated statistically significant therapeutic effects of each therapeutic approach. Additionally, when the approaches were compared, the class of psychotherapies that was made of combinations of two or more types of interventions (combined) showed the strongest treatment effect.
Among the implications of these findings is the plurality of good choices for an individual suffering with MPA. The development of programs to raise awareness of the prevalence of music performance anxiety and available treatments is recommended. For researchers, greater standardization in methodology and periodic meta-analysis is encouraged.
|Commitee:||Gall, M. D.|
|School:||California Institute of Integral Studies|
|School Location:||United States -- California|
|Source:||DAI-B 75/09(E), Dissertation Abstracts International|
|Subjects:||Psychology, Clinical psychology, Performing Arts|
|Keywords:||Meta-analysis, Music performance anxiety, Stage fright|
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