The assessment and treatment of performance anxiety in musicians [see comments]

Author(s): Agras, W. S.

Journal/Book: Am J Psychiatry. 1991; 148: 598-605.

Abstract: OBJECTIVE: Performance anxiety in musicians may be severe enough to require intervention but has been the subject of relatively little clinical research. The authors' objectives were to describe the results of a comprehensive clinical and laboratory assessment and to perform a double-blind, placebo-controlled study comparing buspirone, cognitive-behavior therapy, and the combination of these treatments for performance anxiety. METHOD: Ninety-four subjects were recruited by mass media announcements and were seen in a university-based outpatient psychiatric clinic. Assessments were 1) questionnaires for all 94 subjects, 2) diagnostic interview of 50 subjects, and 3) laboratory performance of 34 subjects. Treatment conditions were 1) 6 weeks of buspirone, 2) 6 weeks of placebo, 3) a five-session, group cognitive-behavior therapy program with buspirone, or 4) the cognitive-behavior therapy program with placebo. Treatment outcome measures included subjective anxiety ratings and heart rate measures during a laboratory performance, a questionnaire measure of performance confidence, and a blind rating of musical performance quality. RESULTS: All subjects fulfilled criteria for DSM-III-R social phobia. Of the 15 full-time professional musicians, ten had tried propranolol and three had stopped performing. Most of the subjects had substantial anxiety and heart rate increases during laboratory speech and musical performances. Cognitive-behavior therapy resulted in statistically significant reductions in subjective anxiety, improved quality of musical performance, and improved performance confidence. Buspirone was not an effective treatment. CONCLUSIONS: Cognitive-behavior therapy is a viable treatment approach for performance anxiety in musicians.

Keyword(s): Adult ; Anxiety Disorders diagnosis; Anxiety Disorders psychology; Combined Modality Therapy; Double Blind Method; Follow Up Studies; Occupational Diseases diagnosis; Occupational Diseases psychology; Personality Inventory; Placebos ; Psychiatric Status Rating Scales; Questionnaires Anxiety Disorders therapy; Buspirone therapeutic use; Cognitive Therapy; Music ; Occupational Diseases therapy Comparative Study; Female; Human; Male; Support, Non U.S. Gov't; Support, U.S. Gov't, P.H.S. Placebos; Buspirone

Zurück | Weiter