Regina Studer

Hyperventilation complaints in music performance anxiety among classical music students

OBJECTIVE Despite the importance of respiration and hyperventilation in anxiety disorders, research on breathing disturbances associated with hyperventilation is rare in the field of music performance anxiety (MPA, also known as stage fright). The only comparable study in this area reported a positive correlation between negative feelings of MPA and hyperventilation complaints during performance. The goals of this study were (a) to extend these previous findings to the period before performance, (b) to test whether a positive correlation also exists between hyperventilation complaints and the experience of stage fright as a problem, (c) to investigate instrument-specific symptom reporting, and (d) to confirm gender differences in negative feelings of MPA and hyperventilation complaints reported in other studies. METHODS We assessed 169 university students of classical music with a questionnaire comprising: the State-Trait Anxiety Inventory for negative feelings of MPA, the Nijmegen Questionnaire for hyperventilation complaints, and a single item for the experience of stage fright as a problem. RESULTS We found a significant positive correlation between hyperventilation complaints and negative feelings of MPA before performance and a significant positive correlation between hyperventilation complaints and the experience of stage fright as a problem. Wind musicians/singers reported a significantly higher frequency of respiratory symptoms than other musicians. Furthermore, women scored significantly higher on hyperventilation complaints and negative feelings of MPA. CONCLUSION These results further the findings of previous reports by suggesting that breathing disturbances associated with hyperventilation may play a role in MPA prior to going on stage. Experimental studies are needed to confirm whether hyperventilation complaints associated with negative feelings of MPA manifest themselves at the physiological level.

Stage fright: its experience as a problem and coping with it.

Purpose and methodThis questionnaire survey of 190 university music students assessed negative feelings of music performance anxiety (MPA) before performing, the experience of stage fright as a problem, and how closely they are associated with each other. The study further investigated whether the experience of stage fright as a problem and negative feelings of MPA predict the coping behavior of the music students. Rarely addressed coping issues were assessed, i.e., self-perceived effectiveness of different coping strategies, knowledge of possible risks and acceptance of substance-based coping strategies, and need for more support.ResultsThe results show that one-third of the students experienced stage fright as a problem and that this was only moderately correlated with negative feelings of MPA. The experience of stage fright as a problem significantly predicted the frequency of use and the acceptance of medication as a coping strategy. Breathing exercises and self-control techniques were rated as effective as medication. Finally, students expressed a strong need to receive more support (65%) and more information (84%) concerning stage fright.ConclusionStage fright was experienced as a problem and perceived as having negative career consequences by a considerable percentage of the surveyed students. In addition to a desire for more help and support, the students expressed an openness and willingness to seriously discuss and address the topic of stage fright. This provides a necessary and promising basis for optimal career preparation and, hence, an opportunity to prevent occupational problems in professional musicians.

Hyperventilation in anticipatory music performance anxiety.

Objectives and Methods Self-report studies have shown an association between music performance anxiety (MPA) and hyperventilation complaints. However, hyperventilation was never assessed physiologically in MPA. This study investigated the self-reported affective experience, self-reported physiological symptoms, and cardiorespiratory variables including partial pressure of end-tidal CO2 (PETCO2), which is an indicator for hyperventilation, in 67 music students before a private and a public performance. The response coherence between these response domains was also investigated. Results From the private to the public session, the intensity of all self-report variables increased (all p values < .001). As predicted, the higher the musician’s usual MPA level, the larger were these increases (p values < .10). With the exception of PETCO2, the main cardiorespiratory variables also increased from the private to the public session (p values < .05). These increases were not modulated by the usual MPA level (p values > .10). PETCO2 showed a unique response pattern reflected by an MPA-by-session interaction (p < .01): it increased from the private to the public session for musicians with low MPA levels and decreased for musicians with high MPA levels. Self-reported physiological symptoms were related to the self-reported affective experience (p values < .05) rather than to physiological measures (p values > .17). Conclusions These findings show for the first time how respiration is stimulated before a public performance in music students with different MPA levels. The hypothesis of a hyperventilation tendency in high-performance-anxious musicians is supported. The response coherence between physiological symptoms and physiological activation is weak.

Employment 12 months after kidney transplantation: An in-depth bio-psycho-social analysis of the Swiss Transplant Cohort

Background Return to work with or after a chronic disease is a dynamic process influenced by a variety of interactions between personal, work, societal and medical resources or constraints. The aim of this study was to identify predictors for employment 12 months after transplantation in kidney patients, applying a bio-psycho-social model. Methods All kidney patients followed in the Swiss Transplant Cohort between May 2008 and December 2012, aged 18 to 65 were assessed before, 6 and 12 months after transplantation. Results Of the 689 included patients, 56.2% worked 12 months post- transplantation compared to 58.9% pre-transplantation. Age, education, self-perceived health (6 months post- transplantation), pre- transplantation employment and receiving an organ from a living donor are significant predictors of employment post- transplantation. Moreover, while self-perceived health increased post- transplantation, depression score decreased only among those employed 12 months post- transplantation. Pre- transplantation employment status was the main predictor for post- transplantation employment (OR = 18.6) and was associated with sex, age, education, depression and duration of dialysis. An organ from a living donor (42.1%) was more frequent in younger patients, with higher education, no diabetes and shorter waiting time to surgery. Conclusion Transplantation did not increase employment in end-stage kidney disease patients but helped maintaining employment. Pre-transplantation employment has been confirmed to be the most important predictor of post-transplantation employment. Furthermore, socio-demographic and individual factors predicted directly and indirectly the post-transplantation employment status. With living donor, an additional predictor linked to social factors and the medical procedure has been identified.

The relationship between music performance anxiety, subjective performance quality and post-event rumination among music students

According to cognitive models, the negative perception of one’s performance and the post-event rumination (PER) occurring after stressful social events maintain social anxiety. These aspects have hardly been studied in music performance anxiety (MPA), a specific form of social anxiety. The first aim of this study was to analyze the development of negative and positive PER over two days following a soloist concert, depending on the usual MPA level. The second aim was to investigate if subjective performance quality serves as mediator between MPA and PER. Negative and positive PER were assessed 10 minutes, one day and two days after a concert in 72 music students with different levels of usual MPA. Subjective performance quality was measured 10 minutes after the study concert. An increasing usual MPA level was associated with more negative and less positive PER. Both decreased over time. Negative PER decreased less rapidly in high-anxious than in low-anxious musicians and positive PER decreased more rapidly in low-anxious than in high-anxious musicians. Subjective performance quality mediated the relationship between MPA and PER. These findings extend previous knowledge in social anxiety to the field of MPA and have implications for interventions aiming at reducing MPA.

0276 Predictors of return to work 12 months after solid organ transplantation: results from a cohort study in switzerland

Background Return to work with or after a chronic disease is not a very well understood process, influenced by a variety of personal, professional, societal and medical factors. The aim of this study is to identify predictors for return to work 12 months after a solid organ transplant, applying a bio-psycho-social model. Methods Explorative study based on patients included in the Transplant Cohort Study, a national, prospective, multicentric cohort, who underwent a first solid organ transplant (kidney, liver, heart, lung). Bio-psychosocial factors were tested and predictors of return to work identified using logistical regression models. Results Among the 636 patients included in the study, 49.8% (317) were employed 12 months post transplant. The major predictor for returning to work 12 months post transplant was pre-transplant employment status (OR: 10.8). Accordingly, the population was stratified in employed and unemployed pre transplant groups. Age, self-perceived health (SPH, six months post-transplant) and the transplanted organ were significantly associated with post transplantation employment status in both groups. Additionally, return to work was influenced by education, depression (six month post-transplant) and waiting time in the employed pre transplant group and by invalidity pension in the unemployed pre transplant group. Conclusion Employment rate pre transplant being highly associated with employment status post transplant, the process promoting return to work should be started well before surgery.