Repeated stage exposure reduces music performance anxiety

F on ie s in Psychology 01 on ie sin.o g
Repea ed s age exposu e educes
music pe o mance anxie y
Vic o Candia
1
*, Ma inKusse ow
2, Oli e Ma gulies
1 and
Ho s Hildeb and
1,3
1 Depa men o Music, Ins i u e o Music Resea ch (IMR), Zu ich Uni e si y o he A s (ZHdK), Zü ich,
Swi ze land, 2 Depa men o In o ma ion Technology and Elec ical Enginee ing, Wea able Compu ing
Lab ETH, Zü ich, Swi ze land, 3 Swiss Uni e si y Cen e o Music Physiology, Basel Uni e si y o he A s,
Basel, Swi ze land
Backg ound: High hea a e (HR) and es lessness a e wo impo an ea u es
o music pe o mance anxie y (MPA). In a case epo o a cellis su e ing om
his condi ion, we showed ha HR and es lessness dec eased a e epea ed
li e pe o mances o he same musical exce p , he eby posi i ely modula ing
objec i e pe o mance c i e ia and subjec i e componen s. He e, we la gely
eplica e hese esul s in a g oup o 18 s ing playe s epo ing MPA.
Me hods: Objec i e measu emen de ices included a minia u ized
elec oca diog am moni o and h ee 3-axis accele ome e logge s. Subjec i e
measu es included he Mul idimensional Men al Heal h Ques ionnai e (MDBF)
and a cus omized isual analogue scale (VAS) ques ionnai e o MPA. Non-
a is ic pe o mance e o s we e assessed by music expe s using a composi e
sco e o echnical playing e o s (i.e., in ona ion e o s, omission o no es, and
bowing noise). Da a we e collec ed om each s udy pa icipan du ing h ee b ie
public solo pe o mances o he same musical exce p , wi h each pe o mance
occu ing be o e a new audience on he same day.
Resul s: F om he 1s o he 3 d pe o mance, HR, VAS, and playing e o sco es
dec eased signi ican ly. MDBF (RU scale) showed a signi ican inc ease in calmness
om he 1s o he 3 d pe o mance on s age. HR and RU, VAS, and RU, as well as
bow accele a ion and o e all du a ion o playing co ela ed signi ican ly ac oss
pa icipan s and pe o mances.
Discussion and conclusion: We conclude ha epea ed s age exposu e
signi ican ly educes HR as well as es lessness and playing e o s linked o MPA.
Public pe o mances a e s ill success ul when HR is signi ican ly highe han
du ing es pe iods. These esul s unde sco e he impo ance o s age aining
o become accus omed o ealis ic public sel -exposu e. Musicians – especially
s uden s – should conside his componen o s age aining as an in eg al pa
o hei p ac ice ou ine. The e o e, s age aining can educe MPA, p omo e
be e li e pe o mances and p e en s ess- ela ed men al diso de s and
physical inju ies. These esul om excessi e sel -exe cise s a egies common
in musicians expe iencing MPA. HR moni o ing should be an in eg al pa o
e alua ing he e ec i eness o in e en ions o be e MPA managemen and
e icien pe o mance aining.
KEYWORDS
music pe o mance anxie y, s age igh , coping, s age exposu e, musicians’ medicine,
musicians’ heal h, music physiology
OPEN ACCESS
EDITED BY
Michiko Yoshie,
Na ional Ins i u e o Ad anced Indus ial
Science and Technology (AIST),
Japan
REVIEWED BY
Ghizlane Bend iss,
Weill Co nell Medicine-Qa a ,
Qa a
Dianna Theado a Kenny,
The Uni e si y o Sydney,
Aus alia
*CORRESPONDENCE
Vic o Candia
ic o [email p o ec ed]
SPECIALTY SECTION
This a icle was submi ed o
Pe o mance Science,
a sec ion o he jou nal
F on ie s in Psychology
RECEIVED 17 Janua y 2023
ACCEPTED 28 Feb ua y 2023
PUBLISHED 20 Ma ch 2023
CITATION
Candia V, Kusse ow M, Ma gulies O and
Hildeb and H (2023) Repea ed s age exposu e
educes music pe o mance anxie y.
F on . Psychol. 14:1146405.
doi: 10.3389/ psyg.2023.1146405
COPYRIGHT
© 2023 Candia, Kusse ow, Ma gulies and
Hildeb and . This is an open-access a icle
dis ibu ed unde he e ms o he C ea i e
Commons A ibu ion License (CC BY). The
use, dis ibu ion o ep oduc ion in o he
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c edi ed and ha he o iginal publica ion in his
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ep oduc ion is pe mi ed which does no
comply wi h hese e ms.
TYPE O iginal Resea ch
PUBLISHED 20 Ma ch 2023
DOI 10.3389/ psyg.2023.1146405
Candia e al. 10.3389/ psyg.2023.1146405
F on ie s in Psychology 02 on ie sin.o g
1. In oduc ion
MPA is a o m o anxie y ha mani es s in unwan ed and
unpleasan physiological and psychological esponses. Inc eased
sympa he ic ac i i y is a p ominen indica o o MPA (Yoshie e al.,
2009; DeCa o e al., 2011; Kenny e al., 2014; Kenny and Acke mann,
2015; Jane, 2022). In addi ion, e ec s o MPA on neu o-endoc ine
egula o y sys ems ha e been iden i ied (Gomez e al., 2018; Haccoun
e al., 2020).
Along wi h psychological ac o s, o ins ance, lack o gene al sel -
con idence, iden i ied as a majo sou ce o MPA (Kenny e al., 2014),
musicians lis soma ic signs caused by excessi e physical a ousal
be o e o du ing pe o mance among he main causes o hei MPA. In
addi ion, solo pe o mance has majo nega i e e ec s on MPA (Kenny
e al., 2014). Nega i e pos -e en umina ion has been epo ed o
p omo e pe o mance anxie y (Nielsen e al., 2018; Guyon e al., 2020)
e en beyond he s age (Haccoun e al., 2020). The ac o s men ioned
abo e a e no limi ed o o ches al musicians. Many playe s – whe he
o s ings o no – su e om MPA (see o example Yoshie
e al., 2009).
Some knowledge on MPA managemen echniques ha e been
epo ed. Fo ins ance, p ac ical expe ience wi h aining o minimize
pe o mance anxie y shows ha building a pe sonal s age
cho eog aphy, including clapping, bowing o e e ences, can p omo e
a compe en on-s age beha io , which also con ibu es o g ea e
con idence when pe o ming (Hildeb and and Nübling, 2004;
Hildeb and , 2009; Williamon e al., 2014). P ac icing unde s ess,
i.e., o -s age, has also a posi i e e ec on pe o mance unde eal-li e
condi ions (Oudejans and Pijpe s, 2009, 2010). The use o ideo
came as leads o a s eng hening o he indi idual’s sel -pe cep ion
and o a moni o ing p essu e ha is ypical o psychologically
s ess ul si ua ions (DeCa o e al., 2011; Papageo gi and Welch, 2020),
he e o e, i helps mimicking and p ac icing such si ua ions.
Recen wo k has shown ha no only he ype o a en ion de o ed
o a mo o ask can imp o e o sus ain skill ul pe o mance
(Hildeb and and Nübling, 2004; Mo nell and Wul , 2019) bu also he
iming a which an in e nal o ex e nal ocus o a en ion is igge ed.
Using an in e nal ocus o a en ion du ing pe o mance p epa a ion,
hen swi ching o an ex e nal ocus o a en ion du ing pe o mance,
imp o es pe o mance o a well-lea ned skill (Mo nell and Wul , 2019;
Becke e  al., 2020; Aiken and Becke , 2022) o a leas is no
de imen al o i (DeCa o e al., 2011). Fo example, DeCa o and
colleagues ha e used dis ac ion asks designed o di e a en ion
om an in e nal con ol ocus while p ocedu al asks a e pe o med
unde moni o ing s ess, and demons a ed hei e ec i eness
(DeCa o e al., 2011). In o he wo ds, he ocus o a en ion should
bedi ec ed owa ds musical aspec s, away om an e o -o ien ed,
analy ical, and pas -o ien ed ocus. One could speak o a “musical
memo y aining.” Such aining in ol es so-called “semi-men al”
aining me hods (i.e., ue- o- he-o iginal simula ed ins umen al
and pe o mance mo emen s wi hou an ins umen , including body
mo emen s) designed o igge men al ep esen a ions o he a ge
sound and musical pe o mance (Hildeb and , 2010) The goal o such
aining is o s eng hen and s imula e he audi o y-mo emen
associa ion – a e y impo an sa e y dono on s age.
The impo ance o cons uc i e eedback o a be e managemen
o MPA has ben also epo ed. In pa icula , he abili y o de ise
solu ions and s a egies aimed a co ec ing weaknesses and wo king
h ough hem cons uc i ely (Hildeb and and Nübling, 2004;
Hildeb and , 2009, 2010). The help o a cons uc i ely o ien ed
audience o dampen he e y common des uc i e e iew o
undesi able ou comes (Nielsen e al., 2018; S ude e al., 2019; Guyon
e al., 2020; Haccoun e al., 2020) ha ha e been ela ed o MPA, has
been discussed o help cons uc a pe spec i e o u u e pe o mance
(B odsky, 1996, 1999; Hildeb and , 2009).
Among o he e ec s, sympa he ic ac i a ion sho ens
ca diomyocy e ac ion po en ials, inc easing HR (i.e., posi i e
ch ono opy) and sho ening a io en icula conduc ion (i.e.,
posi i e d omo opy; Schmid e al., 2019). Pa asympa he ic ac i a ion
e e ses bo h (i.e., nega i e ch ono opy; nega i e d omo opy;
Schmid e  al., 2019). Thus, an impo an ma ke o inc eased
sympa he ic ac i i y, and he e o e o MPA, is a highe HR (Schmid
e  al., 2019). No su p isingly, se e al au ho s ha e included HR
measu emen s in s udies on o example s ess du ing spo s
(Oudejans and Pijpe s, 2009, 2010; Kusse ow e al., 2010), epea ed
psychosocial s ess induced by eal and i ual s esso s, including he
same s esso o e di e en pe iods o ime (Schomme e al., 2003;
Ko hgassne e al., 2021, 2022), acu e psychological s ess (T o man
e al., 2019) and MPA (Yoshie e al., 2008; Yoshie e al., 2009; Kusse ow
e al., 2012; Kenny e al., 2013; S ude e al., 2014). In addi ion o HR,
se e al au ho s ha e used hea a e a iabili y (HRV) in he con ex
o spo s and exe cise psychology o measu e s ess (Mosley and
Labo de, 2022).
Expe ience can modula e men al and soma ic esponses media ed by
sympa he ic ne ous sys em ac i i y and he eby posi i ely a ec s
pe o mance ou comes (Oudejans and Pijpe s, 2009, 2010; Kusse ow
e al., 2012). O he au ho s ha e al eady demons a ed habi ua ion o
sympa he ic esponses o epea ed psychosocial s ess induced by eal and
i ual s esso s (Ko hgassne e al., 2021). Highe hea a es (i.e., highe
sympa he ic ac i i y) ha e been shown o dec ease signi ican ly (i.e., lowe
sympa he ic ac i i y) a e epea ed exposu e o he same s esso – in his
s udy, a li e audience – o e di e en pe iods o ime (Schomme e al.,
2003; Ko hgassne e al., 2021, 2022).
In his s udy, we es ed he e ec s o expe ience on MPA le els
using epea ed li e pe o mances o he same musical exce p s in a
g oup o s ing playe s who epo ed MPA. To ou knowledge, apa
om ou p e ious case epo (Kusse ow e al., 2012), no simila s udy
has been conduc ed. Wi h he p esen s udy, weaimed o eplica e he
indings o he case epo in a g oup o musicians a ec ed by
MPA. Weaim o con ibu e o managemen echniques o MPA by
epo ing he e ec s o an in e en ion on momen a y MPA (i.e.,
epea ed li e pe o mances o he same musical exce p s wi hin a day)
and i s objec i e and subjec i e e alua ion. The p o o ypical se
we es ed is a key componen o a success ul s age aining p og am
conduc ed since 1998 a he Zu ich and Basle Uni e si ies o Music
(Hildeb and , 2009, 2010).
To assess he e ec s o epea ed li e pe o mance on he
physiological and psychological componen s o MPA (i.e., s ess
desensi iza ion) unde compa able, eal-wo ld s ess condi ions,
we c ea ed a pe o mance si ua ion in a highly demanding
en i onmen . I consis ed in epea ed solo pe o mances in on o
li e p o essional audiences (Kenny e al., 2014; Papageo gi and Welch,
2020) di e ing be ween each pe o mance. This added a dimension
o implici social app aisal iden i ied as a key componen o
manipula ing psychosocial s ess and elici ing physiological s ess
eac i i y (DeCa o e  al., 2011). We measu ed physiological and
Candia e al. 10.3389/ psyg.2023.1146405
F on ie s in Psychology 03 on ie sin.o g
psychological esponses in s ing playe s, who ep esen one o he
la ges popula ions o musicians (S einme z e al., 2015) o whom
wep esen ed MPA moni o ing da a in he pas (Kusse ow e al., 2012).
To eplica e a p e ious case epo on MPA moni o ing
(Kusse ow e al., 2012), weused HR as an objec i e indica o o MPA
and assessed changes in HR be o e, du ing, and a e he li e
pe o mances. We co ela ed hese changes wi h subjec i e
assessmen s o MPA and wi h a s anda d measu e o mood du ing
h ee sho public solo pe o mances o he same musical exce p ,
each on he same day and in on o a new audience. To moni o
mo emen dynamics, weused accele ome e s.
E alua ing HR alone o iden i y s ess esponses can bemisleading
because physical ac i i y i sel can ac as a con ounding a iable. Fo
his eason, wecompa ed HR du ing pe o mance and du ing play-
ee ime by compa ing HR while hopping in place o 60 s (baseline
o maximal physical ac i i y) wi h HR du ing pe o mance. I needs
o bes a ed ha , in ou p e ious case epo (Kusse ow e al., 2012),
wecompa ed exe cise in daily li e as eco ded in a dia y o ac i i ies
pe o med du ing he day as exe cise baseline. The e o e, maximal
physical ac i i y a baseline was be e con olled in he s udy
p esen ed he e, as all pa icipan s pe o med he same physical ac i i y
o he same amoun o ime.
In he pas , echnical and a is ic componen s we e used o e alua e
he quali y o a musical pe o mance du ing MPA (Yoshie e al., 2009).
The e alua ion o a is ic componen s, howe e , is di icul o ep oduce.
In his se ies o measu emen s, we he e o e chose no o e alua e he
a is ic componen . As in ou p e ious case epo (Kusse ow e al.,
2012), we used a manual, expe -based assessmen o echnical
pe o mance e o s o de e mine he echnical quali y o he
pe o mance only. Technical componen s such as pi ch (e.g., he co ec
no e, no e omissions) and hy hm can bebe e de e mined om he
sco e and subjec i e imp essions. Fo example, in ona ion quali y has
been shown o bea good p edic o o lis ene s’ pe o mance a ings
(Johnson and Ge inge , 2007), and some au ho s ha e shown ha pi ch
e o s a e he easies e o s o no ice (Doane, 1989; Waggone , 2011).
We hypo hesized ha epea ed s age exposu e wi h he same
musical exce p s would posi i ely modula e MPA. Speci ically,
wehypo hesized dec eased HR, lowe VAS sco es o MPA, highe
subjec i e well-being and calmness, ewe pe o mance e o s and, in
addi ion, changes in bow mo emen dynamics om he i s o he
hi d pe o mance.
2. Me hods
2.1. Pa icipan s and e hics
The 18 s ing playe s (12 iolin, 1 iola, 5 cello; 12 emale, 6 male;
mean age 21.11 SD 2.25; see Table1 o comp ehensi e demog aphic
da a) ga e hei w i en in o med consen p io o pa icipa ion.
Requi emen s o pa icipa ion in he s udy we e an age be ween
18 and 35 yea s, no ca diac, espi a o y, o me abolic p oblems, no
diseases o he ne ous sys em, including psychia ic diseases o
diseases o he musculoskele al sys em. No use o medica ions ha
a ec he ne ous sys em, ca dio ascula sys em, o espi a o y
sys em, especially no use o be a-blocke s. No heal h p oblems
associa ed wi h he pe o mance o a hle ic maneu e s such as
jumping on he spo o 1 min (Table2).
The s udy was conduc ed acco ding o he guidelines o he
Decla a ion o Helsinki1 o he ea men o expe imen al subjec s. The
local E hical Commi ee a ETH Zu ich app o ed he s udy p o ocol
(EK 2010-N-57). The s udy was ca ied ou a he Zu ich Uni e si y o
he A s (pa ne ins i u ion o his s udy). Pa icipan s ecei ed a
mone a y compensa ion o 30 Swiss F ancs o hei pa icipa ion.
1 h p://www.wma.ne
TABLE1 Demog aphic da a o pa icipan s.
S udy Pa icipan s Gende Age Ins umen
1 Female 19 Violine
2 Female 20 Violine
3 Female 20 Violine
4 Female 20 Viola
5 Female 21 Violine
6 Female 21 Violine
7Male 22 Cello
8Male 19 Violine
9Male 27 Violine
10 Female 22 Cello
11 Female 23 Violine
12 Female 21 Violine
13 Male 21 Cello
14 Male 19 Violine
15 Male 21 Cello
16 Female 23 Violine
17 Female 17 Cello
18 Female 24 Violine
Mean 21.11
SD 2.25
TABLE2 Measu emen me hods and pa ame e s.
Pa ame e s
measu ed
Me hods
Objec i e measu emen de ices
Hea a e (HR) One ligh weigh (10 g) ECG-moni o (sampling a e = 256 Hz)
Body mo emen Th ee 3-axis accele ome e logge s a ached o:
- he ou side o bo h o ea ms a he w is – o measu e
mo emen du ing playing
- he le high abo e he knee – o measu e o al body
mo emen (sampling a e = 32 Hz ( ange ± 4 g)
Subjec i e measu emen ools
MPA-le el 10-i em VAS (1 = no MPA, 10 = ex eme MPA)
Le el o cu en
men al well-
being
Mul idimensional men al heal h ques ionnai e (MDBF);
con ains h ee bipola dimensions o cu en men al well-being:
1) good-bad mood (GS)
2) ale ness- a igue (WM) and
3) es - es lessness (RU)
Candia e al. 10.3389/ psyg.2023.1146405
F on ie s in Psychology 04 on ie sin.o g
2.2. Objec i e da a
A wea able sys em eco ded ca diac ac i i y and body mo emen
simul aneously. The sys em consis ed o an elec oca diog am (ECG)
moni o (CamN ech, model: Ac iwa eCa dio, h p://www.camn ech.
com/cn ca dio.h m) and h ee 3-axis accele ome e logge s (Kusse ow
e al., 2010, 2012). The ECG moni o was a ligh weigh (10 g), single-
channel wa e o m eco de wi h an in eg a ed 3-axis accele ome e .
I was a ached o he ches o he musicians wi h wo ECG elec odes
(Ag/AgCl, 254mm
2
); he sampling a e was 256 Hz. The accele ome e s
we e a ached o he ou side o bo h o ea ms a he w is o measu e
mo emen du ing playing, and o he le high abo e he knee o
measu e o al body mo emen a baseline (see below o mo e de ails).
The sampling a e o he accele ome e s was 32 Hz ( ange ± 4 g). The
senso s we e wo n com o ably unde he musicians’ clo hing and did
no in e e e wi h hei ac i i ies o pe o mances (Kusse ow e al.,
2012). Fo a g aphical ep esen a ion o he mul i-senso sys em, see
Figu e1in Kusse ow e al. (2012).
All pa icipan s we e eco ded wi h he mul i-senso eco ding
sys em, i s a baseline, which consis ed o a 60 s hopping on he spo
a e a s anding quie ly (baseline o maximal physical ac i i y), and
hen du ing he li e pe o mance. The eco ding sys em emained
a ached o pa icipan s un il hei inal pe o mance on s age.
2.3. Subjec i e da a
Be o e and a e each pe o mance, musicians we e in he p ac ice
oom o sel -e alua e hei li e pe o mance in e ms o MPA le el
using a 10-i em VAS (1 = no MPA, 10 = ex eme MPA). In addi ion,
hey comple ed MDBF scales on he le el o calmness and composu e
and on mood and ale ness (S eye e al., 1997).
We included he MDBF o con ol o cu en psychological well-
being, i.e., well-being du ing measu emen s, because di e ences along
he GS and WM scales would indica e changes in mood o e ime (i.e.,
mo e a igue o low mood), bo h dimensions a e known o in luence
expe imen al measu emen s in gene al. In addi ion, he MBDF
con ains a dimension ha is closely ela ed o psychological
componen s associa ed wi h MPA, namely he deg ee o es -
es lessness. We did no include he Kenny Music Pe o mance
Anxie y In en o y because he ques ionnai e canno p o ide
in o ma ion abou cu en mood du ing – o ins ance – MPA
episodes. In addi ion, o ou knowledge, a alida ed Ge man e sion
o he K-MPAI was s ill pending by he ime o measu emen s. The
Mul idimensional Men al Heal h Ques ionnai e (MDBF) consis s o
24 i ems (each wi h a i e-poin esponse scale) o measu e h ee
bipola dimensions o cu en men al well-being: good-bad mood
(GS), ale ness- a igue (WM) and es - es lessness (RU). All h ee
scales can bedi ided in o wo pa allel es hal es each, which can
be used o measu e men al well-being o e ime. The in e nal
consis ency (C onbach’s alpha) o he scales o he long o m lies
be ween α = 0.86 and α = 0.94, o he sho o ms be ween α = 0.73 and
α = 0.89.
2
Pa icipan s did no ecei e eedback on he quali y o
hei pe o mance.
2 h ps://www. es zen ale.ch/shop/de -meh dimensionale-
be indlichkei s agebogen.h ml#1+1
2.4. Pe o mance p o ocol
2.4.1. Wa m-Up
Be o e each pe o mance, pa icipan s we e no allowed o wa m
up o mo e han 3 min. To inc ease pe o mance s ess, pa icipan s
we e no allowed o wa m up wi h passages hey we e going o pe o m
on s age. Abou 2 min be o e he pe o mance began, hey le he
p ac ice oom and walked o e o he conce hall and on o he s age.
2.4.2. On s age
All pa icipan s played hei pieces om memo y. Du ing he
pe o mances, he iolinis s and he iolis played in s anding posi ion.
2.4.3. Audience and music pieces
A o a ing audience o 15–20 people pe pe o mance, including
p o essional-le el music s uden s and eache s, was p esen o all li e
pe o mances. The musicians played he same piece o music in all
h ee pe o mances. Time in e al be ween appea ances on s age was
abou 1.5 h and we e accompanied by a p o essional pianis when
needed. Pa icipan s we e asked o sel -selec he pieces hey ound
mos challenging and pa icula ly well sui ed o igge hei MPA.
2.5. Analysis p ocedu es
Audios and ideos o he pe o mances we e eco ded o la e
e alua ion o he echnical, non-a is ic, quali y o he pe o mance.
The beginning and end o each pe o mance we e de e mined by
hand. Segmen a ion o da a was pe o med using MATLAB so wa e
(Ma hWo ks Inc., Na ick, MA; h p://www.ma hwo ks.com/).
2.5.1. Compu a ion o HR and body mo ion
Hea bea se ies (RR-in e als) we e compu ed using a ee
implemen a ion
3
o he Pan-Tompkins-Hamil on algo i hm (Hamil on
and Tompkins, 1986). To ge a uni o m sampling, hea bea se ies
we e in e pola ed, ma ching he sampling o he co esponding body
mo ion da a (accele a ion). The HR se ies
x
HR
in bea s⋅min−1 (bpm)
was compu ed om he hea bea ime se ies
x
RR
(in ms) by
xx
HR RR
=⋅ ⋅
−
610
41
. To ob ain a ep esen a ion o o e all body
mo ion dynamics, wecompu ed he L2-No m
|| ||,,aaa
xyz
()
om he
h ee axes o an accele a ion senso . To omi s a ic accele a ion
componen s, he h ee accele a ion axes we e high-pass il e ed ( i s
o de Bu e wo h il e , cu -o equency 0.1 Hz).
2.5.2. Compu a ion o ela i e du a ion o
execu ion
To assess he ela i e changes in playing ime o each pe o me ,
wecalcula ed he ela i e change in du a ion o execu ion by di iding he
o al du a ion o execu ion a he 3 d pe o mance by he o al du a ion
o execu ion a he 1s pe o mance. The e o e, alues >1 indica ed
longe playing imes du ing he 3 d pe o mance compa ed wi h he 1s
pe o mance; alues <1 indica ed sho e playing imes du ing he 3 d
pe o mance. Rela i e changes we e p esen ed as pe cen age di e ences.
3 h p://www.eplimi ed.com
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F on ie s in Psychology 05 on ie sin.o g
2.5.3. Assessmen o non-a is ic pe o mance
quali y
Non-a is ic pe o mance e o s we e assessed by music expe s
using a composi e sco e o echnical playing e o s: in ona ion e o s,
omission o no es, bowing noise).
So wa e de eloped in MATLAB was used o slice all comple e
audio samples in o segmen s o equal leng h (3 s). The segmen ed
audio samples we e played o wo p o essional musicians. Ra ings
we e made by lis ening oge he o all indi idual exce p s om each
pe o me o each o he h ee li e pe o mances. The expe s
collec i ely ag eed on e o ca ego ies and e o s ha ell in o hose
ca ego ies o each segmen . Only e o s o which he e was
comple e ag eemen among he e alua o s we e conside ed. The
ollowing ca ego ies o playing e o s we e conside ed: inco ec
in ona ion, no e e o s (i.e., missing no es, hy hmic e o s), and
bowing e o s (i.e., poo sound p oduc ion such as bow whis les).
Musical no es ha had wo o all h ee ypes o e o s we e assigned
one e o sco e pe e o ca ego y. Wesummed he numbe o
echnical playing e o s om all h ee ca ego ies o ob ain a
composi e sco e ha ep esen ed an indi idual echnical
pe o mance sco e o each pe o mance (i.e., 1s , 2nd, and 3 d
pe o mance) and each playe .
2.5.4. S a is ical analyses
Whe e app op ia e, he F iedman Tes , Wilcoxon Signed Rank
Tes , Spea man ank co ela ion, and Mann–Whi ney U Tes as well
as Pea son’s we e used. Fo all compa isons, he signi icance le el was
se a p < 0.05. Ou hypo heses would be e ec i ely one-sided,
conside ing ha we es ed based on ou p e ious case epo .
Ne e heless, we epo he wo-sided es alues he e o a oid
o e es ima ing esul s; he one-sided p- alue can be ob ained by
di iding he epo ed p- alues by wo.
2.6. Resul s
2.6.1. Lowe HR a e epea ed pe o mances
The F iedman Tes o changes in HR, including baseline (a
1 min un o hopping on he spo ) and he h ee li e pe o mances,
e ealed highly signi ican changes (p = 0.00001). Indi idual pos -
hoc compa isons using he Wilcoxon Rank Tes showed signi ican
changes [HR du ing baseline < HR du ing 1s pe o mance
(p = 0.028); HR du ing baseline > HR du ing 3 d pe o mance
(p = 0.048); HR du ing 1s pe o mance > HR du ing 2nd
pe o mance (p = 0.0002) and 3 d pe o mance (p = 0.0002); HR
du ing 2nd pe o mance > HR du ing 3 d pe o mance (p = 0.0005);
see Figu e1].
2.6.2. Subjec i ely less MPA a e epea ed
pe o mances
The F iedman Tes o he ailo ed MPA ques ionnai e o
subjec i ely pe cei ed pe o mance anxie y (VAS: 10 = MPA a
maximum) showed highly signi ican changes (p = 0.0009). Indi idual
pos -hoc compa isons using he Wilcoxon Rank Tes e ealed he
ollowing esul s: 1s pe o mance sco es >2nd pe o mance sco es
(p = 0.001); 2nd pe o mance sco es >3 d pe o mance sco es
(p = 0.0278); 1s pe o mance sco es >3 d pe o mance sco es
(p = 0.00038; see Figu e2).
2.6.3. Unchanged MDBF GS and WM sco es
The F iedman Tes o he good-bad mood (GS) and ale ness-
a igue (WM) scales o he MDBF did no show signi ican changes.
2.6.4. Highe MDBF RU sco es om 1s To 3 d
pe o mance
The F iedman Tes comp ising he a e age o p e and pos sco es
o all h ee pe o mances o he RU scale o he MDBF (i.e., deg ee
o es - es lessness) e ealed signi ican di e ences (p = 0.00637).
Sco es o he 1s compa ed o he 2nd assessmen sligh ly ailed o
achie e signi icance (p = 0.0561). Highe sco es o es - es lessness
we e epo ed o he 3 d compa ed o he 1s assessmen (p = 0.0164)
and he 3 d compa ed o he 2nd assessmen (p = 0.029). All indi idual
compa isons we e made using he Rela ed-Samples Wilcoxon Signed
Rank Tes (see Figu e2).
2.6.5. HR and RU co ela ed nega i ely ac oss
pa icipan s and pe o mances
The e was a highly signi ican nega i e co ela ion be ween HR
and RU sco es (Spea man’s ank co ela ion ac oss pa icipan s and
pe o mances ( = −0.54, p = 0.000030; see Figu e3).
2.6.6. VAS and RU co ela ed nega i ely ac oss
pa icipan s and pe o mances
The e was a nega i e VAS and RU-MDBF co ela ion when
calcula ed ac oss all pa icipan s and all h ee pe o mances
(Spea man’s ank co ela ion = −0.4 p = 0.00155). No e ha one
pa icipan ga e a VAS a ing o 1 o all h ee pe o mances while his
HR pa e n was like he one o he o he pa icipan s; he could
he e o e be conside ed an ou lie . A ecalcula ion wi hou his
pa icipan esul ed in a Spea man’s ank co ela ion o = −0.54
p = 0.00005; see Figu e3).
2.6.7. Lowe e o sco es a e epea ed
pe o mances
The o al e o s (i.e., in ona ion, no e omissions, bowing e o s)
a ed by wo expe s di e ed signi ican ly among he h ee li e
pe o mances (F iedman Tes p < 0.00001). All indi idual compa isons
FIGURE1
Hea a e (HR). HR changes om baseline o 3 d pe o mance.
Baseline (g een) consis ed o a 1 min un wi h hopping on he spo .
Ba s 2 o 4 ( ed) show HR du ing on-s age pe o mance om 1s o
3 d pe o mance. Shown a e means and s anda d e o (S.E.) o
means.

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F on ie s in Psychology 06 on ie sin.o g
using he Rela ed-Samples Wilcoxon Signed Rank Tes we e signi ican :
numbe o e o s du ing 1s pe o mance > numbe o e o s du ing 2nd
pe o mance (p = 0.00036); numbe o e o s du ing 2nd
pe o mance > numbe o e o s du ing 3 d pe o mance (p = 0.0018);
numbe o e o s du ing 1s pe o mance > numbe o e o s du ing 3 d
pe o mance (p = 0.0002; see Supplemen a y Figu e1).
2.6.8. Two di e en pa e ns o o e all du a ion
o execu ion ac oss pe o mances
Analysis o di e ences in du a ion o execu ion om he 1s o he
3 d pe o mance, exp essed as pe cen age changes, e ealed wo
g oups wi h opposi e pa e ns o o e all playing speed (Mann–
Whi ney U, wo-sided es . U alue = 0, c i ical alue o U a
p < 0.05 = 15, p = 0.00044): One g oup (G1 n = 9) played as e du ing
he 3 d pe o mance, whe eas he o he g oup (G2 n = 8) played
slowe . One pa icipan om G1 was excluded because he playing
ime was a i icially p olonged due o memo y lapses, which made he
1s pe o mance slowe . No e ha including his pa icipan would
ha e made he di e ences e en s onge ; see Figu e4).
2.6.9. HR spli by du a ion o execu ion was
simila be ween subg oups
Pe cen age changes in HR om 1s o 3 d pe o mance did no
di e be ween G1 and G2 subg oups (Mann–Whi ney U alue = 23,
c i ical alue o U a p < 0.05 = 15, p > 0.05), no did hey di e in
baseline HR (Mann–Whi ney U: U alue = 35, c i ical alue o U a
p < 0.05 = 15 p > 0.05). Indi idual compa isons be ween subg oups and
co esponding pe o mances (e.g., G1, 1s pe o mance s. G2, 1s
pe o mance) we e no signi ican (Mann–Whi ney U, p > 0.05, o all
h ee compa isons). F iedman Tes s o G1 and G2 sepa a ely, we e
bo h signi ican (G1 p = 0.0003; G2 p = 0.00034). Indi idual pos -hoc
compa isons using he Sign Tes o bo h g oups sepa a ely yielded he
ollowing esul s: G1 1s > 2nd z- alue = 3, p = 0.0027; 2nd > 3 d
pe o mance: z- alue = 2.33, p = 0.01963; 1s > 3 d: z- alue = 3,
FIGURE3
HR and RU co ela ion (le ), VAS and MDBF co ela ion ( igh ). Nega i e HR and RU Spea man’s ank co ela ion ac oss pa icipan s and all h ee
pe o mances. Shown a e all h ee RU sco es and HR alues o each pa icipan (le ). Musicians wi h highe HR sco es epo ed being less calm.
Spea man’s ank co ela ion o nega i e VAS and RU ( igh ) calcula ed ac oss pa icipan s and all h ee pe o mances. Shown a e all h ee RU and VAS
sco es o each pa icipan . The g een do s ep esen he VAS sco es o he only pa icipan who sco ed all h ee pe o mances wi h a 1.
FIGURE2
MPA-Ques ionnai e and MDBF-Ques ionnai e MDBF (RU scale). Tailo ed MPA ques ionnai e (le ; VAS: 10 = MPA a maximum). MDBF (RU scale; igh ),
which indica es he deg ee o es - es lessness. Highe alues mean mo e calmness and se eni y. Shown a e mean alues and S.E. o he means.
Candia e al. 10.3389/ psyg.2023.1146405
F on ie s in Psychology 07 on ie sin.o g
p = 0.0027. G2 1s > 2nd: z- alue = 2.83, p = 0.00468; 2nd > 3 d
pe o mance: z- alue = 2.282, p = 0.00468; 1s > 3 d: z- alue = 2.83,
p = 0.00468 (no e ha he educed numbe o n-pa icipan s pe g oup
did no allow calcula ion o an exac p- alue using he Rela ed-
Samples Wilcoxon Signed Rank Tes ; see Figu e4).
2.6.10. Unco ela ed pe cen age changes in RFA
and HR
Pe cen age changes in igh o ea m (i.e., bow’s a m) accele a ion
(RFA) we e no co ela ed wi h pe cen age changes in HR
( = −0.0008, p> 0.05). Pe cen age changes in du a ion o execu ion
we e also no co ela ed wi h pe cen age changes in HR ( = −0.32,
p> 0.05). This was also ue o bo h subg oups.
2.6.11. Mode a e and nega i e co ela ions o
pe cen age changes in du a ion o execu ion and
pe cen age changes in RFA- alues
The Pea son’s o he co ela ion o he pe cen age changes in
du a ion o execu ion wi h he pe cen age changes in RFA alues was
−0.51 (p = 0.036484), indica ing a mode a ely nega i e ela ionship,
wi h bow accele a ion accoun ing o 26% o he changes in du a ion
o execu ion om i s o 3 d pe o mance (see Figu e4).
Pe cen age changes in HR did no co ela e wi h pe cen age
changes in RFA (  = −0.0008, p > 0.05). This was also ue o
bo h subg oups.
3. Discussion
3.1. O e iew o he ob ained esul s
In his s udy, weshowed ha epea ed li e pe o mances wi h he
same musical exce p s lowe ed HR, led o less subjec i e MPA and
mo e calmness among pa icipan s. HR and le el o calmness we e
nega i ely co ela ed: he highe he measu ed HR, he less calmness
among pa icipan s. In addi ion, epea ed li e pe o mances esul ed
in lowe e o sco es, mos no ably, wi hou addi ional o -s age
p ac ice. Analysis o di e ences in du a ion o execu ion om he 1s
o he 3 d pe o mance e ealed wo g oups wi h opposi e pa e ns o
o e all playing speed: one g oup played as e a he 3 d pe o mance;
he o he g oup played slowe . The g oups did no di e in HR om
1s o 3 d pe o mance, no did hey di e in baseline-HR o
indi idual compa ison o he h ee di e en ime poin s. When
analyzed sepa a ely, bo h subg oups showed simila HR pa e ns o all
pa icipan s when conside ed as a single g oup. Pe cen age changes in
RFA we e mode a ely and nega i ely co ela ed wi h pe cen age
changes in du a ion o execu ion, wi h bow accele a ion explaining
26% o he changes in du a ion o execu ion om he 1s o he 3 d
pe o mance. I is no ewo hy ha pe cen age changes in RFA and in
du a ion o execu ion did no co ela e wi h pe cen age changes in
HR. This was also ue o bo h subg oups.
3.1.1. HR physical e sus men al componen s
The pa e ns o HR ac oss li e pe o mances canno beexplained
by physical ac i i y alone. Fo ins ance, physical ac i i y eached i s
maximum du ing baseline (i.e., hopping on he spo o 1 min), and
no du ing pe o mances on s age. The pa e ns o HR changes we e
also consis en e en when he da a we e analyzed based on he di e en
pa e ns o du a ion o execu ion. Ou da a con i ms once mo e ha
expe ience can modula e men al and soma ic esponses media ed by
sympa he ic ne ous sys em ac i i y posi i ely a ec ing pe o mance
ou comes (Oudejans and Pijpe s, 2009, 2010; Kusse ow e al., 2012). I
also con i ms he habi ua ion o sympa he ic esponses o epea ed
psychosocial s ess induced by eal and i ual s esso s (Ko hgassne
e al., 2021), wi h hea a es signi ican ly dec easing a e epea ed
exposu e o he same s esso o e di e en pe iods o ime (Schomme
e al., 2003; Ko hgassne e al., 2021, 2022).
Because he pe cen age di e ence in RFA in bo h subg oups om
1s o 3 d hi d pe o mance was minimal (+1.6% o G1 and −0.07%
o G2), he changes in RFA canno explain he obse ed changes in
HR om 1s o 3 d pe o mance.
3.1.2. Baseline
An app op ia ely ele a ed hea a e- i.e., unde physiological
s ess condi ions such as unning- is app op ia e o he challenge o
he en i onmen and can bedischa ged by he la ge s ia ed muscle
g oups. Simila a ousal du ing a musical pe o mance would beless
app op ia e because i leads o undesi able physiological esponses
FIGURE4
Changes in O e all Execu ion Du a ion (le ) and Pe cen age Change in Righ Fo ea m Accele a ion ( igh ), om 1s o 3 d pe o mance. One g oup
played as e (G1 n = 9) he o he g oup (G2 n = 8) played slowe du ing he 3 d pe o mance (le ). 100% is shown o cla i y, as a e e ence. On he igh
side, all pa icipan s spli acco ding o ela i e execu ion du a ion co ela ed o pe cen age changes in igh o ea m accele a ion. Red squa es
ep esen G2 (longe execu ion du a ion a he 3 d pe o mance).
Candia e al. 10.3389/ psyg.2023.1146405
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such as emo s, a ch emo s, es lessness as non- unc ional ways o
discha ge he excessi e sympa he ic a ousal. Ne e heless, he e we e
no complains on such non- unc ional discha ges o excessi e
sympa he ic a ousal and no such signs we e e iden du ing e alua ion
o e o s in he selec ed exce p s. Fo example, bow e o s accoun ed
o 18, 20, and 23 pe cen o he e o s du ing he 1s , 2nd, and 3 d
pe o mances, espec i ely. In he case o ad e se physiological
esponses, one would expec a highe numbe o o example bow
e o s du ing he 1s pe o mance because his pe o mance was
close o baseline, he only ime when jumping on he spo was
in oduced. Because pe cen ages o bow e o s emained ai ly
unchanged ac oss pe o mances, we conclude ha he physical
challenge weused as a baseline did no in e e e wi h he esul s.
3.1.3. Sympa he ic eac i i y o e he h ee
pe o mances
Time in e al be ween appea ances on s age was abou 1.5 h,
du ing which no p ac ice o passage co ec ions wi h he ins umen
we e allowed. The e o e, wecanno comple ely ule ou he possibili y
ha he dec easing sympa he ic eac i i y ac oss he h ee
pe o mances was due in pa o he deple ion o ad enaline, simply
because he pe o mances occu ed in close succession. This would
indeed be a gene al e ec one would expec a e epea ed
pe o mances on s age. Ne e heless, we a e con inced ha he
epea ed pe o mance o he same piece o music in on o a changing
audience played a signi ican ole in he ma ked changes in HR. In
o he MPA in es iga ions pe o med on 1 day hose who had
p e iously pe o med a Debussy piece had signi ican ly lowe HR
(Kenny e al., 2013). Howe e , i could also be ha bo h he epea ed
pe o mance on s age and he epea ed pe o mance o he same pieces
in on o an audience had a combined, and s ong desensi izing e ec .
A simila s udy wi h pe o mances on consecu i e days o a ew
days apa wi h he same and di e en epe oi es could p o ide new
insigh s bu would in oduce a con ounding ac o ha weneu alized
he e, namely mo e p ac ice hou s be ween pe o mances. In he
p esen s udy, wecould ule ou he esul s being explained by mo e
physical aining, a s a egy epo edly used o cope wi h MPA, o
which ou esul s o e an al e na i e.
In u u e s udies, es ing HR could also bemeasu ed in ime-
lapse, including a ew days be o e pe o mance. Fo example, his
would e eal HR p o iles as he day o pe o mance app oaches and
hou s and days a e pe o mance. The in o ma ion could beco ela ed
wi h alida ed measu es o s a e anxie y, ea o nega i e e alua ion o
amoun o MPA.
3.1.4. Changes in RFA
Since he changes in RFA we e no co ela ed wi h HR and he e
was no oppo uni y o p ac ice be ween he h ee pe o mances,
pe haps hey show he di e en deg ee o con idence in he pe o med
pieces due o an on-s age p ac ice e ec .
3.1.5. Men al componen s as a unc ion o he
MPA le el
In o al, body accele a ion emained unchanged om he i s o
he hi d pe o mance, hus i canno explain he obse ed changes in
HR. Weconclude ha HR changes, as obse ed he e, mos likely
depend on changes in men al componen s as a unc ion o he
MPA le el.
In he p esen wo k, as in ou p e ious wo k (Kusse ow e al.,
2012), wewe e no in e es ed in cla i ying exac ly which men al
componen s a e esponsible o he changes in HR. In ac ,
weconside i one o he con ibu ions o bo h s udies o show ha
i is possible o sepa a e physical and men al componen s
con ibu ing o he obse ed HR du ing MPA episodes. The amoun
o physical exe cise du ing pe o mance canno explain he obse ed
changes in HR (especially du ing he i s pe o mance), so
weconclude ha men al ac o s a e esponsible. This conclusion is
en i ely in line wi h p e ious wo k examining HR esponses du ing
p ac ice and aining compa ed o HR esponses unde e alua ion
and compe i ion condi ions when he same asks – wi h he same
physical con en – we e pe o med (Yoshie e  al., 2008, 2009;
Kusse ow e al., 2010). Fu u e esea ch could shed ligh on speci ic
men al componen s o MPA and HR, such as whe he subjec s wi h
high ea o nega i e e alua ion (FNE) show pa icula ly high HR
esponses compa ed o MPA subjec s wi h low FNE when measu ed
o e ime ollowing an MPA managemen in e en ion. This seems
plausible, as a hle es wi h high FNE showed a signi ican inc ease in
anxie y associa ed wi h lowe pe o mance in s ess ul si ua ions
(Mesagno e al., 2012), and anxie y and HR ha e been shown o
behighe du ing e alua ion and s ess condi ions (No eboom e al.,
2001; Yoshie e al., 2008, 2009; Kusse ow e al., 2010, 2012). Wecan
only specula e abou wha men al elemen s a e a wo k in his se ies,
as hey ha e no been he ocus o ou a en ion. Some o all
pa icipan s in ou g oup may ha e had nega i e hough s du ing
pe o mance, especially du ing he i s pe o mance. This is ela ed
o he men al componen s o anxie y, such as in es ing si ua ions,
also known as cogni i e pe o mance anxie y o CPA. Recen ly, i
has been shown ha indi iduals wi h high ai CPA ha e highe
anxie y le els and a en ion o nega i e hough s (Angelidis e al.,
2019), which can ha e a nega i e impac on pe o mance. In
addi ion, musicians ins uc ed o use an in e nal a en ional ocus
du ing pe o mance pe o med wo se on he echnical and musical
aspec s o hei pe o mances han hose ins uc ed o use an
ex e nal a en ional ocus (Mo nell and Wul , 2019). Al hough
we did no ask abou he hough s pa icipan s had du ing
pe o mance, he lowe numbe o e o s, highe MDBF sco es,
lowe MPA sco es on he VAS, and lowe HR om he i s o he
hi d pe o mance sugges ha i a ec ed, pa icipan s we e less
a ec ed by he wo pe o mance-impai ing cogni ions men ioned
abo e om pe o mance o pe o mance.
3.1.6. Soma ic and cogni i e mani es a ions
Fu u e wo k should conside ha soma ic and cogni i e
mani es a ions a e a leas pa ially independen o each o he –
some ha e mainly soma ic anxie y, o he s mainly cogni i e, o he s
a combina ion o bo h. In he la e g oup, soma ic mani es a ions
may behigh, cogni i e low, o ice e sa. They may also ha e one
o he o he mani es a ion, depending on how close he pe o mance
is and he ype o pe o mance (e.g., “s ake”). Each o hese subse s
o MPA mani es a ions, i adequa ely de e mined, may show a
di e en pa e n o HR esponses. Howe e , assuming ha in ou
sample he e migh beone o mo e ep esen a i es o one o he
g oups wi h di e en soma ic and cogni i e mani es a ions o
anxie y, he consis ency o HR p o iles ac oss pa icipan s in his
se ies, in ou p e ious case epo (Kusse ow e al., 2012), and in
epo s on spo s compe i ions (Kusse ow e al., 2010) sugges (s)
Candia e al. 10.3389/ psyg.2023.1146405
F on ie s in Psychology 09 on ie sin.o g
ha HR esponses a e less ulne able o soma ic and cogni i e
mani es a ion o MPA. Mo eo e , ou assump ions a e consis en
wi h o he s udies in he ield o music pe o mance. P e ious da a
on physiological esponses o music s uden s on s age, pa icula ly
da a on ca diac and espi a o y esponses, al eady e ealed
compa able physiological esponses in hose wi h high subjec i e
a ings o anxie y and hose who a ed hemsel es as ha ing low
anxie y on s age (S ude e  al., 2011a, 2012, 2014). Finally, he
he e ogeneous g oup we s udied in he con ex o MPA
in e en ions is mos likely ep esen a i e o he ype o popula ions
one would encoun e in a Wes e n music high school whe e
musicians a e ained wi h classical i uoso epe oi e –
unde sco ing he gene al ele ance o ou indings.
3.1.7. Du a ion o execu ion
T ai di e ences ha e been conside ed in he pas in he con ex
o MPA, o example, when examining p edic o s o MPA du ing
skilled pe o mance o musical pieces (Kenny e al., 2013). Such
unde lying di e ences may bee iden no only in psychome ic
measu es bu also in physical pa ame e s. Fo ins ance, consequences
o s ess a e eezing and he limi ing o mo emen ampli udes
(Higuchi e al., 2002), inc eased a m s i ness and dec eased o ce
egula ion du ing a peggio pe o mance in skilled pianis s (Yoshie
e  al., 2008), and less well-con olled o ce du ing a pinch g ip
(No eboom e  al., 2001) – he la e being closely ela ed o he
pe o mance o le and igh hand mo emen s in s ing ins umen s.
In ou p e ious case epo , wealso ound ha 3 d pe o mance was
as e in compa ison o i s pe o mance (Kusse ow e al., 2012).
The e o e, weexpec ed ha he analysis o a ia ions in du a ion o
pe o mance would e eal some di e ences in mo emen p o iles
ela ed o MPA. Al hough he small numbe o pa icipan s p ecludes
solid conclusions, he a iable ‘du a ion o execu ion’ e ealed wo
dis inc subg oups in he collec i e measu ed he e. The one subg oup
showed oo much d i e o mo e (i.e., i was un ozen and played
as e a i s pe o mance), whe eas he o he showed he opposi e
pa e n (i.e., i was ozen and played slowe ). Thus, hese mo emen
esponses may ep esen wo dis inc and inna e esponses o
dys egula ed a ousal as caused by anxie y and should beconside ed
in u u e esea ch aimed a implemen ing be e managemen
s a egies o MPA (i.e., some indi iduals may need o beene gized
while o he s may need o becalmed o a medium le el o a ousal
p io o pe o mance).
3.1.8. HR and subjec i e MPA sco es
The pa icipan s’ subjec i e imp ession o hei MPA and
calmness sco es la gely mi o ed HR pa e ns. In addi ion, VAS and
MDBF sco es we e nega i ely co ela ed ac oss pa icipan s and
pe o mances, highligh ing he s ong ag eemen be ween he
subjec i e da a. Fu he mo e, he nega i e co ela ion be ween HR
and RU-MDBF ac oss all pa icipan s and all h ee pe o mances
ounded ou he analyses, showing cong uency be ween physiological
measu es and subjec i e da a.
O e all, hese esul s a e la gely consis en wi h ou p e ious case
epo (Kusse ow e al., 2012) and clea ly sepa a e physical om
men al componen s igge ing HR esponses du ing MPA episodes.
The e o e, we conside HR pa e ns as key pa ame e s in he
in es iga ion and e alua ion o MPA, o ins ance, MPA
managemen in e en ions.
The e a e some limi a ions o some o he me hods weused. Fo
ins ance, he subjec i e da a collec ed elied on indi idual
pa icipan s’ unde s anding o MPA. The e o e, wedid no de ine
MPA o each pa icipan be o e asking hem o a e hei own
MPA. In addi ion, he ques ionnai e did no include ques ions
abou physiological symp oms such as hand swea ing o muscle
s i ness, wo impo an symp oms indica i e o highe MPA. These
limi a ions a ose in pa om he ac ha wewan ed o eplica e
p e ious indings epo ed in a single case epo (see (Kusse ow
e al., 2012). Ce ainly, a unidimensional VAS alone would beno
adequa e o assess he complex mul i- ac o ial na u e o MPA. Fo
his eason, weco ela ed VAS and MBDF o in pa limi his
sho coming. In o he esea ch on MPA in expe ienced musicians,
some au ho s ha e also used 10-poin scales in conjunc ion wi h
o he measu es o ha e pa icipan s a e hei le el o
p e-pe o mance ne ousness (Kenny e al., 2013). In his se ies, as
in ou p e ious case epo (Kusse ow e al., 2012), wea oided
making explici e e ences o physiological symp oms and
commen ing on pe o mance quali y because any explici men ion
would isk igge ing an in e nal a en ional ocus (Mo nell and
Wul , 2019), and ea o nega i e e alua ion (Wa son and F iend,
1969), bo h o which ha e he po en ial o inc ease anxie y (Kenny
e al., 2013; Mo nell and Wul , 2019), and he e o e a ec measu ed
pa ame e s ac oss pe o mances (i.e., o e ime). Fu u e esea ch
should inco po a e o he alida ed ques ionnai es o accu a ely
measu e immedia e anxie y. Fo example, he Immedia e Anxie y
Measu es Scale (IAMS) p o ides alid and eliable cogni i e and
soma ic anxie y sco es and can beused o measu e ask-speci ic
anxie y. I has been co ela ed wi h HR eac i i y measu ed in a
single session (T o man e al., 2019). In addi ion, he ce i ied
Ge man ansla ion o he K-MPAI – R could beused (Kenny, 2017)
as all ansla ed e sions appea o ha e adequa e eliabili y o
measu e anxie y le els (An onini Philippe e al., 2022).
Fu u e esea ch should inco po a e ai measu es, measu es o
o e all MPA (e.g., K-MPAI) and/o a measu e o sel -e icacy and/o
dep ession. These measu es could be hen co ela ed wi h objec i e
measu es such as HR, o o changes in MPA o e much longe
pe iods o ime o alida e changes a e longe pe iods
o in e en ion.
3.1.9. The p ope con ex o manage agains MPA
We belie e ha he con ex wec ea ed is well sui ed o s udying
and aining how o deal wi h MPA. Wec ea ed a solo-pe o mance
en i onmen di ec ly compa able wi h eal audi ion se ings, which
also con ained se e al social-e alua i e ac o s. These ha e been
epo ed o be majo igge s o explici moni o ing, a o m o
dis up i e and excessi e a en ion o skill p ocesses and p ocedu es
du ing he pe o mance o well-lea ned, complex mo o asks
(DeCa o e al., 2011; Guyon e  al., 2022; Sokoli e  al., 2022). Fo
ins ance, he audience included p o essional musicians and ad anced
music s uden s, and appea ances we e ideo aped. The da a ob ained,
especially he HR, show ha he pa icipan s conside ed he si ua ion
as a eal pe o mance consis en wi h pe o mance unde p essu e
(Baumeis e , 1984). Some o he e ec s obse ed he e ha e also been
obse ed in o he pe o mances unde p essu e: Fo ins ance, high
le els o pe o mance anxie y we e indica ed by highe HR ac i i y on
he day o he conce (Hildeb and e al., 2012), in solo pe o mances
wi h di ec o indi ec assessmen (Yoshie e al., 2009; Hildeb and