The Application of Virtual Reality Exposure Versus Relaxation Training in Music Performance Anxiety

Wuerzburg University Hospital

Status

Enrolling

Conditions

Music Performance Anxiety

Treatments

Behavioral: Progressive Muscle Relaxation (PMR)

Behavioral: Virtual Reality Exposure Therapy (VRET)

Study type

Interventional

Funder types

Other

Identifiers

NCT05735860

194/21-sc

Details and patient eligibility

About

The aim of the study is to investigate the effect of exposure treatment using virtual reality (VR) in musicians with performance anxiety compared to a relaxation technique on anxiety symptoms and corresponding cardiovascular parameters. The prospective, randomized clinical trial will include 46 musicians with musical performance anxiety (MPA). The experimental group will receive four exposure sessions in VR and the control group will receive four progressive muscle relaxation (PMR) sessions. Anxiety symptoms will be measured using a german version of the Performance Anxiety Questionnaire and a behavioral assessment test (BAT) before, after the treatment, and at 6-month follow-up. The cardiovascular reactivity will be assessed measuring the heart rate variability (HRV) throughout the BAT and the blood pressure before and after the BAT. Furthermore, blood and saliva samples will be collected before and after the BAT to assess endocrine stress parameters and epigenetic markers. The following hypotheses are derived: 1) Significant and lasting reduction of subjective MPA symptoms for the experimental group receiving VRET at T1 (post/ shortly after treatment) and T2 (follow-up/ 6 months after treatment) compared to T0 (pre/ before treatment). 2) Significant better reduction of subjective MPA symptoms for the experimental group receiving VRET compared to the control group receiving PMR at T1 (post/shortly after treatment) and T2 (follow-up/ 6 months after treatment) compared to T0 (pre/ before treatment). 3) The postulated effects in hypotheses 1 and 2 go along with a significantly higher HRV representing less cardiac stress during the BAT in case of a successful reduction of anxiety symptoms at T1 (post/ shortly after treatment) and T2 (follow-up/ 6 months after treatment) compared to T0 (pre/ before treatment).

Enrollment

46 estimated patients

Sex

All

Ages

18 to 60 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Music performance anxiety (MPA)
- Reporting anxiety and/or avoidance of musical performance situations
- Reporting psychological distress and/or impaired functioning due to the MPA
Sufficient knowledge of the German language (to understand questionnaires and the therapy manual)
Compliance with the covid-19-regulations for local study appointments
Written informed consent

Exclusion criteria

Substance use disorder
Physiological contraindications for an exposure therapy (i.e. epilepsy, serious disorder of the cardiovascular system)
Psychological contraindications for an exposure therapy (i.e. psychotic disorder, substance dependence, borderline personality disorder, acute suicidality)
Use of sedative medication or tranquilizers (i.e. beta-blockers) for the therapy appointments
Claustrophobia
Blood-injection-injury type phobia
Instrument not portable, too big or not playable while standing (i.e. piano, drums, harp, double bass)
Not able to play the instrument blindfold
Current psychotherapy because of the MPA
Recent (< 6 months ago) psychotherapy because of the MPA