Interventions for music performance anxiety: results from a systematic literature review

Abstract Background Music performance anxiety (MPA) is characterised by fears related to performing music. It may result in damages to personal life and professional career, so treatment and prevention are very important. Objective To undertake a systematic literature review on the effectiveness/efficacy of MPA interventions and to integrate these findings to those in the literature reviewed previously. Methods We used PubMed, PsycINFO and SciELO databases and keywords music*, performance anxiety, treatment, therapy and intervention and manual research. We selected articles published between October-2002/July-2016. Results Out of 97 articles, 23 were reviewed. Sixteen studies presented inter-group experimental design, and seven presented pre-post experimental design. The intervention modalities reviewed were cognitive behavioural therapy (CBT), virtual reality exposure, biofeedback, yoga, meditation, music therapy and the Alexander technique. Although the interventions presented some indicators of efficacy in the MPA outcomes and improvement in performance quality, important methodological limitations were observed: low number of individuals and non-specific criteria for their inclusion/exclusion. This reinforces previous findings regarding methodological fragilities associated with this context. Discussion CBT is the most frequently studied modality and with the greatest number of effectiveness indicators. The remaining modalities indicate tendencies in positive outcomes that require further and efficient investigation in more rigorous studies with greater methodological control.

摘要
背景：音乐表演焦虑（Music Performance Anxiety, MPA）以与音乐表演相关的恐惧为特征，可对个人生活及职业生涯造成损害，因此其治疗与预防工作极为重要。
目的：本研究旨在针对音乐表演焦虑干预手段的有效性开展系统性文献综述，并将本次研究发现整合入既往综述的文献结论中。
方法：本研究检索了PubMed、PsycINFO及SciELO数据库，检索关键词包括music*、performance anxiety、treatment、therapy及intervention，并辅以人工检索；最终筛选2002年10月至2016年7月期间发表的相关文章。
结果：初步检索共得到97篇文献，最终纳入23篇进行综述。其中16项研究采用组间实验设计，7项采用前后测实验设计。本次综述涉及的干预手段包括认知行为疗法（Cognitive Behavioural Therapy, CBT）、虚拟现实暴露疗法、生物反馈、瑜伽、冥想、音乐疗法及亚历山大技巧（Alexander technique）。尽管各类干预手段在改善音乐表演焦虑相关结局指标及提升表演质量方面均展现出一定有效性证据，但研究仍存在显著方法学局限：样本量偏小、纳入与排除标准缺乏特异性。这一结果印证了既往关于该领域研究方法学缺陷的相关结论。
讨论：认知行为疗法是目前研究最广泛、有效性证据最充分的干预手段；其余干预手段虽呈现出积极结局的趋势，但仍需开展更严谨、方法学控制更强且样本量更大的高质量研究，以进一步验证其效果。