The Application of Virtual Reality Exposure Versus Relaxation Training in Music Performance Anxiety
Die Nutzung Virtueller Realität Zur Behandlung Von Auftrittsangst
1 other identifier
interventional
46
1 country
1
Brief Summary
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).
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P25-P50 for not_applicable
Started Jan 2022
Typical duration for not_applicable
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
Study Start
First participant enrolled
January 11, 2022
CompletedFirst Submitted
Initial submission to the registry
December 14, 2022
CompletedFirst Posted
Study publicly available on registry
February 21, 2023
CompletedPrimary Completion
Last participant's last visit for primary outcome
March 1, 2024
CompletedStudy Completion
Last participant's last visit for all outcomes
March 1, 2024
CompletedFebruary 21, 2023
February 1, 2023
2.1 years
December 14, 2022
February 9, 2023
Conditions
Outcome Measures
Primary Outcomes (2)
German Version of the Performance Anxiety Questionnaire (Fehm, 2002)
Measuring subjective MPA symptoms for solo and ensemble performances by assessing the total score for the scale solo performance (0-80) and the total score for the scale ensemble performance (0-80). Higher scores indicate more symptoms of music performance anxiety.
Changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)
Heart rate variability
Measuring the cardiac reactivity throughout the BAT in virtual reality
Changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)
Secondary Outcomes (18)
Subjective Units of Distress (SUDs) during the BAT
Changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)
Social Interaction Anxiety Scale (SIAS)
Changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)
Social Phobia Scale (SPS)
Changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)
Beck Depression Inventory (BDI-II)
Changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)
Beck Anxiety Inventory (BAI)
Changes from T0 (pre/ before treatment) to T1 (post/ approx. one week after treatment) and from T0 (pre/ before treatment) to T2 (follow-up/ 6 months after treatment)
- +13 more secondary outcomes
Study Arms (2)
Virtual Reality Exposure Therapy (VRET)
EXPERIMENTALProgressive Muscle Relaxation (PMR)
ACTIVE COMPARATORInterventions
Four VRET sessions of approx. one hour each session taking place in an individual setting accompanied by a therapist. The participants wear a head-mounted display showing different musical performance scenarios (i.e. audition in a concert hall/ recording studio/ in front of a professional jury/ an audience/ a class of music students) that are selected individually by a previously standardized, graded exposure procedure.
Four PMR sessions of approx. 45min each session taking place in an individual setting accompanied by a therapist. The sessions follow a previously standardized procedure.
Eligibility Criteria
You may qualify if:
- 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
You may not qualify if:
- 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
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital of Wuerzburg
Würzburg, 97080, Germany
Related Publications (1)
Bellinger D, Wehrmann K, Rohde A, Schuppert M, Stork S, Flohr-Jost M, Gall D, Pauli P, Deckert J, Herrmann MJ, Erhardt-Lehmann A. The application of virtual reality exposure versus relaxation training in music performance anxiety: a randomized controlled study. BMC Psychiatry. 2023 Aug 1;23(1):555. doi: 10.1186/s12888-023-05040-z.
PMID: 37528410DERIVED
MeSH Terms
Interventions
Intervention Hierarchy (Ancestors)
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- PARTICIPANT
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
December 14, 2022
First Posted
February 21, 2023
Study Start
January 11, 2022
Primary Completion
March 1, 2024
Study Completion
March 1, 2024
Last Updated
February 21, 2023
Record last verified: 2023-02