What is music performance anxiety?

Most educators are aware of the symptoms of MPA in their students, and indeed themselves, from increased heart rate and shallow breathing to anxious thoughts and the avoidance of practice. Lehrer (Reference LEHRER1984) described MPA as a complex phenomenon, combining three modalities of anxiety: somatic, behavioural and cognitive. The tripartite model of MPA is consistent with broader conceptualisations of anxiety (see Lang, Reference LANG and Schlein1968; Clark & Watson, Reference CLARK and WATSON1991) and is commonly accepted in the MPA literature today. It is clear that the frequency, intensity and impact of symptomatology may vary significantly between individuals. It is essential for teachers to understand each component of this tripartite model and how these may impact their students’ musical processes. In common with most forms of anxiety, the physiological and behavioural symptomatology flow on from a triggering cognitive event.

The cognitive component of MPA is well described by Salmon (Reference SALMON1990), who defined MPA as ‘the experience of persisting, distressful apprehension about and/or actual impairment of, performance skills in a public context, to a degree unwarranted given the individual's musical aptitude, training and level of preparation’ (p. 3). This is perhaps the most commonly used definition of the psychological manifestation of MPA in the literature today, and is explicitly referred to in a number of studies, including those authored by Brodsky (Reference BRODSKY1996), Fehm and Schmidt (Reference FEHM and SCHMIDT2006), Kenny (Reference KENNY2004), McGinnis and Milling (Reference MCGINNIS and MILLING2005), Osborne and Kenny (Reference OSBORNE and KENNY2005) and Ryan (Reference RYAN1998). Of key interest to teachers are the concepts of aptitude, training and level of preparation. Students, particularly in their prepubescent years of training, are developing both an aptitude for a particular instrument from a technical perspective, and an aptitude for learning and performing music. The balance between encouragement of attainment in both areas, and the development of realistic expectations is a constant challenge. In instrumental studies, external performative formal assessment can begin at a very young age. Teachers must be mindful of exposing students to performing experiences which are beyond students’ levels of ability, technically, musically and psychologically. Similarly, level of preparation for an audition, examination or performance, will vary significantly over time. Apprehension often comes from misunderstanding of expectations, and teachers are the main source of expectations (Stipek, Reference STIPEK2002), particularly in younger students.

What then are the negative thoughts or cognitions which trigger the MPA process? A broad variety of cognitions relating to MPA have been reported in the literature, by researchers such as Salmon (Reference SALMON1990), Lehrer (Reference LEHRER1984) and van Kemenade and van Son (Reference VAN KEMENADE and VAN SON1995). These cognitions or negative thoughts include catastrophising, fear of memory lapses, fear of negative evaluation and lack of self-belief. Negative cognitions are either self-oriented, such as personal catastrophising, negative-outcome expectancy, and low self-efficacy or perfectionistic, or other-oriented, such as fear of negative evaluation or appearing foolish in public. There has been little research attempting to identify specific cognitive mediators which may trigger, maintain or escalate MPA. For example, research may identify a fear of making mistakes as a psychological symptom of MPA, but it must also determine whether the fear is other-oriented (as in the case of a fear of mistakes being viewed negatively by others), or self-oriented (as a form of fear of failing personal standards or perfectionistic attitudes). Thoughts do not occur in isolation, and the pathways of cognitions leading from normal to impaired musical functioning have not been explored. I will argue later in this article that self-oriented perfectionism is a significant driver of MPA, and that music educators may (unwittingly) exacerbate the condition.

The physiological manifestations of MPA have received more attention in the literature, as their impact upon performance is often more readily apparent. The physiological symptoms of MPA are those typically reported by individuals experiencing a ‘fight or flight’ response. The concept of the fight or flight response was introduced by Cannon (Reference CANNON1927) to refer to the body's general reaction to situations in which threat is perceived. Cannon identified accelerated heart rate; contracted arteries, which leads to cold extremities; inhibited gastrointestinal activity; sweating; dilated pupils, and a rush of adrenalin, as being typical manifestations of sympathetic arousal. Blood vessels constrict, which raises blood pressure, thus causing the body to heat up. Perspiration is then released, but because of the restricted blood supply to the extremities such as hands and feet, this perspiration feels cold. According to Triplett (Reference TRIPLETT1983), the muscles of the diaphragm are shortened, which makes breathing shallow. McCallion (Reference MCCALLION1988) concurred with Triplett when he discussed the panic reflex action of the neck muscles pulling the head down at the back at the same time as raising the shoulders. This also tightens the muscles surrounding the larynx, which may have an impact upon breath-based music activities.

For the general population these symptoms may be uncomfortable, but this level of physiological arousal does not affect their completion of tasks. There are few data (Hiner et al Reference HINER, BRANDT, KATZ, FRENCH and BECZKIEWICZ1987) in the literature on the effect of particular symptoms on differing aspects of performance, that is, dry mouth in singers as opposed to muscle tremor in pianists. This is an important area for future research. It would be expected that different symptoms would be more or less troubling depending on the instrument being played. The issue of symptomatology is particularly relevant when discussing types of instrument played. It is probable that musicians experience MPA in a similar way, but report the symptoms which are most salient to them. For example, a singer may be deeply troubled by dry mouth but a pianist may not notice it. If there is a perceived or actual level of physical or technical impairment, MPA may be strengthened. There are no studies extant which have attempted to measure this. It would be expected that if a part of the body is affected by MPA, for example, vasoconstriction causing decreased blood flow in the fingers, then exponents of an instrument requiring digital dexterity would perceive an impact upon their playing. Clearly it is the responsibility of teachers to identify the physical symptoms of MPA in their students, and offer appropriate technical advice.

Music performance anxiety may also manifest itself in a number of ways behaviourally, such as avoidance of practice or performance (Kirchner, Reference KIRCHNER2002; Salmon, Reference SALMON1990), or an increased number of errors in performance (Kendrick et al., Reference KENDRICK, CRAIG, LAWSON and DAVIDSON1982). Music performance anxiety may also be exhibited through compulsive repetitive practice or checking of instruments, similar to some OCD disorders, although this area has not been researched in the field of MPA. A number of behavioural manifestations of MPA which can be noticed by observers have been reported in the literature (Kendrick et al., Reference KENDRICK, CRAIG, LAWSON and DAVIDSON1982; Sweeney & Horan, Reference SWEENEY and HORAN1982; Craske & Craig, Reference CRASKE and CRAIG1984; Brotons, Reference BROTONS1994). These include repeated moistening of the lips, arm and neck stiffness, shoulder lifting, and distressed or deadpan facial expressions. No study yet, however, has determined how and if these behaviours reflect levels of MPA. One performer may appear relaxed but be experiencing high levels of anxiety, while another may appear tense but be calm. Once again teachers’ level of awareness of their students may help in this area. Observing or recording a number of performances would assist teachers in understanding how their students behave under performance conditions. This information can then be discussed and integrated into planning.

The behavioural impact of MPA most frequently discussed in the literature is that of performance quality (Leglar, Reference LEGLAR1979; Hamann, Reference HAMANN1982; Steptoe & Fidler, Reference STEPTOE and FIDLER1987; Brotons, Reference BROTONS1994; Ryan, Reference RYAN1998; Kirchner, Reference KIRCHNER2002). It would be expected that performance quality would be negatively affected by MPA (Sweeney-Burton, Reference SWEENEY-BURTON1997). Performance quality is in itself a difficult subject to discuss as it is, of course, subjective in nature. Ratings of performances may be made by the performers themselves, or by external sources, such as examiners or audiences. In addition, the parameters of performance quality may vary according to situation and experience. A performance which has musical errors in terms of accuracy of pitch and rhythm may be expressively superior to one which is technically more adept. A performer may look calm and perform poorly, while another may look extremely uncomfortable and perform well. When discussing performance quality it is essential to clarify the criteria. Once again, teachers are very familiar with the normal disposition of their students, and should be able to identify behaviours which may be inhibiting desired performance outcomes.

Prevalence of MPA

There is a high prevalence of MPA across a broad spectrum of sample groups. The current consensus from the literature is that MPA develops during childhood (Gratto, Reference GRATTO1998; Ryan, Reference RYAN1998; Maroon, Reference MAROON2002; Rae & McCambridge, Reference RAE and MCCAMBRIDGE2004; Smith & Rickard, Reference SMITH and RICKARD2004; Osborne & Kenny, Reference OSBORNE and KENNY2005; Fehm & Schmidt, Reference FEHM and SCHMIDT2006), but precisely when is yet to be determined. It affects adolescent populations of musicians to an extent, but is more prevalent by the undergraduate years (Appel, Reference APPEL1976; Cox & Kenardy, Reference COX and KENARDY1993; Esplen & Hodnett, Reference ESPLEN and HODNETT1999; Huston, Reference HUSTON2001; Osborne & Franklin, Reference OSBORNE and FRANKLIN2002; Kokotsaki & Davidson, Reference KOKOTSAKI and DAVIDSON2003). Professionals report high levels of MPA, independent of age or years of experience (James et al., Reference JAMES, BURGOYNE and TEMPLE SAVAGE1983; Steptoe & Fidler, Reference STEPTOE and FIDLER1987; Fishbein et al., Reference FISHBEIN, MIDDLESTADT, OTTATI, STRAUS and ELLIS1988; Kivimäki & Jokinen, Reference KIVIMäKI and JOKINEN1994; van Kemenade & van Son, Reference VAN KEMENADE and VAN SON1995; Raeburn, Reference RAEBURN2000; Huston, Reference HUSTON2001; Osborne & Franklin, Reference OSBORNE and FRANKLIN2002; Jabusch & Altenmüller, Reference JABUSCH and ALTENMüLLER2004). The belief that women appear to be more susceptible than men to developing MPA appears frequently in the literature, but many robust studies (Rae & McCambridge, Reference RAE and MCCAMBRIDGE2004; Fehm & Schmidt, Reference FEHM and SCHMIDT2006) find no difference between genders.

Studies concerning prevalence have been reported from Europe, the Americas, Asia and Oceania, indicating that MPA is neither racially nor culturally specific (Fishbein et al., Reference FISHBEIN, MIDDLESTADT, OTTATI, STRAUS and ELLIS1988; Bartel & Thompson, Reference BARTEL and THOMPSON1994; James, Reference JAMES1997; Rae & McCambridge, Reference RAE and MCCAMBRIDGE2004; Yondem, Reference YONDEM2007). The style of music and instrument played do not appear to be mediators (Fishbein et al., Reference FISHBEIN, MIDDLESTADT, OTTATI, STRAUS and ELLIS1988; Kivimäki & Jokinen, Reference KIVIMäKI and JOKINEN1994; van Kemenade & van Son, Reference VAN KEMENADE and VAN SON1995; Huston, Reference HUSTON2001; Jabusch & Altenmüller, Reference JABUSCH and ALTENMüLLER2004). There are as yet no studies which report on those who never enter the profession, or leave the profession, because of MPA. There is a need for a longitudinal study which assesses the developmental pathways of MPA from childhood to adulthood, and whether the condition causes any particular segment of the population to discontinue music. Music performance anxiety affects individuals in a broad variety of musical endeavours. Professionals and amateurs alike are known to be affected by MPA. This suggests that the circumstances of musical performance and education are more significant that the type of instrument played, ethnicity, cultural background, gender or age. In fact, very few authors appear to question the prevalence of MPA, confirming the common view that MPA is somehow considered an almost normal part of the musician's development.

Research into MPA in children and adolescents has been a recent addition to the MPA literature, with the first papers published by Gratto (Reference GRATTO1998) and Ryan (Reference RYAN1998). A small number of authors have published in the area, including Maroon (Reference MAROON2002), Rae and McCambridge (Reference RAE and MCCAMBRIDGE2004), Smith and Rickard (Reference SMITH and RICKARD2004), Osborne and Kenny (Reference OSBORNE and KENNY2005) and Fehm and Schmidt (Reference FEHM and SCHMIDT2006). While this research is a relatively recent development, the high prevalence of MPA in this population, as reported by the authors above, indicates the need for further investigation. Given that 90% of musicians begin music lessons before the age of 12 (Nagel, Reference NAGEL1990), an understanding of prevalence in this population would seem essential. In primary schools, students have a variety of musical experiences, ranging from choral singing in the classroom to solo performances. There have been no studies which compare prevalence of MPA in children or adolescents in a variety of settings.

Musicians may have many years of formal training before adolescence. In a study of adolescent musicians in a selective music high school by Smith and Rickard (Reference SMITH and RICKARD2004), participants had an average of 6.55 years of musical training. Given that these participants had spent nearly 50% of their lives studying music, and were at a specialist music school, it would appear that MPA is a major concern for teenage musicians, in spite of their training and experience. It is worth noting that years of playing experience is in itself an imprecise measure, it requires quantification of the number of lessons attended, the average amount of practice or the number of solo or ensemble performances played. Such variables may have an impact upon the development of MPA.

Fehm and Schmidt (Reference FEHM and SCHMIDT2006) reported that those adolescent respondents with plans for future study in music or ambitions to be professional musicians reported lower levels of MPA than those without such plans. This finding was also reported in the study by Osborne and Kenny (Reference OSBORNE and KENNY2005).

Among the anxiety disorders, MPA appears unique in that it is acknowledged as being an almost universal condition among some populations, particularly undergraduates (Wardle, Reference WARDLE1969; Appel, Reference APPEL1976; Cox & Kenardy, Reference COX and KENARDY1993; Esplen & Hodnett, Reference ESPLEN and HODNETT1999; Huston, Reference HUSTON2001; Osborne & Franklin, Reference OSBORNE and FRANKLIN2002; Kokotsaki & Davidson, Reference KOKOTSAKI and DAVIDSON2003). In the majority of these studies the reported prevalence of MPA is higher than in the studies involving children and adolescents. Acceptance that an anxiety condition is perceived as almost ‘normal’ in training institutions requires further exploration, not only of MPA, but of its place within the conservatorium culture. Undergraduate classical singers (N = 43) were the subjects of a study into MPA by Kokotsaki and Davidson (Reference KOKOTSAKI and DAVIDSON2003). Interestingly, levels of anxiety were higher among the third-year students than the second-year students, despite extra training and performance opportunities, further supporting the idea that experience is not a mediator of MPA. In this study 65% of participants believed that their performing standards were lower due to MPA. Musicians appear to be significantly more anxious in their ‘workplace’ than the general population. These levels of prevalence are of major concern. There is no other condition in the anxiety disorders where such a high proportion of a population report functional impairment.

There have been a number of studies on the prevalence of MPA in samples of professional performers, including those of James et al. (Reference JAMES, BURGOYNE and TEMPLE SAVAGE1983), Fishbein et al. (Reference FISHBEIN, MIDDLESTADT, OTTATI, STRAUS and ELLIS1987), Wolfe (Reference WOLFE1989), Kivimäki (Reference KIVIMäKI1995), Bartel and Thompson (Reference BARTEL and THOMPSON1994), van Kemenade and van Son (Reference VAN KEMENADE and VAN SON1995), Raeburn (Reference RAEBURN2000), Huston (Reference HUSTON2001), Osborne and Franklin (Reference OSBORNE and FRANKLIN2002) and Jabusch and Altenmüller (Reference JABUSCH and ALTENMüLLER2004). These studies confirm the idea that MPA is a condition with a high level of prevalence among all populations studied in the literature. Research in the area of professional performers indicates that, despite increasing levels of experience, MPA is still of major concern to the majority of musicians. Unfortunately the lack of standard definitions and measures makes assessing accurate levels of prevalence difficult. In order to assess prevalence it is necessary to agree on what exactly is being measured. Stress in performance may or may not be MPA. It would be desirable to undertake a study of a large sample of performers to validate potential measures of MPA, so that the true prevalence of the condition may be assessed. Given that the above studies were of professional performers in the workplace, MPA was obviously not sufficiently debilitating for them to be forced to leave the profession.

Given the high level of prevalence of MPA across all age groups of musicians, it is appropriate to explore the incidence of MPA in teachers and educators. As MPA appears to start at a young age, and develops over time, teachers would presumably influence the development of this condition in their students. Anecdotal evidence suggests that music teachers do little, if anything, to dispel that notion that MPA is somehow a normal part of being a musician. Qualitative research, based upon formal and informal interviews, indicates that around 30% of musicians who leave the profession because of debilitating MPA become educators rather than continue as performers. It seems logical to assume that MPA may be reinforced in the education sector. There is evidence that teachers may influence the development of anxiety in their students, in studies focusing on athletics by Bruch and Heimberg (Reference BRUCH and HEIMBERG1994), and in the MPA literature by Stoeber and Eismann (Reference STOEBER and EISMANN2007).

Three studies in the MPA literature, Wesner et al. (Reference WESNER, NOYES and DAVIS1990), Tamborrino (Reference TAMBORRINO2001), and Kirchner (Reference KIRCHNER2002), have reported high levels of MPA when attempting to assess prevalence of MPA in professional music educators. Despite being unable to manage their own MPA, faculty members feel able to manage this condition in their students. It is not surprising that their students do not have effective coping strategies. There is an obvious need for a series of studies to broaden our understanding of the relationship (if any) between anxious teachers and their students. Teachers and institutions may ultimately unintentionally facilitate the development of MPA if they cannot practice preventative and/or therapeutic paedagogy. There is a need for broad epidemiological studies of a wide variety of populations to assess onset causality and developmental trajectories of MPA. As educational institutions bear responsibility for the holistic care of individuals, this research is clearly warranted.

Implications for educators

Given substantive anecdotal evidence that there is a tacit acceptance of degrees of MPA as ‘normal’ in primary, secondary and elite higher institutions, this issue must be of concern for music educators. This section will offer advice for educators of musicians at each critical stage of their developmental trajectory.

Contemporary understanding of the aetiology of anxiety disorders is that anxiety develops through a combination of a genetic predisposition and an individual's learning history (see Mineka & Zinbarg, Reference MINEKA, ZINBARG and Hope1996; Barlow et al., Reference BARLOW, ALLEN and CHOATE2004; Kenny, Reference KENNY2006; Papageorgi et al., Reference PAPAGEORGI, HALLAM and WELCH2007). In the case of MPA, a learning history is a complex amalgam of experiences with teachers, parents, peers, examinations and performances. Given that students in their early teens may have eight years or more of one-to-one instructional experience, music teachers need to have some understanding of their role in the development and maintenance of MPA. Contextual variables leading up to and following performing experiences must also be considered (Mineka & Zinbarg, Reference MINEKA, ZINBARG and Hope1996).

For young students commencing their studies, music lessons are their first experience of one-to-one learning. Accordingly the influence of instrumental teachers can be profound. Research in the area of early music experiences (Boucher & Ryan, Reference BOUCHER and RYAN2011) has demonstrated that children as young as four can experience the physiological arousal associated with MPA. This level of excitement may generate a positive response in one individual, but an overwhelming sense of loss of control in another. Teachers should explain to students the feelings that may arise in performance, and discuss with them after a performance their positive experiences and any areas for improvement. Many teachers focus on pre-performance planning, but omit to provide a detailed and structured debrief to their students. The efficacy of debriefing is undisputed in the areas of medical education (Perera et al., Reference PERERA, LEE, WIN and WIJESURIYA2008) and sports coaching (Hogg, Reference HOGG1998). Music educators should assist their students to develop an understanding that the process of any performance commences with the selection of suitable repertoire and finishes with a session which discusses the strengths and weaknesses of any given performance. It is also essential that students are dialogue partners in the debriefing process. In younger students they should be asked simple questions, such as what went well, or what would the student would like to do better next time. Such simple interactions provide students with a realistic view of their performance outcomes, and are preferable to unconditional praise or criticism (Kohn, Reference KOHN1993).

As students’ musical experiences accumulate, the balance of positive and negative feedback becomes more critical. Children grow into adolescents, and develop a set of personal values, where ability may become linked to self-worth (Harter & Jackson, Reference HARTER and JACKSON1993). For many students, the period of adolescence brings with it a number of years of musical experience (Nagel, Reference NAGEL1990), not necessarily in auditions but in performances and external examinations. Choice of repertoire commensurate with skills development is of increasing importance at this age. For many teachers the striving for achievement can often result in a striving for perfectionism, as students search for ‘perfect’ pitch or aim to ‘perfect’ their technique. In isolation these terms may seem innocuous, but if repeated lesson after lesson for a number of years by a teacher whom the students hold in high regard, may trigger feelings of perfectionism and MPA in adolescent students (Mor et al., Reference MOR, DAY, FLETT and HEWITT1995). What can sound like well-meaning advice to a student ‘practice that piece and bring it back when it's perfect’ may seem reasonable to a teacher but can be damaging to a student if not explained and contextualized.

Recent research (Moretz & McKay, Reference MORETZ and MCKAY2009; Patston, Reference PATSTON2010) has identified that perfectionism has a key role to play in the development of MPA. If, over time, a musician is convinced that musical perfection is their goal, their search for the unattainable may lead initially to frustration and ultimately to anxiety, as they fail to reach these self-imposed standards. Such failures may be the cognitive mediators, or specific thoughts, which trigger MPA. As with younger students, teachers of adolescents need to build up a realistic framework of goal setting. As a student plays at a higher level, this goal setting should apply to individual lessons, practice sessions, solo and ensemble rehearsals, performances and competitions. Perfectionism is also known to have a significant behavioural component. This may manifest in sufferers of MPA in areas such as practice efficacy. A perfectionist may be expected either to practise incessantly in the pursuit of the perfect performance, or to avoid practice as they believe that the perfect performance is unattainable. Such behaviours may reinforce the condition of MPA. The very best teachers understand that encouraging students to be self-aware and develop the ability to problem solve in the moment is the key to increased skills paralleling an increased confidence in performance. Unfortunately the process of developing perfectionistic attitudes and the commensurate MPA can be incremental, such that a catastrophic experience may appear to come from nowhere. At such times, teachers may be lacking in strategies, as demonstrated by the following typical quote from a teacher:

How then can teachers be aware if they are creating an anxious perfectionist, and how do they find time within a very short lesson to deal with performance psychology and instrumental technique? During 10 years as Head of Music in an internationally regarded tertiary/higher education institution, I incorporated music performance psychology into the music curriculum. Students were offered theory in their first year, encouraged to maintain performance diaries and share performing experiences from a psychological perspective in their second year, and to develop a psychological self-management plan on completion of their third year. In a decade of teaching no student withdrew from their studies due to MPA.

As an experienced educator, teaching in primary, secondary and higher education institutions I have encountered few studio teachers who set annual individualized goals for their students in any written form. Even fewer have structured lesson plans tailored to meet specific individual needs. Many teachers feel confident engaging with the technical aspects of the instrument, but not with the individual who plays it. Music pedagogy is, like music performance, a journey of lifelong learning. If we expect students to be structured in practice, keeping diaries and bringing feedback experiences to the lesson, why not offer documented and structured lessons which include broader aspects of music study and performance? A few minutes dedicated at an appropriate time of year to a discussion of, for example, rehearsal techniques, diet and exercise, music performance anxiety, or a one-, two- or five-year plan, will reap benefits. Opening a dialogue with students which not only acknowledges that nerves may be a part of musical development, but also encourages them to talk about their experiences when discussing such issues, is also a way to identify if students are becoming perfectionistic or overly anxious.

As students progress to tertiary or higher education studies, despite years of training and performance experience, neither perfectionism nor MPA are less prevalent. Studies comparing levels of MPA (Harris, Reference HARRIS1987; Nagel et al., Reference NAGEL, HIMLE and PAPSDORF1989; Watson & Valentine Reference WATSON and VALENTINE1995; Sinden, Reference SINDEN1999; Osborne & Franklin, Reference OSBORNE and FRANKLIN2002; Patston, Reference PATSTON2010) using the Performance Anxiety Inventory (Nagel et al., Reference NAGEL, HIMLE and PAPSDORF1989) (see Fig. 1), reveal that MPA is at high levels in tertiary institutions.

Fig. 1

Comparison between studies of PAI Scores.

PAI score range = 20–80. NHP = Nagel et al. (Reference NAGEL, HIMLE and PAPSDORF1989); S = Sinden; H = Harris; WV = Watson and Valentine; OF = Osborne and Franklin (Reference OSBORNE and FRANKLIN2002); Study 1, Study 2, Study 3 (Patston, Reference PATSTON2010).

A widely accepted measure of perfectionism is the Multidimensional Perfectionism Scale (MPS; Frost et al., Reference FROST, MARTEN, LAHART and ROSENBLATE1990), which measures self-oriented and other- oriented components of perfectionism. Studies using the MPS to compare levels of perfectionism in undergraduate musicians (Patston, Reference PATSTON2010) reported significantly higher levels of perfectionism than studies involving samples of non-clinical undergraduates (Adkins & Parker, Reference ADKINS and PARKER1996; Schweitzer & Hamilton, Reference SCHWEITZER and HAMILTON2002) as demonstrated in Fig. 2. The primary differences between the populations, however, were revealed in the subscale scores of the MPS. Further analysis of the subscale scores revealed the differences are apparent in the self-oriented components of perfectionism, particularly in the Concern Over Mistakes, Personal Standards and Doubts about Actions. Such results are worthy of further investigation.

Fig. 2

Comparison between studies of MPS total scores.

MPS score range 35–175. AP = Adkins & Parker; SH = Schweitzer & Hamilton; Study 1, Study 2, Study 3 (Patston, Reference PATSTON2010).

It is therefore essential that higher education educators are aware of such findings and develop appropriate pedagogic strategies. Given that the stakes are higher in terms of career development, and that it is clear that MPA is not only highly prevalent in tertiary students, but may have been ingrained for some years, a higher level of intervention may be required which is beyond the remit of a studio teacher. It would be expected that higher education educators would be highly experienced in their field of pedagogy. However, given that higher education students are part of a specialised course in music, it is appropriate that students are offered broader studies in music performance psychology. Universities such as the Royal College of Music, with the Centre for Performance Science, and the University of Melbourne, with the Centre for Music, Mind and Wellbeing, are now offering support networks for musicians who have specific concern with aspects of music study and performance beyond those covered in studio lessons. Students are able to study in more detail practice methodologies and music performance psychology, and encouraged to share performance experiences with their peers.

Implications for future research

The study of MPA has made significant progress in the last 20 years. More researchers are analysing aspects of the condition, from origins, to definitions and treatment. There is an increasing awareness within institutions that holistic care of the musician is the contemporary paradigm. However there are many aspects of the condition which are not fully understood, including the role of educators in unintentionally facilitating the development of the condition. There is a need for broad epidemiological studies of a wide variety of populations to assess onset causality and developmental trajectories of MPA. Teachers, and in the case of higher education institutions, faculties, must learn to practice preventative and/or therapeutic pedagogy.

In 2011, the first complete text dedicated to MPA was published, The Psychology of Music Performance Anxiety (Kenny, Reference KENNY2011). This text provides in many ways a starting point for more rigorous, and most importantly, more transparent research into this field. The study of MPA has been to date largely fragmented and divergent. Future research of the vital role that teachers play is clearly warranted. Well-informed, supportive pedagogy of both the individual and their instrument would be a tangible benefit of such research, and reduce the impact of this insidious condition.