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

NCT ID: NCT05735860

Last Updated: 2023-02-21

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 46 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-01-11
• Study Completion Date: 2024-03-01

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).

Conditions

Music Performance Anxiety

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Virtual Reality Exposure Therapy (VRET)

Group Type: EXPERIMENTAL

Virtual Reality Exposure Therapy (VRET)

Intervention Type: BEHAVIORAL

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.

Progressive Muscle Relaxation (PMR)

Group Type: ACTIVE_COMPARATOR

Progressive Muscle Relaxation (PMR)

Intervention Type: BEHAVIORAL

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.

Interventions

Virtual Reality Exposure Therapy (VRET)

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.

Intervention Type: BEHAVIORAL

Progressive Muscle Relaxation (PMR)

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.

Intervention Type: BEHAVIORAL

Eligibility Criteria

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

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Wuerzburg University Hospital

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital of Wuerzburg

Würzburg, , Germany

Site Status: RECRUITING

Countries

Germany

Central Contacts

Daniel Bellinger, Dr. med.

Role: CONTACT

Bellinger_D@ukw.de

0931/201-76345

Kristin Wehrmann, M. Sc.

Role: CONTACT

wehrmann_K2@ukw.de

Facility Contacts

Jürgen Deckert, Prof. Dr. med.

Role: primary

References

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.

Reference Type: DERIVED

PMID: 37528410 (View on PubMed)

Other Identifiers

194/21-sc

Identifier Type: -

Identifier Source: org_study_id