Prolonged performance-related neuroendocrine activation and perseverative cognition in low- and high-anxious university music students

Highlights

• We measured music students’ sC, sAA and perseverative cognition (PC) for 7 days.

• SC and sAA output were largest on concert day; post-concert recovery was only partial.

• Music performance anxiety (MPA) was associated with higher concert-related PC.

• MPA was related to lower sC output and delayed sAA output recovery.

• Concert-related PC was related to day-to-day changes in sC and sAA output.

Abstract

Music performances are social-evaluative situations that can elicit marked short-term neuroendocrine activation and anxious thoughts especially in musicians suffering from music performance anxiety (MPA). The temporal patterns of neuroendocrine activity and concert-related worry and rumination (perseverative cognition, PC) days before and after a concert in low- and high-anxious musicians are unknown. The first goal of the present study was to investigate the prolonged effects of a solo music performance and the effects of trait MPA on salivary cortisol (sC), alpha-amylase (sAA), and concert-related PC. The second goal was to investigate whether concert-related PC is associated with neuroendocrine activity and mediates the effects of measurement day and trait MPA on neuroendocrine responses. Seventy-two university music students collected saliva samples and reported their PC for seven consecutive days. On the fifth day, they performed solo. Measurement day and trait MPA were tested as main predictors of the diurnal area under the curve with respect to ground (sC AUCg, sAA AUCg), awakening responses, and PC. SC AUCg, sAA AUCg, and concert-related PC were highest on concert day. SC AUCg decreased only partially on post-concert days. SAA AUCg remained elevated on the first post-concert day among students with moderate to very high trait MPA. Throughout the assessment period, trait MPA was associated with smaller sC AUCg and higher concert-related PC. Concert-related PC showed significant positive associations with sC AUCg and sAA AUCg but did not mediate the effects of measurement day and trait MPA on these measures. These findings suggest that solo music performances have prolonged neuroendocrine effects and that trait MPA is an important factor having specific effects on university music students’ hypothalamic-pituitary-adrenal axis, autonomic nervous system, and cognitive activity.

Introduction

Music performance anxiety (MPA) has been defined as “the experience of marked and persistent anxious apprehension related to musical performance […] which is manifested through combinations of affective, cognitive, somatic and behavioral symptoms.” (Kenny, 2010, p. 433). MPA is a major issue for musicians, especially music students (Kaspersen and Gotestam, 2002; Patston, 2014). For instance, one third of students of Swiss music universities considered MPA to be a problem, and two thirds expressed the need to receive more support in order to cope better with MPA (Studer et al., 2011).

Music performance situations can be conceived as social-evaluative stressors within the social self-preservation theory. This theory posits that preservation of the social self (i.e., individual’s worth and status within a social group) is a fundamental human motivation (Kemeny, 2009). Music performance situations can be perceived as threatening to the social self because of the combination of several elements (Rohleder et al., 2007): (a) A high level of performance is an important goal to the musicians’ self-identity; (b) The music performance requires the display of high-level cognitive and sensorimotor skills coupled with aesthetic and interpretative abilities; (c) The musicians’ performance is evaluated by others; (d) There are factors that are uncontrollable and unpredictable (e.g., size, composition, and behavior of the audience).

In response to social-evaluative tasks, most people acutely display increased activity of the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis (Dickerson and Kemeny, 2004; Goldstein and Kopin, 2008). Some evidence suggests that, under certain circumstances, these responses are prolonged for hours before and/or after actual exposure to social-evaluative stressors (Rohleder et al., 2007; Wetherell et al., 2015). According to theoretical accounts (Brosschot, 2010; McEwen, 1998; Ursin and Eriksen, 2004) and supported by empirical evidence (e.g., Heponiemi et al., 2007), prolonged stress-related neuroendocrine activation, i.e., neuroendocrine responses that occur before and after actual exposure to a stressor, contributes to the bodily wear and tear that can ultimately cause or codetermine disease. Perseverative cognition (PC), defined as “repetitive or sustained activation of cognitive representations of past stressful events or feared events in the future” (Brosschot, 2010, p. 407) has been put forward as a mechanism through which appraisal of stressful situations can lead to poor health by prolonging neuroendocrine activation (Brosschot, 2010). There is emerging evidence that PC can affect ANS and HPA axis activity and lead to prolonged stress-related neuroendocrine activation (Brosschot, 2010; Ottaviani et al., 2016). Prototypical forms of PC are future-oriented worry and past-oriented rumination (Ottaviani et al., 2016).

Compared to practice, rehearsal, or rest, performing publicly elicits in most musicians short-term changes in endocrine and ANS parameters, that, as a whole, can be interpreted as signs of increased physiological arousal (e.g., Aufegger and Wasley, 2017; Fredrikson and Gunnarsson, 1992; Studer et al., 2012). The limited research on short-term MPA-related neuroendocrine differences has provided divergent results, indicating, for instance, increased (Fredrikson and Gunnarsson, 1992) or similar heart rate reactivity (Studer et al., 2012) in high- compared to low-anxious musicians. Worry, often in the form of catastrophic thoughts, is a central cognitive process just prior to or while performing, in particular in high-anxious musicians (Lehrer et al., 1990; Liston et al., 2003; Oudejans et al., 2017; Steptoe and Fidler, 1987).

Very few studies have taken a broader time perspective in investigating psychobiological aspects of performing in musicians. There is some evidence that musicians can experience increased anxiety days, weeks, and even months before performing (Kenny, 2010; Tartalone, 1992; van Kemenade et al., 1995). However, knowledge about the neuroendocrine activity and PC patterns in low- and high-anxious musicians on the days preceding and following a concert is lacking.

The first aim of the present study was to investigate the 7-day temporal pattern of salivary cortisol (sC), alpha-amylase (sAA), and PC in university music students during four pre-concert days, a concert day, and two post-concert days and the influence of trait MPA on these responses. The second aim was to investigate whether PC is significantly associated with the neuroendocrine responses and mediates the effects of measurement day and trait MPA on these responses.

With regard to the first aim, we predicted a significant main effect of day on sC, sAA, and concert-related PC but not on concert-unrelated PC. Specifically, we expected sC, sAA, and concert-related PC to be highest on concert day. Due to limited empirical research, we treated as exploratory issue the question whether the neuroendocrine activity and concert-related PC significantly increase across the pre-concert days, suggesting a steadily increasing anticipation stress response, and return completely or only partially to initial levels during the post-concert days. A second hypothesis was that trait MPA is positively associated with sC and sAA activity as well as concert-related PC but not concert-unrelated PC. We also tested whether the effect of trait MPA depends on the day (i.e., significant interaction between day and trait MPA) but no specific hypotheses were made given the novelty of this question. With regard to the second aim, we hypothesized that both concert-related and concert-unrelated PC show a significant positive association with sC and sAA activity. Finally, we predicted that concert-related PC is a significant mediator of the predicted measurement day and MPA effects on the neuroendocrine responses.